Psychology

The next time you're faced with a high-pressure situation in sport, try squeezing your left fist tight for thirty seconds. According to a team of German sports psychologists, doing this activates your right hemisphere and is conducive to automatic, skilled performance. This apparently helps prevent choking under pressure, which is linked with left-hemisphere activity, excess self-focus and conscious deliberation. Jurgen Beckmann and his colleagues tested their intervention across three studies. In the first, 30 semi-professional footballers aimed penalty kicks at holes in a wall. They did this in a low-pressure situation then competitively in front of a crowd. The fist squeezing was described to participants as a way to boost concentration. Kickers who squeezed a soft ball in their right fist for thirty seconds prior to the high-pressure situation choked - their performance dipped compared with the no pressure situation. By contrast, the competitors who squeezed their left fist showed no evidence of choking. It was a similar story with 20 Taekwondo practitioners who performed kick combinations in a relaxed context and then again in a filmed high-pressure situation. Those fighters who squeezed a ball with their right fist prior to the high-pressure challenge showed evidence of choking. By contrast, those who squeezed a ball with their left fist actually showed improved performance. The last study involved badminton players performing serves. This time there were three stages - relaxed context, high pressure, and high pressure plus fist tightening. All players showed evidence of choking in the first high pressure situation, but then players who squeezed their left fist prior to the second high-pressure challenge showed a return to normal performance levels while those who squeezed their right fist continued to choke. Beckmann and his colleagues said their "hemisphere specific priming" intervention has practical applications for athletes. "Squeezing the left hand before performing a task under pressure may become a useful part of pre-performance routines in addition to imagination, deep breathing, or cue words." These results are certainly intriguing but it seems amazing that such a simple task could have such profound effects (it statistical terms, the effect sizes were large). Scrutinising the methodology, the most serious problem seems to be a lack of blinding. It sounds from the researchers' descriptions as though the person instructing participants knew the purpose and rationale of the study, so it's possible their expectations about left-fist squeezing may have influenced the performers (a study last year showed how important these effects can be). It's also a shame there wasn't a no-squeeze control group. There must also be question marks over the theory underlying this study. Beckmann's group said there is "a large body of research that shows enhanced right-hemisphere activity facilitates skilled performance." But I looked up a couple of references they cited - including EEG studies with archers and marksmen - and these showed correlations between hemispheric activity and performance, not causal effects. It's also important to remember this study didn't even measure brain activity, so the researchers are asking us to take quite a leap of faith in believing their explanation of the results. I think they realise this. "The exact mechanism underlying the effect of hemisphere-specific priming is still unknown," they wrote. _________________________________ Beckmann, J., Gröpel, P., and Ehrlenspiel, F. (2013). Preventing Motor Skill Failure Through Hemisphere-Specific Priming: Cases From Choking Under Pressure. Journal of Experimental Psychology: General DOI: 10.1037/a0029852 --Further reading-- A study published in April that linked fist squeezing with memory performance came in for some serious peer criticism. Post written by Christian Jarrett (@psych_writer) for the BPS Research Digest.

Sex addiction is an escalating state of dysfunction affecting body, mind and spirit. It is a series of sexual acting-out behaviors that are kept secret and are abusive to self or others. Sex addiction is used to avoid painful feelings, but often can be the source of such feelings. Acting out sexually for a sex addict alters consciousness and feelings. It is a mental preoccupation which includes obsession and compulsion, and is devoid of a caring relationship. Sex addicts are unable to stop their behaviors on their own, but can be responsive to the recovery process using a 12-step model such as Sex Addicts Anonymous (SAA). A formal disclosure is an important piece when putting together the recovery puzzle. It involves the sex addict and his or her partner meeting with a therapist trained in sex and love addiction issues. The disclosure process is a structured confession wherein the addict takes full responsibility for everything that he or she has done in the way of acting out sexually. The addict can then be accountable face-to-face with his or her partner. It is also an opportunity for the sex addict to demonstrate genuine remorse and transparency — two crucial components if the relationship is to continue — and for trust to be reestablished. Typically, the addict will prepare for disclosure by writing a letter or an outline. In conjunction with a therapist’s presence, this provides a structure, so that getting off track is less likely to occur. During this process, it is important for the addict to demonstrate empathy for the experience his or her partner is having, and being willing to listen to how the addict’s partner has been affected by the behavior can be very validating for a partner. It is also important to remain authentic. Often when a sex addict’s partner discovers the addict’s behavior, the partner struggles with an intense feeling of emotional betrayal. The partner may experience shock, confusion, anger, and feelings of hopelessness and humiliation. Their world is forever changed in an instant, and they experience the symptoms of trauma. Living with an addict who engages in behaviors such as lying, discounting his or her partner’s intuitions and observations, and who may even display verbally abusive behaviors is traumatic for a sex addict’s partner. Often after the initial discovery, the addict engages in what is called ‘staggered disclosure.’ Staggered disclosure is a term coined by Dr. Jennifer Schneider and Dr. Deborah Corley. It usually occurs after a partner has made an initial discovery of the sexual betrayal, and the sex addict makes an attempt at damage control by initially disclosing only some of the acting-out behaviors. This type of disclosure can have a very damaging effect on the addict’s partner. By partially revealing information incrementally about the sexual acting out behaviors, the partner loses their already damaged ability to trust both their own intuition and feelings, and it results in great difficulty restoring trust in the sex addict and in rebuilding the relationship. While a staggered disclosure does much to further decrease trust within a relationship, a complete, well thought-out and structured disclosure can have the opposite effect. There is no set time the disclosure should happen, but generally, 90 days after both partner and sex addict make an earnest commitment to individual recovery and therapy is a good time to schedule a disclosure. It is also important for the partner to ask themselves what their goal is with disclosure. The idea is that knowing the truth regarding what has happened can help facilitate the healing process. The sex addict and his or her partner can benefit greatly from professional assistance to help with the trauma of discovery, and to unpack the difficult feelings accompanying it. A solid relationship with a skilled therapist trained in love and sex addiction can help guide the sex addict and their partner through

There are more papers coming out on brain correlates of whatever aspect of our behaviors you care to name than anyone could possibly keep up with. (See, by the way, the nice piece done by David Brooks on how little these studies actually have to do with really understanding our minds.) I have the ‘my eyes glaze over’ experience in just scanning tables of contents of the relevant journals. Occasionally an item pops out that grabs my attention, such as this one (open access) on imaging brain correlates of self esteem. The drums continue to beat (see this book review) on how important a positive self image and an "Up" attitude are for health and longevity. Maybe someone will develop some kind of magnetic zapper that we can shoot ourselves up with whenever whenever we are feeling like a piece of …... Although neuroimaging studies strongly implicate the medial prefrontal cortex (ventral and dorsal), cingulate gyrus (anterior and posterior), precuneus and temporoparietal cortex in mediating self-referential processing (SRP), little is known about the neural bases mediating individual differences in valenced SRP, that is, processes intrinsic to self-esteem. This study investigated the neural correlates of experimentally engendered valenced SRP via the Visual–Verbal Self-Other Referential Processing Task in 20 women with fMRI. Participants viewed pictures of themselves or unknown other women during separate trials while covertly rehearsing ‘I am’ or ‘She is’, followed by reading valenced trait adjectives, thus variably associating the self/other with positivity/negativity. Response within dorsal and ventral medial prefrontal cortex, cingulate cortex and left temporoparietal cortex varied with individual differences in both pre-task rated self-descriptiveness of the words, as well as task-induced affective responses. Results are discussed as they relate to a social cognitive and affective neuroscience view of self-esteem. .... stimulus presentations were blocked in terms of the conditions Reference (Self vs Other, i.e. photographs) and Valence (words), creating four trial types: self-negative (S-N), self-positive (S-P), other-negative (O-N) and other-positive (O-P). Participants were not instructed that they ‘should try to press the buttons as fast as possible’ as is often done in social cognition experiments. In contrast, participants were instructed only to press the buttons ‘so that we can assess afterwards whether you are paying attention to and completing the task’. This passive orientation was intended to focus attention towards introspection and interoception with participants reminded repeatedly of the importance of ‘paying close attention to how you are feeling throughout the different parts of the task’.

New research suggests whether a person believes obesity is caused by overeating or by a lack of exercise predicts his or her actual body mass. The obesity epidemic is a pressing public health issue as two-thirds of U.S. adults are classified as overweight or obese. The trend toward obesity is a global phenomenon and a health pandemic even among Third World nations. In new research published in Psychological Science, researchers Brent McFerran and Anirban Mukhopadhyay, Ph.D., used an online study to determine whether individual beliefs might play a role in these trends. They discovered people seem to subscribe to one of two major beliefs about the primary cause of obesity. “There was a clear demarcation,” said McFerran. “Some people overwhelmingly implicated poor diet, and a roughly equal number implicated lack of exercise. “Genetics, to our surprise, was a far distant third.” McFerran and Mukhopadhyay wanted to dig deeper to see if the pattern could be replicated and, if so, what implications it might have for behavior. To do this, they conducted a series of studies across five countries on three continents. Data from participants in Korea, the United States, and France showed the same overall pattern. Not only did people tend to implicate diet or exercise as the leading cause of obesity, people who implicated diet as the primary cause of obesity actually had lower BMIs than those who implicated lack of exercise. “What surprised me the most was the fact that we found lay theories to have an effect on BMI over and above other known factors, such as socioeconomic status, age, education, various medical conditions, and sleep habits,” said McFerran. The researchers hypothesized that the link between people’s beliefs and their BMI might have to do with how much they eat. A study with Canadian participants revealed that participants who linked obesity to lack of exercise ate significantly more chocolates than those who linked obesity to diet. And a study with participants in Hong Kong showed that participants who were primed to think about the importance of exercise ate more chocolate than those primed to contemplate diet. These findings provide evidence that our everyday beliefs about obesity may actually influence our eating habits — and our body mass. According to Mukhopadhyay, this is “the first research that has drawn a link between people’s beliefs and the obesity crisis, which is growing as fast as people’s waistlines are.” The new findings suggest that, in order to be effective, public health campaigns may need to target people’s beliefs just as much as they target their behaviors. Source: Association for Psychological Science Overweight woman exercising photo by shutterstock.

Fear and uncertainty has plagued the implementation of the Affordable Care Act (ACA) since its inception. There have been wins and losses on both sides, and medical professionals across the country have had growing concerns that the continued battle amongst political parties would increase the gap between quality care and reimbursements. Recent events indicate more changes directly related to psychiatric medicine are on the horizon. One of the greatest victories for both the insurance industry and health providers has been achieved with the announcement that the Obama administration has moved to increase Medicare Advantage payments to insurers by 3.3 percent for 2014. This falls on the heels of the Administration’s initial endeavor to cut those same reimbursements by 2.2 percent in 2014. Meanwhile, the field of psychiatric medicine remains vulnerable to new changes implemented through the ACA, such as the recently released ICD-10 and CPT code modifications. The mandated ICD-10 and CPT code changes has only proven to further increase the problematic issues the public faces in finding, receiving, and paying for mental health services. A 2008 survey conducted by the AMA evidenced that of the psychologists consulted, 33% of their clients paid for their services out of pocket, leaving 67% of service payments made through billing insurance companies. It should be noted that most of these were claims filed with programs funded by federal, state, and local governments. The ACA has taken measures to try and serve the needs of U.S. citizens who require assistance and treatment from mental health professionals. Mandates are now in place requiring insurance carriers to include comprehensive options for mental healthcare within each health insurance plan. This should result in a large reduction in the growing number of individuals who forgo necessary mental health treatment due to financial constraints. And yet a major issue remains enticing more private practice mental health professionals to accept both public and private health insurance. In an effort to provide mental health professionals with a better understanding of the ICD-10 and CPT code changes, the APA released a series of documents summarizing major CPT code changes that directly affect the field of psychiatric medicine. Here is a brief summary of these documents (important links to these changes can be found in the references): Document 90862 has been deleted in one of the biggest CPT code changes. It has been replaced with the appropriate 99xxx series E/M code, which requires more documentation, even up to 11 separate elements. The 90862 code paid lower than a 99214 E/M code for Moderate Complexity. Replace 90801 (Initial Psychiatric Evaluation) with: 90791 (and 90785 report with interactive complexity when appropriate): Psychiatric diagnostic evaluation without medical services. 90792 (and 90785 report with interactive complexity when appropriate): Psychiatric diagnostic evaluation with medical services. New patient E/M codes can be used instead of 90792. Replace 90802 (interactive diagnostic initial evaluation) with: 90791 and 98785 report with interactive complexity 90792 and 98785 report with interactive complexity Replace 90804, 90816, 90806, 90816, 90808, 90821 to be used in all settings (in relationship to time with patient and or family) with: 90832: 30 minutes psychotherapy 90834: 45 minutes psychotherapy 90837: 60 minutes psychotherapy Report with interactive complexity and 90785 when appropriate in all three cases Replace 90810, 90823, 90812, 90826, 90814, 90828 to be used in all settings (in relationship to time with patient and or family) with: 90832: 30 minutes psychotherapy 90834: 45 minutes psychotherapy 90837: 60 minutes psychotherapy Report with interactive complexity and 90785 Replace 90805-90809, 90817-90822 Psychotherapy & Evaluation Management (E/M) with: Proper E/M code (not chosen based on time) and 90833 add-on code for psycho

I remarried 5 years ago and moved to my husband’s native country (non english). My 2 sons are grown up and have their own lives in my native country I visit every 2 months. Since living here I have not been able to feel at home. I hate it here and my life has become very insular. I rarely go out, only with my husband and even then I don’t like to. I have been very sad with whole days or weeks of tearfulness. That time has passed and I am now very numb feeling. I have lack of interest in anything and cannot bring myself to do anything. I miss my family very much and cannot wait until my stepson is old enough for us to move to my home country. I am always tired, fed up and disinterested. I have had a lot of health problems, some of which have settled but I still ache and feel very tired all day. My biggest concern is the not wanting to go out. I make all kinds of excuses to myself, I delay, I feel very stressed and anxious if I have to go out. I struggle with the language (I have had lessons but find it difficult) and am always worried that someone will speak to me. Before I moved here I was a kindergarden teacher and had a normal social life. I have told my husband how I feel and he is understanding and sympathetic but there’s really nothing he can do to help. I went to the doctor for a check up and told him how I have been feeling. He said he didn’t think I’m depressed. I’m not so sure, I’ve never been treated for depression so I have no idea myself. He says I ‘have to get out more’ er yes, that IS the problem. I have tried a language group in the area but hated it as they wouldn’t let us speak! The leaders just did all the talking and when a woman approached me to talk to me (in the second language) we were told off! The local language courses are finished now and I have no contact at all with the outside world apart from once a week to the supermarket with my husband and occasional trips out (which I don’t really like). Really, my question is: Could this be depression or maybe Agrophobia? I do not feel suicidal but I must admit to feeling that I just will be glad when life is over naturally. A: You must love your husband very much to have made this move. It sounds like it hasn’t been what you imagined it might be. Please don’t be hard on yourself. It’s a major adjustment to move to an entirely different country and culture. Yes, you certainly could be suffering from a situational depression. Or – it could be an adjustment disorder. Or – it could also be that you are lonely, homesick and grieving the loss of everything that is familiar to you. Talking to a mental health counselor could help you sort it out. I’m so very sorry that the language school was so unhelpful. The whole point of language is to speak! As an educator, I can’t imagine scolding people for trying to do the very thing that is being taught. I’m sorry there doesn’t seem to be another opportunity. That being the case, I do suggest you purchase a language program on CDs or online. Having more vocabulary will help you feel less alien. Although your doctor meant well by telling you to get out more, it is easier said than done. I’m wondering if maybe one way for you to get back into the world is to do some volunteer work with little children. You were a kindergarten teacher so working with children is part of your identity. I wonder if there is a daycare center that could use your help for a few hours a week. Or maybe you could offer to read stories to little ones at the local library or to play with them so their parents can have a few minutes to do their business there. As you know, children aren’t judgmental. Their language is simpler. And you would probably begin to meet some of their mothers. It might be a gentle way for you to venture out. Having a task to do will make it easier to relate to people and will help motivate

Vitamin D and Cholesterol: The Importance of the Sun (2009) by David Grimes, a British doctor, contains more than a hundred graphs and tables. Most of the book is about heart disease.  Grimes argues that a great deal of heart disease is due to too little Vitamin D, usually due to too little sunlight. I recently blogged about other work by Dr. Grimes — about the rise and fall of heart disease. Part of the book is about problems with the cholesterol hypothesis (high cholesterol causes heart disease).  One study found that in men aged 56-65, there was no relationship between death rate and cholesterol level over the next thirty years, during which almost all of them died (Figure 29.2). There is a positive correlation between death rate and cholesterol level for younger men (aged 31-39). The same pattern is seen with women, except that women 60 years or older show the “wrong” correlation: women in the lowest quartile of cholesterol level have by far the highest death rate (Figure 29.5). A female friend of mine in England, who is almost 60, was recently told by her doctor that her cholesterol is dangerously high. The book was inspired by Grimes’ discovery of a correlation between latitude and heart disease: People who lived further north had more heart disease. This association is clear in the UK, for example (Figure 32.4). Controlling for latitude, he found a correlation between hours of sunshine and heart disease rate (Table 32.3): Towns with more sunshine had less heart disease. No doubt you’ve heard that dietary fat causes heart disease. In the famous Seven Countries study, there was indeed a strong correlation between percent calories from fat and heart disease death rate (Figure 30.2). You haven’t heard that in the same study there was a strong correlation between latitude and dietary fat intake (Figure 30.8): People in the north ate more fat than people in the south. The fat-heart disease correlation in that study could easily be due to a connection between latitude and heart disease. The correlation between latitude and heart disease, on the other hand, persists when diet is controlled for. Grimes convinced me that the latitude/sunshine correlation with heart disease reflects something important. It is large, appears in many different contexts, and has resisted explanation via confounds. Maybe sunshine reduces heart disease by increasing Vitamin D, as Grimes argues, or maybe by improving sleep — the more sunshine you get, the deeper (= better) your sleep. Sleep is enormously important in fighting off infection, and a variety of data suggest that heart disease has a microbial aspect. As long-time readers of this blog know, I take Vitamin D3 at a fixed time (8 am) every morning, thereby improving my Vitamin D status and improving my sleep. Grimes and his book illustrate my insider/outsider rule: To make progress, you need to be close enough to the subject (enough of an insider) to have a good understanding but far enough away (enough of an outsider) to be able to speak the truth. As a doctor, Grimes is close to the study of disease etiology. However, he’s a gastroenterologist, not a cardiologist or epidemiologist. This allows him to say whatever he wants about the cause of heart disease. He won’t be punished for heretical ideas.

A violent attack by someone who is mentally ill quickly grabs the headlines. And it’s usually implied that mental illnesses are a preventable cause of violent crime. Tackle that and we can all sleep safer in our beds. But by pressuring mental health services to focus on the risk of violence we are in danger of actually increasing it. Most of the debate around risk and offending has centred around schizophrenia – the bread and butter of community psychiatry. But what is the evidence relating to the risk of violence in those diagnosed with schizophrenia? It’s tricky because schizophrenia varies so much in character and severity. And other factors known to have an association with violent crime, like migration and social disadvantage, are often also implicated as a part of the cause or consequence of schizophrenia.... Fazel, S. (2009) Schizophrenia, Substance Abuse, and Violent Crime. JAMA: The Journal of the American Medical Association, 301(19), 2016. DOI: 10.1001/jama.2009.675 Schizophrenia, Substance Abuse, and Violent Crime Short, T., Thomas, S., Mullen, P., & Ogloff, J. (2013) Comparing violence in schizophrenia patients with and without comorbid substance-use disorders to community controls. Acta Psychiatrica Scandinavica. DOI: 10.1111/acps.12066 Comparing violence in schizophrenia patients with and without comorbid substance-use disorders to community controls

Academics earn street cred with TED Talks but no points from peershttp://www.psypost.org/2013/06/academics-earn-street-cred-with-ted-talks-but-no-points-from-peers-18527Sent via Flipboard