In the Zone

Have you ever had that feeling when you’re working on something where you are totally focused on the task and don’t notice time passing? This feeling of being completely absorbed and ‘in the zone’ is known in the field of psychology as flow. It has been described by one researcher as being the “optimal experience” under which to perfom (Csikszentmihályi, 1990).

According to Nakamura & Csikszentmihalyi (2014), this state has the following features:

  • Intense concentration
  • Merging action and awareness
  • Loss of reflective self-consciousness (loss of self-awareness)
  • Feeling in control of your actions
  • Feeling as though time is passing quicker than normal
  • Feeling as though the task is rewarding

Whilst being enjoyable, research has shown that flow can also improve our performance in a range of situations, including sport, music and work (Young & Pain, 1999; Wrigley & Emmerson, 2013; & Bryce & Haworth, 2002). Flow is also commonly experienced whilst playing video games, and games are designed to make sure that players can stay in the flow state for as long as possible (Murphy, 2012) – which is what makes them so addictive!

However not every task can result in flow. If it is too hard, or so easy that we get bored and start to relax, we don’t experience flow.  Researchers in Denmark have investigated the workplace activities which can result in increased feelings of flow, and found that taking part in planning, problem solving and evaluation predicted a transient flow state (Neilson & Cleal, 2010). These activities all fit into the above criteria – being hard enough to be interesting but not so hard that they cause feelings of frustration.

Flow_State_large

As flow has been shown to improve performance, are there any ways we can practice entering this state of mind?

Nakamura & Csikszentmihalyi (2014) argue that entering flow is all about our attention, or more specifically our ability to keep our attention focused on the task at hand. If we want to enter the flow state then we need to make sure that the task is challenging, with clear goals and appropriate feedback on our performance to ensure prolonged motivation. If we meet the challenges of a task we increase our skill, which means we can attempt slightly harder activities with a chance of succeeding, meaning we stay in the flow state (see diagram above).

As well as helping us improve our task performance, there is evidence to suggest that flow can also have longer lasting positive effects (Demerouti et al, 2012). One study measured levels of flow during working hours and found that workers who experienced flow had more energy at the end of the day.  When we’re busy or stressed at work, maybe it would be beneficial to structure tasks to help us enter a state of flow, both to improve our performance, and make sure we’re not too exhausted at the end of the day.

 

References:

Bryce, J., & Haworth, J. (2002). Wellbeing and flow in sample of male and female office workers. Leisure Studies, 21, 249 –263

Csikszentmihályi, M. 1990 “FLOW: The Psychology of Optimal Experience” Harper & Row.

Csikszentmihalyi, M., 1997. Flow and the psychology of discovery and invention. HarperPerennial, New York, 39.

Demerouti, E., Bakker, A.B., Sonnentag, S. and Fullagar, C.J., 2012. Work‐related flow and energy at work and at home: A study on the role of daily recovery. Journal of Organizational Behavior33(2), pp.276-295.

Murphy, C., 2012. Why games work and the science of learning.

Nakamura, J. and Csikszentmihalyi, M., 2014. The concept of flow. In Flow and the foundations of positive psychology (pp. 239-263). Springer Netherlands.

Nielsen, K. and Cleal, B., 2010. Predicting flow at work: Investigating the activities and job characteristics that predict flow states at work. Journal of Occupational Health Psychology15(2), p.180.

Wrigley, W.J. and Emmerson, S.B., 2013. The experience of the flow state in live music performance. Psychology of Music41(3), pp.292-305.

Young, J.A. and Pain, M.D., 1999. The zone: Evidence of a universal phenomenon for athletes across sports. Athletic Insight: the online journal of sport psychology1(3), pp.21-30.

image reference https://www.optimoz.com.au/blogs/news/174434951-how-to-foster-the-flow-state

 

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Remarkable Women in Psychology

This week’s post is a special one in honour of International Women’s Day 2018. Whilst some of the most famous figures in psychology are men (think Freud, Jung, Milgram etc), this doesn’t mean that women haven’t made a massive contribution to the field. The work of female scientists should be celebrated, so I’ve picked 5 women who have made a real difference to the field of psychological research to profile below.

1. Mary Ainsworth

Mary-Ainsworth-255x300

Born: 1913. Ohio, USA

Studied: University of Toronto

Most famous for: Devising the Strange Situation – a test to observe attachment type between an infant and their primary caregiver (to find out more about the Strange Situation read my blog post here). Her work makes up the cornerstone of attachment theory – that is the type of attachment an infant has to their primary caregiver (usually their mother). If an infant does not have secure attachment then it may result in emotional or behavioural problems later on in life.

2. Mamie Clark

mamie clark

Born: 1917. Arkansas, USA

Studied: Columbia University

Most famous for: Doing some of the first work into racial bias with young children in segregated America that went on to provide pivotal evidence in the United States Supreme Court case which ruled it was unconstitutional to have separate schools for white and black children. Her experiment used dolls of different skin tones and children were asked questions such as “show me the doll that looks bad” or “which doll would you like to play with?”. The experiment revealed a preference for the white doll, mimicking society at the time. It concluded that racial segregation caused psychological harm to children.

3. Anne Treisman

treisman

Born: 1935. Yorkshire, UK

Studied: University of Oxford

Most famous for: Developing Feature Integration Theory with Gelade in 1980. This states that the individual features of a stimulus (such as colour or shape) are processed simultaneously through an automatic process before object recognition occurs at a later stage. This process explains how we search for a target in a crowded field – if it has a distinctive feature like being a bright colour (e.g. a pink circle in a field of blue ones) then it seems to pop out automatically. However, processing takes longer if the target shares a feature with the distractors (imagine looking for a blue circle in a field of blue squares). In the first example processing happens automatically, whereas the second example requires more attention to find the target. This work has since gone on to form the basis of several new experiments in the field of cognitive psychology, and her paper with Gelade (Treisman & Gelade, 1980) has been cited over 100,000 times.

4. Elizabeth Loftus

130906_NEWSCI_ElizabethLoftus.jpg.CROP.article568-large

Born: 1944. California, USA

Studied: Stanford University

Most famous for: Her work on the reliability of eyewitness testimony. In her well-known experiment, she showed participants a video of a car accident. She then asked half of them “How fast was the car going when it bumped into the other car?” and the other half “How fast was the car going when it smashed into the other car?”. The participants who were asked the second question were more likely to overestimate the speed the car was travelling. Her work in this field shows how careful interviewers must be when talking to eyewitnesses as leading questions can alter their perception of the event. She has gone on to advise courts in several famous cases, including that of OJ Simpson.

5. Dame Vicki Bruce

bruce

Born: 1953. Essex, England

Studied: University of Cambridge

Most famous for: Being a leader in the field of face recognition and eyewitness testimony. In 1986 she developed a Functional Model of Face Processing with Young (Bruce & Young, 1986) which states that there are 7 different codes that we use to process faces which, include expression, pictorial, and structural codes. The model explains how familiar faces are processed differently to unfamiliar ones, and why we have the ‘tip-of-the-tongue’ phenomenon, when we know we know someone’s name but can’t remember exactly what it is. She was awarded an OBE for services to psychology in 1997 and was made a Dame in 2015.

 

 

Were there any people profiled here that you hadn’t heard of before? It’s be really interesting to put this post together, but also frustrating at times – some female psychologists who I wanted to feature don’t have their own Wikipedia page, making it hard to find out their biographical information. This just goes to show that we should celebrate women in science! Please share, using the hashtag #internationalwomensday and if there’s anyone else you think I should have featured here please let me know in the comments below.

 

References:

Ainsworth, M.D.S., Blehar, M.C., Waters, E. and Wall, S.N., 2015. Patterns of attachment: A psychological study of the strange situation. Psychology Press.

Bruce, V. and Young, A., 1986. Understanding face recognition. British journal of psychology77(3), pp.305-327.

Loftus, E.F. and Palmer, J.C., 1996. Eyewitness testimony. In Introducing psychological research (pp. 305-309). Palgrave, London.

Treisman, A.M. and Gelade, G., 1980. A feature-integration theory of attention. Cognitive psychology12(1), pp.97-136.

http://www.naacpldf.org/brown-at-60-the-doll-test

 

Why do we forget?

I realised earlier today that whilst I’ve written several posts about memory, for example this one, about the different types of memory, the link between smell and memory, whether our memory is trustworthy, and about those with perfect memory syndrome, I’ve never actually written a post about the opposite – forgetting. Why is it that we often can’t remember something so simple as what we had to eat yesterday, or a piece of information we need to know for an exam? Read on to find out more..

forgetful

One theory is the Trace Decay Theory of forgetting. This assumes that memories leave a trace in the brain, and if we don’t activate this trace (by thinking about the memory) then it fades, or decays. This theory involves our short term memory, which has a limited duration and can only hold onto information for around 30 seconds. However, it is actually pretty hard to test, meaning there isn’t much evidence to support it. It also doesn’t explain why people can remember things even though they haven’t thought about them for years, which is at odds with trace decay theory.

An alternative theory involving the short term memory is Displacement Theory. This theory is based on evidence which has shown the capacity of the short term memory to be between 5 and 9 items (Miller, 1956). Once new information enters our short term memory, other items in there are displaced. This has been illustrated by asking participants to remember a list of words. Results of experiments using this method have found that people are more likely to remember the words at the beginning and at the end, the ones in the middle have been ‘displaced’.

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https://www.cliffsnotes.com/study-guides/psychology/psychology/psychology-memory/memory-storage

Interference Theory explains forgetting in terms of our long term memory. Have you ever typed in your old password and wondered why it wasn’t working? That’s an example of proactive interference – old knowledge interfering with what we know now. Or how about if you’ve broken your new phone and have to go back to using your old one, but keep pressing the wrong buttons? That’s retroactive interference – new knowledge interfering with what you used to know. Anderson (2003) explains interference as a failure of inhibition in the brain, whilst it might be useful to forget some things over time (e.g. what you had for dinner 3 weeks ago), there are other things which we need to remember, despite new learning. A single retrieval cue (such as sitting at your computer) can link to more than one memory (your old and new password), meaning the correct memory needs to be selected. However a problem with this mechanism means that as well as forgetting potentially distracting memories, problems with inhibiting other memories triggered by the same cue means that useful things are forgotten too.

The above theories assume that the memory has been forgotten because it no longer exists. But what if the problem isn’t with the memory itself, but the process of remembering known as retrieval? Retrieval failure happens when the memory is still contained in our long term memory, but we are unable to access it because certain cues are not there. These cues can be anything such as context about where you were when you learnt the information (external), or how you were feeling (internal). Goddon & Baddeley (1975) asked a group of divers to take part in a memory experiment. Half learnt a word list on land, and half underwater. Half of the group who learnt the list on land then had to recall the list on land, whilst the other half had to do this task underwater. The same happened to the participants in the underwater learning group. They found that participants who had to recall the words in the same setting as they learnt them in performed significantly better than those whose context had changed.

What about when forgetting is more serious? Amnesia is more severe than the types of forgetting we experience in day to day life, as it can involve forgetting large proportions of previous life events or information and is often caused by trauma to the brain. Perhaps the most famous case of amnesia was in Patient H.M., who had most of his hippocampus (structure in the centre of the brain which is thought to be responsible for long term memory) removed to cure his severe epilepsy. Whilst successful in reducing his seizures, he was left unable to retain any new information for more than a few minutes. If you’d like to read more about what H.M.’s case taught us about human memory, I’ve also written a post about that here.

 

References:

Anderson, M.C., 2003. Rethinking interference theory: Executive control and the mechanisms of forgetting. Journal of memory and language49(4), pp.415-445.

Godden, D.R. and Baddeley, A.D., 1975. Context‐dependent memory in two natural environments: On land and underwater. British Journal of psychology66(3), pp.325-331.

Miller, G. (1956). The magical number seven, plus or minus two: Some limits on our capacity for processing information. The psychological review, 63, 81-97.

Scoville WB, Milner B. J. 1957. Neurol. Neurosurg. Psychiatry. 20:11–21

 

Time to Talk Day 2018

Today, February 1st, is Time to Talk day in the UK. This campaign aims to reduce the stigma and discrimination around mental illness, and encourage people to talk about their mental health.

Days like today which aim to raise awareness of mental health problems are important to change the conversation around mental health. By raising awareness they also highlight the problems of funding and resources: mental illness is still not treated with the same importance as most physical health problems, with some people left on long waiting lists to access care (e.g. Hovish et al 2012).

These statistics reproduced from Mental Health UK show the scale of the global burden of mental illness:

  • Mental health problems are one of the main causes of the overall disease burden worldwide.
  • Mental health and behavioural problems (e.g. depression, anxiety and drug use) are reported to be the primary drivers of disability worldwide, causing over 40 million years of disability in 20 to 29-year-olds.
  • Major depression is thought to be the second leading cause of disability worldwide and a major contributor to the burden of suicide and ischemic heart disease.
  • It is estimated that 1 in 6 people in the past week experienced a common mental health problem.

Did anything surprise you? If an estimated 1 in 6 people are currently experiencing a problem with their mental health then why is it still not something we feel we can talk about openly? By joining in the conversation, you can make a difference in how mental illness is perceived and help reduce the stigma. Talking about mental health can also make a big difference to people struggling with mental illness at all stages of their recovery.

thunderclap-image

If you’re interested and would like to find out more then click here to access their website.

One of the great features about the website is that it contains clear advice on what to do if you think a friend, colleague or family member is struggling with their mental health. If you’re worried about someone and would like some help then follow this link to find out more: https://www.time-to-change.org.uk/about-mental-health/support-someone

Thanks for reading – if you liked this post then please share, with the hashtag #timetotalk

 

References:

https://www.mentalhealth.org.uk/statistics/mental-health-statistics-uk-and-worldwide

Hovish, K., Weaver, T., Islam, Z., Paul, M. and Singh, S.P., 2012. Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study. Psychiatric rehabilitation journal35(3), p.251.

Effects of Sleep Deprivation

How are you feeling today? If you’re anything like me and my friends the answer might well be ‘tired’. In modern society it can seem as though everyone is trying to cram as much as possible into their day, with work, family commitments, studying, exercising and fitting in a social life. This coupled with increased smart phone use (hands up if you scroll through Instagram before you go to sleep..), especially in the evenings can lead to people just not getting as much sleep as they should be.

Sleep deprivation is defined as having less that 7-8 hours of sleep a night for adults (Colten, & Altevogt, 2006). However, a recent survey in the UK found that 70% of adults say they sleep for less than 7 hours each night and over 25% said they regularly slept badly (Sleepcouncil.org.uk).

In today’s society it appears to be normal to be sleep deprived. What effect is this having on our mental health?

2017-05-15-Sleep-deprivation-and-your-body-1

Perhaps unsurprisingly, sleep deprivation has been shown to impair our ability to focus. Studies which have examined the effects of sleep deprivation on driving and found participant’s ability to stay in lane was as impaired as a group who were over the legal alcohol limit (Fairclough & Graham, 1999).

Another study looked at the effects of sleep deprivation in students and found that those who had gone without a night of sleep performed significantly worse at a cognitive task than those who had 8 hours sleep the night before (Pilcher & Walters, 1997). Interestingly, the sleep deprived participants in this study rated their performance on the task as higher than those who weren’t sleep deprived! This suggests that when we’ve not slept enough we might not always realise the effect it can have on our performance the next day.

As well as affecting your ability to focus, sleep deprivation has the largest effect on mood (Pilcher & Huffcott, 1996). One study asked participants to go without two nights of sleep, and compared scores on a personality trait questionnaire at baseline and again after they had been awake for 56 hours. When they were sleep deprived, participants showed higher scores of anxiety, depression and paranoia (Khan-Greene et al 2007). Another study has shown than just losing one night’s sleep can increase anxiety scores (Sagaspe et al, 2006). These research suggests that going without sleep can affect the parts of your brain involved in mood regulation such as parts of the prefrontal cortex.

For tips on how to improve your sleep – the full report by the Sleep Council has some useful tips (and more surprising stats) here: https://www.sleepcouncil.org.uk/wp-content/uploads/2013/02/The-Great-British-Bedtime-Report.pdf

 

References:

Colten, HR.; Altevogt, BM. Sleep disorders and sleep deprivation: An unmet public health problem. Washington, DC: The National Academies Press: Institute of Medicine; 2006.

Fairclough, S.H. and Graham, R., 1999. Impairment of driving performance caused by sleep deprivation or alcohol: a comparative study. Human Factors41(1), pp.118-128.

Kahn-Greene, E.T., Killgore, D.B., Kamimori, G.H., Balkin, T.J. and Killgore, W.D., 2007. The effects of sleep deprivation on symptoms of psychopathology in healthy adults. Sleep medicine8(3), pp.215-221.

Pilcher, J.J. and Huffcutt, A.I., 1996. Effects of sleep deprivation on performance: a meta-analysis. Sleep19(4), pp.318-326.

Pilcher, J.J. and Walters, A.S., 1997. How sleep deprivation affects psychological variables related to college students’ cognitive performance. Journal of American College Health46(3), pp.121-126.

Sagaspe, P., Sanchez-Ortuno, M., Charles, A., Taillard, J., Valtat, C., Bioulac, B. and Philip, P., 2006. Effects of sleep deprivation on Color-Word, Emotional, and Specific Stroop interference and on self-reported anxiety. Brain and cognition60(1), pp.76-87.

https://www.sleepcouncil.org.uk/wp-content/uploads/2013/02/The-Great-British-Bedtime-Report.pdf

The Nocebo Effect

The Placebo Effect: a psychological effect in which a treatment which contains no active medical substance causes an improvement in symptoms. For example, a participant in a trial takes a sugar pill believing it could be real medication and find their back pain goes away.

This effect has been well documented and is relatively well known (for more information read my blog post here). But what about the Nocebo effect? In this instance, the opposite happens. A participant in a trial takes a sugar pill, or receives a fake injection, and start to feel negative side effects of the medication. How is this possible when no active medication was received?

To begin to explain how this effect occurs, I’ll start by telling you a bit about how clinical trials are conducted. Before a participant consents to take part in the study, they have to read a participant information sheet which explains all the details of a trial and what will happen. In a drug trial, such as one testing a new medication to help persistent back pain, participants will also have to read a list of potential side effects, much like those you find on the leaflet that comes in the box with medication. When participants sign up, they are told that they might receive the real medication, or they might receive a sugar pill. Having the control group of those who receive fake medication is important in clinical trials, as it allows you to show that any improvement is due to the medication being tested and not other factors such as symptoms improving over time. The reason control groups are given fake medication instead of having no medication at all allows for researchers to see how much of the improvement of the real medication is due to it’s active ingredients, and to show that participants haven’t just got better because of the placebo effect.

placebo-655x353
image from http://www.thehealthsite.com/diseases-conditions/mind-blowing-facts-about-the-nocebo-effect-k0517/

Even though participants have received the placebo medication they can still believe it is the real one – a placebo should be administered in exactly the same way as the real medication to be a true control. Therefore, it is this belief that they have taken the real drugs that can lead them to report side effects from it. One review of the evidence shows that around a quarter of participants taking a placebo drug experience adverse side effects from it, and that this can be higher than the participants taking the real medication! (Barksy et al, 2002). Visual cues can also induce nocebo effects: one study tested how participants rated the effectiveness and side effects of either branded or unbranded drugs (both in fact were placebos). Perhaps unsurprisingly, participants rated the branded drugs as more effective, and thought the unbranded drugs caused more side effects (Faasse et al 2013).

Several explanations have been put forward to explain the nocebo effect, including conditioned responses or participant’s expectations. For example, a doctor giving you an injection warns you that it might hurt, so you feel subjectively more pain than if they had been reassuring. Some studies investigating the neural basis of the nocebo effect in pain have hypothesised that the effect is caused by increased activity in certain areas of the brain such as the hippocampal network (which is involved in pain modulation) (Ploghaus et al, 2001). This activity is in turn caused by increased anxiety, brought on by the expectation of pain.

This brings a certain ethical dilemma for healthcare professionals and those running clinical trials. It is important the the patient or participant is given all of the information, in order to give informed consent. However, if giving someone more information would cause them to feel more pain, what would you do?

 

References:

Barsky, A.J., Saintfort, R., Rogers, M.P. and Borus, J.F., 2002. Nonspecific medication side effects and the nocebo phenomenon. Jama287(5), pp.622-627.

Faasse, K., Cundy, T., Gamble, G. and Petrie, K.J., 2013. The effect of an apparent change to a branded or generic medication on drug effectiveness and side effects. Psychosomatic medicine75(1), pp.90-96.

Ploghaus, A., Narain, C., Beckmann, C.F., Clare, S., Bantick, S., Wise, R., Matthews, P.M., Rawlins, J.N.P. and Tracey, I., 2001. Exacerbation of pain by anxiety is associated with activity in a hippocampal network. Journal of Neuroscience21(24), pp.9896-9903.

Dialectical Behavioural Therapy

Talking therapies such as cognitive behaviour therapy (CBT) are well-known treatments for some mental illnesses including anxiety and phobias. Today’s post is about a type of CBT which isn’t as well known: dialectical behaviour therapy, or DBT.

CBT focuses on changing unhelpful thoughts and behaviours which cause the continuity of illness – for example changing the obsessive thoughts in OCD through talking and challenging beliefs in therapy (for more about CBT, read my post here). DBT also does this, but with an additional focus on accepting who you are as a person at the same time. ‘Dialectical’ just means to resolve differences and find a balance in patterns of behaviour. It has been developed to treat individuals who experience intense emotions, and is one of the recommended treatments for symptoms of Borderline Personality Disorder such as self harm, impulsivity, and unstable relationships (Mind, 2014).

The figure below from the Psychiatric Times shows the 4 sets of primary skills taught as part of DBT: mindfulness, emotion regulation, distress tolerance and interpersonal effectiveness. This training is usually in groups, in addition to 1 to 1 therapy sessions.

DBT

 

DBT has been shown to be more effective at reducing symptoms associated with borderline personality disorder than standard group therapy (Soler et al, 2009). In this experiment, participants were randomly assigned to either receive standard group therapy or DBT over 13 weekly sessions. The group who received DBT had greater improvement in depression, anxiety, emotion regulation, irritability and anger than the group who received standard therapy. It also showed almost twice as high retention rate of participants throughout the programme, suggesting it is an acceptable intervention for the treatment of borderline personality disorder.

Another study which compared DBT to usual treatment for women with borderline personality disorder found that participants in the DBT group showed lower levels of self harm than those who received standard treatment (Verheul et al, 2003). The authors hypothesised that this result could be due to specific features of DBT such as monitoring of self-injury with early sessions focusing on modifying these behaviours, patients being encouraged to phone their therapist before carrying them out, and more support for the therapists themselves resulting in less burnout (and so improved patient outcomes).

Overall, this evidence shows the effectiveness of DBT in treating symptoms of borderline personality disorder. More recently, research has moved to test whether DBT is an effective treatment for other conditions such as traumatic brain injury, substance abuse, depression, eating disorders and conduct disorders. However, one recent review concluded that more evidence needs to be collected to establish whether it is the best treatment for other types of mental illness (Valentine et al, 2014).

Thanks for reading this overview of DBT, if you’d like to find out more then Mind have some great online resources – see the link below.

https://www.mind.org.uk/media/1594506/ms_dbt_2014.pdf

References:

Mind (2014) https://www.mind.org.uk/media/1594506/ms_dbt_2014.pdf

Soler, J., Pascual, J.C., Tiana, T., Cebrià, A., Barrachina, J., Campins, M.J., Gich, I., Alvarez, E. and Pérez, V., 2009. Dialectical behaviour therapy skills training compared to standard group therapy in borderline personality disorder: a 3-month randomised controlled clinical trial. Behaviour research and therapy47(5), pp.353-358.

Valentine, S.E., Bankoff, S.M., Poulin, R.M., Reidler, E.B. and Pantalone, D.W., 2015. The use of dialectical behavior therapy skills training as stand‐alone treatment: A systematic review of the treatment outcome literature. Journal of clinical psychology71(1), pp.1-20.

Verheul, R., Van Den Bosch, L.M., Koeter, M.W., De Ridder, M.A., Stijnen, T. and Van Den Brink, W., 2003. Dialectical behaviour therapy for women with borderline personality disorder. The British Journal of Psychiatry182(2), pp.135-140.

Resilience – innate or acquired?

Hi everyone, and Happy New Year! I’m back after having a few weeks off blogging, and plan to stick to my schedule of 1 post a week in 2018 (usually posted on Thursdays, 4pm GMT).

To start off this year, I thought I’d talk about a concept in psychology which is being applied more to mental health – resilience. Whilst the idea of something being resilient probably isn’t new to you, you may not be aware of how people can be resilient, and what the benefits are of this personality trait.

In psychology, resilience means that someone is able to cope and adapt to difficult life events or stressful situations such as serious health problems or losing their job. It is therefore able to protect against negative outcomes of the stressful event and enable individuals to ‘bounce back’ quicker.

The protective factor model of resilience states that a protective factor such as social support, or self-esteem, interacts with the stressor to reduce negative outcomes such as anxiety or depression (O’Leary et al, 1998). People who have higher levels of social support are more likely to cope with stressful situations, with one study showing that social support moderated the effect of stress on depression scores (Pengilly & Dowd, 2000). Another well-studied protective factor is hardiness, which was identified by Kobasa in 1979. He compared personality traits in executives, and compared who did or did not get ill after stressful life events. He found that those who did not get ill showed more hardiness, which he defined as having a ‘commitment to self’ – an active participation in activities and the outside world; an ‘internal locus of control’ – the idea that you are in control of events that happen to you; and a sense of meaningfulness.

resilience-3
image from https://help4hd.org/on-being-resilient/

As resilience has been shown to have several protective factors on stressful life events, there has been some debate about whether resilience can be taught to improve how people cope, and therefore improve their mental health. One study carried out in college students compared scores on stress levels between a control group and a group who received a resilience intervention (Steinhardt & Dolbier, 2008). The intervention focused on teaching problem solving, coping strategies and awareness of the different responses to stress. Participants in this group were also encouraged to take responsibility and self-leadership (actions coming from the self). Results showed that the group that took part in resilience training had higher resilience scores and scores of protective factors such as self-esteem. They also showed more effective coping strategies and lower scores on tests assessing depression and stress than the control group who did not receive the intervention. This effect was found with only 4 2-hour teaching sessions, showing that resilience can be taught in a relatively short space of time.

Several other studies have shown that resilience can be taught, something which is now gaining in popularity and can be applied to several populations from students to soldiers. Healthcare professionals are also taught resilience techniques as a way of coping with long term stress in emergency situations (McAllister & McKinnon, 2009).

There are some things you can try if you want to improve your resilience. Taking a break, using your support network, and looking after your physical health are all things which could improve how you cope with pressure or stressful situations. For more information on these tips and more, check out Mind.org’s advice here.

 

References:

O’Leary, V.E., 1998. Strength in the face of adversity: Individual and social thriving. Journal of Social issues54(2), pp.425-446.

Pengilly, J.W. and Dowd, E.T., 2000. Hardiness and social support as moderators of stress. Journal of clinical psychology56(6), pp.813-820.

Kobasa, S.C., 1979. Stressful life events, personality, and health: an inquiry into hardiness. Journal of personality and social psychology37(1), p.1.

Steinhardt, M. and Dolbier, C., 2008. Evaluation of a resilience intervention to enhance coping strategies and protective factors and decrease symptomatology. Journal of American college health56(4), pp.445-453.

McAllister, M. and McKinnon, J., 2009. The importance of teaching and learning resilience in the health disciplines: a critical review of the literature. Nurse education today29(4), pp.371-379.

Why do we dream?

Have you ever stopped to wonder why we dream at night? From sweet dreams to recurring nightmares, our mind is rarely silent – regardless of whether we can really remember their content in the morning.

Sometimes, we find our dreams are linked to things going on in our lives right now, worries about future events or strong memories from the past. This therefore seems to suggest that dreams are in some way linked to our memory, but exactly how, no one seemed sure.

Recent research has investigated the role of dreams and REM sleep (the phase of deep sleep) in the consolidation of long term memory. Consolidation just means the process whereby our memories move from short term to long term storage. In our long term memory, memories are stored for recall. Rehearsal (thinking about) these long term memories briefly involves short term processing, and this rehearsal strengthens the storage of these memories. Dreams may play a part in this consolidation and rehearsal process.

To find out more about REM sleep and our sleep cycle then why not read my previous post here.

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Photo by clownbusiness/Shutterstock, with additional illustration by Lisa Larson-Walker

As I mentioned early, our dreams can have similarities to events which have taken place in our lives. Some research has focused on investigating the content of our dreams and found that the events which tend to be included in our dreams are ones which are rated as more emotional, although not more stressful, than those not incorporated (Malinoski & Horton, 2014). This suggests that REM sleep might help to process emotional memories. Further evidence to support this hypothesis is that levels of REM sleep are lower in people with depression (Cartwright, 1983) and PTSD (Ross et al, 1989).

However, although these dreams can contain elements of real life, they are often distorted: it is rare for the complete memory to be ‘played out’ in our dream. It is been suggested that this is because during sleep we cannot access full episodic memories (memories of events) but instead just traces of them.  This has been hypothesised to be due to reduced hippocampus (the part of our brain involved in memory processing) activity during REM sleep (Buzsàki, 1996). The fact that our dreams can contain strange events or impossibilities is thought to be due to a lack of activity in the prefrontal cortex – the area involved in attention and logic (Stickgold et al, 2001).

In addition to consolidating episodic memories another proposed function of our dreams is to enhance learning of procedural tasks (Smith et al, 1996). Studies in rats have found increased levels of REM sleep after procedural learning, and that less REM sleep resulted in poorer memory (Smith et al, 1985).

Whilst REM sleep and our dreams may be useful for certain types of memory consolidation, it doesn’t mean that this is the only way consolidation takes place, or that it is needed to consolidate every type of memory (Stickgold et al, 2001). The authors of this review hypothesize that dreaming enables the brain “to identify and evaluate novel cortical associations in the light of emotions… during REM”. To put it simply, when we dream our brain is working on processing new memories, learning procedures, and our emotions to events.

 

Seasonal Affective Disorder

It’s that time of year – the clocks have gone back, it’s cold, and already getting dark on our commute home. Whilst many people moan about this time of year, for some it can trigger symptoms of low mood and depression.

Seasonal Affective Disorder is defined as “a type of depression that comes and goes in a seasonal pattern.” (NHS Choices). It’s typically worse from December to February, getting better in spring and summer. For SAD to be diagnosed, there has to be clear evidence of worsening symptoms during winter, which can’t be explained by other circumstances (DSM-IV). In addition, there needs to be evidence for part or full remission during the summer months. Symptoms of SAD are similar to those of depression: low motivation and self-esteem, sleep problems, changes in appetite, withdrawing from social interactions and persistent negative thoughts.

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Estimates of the prevalence of SAD range from 0 – 9.4% of the population, depending on who is being studied (Magnusson, 2000). One study compared rates of SAD at 4 different latitudes in the USA and found that is was most common in the northern latitudes (Rosen et al, 1990), which would be expected as SAD can be triggered by lower levels of natural light. This study also found higher rates of SAD in females than males (this finding is in line with overall levels of depression between men and women). It is thought to be caused by the lack of sunlight in winter months disrupting our circadian rhythm, which can be described as our internal body clock. This can affect the serotonin system in the brain, which is responsible in part for mood regulation.

There are various different treatment options for SAD, including light therapy, cognitive behavioural therapy, or antidepressants (Lurie et al, 2006). I’ve spoken about CBT before on this blog (see here for more information), so today I’ll just focus on light therapy and antidepressants as treatments for SAD.

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Light therapy involves sitting by a specialised lamp, which emits a specified wavelength and brightness of light (at least 2500 lux). It is thought to work by encouraging the brain to produce serotonin – a neurotransmitter which is linked to feeling happy. Sitting by a lamp for 30 minutes to an hour each morning is the recommended ‘dose’ of light (NHS.uk). One meta-analysis has shown that light therapy is as effective as drug therapy in treating SAD (Golden et al, 2005).

Some antidepressants also work by increasing our serotonin levels. Known as SSRIs (selective serotonin reuptake inhibitors), they work by stopping as much serotonin from being reabsorbed at synapses in the brain and therefore leading to an increase in our mood. For antidepressants to be optimally effective in SAD, the NHS recommend starting to take them before winter and continue until spring.