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Seminar Archive 2013-14

06th May 2014

Dr Felicity Bishop

Harnessing Placebo Effects in Routine Primary Care: GPs’ and Patients’ Perspectives

Placebos are an essential tool in randomised clinical trials, where they are used to control for bias and contextual healing effects. More controversially, researchers are developing ways of harnessing placebo effects for patient benefit in routine medical practice.

In this seminar, I will present the results of our web-based survey of 783 UK GPs.  The survey showed that 97% of UK GPs have used placebos in clinical practice, and that so-called “pure” placebos (e.g. sugar pills) are used rarely but “impure” placebos (e.g. homeopathy) are used frequently.  Qualitative analysis of GPs’ comments revealed that they perceived a broad array of perceived harms and benefits of placebo-prescribing, reflecting fundamental bioethical principles at the level of the individual, the doctor-patient relationship, the NHS, and society.  While some GPs were adamant that there was no place for placebos in clinical practice, others focused on placebo effects and saw these as ubiquitous and potentially beneficial in primary care.  Our focus group and survey research with patients demonstrates similarly strongly-held and diverse views about harnessing placebo effects in routine primary care. 

If placebo effects are to be better harnessed to benefit patients, then patients and GPs would benefit from educational interventions to dispel myths, challenge misconceptions, and increase knowledge.  

04th March 2014

Prof. Charles Vincent

How safe is our healthcare?

Patient safety is the foundation of good patient care. When a member of your family goes into hospital or receives other healthcare then above all you want them to be safe. There is compelling evidence that, while healthcare brings enormous benefits to us all, errors are common and patients are frequently harmed.

Many more people have their care interrupted or delayed by minor errors and problems; these incidents are not as serious for patients but are a massive and relentless drain on scarce healthcare resources. 

Understanding how to make healthcare safer is hard and actually making care safer is harder still. Healthcare is the largest industry in the world and extraordinarily diverse in terms of the activities involved and the manner of its delivery. We are faced with hugely intractable, multifaceted problems which are deeply embedded within our healthcare systems. 

The presentation will discuss the nature and scale of harm from healthcare, the evolution of patient safety and the quest for safer healthcare.

11th February 2014

Prof. David Blane

What's wrong with socio-economic status?

The presentation will explain why epidemiology increasingly has abandoned the concept of socioeconomic status and the advantages, in terms of life course influences on health and quality of life, of thinking in terms of, and distinguishing between, social class, social status and material circumstances.

To see more information please click here.

07th January 2014

Dr. Andrés Fonseca

TherAppy, the use of mobile device applications in the treatment of mental health conditions

A review of the evidence base for the use of software applications in the treatment of mental health conditions with an overview of current examples.

The presentation will also look into future developments in this field given the rise of mobile devices and the possible upcoming mass adoption of virtual reality and augmented reality devices.

To see more information please click here

03rd December 2013

Professor Paul Bennett

Predicting and treating emotional reactions to genetic risk assessment

The first part of this talk will report findings of a series of studies examining both the short- and long-term emotional consequences of genetic risk assessment.

It will then consider two studies targeted at reducing anxiety in the period during and immediately following the risk assessment process (which may take some weeks).

Finally, the talk will consider theoretical considerations that should guide attempts to reduce distress in the longer term, and a planned intervention study which will use eye tracking to (hopefully!) assess fundamental changes in the processes underpinning anxiety as well as more conventional measures.  

12th November 2013

Dr. Magda Osme

The impact of motivational focus on decision making

Almost all real world decision-making is decision-making that is made in dynamic situations. That is, when we act we generate a change in an outcome. 

However, the difficulty comes in being able to reliably identify whether the change in the outcome is actually the result of our actions, the result of a change in the situation, or a combination of both. The most common ways of reducing this uncertainty is through the assignment of goals, or by evaluating rewards/feedback associated with the outcome.

The talk will discuss the impact of different types of motivational factors (i.e. rewards/feedback/goals) on decision making in dynamic situations in clinical (patients with Parkinson's disease) and non-clinical (young, elderly) populations.

To see more information please click here.

08th October 2013

Dr. Kimberly Dienes 

The biopsychosocial model of risk for depression: Mechanisms of stress sensitivity 

Stress is a familiar and frequent occurrence in the life of every individual.  Between 20% and 50% of persons experiencing life stressors develop depression (Brown & Harris, 1989).  What distinguishes individuals who develop depression following a life stressor from those that do not?  Psychosocial and biological factors may exist that create increased vulnerability to stressors.  Hypothalamic Pituitary Adrenal (HPA) axis dysregulation, personality style, and mood reactivity to daily stressors are just a few of the factors that may combine to create increased stress sensitivity.  We hypothesized the existence of a subgroup of people characterized as at-risk for depression based on the psychosocial variables of elevated negative affectivity and reduced positive affectivity, and assessed whether they had a dysregulated biological stress response system (in the form of distinct patterns of diurnal cortisol secretion and cortisol reactivity to a psychosocial laboratory stressor), in addition to increased mood reactivity to daily stress.

Cortisol secretion patterns were compared for 57 currently depressed, at-risk, and control participants over 5 days and in response to a laboratory stressor (the Trier Social Stress Test). The three groups were also compared on mood reactivity to daily stressors over a two-week period using a daily diary methodology.  At-risk participants did have a distinct pattern of diurnal cortisol secretion and cortisol reactivity to the TSST, though not necessarily as predicted.  The at-risk group reported significantly less emotional reactivity to naturalistic stress than controls, contrary to prediction, but had strong negative response to the TSST in the form of elevated negative mood and poor self-ratings of performance. Additionally depressed participants did differ from controls in the predicted direction on diurnal cortisol secretion, but not on mood reactivity to daily stress.

Individuals who are at risk for depression based on high negative affectivity and low positive affectivity may have a distinct biological stress response system in the form of rapid rise in cortisol and rapid compensatory shut-down of cortisol secretion. Additionally, they may have increased negative mood reactivity to acute psychosocial stressors that may not be seen in daily diary studies assessing daily hassles. Longitudinal research is needed to determine if these at-risk individuals who may be sensitive to life stressors are indeed more likely to develop depression in the future.      

To see more information please click here.

18th June 2013

Dr. Sam Norton

Measuring well-being: psychometric perspectives

The concept of psychological well-being is broad, complex and multidimensional. It is difficult to define and impossible to measure using a single scale.

In the literature, well-being is commonly described and measured using a wide range of related but distinct constructs – such as, depression, anxiety, distress, mental health, quality of life, and life satisfaction. As with the broader construct of health, the traditional view of well-being centred around the absence of illness (e.g. depression and anxiety).  Recently, there has been increasing attention on positive aspects of well-being. Initially this focused on the construct of happiness, operationalised as life-satisfaction, but has broadened out to include other constructs.

Due to its complex multidimensional nature, measuring well-being holds some important challenges that researchers will need to think carefully about. This seminar will give an overview of some of the main issues in the measurement of well-being and will use the topic to introduce key concepts in psychometrics and modern measurement theory.

To see more please click here.

21st May 2013

Professor Ronan O'Carrol

Psychological aspects of organ donation

Unhealthy lifestyles (e.g. smoking, alcohol intake, high calorie diet and inactivity) are increasingly leading to organ failure.

Recent advances in organ transplantation and immunosuppressant medication mean that many more lives can now be saved. However, demand for organs far exceeds supply. For example, in the UK, approximately 90% of the general public approve of organ donation, but only one third have signed up to the UK organ donor register. Reluctance to register appears to be more determined by affective rather than cognitive attitudes. Affective attitudes include fear of doctors harvesting organs before the patient is really dead (medical mistrust), disgust and “jinx” (the idea that one may be tempting fate by signing up). These all clearly distinguish donors from non-donors.

My team are engaged in a programme of research that attempts to understand and overcome some of these important barriers. For example, we are currently conducting a series of studies where we attempt to manipulate the emotion of anticipated regret, to test if this increases intention, and confirmed organ donor registration. In this presentation  he results of some of these studies will be presented.

To see more please click here.

5th March 2013

Professor Myra Hunter

Menopause: from social meanings to psychological interventions

The menopause transition is a bio-psycho-socio-cultural process that is imbued with varied socio-cultural meanings and a range of bodily experiences. 

Recent prospective studies highlight the complex ways in which lifestyle and cultural factors influence women’s experience of the menopause. Research investigating the psychological processes that might influence symptom perception, such as attentional focus, negative affectivity and cognitive representations of hot flushes will be described and a cognitive model of hot flushes will be presented.

A cognitive behavioural intervention for hot flushes was developed in the 1990s that has had positive outcomes in exploratory trials with well women and women who have had breast cancer treatment. The results of three recent randomised controlled trials of CBT for hot flushes and night sweats (MENOS1, MENOS2 and EVA) will be described. Baseline data and secondary analyses will be presented that test the cognitive model. These interventions offer women who have problematic hot flushes and night sweats a safe and acceptable treatment choice.

To see more please click here.

5th February 2013

Professor Lucy Yardley

Digital health interventions: from LifeGuide to UBhave

This talk begins by outlining the key elements and potential advantages of digital interventions. An introduction to the LifeGuide software follows, which explains how this unique open source set of software tools now allows researchers with no programming skills or resources to create their own web-based interactive interventions. Examples are given of the varieties, features and elements of interventions that can be created using LifeGuide.

Three interventions are then used to illustrate what the multidisciplinary LifeGuide team has learned to date from the process of developing and trialling interventions.

  • The development of the ‘Internet Dr’ intervention to support self-management of cold and flu symptoms allowed us to explore whether it was possible to create a single intervention that was acceptable and engaging to users with very different levels of education and computer usage.
  • The development of the ‘PRIMIT’ intervention to promote hand hygiene illustrates the complementary value of qualitative and quantitative pilot work in the development of effective web-based interventions.
  • The ‘INTRO’ intervention demonstrates how LifeGuide can be used effectively as a platform for developing and trialing interventions across several European countries.

The final section of the talk introduces the UBhave project, which is investigating a) how smart phone technology can be used to deliver timely mobile support depending on what the user is doing and feeling and b) how virtual social networks can be harnessed to provide support for engagement with digital interventions.

To see more please click here.

8th January 2013

Professor Jane Ogden

Understanding successful weight loss and maintenance and the development of ‘teachable moments' intervention following bariatric and orthopaedic surgery.

Obesity is linked to a range of health problems yet weight loss is hard to sustain in the longer term.   This talk will describe the results from a series of qualitative and quantitative studies exploring success stories as a means to identify the characteristics of successful weight loss maintenance.  

Central to many such stories are 'epiphanies' often related to life events such as a divorce, diagnosis or the death of someone close.  In addition, such events appear to translate into weight loss maintenance if a number of conditions are met including investment, hope, a matched model of causes and solutions and a shift in identity.   This talk will describe the role of life events and the ways in which they are translated into success.   It will also present data from two interventions designed to turn a life event into a 'teachable moment' as a means to promote weight loss maintenance after two forms of surgery; bariatric surgery and orthopaedic surgery.

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