Archive for the ‘Uncategorized’ Category

Mood induction procedures

Thursday, April 25th, 2013

 

As a teenager I spent hours in my room listening to arch-miserabilist pop band the Smiths.  I felt they really understood my teenage angst, and my love for them withstands even David Cameron’s unrepentant fandom and Morrissey’s regular and unsavory announcements.

We spend a lot of time and money trying to feel good, but there is also a pleasure in the melancholy that listening to every Smiths’ song played back to back can engender.  Alongside teenagers, researchers use various experimental methods for inducing mood states.  These are often used in studies which aim to investigate the correlation between mood and neurological function.

 

Self referential statements

One of the first mood induction procedures was the Velten Mood Induction Procedure.  Subjects read aloud self-referent statements, which progress from the relatively neutral to those associated with either a negative or positive mood.

Example of questions – this site suggests that the Velten mood induction procedure should be used as a form of “guided meditation”.

 

Music

Music can arouse deep emotions in the listener.  The majority of studies use classical music, but a wide variety of musical pieces is used to experimentally induce mood states.  This paper (update 2018 – broken link) lists music used in forty-one music mood induction procedure studies.  The authors find that most musical pieces are used in one study only, but find twelve studies that use Delibes Coppélia to induce happy or elated moods.  No mention of the Smiths.

It’s probably best to ban your teenage children from listening to Stravinski’s Firebird suite.  Played at 80 dB, as one study used this to provoke anger.

Movie clips

Habitual cinema-blubbers will not be surprised that requesting participants to watch movie clips is a common way to manipulate moods experimentally.

In a 2008 study positive mood was induced by participants watching a 10 minute excerpt from a British comedy series (the actual series itself is not identified alas – Monty Python?). Neutral mood induction involved an excerpt from a nature documentary, and negative mood was brought about by an excerpt from a film about dying from cancer.

According the many authors film and music based mood induction is the most effective.

 

Critical feedback.

Another technique is to use verbal feedback. This 2008 (update 2018 – broken link) study asked participants to complete a series of anagrams and then report their answers through an intercom system. To induce a negative mood state they received insults in return.

After the 4th anagram, the experimenter said: “Look, I can barely hear you. I need you to speak louder please.” After the 8th anagram, the experimenter said in a louder and more frustrated voice: “Hey, I still need you to speak louder.” After the 12th anagram, the experimenter said in a very frustrated voice: “Look, this is the third time I’ve had to say this! Can’t you follow directions? Speak louder!

Forming mental images/autobiographical recall.

This approach can use emotionally charged sentences, with subjects asked to try and experience the affective state they would feel if the situation were real.

“Imagine that you just won the lottery and you will have all the money you could ever want” (paper) (update 2018 – broken link)

(These lottery winners are in the lucky situation of not having to use their imagination).

In a similar approach (update 2018 – broken link) participants were instructed to write a short essay about an event they experienced that provoked specific feelings such as anger or sadness.

Combining methods and effectiveness

The most effective mood induction procedures may combine two procedures in the belief that multiple interactions contribute additively to mood.   One type of induction occupies the foreground attention, whilst the other forms the background atmosphere.  So, for example the Velten mood induction procedure has been combined with music mood induction.

The effectiveness of mood induction procedures is questioned by some authors, who dispute whether they can produce moods of sufficient intensity.  Another debate concerns whether the results of experiments using mood induction result from the expectations that the protocol induces in participants, rather than because of the induced mood per se (demand characteristics).

Sponsored by Inexika, creator of iMoodJournal – mood tracking application for iPhone and Android

Photo credit

 

17 June 2018 reviewed – some of the links to papers are broken – sorry.

Psychiatry in the news – 7 April 2009

Tuesday, April 7th, 2009

Guardian reports that Legalisation of drugs could save UK £14bn, says study but it’s hard to imagine that this will do anything to change Jacqui Smith’s position.  Transform discuss further

The Today Programme reported today that care home children whose behaviour during the 1970s/80s was controlled using large doses  of medication have subsequently given birth to children with birth defects.   The drugs in question included Haloperidol, Droleptan and Depixol.  The BBC have Professor Jeffrey Aronson, professor of clinical pharmacology at Oxford University who says that high doses of such drugs can cause genetic damage.  Presumably he’s suggesting that the drugs cause damage to unfertilized eggs – rather than being teratogenic.  These drugs can currently be given to women of child bearing age.  It’s obviously concerning that large doses of sedatives should be given to anyone without a mental health disorder (or even with…) but if they’re right (nb: it doesn’t sound like a very rigerous report and there could be other causes for what they’re suggesting has happened) this would have wide ranging implications.

14 April 2009 Update: I emailed Aronson but as yet no reply.  A very well known academic clinical pharmacologist where I work said to me that he’d never heard of antipsychotics causing oocyte damage. 

Not strictly on psychiatry, but on the subject of this Government’s ongoing project to give us all anxiety disorders, check out the latest Metropolitan Police anti-terrorist tube advert.  New Campaign to urge Londoners to report suspicious activity 

Reds under the bed all over again - reminds me of a Viz cartoon I once read where Jack Black knew that the new bearded people who’d moved into his sleepy, Daily Mail reading village were terrorists because they read the Guardian.

14 April 2009 Update: this annoyed me so much I wrote a full post about it.

Psychiatry book club: proposal

Thursday, January 15th, 2009

As I sat my exam on Tuesday, I’ve got a lot more time for this blog, and I would like to try an experiment in reader participation. Every month or so I’ll nominate a book which a few of us can read and then comment upon. A bit like a book club, but without the red wine or sexual tension.

Nothing too difficult, and obviously I’m very open to suggestions.

This month I thought that we could start with The Bell Jar by Sylvia Plath. I read this about ten years ago and loved it beyond reason; this was before I became a psychiatrist so I’m interested to know what I think of it now. In brief, it’s an autobiographical novel of a young woman who, about when about to break into the world of writing, has a mental breakdown. The real story is well known and Plath committed suicide a month after its publication.

It occurs to me that people might think that I’m doing this to encourage people to buy books through this site. Of course you can, but worldcat lets you know which libraries have a copy of the book near to you.

Miscellaneous

Thursday, July 24th, 2008

 

BBC From our own correspondent ‘A shoulder to cry on in Baghdad’ – Psychiatrists in Baghdad 31 May 2008

(From our own correspondent homepage)

‘How Britons get high – drug users tell their stories’  Observer 20 July 2008

 

‘The Perfect Penis’ and body dysmorphic disorder

Tuesday, June 10th, 2008

 

I got home from the pub the other night and was casually scanning through the TV channels, when I happened across the second half of a curiously compelling documentary.  ‘The Perfect Penis‘ was about an American psychology student who was paying $4000 to have his penis lengthened.  This is not my area of expertise, but apparently this involves cutting a ligament located in the pubis.  A lot of the penis is actually in the body and cutting this lets a bit more of it protrude. 

The next bit sounds worse: to complete the job, the gentleman must then hang a weight off his member for no less than eight hours a day for several weeks after the op.  As well as sounding painful and unbelievably tedious, the results appear barely worth the trouble, with Wikipedia quoting an increase in penis length of 2-3cm and netdoctor stating that the only study available suggested that average increase in length was 0.5cm.  

The chap who was having it done actually seemed pretty normal, although my suspicions of obsessive/narcissistic personality traits were raised by his buff physique.  I didn’t catch all the programme so I didn’t see if he had a psychiatric evaluation.  I suspect not, as it might have spoilt things and there was a bit where he was talking to this psychology supervisor, who said sensible things which were completely ignored.  We got to have a look at the ‘inadequate’ equipment towards the end of the show and it looked perfectly fine to me.  We were also told at the end of the show that the penis surgeon had recently bought a new house in which to keep his four rollers;  I couldn’t help thinking our poor boy had been done. 

Leaving no grotesque stone unturned, the documentary makers included an interview with ‘Mister Mark’.  Mark is a gentleman who has injected enough silicon in his testicles and penis to make his scrotum 1ft in circumference.  He was appeared pleased as punch about this, and even has a website called ‘extremecock.org’ dedicated to his enlarged genitals (full admission: in the spirit of ‘frontier psychiatry’ I did visit this website, but I really wouldn’t recommend it to anyone of an even slightly queasy disposition).  

If I was trying to drum up business for myself, I’d be concerned if the psychology student was suffering from body dysmorphic disorder; Mister Mark is a subject for another day.  At the end of the show it was revealed that he was unwell and that he may be suffering from a silicon embolis.

Body dysmorphic disorder (Also known as dymorphophobia) was first described by Morselli in 1886:

‘A subjective description of ugliness and physical defect which the patient feels is noticable to others, although the appearance is within normal limits.  The dysmorphophobic patient is really miserable in the middle of his daily routines, everywhere and at any time, he is caught by the doubt of deformity’

Typically the patient is convinced that some part of his/her body is too large, too small or misshapen.  This is usually a part of the face, but can be any body part.  To other people the appearance is normal or there may be some slight abnormality.  The patient may be constantly preoccupied and tormented by his/her mistaken belief;  he/she may blame all his other difficulties on it.  For instance they may think that if only their nose were a better shape then they might have a better life or job. 

There may be time consuming behaviours.  I once had a patient who was constantly late for work as he used to spend hours examining his nose in the mirror. There is substantial overlap with other psychiatric disorders, especially depression and social phobia.  At its extreme the BDD may be very disabling and may leave the patient housebound and unemployed.  In the absence of corrective operations, people have been known to take matters into their own hands, for instance using a clothes iron to remove wrinkles on their face.

The prevalence is 1% in the community. The treatment is often difficult and  surgery is usually contraindicated.  Patients usually will have unrealistic expectations and once the operation is complete their concern may transfer to another part of the body. 

Dr David Veale’s site has a BDD reference page which is worth a look.