Introversion vs Extraversion

Introversion and extroversion are probably two of the most widely known personality traits. Stereotypically, an introvert is characterised by someone who is quiet and shy, and prefers to spend time alone. In contrast, an extrovert is usually loud and boisterous, and always needs to be surrounded by people.

The words extrovert and introvert were first popularised almost 100 years ago by Carl Jung in 1921. Introverts prefer the inner world and to focus on their thoughts, whereas extroverts prefer the external world of activities and other people. Introverts also gain their energy from being alone, whereas extroverts recharge by socialising with others.

In modern society, it is extroverts who are praised and rewarded; being called ‘quiet’ is often a negative adjective. In her book ‘Quiet’, Susan Cain explores why the extrovert has become the ideal, and made me realise that there is far more to introversion and extroversion than the stereotypes described above.

For example, Cain describes introversion and extroversion as opposing ends of a scale. People can be firmly at one end, but they can also be somewhere in the middle – known as ambiversion. People can also be extremely different depending on their current situation, with introverts who normally prefer peace and quiet able to enjoy performing on stage in front of thousands. This is characterised by the “person-situation” debate in psychology – are personality traits fixed, or do they just depend on the situation that the person is in? Psychologists on the “person” side argue that we have fixed personality traits which are based on our biology, whilst those on the “situation” side believe that we do not have core traits, but a range of traits which we exhibit in certain situations.

One psychologist in favour of the “person” side of the debate is Hans Eysenck, who developed his personality theory around levels of stimulation – the amount of input we are receiving from external factors. He used this to explain introverts and extroverts, with extroverts preferring higher levels of stimulation than introverts, and so seeking it through spending more time in social situations. The amount of stimulation you prefer has a biological basis, with Eysenck hypothesising that an area of the brain known as the ARAS (see image below) involved is in controlling the balance of stimulation. He believed that the ARAS functioned differently in introverts and extroverts, which is why extroverts seek stimulation, whilst introverts retreat from it (Eysenck, 2017).

ARAS

Although psychologists now think that things are a bit more complicated that Eysenck’s theory, there is some evidence to suggest the basis of it is true. In one of his famous experiments, he put a drop of lemon juice on the tongues of introverts and extroverts and measured the amount of saliva they produced (which showed how stimulating they found the juice). He found that introverts produced more saliva to this stimulus, as they are more sensitive to stimulation (Eysenck & Eysenck, 1967). Another study asked introverts and extroverts to take part in a task whilst wearing headphones which randomly played bursts of noise. Participants were asked to set the level of this noise to what was most comfortable for them, and results showed introverts set this level at an average of 55 decibels, compared to 72 decibels for the extroverts. When introverts had to do the task with the same noise level as the extroverts (or vice versa) they performed much worse, despite their performance being equal before (Geen, 1984).

Research such as this suggests there is a biological basis to whether we are more introverted or extroverted. Which category do you think you would best fit in to?

Thanks for reading and if you want to find out more about this topic I’d definitely recommend reading Susan Cain’s book – referenced below.

References – as mentioned in Cain, 2013:

Cain, S., 2013. Quiet: The power of introverts in a world that can’t stop talking. Broadway Books.

Eysenck, S.B. and Eysenck, H.J., 1967. Salivary response to lemon juice as a measure of introversion. Perceptual and motor skills24(3_suppl), pp.1047-1053.

Eysenck, H., 2017. The biological basis of personality. Routledge.

Geen, R.G., 1984. Preferred stimulation levels in introverts and extroverts: Effects on arousal and performance. Journal of Personality and Social Psychology46(6), p.1303.

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Not Ill Enough

Imagine living with depression. It affects every aspect of your life, from your work to the time you spend with your family. You experience intrusive negative thoughts. You begin to suffer from insomnia, which in turn increases feelings of anxiety. Imagine living with depression, but being told you are not ill enough to qualify for mental health treatment.

This scenario is unfortunately far too common in those seeking help for mental illness. Adult mental health services are often only able to treat the most severely ill, with their treatment focus on those with severe and enduring mental illnesses, such as psychosis or bipolar disorder (McGorry, 2007). This has led to strict eligibility criteria to be put in place when assessing whether someone is suitable to be cared for at their service, something thought to be in part due to a lack of funding and resources (Belling, 2014). If someone visits A&E with a broken arm we don’t wait for it to get worse before we treat it, so why does this happen if someone goes to their doctor with signs of an eating disorder? A recent investigation by the British Medical Associate found waiting lists of up to 2 years in some parts of the UK, (BMA, 2018). Once again this shows the disparity between our attitudes to physical vs mental healthcare.

According to the eating disorder charity BEAT, some people had to wait an average of 182 days to access care in some areas of the UK. This is despite all evidence pointing to the advantages of early intervention: an individual with an eating disorder is 50% less likely to relapse if they can access treatment early. Treatments have also been shown to be more effective if accessed at an early stage (BEAT, 2018).

beat

This problem isn’t just specific to the UK – one study of carers with mental illness in Australia found that they had to push for their relatives to access appropriate care, with one of the main barriers being that they were not ill enough to be admitted to hospital for their mental health, in some cases despite being suicidal (Olasoji, 2017). Another study looked at the treatment gap in different countries (the percentage difference between the numbers needed treatment and those receiving treatment for it) and found the treatment gap for major depression to be between 36% in the Netherlands to 73% in Finland (Kohn et al, 2004). The international nature of this disparity in mental health care shows how global attitudes to mental illness need to change to allow people to access appropriate treatment as soon as they need it.

Young people can also experience disruption to care due to not meeting the eligibility thresholds in adult services, despite being eligible in the children’s service. In contrast to adult mental health services having high thresholds for care, those at children and adolescent mental health services can be much lower. Children’s services are generally perceived as being more supportive and nurturing than adult services, with a focus on treating emotional and developmental disorders, including autism and ADHD (McGorry, 2007). However this means that when young people reach the upper age limit of children’s services (at around 16-18 years old), they cannot be transitioned to adult care, as they do not meet the eligibility threshold. Therefore at this transition boundary, young people can ‘fall through the gap’ between services despite still being unwell. One study in Ireland estimated that two-thirds of young people do not receive a referral to adult services, despite still being unwell when they reached the upper age limit of children’s services (McNicholas et al, 2015). Those who do receive a referral can still experience a gap in care: adult services can have waiting lists of up to 6 months (Hovish et al, 2012).

It is clear that something needs to change to ensure that people with mental illness are able to access timely and appropriate support, without having to wait for their condition to get worse in order to qualify for treatment.

Please share and let me know your thoughts using the hashtag #MHAW18 and help raise awareness.

 

References:

image reference: https://www.beateatingdisorders.org.uk/early-intervention-strategy [accessed 13/05/18]

Belling, R., Mclaren, S., Paul, M., Ford, T., Kramer, T., Weaver, T., Hovish, K., Islam, Z., White, S. & Singh, S. P. 2014. The effect of organisational resources and eligibility issues on transition from child and adolescent to adult mental health services. Journal of health services research & policy, 19, 169-176.

https://www.bma.org.uk/news/2018/february/the-devastating-cost-of-treatment-delays %5Baccessed 13/05/18]

Hovish, K., Weaver, T., Islam, Z., Paul, M. & Singh, S. P. 2012. Transition experiences of mental health service users, parents, and professionals in the United Kingdom: a qualitative study. Psychiatric rehabilitation journal, 35, 251.

Kohn R, Saxena S, Levav I, Saraceno B (2004). The treatment gap in mentalhealth care. Bulletin of the World Health Organization 82, 858-866

McGorry, P. D. 2007. The specialist youth mental health model: strengthening the weakest link in the public mental health system. Medical Journal of Australia, 187, S53.

McNicholas, F., Adamson, M., Mcnamara, N., Gavin, B., Paul, M., Ford, T., Barry, S., Dooley, B., Coyne, I. & Cullen, W. 2015. Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland. Irish Journal of Psychological Medicine, 32, 61-69.

Olasoji, M., Maude, P. and McCauley, K., 2017. Not sick enough: Experiences of carers of people with mental illness negotiating care for their relatives with mental health services. Journal of psychiatric and mental health nursing24(6), pp.403-411.

 

Creativity

Creativity – why does it come naturally for some, but others struggle to use their imagination? What are the best ways to encourage creativity  and how do you be more creative? These are just some of the questions I’ve got about creativity, and I’d love to know how to beat the creative block. Read more to see what I found out..

creativity

When thinking about why some people are more creative than others, it might be useful to start looking at which parts of the brain are involved in creative thinking. One study involved participants with lesions in different parts of their brain, and investigated their ability to generate original ideas (Shamay-Tsoory et al, 2011). They compared their performance in a creative thinking test which involved generating novel images, and thinking of new uses for objects. Researchers found that having a lesion in the right medial prefrontal cortex (see below) had impaired creative thinking, whilst participants who had a lesion in the left medial prefrontal cortex actually had enhanced creative ability. The researchers hypothesised that this result could be explained by language lateralisation – language is controlled by the left side of the brain, and could normally interfere with the creative process. Therefore, when this part of the brain is damaged, our creativity improves.

prefrontal-cortex

Another recent study has examined why some people are more creative than others (Beaty et al, 2018). They used fMRI imaging to scan the brains of participants whilst they took part in a creative problem solving task, and identified a network of structures which was used for generating creative ideas. The researchers then compared the strength of the connections between these areas in people who had low or high creativity scores, and found that the people who had the strongest connections between different brain structures came up with better ideas during the task.

However looking at brain structure isn’t enough, and would be oversimplifying the impact of our physical and social environments on our ability to be creative (Damasio, 2001). Damasio argued that in order to be creative, we must meet the following criteria:

  • the motivation to create
  • the courage to face scrutiny and criticism
  • extensive experience and expertise (e.g. to know what has been done before, what is original)
  • insight into your own mind, and the minds of others
  • the ability to generate and recall a variety of images
  • a large working memory capacity, to be able to hold these images in mind at the same time
  • the ability to make decisions, to choose which ideas to keep and which to discard

When trying to improve our creative performance, one study has examined the role of seeing examples in helping creativity and generating novel ideas (Kulkarni et al, 2012). Participants in a creativity task were either shown examples early, late, or repeatedly in the process, and their performance was compared with those who didn’t see any examples.  They found that seeing examples anywhere in the creative process reduced originality, and that participants who saw examples also produced fewer drawings. The authors hypothesised that this result could be because viewing examples raises the bar of what is an ‘acceptable idea’, so they spent more time refining current ideas as opposed to generating new ones. However, participants who saw examples early in the process were judged to have improved creativity, as measured by number of novel features of drawings and subjective ratings of performance.

 

References:

Beaty, R.E., Kenett, Y.N., Christensen, A.P., Rosenberg, M.D., Benedek, M., Chen, Q., Fink, A., Qiu, J., Kwapil, T.R., Kane, M.J. and Silvia, P.J., 2018. Robust prediction of individual creative ability from brain functional connectivity. Proceedings of the National Academy of Sciences, p.201713532.

Damasio, A.R., 2001. Some notes on brain, imagination and creativity. The origins of creativity, pp.59-68.

Kulkarni, C., Dow, S.P. and Klemmer, S.R., 2014. Early and repeated exposure to examples improves creative work. In Design thinking research (pp. 49-62). Springer International Publishing.

Shamay-Tsoory, S.G., Adler, N., Aharon-Peretz, J., Perry, D. and Mayseless, N., 2011. The origins of originality: the neural bases of creative thinking and originality. Neuropsychologia49(2), pp.178-185.

image reference: http://www.psypost.org/2017/06/depressed-people-medial-prefrontal-cortex-exerts-control-parts-brain-49168

 

 

 

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

 

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’.

25298
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

 

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.

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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.

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.

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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.