The depression report: a new deal for depression and anxiety disorders.

Crippling depression and chronic anxiety are the biggest causes of misery in Britain today. They are the great submerged problem, which shame keeps out of sight. But if you mention them, you soon discover how many families are affected. According to the respected Psychiatric Morbidity Survey, one in six of us would be diagnosed as having depression or chronic anxiety disorder, which means that one family in three is affected. That is the bad news. The good news is that we now have evidence-based psychological therapies that can lift at least a half of those affected out of their depression or their chronic fear. These new therapies are not endless nor backwardlooking treatments. They are short, forward-looking treatments that enable people to challenge their negative thinking and build on the positive side of their personalities and situations. The most developed of these therapies is cognitive behaviour therapy (CBT). The official guidelines from the National Institute for Clinical Excellence (NICE) say these treatments should be available to all people with depression or anxiety disorders or schizophrenia, unless the problem is very mild or recent. But the NICE guidelines cannot be implemented because we do not have enough therapists. In most areas waiting lists for therapy are over nine months, or there is no waiting list at all because there are no therapists. So, if you go to the GP, all that can be provided is medication (plus at some surgeries a little counselling). But many people will not take medication, either because they dislike the side effects or because they want to control their own mood. The result is tragic. Only one in four of those who suffer from depression or chronic anxiety is receiving any kind of treatment. The rest continue to suffer, even though at least half of them could be cured at a cost of no more than £750. This is a waste of people’s lives. It is also costing a lot of money. For depression and anxiety make it difficult or impossible to work, and drive people onto Incapacity Benefits. We now have a million people on Incapacity Benefits because of mental illness – more than the total number of unemployed people receiving unemployment benefits. At one time unemployment was our biggest social problem, but we have done a lot to reduce it. So mental illness is now the biggest problem, and we know what to do about it. It is time to use that knowledge. 2 But can we afford the £750 it costs to treat someone? The money which the government spends will pay for itself. For someone on Incapacity Benefit costs us £750 a month in extra benefits and lost taxes. If the person works just a month more as a result of the treatment, the treatment pays for itself. So we have a massive problem – the biggest problem they have for one in three of our families. But we also have a solution that can improve the lives of millions of families, and cost the taxpayer nothing. We should implement the NICE guidelines; and most people with mental illness should be offered the choice of psychological therapy. Everyone who wants something done should write to their MP calling for action.

Interference between postural control and mental task performance in patients with vestibular disorder and healthy controls

OBJECTIVES - To determine whether interference between postural control and mental task performance in patients with balance system impairment and healthy subjects is due to general capacity limitations, motor control interference, competition for spatial processing resources, or a combination of these.METHOD - Postural stability was assessed in 48 patients with vestibular disorder and 24 healthy controls while they were standing with eyes closed on (a) a stable and (b) a moving platform. Mental task performance was measured by accuracy and reaction time on mental tasks, comprising high and low load, spatial and non-spatial tasks. Interference between balancing and performing mental tasks was assessed by comparing baseline (single task) levels of sway and mental task performance with levels while concurrently balancing and carrying out mental tasks.RESULTS - As the balancing task increased in difficulty, reaction times on both low load mental tasks grew progressively longer and accuracy on both high load tasks declined in patients and controls. Postural sway was essentially unaffected by mental activity in patients and controls.CONCLUSIONS - It is unlikely that dual task interference between balancing and mental activity is due to competition for spatial processing resources, as levels of interference were similar in patients with vestibular disorder and healthy controls, and were also similar for spatial and non-spatial tasks. Moreover, the finding that accuracy declined on the high load tasks when balancing cannot be attributed to motor control interference, as no motor control processing is involved in maintaining accuracy of responses. Therefore, interference between mental activity and postural control can be attributed principally to general capacity limitations, and is hence proportional to the attentional demands of both tasks

Effect of mental training on short-term psychomotor skill acquisition in laparoscopic surgery - a pilot study

Aim: The mental demands of laparoscopic surgery create a steep learning curve for surgical trainees. Experienced surgeons informally conduct mental training prior to starting a complex laparoscopic procedure. Reconstructing haptic feedback to mentally observe surgeon-instrument-tissue interaction is considered to be acquired only with experience. An experiment was devised to implement mental training for the haptic feedback reconstruction and its effect on laparoscopic task performance was observed.Methods: Twenty laparoscopy novice medical students with normal/corrected visual acuity and normal hearing were randomised into two groups. Both groups were asked to apply a pre-established consistent force by means of retracting a laparoscopic grasper fixed to an electronic weight scale. Studied group underwent mental training while control group conducted a laparoscopic task as a distraction exercise. Accuracy of the task performance was measured as primary outcome. Performance between dominant and non-dominant hands was the secondary outcome.Results: Baseline assessment of both dominant and non-dominant hands between groups were similar (P > 0.05). Mental training group improved their performance (0.66 ± 0.04) vs. (1.06 ± 0.14) with dominant hand (P < 0.01) and (0.73 ± 0.04) vs. (1.10 ± 0.20) with non-dominant hand (P < 0.05), when compared with control group.Conclusion: In a laparoscopic task performance, skill transfer is significantly accurate if mental haptic feedback reconstruction is achieved through mental training

Effect of time span and task load on pilot mental workload

Two sets of simulations designed to examine how a pilot's mental workload is affected by continuous manual-control activity versus discrete mental tasks that included the length of time between receiving an assignment and executing it are described. The first experiment evaluated two types of measures: objective performance indicators and subjective ratings. Subjective ratings for the two missions were different, but the objective performance measures were similar. In the second experiments, workload levels were increased and a second performance measure was taken. Mental workload had no influence on either performance-based workload measure. Subjective ratings discriminated among the scenarios and correlated with performance measures for high-workload flights. The number of mental tasks performed did not influence error rates, although high manual workloads did increase errors

The influence of macronutrients on cognitive performance : effects across age and task difficulty : thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Psychology at Massey University

The effects of pure glucose, protein, and fat ingestion on tasks of paragraph recall, word recall, and mental arithmetic were examined. These effects were also investigated with regard to the age of the participant and the task difficulty level. Twelve young and twelve older adults participated in the study. Over four separate morning sessions, participants ingested one of the four drinks (glucose, protein, fat, or placebo), and completed easy and hard versions of the paragraph recall word recall, and mental arithmetic tasks. The between-group factor was Age of the participant (young or older adult). The within-group factors were type of Nutrient ingested (glucose, protein, fat, or placebo), and Difficulty Level (easy or hard). No effects of Nutrient were found in regard to overall task performance, collapsing across Age and Difficulty Level. There was no effect of Nutrient on the different performance levels of both age groups, or for the two task difficulty levels. However, post-hoc analyses did reveal a significant Nutrient x Age interaction for the elderly after ingestion of the protein drink. Trends in the data also pointed towards an enhancement effect of glucose for the paragraph recall and mental arithmetic tasks. Trends associated with performance levels after fat ingestion showed that fat tended to enhance mental arithmetic accuracy performance for the older adult age group. Protein did not appear to differ from placebo on any of the tasks, with the exception of the deficit in performance seen with the elderly on the mental arithmetic accuracy task. In addition, a post-hoc analysis of the effects of Nutrient on mood-state showed a significant Nutrient x Mood x Time interaction. These results were discussed in light of task-specific effects of nutrients and nutrient metabolism

Examination of a Screening Tool for Athletes’ Mental Health and its Direct Implications to Sport Training and Competition

The Sport Interference Checklist (SIC) is a psychometrically validated instrument designed to assess how often cognitive and behavioral factors interfere with athletes performance during training and/or competition as well as the extent to which athletes are interested in pursuing sport psychology to address these problems. The success of this scale inspired an interest in developing new items that assess the influence of specific mental health concerns on sport performance using the SIC format. The Sport Interference Checklist’s Sport Specific Screen for Mental Health (SIC-SSSMH) was empirically developed using 259 athletes to assist in the identification of mental health problems explicitly reported to influence sport performance in both training (SIC-SSSMH-T) and competitive settings (SIC-SSSMH-C). An additional scale was developed to determine athletes’ desire to pursue services from a sport psychologist for endorsed sport-specific mental health factors (SIC-SSSMH-DSP). Factor analyses of SIC-SSSMH-T and SIC-SSSMH-C items reveal one factor for each scale, accounting for 38% of the total variance on the Training scale and 36% of the total variance on the Competition scale. SIC-SSSMH-DSP items also yielded one factor accounting for 54% of total variance. Factor scores for each of these scales exhibit acceptable internal consistency. In addition, these scales demonstrate high convergent validity when compared to the Symptom Checklist 90-Revised (SCL-90-R), a well-established screen for general mental health factors. Recommendations for future screening sport-specific mental health factors are discussed in light of the results

Mental health

PHN Discussion Paper #2 – Mental Health notes a key role for Primary Health Networks in realising effective and lasting improvement in mental health outcomes, through adopting a person-centred approach in service design and enabling integration across service providers in local health systems. The 2014 National Mental Health Commission report noted that “They (PHNs) can work in partnership and apply targeted, value-for-money interventions across the whole continuum of mental wellbeing and ill-health to meet the needs of their communities.” Notwithstanding this, there are challenges and barriers to be resolved in order to effect meaningful and sustainable improvement in mental health outcomes and health system performance.  Further exploration of the challenges and barriers is warranted in order to enable PHNs to deliver on their objectives.&nbsp

Brainstem response and state-trait variables

A series of investigations are summarized from a personality research program that have relevance for mental state estimation. Of particular concern are those personality variables that are believed to have either a biological or perceptual basis and their relationship to human task performance and psychophysiology. These variables are among the most robust personality measures and include such dimensions as extraversion-introversion, sensation seeking, and impulsiveness. These dimensions also have the most distinct link to performance and psychophysiology. Through the course of many of these investigations two issues have emerged repeatedly: these personality dimensions appear to mediate mental state, and mental state appears to influence measures of performance or psychophysiology

Paying attention to working memory: similarities in the spatial distribution of attention in mental and physical space

Selective attention is not limited to information that is physically present in the external world, but can also operate on mental representations in the internal world. However, it is not known whether mechanisms of attentional selection in mental space operate in a similar fashion as in physical space. We studied the spatial distribution of attention for items in physical and in mental space by comparing how successfully distracters were rejected at varying distances from the attended location. The results indicate very similar distribution characteristics of spatial attention in physical and mental space. Specifically, we found that performance monotonically improved with increasing distracter distance relative to the attended location suggesting that distracter confusability is particularly pronounced for nearby distracters relative to further away distracters. The present findings suggest that mental representations preserve their spatial configuration in working memory, and that similar mechanistic principles underlie selective attention in physical and mental space

Block design performance in the Williams syndrome phenotype: A problem with mental imagery?

Williams syndrome (WS) is a rare genetic disorder which, among other characteristics, has a distinctive cognitive profile. Non-verbal abilities are generally poor in relation to verbal abilities, but also show varying levels of ability in relation to each other. Performance on block construction tasks represents arguably the weakest non-verbal ability in WS. In this study we examined two requirements of block construction tasks in 21 individuals with WS and 21 typically developing (TD) control individuals. The Squares task, a novel two-dimensional block construction task, manipulated patterns by segmentation and perceptual cohesiveness to investigate the first factor, processing preference (local or global), and by obliqueness to examine the second factor, the ability to use mental imagery. These two factors were investigated directly by the Children?s Embedded Figures Test (CEFT; Witkin, Oltman, Raskin & Karp, 1971) and a mental rotation task respectively. Results showed that individuals with WS did not differ from the TD group in their processing style. However, the ability to use mental imagery was significantly poorer in the WS group than the TD group. This suggests that weak performance on the block construction tasks in WS may relate to an inability to use mental imagery