Raj Persaud in conversation - the podcasts ((6) psychiatry at the cutting edge academic psychiatrists and psychologists discuss the latest research findings)
Virtual Reality Therapy. Will Virtual Reality replace therapists? Raj Persaud talks to Leanne Casey and Wesley Turner

Will therapists be replaced by Virtual Reality Technology? Psychiatrist Raj Persaud talks to psychologists Wesley Turner and Leanne Casey from Griffith University, Brisbane, Australia who have just published an analysis of how effective the latest Virtual Reality psychological treatments are.

 

Their study is entitled 'Outcomes associated with virtual reality in psychological interventions: where are we now?' and is published in the academic journal Clinical Psychology Review (Volume 34, Issue 8, December 2014, Pages 634–644)

 

If you are a professional and interested in further information on CPD Online or wish to earn CPD credit points, particularly from listening to this podcast, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

After listening to this podcast if you go to the College site and answer the mcq questions there about the interview, you can obtain on line CPD points.

 

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/religious-beliefs-and-depression_b_5165183.html

 

 

A recent article on other ways new technology is changing psychiatry and psychology:

 

 

Does Brain Scanning Research Reveal Your Real Religious Belief - More Than Church Attendance?

 

RAJ PERSAUD AND PETER BRUGGEN

A new brain scanning study has found that high personal importance of religion or spirituality in your life is associated with thicker cortex in several brain regions.

 

Some of these same regions were found to be associated with a higher risk for developing clinical depression, if that part of the brain cortex was thinner.

 

The study, entitled, Neuroanatomical Correlates of Religiosity and Spirituality - A Study in Adults at High and Low Familial Risk for Depression, concludes that a higher importance of religion or spirituality was associated with thicker cortex in certain brain regions, possibly conferring greater resilience to the development of depressive illnesses.

 

The study, published in the prestigious Journal of the American Medical Association - Psychiatry, focused on those with a high or low familial risk for developing clinical depression, because of a previously strong family history of this psychiatric diagnosis.

 

The team of academics who conducted this Magnetic Resonance Imaging (MRI) study, led by Dr Myrna Weissman, from Columbia University, argue that this brain finding could account for why being religious or spiritual, in certain circumstances, might contribute to improved resilience to depressive psychiatric illnesses.

 

Being religious or spiritual, possibly by expanding a physical brain reserve, counters to some extent the vulnerability that brain thinning in those areas poses for developing depression that runs in families.

 

For those attending church services this Easter weekend it may be surprising that the study found it was the personal importance of religion or spirituality in your life, but not the frequency of attendance of church, that was associated with thicker brain areas. In a sense the brain scans revealed your true faith more than church attendance did.

 

The same team had previously reported a 90% decreased risk, assessed over a 10-year period, of developing clinical depressive disorder in those from families where there was a high incidence of depression, if religion or spirituality was highly important to the adult studied.

 

Several others studies have found that intensity of religious experiences is associated with increased blood flow in similar brain regions found to be structurally thicker in this study.

 

The authors of this new study, Lisa Miller, Ravi Bansal, Priya Wickramaratne, Xuejun Hao, Craig Tenke, Myrna Weissman and Bradley Peterson, found that, oddly, a high frequency of attendance of religious services was not associated with brain thickness, yet rating religion or spirituality as personally important in your life was.

 

This appears a paradox - people who go to church a lot were not reaping the same benefit in their brains, in terms of protecting from depression, as those who believed that religion or spirituality was important to them.

 

The authors point out that although some may go to church in order to promote their spirituality, others may attend whether or not religion is genuinely personally important to them. In this study 49 participants reported high church attendance, yet only 21 of those also reported high importance of religion or spirituality in their lives. The remaining 28 participants may be attending services for a host of non-religious reasons, which may include social support. 

 

This research found that the participants who frequently attended religious services were in fact at increased risk of depression, suggesting that a subset of participants may attend religious services for comfort or management of depressive symptoms.

 

Although frequent attendance may express, sustain, and cultivate personal importance of religion or spirituality, these findings suggest that religious beliefs and experiences, and not overt behavior (such as attending church a lot), are associated with brain thickness.

 

That going to church might not be the key to the protective effect of religion or spirituality on those predisposed to depression, through a high risk family history, is further bolstered, according to Myrna Weissman and her colleagues, by other recent research. For example, those who regularly meditate also have certain thicker brain regions. Another recent study found that meditation training for eight weeks increased cerebral gray matter density in specific brain areas.

 

The authors of this study, from Columbia University and the New York State Psychiatric Institute, are not claiming that religion or spirituality generally protects you from depression. Instead, they are suggesting that if you consider that religion or spirituality in your life are important, then that appears to confer a neuroanatomical resilience. And that is in those who otherwise are predisposed to developing depressive illness, due to a strong family history for this kind of psychiatric problem.

 

Previously, we reported some other new research, from a team of academics led by Professor Michael King from University College London, where over 8,000 people were investigated, revealing that those who held a religious or spiritual understanding of life, had a higher incidence of depression compared with those with a secular life view.

 

Entitled Spiritual and religious beliefs as risk factors for the onset of major depression: an international cohort study, the investigation had been published in one of the most respected academic psychiatric journals, Psychological Medicine.

 

Perhaps one way of resolving the differing results is that the Psychological Medicinestudy was conducted on populations outside the USA - in the UK, Spain, Slovenia, Estonia, the Netherlands, Portugal and Chile. It could be that how important religion is in your country and culture, as well as the particular population studied, also has an impact on your brain and psychology.

 

Generally speaking Europeans are perceived as less religious than North Americans.

In the Psychological Medicine study, their findings varied by country; in particular, people in the UK who had a spiritual understanding of life were the most vulnerable to the onset of major depression. Yet, regardless of country, the stronger the spiritual or religious belief at the start of the investigation, the higher the risk of onset of depression over the next year.

 

In the specific situation of where you inherit a brain that might be predisposed to developing depression, it appears that higher importance of religion or spirituality in your life, perhaps in the USA at least, could be protective. It is also notable that the more recent brain scanning study found it was sustained interest in religion or spirituality, over a longer period, which was most strongly associated with thicker brain structures, rather than reporting a high level of spirituality at only one point in time.

 

However, given the not dissimilar findings on the brain effects of meditation, whether these structural brain changes and protective effect of religion or spirituality, are something specific to beliefs in God, is open to question.

 

Science is revealing that merely attending religious services may not deliver brain or mental health benefits, instead these appear linked to what you really believe.

 

Neuroscientists might now be able to tell, by examining your nervous system using the latest brain scanning technology, what you really believe, in the inner depths of your 'soul', but which you keep hidden from the rest of the congregation.

 

A private inner space that was supposedly only before accessible to God?

 

 

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

Download it free from these links:

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Freud on the Brain. Latest neuroscience research supports Freud?

Can neuroscience prove the existence of the Unconsious?

 

Dr Raj Persaud in conversation with Institute of Psychiatry neuropsychiatrist Professor Tony David: Does the latest neuroscience research support Freud?

This podcast is based on a paper recently published entitled:

Neural correlates of recall of life events in conversion disorder.

Aybek S, Nicholson TR, Zelaya F2, O'Daly OG, Craig TJ, David AS, Kanaan RA.

JAMA Psychiatry. 2014 Jan;71(1):52-60. doi: 10.1001/jamapsychiatry.2013.2842.

The paper is a brain imaging investigation of conversion disorder or hysteria. The study probes a neuroscience explanation for conversion symptoms, where a traumatic experience is transformed into a symptom, such as paralysis of a leg.

 

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

A related article which may be of interest originally published in The Huffington Post

http://www.huffingtonpost.co.uk/dr-raj-persaud/can-you-completely-forget-who-you-are-as-a-man-with-almost-total-amnesia-grabs-the-headlines---what-it-reveals-about-us_b_5577306.html

 

Can You Completely Forget Who You Are? As a Man With Almost Total Amnesia Grabs the Headlines - What It Reveals About Us

 

Raj Persaud and Peter Bruggen

The UK media reports that a man with severe amnesia, who still cannot remember even his own name, or where he comes from, but who was discovered in Peterborough, suffering from severe amnesia two months ago, is baffling mental health experts.

 

They are now appealing to the public for help, in the hope that someone might recognise him.
'Robert' is reportedly suffering from an upsetting and very severe case of amnesia where he cannot recall any details of his life, including his own name, age, where he is from; or his job.

 

One key clue is that although 'Robert' (a name given to him by hospital staff) speaks English, his accent seems to be eastern European, and he also appears to understand some Lithuanian and Russian.

 

Similar cases, which could explain this mysterious incident, include a clinical case report, published in 2010, entitled 'Running towards a different life: A case of Dissociative Fugue', by Dr M. Santos and Dr E. Gago from Hospital Magalhães Lemos, Portugal.

 

The paper, published in the academic journal 'European Psychiatry', explains that the diagnosis of fugue in psychiatry derives from the Latin word for flight-- fugere. Dissociative fugue is an extremely rare psychological condition - the sufferer suddenly and without warning travels far from home, completely unable to recall their past.

 

These episodes are usually linked, explain Santos and Gago, with severe stress or trauma, such as disasters, losses of loved ones or intolerable burdens at work or home. The amnesia appears completely genuine, with patients displaying no conscious understanding of the psychological reason for the flight. This is usually accompanied by muddles over personal identity and sometimes even complete assumption of a new self.

 

Santos and Gago report that the journeying associated with 'Dissociative Fugue' can last for several months. Some patients travel thousands of miles from home while in this state.

 

Another recent study entitled 'Dissociative memory impairments and immigration' also published in 'European Psychiatry' in 2010, by Dr A. Staniloiu, Dr S. Borsutzky and Dr H.J. Markowitsch, suggest there is even a possible link between this kind of psychological problem and immigration.

 

The authors from the University of Bielefeld, Germany, argue that stressful experiences arising during migration could precipitate these symptoms, though a delayed onset at times occurs reflecting an 'incubation' effect.

 

Another recent study suggests an effective treatment for 'Dissociative Fugue' which appears to have fallen out of favour recently, which might explain why it may not have been used in more current cases.

 

The case study entitled 'Amytal interview using intravenous lorazepam in a patient with dissociative fugue', reports a middle-aged white female picked up by emergency medical services in the USA, who could not remember her name, address, and did not know the name of the city.

 

Lorazepam (a sedative drug a bit like Valium) was given intravenously by the psychiatrist. Although relaxed and sleepy the patient was kept awake by asking her to restate the name of her present in-patient psychiatrist, whom she had become close to. She was led back in fantasy to the gas station where she was picked up and was requested to identify it. Once she successfully named a location from her personal history, she was led to give her name, hometown, birthday, social security number, employment, motherhood and marital status.

 

The investigation, published in the journal 'General Hospital Psychiatry' in 2006, reports that after she awoke the patient described past and recent sexual assaults. The recent rape was about 10 days before hospitalization. A final diagnosis of Dissociative Fugue was made, and the patient was discharged to outpatient follow-up and the Victims of Violent Crime clinic.

 

The authors of this paper, Dr Sunday Ilechukwu, from the Ann Arbor Health Care System and Dr Thomas Henry, then at Wayne State University, USA, argue that procedures like this provide the patient with an opportunity for the recall and review of recent emotional crisis, linkage to past trauma and provision of context to current experience.

 

The authors contend that the simple but critical process of naming her identity under sedation, probably helped her come to terms with the precipitating conflict.

 

The authors also argue care needs to be taken to minimize the risk of introducing false or distorted memories. The use of video-recorded feedback may also help consolidate gains made during the interview.

 

The authors conclude that the so-called 'sodium amobarbital' interviews have been in use for about 70 years and refers to the use of an older barbiturate type drug, could be brought back into modern psychiatric practice. The study suggests that such pharmacological-facilitated interviews continue to be a useful procedure with such cases, but that a safer more modern drug, such as lorazepam, can be used as an alternative.

 

But why should trauma lead some people to forget even who they are? Another study entitled 'A case of persistent retrograde amnesia following a dissociative fugue: Neuropsychological and neurofunctional underpinnings of loss of autobiographical memory and self-awareness', argues that, since memories can be vivid, threatening and painful, they may be removed from consciousness as a way of protecting the self-concept.

 

The authors, Kristina Hennig-Fast, Franziska Meister , Thomas Frodl , Anna Beraldi , Frank Padberg, Rolf Engel , Maximilian Reiser , Hans-Jürgen Möller and Thomas Meindl, brain scanned an individual suffering from these fugue like symptoms. The results highlighted the key role of visual and emotional properties of autobiographical memory in the maintenance of this kind of amnesia.

 

 

The study published in the journal 'Neuropsychologia', found reduced neural activity within the brain network producing autobiographical memory retrieval. The authors based at Ludwig-Maximilians-University, Munich, Germany, posit a protective defence mechanism caused by neuronal inhibition that serves to prevent an overflow of intensive aversive emotions.

 

 

The authors suggest that visual imagery plays a central role in the recall of autobiographical memories. Defects in the way the brain visually processes memory which might help explain puzzling phenomena such as Dissociative Fugue.

 

 

Their patient regained only three remote and strongly negative childhood memories dating from the time before the dissociative fugue. All were highly negative, vivid and fragmented episodes comparable to frozen images, e.g. of the coffin at his grandfather's funeral.

 

 

It must surely be one of the most disturbing experiences of all, not to recall anything of our past except alarming fragments. Psychiatric investigation of this kind of suffering is helping to reveal how the normal sense of personal identity is achieved. Visual aspects of memory may be more important than we previously realised. The fact that it can be lost suggests we shouldn't take it for granted.

 

 

Trying to uncover who 'Robert' really is, could also help us find ourselves.

 

 

 

If you are a psychiatrist, or a similar clinical professional, who is collecting Continuing Professional Development Points, after listening to this podcast and podcasts like this, it is possible to visit the Royal College of Psychiatrists CPD web site, and after completing some questions (plus registering with the site), gain CPD points on-line.

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 

 

 

 


10,000 suicides. Did the recession lead to 10,000 excess suicides?

Did 10,000 people kill themselves because of the last recession?

 

Raj Persaud in conversation with Oxford University Sociologist Aaron Reeves - how did the recession lead to 10,000 excess suicides?

 

Aaron Reeves is a post-doctoral researcher and an adjunct lecturer in the Department of Sociology at the University of Oxford. He is also a post-doctoral research fellow at Nuffield College and his research interests include: political economy of health, social protection, social and cultural exclusion, and quantitative sociology.

 

He is currently working with Dr. David Stuckler examining natural experiments in relation to poverty-reduction and health as well as exploring the impact of the recession and austerity on health outcomes. In addition to this he is also working on projects analysing the association between social position and the intergenerational transference of cultural practice.

 

Dr Reeves completed his PhD in Applied Social & Economic Research with the Institute for Social and Economic Research, University of Essex and has published several articles linking healthcare and the economy.

 

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

A related article which may be of interest

 

http://rajpersaud.wordpress.com/2014/08/22/after-the-robin-williams-tragedy-will-there-by-copycats-raj-persaud-and-professor-sir-simon-wessely-president-of-the-royal-college-of-psychiatrists/

 

After the Robin William’s tragedy – will there be copycats? Raj Persaud and Professor Sir Simon Wessely (President of the Royal College of Psychiatrists)

 

Raj Persaud and Professor Sir Simon Wessely (President of the Royal College of Psychiatrists)

 

 

 

Robert Enke, a very famous German football goal keeper, killed himself on the railway on 10th November 2009.

 

 

 

The number of railway suicidal acts, in the following two weeks, more than doubled in Germany.

 

 

 

The study which uncovered this is entitled ‘One followed by many?—Long-term effects of a celebrity suicide on the number of suicidal acts on the German railway net’, and is recently published in the ‘Journal of Affective Disorders’. There was also an increase of railway suicides of 19% in the following two years, as compared to the two years before this tragic event.

 

 

 

The authors of the study,Ulrich Hegerl, Nicole Koburger, Christine Rummel-Kluge, Christian Gravert, Martin Walden and Roland Mergl, found the 25% increase of fatal railway suicides between 2007 and 2010 was significantly greater than the 6% increase in the total number of suicides in Germany over the same period.

 

 

 

The authors based at the University of Leipzig, and Deutsche Bahn AG (the German Railway Company), conclude that Enke’s suicide probably led to copycat suicidal behaviour on the railways.

 

 

 

 

 

The authors point out that the media attention of the footballer’s suicide was exceptional and enduring, and this may have had an impact. For example, television broadcasts of a public mourning ceremony, held in the team’s stadium, were viewed by almost 7 million German viewers.

 

 

 

30 railway suicidal acts occurred in the two-week interval before Encke’s suicide, 71 railway suicidal acts in the two week interval following this event; an increase of 137%.

 

 

 

But what is more ominous is that this research found an elevated long-term ‘attractiveness’ of railway suicidal acts after Enke’s suicide.

 

 

 

The authors conclude that their findings are a strong argument for improving media coverage of suicides, and community suicide preventive programs.

 

 

 

A study entitled ‘To What Extent Does the Reporting Behavior of the Media Regarding a Celebrity Suicide Influence Subsequent Suicides in South Korea?’, just published in the journal ‘Suicide and Life-Threatening Behavior’, investigated the world record copycat effect thus far. This was the suicide of the Asian star actress Choi Jin-shil; starring in 18 films, she has been described as South Korea’s equivalent of Julia Roberts .

 

 

 

The authors, Jesuk Lee, Weon-Young Lee, Jang-Sun Hwang and Steve Stack, found her death on 2 October 2008 was subsequently associated with 429 additional suicides in South Korea, which is a record copycat effect.

 

 

 

Another recent investigation entitled, ‘Changes in suicide rates following media reports on celebrity suicide: a meta-analysis’, examined 10 studies from around the world, probing for similar copycat effects, examining 98 suicides by celebrities.

 

 

 

The team of authors, led by Thomas Niederkrotenthaler,  King-wa Fu, Paul Yip, Daniel Fong, Steven Stack, Qijin Cheng and Jane Pirkis, report a change in suicide rates of on average roughly almost three suicides per 1000 000 population, in the month after a celebrity suicide across the world.

 

 

 

Extrapolating from these figures, the worse case scenario would be an additional almost 200 suicides over the next month, in the UK, with approaching 1000 in the USA. Whether or not that happens remains to be seen, but these non-celebrity suicides are unlikely to make the headlines.

 

 

 

 

 

The study, published in the ‘Journal of Epidemiology and Community Health’, report suicides by an ‘entertainment celebrity’, across the planet, had the greatest impact of all in Europe, in terms of copycat incidents, followed by a slightly smaller impact in the USA.

 

 

 

The authors based at the Universities of Vienna, Hong Kong, Melbourne and Wayne State, found a particular celebrity impact on copycat behaviour by entertainment celebrities, as opposed to other prominent people, such as politicians.

 

 

 

Thomas Niederkrotenthaler and co-authors argue the suicide of an entertainment celebrity is so influential perhaps because of audience identification.

 

 

 

Celebrities are revered and may therefore act as particularly strong role models even when it comes to taking their own lives.

 

 

 

Guidelines for media reporting of suicide include that detailed discussion of the particular method should be avoided, and as images of the death scene are highly influential, these should not be broadcast. For details see http://www.samaritans.org/sites/default/files/kcfinder/files/press/Samaritans%20Media%20Guidelines%202013%20UK.pdf. These and similar links may be of special interest for journalists reporting about suicides

 

 

 

But by writing this article are we ourselves violating the media guidelines? Not so, we contend, because the recommendations do not say there should be no media reporting, but that it should be sober and responsible.

 

 

 

Thomas Niederkrotenthaler points out that not all celebrity suicide reporting is associated with increases in suicides subsequently. This is exemplified by the suicide of Rock Star Kurt Cobain. His suicide was widely reported, but there was no copycat phenomenon afterwards, Dr Thomas Niederkrotenthaler maintains.

 

 

 

This may be due to Cobain’s widow, Courtney Love, expressing both her sadness and anger about her far too early loss, in the media, and contacts to support services were published, along with her statements, immediately after his suicide. Indeed, research showed that these mental health services experienced an increase in clients, but there was no upsurge in suicides.

 

 

 

Perhaps the celebrity obsession of the media is in fact a reflection of a deeper problem with journalism, of which suicide reporting is merely a symptom. Reporting of celebrities lives in general tends to remain somewhat naïve. Being rich and famous, according to the classic simplistic media analysis, inoculates against any serious psychological problems.

 

 

 

In a study entitled ‘Psychological strains found in the suicides of 72 celebrities’, the tensions experienced throughout the lives of 72 celebrities were systematically investigated.

 

 

 

The authors, Jie Zhang, Jiandan Tan and David Lester found of 72 ‘celebrity’ suicides, only one had no ‘strains’ at all.

 

 

 

 

 

The authors, from Shandong University School of Public Health and Central University of Finance and Economics, China, and The Richard Stockton College of New Jersey, USA, found the most common pressure was ‘aspiration strain’ – found in 97% of the lives of celebrities who kill themselves.

 

 

 

‘Aspiration strain’ was defined in this study, published in the ‘Journal  of Affective Disorders’, as a gap between an individual’s aspiration and the reality of their life. For example, wishing to be much richer than you actually are.

 

 

 

The study found 30 celebrities who killed themselves suffered at least two contrasting life strains, while 36 had endured three different ‘strains’.

 

 

 

Perhaps the take home message should be that despairing sadness may happen to anyone, irrespective of fame or wealth.

 

 

 

But what many people still do not know is that depression, and also other mental health problems, including personal crises, can be treated, and that there is help available.

 

 

 

That should be the headline story.

 

 

 

 

If you have been affected by any of the issues raised in this article you may find the following of help: Samaritans Helpline: 08457 90 90 90 http://www.samaritans.org

 

 

If you are a psychiatrist, or a similar clinical professional who is collecting Continuing Professional Development Points, after listening to this podcast and podcasts like this, it is possible to visit the Royal College of Psychiatrists CPD web site, and after completing some questions (plus registering with the site), gain CPD points on-line.

 

Raj Persaud is now joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8


Can A Single Session Cure? Can a single session of therapy produce a cure? Professor Windy Dryden talks to Raj Persaud

The assumption that therapy should always be long term has been challenged repeatedly over the last twenty five years.

The difficulty is that Single Session Therapy has become associated in many therapists minds with being “money driven”, “superficial” and “poor quality”.

Professor Dryden builds on the work of a number of researchers and practitioners – from Moshe Talmon’s work on Single Session Therapy via Ost’s One Session CBT Treatment for Phobias and more recently, Andrea Reinecke's single session exposure based treatment of panic attacks at Oxford University.

Professor Dryden advocates an integrated approach combining belief and inference challenge with mindfulness and acceptance strategies.

Windy Dryden

Professor of Psychotherapeutic Studies

Windy Dryden, Emeritus Professor of Psychotherapeutic Studies at Goldsmiths College, University of London was one of the first people in the UK to be trained in CBT, and was the first Professor of Counselling in the UK.

The author or editor of 200 books and over 700 scholarly articles on CBT and Counselling – from “The Handbook of Brief Cognitive Behaviour Therapy” through to “Ten Steps To Positive Living”

He offers a uniquely informed perspective on CBT and psychotherapy as its practiced today and where it is heading in the future.

A RELATED ARTICLE WHICH MAY BE OF INTEREST - FIRST PUBLISHED IN THE HUFFINGTON POST:

http://www.huffingtonpost.co.uk/dr-raj-persaud/new-years-resolutions-psychology_b_4522926.html

 

Psychologists Find the Best Way to Achieve New Year's Resolutions - Is to Not Make Any by Raj Persaud and Peter Bruggen

 

 

New Year's resolutions commonly involve resolving to end bad habits - for example giving up alcohol or smoking.

However the latest psychological research suggests that, paradoxically, trying hard to not do something, might render it more likely you will perform negative habits.

This effect is referred to as ironic mental control. The 'ironic' part refers to the fact that trying not to do things, in particular trying not to think of something, or endeavouring not to have desires, seems to, paradoxically, bring them on more strongly.

If the theory is correct it explains why every year we make New Year's resolutions only to break them quite soon.

The theory of ironic mental control, it is suggested by some, might have been inspired by writer Fyodor Dostoevsky observing in his 'Winter Notes on Summer Impressions', (an 1863 account of his travels in Western Europe): "Try not to think of a polar bear, and you will see that the cursed thing will come to mind every minute."

Harvard psychologist, Daniel Wegner and colleagues in a famous experiment published in the 'Journal of Personality and Social Psychology', then found thoughts of a white bear were more likely to recur for those who initially suppressed thoughts of a white bear, than for participants who had not been asked to suppress such thoughts.

The study entitled, 'Paradoxical effects of thought suppression', found people were amazingly unsuccessful at prohibiting thoughts of a white bear, with at least one 'white bear thought' occurring each minute, despite explicit instructions not to think about a white bear. When told to try to think about a white bear in a subsequent period, these same participants reported even more thoughts of a white bear than participants who hadn't suppressed initially.

In other words, there is even a re-bound effect - which is when liberated to finally allow yourself to think of something you have been suppressing - you tend to go overboard and do even more of it than you would otherwise. So the problems with trying hard not to do something include even if you succeed temporarily, you are vulnerable to periods of lack of restraint, succumbing to splurge or binge even more than before.

One of the very latest studies entitled, 'Why the white bear is still there: Electrophysiological evidence for ironic semantic activation during thought suppression', measured brain electrical activity changes using scalp recordings, when suppressing different words.

The study, recently published in the journal 'Brain Research', has established that trying to suppress thoughts doesn't just produce the opposite effect, this occurs at a fundamental brain activity level.

The authors of the investigation Ryan Giuliano and Nicole Wicha from the University of Oregon and the University of Texas at San Antonio, conclude that thought suppression may be a causal factor in a vast array of psychological problems. It could be a human instinct to actively seek to avoid distressing thoughts, but unfortunately this strategy appears to backfire, resulting in the resurgence of the very thoughts one is attempting to avoid.

Given weight control is such a large part of many people's resolutions, a study entitled 'The ironic effects of weight stigma' by Brenda Major, Jeffrey Hunger, Debra Bunyan and Carol Miller from the University of California, Santa Barbara and the University of Vermont, USA, might explain the frequent failure of New Year's Resolutions over weight. Women were randomly assigned to read a news article about stigma faced by overweight individuals in the job market or to read a control article.

The study published in the 'Journal of Experimental Social Psychology' found weight-stigmatizing news articles caused self-perceived overweight women, to consume more calories and feel less capable of controlling their eating than exposure to non-stigmatizing articles.

The answer to the paradox of New Year's Resolutions might come from a recent study inspired by the common experience that internal dialogue in golfers to avoid hitting the ball into the pond often ends with a splash.

The study entitled 'Unwanted effects in aiming actions: The relationship between gaze behavior and performance in a golf putting task', asked participants to perform a golf putting task with instructions to land the ball on the hole (neutral instructions), avoid putting too short, and avoid putting too long.

The authors, Olaf Binsch, Raoul Oudejans, Frank Bakker and Geert Savelsbergh from VU University, Amsterdam, and Manchester Metropolitan University, found that when participants gazed for longer at a specific area, the ball was more likely to land there.

The investigation, published in the journal 'Psychology of Sport and Exercise' concludes that the negative instruction, for instance, not to putt past a hole, influences mental processes during the putt. Thinking about a behaviour increases the likelihood of engaging in that response, even when the person is trying to avoid it.

Daniel Wegner and Daniel Gold showed this effect applied even to thoughts of past lovers, where they investigated the futility of the desire to put departed relationships out of mind. It seems that the harder one tries to suppress the thoughts of an 'old flame', the more one is disturbed by them.

The study entitled, 'Fanning Old Flames: Emotional and Cognitive Effects of Suppressing Thoughts of a Past Relationship', found that the suppression of thoughts of an old flame promotes the persistent psychological presence of the ex in our minds.

The authors argue, in their study published in the 'Journal of Personality and Social Psychology', that one possible explanation is that thoughts which return to mind following suppression tend to be particularly intrusive. Thoughts that pop into mind in this way seem to create greater emotional disturbance than thoughts that follow from an intentional train of thought.

Daniel Wegner, one of the pioneers in the field of ironic mental control is quoted as arguing that the secret of making successful New Year's Resolutions is to keep them affirmative and positive. Don't resolve to give up smoking - resolve instead to become more fit.

Taking up running is likely to help you give up smoking as pursuing one goal becomes incompatible with the other. Pick goals that are irreconcilable with bad habits. Positive resolutions (do's) might be easier to control than negative ones (don'ts). Don'ts require constant effort and battling with distractions.

So rather than resolving not to do something this New Year, instead determine to be more positive and do something.

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8

 

 


What is a disorder of Attention? What is Attention Deficit Hyperactivity Disorder (ADHD)?

Raj Persaud in conversation with Heidi Feldman Professor of Psychiatry at Stanford University

Professor Heidi Feldman discusses her recent paper in the New England Journal of Medicine on ADHD

Attention Deficit--Hyperactivity Disorder in Children and Adolescents Heidi M. Feldman, M.D., Ph.D., and Michael I. Reiff, M.D. N Engl J Med 2014; 370:838-846February 27, 2014

ADHD is characterized by inattention, hyperactivity, impulsivity, or a combination of these symptoms, which compromise functioning. Management includes medications (shown to improve core symptoms but not necessarily functional outcomes) and behavioral therapies.

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

Personal bio 

Heidi M. Feldman MD PhD holds the Ballinger-Swindells Endowed Professorship in Developmental and Behavioral Pediatrics at Stanford University School of Medicine and serves as the Medical Director of the Mary L Johnson Developmental-Behavioral Pediatrics Clinical Programs at Lucile Packard Children's Hospital. She earned a PhD at the University of Pennsylvania in Developmental Psychology and an MD at the University of California San Diego School of Medicine. She is currently combining neural imaging techniques and behavioral measures to understand the outcomes of children and adolescents born preterm. She has taught Developmental Disabilities: From Biology to Policy in Human Biology at Stanford University. Dr. Feldman is also a dedicated yoga enthusiast and yoga teacher. 

 

A related article first published in The Huffington Post which may be of interest

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/childrens-mental-health_b_4068424.html

 

Is our children's mental health worse than ours? If so - why?

 

Raj Persaud and Professor Sir Simon Wessely (President of the Royal College of Psychiatrists)

 

Under a headline: 'Children as young as five suffering from depression', The Daily Telegraph Newspaper recently declared that the National Institute of Health and Clinical Excellence (NICE)  reported 80,000 children in the UK with severe depression, including 8,000 below the age of 10. Children as young as five can suffer from the psychiatric disorder; NICE affirms more identification of these children is needed.

 

A few days later The Daily Telegraph's new headline was: ''Toxic childhoods’ blamed for 22,000 self-harm cases' - beneath the headline was a byline: 'More than 22,000 children and teenagers were treated in hospital for self-harming in 2012, according to official figures which experts said showed the “toxic” effects of social media and a society obsessed with body image'.

 

Might it be more relevant that the UK currently has one of the highest divorce rates in Europe? At least one in three children here experience parental separation before the age of 16 years. Between a third and a half of all children in the UK have a non-resident parent, usually the father, during some part of their childhood?

 

A study entitled 'Trends in adolescent emotional problems in England: a comparison of two national cohorts twenty years apart', compared large samples of youth 20 years apartusing identical symptom screening in each survey. Twice as many young people reported frequent feelings of depression or anxiety in 2006 as in 1986.

 

Stephan Collishaw, Barbara Maughan, Lucy Natarajan, and Andrew Pickles from Cardiff University and the Institute of Psychiatry, London concluded was there has has indeed been a real and substantial increase in adolescent emotional problems in England over recent decades, especially among girls. The proportion of girls with five or more psychological symptoms doubled.

 

Published in the 'Journal of Child Psychology and Psychiatry', the study found that whether or not they were raised in an intact or socially advantaged family was associated with girls' mental health, but not boys'. 

 

Iryna Culpin from the School of Social and Community Medicine, University of Bristol led a team which conducted a major study entitled, 'Father absence and depressive symptoms in adolescence: Findings from a UK cohort', whose results are just about to be published.

 

This team of researchers, including J. Heron, R. Araya, R. Melotti and C. Joinson, followed up 5631 UK children, and found an association between father absence during the first 5 years of life and increased depressive symptoms at 14 years. But father absence experienced during middle childhood (5–10 years) was not associated with increased depressive symptoms at 14 years.

 

The study - to be published in the medical journal 'Psychological Medicine', found that the association between father absence during the first 5 years of life and depressive symptoms at 14 years was stronger in girls than boys.

 

But exactly why girls are more sensitive to father absence during early childhood remains a mystery. The authors of the current study point to previous work which found father absence during the first 5 years is associated in daughters with earlier timing of first period, increased rate of sexual activity and teenage pregnancy, which are, in turn, associated with increased levels of depressive symptoms in girls.

 

Dr Benjamin Baig, Clinical Lecturer, Department of Child and Adolescent Psychiatry at the Institute of Psychiatry, London, points out that the age of first period has become younger by one year over the last 80 years. He suggests that modern childhood appears to mean becoming biologically older at a younger age, and displaying adult type psychiatric symptoms, chronologically earlier.

 

Karen Schepman, Stephan Collishaw, Frances Gardner, Barbara Maughan, Jacqueline Scott and Andrew Pickles in another study, posed the specific question, 'Do changes in parent mental health explain trends in youth emotional problems?'” English adolescents in 2006 were considerably more likely to be exposed to maternal emotional problems than their counterparts in 1986. The study published in 'Social Science and Medicine' found maternal emotional problems increased across all socio-demographic groups between 1986 and 2006, mirroring increases in adolescent emotional problems over this period. 

 

So if it's not so much bad parenting - but poor maternal mental health - which could be a major culprit, should another favourite media whipping boy - new technology - also still be in the frame for rising childhood mental health problems?   

 

A study just published entitled 'Older Versus Newer Media and the Well-being of United States Youth: Results From a National Longitudinal Panel', followed 719 nationally representative young people, ages 14-24 years in the USA, and found use of older media was more related to school grades. Television was negatively, and book readingpositively related to academic performance. 

 

The authors of the study, Daniel Romer, Zhanna Bagdasarov, and Eian More from the University of Pennsylvania, conclude that despite concerns that excessive use of new media is harmful to adolescent development, it's actuallytelevision which most detracts from academic performance and book reading which most supports it. 

 

Heavy use of the Internet and video gaming may in fact be more a symptom of mental health problems than a cause. The authors of the study, published in the 'Journal of Adolescent Health' point out that withdrawal from social activity, which is a symptom of depression, leads many young people to turn to media use as a replacement for hanging out with friends.

 

Depression in adolescents is linked with clinical low mood in adults, strengthening the case for early intervention if possible  

 

Yet Child and Adolescent Psychiatrists at the country's largest mental health trusts point out they face 30% cuts over the next two years.

 

Jane Costello, Professor of Psychiatry at Duke University in the USA, comments on the predicament: 'The bottom line is that services are so scarce that it hardly matters how many kids need them—the gap between need and availability is so huge.'

 

Cycles of unhappiness repeat themselves. Parental depression is associated with child and adolescent emotional problems, via a variety of pathways, and certainly not just genetic.

 

Given that parental mental health problems are amongst the strongest predictors of child and adolescent emotional disordersthis raises the prospect of a ‘vicious cycle’ of inter-generational transmission of anxiety and depression.

 

More support for Child and Adolescent Mental Health Services, is an investment not just for the present, but for the future.

 

49th Maudsley Debate: ‘Sick Children or Sick Society?’

 

“What should we make of the seemingly inexorable rise in psychiatric diagnoses in children?” Tuesday 15th October 2013, 6pm to 8pm (refreshments served from 5.30pm) Wolfson Lecture Theatre, Institute of Psychiatry Main Building, De Crespigny Park, London SE5 8AF. All Welcome.

 

 


Funeral Mania explained. Is there such a thing as 'Funeral Mania'?

It is said some go high at funerals - is this a real phenomenon?

Raj Persaud in Conversation with Katherine Keyes. 

Katherine Keyes is Associate Professor of Epidemiology Columbia University and with serveral colleagues had published a study in the 'American Journal of Psychiatry' investigating what happens when people suffer one of the worst stresses of all - the unexpected death of a loved one. She talks to Consultant Psychiatrist Raj Persaud about her study which with colleagues appears to have verified there really is such a thing as 'Funeral Mania'.

The Burden of Loss: Unexpected Death of a Loved One and Psychiatric Disorders Across the Life Course in a National Study

Katherine M. Keyes, Ph.D.; Charissa Pratt, M.P.H.; Sandro Galea, M.D., Dr.P.H.; Katie A. McLaughlin, Ph.D.; Karestan C. Koenen, Ph.D.; M. Katherine Shear, M.D.

Am J Psychiatry 2014;171:864-871. doi:10.1176/appi.ajp.2014.13081132

Abstract

Objective  Unexpected death of a loved one is common and associated with subsequent elevations in symptoms of multiple forms of psychopathology. Determining whether this experience predicts novel onset of psychiatric disorders and whether these associations vary across the life course has important clinical implications. The authors examined associations of a loved one’s unexpected death with first onset of common anxiety, mood, and substance use disorders in a population-based sample.

http://www.amazon.co.uk/Dr-Raj-Persaud-Latest-Users/dp/B0082XNF40

 

A related article from The Huffington Post which may be of interest:

 

 

Do Near Death Experiences Finally Confirm the After-life?

RAJ PERSAUD AND PETER BRUGGEN

A new near death experience study, widely reported in the media this week, found high levels of brainwaves at the point of death in rats. Published in the journalProceedings of the National Academy of Sciences, the University of Michigan research discovered in the 30-second period after the rodent's hearts stopped beating, there was a sharp increase in high-frequency brainwaves.

'Near death experience' or NDE research remains a key divide between religion and science - can consciousness function independently of the human body, and therefore, survive bodily death? Could this then prove the existence of a 'soul', and confirm ghosts, plus other paranormal or spiritual phenomena?

A near death experience is defined as unusual recollections associated with a period of unconsciousness during either serious illness or injury, or resuscitation from a cardiac or respiratory arrest. Some people who might have been technically dead, seem to report experiences 'near or beyond death'.

Dean Mobbs from the Medical Research Council Cognition and Brain Sciences Unit, Cambridge and Caroline Watt from the University of Edinburgh Department of Psychology, recently published a paper entitled, There is nothing paranormal about near-death experiences: how neuroscience can explain seeing bright lights, meeting the dead, or being convinced you are one of them, which vigorously rejects any spiritual account.

Published in the journal 'Trends in Cognitive Sciences', Dean Mobbs and Caroline Watt explain that while 3% of Americans declare near-death experiences, such as feeling the soul leaving the body, approaching a bright light and entering another reality, where love and bliss are all encompassing, there are other scientific accounts for all these phenomena.

They report over 50% of those who recount near-death experiences were not in fact in that much mortal danger, so a serious problem for the spiritual account is that, for many experiencers, NDE's aren't revealing what happens near death, but merely what happens when one believes one is in danger of dying.

The lead author of the rat study so widely reported this week, Dr Jimo Borjigin, suggested that the dying brain was also not shutting down as might be expected, but instead, "If anything, it is much more active during the dying process than even the waking state."

Dean Mobbs and Caroline Watt also point out that psychiatric phenomena such as 'Cotard' or 'walking corpse' syndrome, named after the French neurologist Jules Cotard, which results in the feeling and conviction of being dead, could explain some of the peculiar sensations reported in Near Death Experiences.

Mobbs and Watt report that in NDEs, 50% experience being dead, 24% said that they had had an out-of-body experience, 31% remembered moving through a tunnel, and 32% reported meeting with deceased people. Mobbs and Watt contend that electrical stimulation of brain regions can result in a sense of presence (i.e. someone is standing behind us). Meeting deceased people could therefore be hallucinations due to compensatory over-activation in brain structures near areas damaged by whatever is causing death.

But other academics vigorously disagree with Mobbs and Watts attempts to explain Near Death Experiences invoking a purely scientific or non-spiritual account.

For example, in a paper entitled Seeing Dead People Not Known to Have Died: "Peak in Darien" Experiences, Bruce Greyson from the Division of Perceptual Studies, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia Health System, argues that in his collection of 665 NDEs, 138 (21%) included a purported meeting with a deceased person, whereas only 25 (4%) included an encounter with a living human.

While this discrepancy might be viewed as evidence of post-mortem survival of the persons seen, it might also be no more than an expression of the dying person's expectations of imminent death.

But Bruce Greyson points out that more troubling for the scientific account of Near Death Experiences is where those on their deathbeds see, and often express surprise at meeting, a recently deceased person, of whose death neither they nor anyone around them had any knowledge. This excludes the possibility that the vision was a hallucination related to the experiencer's expectations.

Such NDEs are termed "Peak in Darien" cases, after a book by that name published in 1882 by Frances Power Cobbe. The title is taken from a John Keats poem describing the shock of the Spaniards, who, after scaling a peak in Darien (in what is now Panama), expect to see a continent, but are confronted instead with another ocean.

Bruce Greyson reports in his paper, published in the academic journal 'Anthropology and Humanism', many examples, including that of Physician K. M. Dale who related the case of 9-year-old Eddie Cuomo, whose fever finally broke after nearly 36 hours of anxious vigil on the part of his parents and hospital personnel. As soon as he opened his eyes, at 3:00 in the morning, Eddie related that he had been to heaven, where he saw his deceased Grandpa Cuomo, Auntie Rosa, and Uncle Lorenzo. Then Eddie added that he also saw his 19-year-old sister Teresa, who told him he had to go back. His father became agitated, because he had spoken with Teresa, who was attending college in Vermont, just two nights ago. Later that morning, Eddie's parents learned that Teresa had been killed in an automobile accident just after midnight, and that college officials had tried unsuccessfully to reach the Cuomos at their home.

Bruce Greyson relates many other examples, including cases in which the deceased person seen was someone whom the experiencer had never known. For example, Greyson reports cardiologist Maurice Rawlings describing the case of a 48-year-old man who had a cardiac arrest. In a NDE he perceived a gorge full of beautiful colours, where he met both his stepmother and his biological mother, who had died when he was 15 months old. His father had remarried soon after his biological mother's death, and this person had never even seen a photo of her. A few weeks after this episode, his aunt, having heard about this vision, brought a picture of his mother with a number of other people. The man picked his mother out of the group, to the astonishment of his father.

In response to Bruce Greyson's critique that the non-spiritual account of near death experiences ignores difficult to explain phenomena as above, Dean Mobbs points out that such cases Greyson has marshalled are all anecdotal reports, and therefore difficult to rigorously verify.

The spiritual understanding of what happens to us differs from the scientific view because it places greater faith in human experience, and these death-bed stories. Science demands proof that comes from brain scanners, replication and precise measurement.

But because these extraordinary accounts will always exist, does that mean religion will forever survive the onslaught of science?

Or could it be that our first proper glimpse of heaven will instead shortly arrive from a brain scan?

 

 

 

 

This podcast has been made on behalf of the Royal College of Psychiatrists (UK) by Raj Persaud and Peter Bruggen

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

For more general podcasts visit: www.rcpsych.ac.uk/discoverpsychiatry/podcasts.aspx


Sleep problems explained. The psychiatry of sleep problems

How to get a good nights sleep without pills?

Dr Raj Persaud in conversation with Dr Jeremy Beider. Problems sleeping are one of the commonest difficulties that doctors in the UK deal with - possibly leading to massive over-prescribing of hypnotic drugs which can be highly addictive. What are the non-pharmacological ways of achieving a good nights sleep? Raj Persaud in conversation with Jeremy Beider who was presenting on this topic at the Annual International Congress of the Royal College of Psychiatrists at the Barbican.

Jeremy Beider is a consultant in adult psychiatry in West London Mental Health Trust and holds a MSc in Behavioural Sleep Medicine from Glasgow University.

He has Clinical experience at Guy’s and St Thomas’ Sleep Disorders unit and the National Neuropsychopharmacology Clinic UK

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

As a Dream Predicts Lottery Win, and Malaysian Airlines Passenger Posts Eerily Prophetic Picture - Can Dream and Visions Foretell the Future?

 

RAJ PERSAUD AND PETER BRUGGEN

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/lottery-dream_b_5605068.html

 

The UK press has reported that a judge recently ordered a restaurant owner to split half of a million pound lottery prize with his waiter, because of a dream foretelling the future.

The boss of a Turkish restaurant in York, England, bought the winning lottery ticket following a vivid dream experienced by his superstitious employee, predicting the win.

Judge Mark Gosnell's ruling followed a protracted legal dispute between the two men as to whom the prize money belonged to. The Judge's final decision, that the jackpot had to be split by the boss with his waiter, partly turned on a premonition.

It is reported that the waiter dreamt that he was holding a large bundle of cash and standing in front of him was his boss. Being a strong believer in the power of such visions, the dreamer interpreted this to mean that he and his boss would scoop the lottery.

The following day the waiter apparently "pestered" his boss for hours, before the restaurant owner finally agreed to enter the EuroMllions draw.

The judge examined CCTV footage from the restaurant which showed the two men filling in the winning ticket, and ruled in the waiter's favour, accepting the dream explanation was "plausible".

While anecdotal reports of dreams predicting the future abound, Parapsychologists are interested in scientifically testing whether foretelling the future might be possible.

For example, a paper entitled, 'An ostensible precognition of the Arab surprise attack on the Day of Atonement, 1973', published in 1986 by Gilad Livneh, in the 'Journal of the Society for Psychical Research', presented just such a compelling case. A letter to Israeli Prime Minister, Golda Meir, was discussed in which a woman reports her vision about an Arab attack, two weeks before the actual event took place.

While accurate prophecy was a plausible explanation, however, the author also conceded that chance coincidence could not be ruled out, due to the inconsistency of certain details between the dream, and the actual event itself.

Caroline Watt, Natalie Ashley, Jack Gillett, Megan Halewood and Rebecca Hanson from the Department of Psychology, University of Edinburgh, have just published one of the most recent systematic studies on prophetic dreams.

These authors report surveys showing that around one quarter of the population believes in the ability to foretell the future, while about one third report 'precognitive' experiences (precognitive means literally fore-knowing).

The authors also point out the scientific and public importance should some dreams indeed turn out to be reliably prophetic. For example, if such precognitive dreams contain trustworthy information, it might be possible to warn of forthcoming disasters, or even to prevent them from occurring.

This has particular resonance right now given a Dutch passenger feared dead, is recently reported to have posted a photo of the Malaysian Airlines Jet he was boarding, destined to crash in the Ukraine, with the message: "if we disappear, this is what the plane looks like".

Caroline Watt, Rebecca Hanson and colleagues point out that following the Aberfan disaster the British Premonitions Bureau was set up in London, and in the USA the Central Premonitions Registry was established. Both appear to have faltered partly due to an insufficient number of predictions that could be related to specific incidents.

Linking an incident which has now happened with a prior dream could merely be a tendency to see patterns facilitated by the benefit of hindsight.

In another past study reported by the authors of the latest research, participants were asked to document their dreams upon awakening, and then to mail a copy to the researcher. The dreamers were asked to notify the investigator if they noticed any events occurring that corresponded to their dreams. In one series, it was judged that only two out of 265 dreams (over an 8-week period) appeared 'moderately' prophetic.

Caroline Watt, Rebecca Hanson and colleagues' current paper, entitled 'Psychological factors in precognitive dream experiences: The role of paranormal belief, selective recall and propensity to find correspondences', investigated the part of selective recall in prophetic dream experiences. Participants read two diaries, one purporting to be a dream diary, and one claiming to be a diary of incidents in the dreamer's life. The events either confirmed or disconfirmed the reported visions.

A significantly greater number of confirmed than disconfirmed dream-event pairs were recalled by participants taking part in the experiment, possibly indicating a human tendency to see connections over unconnected happenings.

The authors argue that their research, published in the 'International Journal of Dream Research' in April 2014, explain the seeming coincidence between dreams and events that can be interpreted as prophetic.

Two possible psychological mechanisms - selective recall and propensity to find correspondences seem to lead us to experience many more dreams apparently foretelling the future, than may genuinely exist.

These explain the discrepancy between the dearth of scientific support for prophetic dreams, compared with the rather frequently reported experience in the general population, of having dreamed about a seemingly unpredictable future event.

Psychologists Gergo Hadlaczky and Joakim Westerlund from Stockholm University have published a study in 2011 which argues that how surprised you are by coincidences could predict how likely you are to end up believing in phenomena such as parapsychology and the supernatural.

The study entitled 'Sensitivity to coincidences and paranormal belief' and published in the journal, 'Perceptual and Motor Skills' exposed participants to artificial coincidences, who were asked to provide remarkability ratings. Those who were more surprised, when experiencing coincidences, tend towards higher paranormal belief (beliefs such as in telepathy etc).

The most obvious explanation for many coincidences is 'just chance'. Tending to be more surprised by coincidence suggests a tendency to reject the 'it's just chance' account. For example, there will be some who put it down to just chance that two Malaysian Airlines Jets should suffer catastrophe in a short space of time. Others will be much more surprised.

It's possible that a tendency to be more shocked by coincidence simply betrays poor probability reasoning. But it could also have positive survival value in an evolutionary sense. Being more paranoid may mean seeing patterns in what others assume are random events.

Being more astonished by coincidence, could have made you more vigilant for threat in our ancestral environment, more paranoid, and therefore more able to detect and defend against predators in our ancestral past. We could be genetically wired up to be surprised by coincidence.

But paranoia and surprise by chance is only helpful if it leads to an actual action that then produces a positive outcome. The passenger reported to have posted the prophetic internet message about the Malaysian Airlines Jet due to be flying over Ukraine, apparently still did board the plane.

The recent lottery-winner case appears an excellent example of a kind of quasi-scientific proof that dreams can foretell the future, because the person who had the dream then engaged in an action the next day as a direct result - persuading his boss to buy a lottery ticket.

Yet if the waiter in the most recent legal judgement ruling was so convinced by his prophetic dream - why did he not take more precautions to safeguard his claim to the win?

Why did he not foresee that sharing the ticket purchase with his boss was going to lead to a protracted legal battle?

Depending on how you interpret it, this could become an example of how dreams or visions don't really predict the future.

 

This podcast has been made on behalf of the Royal College of Psychiatrists (UK) by Raj Persaud and Peter Bruggen

If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

 

For more general podcasts visit: www.rcpsych.ac.uk/discoverpsychiatry/podcasts.aspx


The science of hearing voices

Raj Persaud in conversation with Professor Peter Woodruff. Professor Peter Woodruff from Sheffield University and Raj Persaud discuss the latest neuroscience research on hearing voices or auditory hallucinations with Raj Persaud - the conversation was recorded at the Annual Congress of the Royal College of Psychiatrists at the Barbican. The latest neuroscience developments appear to hold out the prospect of innovative new non-drug related therapies.

 

Professor Peter W R Woodruff MBBS PhD MRCP FRCPsych

Professor and Head of Academic Clinical Psychiatry
Director of the Sheffield Cognition and Neuroimaging Laboratory (SCANLab)
Deputy head of the Section of Neuroscience

  • 1 July 1999 – present: Professor and Head of Academic Clinical Psychiatry, University of Sheffield & Honorary Consultant Psychiatrist, Sheffield Care Trust (from 1 July 1999)
  • 1997- 1999: Senior Lecturer in Psychiatric Neuroimaging University of Manchester
    Honorary Consultant Psychiatrist, Mental Health Services of Salford.
  • 1995 – 1997: British Telecom Research Fellow in Functional MRI, Institute of Psychiatry London
    Senior Lecturer in Psychiatric Neuroimaging/Hon Consultant Psychiatrist in Psychiatric Intensive Care, Maudsley Hospital London
  • 1994 – 1995: Fulbright Fellow in Functional MRI, Harvard Medical School & Massachusetts General Hospital USA
  • If you are interested in further information on CPD Online or wish to earn CPD credit points, please visit the Royal College of Psychiatrists CPD Online website for further information at www.psychiatrycpd.co.uk

A related article which may be of interest originally published in The Huffington Post:

 

http://www.huffingtonpost.co.uk/dr-raj-persaud/washington-shooting-naval-yard_b_3960983.html

 

 

Could Psychiatrists Have Prevented the Washington Naval Yard Shootings?

 

Raj Persaud and Peter Bruggen

 

As reports began to appear of the disturbed background of Aaron Alexis, the media seems to have universally decided that mass shootings are readily explained by severe mental illness.

 

The assumption is that as psychiatric disorder is so obviously linked to violence, there should be no surprise that the Washington Naval Yard killings involved someone with a mentally troubled history.

 

New research finds that media reporting of mass murder, such as this most recent tragedy, leads to more negative public attitudes to the mentally ill. This in turn may contribute to a pessimistic stereotyped image for psychiatric problems and services. As a result, people who suffer symptoms, as it appears Aaron Alexis could have, may not access treatment which possibly prevents these atrocities.

 

 

A vicious cycle is thus created, ironically perpetuated by media coverage. Is it possible the reporting is part of the cause of such senseless violence? Not because this encourages one sub-type of mass killers - 'infamy seekers' (which it may do) but also as it may discourage early psychiatric intervention?

 

 

Emma McGinty, Daniel Webster and Colleen Barry, from the Johns Hopkins Center for Gun Policy and Research, and the Johns Hopkins Bloomberg School of Public Health, Baltimore recently found that reading a news story about a mass shooting, heightened negative attitudes toward sufferers from mental illness.

 

 

The study entitled 'Effects of News Media Messages About Mass Shootings on Attitudes Toward Persons With Serious Mental Illness and Public Support for Gun Control Policies', involved a national sample of almost two thousand participants. Their findings suggest public perception is that serious mental illness, more than access to guns, accounts for mass shootings.

 

 

The study, recently published in the 'American Journal of Psychiatry', concludes that in the aftermath of mass shootings, the barrage of news stories describing the shooter with psychiatric symptoms, his history, and his actions during the shooting might raise public support for gun control policies. But such coverage also contributes to negative attitudes toward the mentally ill.

 

 

The authors go on to point out that pessimistic public attitudes are linked to poor treatment rates among persons with serious mental health conditions.

 

 

But if there were better psychiatric services, and if the taboo surrounding mental illness was less, so more people accessed better treatment earlier, would it make a difference to these tragic shootings? Could psychiatric interventions prevent these atrocities in the future?

 

 

'The American Journal of Psychiatry' was partly prompted by the Johns Hopkins media effects study, to wrestle with the question of how psychiatrists could make a difference to the apparently rising incidence of mass killing incidents.

 

 

Psychiatrists Richard Friedman and Robert Michels, were in fact responding to the Newtown Connecticut school shooting, at the time of their editorial. Yet their comments anticipate the likelihood that such tragedies would recur soon.

 

 

They did indeed, when Aaron Alexis recently killed 12 people in the Washington Naval Yard.

 

 

The media reports suggested the navy contractor was wrestling with mental illness. He appears to have been hearing voices and complained he was being followed by people using a microwave machine to send vibrations through his body.

 

 

Doctors Friedman and Michels agree that mass killings attract the kind of blanket media coverage which can create misleading impressions. For example, the attention they attract distracts from the fact mass killings are very rare. Friedman and Michels point out that in 2011, mass killings accounted for only 0.13% of all homicides in the United States.

 

 

Friedman and Michels believe the conundrum the public find most difficult to grasp is that although mass murderers probably suffer more mental illness than other killers, the mentally ill as a group actually pose relatively little risk of violence.

 

 

For example, their editorial entitled 'How Should the Psychiatric Profession Respond to the Recent Mass Killings?' quotes that only 4% of violence generally can be attributed to persons with mental illness. The prevalence of violence amongst those with serious mental illness throughout their lifetime is 16%, as compared with 7% among people without.

 

 

Alcohol and drug abuse are far more likely to produce aggression. Those who abuse alcohol or drugs but have no other mental disorder, are nearly seven times as likely as those without substance abuse, to commit violence.

 

 

One possibility is that improving mental health services might make a difference; Aaron Alexis appears to have fallen through the net of treatment.

 

 

But, remarkably, should a psychiatrist have been able to evaluate this man before the shootings, suffering though he appeared to be from hearing voices and delusions, it's not clear he could have been easily detained involuntarily by current mental health legislation. The law, both in the USA and the UK, supports doctors in seeking involuntary admission to hospital, only if they can convince the authorities that a patient is an immediate danger to himself or others.

 

 

Perhaps in the wake of these recent shootings, involuntary mental health legislation and practice should be loosened from 'imminent danger', to a 'reasonable likelihood of violent behaviour'.

 

 

But Friedman and Michels argue that lowering the threshold for involuntary treatment could discourage consulting doctors. People could become more wary of being candid or seeking help voluntarily.

 

Heightened fears of being committed to an institution against their will, might mean some of most unwell patients would be driven further away from the mental health system.

 

 

Mental illness is very treatable, and sufferers can and do return to productive well-being with the right healing, implemented early enough. Yet the fear of being 'locked away' forever in an asylum continues to stigmatise the system.

 

 

As psychiatrists, when we hear these tragic stories of what mental disturbance lay behind a mass shooting, we have a further concern. It is that sufferers from these severe psychiatric symptoms, over and over again, were not receiving adequate treatment.

 

 

The media clouds the key lesson to be learnt, which is that it's neglected and untreated mental illness, not psychiatric disorder alone, which is involved.

 

 

If the truth was more widely understood, about how effective modern treatment of psychiatric problems can be, particularly if dispensed by properly trained professionals, then it is possible that these incidents could indeed become rarer. Clinics might then attract adequate public funding, and even better clinicians, which would all help services become ever more effective.

 

 

Some may possibly argue that even the best mental health system would likely have little impact on deterring mass killings, as some of these killers largely avoid psychiatric treatment - but for the others - and those who might be influenced by friends and relatives observing something amiss, we still believe there could be a worthwhile impact.

 

 

If the USA is not going to embrace tougher gun control, as it appears reluctant to, then it may well be even more imperative they develop absolutely excellent mental health services.

 

In the aftermath of yet another mass shooting tragedy, this might just be our only hope.

 

 

Raj Persaud is joint podcast editor for the Royal College of Psychiatrists and also now has a free app on iTunes and google play store entitled 'Raj Persaud in conversation', which includes a lot of free information on the latest research findings in mental health, plus interviews with top experts from around the world.

https://play.google.com/store/apps/details?id=com.rajpersaud.android.rajpersaud

 

https://itunes.apple.com/us/app/dr-raj-persaud-in-conversation/id927466223?mt=8