Letters

environmental psychology; the language of suicide; referendum; and more

Environmental psychology – aiming for impact, but no silver bullets

We read with interest, although some disappointment, four recent letters to The Psychologist (August–October 2012) bemoaning the lack of research in environmental psychology, and the lack of engagement among psychologists with sustainability issues.

As one of the biggest groups of environmental psychologists in the UK, we would like to draw readers’ attention to the growing amount of high-quality research in this area. A good starting point for those interested might be the February 2009 issue of The Psychologist itself, which featured a number of articles summarising the contribution
of psychologists to addressing environmental issues, including climate change (see tinyurl.com/psych0209).

Key reviews have recently been undertaken on behalf of the APA and other programmes (Swim et al., 2010; Upham et al., 2009; Pidgeon, 2011). The Journal of Environmental Psychology has sections devoted to climate change and sustainability issues, while regular contributions are made by psychologists to leading environmental journals such as Environment and Planning, Global Environmental Change and Nature Climate Change, as well as to the Tyndall Centre for Climate Change Research. There are significant teams working in this area at Cardiff, Exeter, Surrey and elsewhere, with members serving as advisers to national and devolved UK government departments concerned with sustainability and climate policy.

The claim that psychology has not ‘adequately’ addressed the challenges of climate change is important: it has not, but sadly the same can be said of almost every other discipline in the social sciences, and certainly of national and international policy making. Certainly, no silver bullets have yet been found to bring about wholesale changes in environmentally significant behaviour – and are unlikely to be, given the hugely complex nature of the problem. However, we have made important inroads to understanding people’s attitudes towards climate change and the drivers of relevant behaviours, developing effective communication strategies, and appraising policies and interventions.

We also dispute that environmental psychology knowledge does not trickle down to undergraduates. Although not all British universities have a specialist environmental psychology module there are many that do (e.g. Cardiff, Surrey, Sheffield, Canterbury, to name a few).
It also has to compete for space in an already (over)crowded curriculum of ‘core’ modules.

Undoubtedly, there are important issues that need addressing within the discipline in order to see environmental psychological research receive due credit. It does not yet, for example, have its own Section within the BPS – something that would permit readers to more easily identify some of the important research currently being conducted under diffuse headings. On the other hand, we would be most surprised if environmental psychology, climate change and energy-related behaviours were not significantly represented (relative to the actual numbers of academics involved) in a number of the impact cases being prepared by psychology departments for their forthcoming 2014 REF submissions.

The nature of environmental psychology makes it difficult to categorise in a straightforward way. Even though within mainstream psychology ‘environmental psychologists’ are a small minority, much of their influential work has been done in collaboration with other disciplines such as policy analysis, geography, sociology, and communication studies; if we hope to successfully address the many urgent environmental issues it will require going beyond our own disciplinary boundaries. When we broaden out our perspective this way, there is plenty of research that is already contributing to behaviour change and policy in this field.

Dr Christina Demski
Understanding Risk Group
School of Psychology, Cardiff University

References

Pidgeon, N. (2011). Public understanding of and attitudes towards climate change. Foresight International Dimensions of Climate Change Project, Government Office of Science. Retrieved 15 November 2012 from http://tinyurl.com/9j88dsx
Swim, J. et al. (2010). Psychology and global climate change. American Psychological Association. Retrieved 15 November 2012 from www.apa.org/science/about/publications/climate-change.aspx
Upham, P. et al. (2009). Public attitudes to environmental change: A selective review of theory and practice. Living with Environmental Change Programme, Research Councils UK. Retrieved 15 November 2012 from http://tinyurl.com/9kupnmk


Civil unrest in Belfast

Not sectarian clashes, not contentious parades… but new bus lanes. Drivers are incensed that their rush hour car journeys now take longer, sometimes reportedly much longer, as attempts are made to make life better for public transport users and encourage people to switch from their cars. Not a commuter in Belfast, I can’t comment on whether or not the authorities recognised the ‘stages of change model’ mentioned by Birgitta Gatersleben in her article ‘The psychology of sustainable transport’ (September 2012), but the habit of getting into the car and driving in Belfast has proved irresistible, hence the uproar.

Last Sunday morning I came close to being a dead or injured cyclist when a teenage driver emerged from a side road. It could have been a case of ‘looked but didn’t see’ but I’m sure it was a case of impulsivity and risk taking because our eyes met in that split-second of passing.
I hope she heard that single primitive involuntary oath, but I doubt it. While a collision would have resulted in me being carted off to hospital, at best the driver would have been unscathed; and it does seem that there is room to redirect some of the technological effort addressing enhanced driver safety to real-time measurement of competence to drive.

Pat McKenna (‘When to give up driving’ , September 2012) poses the question ‘Are there adequate safeguards for determining whether a driver is still safe to drive?’. The answer must be a resounding ‘No’. Anyone, in any condition, can get into a car and drive, and while the question was posed in relation to older drivers, I contend that the issue extends to all drivers who have been drinking, taking drugs, carrying injuries, are sleep deprived or ill. While it is not practical for someone to take the Rockwood Driving Battery each time they attempt to drive, would some simple tests not be possible? As an example, at least one transport company has fitted breathalysers to their vehicles, and the vehicles will not start if the test is failed.

Two areas, only briefly touched on in the series of articles in the September issue, are planning and the media. Ian Walker, ‘Vulnerable road users’ , talks of sprawling urban planning and this poses the question of the degree to which planners assume car use when local schools, post offices, shops, clinics and factories are closed, forcing people into cars. Pat McKenna speaks of ‘changing the message about cars’ and Brigitta Gatersleben asks if there is anything we can learn from car advertisements. This made me think of Marlborough Man, the undoubted damage that was done by cigarette advertising, and John Steley’s pondering (Letters, September 2012) about the ethics of pointing out the health and environmental impacts of driving. We are not going to see car advertising banned; nor will we see health warnings emblazoned on the sleek efforts of the advertising industry. Taking social norm to mean what is considered acceptable behaviour in our society – and sidestepping the debate about the media and social norms, that is concerning the, probable, two-way interaction between them – consider how the media present our motoring culture through representation of car crime, inept and dangerous drivers, car chases, car pimping, anthropomorphic cars, car racing, car ‘variety’ programmes, violent amoral car games, and so on.

The media has created such a pervasive fantasy that it has reached the dunes of the Sahara. In a TV programme called Extreme Pilgrim, Peter Jones crosses the Egyptian desert by camel with a group of Bedouin to visit the monastery founded by the father of Christian monasticism St Anthony. Around the campfire, under the desert stars, the conversation covers the Bedouin status as conferred by the number of camels the person possesses. The head man talks philosophically about life and God and when asked what he would most like to attain, you would be forgiven for thinking that his ambition might be to attain some sort of spiritual nirvana, but no, he says ‘a car’.
David Brew
Lisburn, Co. Antrim 


Education and behaviour change

I write in response to the two articles on health and mental health in the October issue.

Although I have yet to lay my hands on the Ofsted guidance paper Personal, Social, Health and Economic Education in Schools referenced in the Turnbull and Forshaw article ‘Sexual health – where theory meets life’ (although its somewhat ambitious title itself makes me suspicious) what is, or is not, said in these two articles alarms me.

I cringe at the statement that ‘government bodies, schools and parents all need the specialist knowledge of health psychologists’. Apart from anything else, this strikes me as more than a little authoritarian. What has happened to pupils? Personally, I’ m sick of governments and schools telling people what to do. More basically, I wonder what on earth that specialist knowledge of health psychologists can be. Have I missed something? Certainly the opaque Shute article ‘Promoting mental health through schools’ does little to inform or reassure me.

The references that are cited alarm me. Apart from the Ofsted article (the mere mention of which makes me recoil), the references cited are to statistics on things like teenage pregnancies. These are not exactly psychological indices of psychological health are they? I wonder what concept of health informs their use as such. The assumption then seems to be that more ‘education’ will reduce these things. But, as noted in McKenna’s article in the previous issue of The Psychologist, ‘education’ rarely facilitates behaviour change.

I could ramble on at some length about these two articles. But let me mention just two things.

First, while a good potted Kinsey might do much to facilitate acceptance of a wider range of sexual behaviours, my observations of the repeated reversions of the Kinsey entry in the Wikipedia to political correctness make me deeply sceptical of what such a work might contain. It is not just that the one thing Kinsey most feared – the intrusion of judgements – is likely to occur. There appears to be no widespread appreciation of what he was actually trying to do, and in fact succeeded in doing. It is not that the methodological critiques published at the time – and still around – are wrong.

It is that they are off-beam. They make the assumption that he was trying to do something he was not trying to do and fail to appreciate what he was trying to do – which was to produce a rough sketch map of the domain to be explored and mapped more carefully, not to quantify frequencies.

Second, I would like to publicise one more example of the fundamental error in the assumption that education leads to behaviour change… this time in the very domain the authors are writing about.
Julie Dockrell will perhaps forgive me if I quote her father’s slightly dramaticised paraphrase of the results of their evaluation of a major AIDS education programme (Dockrell & Dockrell, 1995). Bryan’s words were that he had never before given an attainment test in which 98 per cent of those tested knew the correct answers. The problem was that ‘they just didn’t do it’ (use condoms). The problem was not a lack of knowledge.

Turnbull and Forshaw’s article does not exactly read as if they have got the point.
John Raven
Edinburgh

Reference
Dockrell, J. & Dockrell, W.B. (1995). An evaluation of teaching fifteen year olds about HIV/AIDS. Studies in Educational Evaluation, 21, 43–56.

 

Not time enough to change

The review by Roy Baumeister of Steven Pinker’s new book The Better Angels of Our Nature (October 2012) seems like old boys’ club patting on the back kind of stuff. And what I am left wondering is – what exactly is Pinker’s motivation for claiming the world is becoming so wonderfully advanced and ‘violence reduced’ and Baumeister’s motivation for so wholeheartedly endorsing this vision. Why would you want to believe that people (men mostly, we gather) have changed and the world therefore is edging into this future so bright I’ ll need to look out my shades. This theory though seems to contradict the usual evolutionary approach, which argues so little time has past (in evolutionary terms) since our caveman past that our instincts haven’t had time to change. So if human behaviour has changed, it seems more likely a reflection of how we now live – predominantly in cities, where slash hooks and the peasant brutalities, which can so easily erupt as they did in the Spanish Civil War, no longer simmer just below the surface.

However, I do not believe that overall humanity has changed. What appears to have happened to some degree is that subtler means of control are being found: the use of fear and the use of exhaustion possibly, because everyone has to work so hard to survive these days.

Pinker’s theories as I saw described in an earlier review in the Sunday papers rest on the fact that the world population has increased exponentially so to kill an equal proportion comparable to the proportion Genghis Khan and his merry Mongolian conquerors managed to kill back in the 13th century is well nigh impossible as you’d need, Pinker estimated, to kill over 250 million people (and this is only for a mid-20th-century datum base and not for today).
The fact is violence clearly has not disappeared. At times it’s pushed underground, just as racism and sexism are when they are felt to be less acceptable, but I personally don’t think people do become ‘better’ – they just play their cards in different ways.
Lennox Savage
Killanena, Caher, Co. Clare


Engaging members of a community in research 

Dr Simon P. Hammond wrote in October ‘Letters’ about how multimedia tools have the potential to enhance research reporting and amplify impact. They can also be used as one way of engaging with research participants and non-academic research users.

Not all research in psychology can rely exclusively on the engagement of willing undergraduate participants. Without participation from members of the community, research in many areas of psychology could not happen. What is the best way to engage people in the community in research? For our own research, we need to engage a special community – the families of children and adults with autism.

We are aware that members of these families have little available time and so we first needed to find out their views about taking part in research and how we can reach them.We decided to hit the road and actually meet with leaders of parent support groups for families with autism in five locations across Wales in order to find out how much they knew about research and why research is being done, as well as exploring with them their experiences of taking part in research and what researchers might be able to improve on.

We were pleased to hear that most parents were very passionate about taking part in research and had taken part in the past. However, many reported that they never heard back about studies that they had taken part in; for example, one parent reporting how she thought researchers viewed participants: ‘We are important when you want us to take part, but not important when it comes to the results.’

There were calls for more newsletters in order to keep them in the loop. The majority of parents were aware of how long the research journey would be, and they felt they’d like to be updated along the way. But is a newsletter enough?

Many research groups these days also have Facebook and Twitter accounts that enable them to share their research in bite-size chunks with followers who might be collaborators, research participants or interested members of the public. We wonder whether perhaps this should be a standard aspect of research labs; creating a platform from which increased collaboration with participants is quick and easy for researchers and helpful and easy to digest for participants.

But does the availability and ease of social media mean that we don’t need to think about direct contact with participants? For the past few years, participants and their families have been invited to the School of Psychology where we are able to give them a snappy, easy-to-access update on how our research studies are getting along. We also had an ‘Open Door’ policy in the February half-term which was very successful .We have found these events to be an effective way to show our gratitude for their support!

So, what does the gold standard look like for engaging with hard-to-reach participants? Is it a combination of the techniques we have mentioned here? There doesn’t seem to be much academic literature on what best practice is, and so only if researchers begin to discuss this more openly can we be sure that we are all engaging participants in an efficient way that is truly collaborative.

Matt Price
Louise White
Sue Leekam
Wales Autism Research Centre
Cardiff University 


Forum column – Health Matters

In the 1930s my gran cycled round France on her honeymoon and conceived my uncle in a tent by the side of the road (her details not mine). Most people from Oldham went to Blackpool. Three years ago she moved in with me to spend her last few years making friends at the local day centre and watching a wet Colin Firth coming out of the lake. Three weeks ago she had a stroke, cannot speak or walk and is paralysed down one side. 

I am a believer in the right to die and have told my kids to put me out of my misery if I reach that stage. We have put my gran on a ‘Do Not Resuscitate’ and taken her off all the ‘unnecessary’ medication they stuck her on whilst in hospital based upon norms of blood pressure, thyroid activity and bone density that bear no relation to someone three months off their 100th birthday. And we were all outraged when after her second seizure the paramedic shouted at my mum, ‘You are the daughter of this woman, you put her on a DNR, is this what you want for her?’

So when first asked to write this piece I was going to argue the following. As a society have we forgotten that death is a natural process and happens to us all? Surely we know that quality of life is what matters, not life for its own sake? And have the authors of recent debates about the rights of the elderly to have interventions and the ageism of modern medicine forgotten what old old age is really like? My gran played the piano, travelled the world and studied French. She can do none of this now. So as the consultant said after the paramedic rushed her back into hospital to lie on a trolley in A&E, ‘Maybe it’s her time to die.’

But then last week I (think) I changed my mind. I’ve made a card of words so she can point out what she wants to say. But she mumbled them all out, one after the other. ‘Are you practising speaking, Gran?’ She nodded vigorously, believing she could get better. We watched her usual costume drama and when the hero finally proposed she nodded happily knowing that he was about tobe accepted. And then we laughed as she spent a while practising nodding and shaking her head so at least we would know what she did and did not want to do. She’s still trying, she’s still in there. And I think she’s happy. She’s shown a classic response shift and although her quality of life could never be detected by any scale in existence I think in her own resilient and adaptive way she has it. It really is quality, not life that is important. But I couldn’t even judge my own quality of life in a few years time from where I am now. So who am I to judge this for someone else?

Lenzer, J. (2012). Unnecessary care: Are doctors in denial and is profit driven healthcare to blame? British Medical Journal, 345, e6230.
Rapkin, B.D. & Schwartz, C.E. (2004). Towards a theoretical model of quality of life appraisal: Implications of findings from studies of response shift. Health and Quality of Life Outcomes, 2, 14.

Jane Ogden is Professor in Health Psychology at the University of Guildford. Share your views on this and other health-related matters by e-mailing [email protected].

Language and suicide

In response to the letter ‘The language of suicide’ (October 2012), other reasons to be careful about nomenclature when it comes to suicide have been identified.

The Psychology of Persuasion by Robert B. Cialdini cites various sources of data, in chapter 4 on social proof (seeing other people do something makes it all right for me to do it) which strongly indicate how certain troubled people ‘decide how they should act on the basis of how some other troubled person has acted’. The main researcher in this area, Dave Phillips, fascinatingly coined The Werther Effect (tinyurl.com/crwbsn8) for the inevitable sharply elevated incidence of copycat suicides, murders and accidents after a story about suicide is heavily publicised. It’s as if the suicide publicity motivates somewhat distressed people similar to the victims to kill or harm themselves
or others due to the imputed social legitimation just by knowing that others did it and got away with it, accompanied by sympathy and belated attention.

Freudians and hypnotists have identified a handful of primary laws of suggestion that seem to apply, including: concentrated attention/repetition of suggestion; dominant effect; delayed action, and association. Instead of focusing on the impact of the press, Ethan Watters, in Crazy Like Us: The Globalisation of the Western Mind, examines in chapter 1 how the healing professions themselves shape the way illness is experienced, using the example of anorexia which is like a slow suicide by starvation. Anorexia was rare up to the mid-19th century, not because doctors didn’t come across patients with unaccountable malnutrition but, it is claimed, because it wasn’t yet a culturally agreed expression of distress. It hadn’t yet been added to the medically approved ‘symptom pool’ , not yet acknowledged by experts as a recognisable pathological set of behaviours by which to get attention for suffering.

As the DSM (Diagnostic and Statistical Manual of Mental Disorders, the psychiatrist’s bible) and Western categories of disease become standardised throughout the world, local cultures with their own interpretations and treatments are being discarded. Depression and psychological trauma, like anorexia, which are associated with suicide, are being affected in the same way. So when experts say this is the list of experiences to watch out for if you have such and such a disorder, they’ re in effect giving permission for people who buy into their authority to identify with and actually manifest those named symptoms. The repercussions of language are complex and serious.

What is the most responsible way to talk about suicide without risking putting ideas in people’s heads? A popular independent radio station in Ireland is looking for submissions on how best to run a public campaign to reduce suicides. I will pass them any responses to this.
Caroline Hurley
Dublin

Beaton et al. (Letters, October 2012) make a strong and worthy case for us all to stop using the word ‘commit’ in the context of suicide. However, this reader found their repeated use of the word ‘prevent’ in the same context to be just as bad. Given that suicide is neither a crime nor a sin, by what right do the authors seek to prevent it?

I note that in the same issue there is an invitation for research proposals for the suicide prevention research initiative which has as its aim ‘to reduce the risk of suicide’ , as if prevention is the same
as reduction. The Samaritans speak of reducing the numbers of suicides whilst respecting the individual’s right to self-determination – which I believe strikes the right balance.

We may strive to prevent the pain, tragedy and distress that can lead to people wishing to end their lives, but until that is achieved terms such as ‘suicide prevention consultant’ appear to assign suicide the same status as cruelty to animals – are we to introduce a Royal Society for the Prevention of Suicide?
Peter Beaumont
Dorking, Surrey 


Scotland’s referendum –avoiding bias

David Cameron (whose father was from Aberdeen) and Alex Salmond (whose father was from Keswick) have settled on a commitment to a referendum in Scotland to be held in 2014. Salmond is committed to winning approval for Scotland to leave the United Kingdom.
A feature of the agreement is that there will be only one question on the voting paper and it will be fielded only amongst less than 10 per cent of the UK’s population.

A great deal of experimentation in ways of asking questions indicates that how the options are put can influence replies. Salmond has proposed a question that would look something like: Scotland should become an independent nation – Yes/No.

This is a leading question with a clear weight on producing Yes replies. This would be likely to increase if respondents are asked to reply with an X – the motif of the Saltire, which has been intensively publicised as an icon of personal identity north of the border, for several years.

A fairer proposition would be something like:
The best thing for the future of Scotland is to:
become an independent nation [  ]
remain a part of the United Kingdom [ ]

Respondents could or should be asked to reply with a tick (not a cross, for reasons given above). This also would be biasing – toward the first reply favouring independence – but that could be dealt with by printing half the ballot papers with the ‘remain’ option first and the ‘become’ option second.

Experience suggests that the form of the question could make a difference of up to 5 per cent in what may otherwise be thought to be a simple ‘mechanical’ operation of assessing a preference.

It is surely important that psychologists should be involved in pointing out the role of the question in determining the outcome of this historic decision point in which replies from an electorate of less than 10 per cent of its population will determine the future of the United Kingdom.
J. Mallory Wober
London NW3


Ethical observations

Perhaps one of the reasons why psychologists avoid participant observation studies (Forum, October, 2012), or even observational studies, is because such research is unlikely to be approved of by university or departmental ethics committees? Fortunately, it is a long time since Henle and Hubbell hid under students’ beds in order to record their conversation (Henle & Hubbell, 1938), and there is no need to repeat studies such as these. But even today, data gained from both kinds of observational studies are likely to be different from those obtained by questionnaire.

To illustrate: In 2008 I published an observational study of students’ audible comments made about Keele University (Hartley, 2008). Today Keele is riding extremely highly in the recent NSS survey. But if you compare the students’ views heard in 2008 with those made to the NSS questionnaire in 2012 you would find very different pictures. Students are well aware of the purposes of such questionnaires and respond appropriately. Different methods produce different results, and it is a pity that ethics committees prefer some methods over others.
James Hartley
Keele University

References
Hartley, J. (2008). Are students’ voices genuine? Higher Education Review, 40(2), 63–69.
Henle, M. & Hubble, M.B. (1938). ‘Egocentricity’ in adult conversation. Journal of Social Psychology, 9, 227–234.


Misleading nomenclature

I write regarding the seemingly innocuous practice of clinicians referring to medicines for the treatment of dementia as ‘anti-dementia’ drugs.

Whilst I have no concern about the prescription of drugs to help with the symptoms of dementia, nor with the associated UK NICE guidance, I am concerned about the increasingly accepted common practice of describing and promoting these medications to patients and public as ‘anti-dementia’ drugs. The guidance acknowledges that there is currently no cure for dementia, and in 2011 the World Federation of Societies of Biological Psychiatry confirmed that

‘…pharmaceuticals neither cure nor arrest the disease. A modest effect of improvement of symptoms compared with placebo can be observed’ (Ihl et al., 2011).

Whereas it might be accepted that antipsychotics and antidepressants are appropriately labelled as they can often help eliminate those particular symptoms, to refer to medications for dementia as ‘anti-dementia’ is not only factually wrong but also has potential negative implications for the patient, their family and the NHS. In essence, what I am arguing is that it would be far more honest if such medications were offered as ‘medications for the symptoms of dementia’ or even more accurately ‘palliative drugs for dementia’.

This isn’t just being pedantic or indeed anti-medication. If these medications were less enthusiastically described as ‘anti-dementia’ (an unethical misnomer in my view) one wonders if there would be (a) the same take-up and demand for them versus other ‘effective’ and significantly less costly psychosocial/cognitive treatments and (b) the same outrage when proposals are made to restrict availability following independent evaluations that show poor to modest efficacy data.

I propose that both accurate efficacy data and likely side-effect data be more robustly conveyed to patients and public, and that careful consideration be given to prohibiting or at least recommending against the labelling of current drugs for dementia by clinicians as ‘anti-dementia’ until they are actually curative.

The Department of Health has responded: ‘…the Department does not use the phrase “anti-dementia drugs” but instead refers to these drugs (Donepezil, Galantamine, Rivastigmine and Memantine) as ones prescribed for the treatment of Alzheimer’s disease – the terminology used by the National Institute for Health and Clinic

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