The Big 5 Episode 9: Nicki O’Brien “Developing visual communication methods for health challenges” (Funded PhD opportunity)

Picture of a man wearing a mask.

On this episode of The Big 5, Dr. Nicki O’Brien tells us about her innovative work using animated GIFs to teach people about COVID-19 health behaviors like mask wearing and hand washing in Guatemala. She also discusses a funded PhD project starting October 2022. Applications due February 18, 2022.

Show notes:

To follow Nicki on Twitter: @NickijObrien

Check out the GIFs here. And an article about the GIFs can be found here.

Interested in the PhD opportunity? The advert can be found here.

You can find the transcript for this episode here.

The Big 5 Episode 8 Alyson Dodd “Measuring student well-being in line with student priorities” (PhD opportunity)

Photo by George Pak on Pexels.com

On this episode, Alyson tells us about her research on student well-being and what students struggle with during their transition to university. She also tells us about a funded PhD studentship opportunity! (See link below.)

Shownotes:

Find Dr. Alyson Dodd: on Twitter @alysondodd and on her staff profile.

You can learn more about SMaRteN and read the report Alyson references here.

Interested in this PhD opportunity? Check out the advert here.

Transcript for this episode can be found here.

Funded PhD Opportunity: Understanding persuasive effects of message framing for vaccination uptake in university students

Photo by Gustavo Fring on Pexels.com
Author(s): Angela Rodrigues and Nicki O’Brien

The field of health communication tends to centre on analysing the effectiveness of specific information contexts and less on relationships between message framing, intentions and behaviour (Nabi & Green, 2015; Joyce & Harwood, 2014). People’s health-related decision-making is not completely rational (Witteman, van den Bercken, Claes & Godoy, 2009). Framing effect theory suggests that different presentations of health-related information can affect individuals’ decision-making preferences (Tversky & Kahneman, 1981). Research suggests that messages presenting gains are more persuasive in encouraging prevention behaviours (Noar, Harrington & Aldrich, 2009); Rothman, Bartels, Wlaschin & Salovey, 2006). Gain framing messaging may be more effective in promoting vaccination – a type of health preventive behaviour (Park, 2012).

Persuading young adults to get vaccinated is critical for the national vaccination programme as a whole and is also arguably the key to achieving herd immunity. Within the national vaccination programme for young adults, the following vaccinations are available: Human papillomavirus (HPV), meningitis, seasonal influenza, and COVID-19.

According to the latest figures, HPV vaccine coverage for the first dose in 2019/20 was 59.2% in Year 8 (aged 12-13) females (compared with 88.0% in 2018/19) and 54.4% in Year 8 males (Public Health England, 2020). From September 2019 the national HPV vaccination programme became universal with 12- to 13-year-old males becoming eligible alongside females (Public Health England, 2020). For females that missed or chose not to get the HPV vaccine offered in school, they can get the vaccine up until their 25th birthday; males can take up the vaccine until they are 45 years old (NHS, 2021).

Influenza is a vaccine-preventable disease, and annual influenza vaccination is the most effective method for prevention (WHO, 2012). Despite not part of the national vaccination programme, some universities are implementing a flu vaccine for their student communities (https://www.ucl.ac.uk/students/support-and-wellbeing/health-care/vaccinations/get-flu-vaccination).

Research has found low seasonal flu vaccine uptake and low vaccine knowledge among university-aged students (Ryan, Filipp, Gurka, Zirulnik, & Thompson, 2019). In the US – where influenza vaccination is recommended for everyone aged ≥6 months – data show that vaccination rates range from 9-30% in university students (Ryan, Filipp, Gurka, Zirulnik, & Thompson, 2019). Recent evidence suggests that making the flu vaccine part of the national vaccination programme for young adults (<20 years old) might be cost-effective (Hill et al., 2020). 

Amid the COVID-19 pandemic, the urgency to vaccinate young adults and promote COVID-19 vaccination uptake in this population is particularly pronounced (Lucia, Kelekar & Afonso, 2021). Recent NHS England figures show that approximately 75% of 18-24 years olds have had one COVID-19 vaccination; but only approximately 60% have had two vaccinations (NHS England COVID-19 Dashboard 21 Oct. , 2021). Together, these figures highlight that a proportion of young adults is left unvaccinated. Vaccination of young adults can potentially provide direct protection for the recipients and indirect (herd) protection for the community (Pebody et al., 2018).

In the transition period of attending university, for many away from home, there might be an opportunity to promote a range of vaccinations to young adults, and shape these emerging adults’ vaccination habits for other vaccines, such as the COVID-19 vaccines. As settings within which students become independent, universities have both a responsibility and the potential to enable healthy development (Tsouros, Dowding, Thompson & Dooris, 1998). Accordingly, ‘health-promoting universities’ are being called upon to embed health into all aspects of campus culture and of providing health-promoting activities for students (Bachert et al., 2021).

Understanding underlying mechanisms that drive young adults’ preferences for and engagement with vaccination campaigns could inform the design of effective messaging to influence their decision-making processes when communicating during a public health crisis.

What is the aim of this PhD project?

This PhD project will develop and test, evidence-based vaccination messages targeted at young adults, using framing theory as theoretical approach.

Objectives

  1. Appraise existing vaccination campaigns directed at young adults by exploring effective behaviour change strategies and mechanisms of change associated with vaccination uptake;
  2. With young adults, co-design and develop a suite of health messages aimed at promoting vaccination uptake (such as influenza, COVID-19, HPV, meningitis);
  3. Conduct experimental and longitudinal studies to explore young adults’ preferences for and impact of the co-produced vaccination messages.

What skills and knowledge does the PhD candidate need?

We would love to work with someone who feels passionate about health-related behaviour change, and is keen to further our understanding.

You should possess a sound grounding in quantitative and qualitative research methods but have ambition to extend your skills into other research design methods

Applicants will normally have a track record of academic achievement in psychology or a related discipline, demonstrated by a first class or upper second undergraduate honours degree and/or a master’s degree (or equivalent)

About the supervisors

Angela is a Senior Lecturer in the psychology department and has experience in the area of developing and evaluating complex interventions for behaviour change, with a specific focus on theory- and evidence-based interventions. Angela co-Leads the Behaviour Change Research Programme of Fuse (the Centre for Translational Research in Public Health).

Nicki is a Health Psychologist and an Associate Professor in the Psychology department. She has expertise in health behaviour and behaviour change interventions, and a particular interest in the application of co-design techniques for intervention development with stakeholders.

The supervisory team works alongside other behaviour change experts in the north east of England and the North East North Cumbria NHIR ARC

More information and how to apply

If you’d like to discuss the opportunity, please contact the principal supervisor, Angela Rodrigues (angela.rodrigues@northumbria.ac.uk). Details on how to submit an application are below. We’ve added some useful reading for prospective candidates at the end of the post

Details on how to submit an application are below. We’ve added some useful reading for prospective candidates at the end of the post

The advert for the post can be found here, this includes full eligibility requirements. As part of the application process you will need to submit a 1000 word proposal of how you would approach the project by 18th February 2022

Full details of the application process can be found here

Further Reading

Ruddy, E., Moor, J., Idowu, O., Araujo Soares, V., Rodrigues, A., & Birch-Machin, M. The Impact of COVID-19 lockdown on health behaviours of the UK population: a cross-sectional study. European Journal of Cancer Prevention. [Manuscript in preparation].

O’Brien N, Vijaykumar S, Craig M, Land E, Aguilar S, Bedoya X, De la Cruz R, Najera E, Nicolau L (Under Review). A before-after cross-sectional survey of the effect of exposure to GIFs communicating Covid-19 preventive behaviours on behavioural cognitions of Guatemalan adults. Annals of Behavioral Medicine.

O’Brien N, Land E, Vijaykumar S, et al. (2021) Languageless animated gifs to communicate COVID-19 preventive behaviours to adults in Guatemala: Development and evaluation of efficacy. International Journal of Behavioral Medicine. 28:S11-S12.

Araújo-Soares, V., Hankonen, N., Presseau, J., Rodrigues, A., & Sniehotta, F. F. (2019). Developing behavior change interventions for self-management in chronic illness. European Psychologist, 24(1), 7-25.

Rodrigues, A., Sniehotta, F. F., Birch-Machin, M. A., Olivier, P., & Araújo-Soares, V. (2017). Systematic and iterative development of a smartphone app to promote sun-protection among holidaymakers: design of a prototype and results of usability and acceptability testing. JMIR Research Protocols6(6), e112.

O’Brien N, Heaven B, Teal G, Evans E, Cleland C, Moffatt S, Sniehotta FF, White M, Mathers J, Moynihan P (2016). Integrating evidence from systematic reviews, qualitative research, and expert knowledge using co-design techniques to develop a web-based intervention for people in the retirement transition. Journal of Medical Internet Research,18(8):e210; doi: 10.2196/jmir.5790

Funded PhD Opportunity: Languageless visual messages to prevent Covid-19 transmission

Authors: Dr Nicki O’Brien, Dr Santosh Vijaykumar and Dr Michael Craig

Background to the project

Effective public health communications are critical to prevent the spread of Covid-19. Internationally, government guidance and legislation have advocated and coerced evidence-based transmission preventive behaviours, such as physical distancing, good hygiene practices such as handwashing, and mask-wearing. Encouraging individual adherence to these behaviours is challenging, requiring input and evidence from psychology and behavioural science.

Research on the individual determinants of transmission preventive behaviours provides evidence of potentially modifiable targets for behaviour change interventions to help during the Covid-19 pandemic. Intention, self-efficacy and outcome expectancies have been shown to predict preventive behaviours of physical, handwashing and mask-wearing.

Information is better retained when health communications include visuals rather than text alone. Visual communications do not rely on language but use images and animations to tell the message narrative. In countries with multiple official languages, visual languageless communications can disseminate messages to the entire population.

The languageless visual messages (GIFs) that have been developed

The proposed project will extend previous work of a collaboration between the supervisory team at Northumbria University and the Human Rights Office of the Archbishop of Guatemala, Guatemala (http://www.odhag.org.gt/). The collaboration developed evidence-based, languageless, animated messages, in the form of GIFs, which have been disseminated via social media across Guatemala and on the national catholic TV channel. The GIFs can be seen here. Guatemala is an exemplar multilingual country with 25 official languages spoken (24 indigenous and Spanish).

The effect of exposure to the GIFs on behavioural beliefs about performing the preventive behaviours has been examined through an online experimental study of Guatemalan adults. The data demonstrated that exposure to the GIFs resulted in significant improvements in key determinants of preventive behaviours, namely intention, self-efficacy and outcome expectancies. These preliminary data suggest promise of the GIFs to have a positive impact on adherence to behaviours, however, this is yet to be determined.

The aim of this PhD project

To identify and explore how different features and potential mechanisms of action of languageless health messages (GIFs), promoting Covid-19 preventive behaviours, impact on their potential effectiveness. The project will include a consensus study to identify the behavioural science evidence base (including the behaviour change features) of the GIFs and a series of experimental studies to explore the effects of exposure to the existing GIFs and modified GIFs (i.e., with varying message features and mechanisms of action) on adherence to preventive behaviours in different Latin American and UK populations.     

The supervisory team

This PhD project will be supervised by Dr Nicki O’Brien, Dr Santosh Vijaykumar, Dr Michael Craig (Department of Psychology), and Ellie Land (Department of Arts). The supervisory team combines the complementary disciplinary, methodological and topic expertise required to fully support this research: Dr O’Brien is a Health Psychologist with expertise in health behaviour and behaviour change interventions. Dr Vijaykumar is a health and risk communication scientist with expertise in public health, behavioural science and new media technologies.  Dr Michael Craig is an experimental psychologist with expertise in the investigation of human cognition and the effects of behavioural interventions. Ellie Land is an award-winning factual animation maker, director, educator and researcher with expertise in animated short, feature-length and interactive films.  

The skills and experience a candidate needs

We are looking for someone who is keen to develop the science of behaviour change within the context of languageless visual health messages. Candidates would be expected to have a background in psychology, public health, health communication or a related discipline, demonstrated by a first class or upper second undergraduate honours degree and/or a master’s degree (or equivalent). An interest in design is desirable but not essential. Knowledge and experience of quantitative research methods are needed.  

More information and how to apply

If you’d like to discuss the opportunity, please contact the principal supervisor, Nicki O’Brien (nicki.obrien@northumbria.ac.uk).

The advert for the post can be found here, this includes full eligibility requirements. As part of the application process you will need to submit a 1000 word proposal of how you would approach the project by 18th February 2022

Full details of the application process can be found here

Funded PhD Opportunity: Developing a framework of community well-being in universities

AUTHORS: Dr Alyson Dodd, Dr Libby Orme and Dr Lisa Thomas

In this post, you’ll be able to read a bit about the PhD programe we have advertised. We’ve included a brief video to introduce the project and the supervision team too

Several leading organisations in the UK Higher Education sector (Hughes & Spanner, 2019Thorley, 2017; Universities UK, 2020) advocate a ‘whole university approach’ that promotes student and staff mental health and well-being via facilitating healthy settings, learning approaches, and support provision.

The problem of the whole university approach 

Existing research has not captured well-being from a whole-university perspective. For example, our own research discusses how student well-being is typically measured by self-report questionnaires asking about subjective or psychological well-being completed by individuals. There is relatively scant research on the well-being of university staff (particularly in non-academic roles) compared to students, but a similar individual approach to conceptualising and measuring well-being is used in research on university staff well-being. 

Research has looked at student and staff well-being separately, often focusing on specific roles and factors underpinning well-being linked to these. While this is important, the sector also needs to develop an understanding of what ‘being well together’ means in universities. In addition, the notion of what community means in universities is not well-understood. For example, the National Student Survey asks students if they ‘feel part of a community of staff and students’, but this is not clearly defined. 

Understanding what community is to students and staff in universities can help shape an understanding of how to facilitate well-being in a university community.   

What is community well-being?

Community well-being is not the same as the sum of individual subjective or psychological well-being in a given community. In a conceptual review, What Works Well-being used the following working definition of community well-being as “the combination of social, economic, environmental, cultural, and political conditions identified by individuals and their communities as essential for them to flourish and fulfil their potential.”  

In order for universities to facilitate a sense of community well-being, first we have to understand what community means to students and staff in Higher Education. Then we can develop a framework for conceptualising and defining universitycommunity well-being, that will inform how we measure whole-university well-being from a whole-university perspective, and evaluate initiatives developed to improve this. 

What is the goal of the proposed PhD Project

In line with the What Works Well-being guidance for developing a framework of community well-being, this project aims to 

  1. develop a model of university community well-being, and
  2. develop an initial measure of university community well-being.  

We hope to do this through a combination of methods, such as qualitative interviews, Delphi surveys, psychometric research and online surveys

What skills and knowledge does the PhD candidate need?

We would love to work with someone who feels passionate about well-being in universities, and is keen to further our understanding.

You should possess a sound grounding in quantitative and qualitative research methods but have ambition to extend your skills into other research design methods

Applicants will normally have a track record of academic achievement in psychology or a related discipline, demonstrated by a first class or upper second undergraduate honours degree and/or a master’s degree (or equivalent)

About the supervisors

Alyson is an Associate Professor in the psychology department and is on the leadership team of the UKRI-funded network SMaRteN, which focuses on student mental health and well-being.  Alyson has led a published scoping review (see further reading), UK-wide stakeholder consultation, and a forthcoming SMaRteN report on measuring well-being in a student population. She chairs a Special Interest Group on this topic. Alyson is also a partner on the Office for Students Challenge Competition project Brighter, which is evaluating student well-being interventions. 

Libby is an Associate Professor of learning and teaching and the deputy head of the psychology department at Northumbria. She has a strong interest in student community and well-being, the transition to university, the use of technology in Higher Education and academic staff development. Libby works across disciplines on projects related to student well-being, what community means, and how these feed into university strategy.

Lisa is a Senior Lecturer in the psychology department, Associate Director of the Psychology and Communication Technology (PaCT) Research Group, chair of the Psychology Department’s Athena Swan team, and Fellow of the HEA. Prior to her lectureship appointment, she was a Senior Researcher for three successive multidisciplinary EPSRC projects- one in particular, ReelLives, explored the ways in which individuals could take ownership of their digital identity. Her research interests lie within Psychology and Human Computer Interaction (HCI)- the role of technologies in life transitions, student community and well-being, self-presentation online and authenticity.

More information and how to apply

If you’d like to discuss the opportunity, please contact the principal supervisor, Alyson Dodd (Alyson.dodd@northumbria.ac.uk). Details on how to submit an application are below. We’ve added some useful reading for prospective candidates at the end of the post

The advert for the post can be found here, this includes full eligibility requirements. As part of the application process you will need to submit a 1000 word proposal of how you would approach the project by 18th February 2022

Full details of the application process can be found here

Further Reading

Atkinson, S., Bagnall, A., Corcoran, R., & South, J. (2017). What is community well-being? Conceptual review.  

Dodd, A. L. (2021). Student mental health research: moving forwards with clear definitions. Journal of Mental Health, 30(3),273-275. 

Dodd, A. L., Priestley, M., Tyrrell, K., Cygan, S., Newell, C., & Byrom, N. C. (2021). University student well-being in the United Kingdom: a scoping review of its conceptualisation and measurement. Journal of Mental Health, 1-13.

Sleeping longer than 6.5 hours a night associated with cognitive decline according to research – what’s really going on here?

Does too much sleep really increase your risk of cognitive decline? Dragan Grkic/Shutterstock
AUTHOR: Dr Greg Elder, Northumbria University

A good night’s sleep is important for many reasons. It helps our body repair itself and function as it should, and is linked to better mental health and lower risk of many health conditions – including heart disease and diabetes. It’s also been shown that not getting enough sleep is linked to cognitive decline and conditions such as Alzheimer’s disease.

But more isn’t always better, as one recent study found. Researchers from the Washington University School of Medicine have published a paper that indicates that just like getting too little sleep, sleeping too much may also be linked with cognitive decline.

The research team wanted to know how much sleep was linked to cognitive impairment over time. To do this, they looked at 100 older adults in their mid-to-late-70s on average, and tracked them for between four and five years. At the time of their study, 88 people did not show any signs of dementia, while 12 showed signs of cognitive impairment (one with mild dementia and 11 with the pre-dementia stage of mild cognitive impairment).

Throughout the study, participants were asked to complete a range of commonplace cognitive and neuropsychological tests to look for signs of cognitive decline or dementia. Their scores from these tests were then combined into a single score, called the Preclinical Alzheimer Cognitive Composite (PACC) score. The higher the score, the better their cognition was over time.

Sleep was measured using a single-electrode encephalography (EEG) device, which participants wore on their forehead while sleeping, for a total of between four to six nights. This was done once, three years after people first completed their annual cognitive tests. This EEG allowed the researchers to accurately measure brain activity, which would tell them whether or not someone was asleep (and for how long), and how restful that sleep was.

Two examples of EEG devices on mannequin heads.
Participants would have worn a device similar to this to track their sleep. wideonet/ Shutterstock

Although sleep was only measured at one period during the study, this still gave the research team a good indication of participants’ normal sleep habits. While using an EEG to measure brain activity may be somewhat disruptive to sleep on the first night, as people get used to the equipment, sleep tends to return to normal the following night. This means that when sleep is tracked from the second night onwards it’s a good representation of a person’s normal sleep habits.

The researchers also took into account other factors that can affect cognitive decline – including age, genetics and whether a person had signs of the proteins beta-amyloid or tau, which are both linked to dementia.

Overall, the researchers found that sleeping less than 4.5 hours and more than 6.5 hours a night – alongside poor quality sleep – was associated with cognitive decline over time. Interestingly, the impact of sleep duration on cognitive function was similar to the effect of age, which is the greatest risk factor for developing cognitive decline.

A good night’s sleep

We know from previous research that lack of sleep is linked to cognitive decline. For example, one study showed that people who reported sleep disturbances, such as insomnia or excessive daytime sleepiness, have a greater risk of developing dementia compared to people who don’t. Other research has shown that people who have short sleeping times have higher levels of beta-amyloid in their brain – which is commonly found in the brains of people who have Alzheimer’s disease.

Researchers don’t know for certain why lack of sleep is linked to cognitive decline. One theory is that sleep helps our brain flush out harmful proteins that build up during the day. Some of these proteins – like beta-amyloid and tau – are thought to cause dementia. So interfering with sleep might interfere with our brain’s ability to get rid of these. Experimental evidence even supports this – showing that even just one night of sleep deprivation temporarily increases beta-amyloid levels in the brain of healthy people.

But it’s less clear why long sleep is linked with cognitive decline. Previous studies have also found a link between over-sleep and cognitive performance, but most relied upon participants self-reporting how long they sleep nightly – which means the data is less accurate than using an EEG to measure brain activity. This new study therefore adds weight to such findings.

What’s surprising about this study’s findings is that the optimal sleep duration is much shorter than that which previous studies have suggested are problematic. The study showed that sleeping longer than 6.5 hours was associated with cognitive decline over time – this is low when we consider that older adults are recommended to get between seven and eight hours of sleep every night.

It could be the case that it isn’t necessarily the length of the sleep that matters, but the quality of that sleep when it comes to risk of developing dementia. For instance, this study also showed that having less “slow-wave” sleep – restorative sleep – particularly affected cognitive impairment.

What we also cannot tell from this study is if long sleep durations can independently predict cognitive decline. Essentially, we can’t rule out that participants who slept longer than 6.5 hours every night might not have already had pre-existing cognitive problems of brain changes suggestive of dementia that weren’t picked up on the tests. And although the researchers were careful to adjust for dementia-related factors, longer sleepers may also have had other pre-existing conditions that might have contributed to their cognitive decline which weren’t taken into account. For example, this could include poor health, socioeconomic status or physical activity levels. All of these factors together may explain why longer sleep was linked to cognitive decline.

There are many factors which can impact on both our sleep quality, and whether we experience cognitive decline. While some factors aren’t preventable (such as genetic predisposition), there are many things we can do alongside getting a good night’s sleep to help reduce our likelihood of developing dementia – such as exercising and eating a healthy diet. But while the researchers of this study seem to suggest there’s an optimal sleep duration – between 4.5 and 6.5 hours every night – the occasional weekend lie-in is unlikely to do your brain any harm.

About the author

Greg Elder is a Senior Lecturer in the Psychology Department at Northumrbia, Associate Director of the Northumbria Centre for Sleep Research, and a member of the Cognition and Neuroscience Group. You can read more posts by the group over in our Cognition and Neuroscience Blog

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Northumbria researchers win Prolific Grant Competition

Richard Brown and Dr Gillian Pepper’s research proposal was crowned the overall winner of  Prolific’s Grant Competition. This will provide valuable funding for Richard’s next PhD study, supervised by Gillian, which aims to investigate perceptions of control over risk.

Photo by Nataliya Vaitkevich on Pexels.com

Over 2000 users of the recruitment platform Prolific voted to select the top 5 proposals out of more than 100 entries from universities and research institutions from around the word. Prolific’s internal review panel then selected the Northumbria Psychology Department’s research duo as the overall winner. The proposal requested £4,700 to pay for future research costs and the winners were awarded this amount in full.

Their winning proposal was entitled “Die young, live fast? Does the feeling that you’ll die young, no matter what you do, encourage unhealthy behaviour and worsen health inequalities?” The study will aim to investigate what causes of death are widely believed to be uncontrollable and what information people use to assess personal risk. This looks to build on previous research conducted by Dr Gillian Pepper and Professor Daniel Nettle at Newcastle University into the Uncontrollable Mortality Risk Hypothesis (1, 2).

The Uncontrollable Mortality Risk Hypothesis

This suggests that people who believe they are likely to die due to factors beyond their control take less care of their health because they are less likely to live to see the long-term benefits of a healthy lifestyle. This is of particular relevance to social class differences in health behaviours. Those from lower socioeconomic backgrounds are typically exposed to greater levels of uncontrollable risk. This may cause them to be less motivated to engage in preventative health behaviours, thus worsening existing health inequalities. To encapsulate the point, the proposal asks, “If you believed you were likely to be a victim of a stabbing before the age of 30, would eating your 5 a day seem very important?”

Little is known about what causes of death are thought to be beyond individual control, or why. By investigating perceptions of control over death, and identifying the informational sources of these perceptions, this study hopes to provide valuable insights for public health interventions. These insights may inform structural interventions aimed at reducing specific types of environmental risk, or help to produce targeted health messaging to influence perceived levels of control. Ultimately, the aim is to produce findings that help to understand health behaviours and how to reduce avoidable deaths.

Richard and Gillian are thrilled with the outcome of the competition and would like to thank everyone that helped and voted for their proposal. Time to get to work!

References

1.         Pepper GV, Nettle D. Out of control mortality matters: the effect of perceived uncontrollable mortality risk on a health-related decision. PeerJ. 2014;2:e459.

2.         Nettle D. Why are there social gradients in preventative health behavior? A perspective from behavioral ecology. PLoS One. 2010;5(10):e13371.

Want to learn more?

Head over to our Health and Wellbeing Blog

Treatments for Mental Health Problems 

To mark World Mental Health Day, I’m writing a blog that covers two separate, but related, things. Both things relate to a question a patient asked me back in about 2014 and which I have thought a lot about since then

“Why aren’t researchers churning out new treatments for mental health problems the way new treatments for cancer get churned out?” 

Author: Dr David Smailes

The first thing I wanted to write about is something that I think is implicit in that patient’s question, but doesn’t exactly answer it. It’s about how well treatments for mental health problems work in comparison to other types of health problems.

How effective are treatments for mental health problems?

A relatively widely held belief is that interventions for mental health problems aren’t very effective. However, at least some of the data we have suggests that treatments in psychiatry (such as medications for things like obsessive-compulsive disorder, depression, and panic disorder) work, on average, about as well as treatments for other types of health problems (such as medications for heart failure, asthma, and COPD). 

A number of caveats need to be added here, as the authors of the study – Leucht and colleagues – noted. For example, it is difficult to compare how well treatments for different illnesses or health problems work because the outcomes researchers in different fields look at are so different. That is, if a psychological/psychiatric treatment doubles the likelihood that a patient recovers from depression, is that treatment as effective as one which halves the risk of someone dying from a heart attack? That’s a hard judgement to make. We also need to take into account things like the side effects of treatments, too. All of this means, in short, that it’s very difficult to say how well treatments for mental health problems work in comparison to treatments for other types of health problems. But looking at the data from Leucht and colleagues’ analysis, treatments for mental health problems seem reasonably effective. 

That being said, I think no one would disagree with the claim that we need to develop novel, more effective treatments for mental health problems. Disappointingly, over the past few decades, few – if any – novel, more effective interventions for mental health problems have been developed. There are many possible explanations for the lack of novel, more effective treatments – low levels of funding in mental health research in comparison to things like cancer researchmental health problems simply being more difficult to understand and develop interventions forresearchers focussing on the wrong kinds of questions. But the possible explanation I’m focussing on here is that too much of the research done into the causes of mental health problems can’t be replicated. 

The problem of replication

When research can’t be replicated, this means that when other researchers try to repeat a study someone else has performed, they fail to find the same results. The results of the original study, therefore, may be untrustworthy. Over the past decade, many scientific fields have re-examined what proportion of the findings they generate are replicable, and in several areas of psychology it has been estimated that only 30-50% of findings are replicable. Mental health researchers have, however, not really examined how replicable (or trustworthy) findings in our field are. But I see no reason to expect that our field will be different to other areas of psychology. This means that it is quite likely that much of the evidence we have about what factors might cause mental health problems will be wrong. And this is important because our understanding of what causes mental health problems tends to shape the treatments we develop to treat mental health problems. So, if we aren’t doing replicable research into what causes mental health problems, then we have little chance of developing novel, more effective treatments for those mental health problems. 

Happily, there are many reasonably straightforward solutions to these problems. We know, for example, that running studies that (a) use larger samples than we have typically achieved in the past, that (b) pay more attention to how well variables are being measured, and that (c) involve fully open reporting of how the study will be run and how its data will be analysed generates findings that are more replicable and trustworthy.

How is the Psychology Department at Northumbria addressing this issue?

Here in the Department of Psychology, we have been conducting studies in line with these solutions, to try to improve the replicability and trustworthiness of mental health research. These studies have tested how replicable some findings in hallucinations research are when large sample sizes are used and have shown how we can examine whether variables in research have been measured effectively. More broadly, Northumbria University has joined the UK Reproducibility Network, an organisation that aims to improve the replicability and reproducibility of all areas of research in the UK. This is a really important step and shows that the university is committed to generating really robust, trustworthy research. 

As I said earlier, some the solutions to the problem of research findings that can’t be replicated and so seem untrustworthy are quite straightforward, but they are often time-consuming and costly. This has meant that the take-up of these solutions has been quite slow. But, at least to me, it does feel like mental health research is beginning to move in the right direction. And the quicker that can happen, the sooner we should be able to start developing novel, more effective treatments to help people struggling with their mental health. 

Interested in hearing about our research in to mental health?

Head over to our health and wellbeing research blog

Why do we dream?

agsandrew/Shutterstock
Author: Professor Jason Ellis, Northumbria University, Department of Psychology

Although science knows what dreams are, it is still not known exactly why we dream, although plenty of theories exist.

Dreams are patterns of sensory information that occur when the brain is in a resting state – as in asleep. It is generally assumed that dreams only occur during rapid eye movement (REM) sleep – this is when the brain appears to be in an active state but the individual is asleep and in a state of paralysis. But studies have shown that they can also happen outside of REM.

Research from sleep studies, for example, shows that REM-related dreams tend to be more fantastical, more colourful and vivid whereas non-REM dreams are more concrete and usually characterised in black and white. Recent studies on dreaming show that during a dream (and in particular a REM-related dream) the emotional centre of the brain is highly active whereas the logical rational centre of the brain is slowed. This can help explain why these dreams are more emotive and surreal.

Evolutionary theory suggests the purpose of dreams is to learn, in a safe way, how to deal with challenging or threatening situations. Whereas the “memory consolidation” theory suggests that dreams are a byproduct of reorganising memory in response to what has been learned throughout the day.

Both theories have at least one thing in common – during times of stress and anxiety we either dream more or remember our dreams more often, as a way of coping with challenging circumstances and new information. This is also in line with another theory of dreaming – the mood regulatory function of dreams theory, where the function of dreams is to problem-solve emotional issues.

Anxiety and stress dreams

While there is no evidence that we dream more when we are stressed, research shows we are more likely to remember our dreams because our sleep is poorer and we tend to wake in the night more frequently.

Studies show the dreams of people with insomnia (a disorder largely characterised by stress) contain more negative emotion and are more focused on the self, in a negative light. Also, the dreams of people with insomnia tend to focus on current life stressors, anxieties and can leave an individual with a low mood the following day.

‘And then I was sitting on top of a palm tree in a white plastic chair.’ Evgeniya Porechenskaya/Shutterstock

Outside of insomnia, research has found that people who are depressed, while going through a divorce, appear to dream differently compared to those who are not depressed. They rate their dreams as more unpleasant. Interestingly though the study found that those depressed volunteers who dreamt of their ex-spouse were more likely to have recovered from their depression a year later compared to those that did not dream of the ex-spouse. Participants whose dreams changed over time, to become less angry and more pragmatic, also showed the greatest improvements. The question is why?

Although our senses are dampened during sleep (with vision being completely absent), strong sensory information, such as an alarm, will be registered and in some cases incorporated into the dream itself. We also know that during times of stress we are more vigilant to threat (on cognitive, emotional and behavioural levels), so it stands to reason that we are more likely to incorporate internal and external signals into our dreams, as a way to manage them. And this may account for these changes in our dreams, when we are anxious, depressed or sleeping badly.

How to sleep better

The current thinking is stress reduction before bed and good sleep management – such as keeping a consistent sleep routine, using the bedroom only for sleep, making sure the bedroom is cool, dark, quiet and free from anything arousing – will reduce awakenings at night and so the frequency of stress-related negative dreams.

That said, using a technique called Imagery Rehearsal Therapy (IRT), mainly used for treating nightmares in people with post-traumatic stress disorder, it appears stress and anxiety associated with nightmares and bad dreams as well as the frequency of bad dreams can be reduced. This is achieved by re-imagining the ending of the dream or the context of the dream, making it less threatening.

The night I became a pink unicorn. Evgeniya Porechenskaya/Shutterstock

There is also evidence that IRT is effective for reducing nightmares in children. Although IRT is thought to be successful by giving the dreamer a sense of control over the dream, this hasn’t been well studied in people who are stressed or anxious.

That said, a recent study showed that teaching people with insomnia to be aware while they were dreaming and to control the dream, as it occurs – known as lucid dreaming training – not only reduced their insomnia symptoms but also reduced their symptoms of anxiety and depression. Perhaps then the key is to manage the dreams as opposed to trying to manage the stress – especially in uncertain times.

Jason Ellis is a Professor of Sleep Science in the Department of Psychology. He is a member of the Health and Wellbeing research group and Director of the Northumbria Centre for Sleep Research.

This article is republished from The Conversation under a Creative Commons license. Read the original article.

COVID smell loss can have profound effects on your life, from weight change to intimacy barriers

Flotsam/Shuttestock
AUTHOR: Vincent Deary, Northumbria University, Newcastle and Duika Burges Watson, Newcastle University

It took a while to be officially recognised, but smell loss eventually became known to be one of the defining features of COVID-19. It’s now widely acknowledged that COVID-19 has a unique effect on smell receptors, and about 10% of those who lose their smell are still reporting problems with smell and taste six months later.

The effects of this can be profound. So we wanted to document what it was like to live with long-term smell and taste problems, and we did this by working with the smell-loss charity AbScent, which has an online support group for people with post-COVID smell problems.

By speaking to people in this group, we were able to build a picture of the wider impacts of disrupted smell following COVID-19. At the time of conducting our research, over 9,000 people had joined the group. Every day we were seeing new accounts of the devastating effect of sensory change.

We started posting questions to get a better sense of what was going on, and the response was overwhelming. People really wanted their experiences to be heard. With the consent of participants, we began to analyse their responses. We ran every theme we detected past the group and got them to comment on our research paper before we finalised it. We wanted to be sure we were telling their stories correctly. Here’s what we found out.

The end of food satisfaction

It’s been hard for people even close to me to understand the severity of the loss and how it’s affected my life.

Before we go further, let’s define a few key terms. Anosmia is total loss of smell. Parosmia is where normal smells are distorted, usually unpleasantly. Taste is what is picked up by the receptors on the tongue. Flavour is the total sensory experience of food, to which smell is the major contributor, but the other senses are also involved. This means that even if your taste (tongue) is fine, loss of smell will seriously affect flavour.

The first thing that struck us was how unpredictable and disorientating the sensory loss experience could be. For some, the effects were absolute:

It was like a light switch: from 100% to 0% in a couple of hours… No distorted smells, no whiffs, nothing. It’s like my nose switched off.

For others, things were more fluid. Anosmia could mutate into parosmia. Food that was fine one day could become disgusting the next. This “chaos narrative” – as sociologists call it – meant that smell loss was very difficult to live with, let alone manage. A condition over which there was no control.

A woman disgusted at the smell of a cup of coffee
What was once familiar and enjoyable could suddenly become strange and unpleasant. Farknot Architect/Shutterstock

The effect on appetite was also unpredictable. As might be expected, people had trouble eating – particularly when normal smells were distorted. Some were really struggling, reporting malnutrition and severe weight loss.

Less obviously, some people reported weight gain. These were usually people with anosmia, who were “chasing flavour” after losing their sense of smell. You can understand this if you realise the distinction between wanting and liking in what psychologists call the pleasure cycle.

Wanting is where you are chasing the thing you are going to consume. Liking is when you have got it and you are savouring it. In anosmia, that savouring part is no longer there, but this doesn’t stop the wanting:

Food satisfaction is lacking and I see myself eating more to try to get that satisfied feeling… I am gaining weight due to a constant urge to satisfy what can never be satisfied.

Intimacy is a scent

But it wasn’t all about food. Until you lose it, you don’t realise how essential eating is to everyday joys, especially social pleasures:

I am grieving for my lost senses. No more wine and cheese tasting nights or gin cocktails with my “girls”.

Even more heartbreaking was the effect of sensory changes on intimate relationships. There were a lot of posts where people described the loneliness of no longer being able to smell their partner or their children. Again, until it is gone, you don’t realise how important smell is to intimacy and connection. Even worse was the effect of parosmia:

His natural odour used to make me want him; now it makes me vomit.

How do you tell your lover that?

A man smelling his girlfriend's hair
Smell is an important but underappreciated part of what makes a person seem who they are. puhhha/Shutterstock

Some people’s relationships with themselves and the world had also changed. Some with no sense of smell reported feeling detached from themselves and the world. With parosmia, it could be more disturbing yet, with disgusting smells being triggered by everyday scents, making the world feel like a dangerous and confusing place.

For some these sensory changes were, fortunately, temporary. However, months down the line, many are stuck with profound sensory changes, with all the distress that brings. While there is evidence that smell training helps sensory recovery in other conditions, we are still at the early stages of understanding and developing treatments for what amounts to a pandemic of altered sensing.

About the Authors

Vincent Deary, is a Professor of Applied Health Psychology, within the Health and Wellbeing Research Group in the Department of Psychology at Northumbria University. He is also a member of the Altered Eating Network: https://twitter.com/AlteredEating

Duika Burges Watson, is a Lecturer in Global Health, Newcastle University

Read more?

Head over to the Health and Wellbeing Research section of the blog

This article is republished from The Conversation under a Creative Commons license. Read the original article.