The Psychologist January 2015

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psychologist vol 28 no 1

january 2015 www.thepsychologist.org.uk

The ‘street children’ of Latin America Graham Pluck with a story of challenge and survival for millions

letters 2 news 8 interview 40 reviews 66

radical behaviourism 24 mindfulness in psychology 28 mental illness – head to head debate 34 looking back: Asch’s line studies 72

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The ‘street children’ of Latin America Graham Pluck with a story of challenge and survival for millions of young children worldwide

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The ‘strange death’ of radical behaviourism 24 Freddy Jackson Brown and Duncan Gillard argue that it has a fundamental role to play in psychology making a difference in society 20

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...reports news 8 speaking out on the ‘replication crisis’; big data; the Mind Media Awards; neuroscience on the stage; a decade of Mind Hacks; have we overdosed?; Psychology4Students; and more

ISSN 0952-8229 Cover Photo by Graham Pluck: A young boy selling chewing gum to motorists in Quito, Ecuador.

The publishers have endeavoured to trace the copyright holders of all illustrations. If we have unwittingly infringed copyright, we will be pleased, on being satisfied as to the owner’s title, to pay an appropriate fee.

Mindfulness in psychology – a breath of fresh air?

Edo Shonin, William Van Gordon and Mark Griffiths consider the evidence

New voices: Stubbing out smoking in schizophrenia 32 Theodore Lloyd with the latest in our series for budding writers

December 2014 issue 53,306 dispatched

© Copyright for all published material is held by the British Psychological Society unless specifically stated otherwise. As the Society is a party to the Copyright Licensing Agency (CLA) agreement, articles in The Psychologist may be copied by libraries and other organisations under the terms of their own CLA licences (www.cla.co.uk). Permission must be obtained from the British Psychological Society for any other use beyond fair dealing authorised by copyright legislation. For further information about copyright and obtaining permissions, e-mail permissions@bps.org.uk.

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society 44 President’s column; Practitioner of the Year; new Discovery Service, and more

The Psychologist is the monthly publication of The British Psychological Society. It provides a forum for communication, discussion and controversy among all members of the Society, and aims to fulfil the main object of the Royal Charter, ‘to promote the advancement and diffusion of a knowledge of psychology pure and applied’.

Managing Editor Jon Sutton Assistant Editor Peter Dillon-Hooper Production Mike Thompson

Journalist Ella Rhodes Editorial Assistant Debbie Gordon Research Digest Christian Jarrett (editor), Alex Fradera

Associate Editors Articles Michael Burnett, Paul Curran, Harriet Gross, Rebecca Knibb, Charlie Lewis, Wendy Morgan, Paul Redford, Mark Wetherell, Jill Wilkinson Conferences Alana James History of Psychology Nathalie Chernoff Interviews Gail Kinman, Mark Sergeant Reviews Emma Norris Viewpoints Catherine Loveday International panel Vaughan Bell, Uta Frith, Alex Haslam, Elizabeth Loftus

the

psychologist vol 28 no 1

january 2015

the issue ...debates letters 2 tackling child sexual abuse; assisted dying; Maslow – triangle or ladder?; terror porn; New Year’s resolutions; Leslie Reid (1924–2014); and Hazel Dewart (1949–2014) head to head are understandings of mental illness mired in the past? John Cromby thinks so; Vaughan Bell disagrees

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...digests learning, empathy, happiness at work, gut instinct, and more, in the latest from our free Research Digest (see www.researchdigest.org.uk/blog)

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...meets interview Daryl O’Connor talks to Gail Kinman about being a twin, stress and health, and the influence of conscientiousness

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careers we talk to Fiona Price about putting a background in psychology to use in diverse settings, and Captain Duncan Precious gives his personal reflections on a unique role as a uniformed clinical psychologist in the Army

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one on one with Aleks Krotoski, writer, broadcaster and social psychologist

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...reviews

I believe it was all-round raconteur Stephen Fry who once said ‘Christmas is a time for saying that Christmas is a time for doing things that one should, frankly, be doing anyway. “Christmas is a time for considering people less fortunate than ourselves.” Oh, July and August aren’t, is that it?’ Nevertheless, I hope that you find the time this festive break to read Graham Pluck’s thoughtful piece on street children, as a British psychologist living and working in South America (see p.20).

And, as ever, how we can help the mentally vulnerable is on the agenda, with John Cromby and Vaughan Bell taking part in our first ‘head to head’ in aeons on p.34.

Our main aim is to serve as a genuine forum for debate, and we hope that our relaunched website will increase engagement with our readers and beyond. Take a break from the Christmas TV and have a look – there has been lots of exclusive and multimedia content, including chef Heston Blumenthal on his work with psychologists. Just imagine their multisensory festive feast… we hope you enjoy yours.

Dr Jon Sutton Managing Editor @psychmag

a visit to the Institute of Sexology; How to Build a Girl; Serial, the podcast; ‘1 in 4’ on All in the Mind; Broadmoor; Great Myths of the Brain (for an exclusive extract, see ‘Reviews’ at www.thepsychologist.org.uk); The Paedophile Next Door; and more 66

...looks back The line between conformity and resistance another take on Solomon Asch’s famous line judgement tasks, from Jolanda Jetten and Matthew J. Hornsey

The Psychologist and Digest Editorial Advisory Committee Catherine Loveday (Chair), Phil Banyard, Olivia Craig, Helen Galliard, Harriet Gross, Rowena Hill, Stephen McGlynn, Tony Wainwright, Peter Wright

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20 years ago Go to www.thepsychologist.org.uk for our complete archive, including adoption

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Big picture centre-page pull-out Photo and artwork by Cigdem Esin

LETTERS

Tackling child sexual abuse – a lesson fr

contribute

THE PSYCHOLOGIST NEEDS YOU! Letters These pages are central to The Psychologist’s role as a forum for communication, discussion and controversy among all members of the Society, and we welcome your contributions.

Send e-mails marked ‘Letter for publication’ to psychologist@bps.org.uk; or write to the Leicester office.

Letters over 500 words are less likely to be published.

The editor reserves the right to edit or publish extracts from letters. Letters to the editor are not normally acknowledged, and space does not permit the publication of every letter received.

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offences, Phil Gormley, deputy director general of the National Crime Agency, called for a proactive approach in developing ‘a range of interventions to prevent people offending… [and] to enable people to seek help to prevent their offending from becoming even more serious’.

Convicted offenders make up only the tip of an iceberg, with vast numbers of those attracted to children remaining hidden throughout their lifetimes.

Research from Michael Seto estimates that paedophilia affects around 1 per cent of the global population, a figure suggesting British society may currently contain 641,000 such individuals; more than seven times the total capacity of British prisons (87,879).

These figures seem to be supported by Phil Gormley’s assertion that we cannot ‘simply arrest our way out of this problem’.

One country that I would suggest is not failing this sexual underclass is Germany. I was shocked to find a recent search of the BPS website returned no mention whatsoever of Prevention Project Dunkelfeld [although see p.70]. Prevention Project Dunkelfeld (PPD: see www.dont-offend.org) is a free, confidential treatment programme for help-seeking paedophiles and hebephiles that has been operating across Germany since 2005. Named after the population segment not known to the authorities or the law, Prevention Project Dunkelfeld (German for ‘dark field’) aims to TIM SANDERS

I would like to echo the sentiments of Alex Hossack in a recent letter regarding social attitudes towards sexual offending (‘Sex offenders – time to step outside the anger?’, October 2014).

I had been drafting a letter to The Psychologist along very similar lines and I was glad to see that Hossack’s contribution was so wellreasoned and similar to my own. However, when Hossack asserts that ‘the biggest inhibitor of change is media myths’, I would argue for a slightly different conclusion.

The impact of media reporting stands alongside, and potentially obscures, similar ills inherent in our legislation. As I see it, the main stumbling block for unconvicted and wouldbe offenders seeking psychological support lies in our mandatory reporting laws. These laws bind social, medical and mental health professionals into compulsorily contacting police if they believe that a crime has been committed or is likely to be committed, superseding all confidentiality clauses. In this way, as Hossack pointed out, it becomes almost impossible to provide treatment to individuals of this nature, but no practical solutions were mooted.

It is clear that British society is currently failing the victims of child abuse as well as the adults who may prey on them.

Following the arrests of 660 people for child pornography

…and much more We rely on your submissions throughout the publication, and in return we help you to get your message across to a large and diverse audience.

‘Reach the largest, most diverse audience of psychologists in the UK (as well as many others around the world); work with a wonderfully supportive editorial team; submit thought pieces, reviews, interviews, analytic work, and a whole lot more. Start writing for The Psychologist now before you think of something else infinitely less important to do!’

Robert Sternberg, Oklahoma State University For details of all the available options, plus our policies and what to do if you feel these have not been followed, see www.thepsychologist.org.uk/contribute

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letters

rom Germany? provide therapeutic and pharmacological support to the estimated thousands attracted to children, regardless of their offending history. Under the PPD model, treatment is open to those who have never committed a crime, those who have committed a crime and have not been caught, and those who have committed a crime and already been punished.

Structured treatment is provided weekly in an anonymous group setting, as well as in one-to one sessions where necessary. Interventions include CBT, as well as sexological and medical approaches, with the option of pharmacological support, employing SSRIs and androgen antagonists. In some contexts, therapy is also offered to the client’s partner and relatives, in order to promote the repair of interpersonal relationships and continued support at home. The programme is designed to run for 50 sessions, or approximately one year.

Rather than perpetuating Britain’s reactive and potentially wasteful method of forcing convicted sex offenders through psychosocial treatment, regardless of their desire to change, PPD is a voluntary service that accepts only help-seeking and committed individuals, those for whom psychological intervention is far more likely to make a difference. In times of increasing austerity, the German model maximises funding by working in partnership with universities. A UK programme could follow suit, with academic funds being provided in return for researchers gaining voluntary access to a notoriously inaccessible sample.

The goal of the treatment programme is to increase personal awareness and enable service users to control and transform their paedophilic desires into more positive thoughts and actions. The project hinges on the theoretical standpoint that users are not at fault for their sexual feelings, but that they are responsible for how they act upon them. PPD offers many potential benefits beyond psychotherapy, such as increased personal accountability and decreased isolation. In this way, learning to boost social and legal compliance can run parallel with improvements in mood and self-esteem. A network of 10 treatment centres has been established throughout Germany, with the hope of eventually providing a national system geared towards the primary prevention of child sexual abuse by accepting, training and reintegrating possible offenders into the functional fabric of society.

In this country the work of the Lucy Faithfull Foundation and their Stop It Now programme (www.stopitnow.org.uk) go some way towards bridging current neglect, but without more sustained funding even these limited services are being crushed by the weight of help-seeking paedophiles, with an average of 2000 calls per month going unanswered.

In sum, PPD is hailed as a robust attempt to proactively tackle the collective suffering caused by child sexual attraction, with positive results being documented since 2009. However, according to project leader, Dr Klaus Beier, this beneficial work is only made possible by the anonymity afforded under German law. Unlike the UK, Germany does not have a mandatory reporting policy and without a reassessment of our laws, this progressive project could never be realised here in Britain. Is it time to ask ourselves if mandatory reporting is doing more harm than good?

Ben Aaron MacLeod Writer and author Newcastle upon Tyne

read discuss contribute at www.thepsychologist.org.uk

Removing the fear of dying I am writing in response to Louise Mullins’ letter (November issue) about the practice of administering high levels of morphine to dying patients to relieve pain and hasten death. I have Stage III ovarian cancer, currently in remission, but Stage IV (terminal) will arrive for sure.

Medical evidence has shown cancer cells have spread to surrounding tissue so it is just a matter of time before secondaries develop. I am 62.

While the medical care I am receiving in a major London hospital has been truly excellent, no one at any time has ever engaged with me on an emotional or psychological level. The only questions asked of me have been medical ones.

With no husband or children I feel alone and isolated with my fears and worries. I accept my diagnosis

and prognosis, but because I have a lack of knowledge about the process of dying, I have a fear of death. I know nothing about the Assisted Dying Bill, have not read your letters in previous issues but simply picked up your November issue by chance in someone else’s house.

It would never occur to me to ask for an assisted death before my time is due, but once admitted to a hospice knowing that death is not far away, then I would be only too delighted to receive enough morphine to sedate me, to ease the pain and to help me on my way. I didn’t know that this option could be available, but if so then I have less to fear.

Without this underlying fear, then the quality of what time I have left will be greatly improved.

Andrea Sterlini Enfield

Away with the triangle!

Hazel Guest (‘Looking back’, December 2014) makes an interesting point about Maslow’s Hierarchy of Needs, but she still refers to the ‘triangle or pyramid, which is reproduced in countless publications’.

Indeed, it appears on p.983, complete with the additional level that is the subject of her article.

In 1943 Abraham Maslow launched his theory of a hierarchy of needs.

He later elaborated on it, and the latest edition of his book came out 44 years later (Maslow 1987). There is no triangle in this book. At some point in this period, some bright spark (probably a text editor) had the idea of printing out this

hierarchy in the form of a triangle or pyramid. This produced a very attractive diagram, and later versions added colour to make it even more so. And this is the version that Hazel Guest has used, adding the extra level (intrinsic values) that she argues for in her article.

What is wrong with the triangle is that it suggests that there is an end-point to personal growth.

What is also wrong is that it suggests that this end-point is not far away. So the questions that are raised here are: Is there an end-point; and if so, where is it?

The main writer in recent times who has suggested that

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NEWS

Speaking out on the ‘replication crisis’ Psychologist Dr Simone Schnall (University of Cambridge) has spoken about her own personal experience of the so-called ‘replication crisis’ within psychology at an event organised by the online debating forum Edge.

Dr Schnall began her talk speaking about the complicated nature of replications in social science. She said: ‘When it comes to social psychology it’s a little more complicated because what we usually do is test a specific question with various different experiments… These are called conceptual replications. Our entire literature is built on those conceptual replications, but those are not the ones people are now discussing. They’re different. They’re called direct replications.’

According to Schnall, replicating social psychology experiments is not as simple as in hard sciences such as medicine where a direct replication can be done simply by administering the same dosage of a drug to a patient. She moved on to talking about her work, which looks at the links between physical and moral disgust. Pointing to a paper

by David Stanley and Jeffrey Spence where they discuss the expectations for replications and used computer Simone Schnall stimulations, in which they ran experiments thousands of times under perfect conditions with nothing but measurement error, she said: ‘Even then one gets a great variability of results. The conclusion is that any one given study is not conclusive. That’s why normally we do lots of studies to see if there’s a general pattern.’

Dr Schnall suggested that after it emerged that social psychologist Diederik Stapel had fabricated data, leading to scores of papers being retracted in 2011, it made the community adopt a mind-set where people felt they needed to do things differently and look out for fraudsters and false positives. As well as this shift in attitude towards replication, Dr Schnall explored the lack of a system for choosing which studies should be selected for replication and suggested that a disproportionate number of studies had been singled out for

replication because findings may be counterintuitive if one is unfamiliar with the literature and studies appear easy to conduct.

She also said there were issues with the quality of some replication studies and the conclusions drawn from them.

‘Often the way these replications are interpreted is as if one single experiment disproves everything that’s come before.

That’s a bit surprising, especially when a finding is negative, if an effect was not confirmed. We don’t usually do that with positive findings… we don’t say this now proves once and for all that such and such effect is real. It perhaps comes with that idea that it intuitively seems like this is the real study because we repeated exactly what had been done before.’

Some of the issues with this increase in direct replications have affected Dr Schnall: one special issue of the journal Social Psychology (see tinyurl.com/qe5sru4), with 15 replication papers covering 27 earlier reported effects, went to print without having undergone any peer review, and one of her own findings was reported to have not been replicated by some researchers. She added: ‘I looked at their data, looked at their paper and found what I consider to be a statistical problem.

What was really interesting, though, was that when I alerted the editors, they were not very interested. They were not interested at all. In fact, they denied me the right to a published response. I had to fight tooth and nail to get that response.

‘Let’s think about it in the legal context. This is to declare a verdict on the quality of people’s work without a judge and without having given the people whose work is concerned any right to even look at the verdicts, never mind to defend themselves.’

A recent paper reported several successful replications of Schnall’s work, and a re-analysis of the claimed failed replication actually revealed the predicted effect (see tinyurl.com/nk66bhj).

Meanwhile there has been a growing concern among academics about the legality of post-publication peer review, and the general tone of discussion surrounding their work outside of the formal journals publishing process (see Tom Stafford’s Mind Hacks article on this subject: http://tinyurl.com/qcmqpg7). For example, Times Higher Education has reported on a scientist in the US who has started legal action after, he claims, anonymous comments questioning his science cost him a job offer. ER I For a video and the full transcript of Dr Schnall’s talk see tinyurl.com/k97w4jv. See also tinyurl.com/psycho0512 for our special issue on the topic.

TRANSFORMING RESEARCH FUNDING The mental health research charity MQ: Transforming Mental Health has announced £1.5 million in funding awards as part of its new research programme PsyIMPACT. The awards aim to support ways of providing better and more accessible psychological treatments for common mental disorders.

The four projects that have been awarded

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funding include a team at King’s College London who are developing new evidencebased psychological treatments for worry and rumination, a dominant symptom of depression and anxiety disorder. The fund is also supporting the first trial of a computerbased preventative intervention at Birkbeck, University of London, for 10-month-old infants

at risk of ADHD. Cynthia Joyce, Chief Executive of the charity, said: ‘Psychological treatments help so many people. Research in this area has the potential to transform the scale and impact of psychological therapy in the UK, meaning more people can get access to care in a way that works for them.’ ER

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It is big, but it’s not always clever Computer scientists at McGill and Carnegie Mellon Universities have pointed out some of the flaws in using large sets of data from social media to learn about human behaviour, in a new article published in Science. They said the approach is now taken in thousands of papers, some of which contain erroneous data.

Derek Ruths, an assistant professor in McGill’s School of Computer Science, said that faulty results gleaned from using such data can have huge implications. He said: ‘Many of these papers are used to inform and justify decisions and investments among the public and in industry and government.’

Ruths and Jürgen Pfeffer of Carnegie Mellon’s Institute for Software Research have highlighted several issues involved in using social media datasets as well as strategies to address them. The challenges include the fact that different social media platforms attract different users: for example, Pinterest is dominated by females aged 25–34 but researchers often don’t correct for the distorted picture these populations can produce. They also pointed out that the design of social

media platforms can dictate how users behave and, therefore, what behaviour can be measured. For instance, on Facebook the absence of a ‘dislike’ button makes negative responses to content harder to detect than positive likes.

The large numbers of spammers and bots, which masquerade as normal users on social media, also pose an interesting problem for researchers – they can get mistakenly incorporated into many measurements and predictions of human behaviour. The researchers said that many of these problems have well-known

solutions from other fields, such as epidemiology, statistics and machine learning, Ruths and Pfeffer wrote: ‘The common thread in all these issues is the need for researchers to be more acutely aware of what they’re actually analysing when working with social media data.’

Tom Stafford (University of Sheffield) told The Psychologist that it was a tremendously exciting possibility to have access to digital track of human behaviour. He added: ‘And just because they’re online doesn’t mean they don’t reflect real feelings and behaviour. Using such data means you can remove sample error, but you cannot remove sample bias. What psychology needs to get to grips with is doing properly controlled comparisons.

‘The same things which were fundamentally important in pre-big-data times are still important. Things such as theoretical questions – what you are interested in and why – and a strong causal inference based on experiments using random assignment where possible.

And, where experiments aren’t possible, using properly controlled comparisons like those used by epidemiologists.’ ER

Mental health in the media awards This year’s Mind Media Awards were dominated by young winners as the BBC Three documentary Diaries of a Broken Mind, teen drama My Mad Fat Diary, 15-year-old blogger Ellen White and Radio 1 took home the top prizes.

The annual awards aim to celebrate the best portrayals and reporting of mental health in the media. They honour broadcasters, bloggers and journalists who have made a contribution to changing attitudes and tackling mental health stigma. The ceremony, hosted by comedian Helen Lederer, also featured guest presentations from TV presenter Jameela Jamil and actress Denise Welch.

BBC Three’s intimate documentary Diaries of a

Broken Mind – a film that included self-recorded footage by 25 young people with various mental health problems over six months – was awarded Best Factual TV Programme. Teenager Ellen White claimed the Blogger award for her website where she posts about living with obsessive compulsive disorder. The 15-year-old was recognised for providing peer support to other young people going through similar issues. The musings of a teenager were also honoured in the drama category with E4 comedy My Mad Fat Diary, based on the teenage years of writer Rae Earle.

BBC Radio 1 and 1Xtra were presented with the

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Ellen White won the Blogger award

Making a Difference award, for their long-standing commitment to reporting on

mental health issues.

ER

I The full list of winners can be found at tinyurl.com/q76346z

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news

Have we overdosed?

Ella Rhodes reports from a debate on psychiatrists and the pharmaceutical industry

NEUROSCIENCE ON THE STAGE A young theatre group have created a play based on the development of the teenage brain, with the help of neuroscientists from University College London. Teenagers from the Islington Community Theatre (ICT) have been working alongside Professor SarahJayne Blakemore over the last two years on their play, Brainstorm.

The young people contacted Professor Blakemore after watching her TED talk, and she, together with her PhD student Kate Mills, helped them to develop their play and understand the science behind the developing teenage mind. They performed an early version of the play to family and friends around 18 months ago [see our review, tinyurl.com/lw9gjod) and a short version of the play at the Royal Albert Hall in spring 2014. The early versions of the piece used dance, song and monologue to portray the effects of changes in the brains of teenagers and explain the fact these can sometimes lead to feelings of loneliness, self-consciousness and recklessness. At the Royal Albert Hall performance Professor Blakemore joined the performers on stage to give a short lecture about the neuroscience of the teenage brain.

Professor Blakemore said: ‘I’ve worked with the Islington Community Theatre quite closely, especially in the run up to a short performance we did together at the Royal Albert Hall last April. The ICT director, Ned Glasier, successfully applied for a Wellcome Trust public engagement award and this is being used to fund a new version of the play, which will be rolled out at the Park Theatre in January, and a further production possibly at the National Theatre later next year. I really enjoy hanging out with the young people at ICT – they are an amazingly talented group of teenagers.’ ER I The play runs at Park Theatre, Finsbury Park in London from 8 to 11 January; book tickets at tinyurl.com/net4ggw

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This at times fractious debate, held at London’s Emmanuel Centre on 12 November, discussed the pros and cons of Big Pharma within psychiatry. Author Will Self and Professor Sir Simon Wessely, President of the Royal College of Psychiatrists, were among the panellists debating the motion ‘We’ve overdosed: Psychiatrists and the pharmaceutical industry are to blame for the current “epidemic” of mental disorders’.

Speaking alongside Self, for the motion, was psychoanalyst and author Darian Leader. Alongside Professor Wessely in the against camp was Dr Declan Doogan, the former Head of Worldwide Development at Pfizer Inc. and current CEO of Portage Biotech.

The audience vote prior to the debate was 43 per cent for the motion, 28 per cent unsure and 29 per cent against. How would the arguments, each presented with emotion and conviction, sway the vote?

Will Self – whose two most recent novels, Umbrella and Shark, follow the story of a psychiatrist Zack Busner – raised concerns over the mechanism of action of antidepressant drugs, saying: ‘I’ve been on a personal journey with this question for many years, and it’s affected me personally.’ He spoke of his experience making a documentary for BBC Radio 4 to mark the 25th anniversary of Prozac and his concern that the ‘assumed’ effect of SSRIs in rectifying low serotonin levels had been disproved.

He said: ‘The double blind and longitudinal studies of SSRIs show that a good, brisk walk, a talk with a friend, or heroin, are all just as effective in alleviating depression.’ Self added that he did believe that SSRIs were prescribed in good faith but that the reason they work is because people believe they work. He added: ‘They work because we have faith, we the people have faith, and what we have faith in is medical science.’ Self also outlined his concerns about iatrogenesis, or ‘doctor-created diseases’: ‘The new edition of DSM contains a lot of diseases that, in my view, are collections of symptoms that have proved to be responsive to certain psychopharmacological compounds.’

Declan Doogan was next to take the stand and argued that drugs used for treatment of psychiatric disorders were, in fact, much more effective than placebos

and that the image of Big Pharma companies as evil-doers was misleading and unfair on patients. He said: ‘Why is talk therapy so much more acceptable than drug therapy?... Depression is a clear disease, at least as toxic as some of the diseases it coexists with. Antidepressants do work.’

Dr Doogan went on to speak of the increase in prescribing of psychotropic drugs and said that mental illness was a very prevalent phenomenon, citing statistics that 20 per cent of children in the UK would have a mental health disorder in 2014. Is the problem underrather than over-diagnosis of such problems? Doogan suggested the increases in prescriptions of psychotropic medicine could be due to patients being treated for longer.

Psychoanalyst and author Darian Leader, arguing for the motion, said that around 100 years ago depression was seen as a symptom rather than a disorder in its

own right. He added that from the 1960s onwards many new mental health disorders had been emerging. He posed the question, what happened to allow that diagnostic expansion? He suggested this could be due to changes to the legal regulatory landscape of drugs, arguing that relatively recent changes meant pharmaceutical companies had to specify on new drugs which disease category they

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aimed to treat. He said that this changed the market in a number of ways, including the shift to marketing illnesses rather than marketing the drugs themselves.

Leader said that over the years there has been a change in the definition of depression. Whereas in the past there had been a number of different, competing descriptions, now the classification of depression has become standardised and reflects how the drugs used to treat it act: ‘Rather than finding the pharmacological key that will unlock the illness, it’s the other way round, you have the lock and anything that fits it can be defined as the illness.’

Professor Sir Simon Wessely, President of the Royal College of Psychiatrists, started by pointing out that much of his life’s work had been concerned with the psychological treatments of mental illness and epidemiology. He said: ‘Is there an epidemic of mental disorder? The facts are very clear, there is no such epidemic. Rates of psychiatric disorders have remained the same over the last 20 years.’ Although admitting there had been an increase in anxiety problems and eating disorders, Professor Wessely suggested people may believe there is an epidemic because the public and media are much more willing to talk about mental health problems.

He pointed out that, in his work with ex-servicemen and women suffering with PTSD, the rate of people coming forward had increased while the numbers of people with the condition had remained largely stable.

However, he pointed out that many people were still not coming forward for treatment for lack of services and the remaining stigma around mental health issues. He said three quarters of people with depressive disorders were not being treated: ‘If that was cancer or diabetes we would say that was scandalous.’

Questions were then put to the panel and a final vote taken. There had been a large swing against the motion, an increase to 52 per cent, with 46 per cent in favour compared with 43 per cent before the debate. Just 2 per cent remained unsure. For this audience at least, psychiatrists and the pharmaceutical industry are not behind any ‘epidemic’ of mental disorders.

Celebrating a decade of Mind Hacks To celebrate the 10th anniversary of their award-winning blog Mind Hacks (see Society, December 2014), Dr Vaughan Bell (University College London/South London and Maudsley NHS Trust) and Dr Tom Stafford (University of Sheffield) held a live event in November. London’s Grant Museum of Zoology – the ‘room of death’, as Tom Stafford put it – was the venue for a gathering in the style of the blog itself: intelligent and entertaining.

First up was Professor Sophie Scott (University College London), on the science of laughter. Laughter is primarily an affiliative and social behaviour: we laugh because we like, love and want to be with people. But recounting a tale of a group of teenagers pranking her at Ipswich railway station, Scott demonstrated how laughter can send the message ‘We are in two different groups – we will mark that by laughing at you’.

Nietzsche once said only humans laugh, because we are the only species who understand tragedy. But Scott pointed to work by Jaak Panksepp on rats to counter this. They will ‘laugh’ when tickled, and eventually even when the tickling researcher enters the lab.

Next, science journalist and blogger Ed Yong took aim at oxytocin, the ‘poster child for how science can be twisted by imagination and alliterative soundbites’.

Sure, the molecule can make wombs contract before birth, trigger the release of breast milk and turn neglectful prairie voles into caring ones. But can it boost trust, and basically make humans ‘like you, but better’? Yong fears that those who advocate it as some sort of wonder drug of human goodness have probably only read the abstracts of the scientific papers they cite. There are contextual effects (it only impacts on certain people in certain situations), and it can also have a ‘dark side’. The hype around oxytocin exploits vulnerable people, with some parents buying it in an attempt to treat their child’s autism or depression. Yong railed against studies that are little more than ‘poxy little happy clappy kumbaya stuff’, only looking for positive effects so unsurprisingly finding them. ‘It comes down to salesmanship and a desire for a simple panacea’, he concluded.

Also targeting brain myths was Professor Sarah-Jayne Blakemore (University College London), who is

read discuss contribute at www.thepsychologist.org.uk

concerned by how the use of neuroscience in education is flourishing. Companies sell products supposedly based on neuroscience findings, and schools spend their hard-earned and limited budgets on ‘brain exercises’ whose effects could be achieved by just having a break or doing something new. Blakemore puts this down to the seductive allure of neuroscience, the finding that people are more likely to find a bad explanation convincing if it comes with random brain words attached.

Why do we need to frame things in such terms, Blakemore wondered. ‘I challenge you to produce a single finding in neuroscience that has implications for education that we didn’t already know from psychology or education’, she said.

Bringing the cake to the party was Neuroskeptic, ‘from the internet’.

‘Birthdays are deadly; try to avoid them’, was his advice, pointing to a range of research on the topic. For example, in Canada you are more likely to be diagnosed with ADHD if you are one of the younger children in the school year; and in women, death rates are higher just after your birthday.

Thankfully alive and flourishing, the seed for mindhacks.com was sown – as so many are – over a bottle of red wine, more than a decade ago. Tom Stafford took the audience through the history and prehistory, including the book of the same name. Taking one example of a way we can ‘mind hack’, taking the experiments scientists do and ‘open sourcing’ the experience, Tom showed how we can use the way our eyes and minds adapt to the dark in order to make that nocturnal trip to the loo that little bit easier.

Tom then handed over to Vaughan, pointing out that of more than 5000 blog posts over the years – more than 2.2 million words – Vaughan had written 96 per cent of them, so he deserves all the credit (or 96 per cent of it at least). The climax of the evening was left to Vaughan and Neuroskeptic, acting out the sex scene from Susan Greenfield’s novel 2121.

You really had to be there.

The Greenfield novel is a dystopian view of what happens when there’s too much internet. Let’s hope that Vaughan and Tom don’t heed her warning, and that these true pioneers of public engagement in psychology continue to inform and entertain for many years to come. JS

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Psychology4Students Ella Rhodes reports from two of the Society’s flagship events in November (Sheffield) and December (London) The Mercure Hotel in Sheffield saw more than 250 A-level psychology students swarm through its doors for five inspiring talks covering a vast range of topics, including the role of glucose in memory and the rules of attraction. Dr Catherine Loveday, from the University of Westminster and the Society’s conference committee, welcomed the students. She apologised for the lack of female speakers, but said the event aimed to give students a ‘taste of something different’ within psychology.

Richard Stephens (Keele University) was first to take to the stage giving the audience an enlightening view into his research into swearing and pain, for which he won the Ig Nobel Peace Prize (see also our September 2013 issue). He started by running a Stroop test on the gently chuckling audience, using swear words.

The gathering quickly lost track of the test itself, with Dr Stephens saying: ‘This really nicely demonstrates the power swear words have.’

He went on to tell students that in cold pressor studies of pain tolerance, when participants repeated a swear word rather than a neutral word as they immersed their hand in ice water, they experienced less pain as a result. He concluded that swearing was a form of ‘stress-induced analgesia.’ But Stephens also pointed out that these pain-relieving effects are less pronounced in people who swear more generally in their day-to-day lives. When the time for questions came around scores of hands shot in the air.

One student asked Dr Stephens if he had a favourite swear word, to which he replied, ‘I have the usual repertoire.’

When the next speaker, Daniel Gurney (University of Hertfordshire) stepped up to outline his work with body language, there was a perceptible shift in the audience as everyone adjusted to sit up that little bit straighter. Dr Gurney ran several demonstrations on the audience, showing that holding a pen between one’s teeth, forcing a smile, can make a psychology joke seem funnier – showing that body language not only affects those around us but our own emotional experience as well. He then went on to demonstrate that one’s posture could affect thoughts, as well as emotions. Half the audience were told to lean left while the other half leant right. Those leaning right estimated that the Eiffel Tower was

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taller, as our mental perception of numbers runs from left to right, lowest to highest.

Gurney then described a word to the crowd and asked them to guess it while sitting on their hands so they couldn’t use gestures as cues. This took a considerably longer time than when hands were free to ‘act out’ the word in question (‘glockenspiel’). But aside from the intrigue of body language, he also pointed out that gestures of questioners in eyewitness interviews could affect subsequent testimony, for example doing a stabbing motion while questioning can cause people to say they saw a knife involved in an attack.

Just before lunch, Alan Gow (HeriotWatt University) took to the stage with an intriguing set of props. He started by asking five volunteers on stage, each was asked to blow up a balloon, the first to show the small size of a baby’s brain, the last to show the size of a 20-year-old brain. He then asked the audience, who were also clutching balloons, what they thought happened to the size of the brain after the age of 20. Rather disconcertingly, many of the students let go of their balloon brains entirely. While the reality may not be quite so extreme, Dr Gow did confirm that after a certain age the volume of the brain does begin to decrease. To illustrate connections within the brain Dr Gow then threw several balls of wool into the audience asking each person to grab a piece and throw it back, explaining that as people age the myelin sheaths ‘insulating’ neurons gradually degrade affecting cognitive skills. He said: ‘There’s a linear decline from its peak in your early 20s, in terms of being able to take in information and quickly process it and respond accordingly.’ But he did point out that there were still cognitive processes that improved with age and experience, giving the example of word knowledge.

Gow then went on to quiz the students about what lifestyle factors they thought could worsen cognitive decline with age.

The audience were on top form throwing out suggestions such as drugs, alcohol and low cognitive stimulation. He also pointed to his own research, which had been published on the day of the conference, showing that having more complex jobs can lead to slower cognitive decline. This showed the students first-hand how exciting the world of research can be.

Appropriately, following lunch, Michael Smith (Northumbria University) spoke about research into the effects of glucose on memory. He began by handing out sweets to the crowd, explaining that the brain, though a relatively small organ, uses around 20 per cent of the body’s energy resources.

A comprehensive review of previous research has shown that glucose does seem to enhance certain aspects of the brain, but the picture is not as clear-cut as giving people sweets to enhance cognitive performance. Dr Smith said that in healthy young participants, glucose seems to be most effective when attention is divided. If participants are carrying out a memory task and are simultaneously asked to perform a motor task, they perform better after a glucose drink.

Smith also outlined one of his PhD student’s research into people with diabetes, who have problems regulating glucose levels, as well as healthy people whose bodies are less good at coping with glucose. He said: ‘We’ve found that diabetes and poor glucoregulation impacts on memories for faces and words.’ He also said that people with diabetes are poorer at walking in a straight line when their attention is on something else, such as maths problems, and that he would also be looking into the number of falls that older adults with diabetes have (higher than average).

Viren Swami (University of Westminster) was the final speaker of the day, presenting a very popular talk on the rules of attraction. He outlined that humans were social animals and drawn into relationships. Dr Swami then went on to use comic book hero Scott Pilgrim as an example of a guy who meets a girl and is attracted to her, and centred his talk around giving Scott tips on how to attract her.

Swami said there were three things that facilitated attraction. First, he pointed to some early sociological research showing that a majority of people start relationships with those in close proximity – 60 to 70 per cent of long-term relationships are formed with people we work with or go to school with. Research has even found that people tend to be

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more attracted to those who live in the same London borough as them. Second, don’t get too hung-up on looks. Swami said although attractive people are perceived as having better personal qualities, succeed more in their occupations, and have a higher starting wage, people looking for long-term partners are often seeking warmth, humour, understanding and kindness rather than attractiveness. The final lesson for Scott Pilgrim was that ‘birds of a feather flock together’: many people say opposites attract, but there’s actually little or no evidence of this in the literature.

Swami said we should choose partners who are of similar levels of intelligence and attractiveness in order to form more stable attachments.

…and on to London The Psychology4Students event in London was held at Kensington Town Hall, welcoming more than 700 students to hear another excellent collection of talks in hugely varied areas of the discipline.

Jim McKenna (Leeds Beckett University) was first up with a talk on behaviour change. Professor McKenna’s talk focused mainly on attention and the way this impacts on the success of behaviour change interventions. He opened his talk by convincing the gathered students of his magical abilities, performing a card-disappearing trick to illustrate the importance of attention. ‘If I’m offering anything to you today it’s to do the smallest thing you can do for the greatest effect in behaviour change.’

McKenna went on to outline the roles of the ‘reptilian’ brain and mid-brain in forming habits and the prefrontal cortex in executive function and inhibition, giving examples of the way our ‘habit brain’ leads us to occasionally make erroneous snap judgements. He also spoke about the

roles of emotion in effective behaviour change. Helping people to focus on positive emotions can be helpful in adopting new behaviours.

Willpower may be a finite resource, which should not be relied upon too heavily, McKenna said. Instead, we should focus on small and easy-to-achieve goals as well as using triggers in our everyday lives as reminders for carrying out a particular activity.

Dr Almuth McDowall was next to present her work, on work–life balance. This is a topic that is important across generations, she said, showing a clip of her 10-year-old daughter speaking about what it was like having two parents who work full-time.

McDowall discussed whether a poor work–life balance was a modern epidemic, with dual-earners being the norm in the UK, people having greater job demands and the use of technology making it difficult to escape work. She added that there is considerable regional variation: ‘London is a real hotspot for unhappiness.’

McDowall went on to say that different occupations pose different problems. She gave the example of police officers, whose shifts cover 24 hours a day, seven days a week, and who don’t know what next day might bring. Some people’s work and life are entirely separate, while some do not make the distinction between work and private life: McDowall concluded that it is not necessarily better or worse to be either, but what you have has to match your needs.

Helen Fisher (King’s College London) spoke about childhood psychotic symptoms, whether these are a bad omen or a developmental hiccup (see also her article in our November 2013 issue). She demonstrated that most people had been through some psychotic-type experience, (e.g. having the feeling of being followed) but said psychosis is on a continuum.

In the general population magical ideas and strange experiences are common, but in more serious cases this can be a diagnosable psychotic disorder. Dr Fisher also spoke about other psychotic symptoms, including delusions, disorganised speech and behaviour and hallucinations – showing a YouTube clip to give the whole audience a visual hallucination.

Fisher went on to say that psychotic symptoms are common in a small proportion of young people. She worked on the New Zealand–based Dunedin

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Multidisciplinary Health and Development Study – a longitudinal study of just over 1000 babies born between 1972 and 1973 who were studied up until the age of 38. A psychiatrist interviewed the participants at the ages of 11, 18, 21, 26, 32 and 38. In later life it was found that children who showed psychosis symptoms at 11 were more likely to have schizophrenia and PTSD and were much more likely to have committed or attempted suicide. Only one of the children who had symptoms at 11 had no psychological problems upon reaching adulthood.

Dr Andrea Oskis (Middlesex University London) was the penultimate speaker with a talk on relationships, stress and parents. She started by outlining attachment research from its beginnings with ‘cupboard love’ theories by people such as Freud and Skinner, to Harlow’s work with monkeys and the development of Bowlby’s attachment theory. Oskis then spoke about her own PhD work on adolescent attachment styles and gave examples of quotes from securely and insecurely attached people.

She has also looked at the relationship between attachment style and the cortisol awakening response – the peak in cortisol levels typically seen upon waking in healthy participants. The ‘anxious insecure’ group had a much flatter cortisol profile compared with securely attached and insecure avoidant type.

Dr Caspar Addyman (Birkbeck, University of London) drew countless numbers of ‘awws’ from the audience with his presentation on laughter in babies, complete with a number of hilarious video clips. He started his talk by suggesting that laughter goes back around 60 million years in human history.

His recent work has involved asking parents to fill in online questionnaires and field reports on what made their babies laugh, finding that laughter and smiles start as early as three weeks.

Addyman said his research has also shown that babies laugh around 100 times a day, most often prompted by tickling or favourite games such as ‘peekaboo’. ‘Crying starts early but laughter starts before they can communicate in other ways,’ Addyman concluded. ‘It’s babies telling you whatever you are doing keep doing it, it’s fantastic. We think that learning is about people forcing facts into your head but when you’re a baby you learn for yourself.

You discover almost everything by doing it.’ An apt conclusion to a highly interactive pair of events, which gave me and the large audiences plenty to smile and think about.

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DIGEST

How guessing the wrong answer helps you learn the right answer It’s well known that taking tests helps us learn. The act of retrieving information from memory helps that information stick. This seems intuitive. More surprising is the recent discovery that guessing aids subsequent learning of the correct answer, even if your initial guess was wrong.

Let’s consider a simple example in the context of learning capital cities. Imagine you don’t know the capital of Brazil. In the first scenario, I show you the word Brazil and your task is to say the capital. Because you don’t know, you guess ‘Rio de Janeiro’. This guessing phase takes 8 seconds. I then show you, for 5 seconds, the word Brazil together with the correct answer ‘Brasilia’. In the second scenario, you simply have 13 seconds to study the country/capital pairing Brazil and Brasilia.

Later on, I test you on the capital of Brazil. The new research on guessing finds that you’re more likely to recall the correct answer in the first scenario, in which you initially guessed wrong. This is counterintuitive for two reasons – first, you had less time to study the correct information (5 seconds vs. 13 seconds), and second, you came up with a wrong answer, which you’d think would interfere with your memory for the correct answer once I gave it to you.

How can this be? A new study by Veronica Yan and her colleagues at the University of California, Los Angeles, puts two possibilities to the test. To understand the first of these, we need to realise that prior research on the guessing effect has tended to use word pairs related by meaning, such as ‘olive’ and ‘branch’ or ‘whale’ and ‘mammal’. Some participants simply study the word pairs, others guess each In Memory and Cognition partner word before being shown the correct word.

The guessing process leads to superior memory for Yan et al.’s final study examined the duration of the beneficial the word pairs than simply studying them, even when the guessing effect. They reasoned that perhaps the benefit will only guessing is wrong. be short-lived, while participants are easily able to remember Crucially, this past research has tended to use word pairs and suppress their guessed answer. In fact the learning benefits only weakly related in meaning, while the participants in the of guessing, even incorrectly, was found even when participants guessing condition usually guess strongly related words. Yan and were tested 61 hours after the guessing process. her colleagues reasoned that this could be a way for the guessing So why does guessing have this beneficial effect for process to be a memory aid. When it comes to the memory test learning? The truth is we still don’t really know. An explanation on the word pairs, participants in the guessing condition can use with growing support has to do with what psychologists call the rule of thumb ‘the correct answer is always weakly related to ‘semantic activation’. Essentially they’re saying that guessing the first word’. This is a shrewd observation on the part of Yan activates the mental web of knowledge and facts associated with and her team, but they found no evidence to support their theory. the correct answer, which makes the subsequent storage of that The beneficial guessing effect still occurred even when they used correct information easier once it’s given. ‘The basic idea is that a mix of strongly and weakly related word pairs. this [guessing-related] activation.. affords a richer encoding of The second explanation Yan’s team tested had to do with the subsequently presented target,’ the researchers said. whether a person’s guesses are always wrong. If the initial guess From a practical perspective, this research on the beneficial is always wrong, perhaps this makes it easy to always suppress effects of guessing suggests that teachers shouldn’t worry too the guess information, thereby aiding recall of the correct much about giving students tests that are too difficult. Even if answer once it’s given. Yan’s team also found this explanation they keep getting the answers wrong, so long as they’re given wanting. Participants still benefited from the guessing effect the correct information afterwards, the act of guessing is even when the procedure was rigged so that half their guesses actually likely to assist their learning, not hinder it. CJ were right and half were wrong.

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Happy people think they’re good at empathising with the pain of others. They’re wrong In PLoS One Which of your friends – the happier, or the more melancholy – is better at spotting your excitement that Chris is attending your birthday, or that a B+ has left you disappointed?

Evidence suggests that more upbeat people consider themselves especially empathic, and it would be reasonable to believe them, given that they know more people on average, and tend to form deeper, more trusting relationships. The reality, however, is more complicated. New research led

by Yale’s Hillary Devlin suggests that cheerful people may think they’re high in empathy, but their confidence outstrips their ability.

Devlin assessed her 121 adult participants’ level of trait positive affect – essentially their average happy mood from day to day – and asked them how strong they were at empathising. Happier participants tended to believe they were better empathisers in general.

The researchers next studied videos of people giving a monologue about an autobiographical event. For each of the four videos (two positive events, two negative) participants rated, second-bysecond, the level of negative or positive emotion they thought the speaker was feeling.

Participants with a more upbeat personality believed their accuracy on this task to be higher than the others.

However, the speakers had conducted an identical rating process on their own videos,

and it turns out the happier participants were no closer to the true feelings than the more downbeat participants. In fact, happy participants found it harder to judge the emotional tone of a highly negative monologue, in which a participant described the death of a parent.

There was one ray of sunshine for the positive participants: they were marginally more accurate in the

two positive videos at spotting upward shifts in the speakers’ emotions, for example as their happiness intensified slightly.

This raises the possibility that upbeat people may be more sensitive to shifts in emotion that match their own disposition. But more generally, their high confidence in their own empathy appears unfounded, and they may struggle to drop down into the headspace of someone feeling very low.

In psychology research, measures of empathy are often based on participants’ assessments of themselves, so this new study suggests researchers need to be aware that such beliefs may not track reality. For the rest of us, it’s useful to know that you don’t need to be a Pollyanna to figure out how people are doing.

Sometimes, it’s the Eeyores of this world who are more understanding. AF

When Korea imposed a limit on working hours, did it make people happier?

In the Journal of Happiness Studies Across different professions, many people are familiar with the sense of having to deliver more with less, meaning clocking-off time falls later and later. One way to protect workers’ rights, and look after their well-being, is to introduce working hours restrictions. But a new paper by Korea University’s Robert Rudolf investigates the impact of such a reform, and its conclusions are disappointing.

Beginning its roll-out in 2004, the (South) Korean Five Day Working Reform was intended to manage the nation’s subservience to the office: employees there work some of the longest hours among the OECD countries – more than 50 per week on average.

Rudolf first investigated how working hours affect well-being within a dataset of roughly equal

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numbers of men and women, all married with children.

This group is likely to experience conflict between home and work life, and is a demographic targeted by the Reform. Over 50,000 data points were available, each representing a person in a given year between 2000 and 2008 – that is, either side of the introduction of the new government policy.

Overall, Rudolf found that workers disliked very high working hours: working longer was associated with less satisfaction with their job and with their life as a whole. (These and subsequent analyses control for income.) Nothing too surprising there. But a second analysis was restricted to changes in working hours that were the direct consequence of the Working Reform, and here

things become more illuminating.

Looking at the effects of imposed reductions in working hours helps reduce the complicating influence of other factors – for example, if people choose to downsize their hours to make space for a highly fulfilling new hobby, this could give an inflated impression of the value of shorter hours. The new data showed that although employees, especially women, reported a preference for their decreased hours, there was (for both genders) no significant effect on job satisfaction, and no

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hint of an improvement in life satisfaction. Unasked for drops in hours did not make people happier.

Clearly, individuals electing to reduce their hours are likely to reap well-being benefits, whether their aim is to ease the burden on their home responsibilities or release time to recuperate from working stressors. But this study suggests enforced reductions – in this case of about 10 per cent, an average of five hours – may not noticeably affect overall life satisfaction.

Why might this be? Rudolf points out previous evidence that in the short term, capping hours often just means employees have to get the same work done in a shorter time, which is likely to be stress-inducing. In other cases, the release of hours may have been insufficient to really impact home-life routines, as many working men and women were still clocking in between 40 to 50 hours. More radical solutions may be needed to qualitatively change our experience of work. AF

LINK FEAST The Best Optical Illusions to Bend Your Eyes and Blow Your Mind – In Pictures Highlights from the book Eye Benders: The Science of Seeing and Believing, which was recently awarded the Royal Society Young People’s book prize. tinyurl.com/nm9cfmj Major Brain Pathway Rediscovered Mo Costandi reports on new findings concerning a white-matter tract at the back of the brain. tinyurl.com/lvbp7tu I Nearly Died. So What?

Meghan Daum at the New York Times draws on her own experiences to challenge the fashionable idea that crises always impart lessons and bring out the best in people. tinyurl.com/lnoaa2x BBC Radio 4’s All in the Mind A recent episode tackled problem gambling, a new take on Milgram, plus the latest psychology research discussed by our own Research Digest Editor. tinyurl.com/ohhuqso Winter Is a Black Hole: How I Deal With Seasonal Depression ‘Seasonal depression hits for me, like clockwork, the day after Halloween’ – writes Dayner Evans at Gawker.com. tinyurl.com/l8laad7 Fooled by Your Own Brain Don’t be so certain your senses are telling you the truth, says Virginia Hughes at Nautilus. tinyurl.com/n9dz3k4

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When we get depressed, we lose our ability to go with our gut instincts In the British Journal of Clinical Psychology People who are depressed often complain that they find it difficult to make decisions. A new study provides an explanation. Carina Remmers and her colleagues tested 29 patients diagnosed with major depression and 27 healthy controls and they found that the people with depression had an impaired ability to go with their gut instincts, or what we might call intuition.

Intuition is not an easy skill to measure. The researchers’ approach was to present participants with triads of words (e.g. SALT DEEP FOAM) and the task was to decide in less than three and a half seconds whether the three words were linked in meaning by a fourth word (in this case the answer was ‘yes’ and the word was SEA).

Some triads were linked, others weren’t.

If the participants answered that the words were linked, they were given eight more seconds to provide the linking fourth word.

However, it was perfectly acceptable for them to say that they felt the words were linked, but that they didn't know how. Indeed, when this occurred, it was taken by the researchers as an instance of intuition – that is, ‘knowing without knowing how one knows’.

There were no differences between the depressed patients and controls in the number of times they provided the correct fourth, linking word, nor in the number times they provided no response at all. This suggests both groups were equally motivated and attentive to the task. But crucially, the depressed patients scored fewer correct intuitive answers (i.e. those times they stated correctly that the words were linked, but they didn't consciously know how).

Having poorer intuition on the task was associated with scoring higher on a measure of brooding (indicated by agreement with statements like ‘When I am sad, I think “Why do I have problems others don't have?”'), and in turn this association appeared to be explained by the fact that the brooding patients felt more miserable.

Remmers and her team said their study makes an important contribution – in fact, it’s the first time that intuition has been studied in people with major depression. The results are also consistent with past research involving healthy people that’s shown low mood encourages an analytical style of thought and inhibits a creative, more intuitive thinking style.

However, I couldn’t help doubting the realism of the measure of intuition used in this study. Is a judgement about word meanings really comparable to the gut decisions people have to make in their lives about jobs and relationships?

Two further questions that also remain outstanding are whether an impairment in intuitive thinking is a symptom or cause of depression; and is this intuition deficit specific to depression or will it be found in patients with other mental health problems? CJ The material in this section is taken from the Society’s Research Digest blog at www.researchdigest.org.uk/blog, and is written by its editor Dr Christian Jarrett and contributor Dr Alex Fradera. Visit the blog for full coverage including references and links, additional current reports, an archive, comment and more.

Subscribe to the fortnightly e-mail, friend, follow and more via www.bps.org.uk/digest

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Babies’ anxiety levels are related to their fathers’ nervousness, not their mothers’ In Developmental Science Picture a one-year-old infant crawling across a table top.

Half way across, the surface becomes transparent so that it appears there is a deep drop.

On the other side is the infant’s mother or father, encouraging them to crawl across the ‘visual cliff’. Will the baby's anxiety levels be influenced more by the mother’s own anxiety or the father’s?

This was the question posed by Eline Möller and her colleagues in what is the firstever study to examine paternal behaviour in the classic visual cliff paradigm. Taking part in the research were 40 mothers, 41 fathers, and their one-yearold infants. Only one parent participated at a time, so some infants crawled towards their father, others crawled towards their mother.

Surprisingly perhaps, mothers’ and fathers’ verbal and facial encouragement – examples included clapping, smiling and calling out ‘You’re doing great’ – made no difference to the infants’ anxiety levels and boldness (as measured by the baby’s body language, facial expressions, crying, and avoidance of the cliff).

What about the parents’ own anxiety as revealed in their gestures, posture, facial expressions and nervous exclamations such as ‘Be careful’? Here the researchers found that the anxiety of male and female infants was correlated with their father's anxiety, but not their mother's.

We can’t know the causal direction here – it’s possible that the infants were responding to their fathers’ (but not their mothers’) nervousness, or that the fathers (unlike mothers) were made nervous by their baby’s anxiety, or possibly both.

Either way, the result suggests that fathers may play a more significant part than mothers in the anxiety levels of their infants, at least in situations involving physical

DIGEST DIGESTED Full reports are available at www.bps.org.uk/digest

hazards. This is consistent with evolutionary-based claims that human fathers have tended to be more responsible for teaching their offspring how to deal with external challenges (such as strangers and new places), whereas mothers deal with ‘internal’ situations, such as feeding and comforting.

Such arguments are supported by research showing that fathers usually encourage more risk-taking and competition in their children than mothers.

Möller and her team also looked at the babies’ trait levels of nervousness and anxiety.

They found that among the babies who are anxious more generally (not specifically in the visual cliff situation), there was an even stronger link between infant and paternal anxiety. For infants with an anxious temperament, then, fatherly confidence seems to be especially important.

The study has some important limitations including the fact the people who coded the behaviour and body language of the babies and parents could clearly see the gender of the parent involved (this raises the possibility that the researchers’ prior assumptions about mothers and fathers may have influenced how they performed their coding). However, the coders were unaware of the study aims and hypotheses.

Limitations aside, research on the way fathers interact with their young children is rare and this study makes a novel contribution. It may also have clinical implications. The results suggest ‘anxious signals from the father can maintain or exacerbate fearful behaviour of the child, whereas with non-anxious and confident behaviour a father can teach his child that the world is safe,’ the researchers said.

‘In this sense, fathers can act as a buffer against child anxiety.’ CJ

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Bankers started behaving dishonestly in a coin-tossing game when they were reminded of their professional identity. The same effect wasn’t found when other professionals were primed about their own jobs, nor when students were prompted to think about banking. Nature Ed Diener and his colleagues in the US have compiled a list of the 200 most eminent psychologists based on research citations, awards and textbook mentions. Albert Bandura tops the list, followed by Jean Piaget and Daniel Kahneman. Archives of Scientific Psychology When our age ends in a 9 (such as 29, 39, 49, etc.) we are particularly prone to self-reflection. US researchers found that this can affect our behaviour in striking ways: first marathons, extramarital affairs and suicides were all found to be particularly high among ‘9-enders’. PNAS Lying to children of a certain age could encourage them to do the same. After a researcher lied to children about a bowl of sweets, those aged five and up more often lied about peeking at a toy. The same effect wasn’t found for three- and four-year-olds.

Developmental Science Loneliness is a disease that changes the brain’s structure and function, according to a review of human and animal research. One study found that lonely people are more likely to develop dementia; another with rats found that those kept in isolation had suppressed growth of new neurons.

Psychological Bulletin ‘Confidence intervals’ are often touted as a preferred way of reporting psychology results, but a new survey of students and researchers has found that they are widely misunderstood. Rink Hoekstra and his colleagues said this is indicative of a ‘serious problem in scientific practice’. Psychonomic Bulletin and Review Collective nostalgia inspires group loyalty. For example, after students reminisced with sentimentality about memories involving their fellow students, they showed more willingness to invest in a university publicity campaign. Journal of Personality and Social Psychology

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ARTICLE

The ‘street children’ of Latin America Graham Pluck with a story of challenge and survival for millions of young people worldwide ‘Street children’ live or work in the cities of many countries, particularly in low- and middleincome countries of Latin America, Africa and Asia. They are exposed to violence and abuse and are frequently exploited. Levels of substance abuse are typically very high, particularly glue sniffing.

On the other hand, many ‘street children’ demonstrate notable psychological resilience and adaptability. The necessity of their daily existence may even drive development of some cognitive functions, such that they outperform children from more conventional backgrounds.

questions

Dahlman, S., Bäckström, P., Bohlin, G. & Frans, Ö. (2013). Cognitive abilities of street children: Low-SES Bolivian boys with and without experience of living in the street. Child Neuropsychology, 19(5), 540–556. www.streetchildrenresources.org

references

resources

A

Who are ‘street children’ and why are they spending so much time unsupervised in the urban environment?

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What effect does being a ‘street child’ have on a young person’s emotional and cognitive development?

Amnesty International (2003). Rio de Janiero 200: Candelária and Vigário Geral 10 years on. London: Amnesty International.

Aptekar, L. (1989). Characteristics of the street children of Colombia. Child Abuse & Neglect, 13, 427–437.

Aptekar, L. (1991). Are Colombian street children neglected? Anthropology and Education Quarterly, 22, 326–349.

Ardila, R. (2004). La psicología

t traffic junctions all over Quito, Ecuador’s capital city, poor children sell fruit, newspapers or chewing gum to middle-class motorists in shiny 4x4s. If not selling, they may just hang around in the urban centres; some are gang members involved in petty crime and violence; others are working, for example shining shoes. Some, particularly those literally homeless and lacking support from families or aid agencies, are involved in the sex industry (Schlaefer, 2005).

This is a version of childhood hidden from most in the developed Western countries. But it is common in Latin America, and indeed in many low- and middle-income countries in Africa, Asia and Europe. The number of children living this way worldwide is effectively unknown. However, we can note that significant portions of the youth populations of some of the most populous countries in the world live or work unsupervised in the city streets… many, many millions of children.

As a British psychologist, living in South America and teaching and researching at one of its universities, I frequently see and interact with the niños de la calle (‘street children’). With an interest in the psychological issues of the region; and as a traveller, I’ve observed street children in most of the countries of Central and South America. In fact, the only Latin American country in the region in which they are notably absent is Cuba. This in itself shows that to consider the issue of ‘street children’ as purely an economic development issue is

latinoamericana: El primer medio siglo. Revista Interamericana de Psicologia, 38, 317–322.

Arnett, J.J. (2008). The neglected 95%: Why American psychology needs to become less American. American Psychologist, 63(7), 602–614.

Cruza-Guet, M.C., Spokane, A.R., LeónAndrade, C. & Borja, T. (2011).

Diversity, hegemony, poverty, and the emergence of counseling psychology

misleading. Cuba is one of the poorest countries in Latin America, yet manages to keep virtually all its children housed and is the most successful at keeping them out of the labour market. Clearly, a deeper understanding of the contexts that create the situations of streetconnectedness of children must take into account political, cultural, social and indeed psychological factors.

Psychological health challenges The lives of the so called ‘street children’ in Latin America and in other countries, cry out for attention from psychologists.

The levels of potentially psychologically toxic factors that such children are exposed to is shocking. One of the most common observations is precocious and pernicious substance abuse by streetconnected children.

The lives of ‘street children’ cry out for attention

in Ecuador. In L.H. Gerstein, P.P. Heppner, S. Aegisdottir & S.M.A. Leung (Eds.) Essentials of crosscultural counseling (pp.393–401).

London: Sage.

Dahlman, S., Bäckström, P., Bohlin, G. & Frans, Ö. (2013). Cognitive abilities of street children. Child Neuropsychology, 19(5), 540–556.

Henrich, J., Heine, S.J. & Norenzayan, A. (2010). The weirdest people in the

world? Behavioral and Brain Sciences, 33(2–3), 61–83; discussion 83–135.

Huang, C.C., Barreda, P., Mendoza, V. et al. (2004). A comparative analysis of abandoned street children and formerly abandoned street children in La Paz, Bolivia. Archives of Disease in Childhood, 89, 821–826.

Koller, S.H. & Hutz, C.S. (2001). Street children: Psychological perspectives.

In N.J. Smelser & P.B. Baltes (Eds.)

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In one study of 124 abandoned children (mean age 14) who lived and worked on the streets of La Paz, Bolivia, 58 per cent reported alcohol use, 40 per cent reported glue sniffing and 88 per cent reported the abuse of paint thinner (Huang et al., 2004). Similarly, in Ecuador, a study of homeless children who were in contact with neither families nor care agencies (also mean age 14) reported even higher levels: 98 per cent reported cocaine use and 98 per cent reported solvent abuse (Schlaefer, 2005).

In Medellin, Colombia, a study following DSM-IV criteria estimated that 58 per cent of the street connected children (mean age 15) they surveyed met criteria for substance dependence (Ricardo Ramírez et al., 2011).

In contrast to the numerous studies on substance misuse by street-connected youths in developing and middle-income countries, there are few methodologically rigorous studies of mental health. This is surprising considering the scale of the issue and the significant challenges to psychological well-being faced by many children living or working unsupervised in urban environments.

The problem appears to be that although anthropologists have seen the lives of homeless or streetworking children as worthy of study, few psychologists or psychiatrists have followed suit.

Consequently, the available academic literature is mainly ethnographic in nature.

These studies tend to suggest high levels of

International encyclopedia of the social & behavioral sciences. Oxford: Pergamon.

Muñoz-Echeverri, I.F., Noreña-Herrera, C., Londoño, B.E. & Rojas-Arbeláez, C.A. (2011). Morbilidad atendida y conductas de riesgo de la niñez y adolescencia en situación de calle de Medellín, 2008. Revista de Salud Pública, 13, 207–218.

Pacherres, M. (2003). Infancia y trabajo:

internalising and externalising behaviours.

A recent systematic review of the health of street children was able to identify only eight studies that had used diagnostic categories or validated measures of mental health (Woan et al., 2013). These suggested high levels of hopelessness, depression, self-harm and suicide among groups of street children in different parts of the world. The lack of formal measures of mental health is even more surprising considering the wealth of information available on exploitation and trauma experienced by children living and/or working in the urban environment.

A study of homeless and unprotected children in Ecuador documented very high levels of sexual abuse and exploitation (Schlaefer, 2005). Of her sample of 226 street youths (mean age 14), all lacking contact with family or aid agencies, all but one claimed to have experienced penetrative sex, and the mean age of first sexual intercourse was 8.6 for boys and 5.8 for girls. For both groups of children, 96 per cent reported experiencing forced sexual activity, and all said that they occasionally exchanged sex for money or drugs.

Similarly, in a study in Medellin, Colombia, involving street-connected children and adolescents aged 7 to seventeen, 84 per cent reported sexual activity. This included 79 per cent of those aged under 12 (Muñoz-Echeverri et al., 2011).

Needless to say, in addition to sexual exploitation, children who live or work on the streets are highly vulnerable to physical violence. A globally focused review by the charity ‘Consortium for Street Children’ suggested that not only are levels of violence experienced by street child populations very high, they are remarkably similar across the globe (Thomas de Benitez, 2007).

In the study in La Paz described above, the majority of children reported having been physically assaulted, by their peers, by family members or by the

Niñas y niños que trabajan en una zona urbana de Lima. In IFEJANT (Ed.) Infancia y adolescencia en América Latina (pp.173–188). Lima, Peru: Instituto de Formación Para Educadores de Jóvenes y Niños Trabadores de América Latina y el Caribe (IFEJANT).

Parks, R.W., Stevens, R.J. & Spence, S.A. (2007). A systematic review of cognition in homeless children and

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police. In fact, 90 per cent reported having been beaten with sticks by police officers (Huang et al., 2004). Indeed, violence against vulnerable children living or working in the streets meted out by members of government security forces or vigilante groups is a common theme in Latin American countries.

In Brazil numerous such reports exist.

The most notorious was the Candelária massacre of 1993, when, according to Amnesty International, a group of hooded and armed men attacked a group of 50 homeless children as they slept outside a church. Some died instantly from gunshot wounds, others were abducted and murdered elsewhere. The hooded men were later identified as military police officers (Amnesty International, 2003).

In our own interviews with former street-connected children, now attending an assistance and educational programme here in Ecuador, we have heard stories of extreme violence, of sexual assaults and of police brutality. Perhaps not surprisingly, over half of the children we have interviewed meet DSM criteria for post-traumatic stress disorder (Pluck et al., 2014).

This is the reality for many of the poorest and most vulnerable children in Latin America. A recent review of street child research globally noted that views of the public tend to polarise between viewing them on the one hand as being helpless victims of hunger and violence, and on the other hand as drug taking criminals lacking morality (Thomas de Benitez, 2011). It is when the latter perspective prevails that persecution ferments.

Adaption and survival So do street-connected children of Latin America show significant effects of mental ill health and trauma? Several writers have argued that many children in these situations show remarkable levels of adaptability and resilience. It has been noted that many children who choose to live on the streets in poor countries are

adolescents. Journal of the Royal Society of Medicine, 100(1), 46–50.

Pinzón-Rondón, A.M., Briceño-Ayala, L., Carlos Botero, J. et al. (2006).

Trabajo infantil ambulante en las capitales latinoamericanas. Salud Pública de México, 48, 363–372.

Pluck, G. (2013). Cognitive abilities of ‘street children’: A systematic review.

Chuo Journal of Policy Sciences and Cultural Studies, 21, 121–133.

Pluck, G., Banda-Cruz, D.R., AndradeGuimaraes, M.V., Ricaurte-Diaz, S. et al. (2014). Post-traumatic stress disorder and intellectual function of socioeconomically deprived ‘street children’ in Quito, Ecuador.

International Journal of Mental Health and Addiction (Advance online).

Pluck, G., Lee, K.H., David, R. et al.

(2012). Neuropsychological and cognitive performance of homeless

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‘street children’

doing so as an alternative to poverty and abuse in the family home. In fact, several studies report that when compared with poor children who do not leave home, the homeless children do not show raised levels of psychological distress (Koller & Hutz, 2001).

It is perhaps too easy to continuously focus on the negative, on the mental health, on the victimisation, on the substance abuse. It could be argued that many children working and surviving in the streets are showing real adaptive skills and initiative. For example, one study in Lima, Peru, found that child street workers gave a variety of reasons for working, from needing to buy food or clothes to wanting to help their parents, and although most reasons were basically economic, many said that they worked because they enjoyed it, to meet people or to expand their group of friends (Pacherres, 2003).

Furthermore, some authors have suggested that street life actually enhances development of children, as their experiences give them real and valid learning opportunities not available to conventionally schooled children. For example, Aptekar (1989) has suggested: ‘Street life, rather than taking away from cognitive growth, may actually add to it’ (p.43). In support of this he studied IQ scores in a group of 56 local authority detained boys in Cali, Colombia. All were involved with a street child programme and had had no family contact for at least three months (Aptekar, 1989, 1991).

From his studies, Aptekar concluded that ‘most street children were functioning adequately intellectually, neurologically, and emotionally’ (Aptekar, 1991, p.328). However, measuring IQ scores in low- and middle-income countries is often problematic, as locally validated and normed versions may not available.

In a recent systematic review of intellectual function of groups identified as street children across the world, only five reports could be identified, including Aptekar’s sample from Colombia (Pluck,

adults. Canadian Journal of Behavioural Science, 44, 9–15.

Ricardo Ramírez, C., Correa Arango, M., Velásquez Tirado, J.D. et al. (2011).

Características sociodemográficas y trastornos mentales en niños y adolescentes habitantes de la calle en un centro de atención social de Medellín, Colombia. Medicina UPB, 30, 21–29.

Saxe, G.B. (1988). The mathematics of

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2013). Overall, the pattern of intellectual function of street children samples in developing countries was equivalent to patterns observed amongst homeless children and adults in more developed countries; that is, performance about one standard deviation below the estimated population mean (Parks et al., 2007; Pluck et al., 2012).

Nevertheless, it could be that street experience, although not conducive to overall intellectual development, has particular positive influences on cognitive development, depending on the local context. There is evidence for this. Child street vendors in Brazil often work selling candies and the like on buses or street corners. To do this they must buy in bulk and calculate sale prices to maximise profits; in addition they have to quickly calculate total prices and change to be given to customers.

Although not attending school, their arithmetic abilities surpass those of non-working urban school-attending children or ruralDifferent street-connected children have very living children (Saxe, 1988). different lives So the studies of street vendor considered a test of divergent thinking mathematics suggest very specific and of imagination. That the homeless situational drivers of cognitive children performed better suggests that development. However, there is also some their life experiences had driven evidence of a more general improvement development of cognitive skills useful for in cognitive ability. In one study, 36 boys adaption and survival. Certainly, we can (mean age 14) who had spent at least six see why noticing alternative uses for months living on the streets of La Paz or objects might be a useful skill for its neighbouring city Al Alto, Bolivia, extremely poor street-living children. were compared with a similarly poor group (but without experience of street living) on a battery of cognitive tests.

It was found that the homeless group Strengths and weaknesses were not significantly impaired on any Psychologists and others working with or measures, and on one measure performed studying the lives of street children must significantly better than the comparison resist dual temptations – on the one hand sample (Dahlman et al., 2013). seeing everything as victimisation, Interestingly, this better performance demanding sympathy, and on the other was on the Alternative Uses Test, in hand romanticising their lifestyles. But which participants are asked to think of how can we reconcile these observations, multiple uses for common objects. This is of multiple and complex problems,

street child vendors. Child Development, 59, 1415–1425.

Schlaefer, K. (2005). Voices from the shadows.

Berkeley, CA: School of Public Health, Uni of California, Berkeley.

Swanson, K. (2010). Begging as a path to progress: Indigenous women and children and the struggle for Ecuador's urban spaces. Athens, GA: University of Georgia Press.

Thomas de Benitez, S. (2007). State of the

world's street children: Violence.

London: Consortium for Street Children.

Thomas de Benitez, S. (2011). State of the world's street children: Research.

London: Consortium for Street Children.

Woan, J., Lin, J. & Auerswald, C. (2013).

The health status of street children and youth in low- and middle-income countries. Journal of Adolescent Health, 53(3), 314–321.e12.

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exploitation, violence, trauma and drug abuse with notable strengths, resilience and adaptability? One of the reasons for this contrast is the inappropriate use of the term ‘street child’. It is simply used to categorise too many different life contexts under one convenient expression.

Firstly, it covers children who are literally homeless as well as those who spend many hours working in the streets, but do have a home to return to. A study of 972 child street workers in five Latin American cities (Bogotá, Guatemala City, Mexico City, Quito and San Salvador) reported that only 18 per cent were literally homeless (Pinzón-Rondón et al., 2006). However, in total 48 per cent would be considered ‘street children’ because they were working long hours in the street environment unsupervised by adults.

Although homeless and streetworking children in Latin America will frequently describe themselves as niños de la calle, it appears to be a label of convenience originated by outsiders.

Psychologists need to focus on more appropriately and narrowly focused groups, such as abandoned and homeless children, children in homeless families, street-side working children, and so on., rather than the overly inclusive category of ‘street children’. In some of these groups, but not others, we may observe

‘street children’

trauma, mental illness or stunted cognitive development, in others we may observe resistance, resilience or contextspecific cognitive development.

In this review I have tried to give additional context, such as living conditions and social connections, when describing the various samples reported in the literature. However, ‘street children’ remains the common parlance, partly because it is the expression most readily understood by the public, and that most used by charities, who rely on public attention.

Some researchers distinguish between children in the street (streetworking, with homes to go to) and children of the street (literally homeless).

This is somewhat better. Others prefer expressions such as ‘street-connectedness’ that carry the meaning without nominalising the individuals as somehow being part of the street.

The constant emphasis on the negative aspects of the lives of streetconnected young people, lumping them all together, is potentially stigmatising.

Not all street children take drugs, not all are involved with crime or prostitution.

Indeed many are very hard-working (the study by Pinzón-Rondón et al., 2006, reported that most child street workers in Latin American cities work more than 40 hours a week).

Different street-connected children have very different lives. The concept of the ‘street child’ lumps together, amongst many other lifestyles, the drug-using violent gang-members with children honestly working long hours, in highly polluted environments, to help their families survive the daily battle against extreme poverty. This is profoundly unfair. Indeed, research in Ecuador has suggested that many poor families, particularly indigenous Americans, see street begging or street working by children in a positive light, where they learn financial skills and contribute to their community (Swanson, 2010).

Final comments The lives of poor children in Latin American and other low- and middleincome countries often differ markedly from many of those in the richer, more developed countries. In a globalised 21st century, psychologists must stop focusing solely on their local contexts and consider the psychological lives of adults and children around the world. It is not enough for the study of child development in poor countries to be left to the psychologists in those countries.

Psychologists in Britain and other

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developed countries have a responsibility to study the psychology of people as it is, globally, and to develop collaborations with psychologists and clinicians across geopolitical boundaries. In the past, psychological research has been shockingly biased towards inclusion of participants from rich, developed countries, people who are effectively minorities on this planet. Recent research suggests that such participants are notably unrepresentative of humans in general (Henrich et al., 2010).

Interactions between psychologists in the industrialised-developed countries and those in less developed low- and middle-income countries could benefit from the synergy of fresh approaches.

For example, the majority of published psychological research originates in the USA or other English-speaking countries, with only a tiny proportion from Latin America (Arnett, 2008).

However, in Latin America there has traditionally been an emphasis on applied (as opposed to investigative) psychology, where strengths have developed in psychotherapy (Ardila, 2004; Cruza-Guet et al., 2011). Furthermore, research in poorer countries, such as many of those in Latin America, can present opportunities for study and learning not available or not easily accessible in the developed, industrialised West.

The lives of street children is but one example. Related issues are the effects of poverty in general, in countries where the poverty can be extreme and the gap between rich and poor is huge. The effects of formal education on cognitive and brain development can be studied, where there are populations of children with or without access to schooling.

The millions of poor children of Latin America and other countries suffer many problems and challenges. As academia globalises, there are opportunities for psychologists in the developed, industrialised countries to research, propose interventions and raise awareness of problems faced by low- and middleincome countries. This could help, if only a little, to bring the millions of streetworking and homeless children of the world out of the shadows and receive the attention that they deserve.

Graham Pluck is at Universidad San Francisco de Quito, Ecuador gpluck@usfq.edu.ec

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HEAD TO HEAD

Understandings of mental illness – mired in the past?

Are psychological conceptions stuck in the 20th century?

John Cromby thinks so: Vaughan Bell disagrees.

the available textbooks in this field. The majority have the term ‘abnormal’ in the title, and their chapters are structured around the diagnostic categories of the DSM or ICD. This is in part because the psychiatric idea of distress as diseases with primary biological causes also dominates the research. Calton et al.

(2009) found that of 10,000 papers at major international conferences on schizophrenia 75 per cent were predominantly biological in their orientation, whereas less than 5 per cent took a predominantly psychosocial stance and less than 2 per cent included any overt consideration of actual experiences of distress.

All this would be understandable if there were good evidence that the illness model is correct, but in respect of the functional psychiatric diagnoses – those that comprise the vast majority, schizophrenia, depression, anxiety disorder, eating disorders, personality disorders, and so on – this is simply not the case. There is, of course, good evidence for biological causation in relation to the organic diagnoses – the dementias, intellectual impairment, Huntington’s disease, Korsakoff’s syndrome, syphilis, and so on; however, in relation to the functional diagnoses this evidence is lacking.

We are at once personal, social and biological beings All knowledge is shaped by its past: psychological understandings are no exception. But ‘mired’ suggests a negative shaping, a constraining or unhelpful trajectory. I would argue that the tendency to still conceive of psychological distress as Dr John mental illness, as diseases Cromby is at with primarily biological Loughborough causes, is indeed constraining University and unhelpful.

The prominence of this tendency in psychology is illustrated by

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Calton, T., Cheetham, A., D'Silva, K. & Glazebrook, C. (2009). International schizophrenia research and the concept of patient-centredness – an analysis over two decades.

International Journal of Social Psychiatry, 55(2), 157–169.

Cromby, J., Harper, D. & Reavey, P. (2013).

Psychology, mental health and distress.

London: Palgrave.

Department of Health (2003).

Mainstreaming gender and women's mental health: Implementation guidance. Retrieved 11 August 2011, from www.dh.gov.uk/en/Publications andstatistics/Publications/Publication sPolicyAndGuidance/DH_4072067 Gazzaniga, M.S. (2000). The mind’s past.

Berkeley, CA: University of California Press.

Harré, R. (2002). Cognitive science: A philosophical introduction. London:

More than a century of extremely well-funded research using increasingly sophisticated technologies has failed to consistently demonstrate that any biological disease or impairment is the cause of any one of these presumed illnesses.

In other words this research has failed to establish that these experiences are illnesses – rather than acquired, and frequently meaningful, responses to circumstances and life events. And this, of course, is why diagnosis is still dependent upon interviews, observations and history taking. There are no objective tests such as we see in physical medicine, simply because no biological impairment has ever been consistently identified in relation to any of these diagnoses. Despite this, some psychologists cling to illness models of the experiences associated with these diagnoses, even though doing so impedes the development of consistently psychological explanations and plays down other relevant bodies of evidence.

In this sense, understandings are mired in the past.

John, I admire your compassion, but I’m struck by the distinction you make between people who have difficulties associated with clear biological differences that are detectable Dr Vaughan through medical tests Bell is at (what you call an University ‘illness’ – although College this is not a definition London of illness I recognise) and people with ‘acquired, and frequently meaningful, responses to circumstances and life events’. This strikes me, I have to say, as an unhelpful false dichotomy. Let’s take a patient with epilepsy who develops seizures after being attacked and brain-injured in the street and now hears music from his childhood whenever a generalised seizure is about to occur. The patient

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King, M., Coker, E., Leavey, A. et al.

(1994). Incidence of psychotic illness in London: Comparison of ethnic groups. British Medical Journal, 309, 1115–1119.

Lee, S. (2001). Fat phobia in anorexia: Whose obsession is it? In M. Nasser, M.A. Katzman & R A. Gordon (Eds.) Eating disorders and cultures in transition. London: Routledge.

Melzer, D., Fryers, T. & Jenkins, R. (2004).

Social inequalities and the distribution of the common mental disorders. Hove: Psychology Press.

Newton, T. (2007). Nature and sociology.

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Read, J., Fosse, R., Moskowitz, A. & Perry, B. (2014). The traumagenic neurodevelopmental model of psychosis revisited. Neuropsychiatry, 4(1), 65–79.

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Gazzaniga (2000), we even have a left arrives in the clinic anxious, depressed hemisphere system specialised for this. and having difficulty adapting to their Likewise, your response assumes that new circumstances. Which part of this I am saying that biology is irrelevant to don’t you find meaningful? Every distress: this is also wrong. Biology response to the attack, from the continuously enables all experiences, development of seizures, to the hearing including experiences of distress. of childhood music, to the worries about So of course the person with epilepsy the future, is perfectly meaningful when whom you describe will find meaning in we consider the person as a whole and their experiences. And of course these not just a disembodied mind. meanings will be enabled by their biology, In fact, there are biological causes in shaped by their culture, and reflective of everything we do and experience. The their individual trajectory of social fact that we can’t adequately explain them relations. More specifically, in this does not make biology suddenly neurological example EEG or MRI irrelevant. Your exact same argument examinations could identify neural applies to social factors, of course, but features or patterns associated with the I don’t see you arguing that we should person’s seizures. However, the lack of ignore the role of society because we don’t consistent biological have a perfect theory of evidence means that human interaction. If this kind of objective you’re arguing that social “the primary causes of testing is not possible factors are important distress are, in fact, not for any of the because we have solid simply biological at all” functional psychiatric evidence that they play a diagnoses. Your role, then I’m afraid response makes the biology cannot be excluded further assumption that by highlighting either. We are at once personal, social this I am naively separating biological and biological beings. All are important, and social factors, but that is not correct whether you call someone’s problems either. distress, illness or a problem of living.

For me, the best part of your response These concepts are tools and none is the is your proclamation of ‘death to the final answer. If we’re stuck in the 20th ideology of explanations’. Nevertheless, century it is because people persist in we must tread cautiously when making seeing different levels of explanation as such assertions. All psychological research mutually exclusive. Death to the ideology necessarily presumes some notion of of explanations! All are tools, to be forged persons and their worlds. It is therefore by evidence, and used in the service of a always entangled with values, ethics, common humanity. morals and – ultimately – ideology. We must also be mindful that the conceptual Vaughan, there are various and methodological development needed assumptions embedded in to produce research of the kind you call your response. It may help for has, for the most part, simply not to make some of them been conducted (Rose 1997; Newton, explicit. Your response 2007). assumes I would deny With these caveats always in mind meaning to a person then, yes, let’s challenge the taken-forexperiencing epilepsy: this is granted distinctions – the dualisms – wrong. Both theory and evidence suggest between biology and culture, individual it is part of our species-nature to be and social, and so on. But let us also meaning creators who use cultural distinguish the truism that biology enables resources to narrate our experiences. psychological distress from the According to the neuroscientist

Read, J., van Os, J., Morrison, A.P. & Ross, C.A. (2005). Childhood trauma, psychosis and schizophrenia: A literature review with theoretical and clinical implications. Acta Psychiatrica Scandinavica, 112, 330–350.

Rose, S. (1997). Lifelines: Life beyond the gene. Oxford: Oxford University Press.

Tienari, P. (1991). Interaction between genetic vulnerability and family environment: The Finnish adoptive family study of schizophrenia. Acta Psychiatrica Scandinavica, 84(5), 460–465.

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unsubstantiated belief that biological impairments cause it. Let us recognise that we do not have to accept psychiatric concepts of mental illness in order to include biology in our understandings.

And let us recognise the robust evidence that the primary causes of psychological distress are, in fact, not simply biological at all.

Many thanks for a thoughtful reply, John, but I can’t help being struck by your seeming to have quite a narrow view of causality.

If we accept that we are biological, we must accept that biology is causal. If we are psychological beings, we must accept that psychology is causal. Both of these are true at the same time. There is no one causality that necessarily trumps the others, just theories about causes, at different levels of explanation, some of which are better supported by evidence than others.

You rightly note that different theories of causality are culturally entangled with values and ideology, but it seems to me that by suggesting that biology plays no causal role, rejecting the laws of physics in the process I note, you are as much a slave to those values and ideology as the person who argues only biology ‘matters’.

As to your distinction between biology ‘causing’ and ‘enabling’ distress, I’m afraid I’m lost as to how this makes sense either philosophically or scientifically.

But here’s where I do agree with you.

When you say ‘we do not have to accept psychiatric concepts of mental illness in order to include biology in our understandings’ I wholeheartedly agree.

Let’s sidestep the argument over what might be considered ‘psychiatric’ (dear old Foucault, of course, would have us psychologists well within the psychiatric power structure) and just say that one does not have to work within a medical framework to successfully work with people to overcome their distress or impairment.

These frameworks are tools, however, and to suggest that certain approaches are necessarily more compassionate than others entirely misses the point. Just as some people object to their psychological distress being medicalised, others object to their problems being ‘psychologicalised’. Is it our job to persuade people of our own prejudices?

Or to inform them of how each can be a tool for progress? If our responsibility lies anywhere, it is to highlight how social and psychological approaches are underemphasised while simultaneously

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encouraging an integrated view of human existence. A 21st-century psychology should drop the incoherent battles over the false dichotomies of the mind when the issue is one of understanding people in all their rich complexity.

So it seems we agree that the idea of mental illnesses with primary biological causes is unhelpful. We also agree that more attention should be paid to social and psychological influences. But we disagree, somehow, about causality.

The distinction between enabling and causing comes from Harré (2002). Simply put, we all have dreams, desires, wishes and hopes.

We all experience pains and frustrations when these are challenged or blocked. All of these experiences – all the dreams and desires, all the pains and frustrations – are made possible or enabled by biology. But this does not Biological features are only associated with distress when their bearers occupy toxic environments mean that they are simply caused by just like you won’t find unemployment is good evidence for various other causal biology. Their causes are vastly more inside a person, but claiming they are influences – but they all seem to operate complex, and in many respects not not part of the causal chain defies reason probabilistically and contingently, in simply biological at all. Nothing here and leads us into dualism. complex and sometimes synergistic breaches the laws of physics.

I sense that a great deal of your interactions.

In our recent textbook on distress misplaced objection relates to diagnosing Such an account of causality is needed (Cromby et al., 2013) my co-authors ‘mental illnesses’ which you seem to precisely because distress is not illness. and I used Harré’s distinction between arbitrarily distinguish from ‘biological It is, instead, a set of variable, fluctuating enabling and causing. In the chapter illnesses’ – based, entirely it seems, on and heterogeneous psychological on causal influences we characterised what methods we use to diagnose them. experiences. These experiences are causality in distress as multiple, complex, But this argument is not an attempt to biologically enabled and culturally shaped over-determined, neither necessary nor address human nature – it’s just pointing (e.g. Lee, 2001). They are simultaneously sufficient, probabilistic, contingent and at whatever we cannot diagnose thoroughly bound up with social and (sometimes) synergistic. biomedically and saying, somewhat material circumstances, power relations This notion of causality is necessary bombastically, ‘See! No biology there!’

(Foucault was right!), personal because, although biology remains The goalposts shift, of course, every time biographies, relationships, and life influential, there is no consistent evidence science makes a new discovery; but more events. for causal biological impairments, than that, I find it a naive approach to diseases or diatheses (as in the diathesisunderstanding ourselves that misdirects I’m afraid, John, you’ve stress model). It is necessary because us from genuinely important debates lost me. I entirely agree there is good evidence that social about the validity of diagnoses as tools for with what you say about inequality causes distress (Melzer et al., directing treatment and the role of the under-appreciated social 2004) – albeit that most people in poverty medically sanctioned classification as an factors that can promote, do not experience distress. There is good agent of social power – both of which enhance and cause distress, evidence that trauma, abuse and neglect have important implications for the but the fact you think these cause distress (Read et al., 2005) – humane care of people who are are in competition with although most people abused as children experiencing distress. biological accounts seems to be an do not receive diagnoses. There is good When you talk about how poverty, ideological position rather than coherent evidence that distress is more common marginalisation, abuse and neglect are argument. To say biology has no causal amongst women (Department of Health, under-emphasised in debates about role in distress is like saying humans 2003) – although most women do not mental health, I’ll be shoulder-to-shoulder have no causal role in unemployment. receive diagnoses. There is good evidence with you. But when you try and justify Just because you’re trying to explain that black people in the UK are more this by reality-stretching accounts of a higher-level concept you don’t get to likely than white people to be given a causality and critiques based on strawignore the components of the system diagnosis of schizophrenia (King et al., man definitions of illness, I can only if you want to understand how it works.

1994) – even though most will never be think you’re undermining these laudable You won’t find distress inside a neuron, given this diagnosis. And likewise, there

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head to head

aims. So here’s what I propose for the 21st century: a tools-based approach to mental health resting on sound philosophy and nuanced empiricism with compassion and respect as its highest ideals. Join me on the barricades, John, we need good people.

The evidence suggests that biological illnesses are not the primary causes of distress. I have acknowledged that biology nevertheless remains influential. So we need sophisticated accounts of biological influence that go beyond commonsense assumptions. Consider (1) general traits (2) general biological capacities and (3) concepts of biological difference.

First, general traits: in the adoption study by Tienari (1991), children born to parents given diagnoses of schizophrenia were only themselves at increased risk of diagnosis if the adoptive home was dysfunctional. Tienari hypothesised that what these children inherited was not a genetic predisposition for schizophrenia, but a general tendency to be more sensitive and reactive to others. This trait – which might make its bearers better lovers, parents or colleagues – had adverse consequences only when those carrying it were placed in toxic environments, because the effects of those environments were then felt more keenly.

Second, general biological capacities – for example, Gazzaniga’s (2000) putative left-hemisphere system – can get adversely socialised (by social inequality, abuse, racial prejudice, etc.) to produce the intrusive voice-hearing associated with psychotic-spectrum diagnoses.

Research has begun detailing the specificities of these interacting social, material and relational forces and capacities.

Third, Read and colleagues (2014) traumagenic neurodevelopmental model compares the neural consequences of child abuse with the brain features sometimes observed amongst people given psychotic spectrum diagnoses. It reconceptualises the biological differences seen in some people with these diagnoses as injuries, not illnesses.

A simplistic account of these examples might erroneously posit biological causes. A sophisticated, ethically sensitive account recognises that these biological features are only associated with distress when their bearers occupy toxic environments. This account identifies those environments as the causes of distress, and the biological

features as enabling, mediating, or even (as in the third example) being produced by them.

Despite more than a century of research, the illness model of distress is unproven. Despite the ideological bias toward biological causes, good evidence for social and psychological causation has emerged. Some biological influences have been identified (the above are not the only examples) and clinical psychological techniques that do not presume biological illness have been developed. Biology does not simply cause distress – it enables it.

Time, now, to leave the mire.

What you describe in your first example, is called a gene–environment interaction, and it is the mainstay of modern genetics. In this case, you think you’re arguing against the orthodoxy, but you’re actually arguing for it. This is a good thing, because it’s a well-supported foundation for understanding human nature. Your second example sounds like the ghost of Julian Jaynes (who sounds like he owes an apology to Michael Gazzaniga), and the third example like a reasonable attempt to highlight the under-appreciated effects of trauma while incorrectly suggesting that this fully explains any biological differences found between people with psychosis and people without. Psychosis is sometimes compared to fever (not a medical illness, you might be interested to know) because it seems to be a common result of what happens when lots of things start working unpredictably through various pressures on their functioning. In the case of

psychosis, these pressures can be trauma, a history of child abuse, drugs, brain injury, neural instability (like epilepsy) and our susceptibility to these differs, in part, due to genetics and prenatal development. Call it what you will – psychological distress, illness, disorder, revelation – but let’s not blinker ourselves to inconvenient evidence.

I think, however, you reveal both your humanity, and the source of your misunderstanding, when you say you are arguing for an ‘ethically sensitive account’ of human nature. If I might say, John, one thing I have been impressed by during our exchange is how you have consistently championed a compassionate approach to human suffering. But ethics relates to how we apply knowledge, not the knowledge itself. To say that some sorts of knowledge are ‘ethical’ is a category error and there is no ‘ethically correct’ theory of human nature, only those that are better supported by evidence than others. Ethics enters the picture when we attempt to translate our understanding into action.

Compassion lies not in our tools, but in our actions and objectives.

Theories, evidence, science, humanities, fMRI, grounded theory, blood tests, twin studies, art, matrix algebra, clinical experience, neuropsychological tests, statistics, lived and shared experience, are all tools – ways for us to understand ourselves – for which humanity should be our common aim. This is the 21st century in which I want to live, and in which I hope we can work together to alleviate distress and disability. j.cromby@lboro.ac.uk vaughan.bell@ucl.ac.uk

Let the debate continue To share your views on this topic, e-mail your letters to psychologist@bps.org.uk or go to our new website – http://thepsychologist.bps.org.uk – to comment at the bottom of this debate.

Each month, on the inside front cover of this publication, we state that The Psychologist ‘provides a forum for communication, discussion and controversy among all members of the Society’. But does it?

Yes, we have our ‘Letters’ pages each month, and the occasional ‘Opinion’ piece (all collected on our new website at http://thepsychologist.bps.org.uk/debates). But the ‘head to head’ debate you have just read is our first for more than 12 years. And it’s not for want of trying… during that time I have repeatedly invited psychologists and non-psychologists, members and non-members, to take each other on in print. People don’t seem to like doing it, so credit to John and Vaughan for agreeing to this one.

However, readers have often asked me for more debate in the publication, arguing that the discipline moves on through the airing of genuine controversy in such a prestigious and prominent forum. So get in touch, or engage on Twitter @psychmag – let’s have your suggestions for topics and participants.

Dr Jon Sutton (Managing Editor)

read discuss contribute at www.thepsychologist.org.uk

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Annual Conference 2015 5-7 May / ACC, Liverpool Programme available Our programme timetable is now available to download Registration is open – earlybird rates are available until 17 March Book your place at www.bps.org.uk/AC2015 Our 2015 conference dinner is taking place on Wednesday 6 May at the Rum Warehouse, located in the heart of Liverpool’s docklands.

The dinner is £40 to book or is included in the residential package. The dinner includes a three course meal, drinks and live music.

Take part in the conference by presenting a poster – the deadline for submitting is 7 January

#bpsconf www.bps.org.uk/ac2015 ‘big picture’ pull-out www.thepsychologist.org.uk

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BIG PICTURE

More information at: www.chila-kumari-burman.co.uk www.socresonline.org.uk/18/3/1.html www.uel.ac.uk/cnr

Can images provide us with different understandings of lives than the verbal stories we tell? In 2010 Corinne Squire, Cigdem Esin and Leverhulme Artist-in-Residence Chila Burman, at the Centre for Narrative Research, University of East London, investigated this question. Using a variety of materials, Burman helped participants make life-sized ‘visual autobiographies’. Squire and Esin interviewed them about the process, and Burman curated an exhibition of their work at a local gallery. Throughout, field notes were made, to create ‘activity narratives’ of participants’ involvement.

Participants’ images demonstrated many resources that did not appear in the interviews: for instance, children’s international connections, and migrants’ knowledge of visual traditions from their regions of origin. In addition, participants’ stories seemed only partly determined by socio-economic status. Students’ stories showed a wide range of cultural involvement, and children shared many visual cultural references across socio-economic status.

The research process also allowed for change.

One young man followed his postcode-dominated visual autobiography with an interview story of moving away and educating himself. And an older woman used the entire research process to redefine herself as an ‘artist’.

Project members are continuing with this method of work, in particular, investigating young women’s visual identity constructions (Esin), and resource mapping (Squire).

Photo and artwork by Cigdem Esin, from a project led by Esin, Corinne Squire, and Chila Burman. ‘Big picture’ ideas? jon.sutton@bps.org.uk.

‘You are here’

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INTERVIEW

Healthy disclosure Daryl O’Connor talks to Gail Kinman about being a twin, stress and health, and the influence of conscientiousness

understand that psychology was not your first career choice.

ICorrect.

I originally studied town and country planning but quickly got interested in psychology. The main driver was that I am an identical twin. In fact, I am a ‘mirror’ twin, where the egg split sometime between week one and two after fertilisation. Mirror twins have opposite features: Rory (my twin) is right handed and I’m left handed. Anyway, the classes I started taking in introductory psychology focused heavily on twin studies and, as a twin myself, I was intrigued and excited by their implications. Rory and I were together constantly (in a good way!) until we were 18 and then we were separated when we went off to university in different parts of the UK. However, things turned full circle when we both decided to pursue a career in psychology, as it felt like we became twins again. Rory is now Professor of Psychology at Glasgow University and I am Professor of Psychology at Leeds.

There are very many different perspectives in psychology yet you and Rory both ended up specialising in health psychology. How much was this a reflection of your twin status?

It was completely coincidental. Tom Cox inspired my interest in health psychology.

When I was doing my undergraduate degree at Liverpool, one of the core health psychology texts was Tom’s seminal book on stress. After my degree, I was lucky enough to work for him as a research assistant for the summer. After that, I did my PhD which explored the effects of stress and the psychosocial work environment on psychological and physiological outcomes in general practitioners. Next I was awarded a World Health Organization funded postdoctoral position looking at the effects of testosterone on behaviour, cognition and sexual function in men, but I continued to be interested in stress and health. Rory became interested in depression and suicide and went down that route, albeit

40

conceptualising suicide as a ‘health’ behaviour and drawing upon theories and constructs from health psychology. Since 1999, we have published many papers together on various topics of common interest, but also have our own professional identities. Rory and I work well together – your twin can be your best critic and say things that other people couldn’t get away with!

You are particularly well known for your work on stress, health and individual differences. Why are some people more vulnerable to the negative effects of stress than others?

This question has fundamentally driven my career. Virtually every paper I have published has examined the role of some form of individual difference in predicting health and/or disease, whether it is eating style, cortisol reactivity to stress, the cortisol awakening response or, most recently, trait rumination and perseverative cognition.

I am particularly fascinated by the role of personality; Howard Friedman’s research on the implications of conscientiousness for health and longevity has been a great influence on me. After controlling for many confounding variables, Friedman found that conscientiousness measured in childhood (in 1921) predicted survival 60 years later.

What was even more impressive was the magnitude of this effect was comparable to the influence of cholesterol and blood pressure levels in adulthood.

Many subsequent studies have highlighted the health benefits of conscientiousness, but I am interested in exploring why conscientiousness is so protective of well-being. Health behaviours clearly have an important role to play, in that conscientious children are less likely to become heavy drinkers and smokers or excessive consumers of junk food.

Nonetheless, health behaviours alone do not account for the health benefits of conscientiousness. My particular interest lies in the role played by stress. Do

conscientious people respond differently to stress? Do they tend to engage in less unhealthy behaviour when responding to stress? Does conscientiousness moderate the relationship between stress and illness? We have found evidence for all three of these mechanisms.

Individual difference constructs such as conscientiousness can be notoriously difficult to measure validly and reliably. Some are very transparent, which is a problem when a trait is socially desirable. Have measures improved?

Yes, we are realising that conscientiousness should be examined, not as a global construct, but at the facet level. Brent Roberts at the University of Illinois has done some ground-breaking research on the lower-order structure of conscientiousness which has revealed at least five replicable facets: orderliness, self-control, industriousness, responsibility and traditionalism. Other facets (such as decisiveness, punctuality and virtue) are currently under investigation. Looking at conscientiousness at the facet level has yielded very interesting findings. My own research has found that some facets have proactive effects (promoting positive health behaviours), whereas others can have inhibitory effects (encouraging negative health behaviours). Our recent work has also confirmed our earlier findings demonstrating that conscientiousness and its facets do indeed moderate the effects of daily stressors on stress-related outcomes. It seems that order, industriousness and responsibility may be most important in terms of stress.

We also have very exciting emerging evidence indicating that individuals who are high and low in conscientious appraise stressful events differently.

You have also found that perfectionism can be a risk factor for health. Does this also benefit from a facet-level approach?

Perfectionism is a strong vulnerability factor for stress and many negative health outcomes such as depression, anorexia and suicide. For a perfectionist, a stressful encounter is typically seen as an opportunity to fail. We have found that perfectionists respond to stress with more negative health behaviours than people who are less perfectionistic. As with conscientiousness, perfectionism has been shown to be multifaceted. Most people tend to see perfectionists as having excessively high standards for themselves, but ‘socially prescribed’ perfectionists believe that other people have excessively

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high expectations of them – and they will only be valued if they live up to these expectations. Self-oriented perfectionism is sometimes seen as adaptive, but there is a difference between the desire to excel and the need to be perfect. Rory and I have found that both self-oriented and socially prescribed perfectionism are risk factors for well-being, but the latter is more consistently damaging for health over the long term.

Individual differences in emotional expressivity also feature heavily in your work. How does this relate to health and disease?

Alexithymics have difficulty in identifying and expressing their own emotions and appreciating those of others. It is a risk factor for a wide range of mental and physical disorders, including depression, social phobia, asthma and hypertension.

There is evidence that alexithymics may engage in negative health behaviours, such as binge eating and substance abuse, as a way of discharging tension arising from unpleasant emotional states that are not consciously appraised. It is a difficult disorder to manage, as alexithymics do not respond well to psychological therapies.

For several years now, I have been looking at the advantages of written emotional disclosure for health. The extraordinary and wide-ranging benefits of emotional writing for well-being were first highlighted by Pennebaker in the 1980s, and there is now little doubt that the technique can improve health and certain health behaviours. It seems, however, that it only works for some people for some of the time. We have been trying to find out who will find written emotional disclosure most beneficial and the circumstances in which

Professor Daryl O’Connor is in the School of Psychology, University of Leeds d.b.oconnor@leeds.ac.uk

it is most effective. It might be assumed that emotional writing would help alexithymics engage with their emotions and therefore enhance their well-being.

Nonetheless, our research findings indicate that the technique tends to be generally ineffective for these people, as alexithymics do not have the insight or emotional vocabulary to meaningfully engage with the task.

So how does written emotional disclosure work? Why is it so beneficial?

It is likely to work differently for every single person who uses it. There are many possible mechanisms to explain the observed health gains, such as emotional self-regulation, habituation, catharsis and meaning-making. Disclosing emotional reactions in writing could also be a proxy for social support, which would benefit people who are unable or unwilling to disclose their feelings to others. I think exposure therapy is the most likely explanation – written emotional disclosure works because people spend a lot of time and psychological resources trying to repress traumatic memories, thoughts and feelings. Through the writing task, people are encouraged to reflect on these feelings, learn from them and slowly extinguish them. This then frees up cognitive, psychological and behavioural resources.

Written emotional disclosure has been found to have many benefits for people with chronic health problems, but it may have particular promise for people with serious illnesses such as cancer. A key benefit may be via self-affirmation, where people focus on positive outcomes of their cancer experience; for example, ‘Having cancer has made me realise that I have a great marriage, good friends etc.’ or they may have re-evaluated the importance of work in their lives and focused more on family.

Sharing personal experiences of trauma and illness via blogs, Facebook and Twitter has become much more common. Might the benefits of guided emotional writing decrease as people are more likely to disclose such feelings publicly anyway?

Good question. I think more research is needed to explore this and the implications of social media for other key health issues. People commonly post their health behaviour goals on Twitter and Facebook – this then brings one’s intentions into the public domain. How this then impacts on health behaviour change and maintenance is as yet unknown, but ought to be carefully evaluated. For

read discuss contribute at www.thepsychologist.org.uk

instance, it would be interesting to explore whether behavioural intentions declared on social media are stronger, more stable and better formulated than privately formulated intentions and the implications of success and failure.

You have recently published a paper with Suzanne Segerstrom that issues four challenges for stress research that have the potential to lead to major advances in the field of health psychology. What are they?

The first relates to the need to review and refine the way stress is defined and measured. Stress has been conceptualised as a stimulus, an outcome and a transaction – it can be located in the environment, in physiological and psychological response, and in individual appraisal. Careful conceptualisation and assessment can differentiate among these locales, as well as reveal interactions amongst them. Second, coping is one of the most modelled constructs within health psychology, but more insight is required into coping as a transaction between the person and the stress. In other words, which coping styles and strategies moderate the effects of stress under which conditions? Third, more knowledge is needed about the effects of stress over the lifespan – there is a wealth of data that is publicly available to track these effects over time and detect differences within and between subjects.

Finally, most published research on stress and health tends to be cross-sectional, and more innovative techniques and technologies are needed. Daily diaries, ecological momentary assessments and multilevel modelling techniques have particular potential in capturing the cascading effects of stressful events.

To conclude, if you could choose one individual difference construct that has the potential to enhance knowledge of stress and health what would it be?

Tricky… I don’t think one particular individual difference construct holds the key to enhancing knowledge in the stress and health area. However, I’d go with conscientiousness (and its facets) due to its sheer power in predicting health and longevity. Two recent large-scale, longitudinal studies showed that conscientiousness was the only personality factor to predict all-cause mortality and brain ageing. That said, related constructs such as self-control and executive control function have emerged as incredibly important individual difference variables. Ignore the role of personality and individual differences at your peril.

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LOOKING BACK

The line between conformity and resistance Jolanda Jetten and Matthew J. Hornsey take another look at Solomon Asch’s famous line-judgement studies

Whenever you find yourself on the side of the majority, it is time to pause and reflect.

Mark Twain The individual has always had to struggle to keep from being overwhelmed by the tribe. If you try it, you will be lonely often, and sometimes frightened. But no price is too high to pay for the privilege of owning yourself.

Friedrich Nietzsche

n most Western cultures, there is a prevalent notion that one should stand strong in the face of pressures to conform. Doing so is seen as an act of courage and personal strength, while going along with the majority is considered a sign of weakness – what cowards and weak-willed people do.

Indeed, as the above two quotes indicate, some novelists and philosophers have argued that we should worry if we find ourselves in the majority: by definition, being truly in charge of one’s own destiny means standing clear from the crowd.

Perhaps there is so much admiration for those who are able to resist conformity precisely because it is so difficult not to go along with the crowd. At least, this is the message that comes across from classic social psychological theorising. The socalled ‘line-experiment studies’ by Solomon Asch have been particularly important in demonstrating the power of conformity in a group. These studies have

references

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Asch, S.E. (1952). Social psychology.

Englewood Cliffs, NJ. Prentice-Hall.

Asch, S.E. (1955). Opinions and social pressure. Scientific American, 193, 31–35.

Hornsey, M.J., Majkut, L., Terry, D.J. & McKimmie, B.M. (2003). On being loud and proud: Non-conformity and counterconformity to group norms. British Journal of Social Psychology, 42, 319–335.

Jetten, J. & Hornsey, M.J. (2012). Conformity: Beyond the Asch line judgment studies.

often been interpreted as showing how quickly people give in to conformity pressures and how easy it is to get them to uncritically adopt the majority point of view; this to such an extent that we conform to a majority when it is obvious that the majority is wrong and we are right. Let us discuss these studies in greater detail.

The line-judgement studies Imagine that you were a participant in one of these studies. After arriving at the laboratory, you meet six other participants and you are told that you are taking part in a psychological study on visual judgements. The experimenter informs you that you will be comparing the length of lines. You are shown two white cards (see Figure 1). One card has a reference line on it and on the other card, three comparison lines are drawn (labelled A, B, and C). The experimenter tells you that it is your task is to say out loud which of the three comparison lines is similar in length to the reference line. This looks like an easy task.

Participants sit around a table and on each trial they are asked to call out their answers in the order in which they are seated. You are seated in the sixth position, where all but one of the others will have to call out their response before you. The study starts uneventfully and on the first couple of trials everyone agrees which comparison line is similar in length to the reference line. You start to get

In J. Smith & S.A. Haslam (Eds.) Refreshing social psychology: Beyond the classic studies (pp.76–90). London: Sage.

Moscovici, S. (1985). Social influence and conformity. In G. Lindzey & E. Aronson (Eds.) Handbook of social psychology: Vol. 2 (pp.347–412). New York, Random House.

Smith, J.R. & Haslam, S.A. (Eds.) (2012).

Refreshing social psychology: Beyond the classic studies. London: Sage.

bored. But then, suddenly, something unexpected happens: the first participant calls out the wrong answer. That is strange… is there something wrong with the person’s vision? It must be. But then, the second and third person give the same answer as the first person.

Participants four and five also call out the line that so clearly fails to match the reference line. What is happening? Are they all blind? Then it is your turn. This is tricky! What should you say? Should you go along with the majority (even though you know they are wrong), or should you stand out by calling out the obviously correct answer?

There are two things the experimenter has not told you about this study. First, the other participants are not participants like you but assistants of the experimenter (‘confederates’) who are instructed to call out wrong answers on about half of the trials (so called ‘critical’ trials). Second, even though the study was introduced as a study on visual perception, the actual aim of the study is to examine conformity. More specifically, the goal is to examine conformity to a majority when that majority is clearly wrong.

Results showed that when all people before you clearly give the wrong answer it is difficult to withstand conforming.

Asch found that 76 per cent of participants conformed at least once to the wrong majority answer. This is a high percentage, particularly when considering that when people had to make these judgements on their own they made mistakes less than 1 per cent of the time (Asch, 1955, pp.32–33). More than four in 10 participants conformed four or more times in the 12 critical trials, with almost 11 per cent going along with the clearly wrong judgement 10 times or more.

Videos of the experiments show participants’ bewilderment when they hear others call out the wrong line.

Participants squint and look at the lines from different angles, just to be able to see what the majority appeared to be seeing. Asch describes the non-verbal behaviour of his participants: After the first one or two disagreements he would note certain changes in the manner and posture of this person. He would see a look of perplexity and bewilderment come over this subject’s face at the contradicting judgements of the entire group. Often he becomes more active; he fidgets in his seat and changes the position of his head to look at the lines from different angles.

He may turn around and whisper to

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his neighbour seriously or smile sheepishly. He may suddenly stand up to look more closely at the card.

At other times he may become especially quiet and immobile (Asch, 1952, p.454).

The background of the linejudgement studies Asch’s interest in conformity began when he became aware of classic research on hypnosis and suggestion. In these studies, people are typically asked to give their opinion on a topic, after which they are confronted with an authority or group of people saying the opposite. When people are again asked for their opinion, they shift their views and attitudes and start to agree with the majority/authority. Asch and many others were puzzled by this finding: why would people change their mind when the authority or majority did not even present arguments to support their views? Conformity not only seemed the irrational thing to do, but also potentially dangerous: people could easily fall in the trap of conforming to others who are not only wrong, but might have evil intentions.

It was the latter danger that many ordinary Americans in the 1950s were most fearful of. With the horrors of WWII fresh in their minds, people had not forgotten the ease with which ordinary soldiers seemed to be capable of extreme atrocities because they were only doing what the majority was doing… just ‘following orders’. This fear of conformity was fuelled when, at the height of the Cold War, reports emerged that suggested that American prisoners of war were brainwashed by the communists – they denounced American capitalism and appeared to fully embrace the communist cause. It was particularly troubling that it did not appear to take all that much for these soldiers to take the side of their captors.

The impact of the studies It is not difficult to understand why the Asch studies attracted so much attention.

The findings bothered people because they suggest that people appeared to be going along with the majority in a sheeplike fashion. Asch-style conformity has been argued to underlie behaviours as diverse as war crimes, eating disorders, and football hooliganism. The Asch studies appear to show that individuals are unable to resist group pressure and that they become slaves of immediate influences. On a lighter note, the insights that emerged from Asch’s insights have

been used to design all sorts of pranks.

Best known are the elevator pranks whereby naive participants enter an elevator filled with confederates who all behave in a similar but illogical way. For example, in one prank, all confederates face the rear as soon as they enter an elevator. Very quickly the naive participants conform and turn to face the rear.

Moscovici commented in 1985 that: ‘the Asch studies are one of the most dramatic illustrations of conformity, of blindly going along with the group, even when the individual realizes that by doing so he turns his back on reality and truth’ (p.349). However, after closely engaging with Asch’s work, we wondered whether this is really the key point to take away from the studies (see Jetten & Hornsey, 2012). Do the data really show the prevalence of conformity? Is the behaviour that Asch’s participants show evidence of mindless and sheep-like behaviour? Or did people engage in sensible behaviour given the enormous

way, it appears that the studies do not just show evidence of conformity, they also provide evidence of significant levels of resistance and non-conformity. In fact, every one time participants conformed, they also dissented twice. In other words, participants were more likely to resist going along with the majority than to conform to it. Given this, it is ironic that the Asch line-judgement studies have become known as the ‘conformity studies’ when the dominant response appeared to be non-conformity and dissent.

The relatively high level of dissent found in Asch’s studies is particularly striking given that the paradigm was almost uniquely designed to elicit conformity. In the line-judgement task, the potential costs of standing out were immediate (i.e. ridicule or negative attention from other people in the room).

In contrast, the cost of violating what you think to be true was minimal. It doesn’t matter whether you call out A or B because it doesn’t involve betraying a belief that is important to you. So in this case, an analysis of pros and cons would lean the participant toward conformity. Subsequent research has shown that if people find themselves in a minority on a social issue that is important to them – a social justice issue for example – then conformity is negligible, and in fact counter-conformity is more apparent (e.g. Hornsey et al., 2003).

It is also instructive to consider what it is that those who resisted conformity pressure said.

Asch reports two types of responses. First, some resisted going along with the majority because they were Figure 1: Participants’ task is to call out which of the confident of their own comparison lines on the right (labelled A,B, or C) judgement and responded matches the reference line on the left. without much comparison to the majority. Second, some resisted conformity pressure they were facing? In because they believed that the majority what follows, we unpack these issues in might be correct, but could not help greater detail. themselves and had to call out what they saw. In other words, those who resisted were more concerned about being correct Resistance and being true to their own perceptions There is another way to interpret the than about not fitting in. results. In Asch’s own words, ‘about one It thus appears that Asch’s linequarter of the subjects were completely judgement studies shed light on the independent and never agreed with the conditions and experience of conformity, erroneous judgement of the majority’ but also on the ability of people to go (Asch, 1955, p.33). It is also clear that against the majority despite enormous only approximately 11 per cent of pressure to conform. Indeed, Asch was participants conformed on almost all just as much convinced of the vitality and trials. When looking at the results in this

read discuss contribute at www.thepsychologist.org.uk

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looking back

realness of independence as he was of the power of conformity. He states that ‘we should be skeptical, however, of the supposition that the power of social pressure necessarily implies uncritical submission to it: Independence and the capacity to rise above group passion are also open to human beings’ (1955, p.32).

He finishes his article by saying: ‘anyone inclined to draw too pessimistic conclusions from this report would do to remind her/himself that the capacities for independence are not to be underestimated’.

Blind conformity?

We also asked the question of whether Asch’s findings really provide evidence that conformity is a reflection of ‘blind’ or passive responding. In this respect, it is revealing to read what participants said when asked after the study to elaborate on what informed their responses. Many of those who conformed spontaneously mentioned that they went along with the group because, even though they did not think the majority was right, they did not want to appear foolish or like the odd-one -out. Some mentioned they did not want to ‘spoil the study results’ (Asch, 1955, p.33) and believed they acted in everyone’s interest by not rocking the boat. Others believed that they themselves were victims of optical illusions, and that the majority was actually right – simply because it was inconceivable that so many people could be wrong. They convinced themselves that ‘I must be wrong and they must be right’.

These accounts provide a number of important insights. In particular, it becomes clear that people were actively trying to make sense of the situation by developing different theories on why the majority was giving these obviously wrong responses. Accounts that people were blindly and passively following the majority do not do justice to what the experience must have been like.

Participants did not sit back and let the majority overwhelm them. Rather, they engaged and actively tried to read the context in order to develop a strategy for how to resolve the disagreement between what they saw and the majority response.

The results also provide insights into how participants may have resolved this conflict. The majority of participants conformed on some trials and resisted conformity on other trials. It thus appears that most participants engaged both in conformity and in non-conformity. This is an interesting strategy because it allows

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The real participant (middle) squints and looks at the lines more closely when other respondents unanimously call out the wrong response (from Asch, 1955)

participants to not only stay true to their own judgement, but also to signal to the others that one is mindful of the majority and does not desire to completely break their connection with them. Interestingly, this is a strategy that many people use intuitively when confronted with others that have a different opinion: before we put points of disagreement on the table, we highlight and explicitly acknowledge where we agree with the other.

Asch was certainly very aware of the power of the situation. He emphasises that, once we find ourselves in the midst of a group, we are not indifferent to it and individuals are concerned about what others around them think. To take note of what others say and do is the only sensible thing to do. He says: The individual comes to experience a world that (s)he shares with others.

(S)he perceives that the surroundings include him/her, as well as others, and that (s)he is in the same relation to the surroundings as others. (S)he notes that (S)he, as well as others, is converging upon the same object and responding to its identical properties.

Joint action and mutual understanding require this relation of intelligibility and structural simplicity.

In these terms, the ‘pull’ toward the group becomes understandable (Ash, 1952, p.484).

In other words, going along with the majority – even though you know they are wrong – is not necessarily a sign of ‘blind conformity’. Such conformity can actually be motivated by a very different concern: to show others that you are sensitive to their opinions, that you listen to them and, more generally, that you are interested in maintaining harmony within the group. Who hasn’t found themselves in meetings where one decided to not speak up or express dissent and to go along with the majority (even though they were so obviously wrong) just so the group harmony would be maintained? In

Asch’s words, even if we find that people conform: we should be skeptical…of the supposition that the power of social pressure necessarily implies uncritical submission to it. (1955, p.32)

Putting dissent back on the agenda What is it, then, that we should conclude from Asch’s findings? We suggest that there are two points that emerge when engaging more closely with his studies and his work. The first conclusion is that there is a disconnect between the way Asch talked about his results and how his results have later been reported in social psychological textbooks. While textbooks and popular accounts present the linejudgment studies as providing evidence for the prevalence of conformity, Asch not only found more evidence for nonconformity than conformity, his findings also provide important (but often ignored) insight into dissent – of going against the majority despite enormous pressure. It seems timely to put the study of dissent back on the agenda and to engage more closely with these insights.

Second, the Asch studies have come to symbolise the often sheep-like nature of individuals. Reading his original reports of the studies, however, shows that there is so much more that is going on in these studies. Furthermore, Asch provides a much more nuanced view of what he aimed to do, and also what he felt the implications were of his work. It is not just rational to listen to what these other people have to say and at times to go along with them, it is sometimes the cleverest thing to do.

I Jolanda Jetten and Matthew J. Hornsey are Professors of Social Psychology at the University of Queensland, Australia j.jetten@psy.uq.edu.au m.hornsey@psy.uq.edu.au

vol 28 no 1

january 2015

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vol 28 no 1

january 2015

ONE ON ONE

… with Aleks Krotoski

‘we have to take risks, fall over sometimes’

Digital Human It’s more a delight – that people who don’t think they want to listen to a radio programme about technology get sucked in to the stories. It’s about human behaviour, not about the tech, and I’m so pleased that this has shone through.

One nugget of advice for aspiring psychologists Be rigorous and thorough.

And don’t be afraid to share.

One person who inspired you My first social psychology teacher, Steve Mayer, at Oberlin College, Ohio.

One moment that changed the course of your career Walking down the street to do a ‘piece to camera’ for a Channel 4 programme doing my nails, and thinking, ‘Is this what I got a psychology degree for?’ Decided then and there to quit television and go back to university to study for a PhD. One book that you think all psychologists should read The Superstition of the Pigeon

by B.F. Skinner: a classic told delightfully.

One great psychological resource on the internet I’m a big fan of the BPS’s Research Digest; Christian Jarrett’s coverage of the latest psych studies is excellent.

I also follow quite a few psychologists on Twitter and

coming soon

Aleks Krotoski is a writer and broadcaster (BBC and The Guardian) and social psychologist. aleks@alekskrotoski.com

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am a fan of getting their works in progress as and when they tweet.

One thing that you would change about psychology/ psychologists I think we have to be better about communicating with the public, as with all science. Rather than wait for an issue to blow up in the headlines, we need to pre-empt public understanding and get those dialogues going so people can appreciate and understand the nuances of scientific knowledge.

One challenge you think psychology faces The most irksome issue I face is the perception that psychology (in general, and social psychology specifically) isn’t a science, but an ‘art’.

I get this all the time from the hard science community, and from the science communication community too.

One regret I really wish I’d stop dithering about whether I should pursue a career in academia or in journalism!

One surprising thing about your BBC Radio 4 series The

Synaesthesia, successful ageing, sexual abuse, and much more...

I Contribute: reach 50,000 colleagues, with something to suit all. See www.thepsychologist.org.uk/contribute or talk to the editor, Dr Jon Sutton, on jon.sutton@bps.org.uk, +44 116 252 9573 I Comment: email the editor, the Leicester office, or tweet @psychmag.

I To advertise: Reach a large and professional audience at bargain rates: see details on inside front cover.

One alternative career path you may have chosen I could have been a clinical psychologist and an

environmental psychologist.

I’m pretty myopic! In my fantasies, I’d have been an Olympic beach volleyball player, but I was too old to really push it when I rediscovered my sport.

One film This is always a difficult one as my points of reference change every day. Eternal Sunshine of the Spotless Mind is a film about the mind that makes me smile and cry. It’s a wonderful story, and shows why we have to take risks and fall over sometimes.

One hero/heroine from psychology past or present I don’t really go for heroics; rather, I’m enamoured with ideas!

One thing that organised psychology could do better Support some really far-out

work – collaborations between psychologists and artists, mathematicians, developers, designers, chefs, magicians.

Break the perception that written work is the dominant output for psychological inquiry.

One great thing that psychology has achieved Ethics committees. Thank goodness for ethics committees.

One problem that psychology should deal with There are as many questions as people in the world. It’s impossible to pin down.

One proud moment Encouraging my stepmum to use interpretative phenomenological analysis in her MA in hand therapy – a discipline which she was responsible for establishing – and then watching her become a fierce proponent of it in her clinical research.

One resource of your own Untangling the Web: What the Internet Is Doing to You – it’s actually more a psychology book than a book about the web. Like Digital Human, it focuses on the human, and what we’re able to learn about our attitudes and behaviour by observing our lives through the lens of technology. Also, it was the place where I published the results of the academic work I did in the 2000s, so felt great to bookend that part of my career for the general public.

vol 28 no 1

january 2015