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The globalisation of mental illness Ross White questions recent developments

Incorporating Psychologist Appointments ÂŁ5 or free to members of The British Psychological Society

news 170 careers 216 reviews 226 looking back 234

how power affects the brain 186 involuntary autobiographical memories 190 the long reach of the gene 194 children and technology 200


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Contact The British Psychological Society St Andrews House 48 Princess Road East Leicester LE1 7DR tel 0116 254 9568 fax 0116 227 1314 mail@bps.org.uk www.bps.org.uk www.twitter.com/bpsofficial

Welcome to The Psychologist, the monthly publication of The British Psychological

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

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letters qualitative research and the REF; rape in India; intelligence; diagnosis; new environmental ‘Forum’ column; and more

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news and digest 170 what should we worry about?; psychosocial support in Algeria; fMRI retrospective; cosmetic surgery; the gorilla on the lung; reports from the Society’s Division of Occupational Psychology Annual Conference; nuggets from the Society’s Research Digest; and more

The globalisation of mental illness Ross White considers the issue 182

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How power affects the brain Ian H. Robertson on what he has dubbed the ‘winner effect’

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Involuntary autobiographical memories Rosemary Bradley, Chris Moulin and Lia Kvavilashvili with some surprising findings and implications

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The long reach of the gene Gary Lewis and Timothy Bates discuss genetic influence on politics, prejudice and religiosity

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Children and technology Jon Sutton talks to Nicola Yuill from the University of Sussex

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society 204 President’s column; Fellowship; North West/North East of England Branch Conference; and more careers and appointments

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it’s a social psychology special as we meet Elizabeth Stokoe and Mick Billig

march 2013

THE ISSUE Have you heard of ‘brain fag’? ‘Ghost sickness’? ‘Koro’? All are so-called ‘culture bound syndromes’ listed in DSM, the latter referring to a person’s overwhelming belief that their genitals are shrinking and will disappear. Why have such syndromes remained largely ‘culture bound’, while Western concepts have crept across the globe? In 2004 the New York Times wrote that ‘the notion that [your soul] can catch cold (kokoro no kaze) was introduced to Japan by the pharmaceutical industry to explain mild depression to a country that almost never discussed it’. That article (see tinyurl.com/a4jh3ac) went on to conclude that ‘rather than expanding options for care for those who suffer, the globalization of psychopharmacology may ultimately sow a monocrop of ideas about health and sickness’. In this issue (p.182), Ross White raises a similar possibility: that globalising notions of psychiatric illness may cause more harm than good. Elsewhere there’s our usual serving of articles, interviews, news, reviews, and another excellent contribution from a ‘New voice’. Dr Jon Sutton

reviews 226 terrorist’s creed; My Mad Fat Diary; Les Misérables; How to Build a Bionic Man; and apps, radio, and more in our broader section new voices 232 parenting next door to the bogeyman – Suzanne Dash with the latest in our series for budding writers (see www.bps.org.uk/newvoices) looking back 234 the work of Frances Hodgson Burnett and its commentary on mind and body in illness, with Anne Stiles one on one

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…with Shivani Sharma

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NEWS

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Worrying on the Edge Edge.org, the online soapbox for scientists and other intellectuals, has published the answers to its latest annual question – What should we be worried about? As usual, numerous psychologists were invited to contribute, including many of our home-grown colleagues. Recurring anxieties were cultural homogenisation and the march of technology, especially the internet (read all the answers at http://edge.org/annual-question). At the Institute of Cognitive Neuroscience, University College London, Sarah-Jayne Blakemore believes we should be concerned about the effect of environmental factors on the development of the adolescent brain, something she says we know little about. She highlighted the possible adverse effects of excessive gaming and social networking, and the UNICEF estimate that 40 per cent of teenagers worldwide lack access to secondary education. ‘Adolescence represents a time of brain development when teaching and training should be particularly beneficial. I worry about the lost opportunity of denying the world’s teenagers access to education,’ she said. For Susan Blackmore, what’s worrying is that we’re losing our manual skills and developing an ever deeper dependent relationship with technology. ‘Whether it’s climate change, pandemics, or any of the other disaster scenarios… and we can no longer sustain our phones, satellites and Internet servers.

What then?’ she asks. ‘Could we turn our key-pressing, screen swiping hands to feeding ourselves? I don’t think so.’ The availability of superficial knowledge at the touch of a button is creating ‘a drearily level playing field’, according to Nicholas Humphrey at the LSE. We used to have to work hard to discover and learn things, he said, and the journey was arguably more important than the ultimate facts. But ‘soon no one will be more or less knowledgeable than anyone else,’ Humphrey warned, ‘…it will be knowledge without shading to it, and, like the universal beauty that comes from cosmetic surgery, it will not turn anyone on.’ The loss of death, that’s what Kate Jeffery, Head of the Department of Cognitive, Perceptual and Brain Sciences at UCL, thinks we should be worried about. Death allows species to improve and flourish, she said, and yet genetic research promises to create a world filled with not just your grandparents’ parents’ parents, and their parents, but everyone else’s too. ‘Truly would the generations be competing with each other: for food, housing, jobs, space.’ Away from the concerns of technical and medical progress, it’s the persistence of the gap between C.P. Snow’s two cultures that worries Simon BaronCohen, director of the Autism Research Centre at Cambridge University. In particular, he thinks the gap may have widened when it comes to the way that

sex differences are understood. ‘[T]he debate about gender differences still seems to polarize nature vs. nurture,’ he said, ‘with some in the social sciences and humanities wanting to assert that biology plays no role at all, apparently unaware of the scientific evidence to the contrary.’ Meanwhile, Bruce Hood, Director of the Bristol Cognitive Development Centre at the University of Bristol, argued that we should be worried about the recent trend towards placing so much value on the societal ‘impact’ of science research, especially its economic merits. ‘I would submit that focusing on impact is a case of putting the cart before the horse or at least not recognizing the

SURVEYING OUR VALUES Social commentators often bemoan the loss of family values and rise in selfishness in contemporary Britain. A new survey of the nation’s values paints a far more positive picture. Last December, the Barrett Values Centre asked 4000 people across the UK to pick the 10 values or behaviours that most reflect who they are. The five most commonly chosen values were ‘caring’, ‘family’, ‘honesty’ and ‘humour/fun’. Respondents also said they experienced values in their local community that largely matched their own values, in terms of family and friendship. It was a different story at the national level, where there was a striking disconnect between the values people would like to see reflected in the way the UK operates, and the values they perceived to be operating. The top three desired values were: employment opportunities, caring for the elderly and caring for the disadvantaged. Yet the top three perceived values at the national level were: bureaucracy, crime and violence, and uncertainty about the future. The UK’s ‘cultural entropy’ score (based on the proportion of negative values selected by respondents) was higher than eight of nine other

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European nations surveyed, and higher than in the US, Canada and Australia. The survey was supported by the Action for Happiness movement and the UK Office for National Statistics. The chief executive of Action for Happiness, Dr Mark Williamson, said: ‘At a time when many people fear we are losing our moral foundations, this research shows that what people in the UK actually value most of all is caring for others.’ Critics may have concerns about the survey methodology. As well as the reliance on self-report, respondents’ choice of values was inevitably constrained by the values they were given to choose from. For instance, in the list of 93 national values, people could choose ‘animal welfare’ but not ‘mental health’, which wasn’t in the list; ‘environmental pollution’ but not ‘green space’ or ‘scientific progress’; ‘tolerance’ but not ‘uncontrolled immigration’. CJ I The United Kingdom Values Survey: Increasing Happiness by Understanding What People Value is available in PDF form at tinyurl.com/bzkqxdj

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PAUL BOX/REPORTDIGITAL.CO.UK

NEW CENTRE IN BATH

value of theoretical work,’ he said. Among the international contingent of psychologist contributors were Mihaly Csikszentmihalyi, the man who developed the concept of ‘flow’, and Alison Gopnik the author and developmental psychologist. Like many of his British colleagues, Csikszentmihalyi highlighted his anxieties about technology, especially the arrival of 3D immersive role-playing games. The ‘incessant warfare’ involved in such games is not virtual to the child, he warned – it’s the child’s reality – and within one or two generations Csikszentmihalyi believes our children will grow up unable to tell reality from imagination. ‘Of course

humanity has always had a precarious hold on reality,’ he said, ‘but it looks like we are headed for a quantum leap into an abyss of insubstantiality.’ Alison Gopnik is also worried about children; in particular she’s worried that many parents worry about the wrong things – middle-class concerns like the direction of push-chair seats or the rights and wrongs of co-sleeping – but that as a society we don’t worry enough about the bigger picture, the huge numbers of children who continue to live below the poverty line and who lack a safe, stable environment in which to develop. ‘Children, and especially young children, are more likely to live in poverty than any other age group,’ she said. ‘This number has actually increased substantially during the past decade. More significantly, these children not only face poverty but a more crippling isolation and instability.’ CJ

I What do you think we should be worried about? Send your thoughts to psychologist@bps.org.uk

Rapid deployment January saw a British Red Cross psychosocial support team hurry to Algeria to help Britons who had been involved in the four-day siege and hostage crisis. The team, including clinical psychologist Dr Sarah Davidson, travelled to North Africa the day after militants overran a gas plant facility. Davidson, Deputy Clinical Director on the professional doctorate in clinical psychology at the University of East London, said: ‘We went as part of the Foreign and Commonwealth Office’s rapid deployment team, which is responsible for supporting Britons overseas. We were there to provide emotional support and practical help to British nationals caught in the situation, and their relatives.’

Dr Sarah Davidson in Algeria

Part of the team’s role was ‘bearing witness’. Davidson said: ‘We listened to what the people affected wanted to share and helped them think of ways of understanding their traumatic experiences and how to deal with them. Those who escaped were worried for those

read discuss contribute at www.thepsychologist.org.uk

they’d left behind and they felt a huge responsibility for getting the best outcome possible. We helped them focus on what they could do, but also to recognise the limitations of what they could do. We also worked with them on looking after themselves, for example trying not to spend lots of time imagining what their friends were going through, and encouraging them to seek support from friends and partners. As they begin to recover it will be important to not constantly retell the story but to plan points to grieve and mark what happened.’ JS I Davidson wrote about her work in The Psychologist in April 2010 (see tinyurl.com/a9j2mev)

A new centre providing specialist treatment for anxiety disorders is to open later this year in Bath. A partnership between the University of Bath and Avon & Wiltshire Mental Health Trust, the new Centre for Specialist Psychological Treatments of Anxiety and Related Problems will also conduct cuttingedge research and provide assessment and training. BPS Fellow and Chartered Psychologist Professor Paul Salkovskis will be the Centre’s new clinical director.

SOCIAL PSYCHOLOGY REPLICATIONS In the wake of recent concerns about the replicability of findings in social psychology, a special issue of the journal Social Psychology has been announced, dedicated to replicating important results in social psychology. The deadline for full replication proposals is imminent, closing on 28 Feb (grants of up to $2000 are available); proposals based on aggregating existing data have until 30 March. I tinyurl.com/bh2ctjh

NORMAN KREITMAN Norman Kreitman, the psychiatrist and psychotherapist who coined the term ‘parasuicide’, to refer to non-fatal acts of self-harm, has died aged 85. A pioneer in suicide research, he identified self-harm and previous attempts at suicide as major risk factors for a person later taking their own life. Kreitman was also a poet. ‘Yet you imply your history/requires a unique and loving repair/I think that where you have come from/depends on where you are now’ are lines from ‘Therapist’, published in 1984.

CARE QUALITY CONCERNS Concerns have been raised by the Care Quality Commission (CQC) about the treatment of people detained or treated in the community under the Mental Health Act. The number of people subject to the Act has risen by 5 per cent, and evidence was found in some hospitals of a lack of patient autonomy. ‘CQC is concerned that some hospitals have allowed cultures to develop where control and containment are prioritised over treatment and care,’ said the organisation’s chief executive. CJ I Full findings at tinyurl.com/adfjfr8

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fMRI retrospective Last year marked 20 years since the first functional MRI paper was published, a milestone that’s prompted a series of retrospectives on the field (see also News, October 2011). The latest appears as a special section in the January issue of the journal Perspectives on Psychological Science. The emphasis of the (mostly US) contributors is on ways that functional MRI has indeed informed and constrained cognitive psychology theories. Recalling the advent of the technology, the section editors Mara Mather (USC Davis), John Cacioppo (University of Chicago) and Nancy Kanwisher (MIT) observed in their introduction how ‘few events are as thrilling to scientists as the arrival of a novel method that enables them to see the previously invisible’. But they also noted the later onset of scepticism. For instance, Michael Page (University of Hertfordshire) wrote in 2006 (see tinyurl.com/b8aemgq) that the explosion of fMRI ‘has not resulted in a corresponding theoretical advancement, at least with respect to cognitive psychological theory’. Was he right? Denise Park and Ian McDonough (University of Texas at Dallas) argued for

the major theoretical contribution of fMRI in the field of ageing. Traditional cognitive theories – such as limited resource theory and speed of processing theory – tended to espouse a view of ageing as ‘a passive model of decline’, they said. Since then, findings from fMRI, showing, for example, bilateral activation in older brains versus unilateral activation in younger brains (to the same tasks), had fundamentally changed this view, leading to more dynamic models of adaptation ‘characterized by plasticity and reorganization of function in response to neural degradation and cognitive challenge’. Examples of fMRI research advancing cognitive theory are rare, admitted Michael Rugg (University of Texas at Dallas) and Sharon Thompson-Schill (University of Pennsylvania), but examples do exist. The pair described work comparing brain-activation patterns associated with colour memory versus colour perception. Results have shown that the amount of anatomical overlap depends on task difficulty and subject factors (such as a preference for verbalisation or visualising information).

These findings suggest colour is represented at different levels of abstraction, available for both perception and memory – ‘it is arguable that no other method possesses the combination of spatial resolution and coverage necessary to identify this phenomenon,’ Rugg and Thompson-Schill said. It’s also important to note that the relationship between cognitive theory and functional brain imaging isn’t just one way – cognitive theory also influences the way we interpret fMRI findings, so said John Wixted and Laura Mickes (University of California San Diego). They gave the example of memory experiments in which participants say whether a stimulus is merely familiar to them (they ‘know’ they’ve seen it before), or if they can actually ‘remember’ encountering it. ‘Remember’ responses tend to be associated with increased hippocampus activity, but how to interpret this depends

Spotting the gorilla on the lung When our attention is consumed by a challenging task, it leaves us surprisingly oblivious to the unexpected. In a dramatic new study, this ‘inattentional blindness’ led 20 out of 24 experienced radiologists to miss the presence of a surprise matchbox-sized gorilla located on five slices of a lung CT scan (a picture is available at tinyurl.com/awtbq87). The radiologists had been searching through several such scans looking specifically for light, circular nodules, which are a sign of lung cancer, although they would usually be expected to also notice any other aberrant structures. Trafton Drew, Melissa Vo and Jeremy M. Wolfe (Brigham & Women’s Hospital and Harvard University), who

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conducted the study, were interested in the extent to which expertise at a primary challenging task can offset the effects of inattentional blindness. As expected, the radiologists exhibited less inattentional blindness than a control group of 25 nonmedical participants, none of whom spotted the gorilla. The radiologists also spotted more of the nodules (55 per cent vs. 12 per cent). Nonetheless, the degree of inattentional blindness exhibited by the radiologists was striking. Eye-tracking

records showed that 12 of the radiologists who missed the gorilla had in fact looked right at it for an average of half a second. ‘It would be a mistake to regard these results as an indictment of radiologists,’ Drew and his colleagues concluded. ‘As a group, they

are highly skilled practitioners of a very demanding class of visual search tasks. The message of the present results is that even this high level of expertise does not immunize against inherent limitations of human attention and perception.’ The researchers said that furthering our understanding of these processes will help in the design of optimal medical and other search tasks, so minimising the risk of important information being missed. CJ

I The study is in press at Psychological Science

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FUNDING NEWS Wrapping up the special section, Mara Mather and her co-editors shared their view that fMRI can inform cognitive theory by helping to answer four questions: ‘Which (if any) functions can be localized to specific brain regions? Can markers of Mental Process X be found during Task Y? How distinct are the representations of different stimuli or tasks? And, do two Tasks X and Y engage common or distinct processing mechanisms?’ But the editors also listed fMRI’s limitations, including its inability to demonstrate the causal role of brain activity, and the limits of its spatial resolution, with each voxel reflecting the activity of hundreds of thousands of neurons. ‘The best approach to answering questions about cognition’, they concluded, ‘therefore is a synergistic combination of behavioral and neuroimaging methods, richly complemented by the wide array of other methods in cognitive neuroscience.’ CJ I All 12 contributions to the special section are at pps.sagepub.com/content/8/1.toc Please send your verdict on the contribution of fMRI to cognitive theory to psychologist@bps.org.uk

Cosmetic surgery guidelines Psychological assessment is at the heart of new cosmetic surgery ‘professional standards’ guidelines published by the Royal College of Surgeons. The new document states that it should be standard practice to discuss relevant psychological issues with a patient during consultation prior to cosmetic surgery. ‘It is neither possible nor necessary for every patient to undergo a detailed psychological assessment with a clinical psychologist,’ the document states. ‘However, all practitioners should consider if they should refer a patient to a clinical psychologist before proceeding with further consultations or treatments and referral pathways should be in place.’ The guideline draws particular attention to patients with a history of psychiatric problems, especially eating disorders, body dysmorphic disorder or personality disorders. Concerns about cosmetic gynaecological surgery are also addressed, and it’s stated that: ‘High levels of anxiety regarding body image where appearance is within the normal range should trigger psychological referral.’ Among the contributors to the professional standards document were Chartered Psychologist and Associate Fellow Dr Andy Clarke, a Consultant Clinical Psychologist in Plastic and Reconstructive Surgery at the Royal Free Hospital; and Chartered Psychologist and Associate Fellow Professor Nichola Rumsey, Research Director of the Centre for Appearance Research, University of the West of England. CJ

I Professional Standards for Cosmetic Practice is at tinyurl.com/axnmeqc

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The Wellcome Trust has launched The Hub at Wellcome Collection, an initiative to provide resources and a stimulating space for researchers and other creative minds to collaborate on an interdisciplinary project linked to the Trust’s vision of improving human and animal health. Up to £1m is available for up to two years. Applications can be made by universities, charitable bodies and other not-for-profit organisations. Preliminary applications deadline: 3 May 2013. I tinyurl.com/azptrs2 The Worshipful Company of Curriers has healthcare bursaries available to enable established primary healthcare professionals to undertake research or personal study to enhance the healthcare of families and children in inner London who, through socioeconomic deprivation or other adverse social factors, are at high risk of physical and psychological illness. Further details are available on the website. The closing date for applications is 31 March 2013. I tinyurl.com/a6q7k6x The ESPRC has a call to fund Centres for Doctoral Training. The closing date for outline proposals is 4 April 2013. I tinyurl.com/9wd6fq6 The BBSRC Strategic Longer and Larger Grant scheme is open for the submission of outline proposals. Applications are encouraged in specific strategic areas, including ageing across the life-course. Deadline for outline applications: 18 April 2013. I tinyurl.com/y6v8y2e The Society for Education, Music and Psychology Research (SEMPRE) has two grant schemes available: I The Arnold Bentley New Initiatives Fund: one grant of up to £3000 to support new interdisciplinary initiatives concerned with the advancement or promotion of research in the psychology of music or music education. I Reg and Molly Buck Award: one grant of up to £2500 to support a postdoctoral research project in an area of study that embraces SEMPRE’s aims. Applications to both schemes can be made at any time. I www.sempre.org.uk/awards

info

on cognitive psychology theory. The dualprocess signal-detection model says this means the hippocampus supports recollection. By contrast, the continuous dual-process (CDP) model says that ‘remember’ responses reflect the strength of the memory signal (regardless of whether it’s based on recollection or familiarity), and that hippocampus activity is therefore a mark of memory signal strength, not recollection per se. A more sceptical contribution came from Max Coltheart (Macquarie University, Sydney). He highlighted a review he published with others last year of cognitive neuroimaging articles published in leading journals between 2007 and 2011. Of the 199 articles concerned with cognitive functions, just 10 per cent had attempted ‘any kind of evaluation of cognitive theories.’ Coltheart also warned against what he called the ‘consistency fallacy’ – the tendency for brain imaging researchers to report ways that their results are consistent with some cognitive theory without pointing out ‘explicitly what pattern(s) of neuroimaging data that are inconsistent with the theory could plausibly have been obtained in the neuroimaging study’.

For more, see www.bps.org.uk/funds Funding bodies should e-mail news to Elizabeth Beech on elibee@bps.org.uk for possible inclusion

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HUMAN BRAIN PROJECT A project to create a computer simulation of the human brain has won €1 billion of funding from the European Commission as part of a Future and Emerging Technologies competition. It’s hoped the Human Brain Project will lead to medical benefits, including advances in diagnosis, and the development of systems with brain-like intelligence (www.humanbrainproject.eu).

STANDARD GUIDELINES CALL Psychologists at the University of Sussex have called for standardised global guidelines on what constitutes safe levels of alcohol consumption. Richard de Visser and Nina Furtwængler looked at government guidelines across 57 countries and found huge discrepancies, including a 10-fold difference in accepted blood alcohol levels for drivers. ‘Agreed guidelines would be useful for international efforts to reduce alcoholrelated harm by increasing people’s capacity to monitor and regulate their alcohol consumption,’ said de Visser (see tinyurl.com/a9aypum).

ROBOT INTERVIEWS Leading questions are known to provoke inaccurate information from eye-witnesses, but intriguing new research suggests this isn’t the case when a robot does the interviewing. The findings by Mississippi State University researchers were reported by New Scientist and are due to be presented at the Human–Robot Interaction Conference in Tokyo this month.

MORE NEGATIVE OUTCOMES The UK Council for Psychotherapy and the British Psychoanalytic Council (BPC) have published a survey of their members, which they argue shows longer-term psychotherapy on the NHS is under threat. Seventy-seven per cent of the 800 therapists surveyed said that they’d observed negative outcomes for clients as a result of cuts to services. Gary Fereday (Chief Executive of BPC) said ‘IAPT [improving access to psychological therapies] services are helping many people, but the service was intended to be a way of improving access, and not become the only service available.’

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Silent witnesses: Using theatre to combat crime How can we reduce the risk of children who witness or experience violent crime becoming perpetrators themselves? Perhaps some answers will be gleaned from Silent Witnesses, an 18-month long collaboration between Theatre Centre and senior developmental psychologists Dr Edward Barker and Dr Natasha Kirkham from Birkbeck, University of London. Working with Year Five pupils Dr Edward Barker and Dr Natasha Kirkham across 10 inner-city primary schools at a workshop in Hackney from Birmingham, Cardiff, Liverpool, London and Manchester, Silent Witnesses will aim to help children deal with violence they may have witnessed in their community, on television or in computer games. The project also seeks to raise awareness among parents and teachers of the role they can play in improving children’s safety and well-being. It will culminate with a tour of a new play by Ed Harris in spring 2014, commissioned and produced by Theatre Centre. The project comprises three stages. First, the pupils will participate in a two-day residential programme run by playwright Ed Harris and Dr Kirkham. These involve creative writing workshops and group discussion. Then Harris will draw upon the material created in the workshops and the conversations held in schools to create a script that will be developed and rehearsed by Theatre Centre. The production will then be toured to targeted primary schools across the UK. Children, teachers and parents of children at participating schools will complete pre-play and post-play questionnaires evaluating their attitudes to violence and their responses to the play. By the end of the 18-month long project researchers from Birkbeck will have gathered evidence from over 5000 children, teachers and parents about the role of creative expression in changing responses to, and understanding of, violent behaviour. Dr Barker said: ‘We hope that by including children’s voices in the development of the play we will help to engender an atmosphere where children can talk to adults about their experiences of witnessing violence, and adults are equipped to support children and help them reduce their potential to react aggressively themselves.’ Emma Penzer, Headteacher at Mandeville Primary School, Hackney, said: ‘This project will be of great benefit to the children and staff at Mandeville Primary School. Gilpin Square and other neighbouring areas experience a high level of crime. Many children have witnessed shootings, knife crimes and criminal damage, amongst other crimes. Very rarely do they talk about them, particularly to school staff.’ JS

Suicide rates rising Months after the UK government launched its new suicide prevention strategy for England, the latest published figures from the Office National Statistics show that suicides rose significantly in the UK in 2011, with 437 more people taking their own lives compared with 2010 (a rise of 11.1 to 11.8. deaths per 100,000 population). The latest figures show men remain at particular risk, with three times the number

of suicides compared with women. For both men and women, the rate of suicide was highest among the middle-aged. A decade prior to 2010, male suicides had been almost consistently in decline. Female suicides declined from 2004 to 2007, but have mostly been rising ever since. For information on a recent Samaritans report on suicide and the government suicide prevention strategy, see November News. CJ

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division of occupational psychology conference

One personality to rule them all? The general factor of personality, or GFP, is analogous to g, the intelligence quotient that predicts to differing degrees the multiple intelligences – verbal, musical, numerical – that sit below it. This symposium at the Division of Occupational Psychology’s Annual Conference reminded us that whereas Spearman posited g in the 1900s, and Thurstone the model of multiple differential intelligences in the 1920s, it took until the 1950s for Phillip Vernon to finally reconcile the models. Practitioners who use personality emphasise its differential qualities: many facets, no one right profile. But the researchers who advocate GFP argue that there is indeed such a thing as having lots of personality, and this global factor is meaningful as it predicts a range of life outcomes. Critics question whether the GFP is down to statistical artefacts, such as an individual’s desire for social desirability influencing all their questionnaire responses.

Rob Bailey, of OPP, used his presentation to question whether a GFP could truly be useful for practitioners. He pointed out the global factor is described as reflecting people who are relaxed, sociable, emotionally intelligent, satisfied with life, and altruistic, with a low score meaning the opposite of these things. He challenged the audience to imagine cases where such information could be provided to an individual in any constructive fashion, compared to the conventional profiling approach. Bailey then presented a data set of over 1200 individuals paid to complete a 16-factor personality questionnaire, the absence of career implications giving them little incentive to ‘fake nice’ and apply spin to their results. His analysis suggested that folding factors together into more global ones lost power in predicting variables like job

satisfaction, and that granular measures may be a better bet. Rainer Kurz and Rob McIver of Saville Consulting also presented, looking more sympathetically at how a GFP-approach might be useful. McIver’s presentation showed the farthest extent of their work, which explores focusing less on one invariant global factor in favour of a particular super-score that predicts success for a particular job. He demonstrated that when a personality test is built item by item to fit with the aspects of job success that matter in the role, this criterion-based approach can let you produce single personality super-scores that are good predictors of success. The data suggested that with methodological pruning of what traits to value and which to discount, even tests that aren’t developed this way can be effective predictors. This approach is very different from a purely statistics-driven factor extraction of a global factor, and calls for psychologists to know their psychometrics and understand the target job. But it seems a promising direction to take in this area. AF

A BALANCING ACT Who is responsible for work–life balance? The individual, the organisation, or even the legislative system? That was the question posed at the start of this symposium, and it became clear that ‘one size fits all’ policies and practices don’t exist: we must tailor solutions according to needs and wants. First up was Dr Ellen Ernst Kossek (Purdue University, USA), who identified the importance of feeling in psychological control of boundaries. Based on three validated measures of ‘cross role interruption behaviours’, ‘boundary control’ and ‘work–family identity centralities’, Kossek outlined different profiles. You’re either an ‘integrator’ or a ‘separator’, or you cycle between the two: a ‘volleyer’. Add in consideration of whether your well-being level is high or low and you end up

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with six styles, including the ‘fusion lovers’ who are happy to integrate work and family life, the ‘job warriors’ who volley away to their heart’s discontent, and ‘captives’ who are the separators with low well-being. It’s also important to note that although most measures of work–life balance focus on the family, it’s an issue for the childless too. The image of Winston Churchill in his pyjamas, as an early remote worker, was a rousing one to begin the talk by Dr Christine Grant and colleagues from Coventry and Warwick Universities. Grant described her work to outline competencies related to the effective e-worker, and to develop an assessment tool. Organisations can provide training for existing and new e-workers, Dr Grant said, before

leaving us with the thought that ‘a good manager is always a good manager; a bad manager is worse as an e-worker’. It’s one thing taking your work home with you when you’re an academic, but another entirely when you’ve just been pulling a family out of some motorway wreckage. Dr Almuth McDowall (University of Surrey) looked at work–life balance selfmanagement strategies in the police force, eliciting 134 behaviours from interviews. Some were context-specific, for example in the police it’s actually very important not to take work home with you, as it is confidential and often intrusive material. McDowall said communication and negotiation over work–life balance is vital, and that there is a separate competence for line managing work–life balance in others.

Finally, Professor Gail Kinman (University of Bedfordshire) tackled a subject close to home for many: work– life conflict in UK academics. She noted that academics vary in the extent to which they wish their roles to be integrated, with many highly absorbed in the job role and most working considerably over the 48-hour working time directive. In Kinman’s survey of 760 academics in at least 99 universities, most academics weren’t getting the separation they wanted. Working at home and ICT use predicted work–life conflict. Kinman called for enhanced sensitivity to variation in boundary management styles and preferences amongst colleagues and supervisors, citing the example of sending e-mails at the weekend as potentially role modelling that behaviour for the recipient. JS

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Evidence-based management Most managers use everything but the evidence, lamented Michael Frese of the NUS Business School, Singapore, and Leuphana University, Germany, in his keynote on evidence-based management. They use obsolete knowledge, draw on personal experience, they apply specialised skills to general situations, they’re a sucker for hype (following the latest popular book), and they mindlessly mimic top business performers. Part of the problem, Frese believes, is with the field’s academic journals. He criticised the Harvard Business Review for its plethora of anecdotes, misguided assessments of the literature, and for proliferating confusing concepts like ‘deep smarts’ (instead of ‘expertise). ‘Science does not produce actionable knowledge,’ Frese said, ‘managers do not know the little evidence that there is, even business journals are not very good at providing evidence to managers, and consultants are often negligent in their role to translate evidence into actions.’ Evidence-based management aims to overcome these problems by going beyond personal experience and single studies. It uses meta-analyses and systematic reviews to combine the evidence from multiple studies, thereby cancelling out the biases of individual studies and allowing identification of moderating factors. Medicine has shown us how to use evidence professionally, Frese said, and evidence-based management can translate this approach, using the current best evidence to inform managerial decisions. Here Frese struck a more optimistic tone – ‘the correlations being produced in medicine are not that

outrageously different from the correlations we produce in occupational psychology,’ he said. Success of small firms was Take the example of connected to the importance of the relationships between personality characteristics personal initiative and entrepreneurial success. A meta-analysis of the developed an Action Principles complex literature showed that approach, incorporating an there is a relationship (need action pathway including for achievement, goals, information search, innovativeness and proactivity planning, execution and are all important; risk taking feedback. He gave an example not so much), despite a of the success of small firms widespread belief of a lack of in Africa, drawing on a metaany relationship. Indeed, the analysis that highlighted the correlation between these importance to success of personality characteristics and personal initiative (made up success was high – ‘equivalent of the factors self-starting, to the effect of Viagra’ in proactivity and overcoming medical research, Frese said. barriers). Frese and his How to apply the colleagues conducted a findings from evidence-based randomly controlled trial, management? Frese cited training entrepreneurs in a study about Uganda for three days to be internationalisation and more proactive and success from 2007, which anticipatory in their planning. showed an international The trained entrepreneurs approach was advantageous outperformed controls, and in for young firms and small one striking example, it was firms, but that this was those entrepreneurs who’d moderated by country – it was undergone the training who true for American firms and, adapted to a visit by the to a lesser extent, European Queen and turned it to their firms, but not for Japanese. advantage, an outcome Frese’s approach wouldn’t mediated by their increased be to fly out to a Japanese personal initiative. company and simply tell them The small business owners not to bother going didn’t start conducting international. Rather, he’d say, regression analyses, Frese ‘You have to worry more, you explained. Rather, they started have to be more attentive to asking more questions, paying how you internationalise attention to feedback, seeing compared to an American what worked and adopting the firm.’ The reasons for the perspective of the customer – Japanese situation may have to what would a customer see do with culture or language – here, what would bother him? we don’t know – but the The policy implications are important message is huge, Frese concluded. If 10 ‘evidence-based management is per cent of small business not a recipe; you have to think managers undertook the same about it, use your knowledge training, on average they’d and expertise, be vigilant and each employ two to three extra have a good feedback system’. employees, which would To help translate science translate into hundreds of into actionable science-based thousands more employed management, Frese has across the country. CJ

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LIFETIME ACHIEVEMENT The 2011 Lifetime Achievement Award went to John Toplis, an expert in top management selection. Now semi-retired, for many years Toplis was head of psychological services at the Post Office. He was also mentored early in his career by Dick Buzzard, who founded the Division of Occupational Psychology. Toplis used his talk to share a shopping list of seven concerns he has about the practice of occupational psychology today and in the future: 1. The fact that only very short training is needed to enable anyone (psychologist or not) to use the best psychometric tests. 2. Licensed test-users are qualified for life, which disregards inevitable changes in best practice. 3. How to integrate results from staff annual appraisals with the results obtained when existing staff are sent to assessment centres – ‘What if a sterling member of staff flunked at 24-hour assessment?’ 4. The diagnostic skills of occupational psychologists are still in the dark ages, ‘it’s a huge black hole’, with most having no training in how to diagnose and treat organisational problems. 5. Are occupational psychologists aware of recent threats to the scientific freedom of speech? (Toplis mentioned Simon Singh’s troubles with the British Chiropractic Association). 6. Are we taking sufficient note of advances in devices for measuring brainwaves, and the potential these may have for assessing and developing cognitive abilities? 7. Finally, Toplis made a case for establishing a new advisory body, an independent organisation to ‘assess the impact of work, working practices and legislation at work.’ CJ

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BANKING CRISIS The complexity of the banking crisis was brought home by Binna Kandola of Pearn Kandola (with help from Rose Challenger of Leeds University Business School) in an interactive session that applied socio-technical systems theory to the collapse of the Lehman Brothers bank in 2008. Kandola described how the bank’s demise was caused by a system-wide failure. There were issues of leadership (Chairman and CEO Richard S. Fuld, Jr. and his deputy Joseph Gregory were overconfident, egocentric and fell victim to groupthink); issues around goals (e.g. ‘growth at all costs’, governments wanting more home-owners, negligent ratings agencies); issues of culture (mergers were allowed in defiance of financial regulations); of processes and procedures (the bank’s own risk procedures weren’t followed); of technology (even economists didn’t understand the new financial products); and infrastructure (which led to situations such as people in

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Hong Kong owning the deeds of property belonging to people in California). Regarding the larger financial crisis, this was also a system-wide failure, not just a banking failure, Kandola said – and there’s a need to address the whole system to stop it happening again, including the wider political culture. As an example, Kandola pointed to the knighthood awarded to the CEO of the Royal Bank of Scotland, Fred Goodwin in 2004 (later annulled in 2012). ‘He didn’t give that knighthood to himself,’ Kandola said. After a group discussion about whether the financial crisis was due to flaws in the design of the system, or to a failure to properly implement the system, Kandola warned ‘this will happen again’. He said financial protections were put in place back in the 1920s after the last global financial meltdown, which stopped it happening again for a long time. ‘But gradually people lifted the safety nets…’ CJ

No dearth of thinking Bar a bit of ‘Gangnam style’ in the speed networking session, my introduction to this year’s DOP conference was Rob Briner’s annual iconoclastic talk on becoming more of an evidence-based psychologist. The University of Bath professor was on fine form as ever, always on hand with a quote that sounds throwaway but really gets you thinking: ‘experts are not good people to ask about stuff’, and ‘single studies in general just don’t matter’. (That one led to discussions around a change of practice on the Society’s own Occupational Digest: see tinyurl.com/occdigrob). Briner challenged the audience to think about how much evidence there actually is for a lot of psychology’s core findings, and what proportion of it they are aware of. Are we really ‘standing on the shoulders of giants’? Or are we caught up in the narrative of ‘It has been demonstrated that…’,

seduced by the confident language of most journal articles? ‘I’ve only ever seen the word “dearth” in the context of literature reviews,’ Briner mused. ‘Nobody goes to the fridge and says “Oh, there’s a dearth of milk”.’ According to Briner, systematic reviews are where it’s at. The audience were challenged to work with occupational psychology colleagues to develop groups who conduct and share rapid evidence assessments. Prepare to have cherished beliefs and preferred techniques challenged, become more efficient at reading journal articles and consider what databases you have access to. Briner left us with the thought that ‘people who say I don’t know often know a lot more than people who don’t say it’: accept and be explicit about ignorance, and a different and more rewarding way of working lies ahead. JS

In search of rationality According to keynote speaker Gerard Hodgkinson (Professor of Strategic Management and Behavioural Science at Warwick Business School), ‘Descartes’ error is alive and well in the workplace’. In a bold and wide-ranging address, Hodgkinson made the case for why and how occupational psychology needs to connect with the social neurosciences. Hodgkinson is bringing psychology into the field of strategic management, trying to help decision makers become more rational. Take how organisations tend to respond to a major threat or opportunity (HMV and Blockbuster come to mind as I write this). Usually there are small, incremental changes, and when it becomes apparent this isn’t sufficient, what does the organisation do? Nothing. There is a period of ‘strategic drift’. Then there is a period of ‘flux’, which on Hodgkinson’s graphic representation looks rather like a tailspin. This is followed by ‘phase 4’, ‘transformational change’ or ‘complete demise’. But to what extent can psychology shed light on this process? Hodgkinson’s 2002 book The Competent Organization

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Emotions at work Better for all ‘Part of being a manager is faking it,’ said PhD student Chiara Amanti of Edinburgh Napier University. ‘This doesn’t really come up in the emotional intelligence literature. Yet emotional regulation is required to get on in life and with people.’ Amanti interviewed eight managers in a university and then analysed the transcripts using interpretative phenomenological analysis. All of them agreed that regulating emotions is a highly important part of being a manager. In fact, it grew more important with increasing seniority, such that many felt they could never be emotionally spontaneous at work. The most interesting thing for Amanti was that this also applied to positive emotions, not just to controlling negative emotions like anger and frustration. For instance, one manager recalled how she’d ‘gushed’ with wonder and delight at the performance of a new lecturer during a review, and yet the manager admitted to Amanti ‘I wasn’t really pleased or happy but I felt that was what was needed.’ The interviewees differed in how they felt about the pressure of regulating their emotions. One male manager said there were certain emotions he simply didn’t feel at work. It’s as if he had fully internalised the role and the organisation’s objectives, such that he felt no contradiction with a ‘true self’. Others made a distinction between their managerial identity and their genuine selves, with both having value. Another man experienced far more tension, tying himself in knots trying to be genuine at work, which he felt was important, while also not really showing his true feelings. Amanti concluded with an impassioned case for the value of her methodological approach. ‘We want to find simple models, to show a correlation, the high variance that’s explained – that’s part of what psychology is – but actually when you get talking to people, their experience is so much more complex, full of paradoxes and contradictions. If we miss that, the interventions we develop are poorer as a result.’ CJ

argued the case for the centrality of the psychological contribution to organisational learning and strategic adaptation, yet 11 years on, he said, there was still only a passing consideration of affective and non-conscious cognitive processes. Why do we continue to sidestep it? Using examples from his practice, Hodgkinson demonstrated how strategising is both an inherently cognitive and affective process. Eliciting a cognitive taxonomy from senior figures in a UK grocery firm, he found that although the market conditions had changed dramatically, mental models – individually and collectively – had not. Decision makers were slaves to their basic psychological processes, for example still focusing on the ‘magic number’ of ‘7 plus or minus 2’ competitors. Hodgkinson showed how he confronts strategic inertia in top management teams, stimulating individual cognitive processes by scenario analysis. Some organisations excel at this: Hodgkinson claims that Shell closed all their facilities within 45 minutes of 9/11. While others were still struggling to comprehend what was happening, their scenario planning had allowed them to take quick and decisive action. Hodgkinson’s latest research draws on social cognitive neuroscience and neuroeconomics to develop a series of counterintuitive insights. His hope is that these can teach people to be more skilled in their control of their emotional, limbic system. True rationality, he concluded, is the product of the analytical and experiential mind. JS

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Can occupational psychology play a part in saving the world? Absolutely, insisted Professor Stuart Carr in his keynote presentation. After all, work is deeply woven into the world, so transforming one can influence the other. Carr brought this home through examples of the United Nation’s 2015 Millennial Development Goals; these include reduction of poverty, which manifests in the wages that workers derive; education, which depends on the capability of teachers and other staff; and gender equality, which can be combated in the workplaces where we spend much of our waking hours. This exemplifies a humanitarian approach to work psychology, ensuring decent work for all workers and ensuring that the work they do meets responsibilities towards multiple stakeholders, rather than the bottom line. Carr provided some examples of how he and collaborators are making inroads into this, for instance by organising a Global Special Issue on Psychology and Poverty reduction that spanned multiple journals, raising awareness of how psychology can point at these issues (see http://poverty.massey.ac.nz/#gl obalissue). Carr also raised another way to use psychology to improve the world: by applying it directly to the conditions of those involved in humanitarian work. These roles can involve risk and be demanding, so it would be useful to investigate this and take steps to foster well-being. And any way to improve the impact of the humanitarian work itself would obviously be beneficial. Carr reported on the creation of online networks such as Humanitarian Work Psychology (see www.humworkpsy.org)

that connect researchers, students and those on the ground, who are commonly isolated, to allow them to share knowledge and put it to work on actual problems. So we can change the world through ‘humanitarian’ work psychology to make conditions of work decent everywhere, coupled with ‘humanitarian work’ psychology that focuses attention on those aspiring to be levers of change in the world. Further examples abounded in the presentation, including a global task force to address pay disparities in humanitarian work: the dual pay levels for foreign and national staff causing distancing of the two groups due to negative appraisals – the former rationalising the latter’s low pay as reflecting their capability, the latter becoming demotivated and distrustful of the attitude of the foreigners, causing a vicious cycle. There is much more to do, and the keynote was a call to arms to the profession as a whole. As Carr reminded us, much occupational psychology work developed in the Peace Corps in the 1960s and following, and only later became concentrated in focus on the for-profit sector. A shift is possible and long overdue. Carr likened this to a Koru, the fern frond native to many countries including his home in New Zealand, whose spiral shape suggests a return to beginnings, and whose swift unfurling denotes the possibility of change. AF

MORE REPORTS For more from the Division of Occupational Psychology Annual Conference, including the dark side of behaviour at work, see the Society’s Occupational Digest at www.occdigest.org.uk.

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‘Tan Tan’ regains his identity Monsieur Leborgne, nicknamed Tan Tan, for that was the only syllable he could utter (save for a swear word or two), died in the care of the neurologist Paul Broca in Paris on 17 April 1861. Arguably the most important case in the history of neuropsychology, Leborgne’s death coincided with a debate raging in scholarly circles about the location of language function in the brain. When Broca autopsied Leborgne’s brain, he observed a malformation on the left frontal lobe – ‘Broca’s area’ – and concluded this was the site of speech production, a moment that the historian Stanley Finger has described as a ‘key turning point in the history of the brain sciences’. Broca was far from being the first person to propose that speech function is located in the frontal lobes (see tinyurl.com/abtq2uv), but crucially, the evidence from Leborgne helped him persuade the academic community. For centuries experts had believed mental functions were located in the brain’s hollows; that the cortex (Latin for ‘husk’) was little more than a rind of tissue and blood vessels. Today, problems producing language are still termed Broca's aphasia in recognition of Broca’s landmark contribution, although Broca in fact named Leborgne’s problems aphémie (meaning ‘without speech’). The Greek term ‘aphasia’ (also meaning ‘speechlessness’), adopted by medicine, was coined in Broca's day by the physician Armand Trousseau. In terms of the historical record, Leborgne is like a mirror opposite of Phineas Gage – another of neuropsychology's legendary cases. The story of Gage’s life and infamous accident, in which a tamping iron shot through his brain, has been researched in depth, inspiring books, poems, YouTube skits and snowmen makers along the way. Yet relatively little is known about the brain damage Gage suffered because no autopsy was performed when he died and his brain was never preserved (that hasn’t stopped scientists from attempting to simulate the likely damage: tinyurl.com/a6u3ljz). In contrast, Broca was careful to save Leborgne’s brain for posterity. He decided against a full dissection, performing a surface In the January issue of Journal of examination only. Today the preserved organ is housed at the the History of the Neurosciences Musée Dupuytren in Paris, where Broca placed it. The brain has been scanned numerous times using modern methods, allowing detailed analysis of the location and nature of any lesions. We now know that the frontal lobe damage to Leborgne’s brain was more extensive and deeper than Broca had realised based on his superficial examinations. But, contra the situation with Gage, while we are well informed about Leborgne’s brain, before now his identity and life story have remained largely mysterious. Broca’s medical notes revealed little. Thankfully, in a new paper, Cezary Domanski at Maria Curie-Sklodowska University in Poland has used archive registers in France to uncover hitherto unknown detailed biographical information about Monsieur Leborgne. Born in Moret-sur-Loing – the picturesque town that inspired Monet and other impressionists – ‘Tan’s’ full name was Louis Victor Leborgne. He was the son of Pierre Christophe Leborgne, a school teacher, and Margueritte Savard. He had three older siblings, Lucille, Pierre and Anne, and two younger siblings, Arsene and Louise. An epileptic since his youth, it was Leborgne’s loss of speech that led to him being hospitalised at age 30. Unmarried, he ended up spending the remaining 21 years of his life in hospital. Before this incapacitation through illness, Domanski tells us Leborgne was a formier in Paris, a kind of skilled craftsman who made the wooden forms used by shoemakers in their work. Together with the information on Leborgne’s family, this news corrects at least one historical myth. The oft-told idea that Leborgne ‘was an uneducated illiterate from the lower social class should once and for all be deemed erroneous’, writes Domanski. Based on his inquiries, the Polish historian offers an intriguing speculation – given that Leborgne’s birthplace of Moret was home to several tanneries, Domanski wonders if his repeated utterance of tan was somehow connected to childhood memories of the pretty town. ‘One thing remains certain,’ Domanski concludes, ‘the memory of the disease and cause of death of “Monsieur Leborgne” proved far more enduring than the story of his life, which was deemed irrelevant even when the patient was still alive. It is time for Louis Victor Leborgne to regain his identity …’ In 2009, out of the blue, a photograph was discovered of Phineas Gage (tinyurl.com/a42wram). I wonder if we will ever look upon an image of Leborgne?

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Can you will yourself happier? In the Journal of Positive Psychology ‘Happiness is as a butterfly, which, when pursued, is always beyond our grasp, but which, if you will sit down quietly, may alight upon you.’ (Nathaniel Hawthorne) A key question for people hoping to improve their wellbeing is whether it is counterproductive to focus too hard on the end goal of being happier. Philosophers like John Stuart Mill have proposed that it is – he wrote that happiness comes to those who ‘have their minds fixed on some object other than their own happiness’. A pertinent study published in 2003 by Jonathan Schooler and his colleagues supported this idea: participants who listened to music with the intention of feeling happier actually ended up feeling less happy than others who merely listened to the music with no happiness goal. But now a new study has come along which purports to show that trying deliberately to be happier is beneficial after all. Yuna Ferguson and Kennon Sheldon criticise the Schooler study on the basis that the music used – Stravinsky's Rite of Spring – is not conducive to happiness, and that's why it interfered with deliberate attempts to feel happier. Ferguson and Sheldon had 167 participants spend 12 minutes listening either to Rite of Spring or an upbeat section from Rodeo by Copland. Crucially, half the participants were instructed to relax and

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observe their natural reactions to the music. ‘It is important that you do not try to consciously improve your mood,’ they were told. The other participants received the opposite instructions – ‘really focus on improving your mood’. Afterwards, two measures of mood were taken – one based on six words like ‘joyful’; the other a continuous measure of positive feelings. The participants who’d listened to the cheery music, and simultaneously tried to improve their mood, reported feeling in a more positive mood than the participants who’d merely listened to the upbeat music, and the participants who’d listened to the down-beat music, whether they strived to feel happier or not. This was despite the fact that the groups did not differ in how much they’d enjoyed the activity, or how ‘pressured’ they'd felt to complete it. A second study was similar, but this time 68 participants visited a psych lab five times over two weeks to spend 15 minutes each time listening to music they had chosen from a pre-selected list covering various genres from folk to hiphop. Again, half the participants were instructed to focus on the music and not their own happiness (they were told that doing so could backfire); the other half were told to think a lot about their happiness and to try to feel happier (they were told that doing so is beneficial). At the end of the two weeks, the group who had deliberately tried to feel happier showed an improvement in their happiness levels compared with baseline; in contrast, the participants who

had merely focused on the music did not enjoy this benefit. This was despite both groups believing to the same degree that the intervention would make them happier, and both groups enjoying their music the same amount. ‘The results suggest that without trying, individuals may not experience higher positive changes in their well-being,’ Ferguson and Sheldon concluded. ‘Thus practitioners and individuals interested in happiness interventions might consider the motivational mindset as an important facet of improving well-being.’ Sceptical readers may not be so easily persuaded. Because there was no attempt to measure the participants’ thought-processes, it’s difficult to know how they interpreted and acted on the two forms of instruction. In the second study in particular, even though they were told there was no need, how do we know the participants didn’t go to lengths outside of the lab to boost their happiness? From a statistical point of view, the first study lacks any measure of change in mood. The second study is also complicated by the music-focus group starting out with, and ending up with, a slightly higher average happiness score than the happiness-focus group (albeit these differences were not statistically significant). This raises the possibility of a ceiling effect for the musicfocus group – perhaps they were already too happy for the intervention to make a difference.

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Lying becomes automatic with practice In the November issue of Frontiers in Psychology Forget shifty eyes or fidgety fingers, psychology research has shown that these supposed signs of lying are unreliable. A more useful foundation for liedetection is the simple fact that lying is more cognitively demanding than telling the truth. False answers usually take slightly longer than honest responses, especially when a suspect is burdened with an extra mental challenge, such as telling their story backwards. However, a new study suggests that the cognitive demands of lying can be reduced with practice. Xiaoqing Hu and his team presented 48 participants with dates, place names and other information and asked them to indicate with one of two button presses whether the information was self-relevant or not. In real life this would be equivalent to a suspect posing as a different person. Instructed to lie, the participants took longer to respond than when they told the truth, consistent with the wellestablished idea that lying is cognitively demanding.

Next, a third of the participants were told about the reaction time difference and given extensive practice at lying more quickly about the selfrelevance of information. The requirement to get faster was made explicit because past research found lying practice without such an instruction was ineffective. On retesting, the trained participants no longer took more time to answer dishonestly compared with telling the truth. ‘Deception is malleable and… can be voluntarily controlled to be more automatic,’ the authors said. Another group had no training but were told about the reaction time difference between lying and truth telling, and encouraged to answer faster when lying. They got faster at lying compared with a control group, but still they were speedier when being honest. The researchers claim that to be more realistic, liedetection research based around the cognitive demands of lying should incorporate the effects of practice.

The material in this section is taken from the Society’s Research Digest blog at www.researchdigest.org.uk/blog, and is written by its editor Dr Christian Jarrett. Visit the blog for full coverage including references and links, additional current reports, an archive, comment and more. Subscribe by RSS or e-mail at www.researchdigest.org.uk/blog Become a fan at www.facebook.com/researchdigest Follow the Digest editor at www.twitter.com/researchdigest

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The globalisation of mental illness Ross White asks whether recent developments are a problem or progress

T

question

Is the scaling-up of psychiatric services in low- and middle-income countries serving to undermine indigenous sources of support for mental distress?

resources

Suman, F. (2010). Mental health, race and culture (3rd edn). Basingstoke: Palgrave Macmillan. http://transculturalpsychiatry.gla.ac.uk

references

The burden (mortality and disability) caused by mental disorders across the globe is on the rise. Psychiatric services for treating mental health difficulties are well established in high-income countries such as the US and UK; and the World Health Organization has supported the setting up of similar services in low- and middle-income countries (LMIC). But is the globalising of psychiatric systems of diagnosis and treatment the most appropriate line of action? This article critically reflects on biomedical explanations of mental health difficulties; highlights concerns about the dearth of research into mental health difficulties in LMIC; discusses the lack of emphasis that psychiatry places on cultural factors; and raises the possibility that globalising notions of psychiatric illness may cause more harm than good.

Alem, A., Kebede, D., Fekadu, A. et al. (2009). Clinical course and outcome of schizophrenia in a predominantly treatment-naïve cohort in rural Ethiopia. Schizophrenia Bulletin, 35, 646–654. Ballenger, J.C., Davidson, J.R.T., Lecrubier, T. et al. (2001) Consensus statement on transcultural issues in depression and anxiety from the International Consensus Group on

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here are huge inequalities in the availability of resources to support mental health needs across the globe; it is estimated that greater than 90 per cent of global mental health resources are located in high-income countries (WHO, 2005). This is all the more alarming when we consider that around 80 per cent of the world’s population live in low- and middle-income countries (LMIC: Saxena et al., 2006). In countries in Africa, Latin America, and south/south-east Asia under 2 per cent (and often less than 1 per cent) of expenditure on health tends to go to services for psychiatric conditions (compared to over 10 per cent in the USA) (Kleinman, 2009). And there is a gathering mental health storm: it is projected that by 2030, depression will be the second biggest cause of disease burden across the globe (Mathers & Loncar, 2006), second only to HIV/AIDS. When four out of five people in LMIC who need services for mental, neurological and/or substance-use disorders do not receive them (WHO, 2008), we have a clear ‘treatment gap’ – the difference between the levels of mental health services required by LMIC populations and what is actually available on the ground. Prominent clinicians and academics, as well as international organisations such as the World Health Organization (WHO, 2008, 2010), have called for the ‘scalingup’ of services for mental health in LMIC. Scaling-up involves increasing the number of people receiving services; increasing the range of services offered; ensuring these services are evidence-based, using models of service delivery that have been found to

Depression and Anxiety. Journal of Clinical Psychiatry, 62, 47–55. Cohen, A., Patel, V., Thara, R. et al. (2008). Questioning an axiom: Better prognosis for schizophrenia in the developing world? Schizophrenia Bulletin, 34, 229–244. Crozier, I. (2011). Making up koro: Multiplicity, psychiatry, culture, and penis-shrinking anxieties. Journal of the History of Medicine and Allied

be effective in a similar contexts; and sustaining these services through effective policy, implementation and financing (Eaton et al., 2011). Yet in light of the limited resources available to support mental health, it is pertinent to ask whether it makes sense to try to export systems of service delivery that have been developed in high-income countries to LMIC. Will this venture be sustainable in the longer term? More importantly, will these systems actually deliver added value for the increase in budgetary expenditure that will be required?

The seductive allure of biological psychiatry In high-income countries mental health services tend to gravitate around psychiatry; the branch of medicine that is concerned with the study and treatment of mental illness, emotional disturbance, and abnormal behaviour. Biological psychiatry is an approach to psychiatry that aims to understand mental illness in terms of the biological function of the nervous system. The rise of biological psychiatry promised great things. Biological explanations of mental illness permeated the public consciousness, and the hunt was on to discover the magical compounds that could redress the chemical imbalances that were purported to cause mental illness. Various different medications have been developed and the marketed. In the past 40 years the sales of psychotropic medications have increased dramatically. Yet despite the exponential rise in sales of these medications, the evidence for biological causes for mental illnesses such as depression and schizophrenia remain fairly weak (Nestler et al., 2002; Stahl, 2000). The continued absence of definitive evidence to support biological processes that are causal in mental illness has led to the suggestion that biological psychiatry is ‘a practice in search of a science’ (Wyatt & Midkiff, 2006). Despite these concerns, biological psychiatry continues to exert a strong influence on the delivery of mental

Sciences, 67, 36–70. Eaton, J., McCay, L., Semrau, M. et al. (2011). Scale up of services for mental health in low-income and middle-income countries. Lancet. doi:10.1016/S0140-6736(11)60891-X. Glenmullen, J. (2002). Prozac backlash: Overcoming the dangers of Prozac, Zoloft, Paxil and other antidepressants with safe, effective alternatives. New York: Simon & Schuster.

Hall, G.C. (2001). Psychotherapy research with ethnic minorities: Empirical, ethical and conceptual issues. Journal of Consulting and Clinical Psychology, 69, 502–510. Harvey, P.D. & Bellack, A.S. (2009). Toward a terminology for functional recovery in schizophrenia: Is functional remission a viable concept? Schizophrenia Bulletin, 35, 300–306.

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health services in high-income countries such as the UK and America. The seductive allure of the rationale underlying biological psychiatry is plain to see. If mental illnesses were to have universal biological causes, then standard treatments could be readily applied across the world irrespective of local differences and associated cultural differences. If evidence-based practices lead to positive outcomes in high-income countries, then similar positive outcomes will be observed in LMIC. Right? This is where the picture gets a bit more complicated. Before we can answer this question we need to be clear on what we mean by: (1) ‘evidence-based practices’ and (2) ‘positive outcomes’. What is considered to be ‘evidence-based practice’ can serve powerful economic and political interests (Kirmayer & Minas, 2000). In 2007, US citizens alone spent £25 billion on antidepressants and antipsychotics (Whitaker, 2010). All this in spite of the fact that claims about drug effectiveness are at times overstated, and that pharmaceutical companies have been found to employ questionable research methodologies (Glenmullen, 2002; Valenstein, 1998; Whitaker, 2010). Professor David Healy (Psychiatrist, University of Cardiff) has stated that a ‘large number of clinical trials done are not

reported if the results don’t suit the companies’ sponsoring (the) study’ (tinyurl.com/dxlh55w). The evidencebase is heavily skewed towards research conducted in high-income countries. Since producing hard evidence depends on the costly standards of psychiatric epidemiology and randomised clinical trials, it can be difficult for clinicians or researchers in LMIC to contribute to the accumulation of knowledge (Kirmayer, 2006). The lack of mental health related research being conducted in LMIC countries is evident in the finding that over 90 per cent of papers published in a three-year period in six leading psychiatric journals came from Euro-American countries (Patel & Sumathipala, 2001). An inductive, bottom-up approach to research emphasising the importance of local conceptualisations of mental health difficulties and focusing on local priorities in different LMIC is required. Even if the research capacity in LMIC can be increased, difficulties remain. The issue of what constitutes ‘positive outcomes’ in relation to mental illness has plagued clinical practice and research for many years. There is currently no accepted consensus on what constitutes positive outcome for individuals with mental illness. Traditionally, psychiatry has been concerned with eradicating symptoms of mental illness. However, it is important to appreciate that clinical symptoms do not improve in parallel with social or functional aspects of service users’ presentation (Liberman et al., 2002). Functional outcome relates to variables such as cognitive impairment, residential independence, vocational outcomes, and/or social functions (Harvey & Bellack, 2009). In this sense, using symptomatic remission as an indicator of recovery can yield better rates of good outcome than using indicators of functional recovery (Robinson et al., 2005). More than 90 per cent of global mental health Another important resources are located in high-income countries consideration relating to outcome

Hopper, K., Harrison, G., Janka, A. & Sartorius, N. (Eds.) (2007). Recovery from schizophrenia: An international perspective. Oxford: Oxford University Press. Kitanaka J. (2011). Depression in Japan: Psychiatric cures for a society in distress. Princeton, NJ: Princeton University Press. Kirmayer, L.J. (2006). Beyond the ‘new cross-cultural psychiatry’: Cultural

biology, discursive psychology and the ironies of globalization. Transcultural Psychiatry, 43, 126–144. Kirmayer, L.J. & Minas, I.H. (2000). The future of cultural psychiatry: An international perspective. Canadian Journal of Psychiatry, 45, 438–446. Kleinman, A.M. (1977). Depression, somatization and the ‘new crosscultural psychiatry’. Social Science and Medicine, 11, 3–10.

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in mental illness relates to the extent to which particular outcomes are culturally sensitive and inclusive (Vaillant, 2012). Marked disparities have been highlighted between ethnic minority groups and white people in outcome, service usage and service satisfaction (Sashidharan, 2001). The lack of culturally inclusive understandings of positive outcome in mental illness is compounded by the underrepresentation of black and minority ethnic groups in mental health related research. This has led to some concluding that there is a lack of adequate evidence supporting the use of ‘evidenced-based’ psychological therapies with individuals from black and minority ethnic populations (Hall, 2001). Considering these issues, it seems that the jury is in no position to deliver a verdict on whether ‘evidence-based’ practices for mental illness developed in high-income countries deliver positive outcomes in LMIC.

Diagnosis and culture Despite the question marks that remain about the causes of mental illness, the veracity of the evidence base, what constitutes good outcome, and how inclusive mental health services are to cultural diversity within the population, the psychiatry-heavy perspective has a powerful say in how mental health difficulties are understood in LMIC. Dissenting voices have questioned the wisdom of this approach. One particular source of dissention relates to the process of psychiatric diagnosis. The international classification systems for diagnosing mental illnesses (such as depression and schizophrenia) have been criticised for making unwarranted assumptions that these diagnostic categories have the same meaning when carried over to a new cultural context (Kleinman, 1977, 1987). This issue has potentially been obscured by the fact that the panels that finalise these diagnostic categories have been criticised for being unrepresentative of the global population. Of the 47 psychiatrists who contributed to the initial draft of the

Kleinman, A.M. (1987). Anthropology and psychiatry: The role of culture in cross-cultural research on illness. British Journal of Psychiatry, 151, 447–454. Kleinman A. (2000). Social and cultural anthropology: Salience for psychiatry. In M.G. Gelder, J.J. Lopez-Ibor & N.C. Andreasen (Eds). New Oxford textbook of psychiatry. Oxford: Oxford University Press.

Kleinman A. (2009). Global mental health: A failure of humanity. Lancet, 374, 603–604. Liberman, R.P., Kopelowicz, A., Ventura, J. & Gutkind, D. (2002). Operational criteria and factors related to recovery from Schizophrenia. International Review of Psychiatry, 14, 256–272. Lopez, S.R. & Guernaccia, P.J. (2000). Cultural psychopathology:

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most recent World Health Organization diagnostic system (ICD-10: WHO, 1992), only two were from Africa, and none of the 14 field trial centres were located in sub-Saharan Africa. Inevitably this led to the omission of conditions that had been described for many years in Africa (Patel & Winston, 1994), such as ‘brain fag syndrome’. (This was initially a term used almost exclusively in West Africa, generally manifesting as vague somatic symptoms, depression and difficulty concentrating, often in male students.) ICD-10 does at least acknowledge that there are exceptions to the apparent universality of psychiatric diagnoses by including what are called culture-specific disorders. One such example is koro; a form of genital retraction anxiety which presents in parts of Asia. Prior to ICD-10 symptom presentations such as koro tended to be subsumed into existing diagnoses such as delusional disorder (Crozier, 2011). But the inclusion of culture-specific disorders only serves to perpetuate a skewed view of the impact of culture on mental health; ‘cultural’ explanations seem to be reserved for non-Western patients/populations that show koro(-like) syndromes, and not for diagnoses that are more prevalent in highincome countries (e.g. anorexia nervosa). Indeed it has been suggested that many psychiatric conditions described in these diagnostic manuals (such as anorexia nervosa, chronic fatigue syndrome) might actually be largely culture-bound to EuroAmerican populations (Kleinman, 2000; Lopez & Guernaccia, 2000). Because people living in ‘Western’ countries tend to see the world through a cultural lens that has been tinted by psychiatric conceptualisations of mental illness, they are blind to how specific to ‘Western’ countries these conceptualisations actually are.

Transcultural psychiatry Culture has been defined as ‘a set of institutional settings, formal and informal practices, explicit and tacit rules, ways of making sense and presenting one’s

Uncovering the social world of mental illness. Annual Review of Psychology, 51, 571–598. Mathers, C.D. & Loncar, D. (2006). Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med, 3, e442. Nestler, E.J., Barrot, M., DiLeone, R.J. et al (2002). Neurobiology of depression. Neuron, 34, 13–25. Patel, V. & Prince, M. (2010) Global

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experience in forms that will influence others’ (Kirmayer, 2006, p.133). Interest in the potential interplay between culture and mental illness first arose in colonial times as psychiatrists and anthropologists surveyed the phenomenology and prevalence of mental illnesses in newly colonised parts of the world. This led to the development of a new discipline called transcultural ‘Western’ narratives about ‘mental illness’ continue psychiatry, a branch of to dominate over local understanding psychiatry that is concerned with the cultural and ethnic context of mental illness. In its early incarnation, transcultural best to meet the mental health needs of psychiatry was blighted by the racist people across the globe. attitudes that prevailed at that time about The need for interdisciplinary working the notion of naive ‘native’ minds. in promoting improved understanding However, over time this began to change about the interplay between culture and as people began to understand that mental illness has been demonstrated by psychiatry was itself a cultural construct. a growing body of evidence indicating that In 1977 Arthur Kleinman proposed a ‘new exporting Western conceptualisations of cross-cultural psychiatry’ that promised a mental health difficulties into LMIC can revitalised tradition that gave due respect have a detrimental impact on local to cultural difference and did not export populations. Ethan Watters’ book Crazy psychiatric theories that were themselves Like Us cites examples from different parts culture-bound. Transcultural (or crossof the world (including China, Japan, cultural) psychiatry is now understood Peru, Sri Lanka and Tanzania) where the to be concerned with the ways in which introduction of psychiatric a medical symptom, diagnosis or practice conceptualisations of mental illness has reflects social, cultural and moral concerns potentially changed how distress is (Kirmayer, 2006). manifested, or introduced barriers to Tensions exist in transcultural recovery (e.g. the emergence of expressed psychiatry. Clinicians, who are motivated emotion in the families of individuals with to produce good outcomes for service psychosis in Tanzania). Watters (2010) users, may work from the premise that cites the work of Gaithri Fernando who there is cross-cultural portability of has written extensively about the aftermath psychiatric or psychological theory and of the tsunami that struck Sri Lanka in practice. Although well intended, this 2006. Fernando claims that ‘Western’ approach can be met with disapproval conceptualisations of trauma and the from social scientists who are focused diagnostic criteria for post-traumatic stress on advancing medical anthropology as disorder (PTSD) were not appropriate for a scholarly discipline. However, it is a Sri Lankan context. Fernando found that becoming clear that in this era of rapid Sri Lankan people were much more likely globalisation, mental health practitioners, to report physical symptoms following social scientists and anthropologists need distressing events. This was attributed to to come together and engage in the observation that the notion of a constructive dialogue aimed at developing mind–body disconnect is less pronounced cross-cultural understanding about how in Sri Lanka. Sri Lankans were also more

mental health – A new global health field comes of age. JAMA, 303, 1976–1977. Patel, V. & Sumathipala, A. (2001) International representation in psychiatric literature: Survey of six leading journals. British Journal of Psychiatry, 178, 406–409. Patel, V. & Winston M. (1994). The ‘universality’ of mental disorder revisited: Assumptions, artifacts and

new directions. British Journal of Psychiatry, 165, 437–440. Robinson, D.G., Woerner, M.G., Delman, H.M. & Kane, J.M. (2005). Pharmacological treatments for firstepisode schizophrenia. Schizophrenia Bulletin, 31, 705–722. Sashidharan, S.P. (2001). Institutional racism in British psychiatry. Psychiatric Bulletin, 25, 244–247. Saxena, S., Paraje, G., Sharan, P. et al.

(2006). The 10/90 divide in mental health research: Trends over a 10year period. British Journal of Psychiatry, 188, 81–82. Stahl, S.M. (2000). Four key neurotransmitter systems. In S.M. Stahl (Ed.) Psychopharmacology of antipsychotics (pp.3–13). London: Martin Dunitz. Summerfield, D. (2008). How scientifically valid is the knowledge base of global

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likely to see the negative consequences of the tsunami in terms of the impact it had on social relationships. Because Sri Lankan people tended not to report problematic reactions relating to internal emotional states (e.g. fear or anxiety), the rates of PTSD following the tsunami were considerably lower than had been anticipated. Fernando concluded that Western techniques for conceptualising, assessing and treating the distress that people were experiencing were inadequate. Watters also explores the way in which understanding about depression has changed in Japan over the last 20 years. This sobering tale allows Watters to explore how the interplay between cultural factors and notions of mental illness can be manipulated for financial gain. In the 1960s Hubert Tellenbach had introduced the notion of a personality type called Typus melancholicus. This idea heavily influenced psychiatric thinking in Japan. Typus melancholicus had substantial congruence with a respected personality type in Japan; ‘those who were serious, diligent and thoughtful and expressed great concern for the welfare of others… prone to feeling overwhelming sadness when cultural upheaval disordered their lives and threatened the welfare of others’ (Watters, 2010; p.228). Although at the end of the 20th century there had been a psychiatric term in the Japanese language for depression (utsubyô), this tended to relate to a rare and very debilitating condition. Prior to 2000 there had been no real market for prescribing antidepressant medications in Japan. However, shifting public perception about Typus melancholicus closer toward the Western conceptualisation of depression would have huge implications for antidepressant prescribing in Japan. Watters (2010) claims that GlaxoSmithKline’s enthusiasm to build a market for its new antidepressant medication in Japan dovetailed conveniently with a GlaxoSmithKline sponsored ‘international consensus group’ of experts on cultural psychiatry discussing cross-cultural variations in depression (Ballenger et al.,

mental health? British Medical Journal, 336, 992–994. Timimi, S. (2010). The McDonaldization of childhood: Children’s mental health in neo-liberal market cultures. Transcultural Psychiatry, 47, 686–706. Vaillant, G.E. (2012). Positive mental health: Is there a cross-cultural definition? World Psychiatry, 11, 93–99. Valenstein, E.S. (1998). Blaming the brain:

2001) concluding that depression was vastly underestimated in Japan. Depression is now conceptualised in Japan as affecting individuals (particularly men) who are too hard-working and have over-internalised the Japanese ethic of productivity and corporate loyalty. In the last few years, the market for antidepressants in Japan has grown exponentially. An important consequence of this ‘aggressive pharmaceuticalisation’, is that psychological and social treatments for depression are being ditched (Kitanaka, 2011).

Globalisation of mental health There is a growing willingness to explore ways of addressing inequalities in the provision made for mental illness across the globe, but translating this willingness into effective action is fraught with potential danger. We must guard against assumptions that indigenous concepts of mental health difficulties in LMIC and strategies used in these contexts to deal with it are based on ignorance (Summerfield, 2008). Despite the apparent sophistication of laws, policies, services and treatments for mental illness in high-income countries, outcomes for individuals with mental health problems may not actually be any better than in LMIC. Research has failed to conclusively show that outcome for complex mental illnesses (such as psychosis) in highincome countries are superior to outcomes in LMIC (where populations may not had access to medication-based treatments) (Alem et al., 2009; Cohen et al., 2008; Hopper et al., 2007). The lack of academic and political engagement with alternative non-Western perspectives means that ‘Western’ narratives about ‘mental illness’ continue to dominate over local understanding (Timimi, 2010), yet we in high-income countries have much to learn about mental health provision; particularly in relation to promoting inclusion of black and ethnic minority members of the population. To conclude, I would like to come

The truth about drugs and mental health. New York: Free Press. Watters, E. (2010). Crazy like us: The globalization of the American psyche. New York: Free Press. Whitaker, R. (2010). Anatomy of an epidemic. New York: Crown. World Health Organization (1992). International statistical classification of diseases and related health problems (ICD-10). Geneva: WHO.

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back to the title. Rather than the globalisation of mental illness, perhaps what we should be aiming for is the globalisation of mental health. This is an immensely more inclusive aspiration. By promoting global mental health there is the potential for clinicians, academics, service users and policy makers from across the world to work together with a shared purpose. By exchanging knowledge, LMIC can benefit from hard lessons learned in high-income countries, and high-income countries can look afresh at how mental health difficulties are understood and treated. It will be important for clinicians and academics working in high-income countries to critically reflect on their own practice and question the accepted wisdom about mental health provision. To assist with this knowledge exchange, a new MSc Global Mental Health programme has been launched at the University of Glasgow. Global mental health has been defined as the ‘area of study, research and practice that places a priority on improving mental health and achieving equity in mental health for all people worldwide’ (Patel & Prince, 2010). The programme seeks to develop leaders in mental health who can design, implement and evaluate sustainable services, policies and treatments to promote mental health in culturally appropriate ways across the globe. Global mental health is an emergent area of study. Momentum is building. Although the challenges are both numerous and complex, the prize is a worthy one. The cost of not acting can be counted in the ever-increasing number of people whose lives are being affected by mental health problems across the globe.

World Health Organization (2005). Mental health atlas 2005. Geneva: WHO. World Health Organization. (2008). Mental health Gap Action Programme (mhGAP): Scaling up care for mental, neurological and substance abuse disorders. Geneva: WHO. World Health Organization (2010). mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health

Ross White is in the Institute of Health and Wellbeing at the University of Glasgow ross.white@glasgow.ac.uk

settings: Mental health Gap Action Programme (mhGAP). Geneva: WHO. Wyatt, W.J. & Midkiff, D.M. (2006). Biological psychiatry: A practice in search of a science. Behaviour and Social Issues, 15, 132–151.

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BIG PICTURE

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When artist Jon Adams, who has Asperger syndrome, met psychologist Professor Simon Baron-Cohen on stage at the Cheltenham Science Festival, a collaboration was born. ‘I’m still learning how Jon thinks,’ Baron-Cohen says, ‘but I am impressed at how he takes a way of thinking in one domain (e.g. geological time) and then translates it to another one (e.g. a walk through time). It may be that that will Image by Jon Adams, with comment from Simon Baron-Cohen. actually give us a new way of looking at things.’ E-mail ideas for ‘Big picture’ to jon.sutton@bps.org.uk. ‘228 is part of my project for the Cultural Olympiad,’ says Adams. ‘For two years I’ve written a map of everything I’ve done each day, and collected sometimes patterns help him make music (like deciding to take objects, photographs and sounds snatches. I was sitting in the a particular sound, run it through a computer program in a very print room at the University and there were a load of bits of systematic way, to see what the output is), and sometimes print waste on the floor so I took some close-up photographs. I also found some interesting rust patterns on the deck of a ship patterns help him make pictures (like seeing how an ordinary process such as rust on metal can nevertheless result in so I took photographs of those too. 228 is a mix of both. It’s like, exquisite shapes, colours and textures, as in this image). if you go to a geological locality, you not only measure what is Imagine a mind that can’t help spotting patterns – that's Jon's there, you also take samples away to cut up, polish down and mind. Now imagine what you do with such a mind. You could put under a microscope. That’s what I do.’ either be overwhelmed (which he sometimes is), or you could Baron-Cohen comments: ‘What comes across in this decide to use that talent to explain to the world: “I am picture’ is Jon's attention to small details and his unusual way different”. I'm delighted Jon is choosing this educational path.’ of seeing the world. He loves patterns and sees them Adams is one of the artists in the ‘Affecting Perception: Art everywhere. As he has explained to me, sometimes patterns & Neuroscience’ exhibition, at the O3 Gallery, Oxford Castle, help him do science (like understanding why particular stones Oxford, 2–31 March. See www.axnscollective.org. are where they are, or why a particular hill is where it is);

‘A mind that can’t help spotting patterns’


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REVIEWS

CHANNEL 4

Are terrorists conservative? It is hard for psychologists to reconcile the apparently irrational and ideologically driven violence with what they claim to know about humanity generally. Terrorists are repeatedly found sane, so psychopathological expertise is not particularly helpful for understanding the behaviour. Massacre-suicides (such as the recent killing of 26 persons by Adam Lanza in Newtown, Connecticut) are rather more explicable (if not predicted or controlled) by what we know about forensic mental health. When trying to understand ideologically driven violence, we have to go beyond cognitive black boxes, neuroscientific over-simplification, and generic personality traits into a context far more challenging and threatening to contemporary psychologists: the humanities. Roger Griffin’s admirably brief book provides a compelling historical and political overview of ideologically driven terrorist violence. He argues terrorists are essentially idealist conservatives reacting violently to their way of life (and/or ideology) being threatened by the forces of modernisation. Rather than adapting (most people embrace positive change, seek to make the best of the inevitable, and avoid conflict), proto-terrorists reject compromise, and zealously defend their cultural milieu from the influences of the enemy. Critically, terrorists see people voluntarily adapting to social change as treacherous, which makes them legitimate targets of violence. The terrorist uses violence to discourage open acceptance and adaptation to modernist developments, or to destroy symbols of modernism. Thus it is that well-intentioned relief, health and educational workers are murdered in tribal north-western Pakistan by Terrorist’s Creed: persons claiming to represent Al-Qaeda; Boku Haram Fanatical Violence attack schools in northern Nigeria; and, common to all and the Human terrorist movements, bombs are placed in shopping streets Need for Meaning or target commuters who show complicity with the enemy Roger Griffin by not supporting the terrorist’s struggle. Griffin notes the conceptual continuity between religious and political zealotry; his earlier work on modern European fascist movements with their conflating of nationalism and idealised collective authoritarianism is put to good use when considering Anders Breivik’s rationalised violence, which epitomises making war on one’s peers when they reject your ideology. He emphasises you don't have to base your world-view on supernatural entities to polarise the world into Manichean good or bad. Finding a potential apocalypse strangely exciting as a way of enabling humanity (the right sort of humanity to you, that is) to have a fresh start also appeals to idealists of all extremes; both views can be seen in the Guardian’s ‘Comment if Free’ blog as much as in the Daily Telegraph’s equivalent. The frequency of extremist views at both ends of the political spectrum suggests a potential for violence-supported ideology in many who will never plant a bomb or fire a gun. Griffin recognises this, and it leads to his conclusion that we need to understand the deeper causes of such views. He suggests our efforts to understand terrorism are, paradoxically, hindered by Western intellectual values; we seek to secularise and rationalise religious (and quasi-religious) beliefs; we assume persons wish to eschew strongly orthodox forms of religion, that they want democracy, that they want moderation, and that they want to move from collectivist to individualistic cultures with Western degrees of liberty. We deny the literal violence of the major belief systems, preferring to see them as metaphors rather than the statement of literal power and certainty they represent. Secular-humanist preconceptions held by Western liberal intellectuals about the world preclude understanding the visceral basis of terrorism, just as they sometimes fail to comprehend the rise of popular far-right nationalism in Europe. Any psychologist interested in terrorism and violence should read Griffin’s book. I Palgrave Macmillan; 2012; Hb £25.00 Reviewed by Dr Vincent Egan who is Senior Lecturer in Forensic Psychology at the University of Leicester

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The blunt reality of a teenage life My Mad Fat Diary e4 My Mad Fat Diary explores the real-life diaries of Rae Earl. Recently discharged from a psychiatric ward 16-year-old Rae welcomes the audience to ‘the social train wreck that is my life’. The series takes you on her rollercoaster journey of selfdiscovery and pursuit of normality. From questioning the direction of a friendship to discovering her femininity, and battling with the exposure of her mental health difficulties, Rae does not hold back in giving you the blunt reality; and sometimes slightly cringe-worthy details of her life. What captures you as a watcher is the sheer rawness in which the content of the series is shown, the real-life element makes some of the events very relatable to everyone and therefore entices the viewer to continue following Rae’s narrative. For example, I’m sure we have all had those moments of vulnerability or embarrassment where you wish the ground would swallow you up. Although the series has humorous connotations, which contributes to its entertainment value, it does respectfully and sensitively, yet subtly, educate the watcher on mental health issues and health implications such as obesity. Seeing such difficulties in a real-life experience may help to normalise mental health for the watcher and hopefully encourage someone with similar difficulties to seek advice. I e4; 10pm Mondays. My Mad Fat Diaries by Rae Earl (published by Hodder) is available in paperback and eBook. Reviewed by Kimberley Keane who is an assistant psychologist

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reviews

Feeling anxious? It’s probably normal All We Have To Fear: Psychiatry’s Transformation of Natural Anxieties into Mental Disorders Allan V. Horwitz & Jerome C. Wakefield The underlying message within this book is that fear and anxiety have formed an integral and healthy component of our ability to survive for millennia. The authors draw on a variety of disciplines to critically review the seemingly ever-increasing prevalence of anxiety disorders and the inadequacy of current diagnostic methods to distinguish between normal and pathological anxiety. The authors also provide an

extensive critique of past methods used to distinguish anxiety disorders, alongside potential future alterations suggested for the hotly anticipated arrival of the DSM-5 in May. While slightly repetitive in places, this book provides a wealth of interesting insights

into the most prevalent anxiety disorders, including specific and social phobia, generalised anxiety disorder, OCD and posttraumatic stress disorder. It also provides a rich overview into the history of anxiety disorders, their prevalence amongst different populations and how pharmaceutical companies have

modified how we view anxiety and what constitutes ‘normal’. This book poses a number of challenging conceptual and practical questions for psychiatry and will be of interest to clinicians and researchers alike. I Oxford University Press; 2012; Hb £18.99 Reviewed by Jack Cotter who is a Research Assistant at the University of Sheffield

NATIONAL FILM BOARD OF CANADA

Turn off the music! More or Less Word of Mouth BBC Radio 4 Psychologists are often divided into those who ‘do numbers’ (quantitative oriented) or those who ‘do words’ (qualitative oriented). Again, as mentioned in a previous Psychologist, Radio 4 wins the day for content and coverage in terms of radio relevant to psychologists. But it isn’t just All in the Mind that should be listened to by psychologists. Two programmes that should appeal to both of these sides are More or Less and Word of Mouth. More or Less (see www.bbc.co.uk/programmes/b006qshd) focuses on the use of numbers and statistics in general (as opposed to just of psychological interest), yet I find each episode usually contains many references to the psychological use of numbers (or words as numbers) and always improves my understanding of the use of statistics. When it comes to words, Word of Mouth (www.bbc.co.uk/programmes/b006qtnz), presented by the ever lovely Michael Rosen, always expands my mind in terms of the changing nature of discourse and word usage in everyday life. Both of these enhance my psychological understanding of the world around me and as such I think should be regular listens (or podcasts in my case). Go on, turn off the music and turn on the words and numbers – it’s good for you, and you will feel better because of it.

The descent into obsessive compulsive disorder The War Inside National Film Board of Canada My eldest son is about to turn nine. So watching this film (www.nfb.ca/film/ocd_war_inside), including the sudden and rapid descent into obsessive compulsive disorder of a nine-year-old boy, I feel it in the pit of my stomach. I expect you will too, whatever your situation. As an insight into how scary OCD can be for the sufferer and their families, this is excellent and educational fare. It’s not a promising start… all whizzing in through the eye to buzzing neurons and scary images. But the testimony from those afflicted with the disorder is simple and effective. To be perfectly honest, of all disorders I have always found it hardest to understand and empathise with OCD. In the excellent Channel 4 series The Undateables, I struggled to root for the OCD sufferer. Yet in this film, there are so many individuals so obviously traumatised and baffled by their own actions that the viewer inevitably gets a new insight into the condition. Again, being honest, I couldn’t watch more than half of it. It's 70 minutes long and I was finding it thoroughly depressing. But if you or your students are studying OCD and could do with a really clear insight into ‘the war inside’, you could do a lot worse. The site in general is a useful resource, with other psychology-related films including Borderline, a 1956 tale of emotional adjustment in adolescence, and the splendidly titled The Hasty Man Drinks His Tea with a Fork, about people caught up in the turmoil of the modern world. I Reviewed by Jon Sutton who is Managing Editor of The Psychologist

I Reviewed by Paul Redford, UWE Bristol

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UNIVERSAL PICTURES

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An arresting read A Psychologist’s Casebook of Crime: From Arson to Voyeurism Belinda Winder & Philip Banyard (Eds.) So the dust has settled, and the crime report is in. But why did it happen, and what can we do about it? Winder and Banyard’s text examines the causes and effects of, and responses to, various types of crime. Their work presents the offences in a straightforward A-to-Z format (or rather A-to-V, with a few skipped in the middle, as it’s actually quite difficult to think of an offence for every letter of the alphabet). For each entry some background is given about the offence and how it is dealt with, followed by typical offender and victim characteristics and a discussion of the psychological issues. I was slightly concerned that, given the subject matter, the text would take either a dry and austere tone or a populist and lightweight one. I am, though, pleased to say that none of those characteristics apply to this book. It is a serious attempt to inject an evidence base into debates about crime, with each chapter providing a thoughtful and well-informed discussion about the featured offence. Yet, it manages to do this in a way that remains engaging and accessible. I particularly like the way in which it integrates research insights with the practicalities of dealing with crime. The editors have done a sterling job in pulling together contributions from a multidisciplinary pool of authors and arranging their work in a consistent style. One point that I would raise though is that, because the chapters are organised according to specific offences, some effort is required on the reader’s part to crossreference the psychological topics that appear throughout the book. A Psychologist’s Casebook of Crime is aimed primarily at forensic psychology students who require a comprehensive introductory text. However, I would also recommend it to anyone else who is involved in criminal justice work. I Palgrave Macmillan; 2012; Pb £26.99 Reviewed by Denham Phipps who is a Research Fellow at the University of Manchester

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Love and loss Les Misérables Tom Hooper (Director) Les Misérables is a staged musical with a long run and a long show. The recent filmic reworking kept absolutely faithful to songs and storyline, editing hardly anything. As a result, Les Misérables is also a long film, but an emotionally engaging one. Many shots were filmed in extreme close up, and actors sang their lines ‘live’ rather than dubbing over, perhaps to try to capture some of the rawness which comes across in the stage production. When I went to see it there was audible crying in the audience. The story of Les Misérables contains many themes that are familiar fodder for psychological exploration and therapy. Most striking to me was the theme of love and loss, from multiple perspectives: parental, romantic, unrequited and brotherly love were all represented and loss explored in different ways, most often through death but sometimes also through abandonment. The lyrics that illustrated this theme best were those in a song about the youths who died in the barricades, but which could be about any grief or loss. The image used is that of an empty chair and table – that idea of the place set for a lost loved one, or as used in some grief therapies, the empty chair symbolising the person who is no longer present: ‘There's a grief that can't be spoken/There’s a pain goes on and on/Empty chairs at empty tables/Now my friends are dead and gone.’ Later in the song the idea of survivor’s guilt crops up: ‘That I live and you are gone/There's a grief that can't be spoken/There's a pain goes on and on.’ Maybe one of the reasons for this show’s longevity and current cinematic revival is the enduring nature of the theme of loss for humankind. It is also perhaps no coincidence that this story is being reworked at this particular time. Not only is the universal theme of love and loss there, but also the theme of social injustice. We may not be facing a social uprising, but in the current economic and political climate we are experiencing growing figures of youth unemployment and ongoing yet under-reported cuts to public services. Watching the scenes of deprivation on Parisian streets made me think of the people who even in our privileged society today have to struggle to afford food and clothing and who in some cases remain miserable and unsupported. Overall I thought that the film was well-done. The singing was admirable, the acting was good and the use of close-up mixed with street tableaux was beautiful. A cinematic spectacle which is likely to resonate at some level, whether or not you are a die-hard ‘Les Mis’ fan. I Reviewed by Lucy Maddox who is a clinical psychologist in the NHS and Associate Editor for ‘Reviews’

Entertaining and educational Asylum Bound Stuart Townsend This book tells the true story of the author’s personal journey through psychiatric nursing training during the late seventies. Falling into nursing by chance rather than desire, Townsend provides an enlightening insight into the realities of working within a mental institution, culminating in the personal realisation

that this is the career for him. In great detail and with disturbing honesty he describes the history of asylums, the medications and treatments used within them, and the sometimescomical antics of both staff and patients. Overall, the book is entertaining and educational; for anyone with an interest in psychiatry, this is a must-read. I P&B Publishing; 2012; Pb £7.99 Reviewed by Victoria R. Kroll who is a postgraduate researcher at Nottingham Trent University

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Beneficial research impact Research for the Public Good: Applying the Methods of Translational Research to Improve Human Health and Well-being Elaine Wethington & Rachel E. Dunifon (Eds.) As researchers, we are constantly asking ourselves ‘Will my research have any impact on current policy and practice?’ This book gives a comprehensive overview of how we can ensure that the findings from our work are being applied in the real world. It also situates itself in the current debates of whether we can adopt a medical sciences model or whether we need to think of different ways of translating evidence in the social sciences. Recommendations include establishing two-way relationships with policy makers and thinking about the possible levels of research impact. Here you will find many examples of successful case studies of translational research from maternity care through to developmental psychology. These examples come from small as well as large qualitative and quantitative studies, mainly from the American context, but the authors also draw on some recent developments in the UK. Within the current funding climate this book feels very relevant and contributes to the debate surrounding different pathways of research impact. A recommended read for anyone who is seriously considering the practical implications of research. I American Psychological Association; 2012; Hb £59.50 Reviewed by Marta Wanat who is a PhD Researcher at Oxford Brookes University

Applying psychology k2n Safety Zone Kay Toon This app, written by Chartered Psychologist Kay Toon, is for ‘people who are functioning well in their lives but sometimes feel out of control of their own emotions and behaviours’. A range of techniques for managing anxiety and lifting mood are presented, alongside quotes and examples from real people who attended the Wakefield Psychology Service. These can be ‘favourited’ and added to a personal ‘safety zone’ for ease of access. There’s quite a lot of reading – about the app, cautions and precautions etc. – before you get into the meat of what’s on offer, and in general the app feels quite text heavy. But there are integrated audio and video demonstrations of various techniques, and Kay tells me that ‘the great thing about digital is that you can keep updating it – I already have a list of improvements!’ She adds: ‘Developing the Safety Zone app has been exciting, and quite daunting. The biggest problems were finding a good app developer, and adapting to writing in a concise form for small screens. There has been great interest from therapists who think the app will be useful for their clients. Hopefully it will soon be accessed by the general public as well.’ It’s good to see psychologists taking advantage of the immediacy and popularity of the app format. I am sure offerings will continue to grow in sophistication as brave pioneers like Kay Toon grapple with what the technology has to offer! I iTunes £2.49 Reviewed by Jon Sutton, Managing Editor

‘There isn’t a blood test to predict whether the woman is going to get mental health problems’ The Great Abortion Divide Panorama, BBC One On 4 February BBC One's Panorama focused on ‘The Great Abortion Divide’. Abortion was legalised in the UK 46 years ago, and last year 200,000 women had one – one of Western Europe’s highest rates. Across their lifetimes, one in three women will have an abortion, and over a third of women terminating a pregnancy have done so at least once before. The programme tackled allegations that doctors in England and Wales are signing off terminations on questionable mental health grounds, with 98 per cent of abortions approved after two doctors sign a document that says the woman could face mental health risks if she continues with the pregnancy. This is despite the Royal College of Psychiatrists review from 2011, which concluded that women with an unwanted pregnancy faced the same mental health risks whether they had an abortion or not. Inevitably, Dr Peter Saunders from the Christian Medical Fellowship didn’t agree: ‘When a doctor knowingly and willingly puts his or her signature to a document saying something for which there isn’t actually any medical evidence base, then I believe that is not only immoral, it’s also illegal, it’s a form of perjury.’ If a woman says she doesn’t want to be pregnant, that is usually

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taken as a risk to her mental health. Dr Clare Gerada (Royal College of General Practitioners) said: ‘I think it’s a realistic interpretation of the legislation. There isn’t a blood test to predict whether the woman is going to get mental health problems, what we have is what the woman tells us.’ I would have liked to have seen more consideration of whether, in the absence of a blood test, there are at least psychological tests that trained professionals could deploy to get a more valid idea of the individual risks involved. It’s clearly an area full of disparities, with the programme focusing on the Northern Ireland situation, where women and doctors risk prison over abortion. And despite the fact that just 1 per cent of abortions in the UK are carried out over 20 weeks of pregnancy, Nadine Dorries MP certainly has a point when she says it doesn’t seem sustainable to have two rooms in a hospital, one with a ‘baby born at 20 weeks, prematurely, with the NHS throwing everything at it to save its life; in the other, a baby at 24 weeks being aborted’. I Reviewed by Jon Sutton, Managing Editor

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CHANNEL 4

Scrap-yard monster trashes programme How to Build a Bionic Man Channel 4

Loving cartwheels Ned the Neuron iPad app £1.99 For psychologists wishing to indoctrinate their kids in neurobiology nice and early, there’s an ideal app for you. Ned the Neuron is a lively, colourful coming of age story about a motor cortex neuron with a love of cartwheels. Written and produced by neuroscientist Erica Warp, the engaging narration can be turned off if preferred. For older children and undergrads, the app also features clickable definitions of basic anatomy terms, plus a few games, including brain anatomy snap. I Reviewed by Christian Jarrett

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The Swiss occupational psychologist Bertolt Meyer was ideally placed to present this documentary. Born with a missing hand and wrist, he sports a hi-tech bionic replacement that cost £30,000 two years ago. It’s a massive improvement on the hooks and plastic substitutes he grew up with, but when Meyer travelled to Johns Hopkins University to see the very latest prosthetic model, he was left speechless. That was the two-fold strength of this documentary. To see the remarkable technological progress – the new life-like, self-learning model was capable of 26 of the human hand’s 27 degrees of motion. And to witness the emotional impact of the technology on the people who can benefit from it. Other inspirational cases included a man whose life was saved by a plastic, pneumatically driven pump inserted in place of his heart; a blind woman whose sight was partially restored by a retinal implant; and a nimble prosthetics researcher, specialising in ankles, who lifted his trouser legs to reveal two robotic legs of his own (he lost his bone and tissue versions in a climbing accident). As Meyer observed, the technology is awesome, and at times it felt like watching a documentary from the future. There were also moments of psychological and philosophical reflection. The researcher with robot legs said he’d rather keep his prostheses than go back to his biological limbs. An ethicist wondered about a future in which people ask for their limbs to be removed so that they can be replaced by superior bionic substitutes. Meyer himself expressed unease when a replica of his own bionic arm was attached to a robot – ‘how can I not feel connected to it?’ he asked. Which leads us on to the documentary’s fatal flaw. That ‘robot’, featuring Meyer’s hand, was the eponymous ‘bionic man’, and its construction served as a Frankentstein-themed narrative device.

Each body part dealt with in the programme, from the heart to the retinal implant, was gradually botched together to create an entire synthetic version of Meyer, complete with a mask of his face. Given the incredible technology featured in the programme, the embarrassing anti-climax was to see the utter uselessness of this doddering $1 million scrap-yard monster as it joined Meyer and others for a celebratory pint, which it duly dropped. Recalling the earlier revulsion that Meyer expressed at the sight of this daft creature, one can only wonder if this is because it sported his face and arm, or because it had spoiled his once-promising documentary. I Reviewed by Christian Jarrett, journalist for The Psychologist and editor of the Society’s Research Digest (www.researchdigest.org.uk/blog)

Sample book titles just in: The Social Neuroscience of Education Louis Cozolino Pursuing the Good Life: 100 Reflections on Positive Psychology Christopher Peterson The Social Psychology of Aggression Barbara Krahé The Oxford Handbook of Leadership Michael G. Rumsey (Ed.) The Sexualization of Girls and Girlhood: Causes, Consequences, and Resistance Eileen L. Zurbriggen and Tomi-Ann Roberts (Eds.) Working Memory: The Connected Intelligence Tracy Packiam Alloway and Ross G. Alloway (Eds.) The Oxford Handbook of Retirement Mo Wang Between Mind and Nature: A History of Psychology Roger Smith Little Box of Big Questions: Philosophical Conversations with Children and Young People Irvine Gersch and Anna Lipscomb For a full list of books available for review and information on reviewing for The Psychologist, see www.bps.org.uk/books Send books for potential review to The Psychologist, 48 Princess Road East, Leicester, LE1 7DR Remember, ‘Reviews’ now covers psychology in any form: books, films, apps, plays, web, TV, radio, newspapers, etc. To contribute, e-mail psychologist@bps.org.uk or tweet your suggestions to @psychmag.

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Profile for The Psychologist

The Psychologist March 2013  

This is a preview of the March 2013 issue of The Psychologist, the monthly publication of the British Psychological Society. To download the...

The Psychologist March 2013  

This is a preview of the March 2013 issue of The Psychologist, the monthly publication of the British Psychological Society. To download the...

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