The Looking Glass: Issue Six by The Looking Glass

THE LOOKING GLASS Oct 2014 Issue Six

Growing Old Alone The links between loneliness and dementia

Maudsley Debate

Being Alone

Child abuse a cause of schizophrenia?

The perils of social isolation

Special Focus on Loneliness

Contents

October 2014

features 05

Growing old alone

Links between loneliness and dementia

Being alone

The perils of social isolation

30th Maudsley debate

Is child abuse a cause of schizophrenia?

Standing up for science

Workshops held by Sense About Science

War and marriage

How serving in the UK Armed Forces affects relationships

regulars 03 Editorial

No man is an island

News and events

All the latest from around the IoP

05 ##

19 Reviews

Locke

Wolf of Wall Street

Student forum update

What your forum has achieved in 2014

Welcome from your editor Britain may be the loneliest place in Europe, loneliness appears to be on the rise, and feeling lonely may be worse for your health than being obese... Several recent reports in the media have highlighted the plight of loneliness in our society and so it seems that our special focus in issue 6 of The Looking Glass is rather timely. On top of our articles exploring loneliness, we have the usual reviews, news, and debate. Thereâ&#x20AC;&#x2122;s also an update from your student forum, who are advertising for new chairs for the upcoming year. So, as we all begin a new academic year, there are plenty of opportunities for you to get involved with the student community at the IoPPN, whether you write for your magazine, become a student chair or simply tell the student forum what you think about your course. We hope this will help stave off loneliness, which may just keep you healthy and happy into old age!

Special focus

A look at loneliness and what it means for our mental health and wellbeing.

EDITORIAL

No man is L

oneliness is currently big news. An internet search for ‘loneliness’ brings up an abundance of recent news articles on the topic. ‘Depression is the disease of loneliness’ (The Guardian, 15 Aug 2014); ‘The truth about loneliness’ (Daily Life, 24 Aug 2014); ‘Loneliness becoming a modern epidemic’ (The Irish News, 21 Aug 2014); and ‘Do you feel lonely?’ (The Guardian, 12 Aug 2014) are a selection from the first few hits on a Google News search. And these are just from August this year. The pages of articles go on everyone is talking about it. It seems that none of us are alone in being lonely. Of course, intellectual musings about the loneliness of human existence have long formed part of philosophical reflections on what it means to be human and how we relate to one another. Over the years, there have been both factual and fictional literary explorations of human existential angst, trying to work out how and why we live, as well as exploring our inability to break the metaphysical barriers that separate us from one another. We are singular individuals, locked into the experiences of our

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own bodies and minds. We cannot experience what it actually means to be someone else, and they cannot directly experience our experiences, although we may attempt to communicate and understand one another’s experiences (for example, in our development of a theory of mind). Moreover, we have a sense of being in but apart from the world around us. As R.D. Laing describes in his opening chapters of The Divided Self, we experience the world in a certain way as our world, but after we are gone the world will continue without us. Solely philosophical studies of the lonely human condition have given way to scientific and sociological perspectives. The focus has become more about measurement: how much loneliness there is in the world, what factors are associated with loneliness, what consequences it can have, and what, if anything, we can do about it. In line with this, people question whether loneliness is increasing. Reports seem to suggest it is (Mental Health Foundation, 2010), despite the fact that we are more mobile and come into contact with

a greater number of people than in the past, and we are more connected to people regardless of geographical location thanks to the internet. Paradoxically, living in a world of intense communication (where it is possible to reach anyone, anywhere in the world, instantly via a host of electronic communication devices) may actually be just as or more lonely than worlds without these technologies and the associated ‘social media’. This makes some sort of sense though. Surely, the quality of communication is what matters rather than the number of contacts or interactions. Although an individual has hundreds of ‘friends’ on Facebook, they may lack any one person with whom they really feel able to talk about their problems. Most of us manage to make the balance between a network of friends with whom we interact in the physical world and a network we interact with in the virtual world. However, there may still be negative effects that result from our increasing use of social media. Facebook has become a competitive environment

References Denti et al., (2012) Sweden’s Largest Facebook study Göteburg: Gothenburg Research Institute Hawkley and Cacioppo (2012) Encyclopaedia of behavioural medicine Ed: Gellman and Turner. New York: Springer

“No man is an island entire of itself; every man is a piece of the continent, a part of the main; if a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as any manner of thy friends or of thine own were; any man's death diminishes me, because I am involved in mankind. And therefore never send to know for whom the bell tolls; it tolls for thee.” John Donne Devotions, Meditation XVII

an island in which photos and statuses may illustrate the brilliance, fun, and success of the page’s owner, much like a website marketing a brand. Most people strictly filter what makes it onto their page and with apps that provide retro filters for photos, their life is lit by a literal dreamy golden glow. A study in Sweden showed that women who spent more time on Facebook reported feeling less happy and being less content with their life (Denti et al., 2012). Seeing others having fun with friends may make a night in alone all the more lonely. Does being lonely have negative effects in the long term? Research by Chicagobased John Cacioppo seems to show a range of adverse effects on sleep, blood pressure, and immunity. Loneliness was also linked with depression and lower subjective wellbeing (e.g. Hawkley and Cacioppo, 2012). A group that seems to be particularly at risk are the elderly, and as our feature on page five shows, this may be associated with an increased risk of dementia. One study suggests that more than a fifth of older adults in Britain feel lonely all the time (Victor and Bowling, 2012).

So, what can be done about it? Recognising a problem is the first step in being able to change it. Recognising that particular groups are more vulnerable to loneliness, and the adverse effects this can have, has led to various schemes and projects to try to tackle loneliness. For example, the Campaign to End Loneliness is an organisation that works with small charities to raise awareness of loneliness and help them to tackle it in their local area. (To find out more about their work, visit their website: http:// www.campaigntoendloneliness.org/). A number of charities such as Age UK also offer befriending schemes for the elderly, as well as providing community transport, lunch clubs, day trips, and other activities to connect elderly people who might not otherwise get much opportunity for social interaction. Worryingly, loneliness appears to be on the rise and it seems to be bad for us, physically and mentally. Perhaps humans have always struggled with finding their place in the world, and loneliness at some stage in our lives in an essential part of this challenge. However, some

Rhianna Goozée of the increase in loneliness may come from the way society is now structured. We more often live in cities, more often alone than in couples or groups, more often without knowing our neighbours. We also live in a society that emphasises the individual and praises independence. However, tackling loneliness can be simple – charities organise day trips, discussion groups, and offer befriending services for the elderly. A simple act like volunteering your time could ease the loneliness of another. It really can be as simple as making someone feel seen and heard. So perhaps we can all halt the loneliness epidemic that is spreading insidiously through Britain. Volunteer as a befriender, talk to your neighbours, have lunch with a friend instead of texting them. Or simply smile at your fellow commuters as you get the tube home tonight. If the research is right, you might not just ease their loneliness… you may help ward off a host of other physical and mental illnesses!

Laing (1960) The Divided Self London: Penguin Classics Mental Health Foundation (2010) The Lonely Society? London: MHF Victor and Bowling (2012) A longitudinal analysis of loneliness among older people in Great Britain. J Psychol 146(3).

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G rowing old alone The links between loneliness and dementia

By Emily Sidlow

s humans, we experience a strong desire to feel connected, and to have a sense of belonging among our peers, friends, and family. This need for social and emotional attachment is vital to our growth and development in early life, but research has also shown that it continues to play a huge role in our overall psychological health well into later life.

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We all feel lonely at some stages of our lives. Whether this results from a missed Saturday night party because of that looming essay deadline or something more sombre, the effects can be wide ranging, and they can have serious and lasting health consequences. Many of us can count ourselves lucky that these moments of loneliness are often temporary, but older adults can struggle to shrug off such feelings quite as easily. While loneliness and isolation in elderly people have been linked to early death, other serious health issues, such as dementia, have also been partially attributed to loneliness.

‘being alone’ that was associated with the onset of dementia. This study showed that a perceived absence of social interaction and attachments may be the most significant factor in cognitive decline, with participants who said they felt lonely 64% more likely to develop dementia within the three year follow-up than those who said they did not feel lonely. It is interesting to note that although social isolation does share certain features with loneliness, this study found that social isolation had no impact on development of the disease. That said, the relationship between dementia, loneliness, and social isolation is a complex one, and As we age, it is natural that social support has been implicated in we experience big changes: many studies as a protective factor bereavement, immobility, going into against development of the disease. care. These, among others, have been labelled as risk factors for loneliness. “Recognising risk factors It is also well-known that the risk of and early symptoms of developing dementia in later life is a very real one (over 800,000 people loneliness could prove to be in the UK have dementia according an important and effective to The Alzheimer’s Society), with intervention for dementia” symptoms ranging from memory loss to personality changes. Loneliness and social isolation, although often While the associations between used interchangeably, are two very loneliness, cognitive decline and distinct concepts. Social isolation dementia are well-established, the is an objective state that can refer particular links amongst them are to numbers of social contacts and sadly not yet well-known, and it interactions, whereas loneliness can be difficult to infer causality. is often thought of as a subjective This ‘chicken-or-egg’ argument has feeling, with emotional and social been touched on in publications aspects. People can be socially ranging from academic journals to isolated without feeling lonely, daily newspapers, and although it is or feel lonely in the company of a widely debated issue, conclusive others, and this distinction is key to evidence has regrettably remained understanding the effects that both elusive. Some suggest that loneliness can have throughout life. causes a decrease in the regular use A Dutch study published in the and stimulation of certain functions Journal of Neurology, Neurosurgery such as memory and cognition, and Psychiatry elucidated the which leads to a gradual worsening discrepancy between the subjective in performance of day-to-day and the objective aspects of activities that were once second loneliness for dementia risk. The nature. Brain health is, in part, due authors noted that it was in fact to the presence of Nerve Growth ‘feeling lonely’ rather than actually Factor (NGF), which is a naturally

occurring protein that serves to drive cell function and prevent cell death. Without regular stimulation, levels of NGF can decrease to harmful levels. Conversely, it has also been postulated that loneliness could actually be a sign of emerging dementia, occurring as a behavioural reaction to impaired cognitive abilities and undetected cellular changes in the brain. It is important to bear in mind the social implications of losing one’s memories or feeling personality changes filtering more regularly into daily life. Dementia can affect awareness and insight, which can render social situations embarrassing or confusing. The Alzheimer’s Society sadly found that almost a third of people with dementia have lost friends, and up to 5% of people with the disorder have kept their diagnosis from friends. The social issues that can be associated with dementia can often lead to a vicious cycle in which it becomes difficult to maintain social relationships, causing withdrawal from others and lowered social support, which in turn worsens the disorder further. Recognising risk factors and early symptoms of loneliness could prove to be an important and effective intervention for dementia, with multiple studies reporting that maintaining an adequate social network is a simple step in the right direction. However, what counts as adequate? Does this simple solution apply to everyone? Many people say they feel lonelier in an unhappy marriage than they do being single, and living alone certainly doesn’t rule out a large and happy network of friends outside the confines of those four walls. Thus, the boundaries are often blurred when one attempts to apply a universal solution to loneliness.

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Feeling lonely or being lonely – it may be the perceived situation of ‘feeling lonely’ that has the biggest impact on dementia onset, rather than the objective state of ‘being alone’. This subjective feeling can, however, often mean something different to everyone.

Loneliness also has strong ties to depression in older adults, as well as dementia. Depression is common in old age, affecting as many as 1 in 5 people over the age of 65. Dementia and depression can share many symptoms, such as impaired concentration, memory problems, and social withdrawal. The fact that both conditions frequently coexist not only confuses the diagnoses, but also the subjective experience of the conditions for the patients themselves. However, a common factor in the prevention of both depression and dementia appears to be the notion of having a solid base of social support. Although it involves no direct treatment of the disorders themselves, the findings of multiple studies both past and present have all concluded with the same assertion: that social support - be that a close-knit group of friends or some regular visits from family members – is vital for the health and wellbeing of elderly adults. This advice has a significant number of important promoters, including the Alzheimer’s Society, Age UK, and the British Psychological Society. In an annual report carried out by the

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Alzheimer’s Society in 2013, 62% of dementia sufferers who lived alone said they felt lonely, emphasising the large effect that a lack of social support can have on the emotional wellbeing of elderly people. These figures only confirm the importance of social support in both the prevention of developing dementia and depression, and lessening the severity of both conditions following a diagnosis. A social network that is perceived as strong and caring can help to provide more intellectual stimulation and mental challenges, and also has the potential to reduce both stress and depression, which are known risk factors for developing dementia. A recent study involving 800 adults showed that taking part in more social activities reduced the chance of experiencing cognitive impairments, and also improved the way in which individuals perceived their situation. It appears that simply believing someone is there when you need them can have a profound effect on cognitive function. While the initial conclusions may seem bleak, there are a number of positives to be taken from the wealth of literature surrounding loneliness and social isolation, and their links

with depression and dementia in older adults. There is a rapidly growing understanding amongst friends, family, and healthcare professionals alike of the grave consequences of loneliness and social isolation, and it is now widely recognised that if not dealt with effectively, the health impacts that they can have are serious and longlasting. The links between dementia and loneliness, although not fully understood, are finally being noticed, and needs are beginning to be met. So, as small or big as our social networks may be, we should all remember to keep them ticking over as they may prove to be much more valuable in the long-term than many of us first thought.

FIND OUT MORE Read the report from the Alzheimers Society at:

http://www.alzheimers.org.uk/ dementia2013 Find out more from the NHS: http://www.nhs.uk/livewell/ women60-plus/pages/loneliness-inolder-people.aspx

BEING ALONE The perils of social isolation

There's no doubt most of us find great comfort being around other people. In fact, many of us will attest to the importance for our mental wellbeing of having a group of good friends and family to talk to. Naturally as humans, we are constantly on the lookout for such stimulation, whether it means texting on a mobile phone during a lonesome lunch break or catching up with friends over the weekend. Even adolescent rats seem to benefit from playful social interactions after spending the day in a cage solo [1]. So, what happens to us when thereâ&#x20AC;&#x2122;s nobody to talk to for long periods? Evidence ranging from sensory deprivation studies to real world isolative cases suggests that there is a dark and sinister aspect to chronic social isolation.

By Lan Mao

So imagine this.

You are placed all alone in a soundproof room with the lights off for 15 minutes. How bored would you be? And what would you be inclined to do? It might surprise you to learn that under these sensory deprived conditions, Mason and Brady [2] observed all nine of their healthy participants actually starting to hallucinate. That is to say, even in that short amount of time, participants were seeing strange shapes and faces in the dark, and they became paranoid. Other studies lasting a bit longer than fifteen minutes have reported similar findings, including the occurrence of auditory hallucinations [3, 4]. It appears some people are more susceptible to these perceptual disruptions than others, depending on personality traits or if they’ve had past hallucinatory-like experiences not inspired by substance misuse [2, 3]. Sounds like these sensory deprivation studies could be a handy way of exploring possible links between psychosis and social isolation, right? Well, it’s not so straightforward. Many of the reported psychotic experiences in these studies are now thought of as pseudohallucinations. In other words they may involve imagery, misinterpretations of existing stimuli such as bodily sensations, and hypnogogic or hypnopompic hallucinations (the dream-like states which can arise when falling asleep and waking up, respectively) [5]. A further criticism of modern sensory deprivation studies is that they tend to last for a short period of time, due to ethical concerns about placing humans in enclosed spaces for too long [6]. What’s more, for some patients with schizophrenia, a twohour stay in a sensory deprived room seems to have the opposite effect, such that their auditory hallucinations became less bothersome, which complicates the idea of social isolation being a contributing factor to psychosis [7]. Despite the limitations of sensory deprivation studies, several real-world examples support the hypothesis that social isolation may be a possible risk factor for psychotic experiences. Among people with deafness and blindness from birth, psychosis is relatively common, and this could be attributed to limited social interactions with others, as well as sensory deprivation effects [8].

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residents culturally similar to them [9]. This is perhaps unsurprising, since most migrants face a lot of socially isolating factors, including language and cultural barriers [10]. Within prison populations, there is further evidence that social isolation in the form of solitary confinement can mar one’s mental wellbeing, particularly if occurring for more than three months [11]. Adverse effects may include long-term psychotic illness, as well as apathy and anxiety, all of which seem to be driven by restricted social interactions [12]. Owing to our fears of being left alone, chronic solitary imprisonment has reportedly been used as a means of torture by the C.I.A. and U.S. military forces [13].

“It remains uncertain, however, as to what the specific effects of social isolation are on people with existing psychosis and indeed, if the effects vary with the acute and stable phases of the illness.” So, what can we make of these real-world examples overall? Is it really social isolation in these situations that paves the pathway to psychosis? On closer inspection, other factors may play a role. For example, migrant populations might have to deal with hostility and competitive societal attitudes [14]. Whereas in the context of prisons, characteristics of this type of environment may be more important, such as the fact that it is often punitive, restrictive, and artificial. These last two features certainly also apply to sensory deprivation chambers. The existence of anomalous cases, like Bob Kull [15], may suggest that perhaps it’s stressful isolation that contributes to mental health problems, rather than social isolation itself. The adventurous Bob Kull voluntarily chose to survive on a remote island for a year, surrounded by fantastic natural scenery and wilderness. Despite the obvious isolation, he remained unscathed by this void of human interaction (aside from the odd email for his own safety). Somehow, he left the island feeling spiritually fulfilled.

First and second generation migrants are So, case studies of social isolation provide also at greater risk of psychosis, particularly a somewhat complex picture. What about those living in communities which lack

the neuroscience of social isolation? What effect does stressful social isolation have on the developing brain? Obviously, slicing through the brains of humans who have just been isolated in chambers isn’t a viable option. So, we mainly rely on animal studies, such as those in rats, to enhance our understanding of the possible mechanisms underlying psychosis and isolation, ideally with treatment in mind. Typically, the experimental rats-reared-inisolation paradigm involves whisking the rat away from its mother after weaning, and putting it into a cage separate from other rats. Then, depending on the researchers’ aims, the alienated rats are left on their own to perfrom a cognitive or behavioural task. On top of that, researchers may deliberately induce psychotic-like states by administering drugs, such as NMDA receptor antagonists (e.g. ketamine, phencyclidine), known to provoke psychosis-like symptoms in healthy humans [16]. On the flip side, researchers might try remediating the rat’s isolationinduced stress with antipsychotics [17]. By now, I guess you’re wondering how we can spot signs that resemble psychosis in rats. True, these rats can’t tell us that they’re hearing voices or being persecuted by cats (and let’s face it, maybe they are). Rest assured, it seems there are numerous parallels drawn between rat-in-isolation studies and schizophrenia; all of which highlight the adversities of keeping developing rats in social isolation. For example, isolated rats persistently flinch at loud noises despite receiving milder warning sounds beforehand (known as the pre-pulse inhibition or PPI response). This indicates a poor ability to integrate sensory information and suppress reflex responses accordingly (a sign of impaired sensorimotor gating, also found in schizophrenia) [18, 19]. Isolation

also affects novel object recognition, meaning that lonely rats can’t immediately tell the difference between a never-beforeencountered water bottle and a familiar one [20]. This seems somewhat analogous to the recognition impairments observed in patients with schizophrenia [21]. The changes in neurotransmitter systems that characterise schizophrenia are also mirrored by rats reared in isolation, including modified dopamine and glutamate functioning [17]. What’s more, when introducing a socially isolated rat into a new cage, they pace around more than socially adapted rats [20]. Antipsychotics, including dopamine receptor antagonists, are known to reduce this hyperactive state, suggesting these speedy rats are likely to have excessive dopamine activity in the mesolimbic area of their brains [17, 22]. Coupled with markedly reduced dopamine release in the prefrontal cortex of isolated rats [23], these findings resemble the classic dopaminergic profile of schizophrenia patients [24]. In summary, chronic adverse social isolation is associated with poor mental health in healthy individuals, and it seems to have a negative impact on brain and behavioural development as illustrated by rat studies. It remains uncertain, however, as to what the specific effects of social isolation are on people with existing psychosis and indeed, if the effects vary with the acute and stable phases of the illness. Having said this, in one Australian study, a moderate proportion of people with psychosis consider social isolation a major issue in their lives [25]. Therefore, whether or not social isolation plays a role in the development of their illness, it makes sense to think about reducing social isolation and expanding social networks, as part of rehabilitation and recovery.

Many sufferers of psychosis report social isolation to be a major issue in their lives.

References 1. van Kerkhof et al. Eur J Neurosci, 2013. 38: p. 3465–3475. 2. Mason and Brady. J Nerv Ment Dis, 2009. 197(10): p. 783-785. 3. Fraser, and Gruehl. Arch Gen Psychiatry, 1960. 2: p. 356–357. 4. Kelm. My nightmare ride in a space capsule., in Ottawa Citizen Weekend Magazine. 1961. 5. Pierre. Harvard Rev of Psychiatry, 2010. 18(1): p. 22-35. 6. Raz. J Hist Behav Sci, 2013. 49(4): p. 379-395. 7. Harris. J Ment Sci, 1959. 105: p. 235-237. 8. Dammeyer. Res Dev Disabil, 2011. 32(2): p. 571-575. 9. Veling et al. Am J Psychiatry, 2008. 165: p. 66-73. 10. Schweitzer et al. Aust N Z J Psychiatry, 2006. 40(2): p. 179188. 11. Kupers. Crim Justice Behav, 2008. 35(8): p. 1005-1016. 12. Smith. Crim Justice Behav, 2008. 35(8): p. 1048-1064. 13. Ojeda. Disaster and trauma psychology. Vol. xv. 2008, US: Praeger Publishers / Greenwood Publishing Group. 14. Selten, Cantor-Graae, and Kahn. Curr Opin Psychiatry, 2007. 20: p. 111-115. 15. Kull. My year alone in the wilderness, in Canadian Geographic Magazine. 2004. 16. Krystal et al. Arch Gen Psychiatry, 1994. 51: p. 199-214. 17. Jones, Watson and Fone. B J Pharmacol, 2011. 164: p. 11621194. 18. Cilia et al. Psychopharmacology, 2005. 180: p. 57-62. 19. Young et al. Pharmacol Ther, 2009. 122: p. 150-202. 20. McIntosh et al. Psychopharmacology, 2013. 228: p. 31-42. 21. Pelletier et al. Schizophr Res, 2005. 74: p. 233-252. 22. Watson et al. Int J Neuropsychopharmacol, 2012. 15(4): p. 471-484. 23. Fabricius et al. Int J Dev Neurosci, 2011. 29: p. 347-350. 24. Davis et al. Am J Psychiatry, 1991. 148(11): p. 1474-1486. 25. Stain et al. Aust N Z J Psychiatry, 2012. 46(9): p. 879889.

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Child abuse is a cause of schizophrenia

DE DE

The 30th Maudsley debate chaired by Professor Til Wykes, explored the existence of a link between child abuse and schizophrenia. The causes of schizophrenia remain debated, but a number of risk factors appear to be associated with its onset. Four experts were called upon to provide an opinion about whether child abuse might be one of the causes, and here we present some of their arguments for and against the motion.

FOR

Dr. John Read University of Auckland

Like any other mental health problem, no one single thing causes one single outcome. This debate isn’t about whether we would like childhood trauma to cause psychosis or whether we wouldn’t, this is about the facts involved. We need to be evidence-based when we address these complex and controversial issues. So part of the prompting of this debate, I think, was the review that myself and international colleagues published towards the end of last year. After looking at all the available research, rather than opinions, we concluded that symptoms considered indicative of psychosis and schizophrenia, particularly hallucinations, are at least as strongly related to child abuse and neglect as many other mental health problems. Recent large scale general population studies indicate that the relationship is a causal one with a dose effect. We now have 47 studies from around the world showing quite definitively that the majority of patients, anywhere in the world, have been sexually or physically abused, and that’s before you include emotional abuse and psychological abuse. There’s another way to come at this than pure numbers and that’s to look at the content of peoples’ symptoms, which sadly has not been a focus of clinicians or researchers for the last 30 years. Here, we’ve had a rather reductionist and simplistic biological approach to these issues, so that content doesn’t matter that much. This is now changing, we are delighted to see, but in the research that has been done we unsurprisingly find a high content of sexual themes within delusions and hallucinations in people who have been sexually abused. Yet another way to come at this is to look and see what’s going on in brains. We demonstrated in 2001 that the same list of things that you can find in the brains of adults diagnosed as schizophrenic, you also find in the brains of severely traumatised children. I want to end by bringing in some voices of real people because the point of this debate, of course, is it’s a theoretical debate, it’s about research, but it’s also about consequences for mental health services. We asked service users the simple question, ‘What do you think about the idea of everybody being asked about trauma?’ – One response was ‘…I just wish they would have said, what happened to you, what happened? But they didn’t’. So I am very confident to stand here tonight and propose the motion that child abuse is a cause of schizophrenia.

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BA T E “There never will be a pill that will take away the pain of a damaged childhood.” Mr Paul Hammersley, University of Manchester, speaking for the motion

AGAINST

Professor Peter McGuffin Institute of Psychiatry

The problem is not with whether child abuse is the cause of schizophrenia or a cause of schizophrenia, the problem is with the word ‘cause’. The second problem is that saying that child abuse causes schizophrenia is not only incorrect. It’s not helpful to families or to carers to emphasise child abuse at the expense of everything else. I’m a geneticist and so I look at the interaction and interplay between social factors and genes in the development of psychiatric disorders, and I think that’s the best balanced way to look at things – to not emphasise one factor above others as a causative factor. There are common fallacies about association. The first fallacy is that having a risk factor means one thing makes you get the other thing. Then there is the belief that two things occurring together means that one causes the other, so that means that having abuse in childhood means that it’s a cause of schizophrenia. Well, let’s just look at sexual and physical abuse. The Office of National Statistics report that the number of adults in the UK who may have been physically abused as children is 9,583,440. That’s 24% of the population between the ages of 15 and 64, the age at which you might develop schizophrenia. What about sexual abuse? Well the number of people in England and Wales who are in that age bracket is about 4,392,000. How many people at any one time in the UK have actually got schizophrenia? Well, it’s something less than a quarter of a million, so a lot of people report having been abused as children either physically or sexually, but quite a small minority of those actually go on to develop schizophrenic symptoms. A paper has recently been published showing a very highly significant association between current low mood and reporting of abuse during childhood – people who are feeling depressed are more likely to report past child abuse. Therefore, we have to be agnostic about whether child abuse actually causes schizophrenia or whether mental disorder might actually cause reporting of child abuse. Is it just schizophrenia or is it schizophrenia and other mental health problems? There’s a strong relationship between child abuse and depression, and indeed other work shows a strong association between being abused in childhood and later having personality problems, and so it goes on. Basically, the relationship is not between reporting child abuse and having schizophrenic-like symptoms. It’s between reporting child abuse and having any form of mental health problem. So finally, I’d like to put it to you that the association between schizophrenia and child abuse is not a causal one. Most abuse, if it occurs, is actually by genetic relatives and those genetic relatives share not just the environment but also their genes. Mentally distressed people are more likely to neglect and abuse their children, it’s a sad fact. So, saying that child abuse causes schizophrenia here is incorrect.

“Dr. Read has expressed some radical views, nothing wrong with that, but my view is that Dr. Read is perpetuating the idea that the families are at fault.” Terry Hammond, RETHINK, speaking against the motion:

This debate took place in June 2006. You can access all past Maudsley Debates on the kcl webpages: http://www.kcl.ac.uk/ioppn/news/ debates/debates-archive.aspx You can also find details of upcoming debates. The series will start again in October 2014.

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News and Events

Autumn 2014

World’s leading scientific minds at the IoP Three of our very own academics, working here at the Institute of Psychiatry, have been ranked among the world’s leading scientific minds within Psychiatry and Psychology. These rankings come from the Thomson Reuters Highly Cited Researchers list for 2014, which represents some of the world leaders in science based on the number of publications and citations that they have achieved. Academics ranking among the top 1% in the world include Prof. Philip McGuire, who heads the IoP’s Department of Psychosis Studies, Sir Robin Murray, a leader of research into schizophrenia, and Professor Allan Young, the head of the IoP’s Centre for Affective Disorders. Also included in the Highly Cited Researchers list were three academics from across King’s: Professor Christopher Matthew and Professor Timothy Spector in the field of Molecular Biology and Genetics, and Professor Stuart Neil in the field of Microbiology. For more information about the Highly Cited list please visit the website: http://highlycited.com . 13

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Art of Psychiatry Society film screening

Luke Fowler will be answering questions after a screening of the film he directed, ‘All Divided Selves’. The film explores the legacy of psychiatrist R.D. Laing. Attendance is free. The film will screen in teh Wolfson Lecture Theatre at 18:00 on 16/10/14, followed by a drinks reception.

IoP becomes the IoPPN This September, the Institute of Psychiatry (IoP) has become the Institute of Psychiatry, Psychology, & Neuroscience (IoPPN). Commenting on the College webpages, the Dean and Head of the IoPPN, Professor Shitij Kapur said: “Our new name reflects the breadth of our research and education expertise and the changing way we understand mental health disorders and brain disease.” Find out more at: http://www.kcl. ac.uk/ioppn/news/records/2014/ September/welcome-to-the-ioppn. aspx .

In the Psychiatrist’s Chair A new series of events will be hosted by Maudsley Learning called “In the Psychiatrist’s Chair”, inspired by the classic series hosted by Dr. Anthony Clare. In this series, leading psychiatrists will be interviewed in the style of a radio show, giving us the chance to learn about current research as well as their personal journey through psychiatry. The first event will see Dr. James Anderson interview Professor Sir Simon Wessely who is a Professor of Psychological Medicine, head of department, and the Director of the King’s Centre for Military Health Research. Also see: http://bit.ly/ITPC-flyer . Student tickets are £10 and can be purchased here: https://itpc. eventbrite.co.uk .

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KCLSU PROTESTS MEETING OF THE KCL COUNCIL report by steffen nestler

n 24 June 2014, a group of about 100 attendants gathered in front of the James Maxwell Building in order to protest the KCL Council Meeting on the proposed redundancies across the health schools. The council meeting was originally scheduled to take place at the Strand Campus, but had been moved to Waterloo Campus to which the protestors quickly adapted. The gathering was made up of approximately equal numbers of students and staff (including post-docs and lecturers). A number of short speeches were delivered, not just by Professor Sir Robin Murray – a supporter of the campaign against these redundancies –, but also members from UCU, LSE, SOAS, and Keep The NHS Public. Student Forum President Lindsey Hines was on hand to give an interview to KingsCollegeLondonTV, an excerpt of which can be viewed here: https://www.youtube.com/watch?v=DTLzCv6TUe0 .

The protest appeared very well organised, though I might be slightly biased in this regard due to my own attendance. The students had prepared placards, were uniformly wearing lab coats, and chanted, among others: “No ifs, no buts, no academic cuts!”, “Students and staff, unite and fight” as well as “Robert Lechler* get out! We know what you’re all about: cuts – job losses – money for the bosses!” The protestors also staged a performance whereby a handful of students in suits popped 120 orange balloons intended to represent the quick and undifferentiated nature of the proposed redundancies. What post-event discussions illuminated was that this event opposed not just recent cuts at KCL, but also the more general development in time whereby it appears that universities are being turned into business ventures. *Robert Lechler is Vice-Principal of the KCL Health Schools (ed.’s note).

The Looking Glass

In June, I attended a workshop run by the charity Sense About Science, who try to equip people to make sense of scientific and medical claims in the public arena. The workshop attempted to give us the skills needed to use the media to Stand Up For Science, with perspectives from both scientists and journalists. This was a really informative day, and I thoroughly recommend it to anyone interested in science media or a ‘fashionable’ field of research.

attended the workshop because I research a subject that is often picked up on in the media, and the public’s understanding of it is sketchy at best. My group investigates the therapeutic effects of a chemical found in cannabis. Suggesting that a constituent of cannabis might be used for beneficial purposes needs to be dealt with very carefully in the media, as cannabis itself can be very harmful to people’s mental health. I wanted to find out how to work with the media to ensure correct information is released into the public domain. What surprised me about those attending the workshop was that many of them seemed to believe it is the media’s responsibility to ensure

that scientific stories are reported accurately. However, as the journalists pointed out, whilst they want their articles to be factual and accurate, at the end of the day a story has to be entertaining. Claire Coleman, a freelance features journalist, highlighted that journalists often have no say about a headline. Often headlines may be inaccurate to tempt readers into reading the article or buying the paper. It is in fact our responsibility as scientists to stand up for our science and ensure we are not misrepresented. However, as a group of early career researchers and PhD students, we were unsure about our ability to this. Surely our supervisors would be better placed. Not necessarily. While they may know more than us in a broader sense, and their opinion may pack more punch than ours, we know our specific areas of interest well and so are better placed to share this knowledge with others. Furthermore, journalists work to tight deadlines and so need to speak to people who are available immediately, which often rules out more senior researchers. Gail Wilson also pointed out that there are small ways to get involved in science communication. One which was hammered home, and which I took to heart, was to join Twitter. Another was to start a blog and some of my fellow attendees did just that.

However, I let myself down recently. An article was published in the ‘king’ of newspapers, the Metro, about e-joints. This led to a cynical letter from a member of the public calling them ‘junkie bait’. As is often the case in this publication, two letters fired back from members of the public criticising the original letter. While I agree with some of the things they said, two inaccuracies stood out. Firstly, that the UK has blocked research into the effects of marijuana (which made me wonder what people think scientists like me and my research group do all day!). Secondly, that cannabis was non-addictive. While some question the concept of cannabis dependence, clinical evidence indicates the condition does exist. Perhaps, these opinions don’t reflect what most people think and maybe (unlike me) other metro readers don’t have such a boring commute that they are reduced to reading the letters… However, in retrospect, I think I could have made it my responsibility to correct them on their misconceptions. This could have been my small way of ‘standing up for science’. However, as a full-time research worker, part-time PhD student and a mother, I didn’t find the time, and by the next day people were moaning about something else. I hope this example will encourage fellow students to stand up for science, even in small ways, by using the media to their advantage or by taking part in debates on Twitter. Hopefully, beginning to interact with the public in small ways such as this will give me the confidence for when John Snow inevitably comes knocking at my door, begging for my opinion on the latest cannabis research…

If this article has piqued your interest, Standing up for Science media workshops are held regularly throughout the year. The workshops are a free fullday event. For more information on other campaigns (such as Ask for evidence, above) and to keep up to date with upcoming workshops, see the Sense About Science website: http://www.senseaboutscience.org/

beth By Eliza ah-Kusi pi Ap

P U E G C N I N D E I N C A ST FOR S

‘Is UK pharmaceutical research fit for the future?’

This summer, Dr. Ruth McKernan returned to the IoPPN to give an Athena SWAN Women in Science lecture entitled “Is UK pharmaceutical research fit for the future?” – a title that she noted was not especially girly, and so she wondered why there were so few males in the audience...

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Athena SWAN Lecture 2014 with Dr. Ruth McKernan Dr. McKernan is Senior Vice President of Pfizer and Chief Scientific Officer at Neusentis, Pfizer’s Research Units in Cambridge and Durham. She gained her BSc in Pharmacology and Biochemistry at King’s College London and her PhD here at the Institute of Psychiatry, during which time she studied the mechanisms of action of antidepressant drugs. After a two-year post-doctoral position in San Diego, USA, McKernan left academia and joined the pharmaceutical industry. As successful as I already knew McKernan to be, having read her biography, it was immediately clear exactly why and how she has become so successful within the pharmaceutical industry. Her confidence and poise made her words easy listening, even for students who may not have explored the ins and outs of pharmaceutical companies. Moreover, the fact that she has got so far may have something to do with her genuine nature. McKernan’s talk started by outlining recent changes and adaptations that the pharmaceutical industry have had to make in order to compete, including the buying and selling of smaller companies, following more stringent regulations, working alongside suppliers to produce drugs, and, most importantly for us, increasing collaborations with academia. McKernan gave a timeline of events that have affected both her personal career and the industry as a whole. She described how this has shaped the way drugs are produced today, even pointing out that there is ever-increasing need and consequently, increasing employment opportunities in medical technology

and biotechnology. She also highlighted areas that are becoming more important to the National Health Service such as data-driven treatment and personalised medicine, where medicines are delivered based on an individual’s biological profile, enabling the right medicines to be prescribed earlier. McKernan also pointed out that the big pharma companies are no longer competing with just each other, but also with tech companies, such as Google and Apple, who are making developments in personal healthcare management. I found Dr. McKernan’s talk an intriguing mix of someone’s own personal experience and struggle, combined with a discussion packed with information and advice about where healthcare is going in the UK. Indeed, I took a lot of what I heard home and started to think about where I could fit into these developments. The second part of the lecture was more of a casual chat with Dr. McKernan about her personal experiences of being a woman, firstly in academia and then in the pharmaceutical industry. I found that she gave a lot of good advice, two pieces of which stood out to me. Firstly, be yourself and find strength in what you are good at. Secondly, ensure you have a strong support system around you, allowing you to enjoy your personal and home life, as well as a successful career. I really enjoyed Dr. Ruth McKernan’s lecture and came away feeling inspired to be a successful woman in science.

By Amanda Worker

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REVIEWS Films Locke The Wolf of Wall Street Locke (2013) Director: Steven Knight Starring: Tom Hardy and Olivia Colman Locke is quite straight forward, but at the same time difficult to explain. This goes for the movie as well as for the character. Essentially, the film revolves around a married construction worker who has found out the woman he once had an affair with has gone into labour. The camera chronicles his attempts at juggling a difficult concrete pour at work, soothing the woman who is about to have his child, and appeasing his unsuspecting wife. Only, we never get to see any of the other protagonists – all conversations are conducted via a hands-free phone during Locke’s drive from Birmingham to London to attend the birth of his third child.

At this point you may ask, how could listening in on someone’s domestic dispute over the phone possibly be entertaining? At first blush, it sounds about as exciting as watching cement dry. However, herein lies the beauty and the genius of this piece of art that some have described as Tom Hardy’s performance of a lifetime in the role of Locke. The production team has done a marvellous job of feeding the viewer regular back stories and twists to maintain the tension, turning this into a veritable thriller. However, without the ‘distractions’ of action sequences, direct engagements between physical beings, and forced jokes,

the film provides moments to reflect and question the motives of this pressurized father. One begins to wonder about the relationships and attachments within his birth family as he speaks about his own parents. It becomes clear that Locke would not get through this night without the friendships he had forged in the past. Nonetheless, as he is driving through the night into the morning, the future always looms through the windscreen. If you are one for character pieces, magnificent acting, and slipping into the perspective of another person with great responsibilities on their shoulder, then this is for you! Reviewed by Steffen Nestler

The Wolf of Wall Street (2013) Director: Martin Scorsese Starring: Leonardo DiCaprio, Jonah Hill, Matthew McConaughey We are never in any doubt throughout Martin Scorsese’s three-hour romp The Wolf of Wall Street that we are watching morally contemptuous behaviour. Nonetheless, one can’t help but feel uncomfortable upon leaving the cinema for the sober light of

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day: does the film reproach bad the ruthless exploitation of hapless behaviour or revel in its excess? rubes, the same way we might cheer on Bugs Bunny as he dexterously Certainly, there is an undeniable evades a bumbling Elmer Fudd. pleasure in watching silvertongued, snake-oil salesman Jordan Indeed, the whole film has a Belfort (Leonardo DiCaprio) manic, Looney Tunes quality. The quickly amass a fortune through plot arc (rise to glory, inevitable

downfall) feels incidental; the film is more a string of raucous comedic anecdotes, heavily peppered with sex, drugs, and scintillating verbal runs. According to the film’s editor Thelma Schoonmaker, much of the tone was the result of extended, off-colour improvisation. One memorable scene has a table of stockbrokers discussing how to behave correctly around “midgets”, as though they were creatures from mythical lore.

tone preceding the denouement. In this regard, watching DiCaprio as his Quaalude-induced paralysis forces him to flop his way from front-door to sports car, all the while drooling and cursing, is a comedic highlight. Another is an early scene where a still-green Belfort is mentored by an elder Wall Streeter, who lays out in matter of fact detail the key principles of finance: take copious amounts of drugs, have sex frequently, and get as much of your client’s money to go from their pocket into yours. The mentor in question is played by none other than charisma-whirlwind Matthew McConaughey whose guttural, chest-beating motivational chant was apparently taken from his own real-life, on-set warm-up exercise.

At the centre of The Wolf of Wall Street is Leonardo DiCaprio’s electrifying performance of a man who, if not an outright psychopath, is certainly an exemplar of narcissism. Charming, superficial, manipulative, and entirely without empathy for others, Jordan Belfort is the life of every party he gatecrashes, ruining one life after It is worth noting that this manic style has a precedent in the fastanother. talking satirical films of Preston The skilful trick Scorsese manages Sturges. Tellingly, critics have come to pull off is to place the viewer’s to view Sturges’ over-the-top style interest and sympathies squarely as a truer representation of 1940s on the side of our debauched America than the more restrained protagonist. There is no moral films of his contemporaries. comeuppance at the end, no final Similarly, one gets the sense we’re reel repentance for his sins, simply meant to feel the same about the reluctant acceptance, as in Jordan Belfort as representative of Goodfellas (1990), that his life is American excess, particularly in less glamorous now the authorities the wake of the 2008 market crash. have caught up with him. And yet, there is something melancholic in With this in mind, it’s worth seeing the wolf tamed, especially examining the final scene. We after the masterful performances, see what looks like TV footage exciting montages, and madcap of Jordan, now demoted to sales

trainer and motivational speaker, asking his audience to sell him a pen. This final shot slowly pans away from the protagonist to a crowd of desperate, expectant faces as they wait to be given the secret to everlasting happiness. In this sense, the film suggests that the excesses of finance, as with narcissism, are an unchangeable force of nature, a vestige of a more violent evolutionary past. It is us, then, who are to blame for indulging said forces, perpetually allowing ourselves to be seduced by them time and time again. As a message, this feels a little on the nose given that the film is one long exercise in immoral seduction, implying we should all feel bad for enjoying something that millions of dollars helped to make so enjoyable. Equally, it feels unfair to pitch narcissism as a problem people other than the narcissist have to deal with, even if research into personality disorders would imply it is a persistent trait that current interventions are only moderately successful in helping. Ultimately, the film is best enjoyed as a straight comedy; a guilty sojourn with a parade of marginal characters you wouldn’t trust as far as you could throw, but who are damn fun to be around. A bit like some the narcissists I know in real life. Reviewed by Raphael Underwood

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WAR AND MARRIAGE How Serving in the UK Armed Forces Affects Relationships

When personal, namely marital relationships, involving members of the UK Armed Forces are covered in the media, the focus often shifts straight to risks of domestic abuse and fear of the partner’s death, quickly citing divorce as the only answer1,2,3. The Looking Glass wanted to find out the extent to which this depiction of the British military is accurate. Therefore, assistant editor Steffen Nestler sat down with Mary Keeling, a post-doctoral psychologist at the King’s Centre for Military Health Research, to discuss. Keeling’s PhD investigated the romantic relationships of the British Military and incorporated several projects, but we decided to focus on qualitative interviews carried out with serving noncommissioned officers (among them infantry, tank, signals, and medical personnel) about their experiences of forming and maintaining romantic relationships whilst serving in the British Army. All six of these soldiers reported being in stable, satisfied relationships with their wives. The overriding theme of the interviews was that the soldiers experience a push and pull between maintaining their military career and a successful relationship. The military is its own peculiar environment, with rules regulating many aspects of the soldiers’ lives, and with strict hierarchies. Additionally, younger “squaddies” occasionally are caught up in a “lad” and drinking culture, which may not be conducive to the formation and maintenance of romantic relationships. Many members of the British Armed Forces face a number of dilemmas that can place a strain on a couple. There is the question of allocating time, energy, and presence to the army or to their

partners. Unfortunately, the nature of military work demands are such that when the call arrives, there is little negotiating whether the soldier deploys or not, and for how long. When deployed, separation anxiety could exist, because one is away from one’s family. This may be further compounded by anxiety regarding how one will be welcomed in the home environment upon one’s return home. Soldiers may experience guilt about missing out on time with their families and for the emotional stress they cause their wives.

“Military service requires a certain level of confidence, bravado or even recklessness, which may not be helpful strategies for emotional management at home.”

A transition that appears to happen for many of the soldiers is a move from strongly attached relationships with their comrades when they are younger soldiers to forming strong attachment relationships with their wives instead: as one soldier put it, “from Bro-mance, to romance”. This transition appeared to coincide with promotion from lower ranks to non-commissioned officer. When it comes to romantic relationships, attachment theory plays an important role in how relationships function. Having securely attached marital relationships where the couples are each other’s secure base is likely to enhance soldiers’ ability to manage successfully both in the army and in marriage. In addition, practical considerations, such as personal finances, certainly also affect partnerships. If a spouse is required to remain in deployment for longer, the spouse at home may have to leave their job to provide childcare or have to find a way to cover the cost of unexpectedly extended childcare needs. Equally, job satisfaction is important to a soldiers’ well-being, and a lack of it could have repercussions for interactions with their significant other.

Soldiers also face an emotional dilemma whereby military service requires a certain level of confidence and stoicism, which may not be conducive to being emotionally available when with their wives. Bravado may be used as an alternative strategy for emotional management at work, but in a marriage, it is essential Subsidised housing is available that this be balanced with more for married couples within army open emotional communication.

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barracks. However, unmarried partners are not entitled to this housing, meaning unmarried couples have to live off the barracks. It is possible that this impacts the unmarried, as they may not have the same access to the supportive environment that comes with living on the barracks. On the other hand, some couples may prefer to have some separation from military life. The amount to which soldiers choose to become immersed in their military life, and the effect this may or may not have, on their relationship appears to be dependent on the individual soldiers and their spouses. What seems most important is that their wives are close to their preferred source of support. When I enquired about what motivated Mary to pursue this particular piece of research, she divulged that she is actually a ‘staunch pacifist’. She started looking for a PhD project after she completed her Master’s

degree, and became attracted to her current field because the topic was somewhat ‘off-piste’. However, one might argue that a researcher doesn’t have to be a supporter of the area they are working on, in the same way that a scientist working on drug development is not necessarily a supporter of the pharmaceutical industry. In fact, scientists with opposing or counter-intuitive opinions can often contribute novel or even groundbreaking opinions. What Mary has achieved is to provide a glimpse into a previously opaque and seemingly distant world. Her study offers some preliminary findings in a field that in the UK had previously been relatively untouched. Very little research has investigated romantic relationships from the serving personnel’s perspective. Mary is currently in the process of editing this research from her PhD to submit to academic journals for publication. In collaboration

with the UK Ministry of Defence, the King’s Centre for Military Health Research has already informed policy surrounding soldiers’ debriefing procedures. It also attempts to dispel certain myths about serving in the UK military with robust evidence. While television reports will likely continue to focus on the most sensationalised and tantalizing features of military service, it is becoming clear that a majority of personnel lead regular lives and maintain healthy relationships. By Steffen Nestler

References http://www.channel4.com/explore/battlescarred/topics/article-relationships.shtml http://www.huffingtonpost.com/2012/05/26/ military-marriage-10-thin_n_1537543.html http://www.telegraph.co.uk/news/uknews/defence/8311796/Married-to-the-armed-forces. html

Student Forum Update

t’s been an eventful summer so far at the IoPPN. As you’ll have seen in the special edition of The Looking Glass, the Student Forum chairs have been providing extra student representation to ensure students are supported during the restructuring. We’ve also been working with Health School students and KCLSU to lead the student response to the proposed redundancies. It’s been a difficult process but the commitment of the IoPPN academic staff to maintaining student standards, and the fantastic student support for the staff, has been inspiring.

Lindsey Hines, Student Forum Chair

On brighter topics, it’s been a busy and rewarding year for the Student Forum and I’m really pleased with what we’ve been able to achieve. After the success of our Student Forum Christmas and Halloween parties, we had KCLSU support to throw a tropical summer party in Thai treehouses. They’re keen to improve their postgrad provision, and we’ve had focus groups and numerous meetings with them to discuss how to do this. The next step is to arrange KCLSU support for monthly Denmark Hill student events next year. On top of this: • We worked to improve the induction process for course/department reps so that it’s easier for them to bring forward student views; • We’ve set up a popular monthly discussion group for PhD Students (Tea at Two, 2nd Tuesday of each month, 2pm

in the Ortus café); • Monthly film screenings with free popcorn and beer have been reinstated (first Tuesday of each month, 6pm start); • We’ve improved our social media; • And finally, we’ve equipped the Graduate Lounge with table football! If all that hasn’t improved the student experience, I don’t know what will – but maybe you do. If you’ve got ideas for events and activities, and you want to ensure that the IoPPN students have their views and concerns represented then please contact us to get involved with the Student Forum next year. The Student Forum runs on volunteers and student engagement, and this year has really highlighted the importance of having our own IoPPN student organisation and the need for vocal student representation. I hope that things will only grow from here.

s far as the postgraduate taught student experience goes, we’ve been working very hard to make sure that your time at the IoPPN is as fun and effective as possible. Aside from a range of student events, the Student Forum has also been actively working to ensure that we guarantee more timely returns for marked work, increased representation of MSc Student issues in departmental meetings, more careers seminars and career fairs, and of course consistent consultation with course leaders for bettering the educational experience for students across departments. It’s been a great year working to try and offer the best experience to my fellow students, representing you in issues such as the ongoing restructuring of the health schools and day to day IoPPN decisions; which is why this autumn if you get the opportunity to volunteer with the Student Forum I highly recommend it. Everything you put into it, it will give that back and more.

A Derek Andrews, PGR co-chair

Aaron Craddolph, PGT co-chair

s we approach the new autumn term, we at the Student Forum have been working hard to assure that PGR students, like myself, are getting the best experience the IoPPN can offer. Unfortunately, King's College London’s medical schools are facing mandatory redundancies that will drastically affect some of my fellow PGR students. The Student Forum have taken a leading role in voicing the student body's displeasure with the restructuring action, while also working constructively with Vice Dean of Education, Susan Lea, to assure all student concerns are taken into consideration. While restructuring has dominated the agenda as of late, we have also found time to address some other issues. We are happy to have successfully lobbied for a new careers fair event in November. We are also pleased to see enhancements made to out of hours dining and water coolers around the IoPPN. Additionally, we are continuing to make progress in our efforts to secure additional teaching opportunities for PGR students within the upcoming undergraduate Psychology program, and will hopefully have positive news on this soon. While this has been a difficult period for all of us at the IoPPN, I have enjoyed my role as PGR co-chair of the student forum and look forward to representing you in the future.

Do you have opinions about your education?

Do you think there’s more to studying than just getting a doctorate?

Are you full of ideas for improving the IoPPN?

is RECRUITING PGR Chairs for the 2014/2015 academic year! We need first and second year PhD students to:  Provide great student representation at the IoPPN

 Run student events and socials  Develop the IoPPN student community. Training is provided and the role counts towards transferable skills, as well as providing invaluable experience of educational involvement and contributing to academic committees.

Contact iop.studentforum@gmail.com for more information

BE PART OF YOUR STUDENT MAGAZINE

We are looking for writers, editors, and artists from amongst the student body and junior researchers at the Institute of Psychiatry. If you are interested in submitting articles, joining the editorial board or contributing artwork to The Looking Glass, then get in contact at:

thelookingglass.ioppn@gmail.com

Editor-in-chief Rhianna Goozée Assistant Editor Steffen Nestler Editorial Board Members Lan Mao Sam Mukhopadhyay Amanda Worker Contributing writers Elizabeth Appiah-Kusi Emily Sidlow Raphael Underwood With thanks to Derek Andrews Aaron Craddolph Lindsey Hines Artwork and images Cover artwork: R. Goozée Pages 2, 3, 7 and 21: R. Goozée Pages 15 and 16: Kindly provided by Sense About Science Pages 10, 11, 17 and 29: Kindly provided by KCL Press and Communications Office Photographs of Student Forum Members provided by the subjects Unless otherwise stated all other images are used with the permission of Microsoft®.