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Blog 4: Applying motivational research to PNP3002

            The PNP3002 coursework involved choosing a relevant topic to blog about and presenting it to your peers. This discussion will relate motivational research to my experience with this form of assessment.

            Green-Demers, Pelletier, Stewart and Gushue (1998) found using interest-enhancing strategies (IES): creating challenges, adding variety, and using valued relevant rationales for a task resulted in higher levels of interest for intrinsic and extrinsic motivation, with interest important for motivation and commitment, increasing desire and likelihood of task completion (Sansone, Weir, Harpster, & Morgan, 1992). The blogs made use of these strategies. Topic freedom created challenges of how to approach the topic, how technical you wanted to be, and accomplishing this with limited words. It also presented a creative challenge normally lacking in coursework by requiring an attention-grabbing introduction. Variety occurred in the topics you and others chose and the format you wrote and presented it. Before beginning we were also presented with rationales for using blogs allowing understanding of benefits beyond grade-achievement.

            However, Green-Demers et al. (1998) also found using stimulation outside the task to increase interest had a negative effect on extrinsic motivation. This was also present through relying on blog pictures, layout or related movie clips for motivation which could become distracting. This conflict also occurred when focusing too much on enjoying reading the research and learning (intrinsic motivation) and then struggling to begin writing it which was less interesting but necessary to get a grade (extrinsic motivation).

            Topic freedom had mixed results in my experience. White and Hoffrage (2009) found more options decreased indecision if options were poor. The freedom to choose topics I could understand was initially appealing. However, White and Hoffrage (2009) also found indecision could be caused by too much choice over worries which option would be the most suitable. This was also present for me, with so much choice, deciding which option would be best led to indecision and procrastination.

            Another important feature was the student-centred discussion groups. Moust, De Volder and Nuy (1989) found participants rated student and teacher led discussion groups as similarly effective at stimulating learning. My experience reflected this with students’ presentations motivating learning of different topics and their discussions aiding critical thinking and understanding through sharing perspectives and knowledge (Gokhale, 1995). However, the tutor was also important for focusing on key points of a presentation (Moust et al., 1989).

            Blogs as an assessment were effective in increasing interest and motivation to learn by being challenging, creating variety and having rationales, with discussion groups aiding understanding and critical thinking. However, there were motivational difficulties from overwhelming choice, and being distracted by intrinsically rewarding learning rather than also being motivated to write the extrinsically important blog.

References

Gokhale, A. A. (1995). Collaborative learning enhances critical thinking. Journal of Technology Education, 7, 22-30. Retrieved from http://scholar.lib.vt.edu/ejournals/JTE/v7n1/gokhale.jte-v7n1.html?ref=Sawos.Org

Green-Demers, I., Pelletier, L. G., Stewart, D. G., & Gushue, N. R. (1998). Coping with the less interesting aspects of training: Toward a model of interest and motivation enhancement in individual sports. Basic and Applied Social Psychology, 20, 251-261. doi: 10.1207/s15324834basp2004_2

Moust, J. H. C., De Volder, M. L., & Nuy, H. J. P. (1989). Peer teaching and higher level cognitive learning outcomes in problem-based learning. Higher Education, 18, 737-742. doi: 10.1007/BF00155664

Sansone, C., Weir, C., Harpster, L., & Morgan, C. (1992). Once a boring task always a boring task? Interest as a self-regulatory mechanism. Journal of Personality and Social Psychology, 63, 379-390. doi: 10.1037/0022-3514.63.3.379

White, C. M., & Hoffrage, U. (2009). Testing the tyranny of too much choice against the allure of more choice. Psychology & Marketing, 26, 280-298. doi: 10.1002/mar.20273

Blog 3: The interaction of emotions and scenario in moral judgements.

A car speeds up, deliberately splashing you with a puddle. You hear them laughing. You stand there dripping wet and seething. You think yes, it is okay to kill bad people. This discussion will analyse the Ugazio, Lamm and Singer (2012) research into the effects of type of emotion and moral scenario on moral judgement.

Ugazio et al. (2012) investigated the effects of induced disgust (a withdrawal behaviour emotion) and induced anger (an approach behaviour emotion) in four types of moral scenarios: disgust-related (moral scenarios associated with disgust), personal (for example pushing one person in front of a train to save five), impersonal (for example pulling a lever to change the track killing one person instead of five), and beliefs (the person’s knowledge of the action’s consequence), in emotion-induced and control groups’ judgements of scenarios being morally acceptable or not. Ugazio et al. (2012) found more actions were acceptable to anger-induced participants and unacceptable to disgust-induced; this effect was strongest in personal and impersonal scenarios. This suggests emotion does influence moral judgement but motivation tendency of an emotion, whether the emotion encourages approach behaviour such as anger or withdrawal such as disgust, is important as is the type of scenario being judged.

            However, Ugazio et al. (2012) predicted impersonal scenarios to be non-significant and disgust-related to be significant. This difference could be due to disgust-related written in third person perspective, whereas personal and impersonal were first person requiring participants to actively imagine performing the scenarios. Ugazio et al. (2012) concludes action imagery as important in mediating emotion’s effects. Scenarios involving physical harm do require more action imagery (Parkinson et al., 2011). Disgust-related did not involve physical harm. Personal and impersonal did. This suggests characteristics of scenarios have effects which Ugazio et al. (2012) failed to control.

However, another possible cause is response measures. In previous research, action acceptability was measured using a Likert scale (Wheatley & Haidt, 2005); however Ugazio et al. (2012) had only “yes” or “no”. This suggests the response method may have been too restrictive to find differences between disgust-induced and disgust-control groups, failing to represent disgust. This would affect action imagery’s importance.

            Scenario response times, shown to reflect inner decision processes, could have helped. For example, Feinberg, Willer, Antonenko, and John (2012) found longer response times were associated with reappraising initial judgements and emotions, which resulted in emotions affecting judgements less. This suggests participants could have been using reappraisal during decision making in Ugazio et al. (2012) resulting in inaccurate representations of emotions’ effects. Using response times would have aided understanding of how participants responded to scenarios.

            Reappraisal represents a problem in Ugazio et al. (2012) because it is effective for anger but not disgust (Russell & Giner-Sorolla, 2011). Use of reappraisal depends on a participant’s skill in understanding and differentiating emotions (Cameron, Payne & Doris, 2013). Ugazio et al. (2012) recorded level of anger and disgust before and after each scenario to ensure the target emotion was still induced, but this does not show if participants controlled emotions to stop it influencing decisions. This suggests participants could differ in differentiation ability, with high differentiators’ induced emotions having no effect on judgement but reappraisal restricted to the anger induced group.

            Another difficulty with Ugazio et al. (2012) is it does not consider conflict level. Carmona-Perera, Clark, Young, Pérez-García and Verdejo-García (2013) found problems recognizing facial expressions resulted in more utilitarian decisions; high conflict scenarios were affected when impairment was in fear recognition, whereas low conflict scenarios were from impaired disgust recognition. This suggests different emotions are effected differently by conflict level which is neglected in Ugazio et al. (2012) therefore failing to fully represent emotions’ effect on moral judgment.

            Ugazio et al. (2012) also fails to investigate the effect of combined anger and disgust on moral judgement. Salerno and Peter-Hagene (2013) found moral outrage requires a combination of anger and disgust and this combination results in a guilty verdict. This suggests anger’s tendency to perceive an action as acceptable will change to unacceptable depending on other emotions. Therefore emotion motivation tendency may be influential but can also be influenced.

            A further difficulty is Schnall, Haidt, Clore, and Jordan (2008) found induced sadness had an opposite effect to disgust. This has implications for Ugazio et al. (2012) as when inducing anger, sadness was also significantly induced. Ugazio et al. (2012) assumes significant sadness (a withdrawal emotion) causes an underestimation of anger but Schnall et al. (2008) suggests sadness may promote acceptability. Therefore Ugazio et al. (2012) is comparing disgust against an anger-sadness combination.

            Analysing Ugazio et al. (2012) this discussion concludes emotion does affect moral judgement. This is influenced by emotion’s motivation and moral scenario. However, it is further influenced by factors not included in Ugazio et al. (2012) such as conflict level, multiple emotion interaction, reappraisal, and emotion differentiation.

References

Cameron, C. D., Payne, B. K., & Doris, J. M. (2013). Morality in high definition: Emotion differentiation calibrates the influence of incidental disgust on moral judgements. Journal of Experimental Social Psychology, 49, 719-725. doi: 10.1016/j.jesp.2013.02.014

Carmona-Perera, M., Clark, L., Young, L., Pérez-García, M., & Verdejo-García, A. (2013). Impaired decoding of fear and disgust predicts utilitarian moral judgment in alcohol-dependent individuals. Alcoholism: Clinical and Experimental Research. doi: 10.1111/acer.12245

Feinberg, M., Willer, R., Antonenko, O., & John, O. P. (2012). Liberating reason from the passions: Overriding intuitionist moral judgements through emotion reappraisal. Psychological Science, 23, 788-795. doi: 10.1177/0956797611434747

Parkinson, C., Sinnot-Armstrong, W., Koralus, P. E., Mendelovici, A., McGeer, V., & Wheatley, T. (2011). Is morality unified? Evidence that distinct neural systems underlie moral judgments of harm, dishonesty, and disgust. Journal of Cognitive Neuroscience, 23, 3162-3180. doi: 10.1162/jocn_a_00017

Russell, P. S., & Giner-Sorolla, R. (2011). Moral anger is more flexible than moral disgust. Social Psychological and Personality Science, 2, 360-364. doi: 10.1177/1948550610391678

Salerno, J. M., & Peter-Hagene, L. C. (2013). The interactive effect of anger and disgust on moral outrage and judgments. Psychological Science, 24, 2069-2078. doi: 10.1177/0956797613486988

Schnall, S., Haidt, J., Clore, G. L., & Jordan, A. H. (2008). Disgust as embodied moral judgment. Personality and Social Psychology Bulletin, 34, 1096-1109. doi: 10.1177/0146167208317771

Ugazio, G., Lamm, C., & Singer, T. (2012). The role of emotions for moral judgments depends on the type of emotion and moral scenario. Emotion, 12, 579-590. doi: 10.1037/a0024611

Wheatley, T., & Haidt, J. (2005). Hypnotic disgust makes moral judgments more severe. Psychological Science, 16, 780-784. doi: 10.1111/j.1467-9280.2005.01614.x

Blog 2: It’s how you choose to think. Emotion regulation in depression-vulnerability.

           Are those tears in your eyes? Do you cope with this emotion by suppressing it and wiping away the tears? Or accepting it and trying to look at the situation differently? Suppression and reappraisal are two of the coping strategies used to regulate emotions. This discussion will analyse the Ehring, Tuschen-Caffier, Schnülle, Fischer and Gross (2010) research into these strategies’ relations to depression-vulnerability.

            Ehring et al. (2010) investigated differences between non-depressed (no history of depression) and depression-vulnerable (previously but not currently depressed) participants’ self-reported use of suppression and reappraisal as emotion regulation strategies in spontaneous and instructed use during a sad-inducing film. Ehring et al. (2010) found prior to manipulation, depression-vulnerable participants reported less emotional acceptance, but no difference in their use of suppression and reappraisal to non-depressed. However, when sadness was induced, depression-vulnerable suppressed their emotions significantly more than non-depressed. But when instructed to use either suppression or reappraisal, both groups benefited from reappraisal. This suggests depression-vulnerable can use reappraisal and gain its benefits, but that they are biased to using the more maladaptive method of suppression. This suggests therapies such as mindfulness or acceptance and commitment therapy would be useful in depression (Ehring et al., 2010), because they develop skills in acceptance and try to stop the patient from excessively suppressing negative emotion.

            However, this paper assumes males and females use strategies equally, but there are differences in neural activity undetected in behavioural outcomes (McRae, Ochsner, Mauss, Gabrieli & Gross, 2008). This suggests sex differences may be influencing the study as non-depressed have 14 males and depression-vulnerable only six, but are missed because Ehring et al. (2010) relies only on self-reports.

            For example, low emotional acceptance has been found to be the strongest factor in depression (Flynn, Hollenstein & Mackey, 2010). This supports Ehring et al. (2010), whereby depressed-vulnerable had lower acceptance, suggesting acceptance is important for resilience against depression. However, when acceptance is high, suppression is important but is more detrimental for males than females (Flynn, Hollenstein & Mackey, 2010). This suggests a sex difference which is not recognised in the study. Ehring et al. (2010) found little difference in the effects of suppression in non-depressed and depression-vulnerable. This could be due to the greater proportion of males in the non-depressed group reducing the average of the non-depressed females.

            Another difficulty with Ehring et al. (2010) is it fails to consider participants’ normal strategy use by focusing only on suppression and reappraisal. Females have been found more likely to use rumination as a coping strategy and males to use problem-solving and distraction (Broderick, 1998; Jose & Brown, 2008). This suggests strategies other than suppression and reappraisal are utilised outside experimental manipulation and are neglected in Ehring et al. (2010), thereby failing to accurately reflect depressive vulnerability.

            Ehring et al. (2010) also used a restricted age limit of 18 to 35 years. However, children’s strategies have been found to change as they age, with suppression and reappraisal used less by older children than younger (Gullone, Hughes, King, & Tonge, 2009). This suggests suppression and reappraisal are replaced by other more adaptive strategies not recognised in the study.

            Further, strategy changes occur in older adults with less efficiency at reappraisal and suppression but efficiency at using situation selection and attentional deployment (Urry & Gross, 2010). This suggests strategies continually change with age as resources such as cognitive control change, and different depression-vulnerabilities may exist depending on age, which is neglected in Ehring et al. (2010).

           Urry and Gross (2010) further found different types of reappraisal with older aged adults better at positive reappraisal than detachment reappraisal. This distinction of different reappraisals is not detailed in Ehring et al. (2010). This is supported in Webb, Miles and Sheeran (2012), in which suppression of emotional expression but not experience was effective, and reappraisal of emotion-inducing stimuli was more effective than emotional response reappraisal. This suggests there are differences within a strategy, which Ehring et al. (2010) fail to control.

            Ehring et al. (2010) suggests reliance on maladaptive suppression is an important depression-vulnerability, but can not determine whether this is a cause or effect. Beblo et al. (2012) found comparing non-depressed with major depressive disorder (MDD), MMD have a greater fear of emotion and suppressed positive and negative emotions. This suggests suppression may be used to combat an existing problem, which then leads to depressive symptoms. This highlights the importance of a depression group to compare against non-depressed and depression-vulnerable to better understand depression-vulnerability.

            Analysing Ehring et al. (2010), this discussion concludes depression-vulnerable can use reappraisal but spontaneity is deficient. However, it is more than a reliance on maladaptive suppression, but interactions of age, sex, fear of emotions and other emotion regulation strategies that determine vulnerability for depression.

References

Beblo, T., Fernando, S., Klocke, S., Griepenstroh, J., Aschenbrenner, S., Driessen, M. (2012). Increased suppression of negative and positive emotions in major depression. Journal of Affective Disorders, 141, 474-479. doi: 10.1016/j.jad.2012.03.019

Broderick, P. C. (1998). Early adolescent gender differences in the use of ruminative and distracting coping strategies. The Journal of Early Adolescence, 18, 173-191. doi: 10.1177/0272431698018002003

Ehring, T., Tuschen-Caffier, B., Schnülle, J., Fischer, S., & Gross, J. J. (2010). Emotion regulation and vulnerability to depression: Spontaneous versus instructed use of emotion suppression and reappraisal. Emotion, 10, 563-572. doi: 10.1037/a0019010

Flynn, J. J., Hollenstein, T., & Mackey, A. (2010). The effect  of suppressing and not accepting emotions on depressive symptoms: Is suppression different for men and women? Personality and Individual Differences, 49, 582-586. doi: 10.1016/j.paid.2010.05.02

Gullone, E., Hughes, E. K., King, N. J., & Tonge, B. (2009). The normative development of emotion regulation strategy use in children and adolescents: A 2-year follow-up study. The Journal of Child Psychology and Psychiatry, 51, 567-574. doi: 10.1111/j.1469-7610.2009.02183.x

Jose, P. E., & Brown, I. (2008). When does the gender difference in rumination begin? Gender and age differences in the use of rumination by adolescents. Journal of Youth and Adolescence, 37, 180-192. doi: 10.1007/s10964-006-9166-y

McRae, K., Ochsner, K. N., Mauss, I. B., Gabrieli, J. J. D., & Gross, J. J. (2008). Gender differences in emotion regulation: An fMRI study of cognitive reappraisal. Group Processes and Intergroup Relations, 11, 143-162. doi: 10.1177/1368430207088035

Urry, H. L., & Gross, J. J. (2010). Emotion regulation in older age. Current Directions in Psychological Science, 19, 352-357. doi: 10.1177/0963721410388395

Webb, T. L., Miles, E., & Sheeran, P. (2012). Dealing with feeling: A meta-analysis of the effectiveness of strategies derived from the process model of emotion regulation. Psychological Bulletin, 138, 775-808. doi: 10.1037/a0027600

Blog 1: Uncontrollable fear, but is that all? A look into Posttraumatic stress disorder.

Imagine surviving a traumatic event only to realise the battle is not over. Posttraumatic stress disorder (PTSD) is a trauma-and stress-or-related disorder that can affect individuals that have been exposed to a traumatic event. The diagnostic and statistical manual of mental disorders (DSM-5) lists symptoms as: re-experiencing the event, for example flashbacks; avoidance of event-related thoughts, feelings or external stimuli; negative cognitions and moods, and arousal which can include hyper-vigilance and exaggerated startle responses (APA, 2013). This discussion will analyse the Jovanovic et al. (2009) focus on failure to inhibit fear responses in unthreatening environments in PTSD symptoms.

Jovanovic et al. (2009) investigated the effect PTSD symptom severity had on participant ability to inhibit fear responses in controls (no PTSD), low number of PTSD symptoms, and high PTSD. Participants were conditioned to different light combinations warning of aversive or safe consequences. Jovanovic et al. (2009) found all groups correctly expected aversive or safe consequences. However, the high symptom group responded with an exaggerated startle response to all stimuli, while control and low symptom groups’ responded appropriately, differentiating between safe and aversive stimuli and learning to transfer the safe quality when safe and aversive lights were combined. This suggests cognitive ability to discriminate safe from threatening stimuli is not the problem as all groups predicted the correct outcomes. The problem is in the response to the stimulus, and therefore the prefrontal cortex’s ability to inhibit the amygdala response (Lanius et al., 2010).

When aversive was paired with a novel stimulus only the high symptom group treated it as dangerous (Jovanovic et al., 2009). This contributes to the understanding of hyper-vigilance of PTSD in which safe environments are treated as threats. This uninhibited fear combined with avoidance would prevent learning new positive associations and extinction of negative associations, helping PTSD symptoms to continue (Rothbaum & Schwartz, 2002; Sijbrandij, Engelhard, Lommen, Leer, & Baas, 2013). Uninhibited fear would therefore be the important target in PTSD therapy.

However, Jovanovic et al. (2009) further found that within the high symptom group the diagnostic clusters of arousal, avoidance and re-experiencing had different responses to stimuli. The failure to inhibit fear was greater in the re-experiencing and avoidance symptoms, with hyper-arousal demonstrating an ability to inhibit fear. This suggests that there may be subtypes within PTSD requiring different treatments (Norrholm, & Jovanovic, 2010; Jovanovic et al., 2010).

Jovanovic et al. (2009) only used fear potentiated startle (FPS) responses of eye-blinking to measure fear. Additional measures would have been beneficial. However, Jovanovic et al. (2009) suggesting skin conductance (SC) is not appropriate. SC does not detect control and PTSD group differences (Glover et al., 2011). It effectively measures numbing and avoiding symptoms, but not re-experiencing or hyper-arousal (Wahbeh, & Oken, 2013). Therefore SC in Jovanovic et al. (2009) would fail to detect two clusters.

Another difficulty with Jovanovic et al. (2009) is although it considers the clusters’ performances it does not stress which symptoms within the clusters are expressed. For example, numbing of emotions, also referred to as dissociation, is included in the same cluster as avoiding an event-related place in DSM-4. One is a lack of emotional expression, the other behaviour to avoid negative emotions. Dissociation has different neurological activity to both re-experiencing and avoidance (Hopper, Frewen, Kolk, & Lanius, 2007; Lanius et al., 2010), individual symptoms in the same cluster could also have differences.

Neurological activity in arousal and re-experiencing symptoms is decreased for the medial prefrontal cortex and increased for amygdala activity (Bremner et al., 1999; Shin et al., 2004). Therefore is a deficiency in the prefrontal cortex’s ability to inhibit the fear response of the amygdala (Lanius et al., 2010). Dissociative symptoms however, show high activity in the medial prefrontal cortex and less activity of the limbic system (Hopper, Frewen, Kolk, & Lanius, 2007), over-inhibiting emotion. This has important consequences for exposure-based therapy, which involves repeated exposure to the event’s emotions, because PTSD with dissociation must first learn to overcome emotional overregulation to benefit (Lanius et al., 2010).

Although DSM-5 has recognised dissociation, removing numbing of emotions from the PTSD symptoms and adding PTSD with dissociative subtype as another disorder which includes detachment from the self or world (APA, 2013), current research still neglects specifying symptoms (Jovanovic, Kazama, Bachevalier, & Davis, 2012). Greater understanding of symptoms is needed to improve treatment (Norrholm, & Jovanovic, 2010).

Analysing Jovanovic et al. (2009), this discussion concludes that uninhibited fear in safe environments should not be the only focus in research. Subtypes to PTSD exist. Improvements in the DSM-5 have acknowledged the subtype of dissociation, but further understanding and recognition of the individual symptom’s effects on the disorder is needed.

 

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) Washington, DC: American Psychiatric Publishing

Bremner, J. D., Staib, L. H., Kaloupek, D., Southwick, S. M., Soufer, R., & Charney, D. S. (1999). Neural correlates of exposure to traumatic pictures and sound in Vietnam combat veterans with and without posttraumatic stress disorder: a positron emission tomography study. Biological Psychiatry, 45, 806-816. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/10202567

Glover, E. M., Phifer, J. E., Crain, D. F., Norrholm, S. D., Davis, M., Bradley, B., Ressler, K. J., & Jovanovic, T. (2011). Tools for translational neuroscience: PTSD is associated with heightened fear responses using acoustic startle but not skin conductance measures. Depression and Anxiety, 28, 1058-1066. doi: 10.1002/da.20880

Hopper, J. W., Frewen, P. A., Kolk, B. A., & Lanius, R. A. (2007). Neural correlates of reexperiencing, avoidance, and dissociation in PTSD: symptom dimensions and emotion dysregulation in responses to script-driven trauma imagery. Journal of Traumatic Stress, 20, 713-725. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17955540

Jovanovic, T., Kazama, A., Bachevalier, J., & Davis, M. (2012). Impaired safety signal learning may be a biomarker of PTSD. Neuropharmacology, 62, 695-704. doi: 10.1016/j.neuropharm.2011.02.023

Jovanovic, T., Norrholm, S. D., Blanding, N. Q., Davis, M., Duncan, E., Bradley, B., & Ressler, K. J. (2010). Impaired fear inhibition is a biomarker of PTSD but not depression. Depression and Anxiety, 27, 244-251. doi: 10.1002/da.20663

Jovanovic, T., Norrholm, S. D., Fennell, J. E., Keyes, M., Fiallos, A. M., Myers, K. M., Davis, M., & Duncan, E. J. (2009). Posttraumatic stress disorder may be associated with impaired fear inhibition: Relation to symptom severity. Psychiatry Research, 167, 151-160. doi: 10.1016/j.psychres.2007.12.014

Lanius, R. A., Vermetten, E., Loewenstein, R. J., Brand, B., Schmahl, C., Bremner, J. D., & Spiegel, D. (2010). Emotion modulation in PTSD: Clinical and neurobiological evidence for a dissociative subtype. Am J Psychiatry, 167, 640-647. doi: 10.1176/appi.ajp.2009.09081168

Norrholm, S., & Jovanovic, T. (2010). Tailoring therapeutic strategies for treating posttraumatic stress disorder symptom clusters. Neuropsychiatric Disease and Treatment, 6, 517-532. doi: 10.2147/NDT.S10951

Rothbaum, B. O., & Schwartz, A. C. (2002). Exposure therapy for posttraumatic stress disorder. American Journal of Psychotherapy, 56, 59-75. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/11977784

Shin, L. M., Orr, S. P., Carson, M. A., Rauch, S. L., Macklin, M. L., Lasko, N. B., Peters, P. M., Metzger, L. J., Dougherty, D. D., Cannistraro, P. A., Alpert, N. M., Fischman, A. J., & Pitman, R. K. (2004). Regional cerebral blood flow in the amygdala and medial prefrontal cortex during traumatic imagery in male and female Vietnam veterans with PTSD. JAMA Psychiatry, 61, 168-176. doi: 10.1001/archpsyc.61.2.168

Sijbrandij, M., Engelhard, I. M., Lommen, M. J. J., Leer, A., & Baas, J. M. P. (2013). Impaired fear inhibition learning predicts the persistence of symptoms of posttraumatic stress disorder (PTSD). Journal of Psychiatric Research, in press. doi: 10.1016/j.jpsychires.2013.09

Wahbeh, H., & Oken, B. (2013). Skin conductance response during laboratory stress in combat veterans with post traumatic stress disorder. J Trauma and Treatment, 2, 167. doi: 10.4172/2167-1222.1000167

“You won’t like me when I’m angry”. Does TV really turn us green?

Believe children are angry miniature hulks, smashing everything in their path and causing chaos? Blame the TV. Eron (1963) found that violent TV is related to long-term aggression in boys, but it is what is viewed and not the length of time of viewing that is important. The research collected aggression scores through peer review. Every child in the class rated one another on 10 items that assessed aggression. Using young children may not have produced accurate representations, although with a class of reviews for every child this should have assisted in producing a more accurate representation through incorporating many children’s responses to produce an overall score. Additional sources such as teachers or family members could also have been used to provide aggression scores, or scores of aggression rated through experimenter observations. Peer review was the only method used to gather aggression scores, although this method does allow the standardisation of questions and interpretations of aggression.

Television was scored on the amount of time spent watching TV and the level of violence watched on TV based on the children’s three favourite shows. This was collected through an interview with both parents. This could have been improved by also asking the children; although the parents’ responses of time spent viewing correlated strongly and had 63% agreeableness on the child’s three favourite shows. Fathers underestimated the time spent viewing TV and mother’s estimates were presumed to be accurate but there was no evidence to support the position that the mother’s estimates were also nearer the truth. Children could have watched more TV than either parent was aware of. The child’s favourite TV show also does not mean they watched it the most. Their favourite show could only be on once a week and therefore it is watched less than other more regular programmes. It also does not mean the entire child’s viewing time is violent. These are presumptions that have been made which may not be true to assume. The violence and story will also vary between episodes and a child’s favourite shows can change. The parents may also not really know a child’s favourite shows and again make presumptions based on what they watch most often and not what they would rather be watching most often.

Although TV shows were not categorised by title alone, they were only categorised as being either anti-social aggressive or not. Therefore they were not assessing the content for the level of violence in each show, just if it was violent or not which may have importance in its influence on children. The TV show raters did have high concurrence rates in the level of violence of the programmes and did have to be knowledgeable of the shows, but this consisted of only two raters. These ratings were also compared to the parents’ ratings of the TV shows’ violence, but again this depends on the parents’ real knowledge of the show.

It was found that as the violence increased, boys’ aggression increased, but as viewing time increased, aggression decreased. This was complementary to their hypothesis which was that content and not time was what was important. The conclusions were that children who watch more TV have temperaments that made them less active, and aggression was released through a fantasy-like way, or their time is taken up watching TV and therefore had less opportunity to act out aggressively. They also considered that the boys may be modelling the characters of the TV shows. However it is possible that they became habituated to the violence so are less affected by it the more they watch. It could also be possible that children who watch the TV for longer could be watching less violent programmes for most of that time, whilst the more aggressive children only watch the violent programs which take up a shorter amount of their time.

Although there is a relationship between TV violence and aggression in children, Eron (1963) did not sufficiently look at the content of the violence watched to make conclusions on the relationship. Improvements would be to include children as an important source of information, using them as an additional cross reference for creating scores in aggression, time spent watching TV, the violence in the programmes and the programmes they watch. The other alternative would be to include researcher observations of the children.

References

Eron, L. D. (1963). Relationship of TV viewing habits and aggressive behaviour in children. Journal of Abnormal and Social Psychology, 67, 193-196. doi: 10.1037/h0043794

Bad dream: Imagine better

Do you have nightmares about monsters and killer clowns? Then its time to retrain your brain and think of fluffy kittens and rainbows. Krakow, Kellner, Pathak and Lambert (1996) found rehearsing a nightmare that has been changed into a more positive event can result in reduced nightmares, better sleep quality and reduced anxiety. A positive detail of this study was its use of a control group. This allowed them to establish the decrease in distress was not significantly different to the control group and therefore not a result of the treatment.

For ethical reasons the control group were instructed in imagery rehearsal after the three month follow up, causing problems as the 18 month evaluation no longer had a control group for comparison. Control groups were important in this study due to the subjective method of treatment and variations of many characteristics and demographics. They tried to counteract this with a questionnaire on factors that may have had an effect at the 18 month interval and through correlations performed at the three month period which suggested that demographics had no effect but this is not to say they could not have had an effect at a later time. The questionnaire is also not as thorough as continuing with a control group.

There was no control or categorisation on the severity of distress nightmares caused. This could be a factor in success of the treatment and if it is more effective for different degrees of the problem. There was also no exclusion of participants based on medication use or prior psychiatric diagnosis except one with chronic schizophrenia. These are important details that may have influenced the treatment. Participants were recruited through a newspaper advertisement so the sample was not truly randomised. The sample was also hugely unbalanced in sex ratio with 45 females and 13 males, causing difficulty in generalising.

Sleep quality used one rating method, with participants free to interpret what constitutes quality sleep and scale graduation as the scale only labelled the far left and far right as very poor and very good. This does not standardise the measure. Distress was measured using a symptom questionnaire which compiled anxiety, depression, somatization and hostility separately and then were combined to give a score of distress. Although reliant on participants accurately representing themselves, this highlights the importance of the convergence of a variety of factors in an objective manner in creating a score for a variable. This is more reliable and valid than the method of sleep quality.

Assessments were completed retrospectively over concerns previous research had shown keeping diaries of nightmares could aid participants due to self-monitoring, exposure and desensitisation (Johnson & White, 1971). Retrospective reporting could have caused problems in the accuracy of nightmare frequency, level of distress and sleep quality reported, and details of the nightmare being forgotten, altered or difficult to recall.

The treatment of imagery rehearsal was subjective and not standardised, with differences in how they changed the dream and how long they spent practicing. Treatment suggested spending 10 to 20 minutes a day but there was no method of ensuring participants conformed. Participants were instructed to change the original nightmare exposing them to it. Therefore some improvement may be due to exposure instead of changing it or through self-monitoring as participants may not have physically catalogued the nightmares but were keeping a mental log knowing they would be asked to recall and change them.

The changing of the original nightmare was dependent on the individual, differing greatly between participants in the original nightmare, process and outcome. The participant then rehearsed the changed dream for several minutes, with instruction not to recall the original. There is no guarantee that participants did not recall the original before recalling the changed nightmare or that the changed nightmare was significantly different to the original. Therefore some improvement could be due to desensitisation or exposure.  

If the frequency of nightmares did not decrease, then they were instructed to make alternate changes. There is no report on how many participants had to make changes, what changes to make, instruction on how long they should wait before making changes or what would be considered as an improvement, making the process very subjective. They were also encouraged to practice their imaging abilities, but no details were taken of people’s abilities and if this had an effect on the treatment.

This study does not explain why it is effective. It also has a limited ability to generalise its findings due to the lack of control over confounding variables and does not consider other important variables such as the severity of nightmares. Its attempts to avoid the beneficial effects of using diary methods may not have been successful and retrospective evaluation has complications concerning accuracy.

References

Johnson, S., & White, G. (1971). Self-observation as an agent of behavior change. Behavior Therapy, 2, 488-497.

Krakow, B., Kellner, R., Pathak, D., & Lambert, L. (1996). Long term reduction of nightmares with imagery rehearsal treatment. Behavioural and Cognitive Psychotherapy, 24, 135-148. doi: 10.1017/S1352465800017409

Clowning around: Not all clowns are evil

Two words: Ronald McDonald. The sight of a clown can strike fear into some people’s hearts, but not all clowns are evil despite what horror films would have you believe. Some clowns are in the business for another reason, to make people happy. These nice clowns are becoming increasingly popular in hospitals for clown therapy.

Fernandes & Arriaga (2010) found the presence of clowns effective in reducing a child’s worries and negative emotions and parental anxiety during preoperative care. A positive detail in this study was its use of pictures to assist comprehension of questionnaire scales (Varni, Limbers & Burwinkle, 2007), but younger children still may not have fully understood the questions and interpreted them differently to a 12 year old. A positive of using child self-report was that they avoided parental influence and better reflected the child’s point of view than the parents could have. This could still have left them vulnerable to experimenter bias. The questionnaires had no fixed points that they had to choose, avoiding forced answers and allowing for more accurate representation.

This was a quasi-experiment as participants were not randomised into groups but labeled group one or two based on what day their operation was. To reduce the threat of individual differences normally countered through randomisation the groups were matched on many demographics, but due to this separation by day many other factors could have affected the outcome. Different days could have had different staff or the same staff but different attitudes which could have affected patients. The staff members already considered clowns as beneficial to families and this may have caused differences in their treatment. The non-clown group also occurred the day after the clown group, which could have affected the mood of staff and resulted in different management of patients.

The study fails to account for factors such as family relations, whether parents are supportive and the strength of the relationships. Temperament and age were recorded but not tested for how it correlated with responsiveness to clowns. Another factor overlooked is the awareness of what was going on in relation to age. Older children would understand what was happening better than younger children and this could be related to stress and anxiety. It is also important how the child and parents cope with stress and general personality characteristics such as pessimistic or optimistic attitudes and their response to strangers. Individual factors in the environment such as conditions of the day, what happened until that point and how parents dealt with theirs and their child’s concerns are important factors which were not taken into consideration.

There is also no investigation into how long the clown’s presence would have been affective for. The clown entertained the child for 15 minutes and left 15 minutes before preparation for the operation. The questionnaires were completed immediately after the clown left; therefore this provides no information as to whether the child remained at these levels and staff and parents’ interactions and abilities to keep the child calm. There was also no baseline condition as evidence for what the child’s emotions were prior to clown interaction and if there was any change.

Each clown’s performance was different. This made it relevant to the child’s age, so tricks entertaining a five year old would not be the same tricks that would amuse a 12 year old, but the interactions were not standardized. Therefore there could be certain actions that are more successful than others and these actions may be different for different age groups.

It doesn’t produce enough clarity into why it is effective because interactions and other variables are so different. At best this study could support that the entertainment performed by clowns produced a temporary improvement. Another important point is it is unclear whether it had been the activities diverting attention from the operation rather than clown interaction that caused improvement and whether providing activities or supportive optimistic staff could be just as successful instead.

References

Fernandes, S. C., & Arriaga, P. (2010). The effects of clown intervention on worries and emotional responses in children undergoing surgery. Journal of Health Psychology, 15, 405 – 415. doi: 10.1177/1359105309350231

Varni, J. W., Limbers, C. A., & Burwinkle, T. M. (2007). How young children can reliably and validly self-report their health-related quality of life?: An analysis of 8591 children across age subgroups with the PedsQL 4.0 Generic Core Scales. Health and Quality of Life Outcomes: 5, 1. doi: 10.1186/1477-7525-5-1