Dirty laundry: The nature and substance of seeking relationship help from strangers online

Interpersonal relationships are vital to our well-being. In recent years, it has become increasingly common to seek relationship help through anonymous online platforms. Accordingly, we conducted a large-scale analysis of real-world relationship help-seeking to create a descriptive overview of the nature and substance of online relationship help-seeking. By analyzing the demographic characteristics and language of relationship help-seekers on Reddit (N = 184,631), we establish the first-ever big data analysis of relationship help-seeking and relationship problems in situ among the general population. Our analyses highlight real-world relationship struggles found in the general population, extending beyond past work that is typically limited to counseling/intervention settings. We find that relationship problem estimates from our sample are closer to those found in the general population, providing a more generalized insight into the distribution and prevalence of relationship problems as compared with past work. Further, we find several meaningful associations between relationship help-seeking behavior, gender, and attachment. Notably, numerous gender differences in help-seeking and romantic attachment emerged. Our findings suggest that, contrary to more traditional contexts, men are more likely to seek help with their relationships online, are more expressive of their emotions (e.g., discussing the topic of "heartache"), and show language patterns generally consistent with more secure attachment. Our analyses highlight pathways for further exploration, providing even deeper insights into the timing, lifecycle, and moderating factors that influence who, what, why, and how people seek help for their interpersonal relationships

Personality Disorder and Verbal Behavior

Today, the development of new technologies means that there are many advanced tools that can be used to improve our understanding of personality disorder, and, in turn, the treatment of personality disorder. One particularly promising tool — indeed, the focus of this chapter — is computerized language analysis. Through the exploration and analysis of verbal behavior, it is possible to empirically develop new insights into personality disorder, broadly defined. That is, by looking at patterns in the way that people with personality disorder use language — the words that they use and the way in which they use them — we can gain access into their broad constellation of thinking, feelings, and behaviors, as well as how precisely each of these features contributes to their pathology. To date, however, there has been very little research at the intersection of verbal behavior and personality pathology. Accordingly, the goal of this chapter is to describe and discuss how personality disorder may become better understood through the application of natural language analysis, providing a rough roadmap for the development of personality disorder studies using modern methods. Specifically, in this chapter we will provide: 1. A brief background and overview of personality disorder; 2. An overview of how natural language processing (NLP) methods have advanced understanding within the wider field of psychology, focusing on personality psychology and psychopathology specifically; 3. Examples that demonstrate how NLP methods can help to resolve some of the fundamental, unanswered questions and debates in the personality disorder literature

Personality Dysfunction Manifest in Words : Understanding Personality Pathology Using Computational Language Analysis

Personality disorders (PDs) are some of the most prevalent and high-risk mental health conditions, and yet remain poorly understood. Today, the development of new technologies means that there are advanced tools that can be used to improve our understanding and treatment of PD. One promising tool – indeed, the focus of this thesis – is computational language analysis. By looking at patterns in how people with personality pathology use words, it is possible to gain access into their constellation of thinking, feelings, and behaviours. To date, however, there has been little research at the intersection of verbal behaviour and personality pathology. Accordingly, the central goal of this thesis is to demonstrate how PD can be better understood through the analysis of natural language. This thesis presents three research articles, comprising four empirical studies, that each leverage computational language analysis to better understand personality pathology. Each paper focuses on a distinct core feature of PD, while incorporating language analysis methods: Paper 1 (Study 1) focuses on interpersonal dysfunction; Paper 2 (Studies 2 and 3) focuses on emotion dysregulation; and Paper 3 (Study 4) focuses on behavioural dysregulation (i.e., engagement in suicidality and deliberate self-harm). Findings from this research have generated better understanding of fundamental features of PD, including insight into characterising dimensions of social dysfunction (Paper 1), maladaptive emotion processes that may contribute to emotion dysregulation (Paper 2), and psychosocial dynamics relating to suicidality and deliberate self-harm (Paper 3) in PD. Such theoretical knowledge subsequently has important implications for clinical practice, particularly regarding the potential to inform psychological therapy. More broadly, this research highlights how language can provide implicit and unobtrusive insight into the personality and psychological processes that underlie personality pathology at a large-scale, using an individualised, naturalistic approach

Dirty laundry:The nature and substance of seeking relationship help from strangers online

Interpersonal relationships are vital to our well-being and, in recent years, it has become increasingly common to seek relationship help through anonymous online platforms. Accordingly, we conducted a large-scale analysis of real-world relationship help-seeking to create a descriptive overview of the nature and substance of online relationship help-seeking. By analyzing the demographic characteristics and language of relationship help-seekers on Reddit (N = 184,631), we establish the first-ever big data analysis of relationship help-seeking and relationship problems in situ among the general population. Our analyses highlight real-world relationship struggles found in the general population, extending beyond past work that is typically limited to counselling/intervention settings. We find that relationship problem estimates from our sample are closer to those found in the general population, providing a more generalized insight into the distribution and prevalence of relationship problems as compared with past work. Further, we find several meaningful associations between relationship help-seeking behavior, gender, and attachment. Notably, several gender differences in help-seeking and romantic attachment emerged. Our findings suggest that, contrary to more traditional contexts, men are more likely to seek help with their relationships online, are more expressive of their emotions (e.g., discussing the topic of “heartache”), and show language patterns generally consistent with more secure attachment. Our analyses highlight pathways for further exploration, providing even deeper insights into the timing, lifecycle, and moderating factors that influence who, what, why, and how people seek help for their interpersonal relationships

Rethinking PowerPoint slide design for multimedia learning

This analysis investigates two differential PowerPoint slide designs—presentation and teleprompter—for multimedia learning. Eye tracking measures assessed differences in fixations. Participants demonstrated greater fixation counts for teleprompter slides, measures of aesthetic liking evidenced that slides incorporating imagery resulted in more pleasurable learning experiences, and visually-based slides influenced more reflective learning and greater activation of information processing. The results offer practical advice for instructors wishing to increase the slide design effectiveness for improved multimedia learning

Challenges and Opportunities: What Can We Learn from Patients Living with Chronic Musculoskeletal Conditions, Health Professionals and Carers about the Concept of Health Literacy Using Qualitative Methods of Inquiry?

The field of health literacy continues to evolve and concern public health researchers and yet remains a largely overlooked concept elsewhere in the healthcare system. We conducted focus group discussions in England UK, about the concept of health literacy with older patients with chronic musculoskeletal conditions (mean age = 73.4 years), carers and health professionals. Our research posed methodological, intellectual and practical challenges. Gaps in conceptualisation and expectations were revealed, reiterating deficiencies in predominant models for understanding health literacy and methodological shortcomings of using focus groups in qualitative research for this topic. Building on this unique insight into what the concept of health literacy meant to participants, we present analysis of our findings on factors perceived to foster and inhibit health literacy and on the issue of responsibility in health literacy. Patients saw health literacy as a result of an inconsistent interactive process and the implications as wide ranging; healthcare professionals had more heterogeneous views. All focus group discussants agreed that health literacy most benefited from good inter-personal communication and partnership. By proposing a needs-based approach to health literacy we offer an alternative way of conceptualising health literacy to help improve the health of older people with chronic conditions

Components, impacts and costs of dementia home support: a research programme including the DESCANT RCT

BackgroundOver half of people with dementia live at home. We know little about what home support could be clinically effective or cost-effective in enabling them to live well.ObjectivesWe aimed to (1) review evidence for components of home support, identify their presence in the literature and in services in England, and develop an appropriate economic model; (2) develop and test a practical memory support package in early-stage dementia, test the clinical effectiveness and cost-effectiveness of routine home support in later-stage dementia and design a toolkit based on this evidence; and (3) elicit the preferences of staff, carers and people with dementia for home support inputs and packages, and evaluate the cost-effectiveness of these approaches in early- and later-stage dementia.DesignWe undertook (1) an evidence synthesis, national surveys on the NHS and social care and an economic review; (2) a multicentre pragmatic randomised trial [Dementia Early Stage Cognitive Aids New Trial (DESCANT)] to estimate the clinical effectiveness and cost-effectiveness of providing memory aids and guidance to people with early-stage dementia (the DESCANT intervention), alongside process evaluation and qualitative analysis, an observational study of existing care packages in later-stage dementia along with qualitative analysis, and toolkit development to summarise this evidence; and (3) consultation with experts, staff and carers to explore the balance between informal and paid home support using case vignettes, discrete choice experiments to explore the preferences of people with dementia and carers between home support packages in early- and later-stage dementia, and cost–utility analysis building on trial and observational study.SettingThe national surveys described Community Mental Health Teams, memory clinics and social care services across England. Recruitment to the trial was through memory services in nine NHS trusts in England and one health board in Wales. Recruitment to the observational study was through social services in 17 local authorities in England. Recruitment for the vignette and preference studies was through memory services, community centres and carers’ organisations.ParticipantsPeople aged > 50 years with dementia within 1 year of first attendance at a memory clinic were eligible for the trial. People aged > 60 years with later-stage dementia within 3 months of a review of care needs were eligible for the observational study. We recruited staff, carers and people with dementia for the vignette and preference studies. All participants had to give written informed consent.Main outcome measuresThe trial and observational study used the Bristol Activities of Daily Living Scale as the primary outcome and also measured quality of life, capability, cognition, general psychological health and carers’ sense of competence.MethodsOwing to the heterogeneity of interventions, methods and outcome measures, our evidence and economic reviews both used narrative synthesis. The main source of economic studies was the NHS Economic Evaluation Database. We analysed the trial and observational study by linear mixed models. We analysed the trial by ‘treatment allocated’ and used propensity scores to minimise confounding in the observational study.ResultsOur reviews and surveys identified several home support approaches of potential benefit. In early-stage dementia, the DESCANT trial had 468 randomised participants (234 intervention participants and 234 control participants), with 347 participants analysed. We found no significant effect at the primary end point of 6 months of the DESCANT intervention on any of several participant outcome measures. The primary outcome was the Bristol Activities of Daily Living Scale, for which scores range from 0 to 60, with higher scores showing greater dependence. After adjustment for differences at baseline, the mean difference was 0.38, slightly but not significantly favouring the comparator group receiving treatment as usual. The 95% confidence interval ran from –0.89 to 1.65 (p = 0.56). There was no evidence that more intensive care packages in later-stage dementia were more effective than basic care. However, formal home care appeared to help keep people at home. Staff recommended informal care that cost 88% of formal care, but for informal carers this ratio was only 62%. People with dementia preferred social and recreational activities, and carers preferred respite care and regular home care. The DESCANT intervention is probably not cost-effective in early-stage dementia, and intensive care packages are probably not cost-effective in later-stage dementia. From the perspective of the third sector, intermediate intensity packages were cheaper but less effective. Certain elements may be driving these results, notably reduced use of carers’ groups.LimitationsOur chosen outcome measures may not reflect subtle outcomes valued by people with dementia.ConclusionsSeveral approaches preferred by people with dementia and their carers have potential. However, memory aids aiming to affect daily living activities in early-stage dementia or intensive packages compared with basic care in later-stage dementia were not clinically effective or cost-effective.Future workFurther work needs to identify what people with dementia and their carers prefer and develop more sensitive outcome measures.Study registrationCurrent Controlled Trials ISRCTN12591717. The evidence synthesis is registered as PROSPERO CRD42014008890.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 9, No. 6. See the NIHR Journals Library website for further project information

The Dementia Early Stage Cognitive Aids New Trial (DESCANT) intervention:A goal attainment scaling approach to promote self-management

Objectives This study investigated goals identified by people with dementia and their carers to promote the self‐management of symptoms and abilities; measured achievement using goal attainment scaling (GAS); and explored the reflections of Dementia Support Practitioners (DSPs) facilitating it. Methods and design Within this pragmatic randomised trial, DSPs gave memory aids, training and support to people with mild to moderate dementia and their carers at home. Data were collected across seven NHS Trusts in England and Wales (2016–2018) and abstracted from intervention records and semi‐structured interviews with DSPs delivering the intervention, supplemented by a subset of the trial dataset. Measures were created to permit quantification and descriptive analysis and interview data thematically analysed. A GAS measure for this intervention in this client group was derived. Results Engagement was high across the 117 participants and 293 goals were identified. These reflected individual circumstances and needs and enabled classification and assessment of their attainment. Seventeen goal types were identified across six domains: self‐care, household tasks, daily occupation, orientation, communication, and well‐being and safety. On average participants achieved nominally significant improvement regarding the specified goals of 1.4 with standard deviation of 0.6. Five interviews suggested that DSPs' experiences of goal setting were also positive. Conclusions GAS is useful for assessing psychosocial interventions for people with early‐stage dementia. It has a utility in identifying goals, promoting self‐management and providing a personalised outcome measure. There is a strong case for exploring whether these clear benefits translate to other interventions in other populations in other places