Post Of The Week – Saturday 1st November, 2014

1) Attitudes To Mental Illness

Although it seems a long way away, it is still my intention to carry on with research work from the last few years on attitudes to mental illness once the AS exams are over. A few things have happened this week which have made me realise that this remains an important topic.

This document from the Mental Health Foundation looks at how best to commission mental health services for young people. The connection between attitude and commission of services is obvious. Services don’t get commissioned if people in general think that a mental health problem is someone’s fault or is incurable. Young people don’t access those services if they think that a mental health problem in themselves or in one of their peers is that person’s fault or if those services are seen as ineffective or inappropriate. The trick is to acknowledge the problem and to commission services which meet young people’s needs.

There are indications that attitudes are improving in many areas of life but the workplace remains a place where stigma is evident. This article emphasises the point.

Finally, the big problem with mental health services is that not enough money is spent on them. Here is Mind’s take on that.

2) Cognitive Therapy Plus Antidepressants For Depression

It is becoming increasingly well established that a combination of biological and psychological therapies is the most effective way to treat moderate to severe cases of Depression. The evidence for this claim is sometimes flawed. Studies tend to follow participants for only a limited period, sample sizes are quite small, participants are not randomly allocated to treatment conditions, there is no control for the quality of therapy on offer.

This study reported on Mental Elf addresses several of these standard criticisms. It follows participants through remission of symptoms to recovery, it is a single study with a large sample which makes it more valid than a meta-analysis of a series of smaller studies, there is random allocation and there is a focus on high quality, personalised therapy. The latter point however creates a further problem of validity. People with Depression in the UK don’t get to spend long enough with a mental health professional for therapy to be properly personalised. A friend of mine who delivers CBT for the NHS points out that he rarely  sees clients for the NICE recommended amount of time. We have therefore to make a distinction between the potential of CBT and drug treatments to deliver change in people’s lives and their actual experience of therapy.

3) Managing Stress Using High Tech

In the stress management part of AS, we look at two longstanding methods of managing stress. For biological approaches, we look at drugs and for psychological approaches we look at Stress Inoculation. The idea of using feedback from physical measures such as heart rate or galvanic skin response has been around for a while. I don’t include it on the course because it is never clear whether the examiners regard this as a biological or psychological approach. This article explains how mobile apps are now being used to make biofeedback more effective. It also explains how other apps take the processes of Stress Inoculation and put them online.

4) Dopamine And Alcohol Addiction

I have this week put on to the Google site a video sent to me by Miss Croft which explains some of the biochemistry of addiction. Crucial to this is how we understand the role of dopamine. We have known for about 20 years that there is a link between genetic abnormalities in the dopamine system and susceptibility to addiction. How this works is not clear.

This brief post explains some of the problems and how a drug is being developed as a possible solution.

5) Competitiveness And Gambling

When we study the cognitive approach to explaining addiction, we look at the relationship between gaming and gambling. The idea is that people learn patterns of thinking from online gaming and apply them to online gambling. Mark Griffiths from Nottingham Trent University is the lead researcher in this area.

In this article, Mark Griffiths looks more broadly at the idea of competitiveness and applies it to gambling. Being competitive is often seen as a desirable trait: it is one of our school’s key values. However, there is an uncomfortable connection between competitiveness and problem gambling.

6) Applications To Education

I decided this year to evaluate applications of Piaget’s and Vygotsky’s theories to education by considering whether neuroscience had more to offer. This turned out to be a largely fruitless pursuit because it became obvious quickly that neuroscience has so far offered little.

Here’s a link to a well-regarded study which has been published this week. A better question than the one about neuroscience is to ask to what extent Piaget’s and Vygotsky’s ideas relate to what we know now about what works. Discovery learning, an approach said to be based on Piaget’s theory, is now regarded as less effective. We could argue about whether other ideas about what works have their origins in these two theories.

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