On #CleanYourVirtualDesktopDay, Dr. Nick Neave tells us about his research on Digital Hoarding. We learn more about how humans anthropomorphise their possessions and why we have such a hard time throwing things away.
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?”
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.
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?
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?
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.
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?
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.
In the simplest of terms, a bilingual person is someone who can communicate in at least two languages (Grosjean, 1982). Until the 1980s, it was believed that being bilingual is disadvantageous because the brain’s capacity is very limited; hence, speaking two languages would use more brain power and make it less effective. Some scientists went as far to say that children growing up in bilingual families are more likely to face learning difficulties. If you think that sounds untrue, then you are absolutely correct!
So, let’s discuss what has changed and how bilingualism is perceived nowadays. In short, rather positively. In the last 20 years, scientists have found substantial evidence for the beneficial impact of bilingualism on the human brain. Many argued that active use of two languages can improve sustained attention and executive functions such as inhibitory control. This means that a bilingual person will have, on average, better ability to focus their attention in response to a stimulus or activity. Additionally, it may be easier for a bilingual to suppress or ignore irrelevant information. This advantage observed in bilinguals is usually explained by the fact that bilinguals need to constantly suppress one language while using another, therefore they obtain some additional cognitive training.
Furthermore, brain scans demonstrated that in certain brain regions, bilinguals and monolinguals differ in activity level when they are performing exactly the same tasks. These findings clearly support the idea that using more than one language provides a person with some extracurricular brain training, which changes its activity. Naturally, contrasting opinions were voiced that didn’t fully agree with the concept of bilingual superiority in cognitive functioning. For instance, Duñabeitia and colleagues (2014) did not find any advantage amongst bilingual children compared to monolingual children on the task measuring inhibitory control.
Despite those contradictory findings, the recent review of the research in the area showed that most studies present results supporting the ‘bilingual advantage’ theory. In fact, there is a general consensus now, that speaking two languages does not constrain one’s cognitive abilities and if anything, it improves them.
All things considered, the belief that bilingualism can be beneficial for the brain is justifiable. Following this logic, researchers started exploring other ways this new knowledge could be applied. Some suggested that since bilinguals receive more cognitive stimulation throughout their lifespan, they may develop additional protection against cognitive decline. After all, growing evidence suggests that stimulating the mind can protect our thinking skills as we grow older. For instance, in a study by Martin and colleagues (2011), it was found that older people who received memory training showed better immediate and delayed verbal recall than people who didn’t.
But how exactly could bilingualism impact cognitive ageing?
Exciting new evidence suggests that being bilingual may impact some mechanisms responsible for slowing down the decline in thinking skills caused by age. One thing that scientists have observed is that the cognitive changes we see in ageing, don’t always map on to physical changes in the brain, in that some people appear to be more ‘protected’ against the effects of age. Researchers have proposed that this is due to something called Cognitive Reserve. This cognitive reserve is proposed to help some individuals cope with brain damage and age-related changes in the brain.
Crucially for our research, it is now believed that we can strengthen our cognitive reserve throughout our lifetime. For example, education, occupation and physical activity are all related improved cognitive reserve. Furthermore, as you could have already guessed, bilingualism is thought to be another contributor to the construct of the cognitive reserve. We can derive from this that people who are bilingual may develop more cognitive ‘resources’, thus mitigating the effect of ageing.
Why does this matter?
If all of the above is true, then is there really a need for further research? Well, the need certainly exists due to the constant increase in cases of dementia, a disorder caused by a serious decline of thinking abilities such as memory and problem-solving. Importantly, cognitive reserve holds out the promise of interventions that could alleviate the risk of dementia. Consequently, since bilingual seniors are thought to possess a better cognitive reserve than non-bilingual seniors, they should be more efficiently protected from developing dementia symptoms.
By 2050 the number of people diagnosed with dementia is projected to at least double! This will impact not only the patients’ families but also taxpayers in general. To prevent this disaster, we need to work and try to find effective ways to slow down cognitive ageing. Researching bilingualism evidently provides some hope for a better understanding of cognitive decline and therefore dementia, which hopefully helps reduce the effect this disease has on the population.
Can you help with our research on this topic?
With this goal in mind, our team has started investigating how bilingualism can strengthen cognitive reserve. We specifically focus on the impact of proficiency in the second language, time passed since acquiring the second language and the frequency of using the second language in day-to-day life.
To keep the sample consistent, we are recruiting people who use English as their second language and are aged 60 or above. The results of our study should provide us with some insight into the role these variables play in the cognitive reserve and we hypothesized that all factors will be positively correlated with better cognitive performance.
It is important to mention that our survey controls for other factors, which could influence cognitive reserve, such as a persons general intelligence, health, social network and activities. If you know anyone who meets our criteria, please let them know (using the link below). Every contribution is priceless and in the long run, may reveal the secrets behind delaying cognitive ageing.