A potential new clinical test of accelerated long-term forgetting

Patients with significant memory problems are assessed with a range of standard memory tests which generally demonstrate that, while the individual can retain the information for a few seconds or minutes, within half an hour, there has been substantial forgetting. However, a class of patients has recently been reported in the literature who pass these standard tests but complain of memory problems with the forgetting becoming obvious a few days or weeks later. This disorder has been termed 'Accelerated Long-Term Forgetting' or ALF and to date there is no clear clinical test to objectively demonstrate and quantify this phenomenon. In 2010, we published a single case study of a patient who shows a classic ALF profile and this new paper is a follow-up one in which we describe a memory test that we have developed that captures our patient's forgetting within an hour of first learning any information. This work came out of Terry McGibbon's Graduate Diploma dissertation and is potentially very important because due to time and financial constraints, most clinicians might see a patient only once rather than being able to reevaluate them a few days or weeks later. If our patient is representative of other ALF patients, then with this new test, a clinician can therefore test for forgetting within one clinical testing session. This may have significant implications for the patient’s diagnosis and subsequent treatment.

Ashok Jansari

Does drinking water help you Wii ?

Previous research has shown that cognitive performance declines in adults that are dehydrated. More recently, studies into the effects of water consumption have shown that cognitive performance improves in schoolchildren after having a drink. However, as this research area is still in its infancy, it is not yet possible to determine which cognitive skills are consistently sensitive to water consumption. Therefore, we did a small pilot study looking at the effect of water consumption in schoolchildren on a range of cognitive and motor skills. 

A group of 15 children between the ages of 8 and 9 years old were given tasks to complete on two occasions. On one occasion they were not given a drink and on the other occasion they were given a 250ml bottle of water to drink, twenty minutes before the testing began. In the ‘no water’ condition none of the children had a drink and in the ‘water’ condition 7 of the 15 children drank the entire 250ml of water whilst the rest drank varying amounts. The mean amount that they drank was 168ml. The children were tested in small groups of 3 or 4 and the conditions were counterbalanced. The children all completed a letter cancellation task, a ball catching task, step-ups and a Wii game. The Wii game called ‘Ravin Rabbids’ was a whack-a-mole style game in which the children had to whack a rabbit every time it stood up using a downward motion with the Wii control. The game required hand eye coordination skills.

The results showed that in the ‘water condition’ the children were less thirsty but no happier. In the letter cancellation task the children performed significantly better in the ‘water’ condition than the ‘no water’ condition; they correctly identified more targets. The children also got a significantly higher score in the ‘ Ravin Rabbids’ Wii game in the ‘water’ condition. There was no immediately apparent benefit of drinking water in the ball throwing and step-up tasks although exploratory analysis showed that children drinking more than 200ml of water did significantly better in the ball throwing and ‘Ravin Rabbid’ Wii game than those who drank less than 100ml. None of the children drank between 100 and 200ml of water.

The results show that children’s performance improves in tasks requiring motor skills and visual attention and these results are consistent with previous studies of school children. What is still to be determined is whether it is purely the motor skills, purely the visual attention, a combination of both or indeed some underlying skill such as speed of processing that is sensitive to water consumption.

This study was published in Education and Health and presented at the Natural Hydration Council annual meeting. There has also been some media interest and Caroline Edmonds has recently completed a round of radio interviews about the effects of water consumption in children.

Full article reference Booth, P., Taylor, B. and Edmonds, C. J. (2012) 'Water supplementation improves visual attention and fine motor skills in schoolchildren'. Education and Health, 30(3), pp. 75-79.

Paula Booth

Coaching in secondary education - training school students to become coaches

Dr Christian van Nieuwerburgh, Programme Leader for the MSc Coaching/Coaching Psychology programmes, has been invited as a guest keynote speaker to a well-respected international educational coaching conference in the US later this month. He will be speaking about his research into coaching in secondary education and the use of coaching in a broad range of educational settings. He is also leading a participative workshop on creating the context for “A-ha!” moments in coaching conversations. Due to interest from US educators, he has also been asked to deliver a full-day pre-conference workshop on “training high school students to become coaches”. Christian’s recently published book, Coaching in Education: Getting Better Results for Students, Educators, and Parents will be given out to nearly 250 delegates at the event.

 

For more information about the event:  http://instructionalcoach.org/conferences/details/seventh-annual-instructional-coaching-conference

 
To follow Christian on Twitter: @ChristianvN

British Identity, Knowledge of Countries, Intergroup Attitudes and Sport Participation of Newham Pupils in the Run-up to the 2012 Olympics

A study recently completed by Virginia Lam has been examining the national
identity, sports participation and knowledge about countries among primary
and secondary school children in East London in the run-up to the 2012 London
Olympics.

There is a surprising lack of systematic psychological research into the link
between group identity (including national identity such as Britishness) and
sport participation although it has been discussed by academics in other
disciplines. With the London Olympics looming, the sense of national
belonging among the British public has likely become heightened. This study
investigated Newham children's and adolescents' British and ethnic
self-identity, knowledge about in-(British) and out-group (foreign)
countries, and attitudes towards their people, competitive attitude and sport
participation in the year running up to the Games.

Over 400 pupils aged 5-15 years were tested using standardised measures.
Results show that strength of British identity declined towards later
childhood (from 8-9 years) whereas that of ethnic identity remained
relatively stable with age. Knowledge about countries shows improvement at
different ages depending on the knowledge domain (geography/emblems/civic).
Pupils' liking for, and stereotypes of, different nationalities did not
differ at age 5-6 years, but diverged from 8-9 years--if liking for different
nationalities converged again at age 14-15 years, when pupils stereotypes of
the groups were most different. Pupils showed increasingly negative
stereotypes of the British, but nevertheless preferred them as one of the
most liked groups, with age.

Both competitiveness and sport participation decreased with age, but the type
of activities they played varied as a function of age, gender (football
became vastly more popular than any other sport with age, particularly in
boys) and ethnicity (cricket was particularly popular among Asian pupils).
Pupils with lower family affluence reported the greatest discrepancy between
generic and actual participation, indicating they are afforded fewer
opportunities to play sport. Those with a stronger sense of British identity
tended to like the British more, but not necessarily also stereotype them
more positively nor like foreign groups less. These findings are discussed in
the light of follow-up research with the same pupils being planned for the
post-Olympic period (autumn 2012).

The preliminary findings (from primary school schools) had been presented as
a poster at the UEL Undergraduate Research Internship awards evening in
October 2011. The full study's initial findings were presented in an invited
talk by Virginia Lam at the Centre of Psychiatry, Queen Mary, in April 2012
and an abstract has been accepted for oral presentation at the BPS Annual
Conference of Developmental Psychology (Glasgow) in September 2012. The full
paper has been submitted to the British Journal of Developmental Psychology
and a non-technical report for schools is available through the Mega Event
Cities website (July 2012 archives):
http://megaeventcities.wordpress.com/home/.

Ginni

School Partnership Collaboration

Deirdre, Ginni and I met with Priya Clarke, the Schools Partnership Officer, to discuss whether the School of Psychology and Education and Community Partnerships could collaborate. Priya arranges for local schools to come and visit UEL as part as what was previously known as the Aim Higher Initiative. This was a government programme set up to try and engage and motivate local children to want to enter higher education. This programme is no longer funded but UEL continue to invite schoolchildren to the campus as part of a programme to build skills and raise aspirations. To find out more information see   http://www.uel.ac.uk/partnerships/index.htm.

Priya arranges for 10 primary school visits and 30 secondary school visits per year. Priya may also be able to establish a relationship between the researcher and the school, so that the researcher could go into school to collect data. Additionally, a summer school is held at UEL for a week during September from 10am till 2.30pm. Priya was very keen to enter into a relationship with the School of Psychology whereby we supply interesting and exciting workshops for the children and in return we are able to collect data for our studies.  A typical visit usually involves a University Workshop which Priya will run, a Campus Workshop which often the school of education runs and a Subject Workshop, which is where we come in. It would be a good idea if we could set up some activity workshops that could be used on a regular basis over the coming years. Each workshop requires a Duty Manager who will need to be on campus but is not required to be at the workshop and a couple of staff members, postgrads or students (who are CRB which Priya can arrange) who can run the workshops whilst data is being collected.

Priya spoke to Ginni, Deirdre and I in detail to discover what our individual data collection needs were. She is more than happy to speak to any other researchers who would like to be involved with this project or would like to collect data from children. Her email is p.clarke@uel.ac.uk. 

Ideas that I have had are: letting the children watch a film? in the Virtual Reality Suite; showing them some clips of cognitive paradigms such as counting the no. of times a team bounces a basketball whilst the monkey runs across the court, upside down faces etc; plastic brains to show the water content or even to reinact some of the classic studies (not Milgram or Zimbardo obviously) but maybe Asch and get some of the children to act as confederates. Anyway, as you can see I’m in need of some good ideas so if you would like to get more involved or just suggest activities please get in contact.

Thanks

Paula

UEL Research Funding Blog

The Research and Development Support Team have announced a new blog, called UEL Research Funding.

This blog will replace the information sheets that were previously used to disseminate funding information and should act to give a more up-to-date set of information for those of you seeking such opportunities.

The blog allows you to sign up for an email notification service, which should prove invaluable.

Tom Dickins

Human Behavioural Diversity

I recently co-edited an edition of Philosophical Transactions B on the topic of Evolution and Human Behavioural Diversity.  The content of this issue is now freely available online at this link.

This issue directly arose from the foundation of the European Human Behaviour and Evolution Association, a history of which can be found at this link.

This issue should interest those of you who think about individual and group differences, and also your students.

Tom Dickins

Twitter feed

All being well a feed has been linked up from this blog to the @UELPsychLondon  twitter account.

Tom and Caroline

Electronic Cigarettes: Are they effective?

The Drugs and Addictions Research Group in the School of Psychology have just published their first ‘electronic cigarette’ study. 

These battery-operated devices are designed to resemble cigarette smoking by delivering nicotine via inhaled vapour without containing the harmful tars and carbon monoxide associated with tobacco smoking.  Whilst the World Health Organization have banned companies  making claims about their therapeutic success, most users state that they use the device to quit smoking. 

So are they effective?  We do not know yet whether the electronic cigarette (e-cigarette) provides a effective means of quitting as randomized controlled trials (RCTs) have not yet been completed (there is one underway in New Zealand).   Our study suggests however, that it can help to alleviate withdrawal symptoms and craving after a short period of deprivation.  We asked 86 participants to remain abstinent from smoking for a least one hour and rate their withdrawal symptom and craving before, and 20 minutes after, using an electronic cigarette for 5 minutes.  Although all e-cigarettes were tobacco flavoured, some contained nicotine and some didn’t (placebo).  For comparison purposes, a further group of participants just held the e-cigarette but didn’t use it. 

Compared to this ‘just hold’ group, those using the e-cigarette reported a significant reduction in craving and withdrawal symptoms.  For males, the nicotine e-cigarette was superior to placebo whilst females did just as well with the placebo.  Unlike other forms of nicotine replacement therapy (e.g. patch and gum), the e-cigarette delivers nicotine AND resembles the act of smoking thus providing the user with the ‘hand-mouth’ activity associated with tobacco smoking.  It is becoming increasingly recognized that these sensorimotor aspects of smoking may be an important aspect of smoking behaviour and our findings suggest that this might be more relevant for females. 

We also included a memory test in our study (remembering three letters whilst performing a distractor task which increased in length over consecutive trials).  Previous research has shown that memory and attention is worse during abstinence from smoking and can be restored after smoking a cigarette.  Participants who received the nicotine e-cigarette in this study did much better on this task compared to those who received placebo or who just held the e-cigarette.  This was particularly apparent at the longer interference intervals. 

Together, these findings suggest that the electronic cigarette has great potential as a quit smoking aid given that it can alleviate craving, withdrawal symptoms and the mild cognitive impairment associated with smoking deprivation.  Whether the placebo  is just as effective as the nicotine e-cigarette for female quitters is an interesting question which will remain unanswered until RCTs have been completed. 

Full article reference:  Dawkins, L., Turner, J., Hasna, S. & Soar, K. (2012)  The electronic-cigarette: Effects on desire to smoke, withdrawal symptoms and cognition.  Addictive Behaviors, 37: 970-973.

Or visit ROAR:  http://hdl.handle.net/10552/1568

Lynne

UEL’s Virtual Reality Research Making International Strides

Since 2003, I have been developing and refining a new tool for cognitive assessment of ‘higher mental functions’ and June 2012 has been a particularly good month for this research.

The human brain is a very complex organ, easily more complicated than the most sophisticated computers ever created. While the brain generally works as one unit, there are specialisations within it such that, for example, visual recognition occurs at the back of the brain roughly behind the ears. Relative to other mammals, the human frontal lobes (also known as the ‘pre-frontal cortex’ or PFC), occupy the largest proportion of the cortex, constitute one third of the brain, and have shown the greatest enlargement through evolution. Whilst more posterior areas of the brain are involved in primary aspects of mental abilities such as language, memory and vision, the PFC seems to play a more complex role in behaviour. The PFC acts as a kind of manager co-ordinating what the rest of the brain does and therefore is known as the ‘executive’ system; when the executive system is damaged, then a person can end up with a variety of problems in areas such as decision-making, planning, multi-tasking and adapting to new situations. This suggests that the PFC co-ordinates functioning at higher-levels of human behaviour.

The executive system can be affected in many different ways; for example strokes, brain surgery or virtually any form of closed head injury (as in a car crash or fall) can all damage the system. Additionally, due to the integrated manner in which the brain works and the fact that the PFC gathers information from other parts of the brain, any change in the system ‘downstream’ can have an impact on higher level functions. Therefore, for example, cognitive problems associated with conditions such as multiple sclerosis or a wide range of different forms of dementia will also have an executive component. Further, since it is believed that the frontal lobes are not fully formed until the early 20s, the executive system will correspondingly not be fully functional until this point in life. Indeed, most forms of behavioural disorders linked to development during childhood such as Autistic Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are linked with poor executive functioning. Finally, due to the hormonal and blood circulation system within the brain, the PFCs are susceptible to the impact of a large range of chemicals.

Given the centrality of the PFC and executive system to so many aspects of behaviour, accurately being able to assess the impact on someone’s life of dysfunction to it is a primary aim of clinical neuropsychologists; once this impact is known then it can possibly determine the course of rehabilitation therapy &/or decisions about going back to work. Unfortunately, the currently available tools for assessing damage to the executive system are notoriously unreliable and this has can greatly affect adjustment to life post-injury. While a number of experimental paradigms have been created to develop theoretical models of the PFCs, they have been poor at assessing dysfunction. Even where tests have been developed specifically to assess clinical populations, their success has been mediocre at best and often the findings are not of great use for health professionals working with the affected individuals. So for example, most assessments will fail to detect deficits in a significant proportion of patients. In a classic example, Eslinger & Damasio (1985) studied a patient known as EVR who had undergone surgery to remove a tumour located in his frontal lobes. Following recovery from the surgery, the patient’s general intellect was unaffected but his ability to manage everyday behaviour was severely changed. Having been a successful accountant pre-operatively, he ruined himself financially within two years. In the same time, he managed to get divorced, married again and divorced again! At a daily level, he would become immersed in the most mundane tasks sometimes taking hours to make the simplest of decisions; eventually the patient had to live in a care home since he could not be trusted to manage his own affairs. Despite this catastrophic change in behaviour, EVR passed all the tests of executive functions that were available at the time. Even when failure on the tasks does occur, the results do not necessarily translate into real-world behaviour; in other words, the tests lack ‘ecological validity’ in that they seldom map onto the problems in everyday living that are common subsequent to PFC damage.

To address the limitations of currently available tests of executive function, I have developed a test known as JEF^© (the Jansari assessment of Executive Functions) has been developed using non-immersive virtual reality (Jansari, Agnew, Akesson & Murphy, 2004). JEF^© uses a standard laptop and is presented as a computer-game with the participant navigating around the virtual environment of an office performing a number of tasks known to rely on intact executive functions. JEF^© is able to successfully detect the executive impairments of patients with brain injury that standard clinical tests fail to do (Jansari et al, 2004). Further, since an individualised profile is produced for each person showing their strengths and weaknesses, this has proven beneficial for the patients to understand their cognitive problems post-injury which itself can have significant positive impacts on psychosocial adjustment; additionally, these profiles can be used by rehabilitation therapists who are attempting to ameliorate the difficulties faced by the patient as well as aiding them to re-enter the workforce (or find gainful employment which can often be severely affected by brain injury).

Following the initial success of JEF^© with patients with brain damage, further studies have shown that it can be used in healthy brain-intact individuals to investigate the impact of chemical substances on higher mental functions. Montgomery, Hatton, Fisk, Ogden & Jansari (2010) have shown the negative impact of the recreational drug ecstasy while Montgomery, Ashmore & Jansari (2011) showed similar with cannabis. Montgomery, Seddon, Fisk, Murphy & Jansari (2012) have also shown that even an amount of alcohol that is within the legal limits for driving in the UK can significantly lower executive performance. Collaborating with one of our colleagues Lynne Dawkins and a colleague Trudi Edginton at Westminster University along with an MSc student, we have demonstrated that while heavy smoking impairs executive performance, nicotine itself can have facilitatory effects even in non-smokers (Jansari, Froggatt, Edginton & Dawkins, 2011). Since it is found that fewer smokers develop Senile Dementia of the Alzheimer’s Type (SDAT) and that nicotine can reduce agitation in dementia, these potentially positive effects of nicotine could have significant impacts on development of drug therapies to deal with dementia. JEF^© has also been used to demonstrate that Androgen-Deprivation Therapy (ADT) which is used for treating prostate cancer that has spread beyond the prostate gland significantly lowers executive performance; patients anecdotally report these problems but this is one of the first times that it has been demonstrated objectively possibly because of the insensitivity of the assessments used previously (Jansari, Mills, Edginton & Green (under review)). Since prostate cancer is the most common form of cancer in the UK and in many Western countries , large-scale drug trials are planned to evaluate this further. Finally, in a recent study in collaboration with Caroline Edmonds and an MSc student aided by the excellent programming skills of Tony Leadbetter we have developed a children’s version of the assessment, JEF-C^© to assess the development of executive functions during adolescence (Jansari, Gordon, Edmonds & Leadbetter, 2012). This is currently being used to investigate higher mental functions in children with ASD, ADHD and Traumatic Brain Injury (TBI).

Following the success of JEF^© a Swedish BSc student translated it into her native language and ran a study with a collaborator in Stockholm to look at how culturally appropriate it was in countries where English is not the first language; using this translated version, we compared Swedish TBI patients with matched controls. We found a significant difference between the two groups showing the utility of JEF^© in other cultures (Jansari, Debreceni, Bartfai & Eriksson, 2008). As a result, JEF^© has now been translated into French, Finnish, Dutch and Portuguese with trials underway to collect normative data in Belgium (French & Dutch), Finland (Finnish) and Brazil (Portuguese).

In June, I visited my collaborators in Belgium where data collection is going well for the French version and there are plans to see if the assessment can be used to look at cognitive impairments related to depression; similarly, research with the Dutch version is going well with plans to see if the assessment can be used with other neuropsychological disorders. Finally, I have been invited by a network of neuropsychologists in India in Mumbai, Delhi, Kolkota and Bangalore to be a co-applicant on a government grant to explore how JEF^© and JEF-C^© can be adapted for use in an Indian population.

So these are exciting times for UEL’s virtual reality research......

Ash

Hydration for Health Conference

Paula and I were invited to attend the Hydration for Health Annual Scientific Conference in Evian, France, funded by Danone Waters and Danone Research. The location was the Hotel Royal Evian, and the conference made the most of beautiful views from the hotel over Lake Leman, with cocktails and canapés on the terrace. This was the most relevant conference for our research and, with all the leaders in the hydration field present, provided a great opportunity to network. It was also a really sociable conference.

The programme considered hydration and thirst, kidney health, trends in fluid consumption, and ways to improve hydration status. While there were no papers specifically on hydration and cognition, all of the talks gave us lots of ideas for studies or different approaches to analysis. There were two sessions that particularly stood out for us.

Talks on the thirst mechanism addressed the question, “Why are we here if the thirst system works perfectly?” and asked, “what happens if we don’t drink?” and “why don’t people drink?” Suggestions were that unlike animals, which are adept at drinking when they are thirsty, humans have become dishabituated to the feeling of thirst. Consequently people do not drink enough which over a long period could lead to health problems. Experimental evidence on thirst was reviewed, including ways in which manipulating the way that we satiate thirst, such as consuming large amounts of fluid or regular sipping, affect exercise performance. Evidence on hydration in older adults, who are a high risk group for dehydration, was also presented. Some of the reasons for this high risk were discussed, including fluid preference, lifetime hydration habits and the ageing process, including diseases that influence hydration.

A session on how to improve hydration status was really useful to us because of its focus on measuring hydration using assessment of urine osmolality, which is one measure that we are currently using.  These were complex studies involving strategies for behavioural change aimed at increasing water consumption in adults, which seemed to have a good level of success. As well as providing useful technical information, it gave us ideas for ways to present data figuratively that Paula is likely to use in her PhD.

The poster stands were really varied. Of particular interest to us was a set of posters by Joan Gandy, a UK dietician and nutritionist, who reported data on worldwide fluid intake studies. The methodological detail on how this was achieved was particularly useful for us. There are clear differences between countries in the types of beverages consumed. In the UK most of our beverages are taken in the form of hot drinks, suggesting that we really are a nation of tea drinkers, along with Poland, Germany, Japan and Uruguay (or perhaps coffee drinkers…).

Caroline and Paula