• The Neural Correlates of a Central Coherence Task in Young Women with Anorexia Nervosa

      Leslie, Monica; Halls, Daniel; Leppanen, Jenni; Sedgewick, Felicity; Lang, Katie; Fonville, Leon; Simic, Mima; Mandy, William; Nicholls, Dasha; Williams, Steven; et al. (Wiley, 2021-07-18)
      Objective: Heightened detail-processing and low levels of central coherence are common in individuals with anorexia nervosa (AN) and predict poorer prognosis. However, it is unclear whether these processing styles predate the disorder or, rather, emerge during later stages of AN. The current study aimed to address this question by investigating central coherence, and the neural correlates of central coherence, in a sample of young women with AN with shorter duration of illness than previous studies recruiting adult samples. Methods: We recruited 186 participants, including: 73 young women with AN, 45 young women weight-recovered from AN, and 68 age-matched controls. Participants completed the Embedded Figures Task during an fMRI scan. Results: There were no significant differences between the participant groups in performance accuracy or reaction time. There were no other between-groups differences in neural response to the Embedded Figures Task. Conclusions: These findings contrast with evidence from older adults demonstrating differences in the neural underpinning of central coherence amongst participants with AN versus control participants. The current study adds to an increasing literature base demonstrating the resilience of neuropsychological traits and associated brain systems in the early stages of AN.
    • Brief Engagement and Acceptance Coaching for Hospice Settings (the BEACHeS study): Results from a Phase I study of acceptability and initial effectiveness in people with non-curative cancer.

      Hulbert-Williams, NJ; Norwood, S; Gillanders, D; Finucane, AM; Spiller, J; Strachen, J; Millington, S; Kreft, J; Swash, B; University of Chester; The University of Edinburgh; Marie Curie Hospice Edinburgh (BMC, 2021-06-25)
      Objectives: Transitioning into palliative care is psychologically demanding for people with advanced cancer, and there is a need for acceptable and effective interventions to support this. We aimed to develop and pilot test a brief Acceptance and Commitment Therapy (ACT) based intervention to improve quality of life and distress. Methods: Our mixed-method design included: (i) quantitative effectiveness testing using Single Case Experimental Design (SCED), (ii) qualitative interviews with participants, and (iii) focus groups with hospice staff. The five-session, in-person intervention was delivered to 10 participants; five completed at least 80%. Results: At baseline, participants reported poor quality of life but low distress. Most experienced substantial physical health deterioration during the study. SCED analysis methods did not show conclusively significant effects, but there was some indication that outcome improvement followed changes in expected intervention processes variables. Quantitative and qualitative data together demonstrates acceptability, perceived effectiveness and safety of the intervention. Qualitative interviews and focus groups were also used to gain feedback on intervention content and to make design recommendations to maximise success of later feasibility trials. Conclusions: This study adds to the growing evidence base for ACT in people with advanced cancer. A number of potential intervention mechanisms, for example a distress-buffering hypothesis, are raised by our data and these should be addressed in future research using randomised controlled trial designs. Our methodological recommendations—including recruiting non-cancer diagnoses, and earlier in the treatment trajectory—likely apply more broadly to the delivery of psychological intervention in the palliative care setting.
    • Tears Evoke the Intention to Offer Social Support: A Systematic Investigation of the Interpersonal Effects of Emotional Crying Across 41 Countries

      Zickfeld, Janis H.; van de Ven, Niels; Pich, Olivia; Schubert, Thomas W.; Berkessel, Jana B.; Pizarro, José J.; Bhushan, Braj; Mateo, Nino Jose; Barbosa, Sergio; Sharman, Leah; et al. (Elsevier, 2021-04-13)
      Tearful crying is a ubiquitous and likely uniquely human phenomenon. Scholars have argued that emotional tears serve an attachment function: Tears are thought to act as a social glue by evoking social support intentions. Initial experimental studies supported this proposition across several methodologies, but these were conducted almost exclusively on participants from North America and Europe, resulting in limited generalizability. This project examined the tears-social support intentions effect and possible mediating and moderating variables in a fully pre-registered study across 7,007 participants (24,886 ratings) and 41 countries spanning all populated continents. Participants were presented with four pictures out of 100 possible targets with or without digitally-added tears. We confirmed the main prediction that seeing a tearful individual elicits the intention to support, d = .49 [.43, .55]. Our data suggest that this effect could be mediated by perceiving the crying target as warmer and more helpless, feeling more connected, as well as feeling more empathic concern for the crier, but not by an increase in personal distress of the observer. The effect was moderated by the situational valence, identifying the target as part of one’s group, and trait empathic concern. A neutral situation, high trait empathic concern, and low identification increased the effect. We observed high heterogeneity across countries that was, via split-half validation, best explained by country-level GDP per capita and subjective well-being with stronger effects for higher-scoring countries. These findings suggest that tears can function as social glue, providing one possible explanation why emotional crying persists into adulthood.
    • Evaluating process and effectiveness of a low-intensity CBT intervention for women with gynaecological cancer (the EPELIT Trial)

      Hulbert-Williams, Nicholas J.; Hulbert-Williams, Lee; Flynn, Ryan J.; Pendrous, Rosina; MacDonald-Smith, Carey; Mullard, Anna; Swash, Brooke; Evans, Gemma; Price, Annabel; University of Chester; North Wales Cancer Treatment Centre; Ysbyty Gwynedd; Addenbrooke's Hospital Cambridge (F1000Research, 2021-03-29)
      Background: Improving survival from gynaecological cancers is creating an increasing clinical challenge for long-term distress management. Psychologist-led interventions for cancer survivors can be beneficial, but are often costly. The rise of the Psychological Wellbeing Practitioner (PWP) workforce in the UK might offer a cheaper, but equally effective, intervention delivery method that is more sustainable and accessible. We aimed to test the effectiveness of a PWP co-facilitated intervention for reducing depression and anxiety, quality of life and unmet needs. Methods: We planned this trial using a pragmatic, non-randomised controlled design, recruiting a comparator sample from a second clinical site. The intervention was delivered over six-weekly sessions; data were collected from participants at baseline, weekly during the intervention, and at one-week and three-month follow-up. Logistical challenges meant that we only recruited 8 participants to the intervention group, and 26 participants to the control group. Results: We did not find significant, between-group differences for depression, quality of life or unmet needs, though some differences at follow-up were found for anxiety (p<.001). Analysis of potential intervention mediator processes indicated the potential importance of self-management self-efficacy. Low uptake into the psychological intervention raises questions about (a) patient- driven needs for group-based support, and (b) the sustainability of this intervention programme. Conclusions: This study failed to recruit to target; the under-powered analysis likely explains the lack of significant effects reported, though some trends in the data are of interest. Retention in the intervention group, and low attrition in the control group indicate acceptability of the intervention content and trial design; however a small baseline population rendered this trial infeasible in its current design. Further work is required to answer our research questions, but also, importantly, to address low uptake for psychological interventions in this group of cancer survivors.
    • Building the capacity for psycho-oncology research: A survey of the research barriers and training needs within the International Psycho-Oncology Society (IPOS)

      Lambert, SD; Coumoundouros, C; Hulbert-Williams, NJ; Shaw, J; Schaffler, J; McGill University; University of Chester; University of Sydney (Wolters Kluwer, 2020-07-28)
      Background: The International Psycho-Oncology Society (IPOS) is a multidisciplinary professional network that aims to improve psychosocial care for individuals impacted by cancer. IPOS encourages research activity, recognising that a high-quality evidence-base is essential to provide best-practice, data-driven clinical care. This study aimed to determine the barriers to research involvement and the training needs and priorities of IPOS members, with the goal of facilitating the development of training resources tailored to the needs of IPOS members. Methods: A link to an online, cross-sectional survey was disseminated to all registered members of IPOS via email. The online survey platform SimpleSurvey was used, and questions included demographic characteristics and items related to research interests, involvement, and training needs. High priority research training needs were identified as research tasks respondents rated as highly important, yet possessed a low perceived skill level in. Results: 32% of IPOS members (n = 142) completed the survey. Participants represented 49 countries and were at a variety of career stages. Overall, participants reported spending an average of 17.3 hours per week on research (range = 0 to 80 hours per week), with 69% of respondents wanting to increase their research involvement. The main barriers to research participation included lack of research funding (80%) and lack of protected time (63%). IPOS members identified five high priority training needs: (1) preparing successful grant applications; (2) preparing research budgets; (3) community-based participatory research; (4) working with decision makers; and (5) finding collaborators or expert consultants. Participants suggested funding access, statistical advisors and networking and mentorship opportunities as ways to enhance research involvement. Members preferred online training modules (39%) and mentorship programs (19%) as methods by which IPOS could provide research support. IPOS was viewed as being able to contribute to many aspects of research capacity building such as networking, training, and dissemination of research findings. Conclusions: IPOS has an important role in encouraging research capacity building among members. This survey provides an agenda for workshops and training opportunities. Mainly, for respondents it was less about training in research methods and more about training in how to prepare successful grant applications, including budgets, and receiving mentorship on this as well as having opportunities to collaborate with other researchers.
    • A Novel Approach for Autism Spectrum Condition patients with Eating Disorders: Analysis of Treatment Cost-savings

      Tchanturia, Kate; Dandil, Yasemin; Li, Zhuo; Smith, Katherine; Leslie, Monica; Byford, Sarah; King's College London; South London and Maudsley NHS Foundation Trust; Illia University (Wiley, 2020-07-10)
      Objective: In the current economic context, it is critical to ensure that eating disorder (ED) treatments are both effective and cost-effective. We describe the impact of a novel clinical pathway developed to better meet the needs of autistic patients with EDs on the length and cost of hospital admissions. Method: The pathway was based on the Institute for Healthcare’s Model of Improvement methodology, using an iterative Plan, Do, Study, Act format to introduce change and to co-produce the work with people with lived experience and with healthcare professionals. We explored the change in length and cost of admissions before and after the pathway was introduced. Results: Preliminary results suggest that the treatment innovations associated with this pathway have led to reduced lengths of admission for patients with the comorbidity, which were not seen for patients without the comorbidity. Estimated cost-savings were approximately £22,837 per patient and approximately £275,000 per year for the service as a whole. Conclusion: Going forward, our aim is to continue to evaluate the effectiveness and cost-effectiveness of investment in the pathway to determine whether the pathway improves the quality of care for patients with a comorbid ED and autism and is good value for money.
    • A leftward bias for the arrangement of consumer items that differ in attractiveness

      Rodway, Paul; Schepman, Astrid; University of Chester (Taylor & Francis, 2020-06-24)
      People are frequently biased to use left side information more than right side information to inform their perceptual judgements. This research examined whether the leftward bias also applied to preferences for the arrangement of everyday consumer items. Pairs of consumer items were created where one item was more attractive than the other item. Using a two-alternative forced choice task, Experiment 1 found a robust preference for arrangements with the more attractive consumer item on the left side rather than the right side of a pair. Experiment 2 reversed the judgement decision, with participants asked to choose the arrangement they least preferred, and a bias for arrangements with the more attractive item on the right side emerged. Experiment 3 failed to find an effect of the ‘attractive left’ preference on participants’ purchasing intentions. The preference for attractive left arrangements has implications for the display of consumer products and for the aesthetic arrangement of objects in general. The findings are discussed in relation to hemispheric asymmetries in processing and the role of left to right scanning.
    • There is no Other Monkey in the Mirror for Spider Monkeys (Ateles geoffroyi)

      Murray, Lindsay; Schaffner, Colleen; Aureli, Filippo; Amici, Federica; University of Chester, Adams State University, Universidad Veracruzana, Liverpool John Moores University, Max Planck Institute for Evolutionary Anthropology (American Psychological Association, 2020-06-18)
      Mirror self-recognition (MSR), usually considered a marker of self-awareness, occurs in several species and may reflect a capacity that has evolved in small incremental steps. In line with research on human development and building on previous research adopting a gradualist framework, we categorized the initial mirror responses of naïve spider monkeys (Ateles geoffroyi) according to four levels. We compared social, exploratory, contingent and self-exploratory responses to a mirror and faux mirror during three short trials. If spider monkeys respond as most monkey species, we predicted they would perform at level 0, mainly showing social behavior toward their mirror-image. However, because spider monkeys show enhancement of certain cognitive skills comparable to those of great ape species, we predicted that they would perform at level 1a (showing exploratory behavior) or 1b (showing contingent behavior). GLMMs revealed that monkeys looked behind and visually inspected the mirror significantly more in the mirror than the faux mirror condition. Although the monkeys engaged in contingent body movements at the mirror, this trend was not significant. Strikingly, they showed no social behaviors toward their mirror-image. We also measured self-scratching as an indicator of anxiety and found no differences in frequencies of self-scratching between conditions. Therefore, in contrast to most findings on other species, spider monkeys did not treat their image as another monkey during their initial exposure to the mirror. In fact, they reached at least level 1a within minutes of mirror exposure. These responses recommend spider monkeys as good candidates for further explorations into monkey self-recognition.
    • Investigating resting brain perfusion abnormalities and disease target-engagement by intranasal oxytocin in women with bulimia nervosa and binge-eating disorder and healthy controls

      Martins, Daniel; Leslie, Monica; Rodan, Sarah; Zelaya, Fernando; Treasure, Janet; Paloyelis, Yannis; King's College London; University College London (Springer, 2020-06-08)
      Advances in the treatment of bulimia nervosa and binge eating disorder (BN/BED) have been marred by our limited understanding of the underpinning neurobiology. Here we measured regional cerebral blood flow (rCBF) to map resting perfusion abnormalities in women with BN/BED compared to healthy controls and investigate if intranasal oxytocin (OT), proposed as a potential treatment, can restore perfusion in disorder-related brain circuits. Twenty-four women with BN/BED and 23 healthy women participated in a randomised, double-blind, crossover, placebo-controlled study. We used arterial spin labelling MRI to measure rCBF and the effects of an acute dose of intranasal OT (40IU) or placebo over 18-26 minutes post-dosing, as we have previously shown robust OT-induced changes in resting rCBF in men in a similar time-window (15-36 min post-dosing). We tested for effects of treatment, diagnosis and their interaction on extracted rCBF values in anatomical regions-of-interest previously implicated in BN/BED by other neuroimaging modalities, and conducted exploratory whole-brain analyses to investigate previously unidentified brain regions. We demonstrated that women with BN/BED presented increased resting rCBF in the medial prefrontal and orbitofrontal cortices, anterior cingulate gyrus, posterior insula and middle/inferior temporal gyri bilaterally. Hyperperfusion in these areas specifically correlated with eating symptoms severity in patients. Our data did not support a normalizing effect of intranasal OT on perfusion abnormalities in these patients, at least for the specific dose (40 IU) and post-dosing interval (18-26 minutes) examined. Our findings enhance our understanding of resting brain abnormalities in BN/BED and identify resting rCBF as a non-invasive potential biomarker for disease-related changes and treatment monitoring. They also highlight the need for a comprehensive investigation of intranasal OT pharmacodynamics in women before we can fully ascertain its therapeutic value in disorders affecting predominantly this gender, such as BN/BED.
    • Predictors of individual differences in emerging adult theory of mind

      Stewart, Suzanne L. K.; Kirkham, Julie A.; University of Chester (SAGE, 2020-05-21)
      Little is known about what factors are associated with emerging adult theory of mind (ToM). We predicted that childhood fantasy play (CFP), need for cognition (NfC), and fiction reading would be positive predictors due to their deliberative, perspective-taking nature while engagement with media and technology would be a negative predictor due to increased interpersonal distance. The best-fit mixed logit model (n = 369) showed that CFP, texting frequency, and NfC were significant positive predictors while smartphone usage and preference for task switching were significant negative predictors. Email and phone call usage were contributing non-significant negative predictors. Our study extends previous findings regarding NfC, and highlights the importance of CFP engagement for ToM beyond immediate childhood. Future research should investigate how subtly different media (e.g., texting vs smartphone use) have differential predictive relationships with social cognition. Data and code are available at doi: 10.17605/OSF.IO/CBD9J.
    • Developing an Integrated Approach

      Tod, David; Lafferty, Moira; Liverpool John Moores University; University of Chester (Routledge, 2020-05-05)
      Integration occurs when consultants combine multiple theoretical orientations and ways of operating to enhance the efficacy, effectiveness, efficiency, and ethical standing of services they provide clients. There is no one model of integration. The models practitioners develop are shaped by their histories, inclinations, and proclivities; the contexts and cultures in which they operate; the types of work they undertake; and the clients they serve. Integrated models allow practitioners to feel congruent, authentic, and comfortable with the ways they help clients. In this chapter, we define integration, discuss why it is viable in our field, examine ways practitioners integrate service delivery systems, consider obstacles to integration, and suggests ways educators and supervisors can assist practitioners.
    • Video-mediated behavior in gorillas (G. g. gorilla): A stage in the development of self-recognition in a juvenile male?

      Murray, Lindsay; University of Chester (American Psychological Association, 2020-03-12)
      The anomalous position of gorillas (G. g. gorilla) in the capacity for self-recognition remains puzzling. The standard measure of self-recognition is Gallup’s (1970) mark test that assesses an individual’s ability to recognize its altered image in a mirror following the application of paint marks to visually inaccessible areas. Here, the results of a small-scale pilot study are presented, utilizing video playback through a television monitor, to examine behavioural differences indicative of developing self-recognition. The behaviors of four Western lowland gorillas at Bristol Zoo, UK were observed while watching a TV screen during five conditions: blank screen, white noise interference, footage of unfamiliar gorillas, self previously recorded, and self-live. Differences were predicted in the frequency of the gorillas’ observed behaviors when viewing each of the conditions: specifically, that there would be more visual inspection, contingent body and facial movements, and self-exploration in the self-recorded and self-live conditions compared to the other conditions. These predictions were partially supported. No agonistic or fear responses were observed and self-exploration was only seen in the self-live condition. During live playback, contingency-checking movements and self-exploration of the mouth were observed, particularly in the youngest gorilla, providing important video evidence of a close parallel to the mouth exploratory behavior witnessed in self-recognizing chimpanzees. On the basis of these preliminary findings of differentiated spontaneous behaviors, a tentative framework is proposed for categorizing gorillas according to levels of developing self-recognition along a continuum.
    • “It’s not just part of my life, it is my life”: The paradoxical identities of a community judo coach

      Ryrie, Angus; Lafferty, Moira E.; Liverpool John Moores, University of Chester (Manchester Metropolitan University Press., 2019-12-31)
      The aim of this chapter is to explore coaching identities and present a case study that captures the everyday realities and multifaceted roles a community judo coach undertakes. In doing so, it provides a platform to explore and discuss the identities exhibited; evaluate practice within contextually different settings to present a realistic appraisal of coaching in the “field.”
    • Recruiting cancer survivors into research studies using online methods: a secondary analysis from an international cancer survivorship cohort study.

      Hulbert-Williams, Nicholas J.; Pendrous, Rosina; Hulbert-Williams, Lee; Swash, Brooke; University of Chester (ecancer Global Foundation, 2019-12-12)
      Recruiting participants into cancer survivorship research remains a significant challenge. Few studies have tested and compared the relative use of non-clinical online recruitment methods, especially in samples of adult cancer survivors. This paper reports on the feasibility of recruiting a representative cohort of cancer survivors using online social media. Two-hundred participants with a cancer diagnosis within the past 12 months were recruited via social media (Facebook, Twitter, Reddit) into a longitudinal questionnaire study. Different methods of online recruitment proved to be more effective than others over time. Paid Facebook boosting, Reddit posts, and Twitter adverts placed by existing cancer charities proved most helpful in reaching our recruitment target (contributing 27%, 22% and 32% respectively). Recruiting online achieved a more demographically and clinically representative sample for our study: our sample was younger, less heteronormative, including those with a range of clinical diagnoses, primary and recurrence illness, and patients who had both completed and were still receiving treatment. This was certainly not a quick method of sample recruitment but that could have been optimised by focussing only on the three most effective methods describe earlier. Whilst we found that online recruitment is significantly lower cost than traditional recruitment methods, and can reduce some biases, there still remains the potential for some biases (e.g. excluding much older participants) and ethical/methodological issues (e.g. excluding those without access to the internet). We outline our recruitment strategy, retention rates, and a cost breakdown in order to guide other researchers considering such methods for future research in cancer survivorship.
    • Subjective versus objective knowledge of online safety/dangers as predictors of children’s perceived online safety and attitudes towards e-safety education in the United Kingdom

      Macaulay, Peter J. R.; orcid: 0000-0003-4891-9940; Boulton, Michael J.; Betts, Lucy R.; orcid: 0000-0002-6147-8089; Boulton, Louise; Camerone, Eleonora; Down, James; Hughes, Joanna; Kirkbride, Chloe; Kirkham, Rachel (Informa UK Limited, 2019-11-27)
    • When speaking English is not enough: The consequences of Language-based stigma for non-native speakers

      Birney, Megan E.; Rabinovich, Anna; Morton, Thomas A.; Heath, Hannah; Ashcroft, Sam; University Centre Shrewsbury, University of Chester (Sage, 2019-11-06)
      We explored the effects of language-based stigma on the relationship between native and non-native speakers. In two studies we found that stigmatized non-native speakers experienced more negative interpersonal interactions, higher levels of intergroup threat, and reduced performance on an English test compared to non-native speakers who did not experience stigma. These effects were mediated by anxiety and moderated by prevention-related goals. Furthermore, native speakers perceived stigmatized (vs. not-stigmatized) speakers’ accents as stronger and their commitment to living in the host country as weaker. Our findings suggest that experiencing language-based stigma can: a) incite a stereotype threat response from non-native speakers, and b) damage their relationship with native speakers on an interpersonal and intergroup level.
    • A personal journey of a long and winding road to Professorial status: An alternative pathway and the challenges, trials and tribulations.

      Lafferty, Moira E.; University of Chester (Springer: Palgrave, 2019-11-01)
      For many years, the awarding of a professorial title was seen as a realistic objective and target for those with a substantive international portfolio of research publications and grant income success. With the changing landscape in Higher Education and a drive within the UK for Universities to show much more social responsibility and engagement we are beginning to see much needed change. In this chapter, I reflect on my personal journey to professorship and how my numerous experiences and diverse portfolio of activity finally came together to have personal and professional meaning. In telling my story, I am to raise awareness of the numerous challenges I encountered as a female, from my early years entering higher education through to my professorial application and beyond. I also reflect on my thoughts and feelings and provide ideas about what we can do to help more women thrive and succeed within academia.
    • Understanding self-respect and its relationship to self-esteem

      Clucas, Claudine; University of Chester (Sage, 2019-10-21)
      The concept of self-respect has received little attention in the psychological literature and is not clearly distinguished from self-esteem. The present research sought to empirically investigate the bases of self-respect by manipulating adherence to morals together with interpersonal appraisals, or task-related competence, in hypothetical scenarios (Studies 1a and 1b) and a situation participants relived (Studies 2 and 3). Participants’ levels of state self-respect and self-esteem were measured. Studies 1-3 found main effects of adherence to morals on self-respect, with self-respect mediating the effect of adherence to morals on self-esteem, but little support for competence and interpersonal appraisals directly influencing self-respect. Self-respect uniquely contributed to anticipated/felt self-esteem alongside competence or interpersonal appraisals. The pattern of results supports the conceptualisation of self-respect as a component of self-esteem associated with morally principled conduct, distinct from performance and social self-esteem. The findings have implications for our understanding of self-esteem and moral behaviour.
    • Communicative roots of complex sociality and cognition.

      Roberts, Anna I.; Roberts, Sam G. B. (2019-10-14)
      Mammals living in more complex social groups typically have large brains for their body size and many researchers have proposed that the primary driver of the increase in brain size through primate and hominin evolution was the selection pressures associated with sociality. Many mammals, and especially primates, use flexible signals that show a high degree of voluntary control and these signals may play an important role in forming and maintaining social relationships between group members. However, the specific role that cognitive skills play in this complex communication, and how in turn this relates to sociality, is still unclear. The hypothesis for the communicative roots of complex sociality and cognition posits that cognitive demands behind the communication needed to form and maintain bonded social relationships in complex social settings drives the link between brain size and sociality. We review the evidence in support of this hypothesis and why key features of cognitively complex communication such as intentionality and referentiality should be more effective in forming and maintaining bonded relationships as compared with less cognitively complex communication. Exploring the link between cognition, communication and sociality provides insights into how increasing flexibility in communication can facilitate the emergence of social systems characterised by bonded social relationships, such as those found in non-human primates and humans. To move the field forward and carry out both within- and among-species comparisons, we advocate the use of social network analysis, which provides a novel way to describe and compare social structure. Using this approach can lead to a new, systematic way of examining social and communicative complexity across species, something that is lacking in current comparative studies of social structure. [Abstract copyright: © 2019 Cambridge Philosophical Society.]