Category: Mental health

False economy? Half of “low intensity” CBT clients relapse within 12 months

Members Of Support Group Sitting In Chairs Having Meeting
Low-intensity CBT can include group-guided self-help, computerised CBT and telephone support

By Christian Jarrett

Heralded as a revolution in mental health care – a cost-effective way to deliver evidence-based psychological help to large numbers – low-intensity Cognitive Behavioural Therapy (CBT) is recommended by NICE, the independent health advisory body in England and Wales, for mild to moderate depression and anxiety and is a key part of the “Improving Access to Psychological Therapies” programme in those countries. Prior studies into its effectiveness have been promising. However, little research has looked at whether the benefits last.

A new study in Behaviour Research and Therapy has done that, following a cohort of people with depression and anxiety over time. Disappointingly, the team led by Shehzad Ali at the University of York, found that after completing low-intensity CBT, more than one in two service users had relapsed within 12 months.

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Your personality may affect your vulnerability to mental health problems

Mental health
Swiss researchers used longitudinal data to test a “personality centred model of psychopathology”

By Christian Jarrett

Your personality describes your behavioural tendencies, your habits of thought and ways of relating to the world. For instance, some of us find it a lot harder to keep our negative emotions in check, which is measured by the Big Five personality trait of neuroticism (or “emotional instability”). It seems logical that people with this kind of disposition might be more prone to developing mental health problems like anxiety and depression, and indeed many studies suggest this to be the case.

From a scientific perspective, however, it’s not clear which comes first: perhaps mental health problems contribute to a more neurotic personality, or maybe living through adversity contributes to a neurotic personality and mental health difficulties.

An important new study in European Archives of Psychiatry and Clinical Neuroscience helps clarify the picture because it is the first, to the researchers’ knowledge, to look simultaneously at people’s personality, life events and mental health problems as they unfold over time. Though they come with important caveats, the findings suggest that some people have a personality profile that predisposes them to mental health problems, to more serious mental health problems when they occur, and even to more adverse life events.  

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New evidence shows the calming power of reminiscing about happy times

Tranquility - symbolized by a brain with relaxing calm blue ocean vision meditation. Isolated vector illustration on white background.By Emma Young

You’ve just had a fight with your partner or a confrontation with a colleague. Now your heart’s racing, and you’re struggling to think straight. What should you do?

Psychologists are not short on ideas for how to calm yourself down after a stressful experience. Seek out a friend? Yes, there’s good evidence that can help. But what if there’s no friend to hand? You could try to alter your view of what just happened from “Disaster!” to “Not really so bad”.

But it can be difficult to engage in this kind of “cognitive reappraisal” when you’re in the immediate aftermath of a stressful event – perhaps because acute stress compromises the neural circuitry that’s involved in emotion regulation.

Your brain needs help if it’s to quickly regain control. And, according to a new study published in Nature Human Behaviour, you can provide it by thinking back over good times.

Continue reading “New evidence shows the calming power of reminiscing about happy times”

Can a good sense of humour protect you from stress?

Barbara WindsorBy Christian Jarrett

They say that if you can laugh at it, you can live with it. Is this true? Does the ability to see the funny side of things really act like a psychological shield against stress? A series of new studies in Personality and Social Psychological Bulletin provides some tentative support for the idea. But the research also illustrates why this is such a difficult topic to study – does humour really reduce stress or is it just easier to see the funny side when you are coping well? And it’s worth remembering the serious risk that if humour is shown to be protective by psychology research – and it’s a big if – that those who suffer most from stress will be put under social pressure to help themselves by cheering up, a situation only likely to intensify their distress.

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New meta-analysis undermines the myth that negative emotions can cause cancer

By guest blogger Tomasz Witkowski

At least one in four readers of this post will die of cancer. This is a simple statistic that leads rationally thinking people to treat the possibility as very likely. And this is what many do: they try to adopt a lifestyle that minimises the risk to some degree. But how do we know what minimises and what increases this risk? Of course, by listening to experts, the best of whom are scientists who research these things. However, whenever there is disquiet brought about by uncertainty, self-titled experts come out of the woodwork. Discussion of factors increasing the risk of cancer is today not only the domain of medical doctors and psycho-oncologists, but is also engaged in by some alternative medicine proponents, pseudopsychologists, and fringe psychotherapists, whose opinions are disseminated by journalists, some more thorough than others (see myth #26 in 50 Great Myths of Popular Psychology for more background).

Among these opinions is the common claim that negative thinking, pessimism, and stress create the conditions for the cells in our body to run amok, and for cancer to develop. Similar declarations accompany therapeutic propositions for changing our way of thinking into a more positive one that will protect us from cancer, or even cure us of the disease. Should you, therefore, begin to fear the possibility of cancer if you are not prone to optimism, or – even worse – have bouts of depression?

Continue reading “New meta-analysis undermines the myth that negative emotions can cause cancer”

Cold symptoms feel worse when you’re lonely

Young sick African woman in bedBy Christian Jarrett

Already substantial evidence suggests that feeling lonely – regardless of whether we actually are socially isolated based on our number of relationships – is bad for our health, affecting our odds of developing heart disease and other chronic conditions. A new study in Health Psychology extends this literature by showing that feelings of loneliness, but not levels of social isolation, seem to increase the toll of acute illness, in this case by worsening the subjective experience of having a cold.

The researchers, led by Angie LeRoy at the University of Houston and Rice University, said their findings could be useful for helping doctors understand their patients’ different experiences of short-term illnesses. It also provides yet more evidence for why interventions aimed at reducing loneliness need to focus on quality not quantity of social interaction – after all, it’s perfectly possible to feel intensely alone in a crowded room.

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Have we overestimated the effectiveness of psychotherapy?

By Christian Jarrett

Most people who undertake psychotherapy seem to benefit from it. How do we know? Arguably, the most important evidence comes from meta-analyses that combine the results from many – sometimes hundreds – of randomly controlled trials. Based on this, it’s been estimated that psychotherapy is effective for about 80 per cent of people (meanwhile, between five to 10 per cent of clients may suffer adverse effects).

But now the more concerning news: a team of researchers led by Evangelos Evangelou at the University of Ioannina, Greece has assessed the quality of 247 of these psychotherapy meta-analyses and they report in Acta Psychiatrica Scandinavica that many of them have serious methodological short-comings.

Coincidentally, a separate research group led by Brent Roberts at the University of Illinois, Urbana-Champaign has just published in Journal of Personality some of the first observational data on how people’s personalities change after undertaking psychotherapy. In contrast to what’s been found in the clinical literature, they report that people who’ve been in therapy seem to show negative changes in personality and other psychological outcomes.

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New study fails to find any psychological benefits of volunteering, but that doesn’t mean you should stop

The London 2012 Olympic VolunteersBy Alex Fradera

Volunteer! Universities, community groups and even the NHS recommend it, citing benefits for society and also yourself. The claimed personal outcomes include boosting your health and subjective wellbeing, but while the former is slowly gathering experimental backing, the wellbeing research is overwhelmingly correlational, making it hard to prove that volunteering is causing the gains (it’s certainly plausible, for instance, that happier people are simply more inclined to give up their time for free). Now the journal Comprehensive Results in Social Psychology has published a more robust test: a randomised study. The researchers looked for evidence to support the mental wellbeing benefits from volunteering … but they looked in vain.

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There’s such a thing as “autism camouflaging” and it might explain why some people are diagnosed so late

By guest blogger Helge Hasselmann

While autism is usually diagnosed in childhood, some people remain “off the radar” for a long time and only receive a diagnosis much later. One possible reason is that they have learned socially appropriate behaviours, effectively camouflaging their social difficulties, including maintaining eye contact during conversations, memorising jokes or imitating facial expressions.

This pattern of behaviour could have serious consequences for the lives of some people with autism. It is easy to imagine that camouflaging demands significant cognitive effort, leading to mental exhaustion over time, and in extreme cases perhaps also contributing to anxiety and depression.

If there are gender differences in camouflaging, this could also help explain the well-known male preponderance in autism spectrum disorders. At least part of the gender imbalance may, in fact, stem from an under-diagnosis of autism in girls because they are better at “masking” symptoms.

Before now, autism camouflaging has not been studied in a systematic and standardised manner: a recent open-access study in the journal Autism, by Meng-Chuan Lai and his colleagues, is the first to offer an operationalisation of camouflaging, which they define as the discrepancy between internal and external states in social-interpersonal contexts. For instance, if an autistic person maintains eye contact during a conversation because they have learnt that this is socially appropriate, even though this clashes with how they really want to behave, this would be an example of camouflaging.

Continue reading “There’s such a thing as “autism camouflaging” and it might explain why some people are diagnosed so late”

Textbook fail: Rosenhan’s classic “On Being Sane In Insane Places” covered without criticism

16373344899_be8f8a89e1_bBy Christian Jarrett

Back in the 1970s, eight mentally well people, including psychologist David Rosenhan, presented themselves at psychiatric hospitals, where they showed signs of mild anxiety and complained of auditory hallucinations, specifically words like “empty” and “hollow”. All were admitted and either diagnosed with schizophrenia or, in one case, manic depression, and, despite acting “normal” after arrival, they were kept in hospital for an average of 19 days. On discharge all were described as having schizophrenia (or depression) “in remission”.

This was Rosenhan’s classic study “On Being Sane in Insane Places” which he claimed showed the stigmatising power of psychiatric labels and the inability of psychiatric staff to distinguish normality from supposed abnormality, as have many others since.

But from a methodological perspective, the study was problematic for a number of reasons and Rosenhan’s interpretation has been hotly disputed. In their highly regarded book on psychology myths, Scott Lilienfeld and his co-authors discuss the problem with Rosenhan’s study at length, such as the fact that in the 70s “in remission” was a very rare discharge diagnosis that actually showed psychiatric staff had realised the “pseudo patients” were mentally well.

Ultimately, Lilienfeld et al argue that it is a myth that “psychiatric labels cause harm by stigmatising people” and that the overly gullible interpretation of the Rosenhan study has helped propagate this myth. Others may disagree, but it’s at least fair to say that Rosenhan’s study had serious issues and that not all psychologists agree that psychiatric labels are in themselves harmful (consider too research that’s found that while clients say psychiatric labels can be difficult to deal with, they can also be beneficial in some ways, in terms of helping them understand their experiences and helping them to access appropriate treatments).

So, how is this classic study covered in textbooks relating to clinical psychology and mental health (the sub-discipline usually referred to on university courses as “abnormal psychology”)? In a new survey of 12 contemporary abnormal psych textbooks in the journal Teaching of Psychology, Jared Bartels and Daniel Peters found that half of them still give space to Rosenhan’s flawed study, but only two include any criticism or alternative interpretation of it at all.

This is a small survey and we’re not told the titles of the books, but the findings suggest that the problem of uncritical textbook coverage of social psychology’s classic, myth-like studies, such as the Stanford Prison Experiment and Milgram’s “obedience research”, may also extend to the realm of classic mental health-related research. Is it that textbook authors are unaware of the criticisms of the Rosenhan study? Possibly, although Bartels and Peters surmise that perhaps authors know of the issues and alternative interpretations, but that these “shortcomings … are considered less important than the edifying message of the stigmatising effect of labels”.

Coverage of Rosenhan’s “On Being Sane in Insane Places” in Abnormal Psychology Textbooks

Image via Flickr/Freaktography

Christian Jarrett (@Psych_Writer) is Editor of BPS Research Digest