Autonomic response in the perception of disgust and happiness in depersonalization disorder

Patients with depersonalization disorder have shown attenuated responses to emotional unpleasant stimuli, hence supporting the view that depersonalization is characterised by a selective inhibition on the processing of unpleasant emotions. It was the purpose of this study to establish if autonomic responses to facial emotional expressions also show the same blunting effect. The skin conductance responses (SCRs) of 16 patients with chronic DSM-IV depersonalization disorder, 15 normal controls and 15 clinical controls with DSM-IV anxiety disorders were recorded in response to facial expressions of happiness and disgust. Patients with anxiety disorders were found to have greater autonomic responses than patients with depersonalization, in spite of the fact that both groups had similarly high levels of subjective anxiety as measured by anxiety scales. SCR to happy faces did not vary across groups. The findings of this study provide further support to the idea that patients with depersonalization have a selective impairment in the processing of threatening or unpleasant emotional stimuli.

Abnormal left and right amygdala-orbitofrontal cortical functional connectivity to emotional faces:state versus trait vulnerability markers of depression in bipolar disorder

Background - Amygdala-orbitofrontal cortical (OFC) functional connectivity (FC) to emotional stimuli and relationships with white matter remain little examined in bipolar disorder individuals (BD). Methods - Thirty-one BD (type I; n = 17 remitted; n = 14 depressed) and 24 age- and gender-ratio-matched healthy individuals (HC) viewed neutral, mild, and intense happy or sad emotional faces in two experiments. The FC was computed as linear and nonlinear dependence measures between amygdala and OFC time series. Effects of group, laterality, and emotion intensity upon amygdala-OFC FC and amygdala-OFC FC white matter fractional anisotropy (FA) relationships were examined. Results - The BD versus HC showed significantly greater right amygdala-OFC FC (p = .001) in the sad experiment and significantly reduced bilateral amygdala-OFC FC (p = .007) in the happy experiment. Depressed but not remitted female BD versus female HC showed significantly greater left amygdala-OFC FC (p = .001) to all faces in the sad experiment and reduced bilateral amygdala-OFC FC to intense happy faces (p = .01). There was a significant nonlinear relationship (p = .001) between left amygdala-OFC FC to sad faces and FA in HC. In BD, antidepressants were associated with significantly reduced left amygdala-OFC FC to mild sad faces (p = .001). Conclusions - In BD, abnormally elevated right amygdala-OFC FC to sad stimuli might represent a trait vulnerability for depression, whereas abnormally elevated left amygdala-OFC FC to sad stimuli and abnormally reduced amygdala-OFC FC to intense happy stimuli might represent a depression state marker. Abnormal FC measures might normalize with antidepressant medications in BD. Nonlinear amygdala-OFC FC–FA relationships in BD and HC require further study.

Special issue of PDS - Based on PDDG meeting, Aston University, September 2007, in honour of Professor Norman Billingham

This edition of Polymer Degradation and Stability comprises selected papers presented at the 27th Polymer Degradation Discussion Group (PDDG) Conference, affiliated to the Macromolecular Group of the Royal Society of Chemistry, held at Aston University, Birmingham (UK), September 2007, in honour of Professor Norman Billingham for lifelong career in Polymer Science. Norman Billingham was one of the main founders of the PDDG meetings which have been held annually at different venues in the UK since 1976, and biennially since 1998. The PDDG meetings are forums for scientific developments and open discussion of all aspects of polymer degradation and stabilisation and have always provided younger researchers a platform for presenting and discussing their work in the field. This 27th PDDG meeting, chaired by Sahar Al-Malaika (Aston University), was dedicated to Norman Billingham, the Guest of Honour, in recognition for his distinguished contributions to Polymer Science particularly in the area of polymer degradation and stabilisation. The meeting was attended by 65 delegates from 15 countries in Europe, USA and Australia, many of whom have worked and collaborated with Norman at some points of their career. The guest editors of this issue wish to add their Congratulations to Norman Billingham for his outstanding contributions and achievements in the field of polymer degradation and stabilisation and to wish him very happy years ahead. We wish also to express our gratitude to Elsevier for sponsoring the 27th PDDG event and our appreciation to Professor Norman Billingham in his capacity as the Editor-in-Chief of Polymer Degradation and Stability, for the support and help received during the preparation of this special issue.

Moving beyond heterosexism? The good, the bad and the indifferent in accounts of others’ reactions to important life events

Latterly the psychology of sexualities has diversified. There has been increased engagement with queer theory and a heightened focus on sexual practices alongside continued interrogation of heteronormativity via analyses of talk-in-interaction. In this article, I offer an argument for juxtaposing the incongruent in order to further interrogate manifestations of heterosexism in lesbian, gay, bisexual, trans and queer (LGBTQ) people’s lives. In this case, accounts of others’ reactions to a happy event and to a sad experience. By drawing on two contrasting data corpuses – 124 people planning or in a civil partnership and 60 women who had experienced pregnancy loss – there is increased potential for understanding variation in ‘normative’ and/or heteronormative interpretations of LGBTQ lives. I suggest that, despite significant legal and structural gains for LGBTQ communities in a number of Western countries in recent years, and lively internal debates within the psychology of sexualities field, critical examination of manifestations of heterosexism should remain a central focus.

Rapid testing for group B streptococcus during labour: a test accuracy study with evaluation of acceptability and cost-effectiveness

OBJECTIVE: To determine the accuracy, acceptability and cost-effectiveness of polymerase chain reaction (PCR) and optical immunoassay (OIA) rapid tests for maternal group B streptococcal (GBS) colonisation at labour. DESIGN: A test accuracy study was used to determine the accuracy of rapid tests for GBS colonisation of women in labour. Acceptability of testing to participants was evaluated through a questionnaire administered after delivery, and acceptability to staff through focus groups. A decision-analytic model was constructed to assess the cost-effectiveness of various screening strategies. SETTING: Two large obstetric units in the UK. PARTICIPANTS: Women booked for delivery at the participating units other than those electing for a Caesarean delivery. INTERVENTIONS: Vaginal and rectal swabs were obtained at the onset of labour and the results of vaginal and rectal PCR and OIA (index) tests were compared with the reference standard of enriched culture of combined vaginal and rectal swabs. MAIN OUTCOME MEASURES: The accuracy of the index tests, the relative accuracies of tests on vaginal and rectal swabs and whether test accuracy varied according to the presence or absence of maternal risk factors. RESULTS: PCR was significantly more accurate than OIA for the detection of maternal GBS colonisation. Combined vaginal or rectal swab index tests were more sensitive than either test considered individually [combined swab sensitivity for PCR 84% (95% CI 79-88%); vaginal swab 58% (52-64%); rectal swab 71% (66-76%)]. The highest sensitivity for PCR came at the cost of lower specificity [combined specificity 87% (95% CI 85-89%); vaginal swab 92% (90-94%); rectal swab 92% (90-93%)]. The sensitivity and specificity of rapid tests varied according to the presence or absence of maternal risk factors, but not consistently. PCR results were determinants of neonatal GBS colonisation, but maternal risk factors were not. Overall levels of acceptability for rapid testing amongst participants were high. Vaginal swabs were more acceptable than rectal swabs. South Asian women were least likely to have participated in the study and were less happy with the sampling procedure and with the prospect of rapid testing as part of routine care. Midwives were generally positive towards rapid testing but had concerns that it might lead to overtreatment and unnecessary interference in births. Modelling analysis revealed that the most cost-effective strategy was to provide routine intravenous antibiotic prophylaxis (IAP) to all women without screening. Removing this strategy, which is unlikely to be acceptable to most women and midwives, resulted in screening, based on a culture test at 35-37 weeks' gestation, with the provision of antibiotics to all women who screened positive being most cost-effective, assuming that all women in premature labour would receive IAP. The results were sensitive to very small increases in costs and changes in other assumptions. Screening using a rapid test was not cost-effective based on its current sensitivity, specificity and cost. CONCLUSIONS: Neither rapid test was sufficiently accurate to recommend it for routine use in clinical practice. IAP directed by screening with enriched culture at 35-37 weeks' gestation is likely to be the most acceptable cost-effective strategy, although it is premature to suggest the implementation of this strategy at present.

Memory bias for emotional facial expressions in major depression

Sixteen clinically depressed patients and sixteen healthy controls were presented with a set of emotional facial expressions and were asked to identify the emotion portrayed by each face. They, were subsequently given a recognition memory test for these faces. There was no difference between the groups in terms of their ability to identify emotion between from faces. All participants identified emotional expressions more accurately than neutral expressions, with happy expressions being identified most accurately. During the recognition memory phase the depressed patients demonstrated superior memory for sad expressions, and inferior memory for happy expressions, relative to neutral expressions. Conversely, the controls demonstrated superior memory for happy expressions, and inferior memory for sad expressions, relative to neutral expressions. These results are discussed in terms of the cognitive model of depression proposed by Williams, Watts, MacLeod, and Mathews (1997).

Abnormally increased effective connectivity between parahippocampal gyrus and ventromedial prefrontal regions during emotion labeling in bipolar disorder

Emotional liability and mood dysregulation characterize bipolar disorder (BD), yet no study has examined effective connectivity between parahippocampal gyrus and prefrontal cortical regions in ventromedial and dorsal/lateral neural systems subserving mood regulation in BD. Participants comprised 46 individuals (age range: 18-56 years): 21 with a DSM-IV diagnosis of BD, type I currently remitted; and 25 age- and gender-matched healthy controls (HC). Participants performed an event-related functional magnetic resonance imaging paradigm, viewing mild and intense happy and neutral faces. We employed dynamic causal modeling (DCM) to identify significant alterations in effective connectivity between BD and HC. Bayes model selection was used to determine the best model. The right parahippocampal gyrus (PHG) and right subgenual cingulate gyrus (sgCG) were included as representative regions of the ventromedial neural system. The right dorsolateral prefrontal cortex (DLPFC) region was included as representative of the dorsal/lateral neural system. Right PHG-sgCG effective connectivity was significantly greater in BD than HC, reflecting more rapid, forward PHG-sgCG signaling in BD than HC. There was no between-group difference in sgCG-DLPFC effective connectivity. In BD, abnormally increased right PHG-sgCG effective connectivity and reduced right PHG activity to emotional stimuli suggest a dysfunctional ventromedial neural system implicated in early stimulus appraisal, encoding and automatic regulation of emotion that may represent a pathophysiological functional neural mechanism for mood dysregulation in BD.

Genetic modulation of the response bias towards facial displays of anger and happiness

Background: Investigating genetic modulation of emotion processing may contribute to the understanding of heritable mechanisms of emotional disorders. The aim of the present study was to test the effects of catechol- O-methyltransferase (COMT) val158met and serotonin-transporter-linked promoter region (5-HTTLPR) polymorphisms on facial emotion processing in healthy individuals. Methods: Two hundred and seventy five (167 female) participants were asked to complete a computerized facial affect recognition task, which involved four experimental conditions, each containing one type of emotional face (fearful, angry, sad or happy) intermixed with neutral faces. Participants were asked to indicate whether the face displayed an emotion or was neutral. The COMT-val158met and 5-HTTLPR polymorphisms were genotyped. Results: Met homozygotes (COMT) showed a stronger bias to perceive neutral faces as expressions of anger, compared with val homozygotes. However, the S-homozygotes (5-HTTLPR) showed a reduced bias to perceive neutral faces as expressions of happiness, compared to L-homozygotes. No interaction between 5-HTTLPR and COMT was found. Conclusions: These results add to the knowledge of individual differences in social cognition that are modulated via serotonergic and dopaminergic systems. This potentially could contribute to the understanding of the mechanisms of susceptibility to emotional disorders. © 2013 Elsevier Masson SAS.

Professional standards research:job satisfaction and innovation

Job satisfaction is a significant predictor of organisational innovation – especially where employees (including shop-floor workers) experience variety in their jobs and work in a single-status environment. The relationship between job satisfaction and performance has long intrigued work psychologists. The idea that "happy workers are productive workers" underpins many theories of performance, leadership, reward and job design. But contrary to popular belief, the relationship between job satisfaction and performance at individual level has been shown to be relatively weak. Research investigating the link between job satisfaction and creativity (the antecedent to innovation) shows that job dissatisfaction promotes creative outcomes. The logic is that those who are dissatisfied (and have decided to stay with the organisation) are determined to change things and have little to lose in doing so (see JM George & J Zhou, 2002). We were therefore surprised to find in the course of our own research into managerial practices and employee attitudes in manufacturing organisations that job satisfaction was a highly significant predictor of product and technological innovation. These results held even though the research was conducted longitudinally, over two years, while controlling for prior innovation. In other words, job satisfaction was a stronger predictor of innovation than any pre-existing orientation organisations had towards working innovatively. Using prior innovation as a control variable, as well as a longitudinal research design, strengthened our case against the argument that people are satisfied because they belong to a highly innovative organisation. We found that the relationship between job satisfaction and innovation was stronger still where organisations showed that they were committed to promoting job variety, especially at shop-floor level. We developed precise instruments to measure innovation, taking into account the magnitude of the innovation both in terms of the number of people involved in its implementation, and how new and different it was. Using this instrument, we are able to give each organisation in our sample a "score" from one to seven for innovation in areas ranging from administration to production technology. We found that much innovation is incremental, involving relatively minor improvements, rather than major change. To achieve sustained innovation, organisations have to draw on the skills and knowledge of employees at all levels. We also measured job satisfaction at organisational level, constructing a mean "job satisfaction" score for all organisations in our sample, and drawing only on those companies whose employees tended to respond in a similar manner to the questions they were asked. We argue that where most of the workforce experience job satisfaction, employees are more likely to collaborate, to share ideas and aim for high standards because people are keen to sustain their positive feelings. Job variety and single-status arrangements further strengthen the relationship between satisfaction and performance. This makes sense; where employees experience variety, they are exposed to new and different ideas and, provided they feel positive about their jobs, are likely to be willing to try to apply these ideas to improve their jobs. Similarly, staff working in single-status environments where hierarchical barriers are reduced are likely to feel trusted and valued by management and there is evidence (see G Jones & J George, 1998) that people work collaboratively and constructively with those they trust. Our study suggests that there is a strong business case for promoting employee job satisfaction. Managers and HR practitioners need to ensure their strategies and practices support and sustain job satisfaction among their workforces to encourage constructive, collaborative and creative working. It is more important than ever for organisations to respond rapidly to demands of the external environment. This study shows the positive association between organisational-level job satisfaction and innovation. So if a happy workforce is the key to unlocking innovation and organisations want to thrive in the global economy, it is vital that managers and HR practitioners pay close attention to employee perceptions of the work environment. In a world where the most innovative survive it could make all the difference.

A KM perspective on implementing an electronic patient record within an NHS hospital

The Electronic Patient Record (EPR) is being developed by many hospitals in the UK and across the globe. We class an EPR system as a type of Knowledge Management System (KMS), in that it is a technological tool developed to support the process of knowledge management (KM). Healthcare organisations aim to use these systems to provide a vehicle for more informed and improved clinical decision making thereby delivering reduced errors and risks, enhanced quality and consequently offering enhanced patient safety. Finding an effective way for a healthcare organisation to practically implement these systems is essential. In this study we use the concept of the business process approach to KM as a theoretical lens to analyse and explore how a large NHS teaching hospital developed, executed and practically implemented an EPR system. This theory advocates the importance of taking into account all organizational activities - the business processes - in considering any KM initiatives. Approaching KM through business processes allows for a more holistic view of the requirements across a process: emphasis is placed on how particular activities are performed, how they are structured and what knowledge demanded and not just supplied across each process. This falls in line with the increased emphasis in healthcare on patient-centred approaches to care delivery. We have found in previous research that hospitals are happy with the delivery of patient care being referred to as their 'business'. A qualitative study was conducted over a two and half year period with data collected from semi-structured interviews with eight members of the strategic management team, 12 clinical users and 20 patients in addition to non- participant observation of meetings and documentary data. We believe that the inclusion of patients within the study may well be the first time this has been done in examining the implementation of a KMS. The theoretical propositions strategy was used as the overarching approach for data analysis. Here Initial theoretical research themes and propositions were used to help shape and organise the case study analysis. This paper will present preliminary findings about the hospital's business strategy and its links to the KMS strategy and process.

Do educators need educating?

Actual text: I was recently at the Spanish College of Optometry biennial conference and attended a meeting of contact lens lecturers from around Spain and Portugal. We discussed various ideas, mainly about how to share good practice and improve standards. What came to my mind was ‘is there a blueprint for training trainers?’ Well probably not but there are many things that we need to acknowledge such as the way students learn for example. Many educators themselves were taught by lecturers who would write on a blackboard or use acetate on an overhead projector, then came the 35 mm slide era followed by the Powerpoint era. More recently there is a move towards a much more integrated approach of various teaching methods. At my university our contact lens and anterior eye lectures generally follow a format where a narrated Powerpoint lecture is uploaded onto our internal virtual learning environment. This narrated version of the slides is designed to give the didactic element of the topic. The students listen to that before attending an interactive seminar on that topic. The seminar is also recorded so that students can listen to that afterwards. The seminar is designed to give additional information, such as case reports, or to clarify key points or for live demonstrations. It is a good way of doubling the contact time with the students without imposing further on an already packed formal timetable as the students can work in their own time. One problem that we noticed with this approach was that attendance can vary. If the students feel that they will gain something from the interactive seminar then they are more likely to attend – exam tips usually win them over! At the Spanish meeting the educators decided that they wanted to have regular meetings. The industry colleagues in attendance said that they were happy to help but could not necessarily give money, but they could offer meeting rooms, pay for lunch and evening meals. They even said that that they were happy to host meetings and invite other companies too (except to manufacturing plants). In the UK the British Committee of Contact Lens Educators (BUCCLE) meets for one day on three occasions in the year. The American Optometric Contact Lens Educators (AOCLE) meets annually at a three day event. Both these organisations get some help from industry. BUCCLE usually has one of its meetings at a university, one at a company training centre/manufacturing plant/national headquarters and one meeting the day before the BCLA annual conference. BUCCLE usually has its pre-BCLA meeting in conjunction with the International Association of Contact Lens Educators (IACLE). So when educators meet what would they discuss; well probably the focus should be on education rather than actual contact lens knowledge. For example sharing ideas on how to teach toric lens fitting would be better than discussing the actual topic of toric lenses itself. Most universities will have an education department with an expert who could share ideas on how to use the internet in teaching or how to structure lectures or assessments etc. In the past I have helped with similar training programmes in other countries and sharing good practice in pedagogy is always a popular topic. Anyone who is involved in education in the field of contact lenses should look at the IACLE web page and look out for the IACLE World Congress in 2015 in the days preceding the BCLA. Finally, IACLE, AOCLE and BUCCLE all exist as a result of generous educational grants from contact lens companies and anyone interested in finding out more about should refer to their respective web pages.

Editorial

Full text: Welcome to issue 1 of 2012 and a belated Happy New Year to all CLAE readers and BCLA members. The hardest job I had for this issue was to decide which papers to include and which papers to hang on to and save for issue 2 of 2012. At the end of December when I was choosing the content for this issue there were additional 5 papers that could have been included. The final choice came down to various factors; such as first come first served – i.e. which papers had been ready and waiting the longest; secondly which papers had been submitted the earliest; are there similar papers so that it may be beneficial to publish them alongside this paper; and also was the content something which needed to be out there quicker than other papers as it was a current hot topic? But it should be noted that once papers are proofed and deemed ready by authors they are published in the epub version and put online for others to see in their final version. An epub version is given a DOI number (digital object identifier) so that it can be cited by other authors. Apart from being on line the only other difference is that an epub version is essentially waiting to be assigned to a particular issue. So those papers that are being held off for issue 2 of this year are actually already available for you to read (and cite) on line. In this issue there is a paper related to the cost of different contact lens replacement schedules – this may be a topic that is debated more in the future since as a society we are thinking more ‘green’ and all trying to help by reducing our carbon footprint, whether that be by recycling or using less in the first place. A timely review paper on the management of allergic eye disease may help us to better manage those patients we see in the spring with pollen allergies. We have two papers looking at different aspects in keratoconus patients, another looking at a modified fluoret strip and its application in measuring tear break up time and a review paper on corneal erosions. Another interesting paper comes from Professor Harminder Dua and his team. Professor Dua is the UK Royal College of Ophthalmologists’ president and has been interested in corneal anatomy and physiology for much of his research career. Finally, an unusual case of an ocular injury related to a snake bite. Overall I would say there is enough to sink your ‘fangs’ into! Finally, it gives me great pleasure in announcing the newest person to join our Editorial Board, Dr Florence Malet. Dr Malet is an Ophthalmologist and since September 2000 she has been at the Bordeaux Hospital in France developing the Contact Lens Unit of in the Ophthalmology University Department. She is ex-president of the French Contact Lens Society and president of the European Contact Lens Society of Ophthalmologists.

A rule-based approach to implicit emotion detection in text

Most research in the area of emotion detection in written text focused on detecting explicit expressions of emotions in text. In this paper, we present a rule-based pipeline approach for detecting implicit emotions in written text without emotion-bearing words based on the OCC Model. We have evaluated our approach on three different datasets with five emotion categories. Our results show that the proposed approach outperforms the lexicon matching method consistently across all the three datasets by a large margin of 17–30% in F-measure and gives competitive performance compared to a supervised classifier. In particular, when dealing with formal text which follows grammatical rules strictly, our approach gives an average F-measure of 82.7% on “Happy”, “Angry-Disgust” and “Sad”, even outperforming the supervised baseline by nearly 17% in F-measure. Our preliminary results show the feasibility of the approach for the task of implicit emotion detection in written text.

The influence of variations in eating disorder-related symptoms on processing of emotional faces in a non-clinical female sample:an eye-tracking study

This study aimed to: i) determine if the attention bias towards angry faces reported in eating disorders generalises to a non-clinical sample varying in eating disorder-related symptoms; ii) examine if the bias occurs during initial orientation or later strategic processing; and iii) confirm previous findings of impaired facial emotion recognition in non-clinical disordered eating. Fifty-two females viewed a series of face-pairs (happy or angry paired with neutral) whilst their attentional deployment was continuously monitored using an eye-tracker. They subsequently identified the emotion portrayed in a separate series of faces. The highest (n=18) and lowest scorers (n=17) on the Eating Disorders Inventory (EDI) were compared on the attention and facial emotion recognition tasks. Those with relatively high scores exhibited impaired facial emotion recognition, confirming previous findings in similar non-clinical samples. They also displayed biased attention away from emotional faces during later strategic processing, which is consistent with previously observed impairments in clinical samples. These differences were related to drive-for-thinness. Although we found no evidence of a bias towards angry faces, it is plausible that the observed impairments in emotion recognition and avoidance of emotional faces could disrupt social functioning and act as a risk factor for the development of eating disorders.

Dissociation of detection and evaluation of facial expressions in adolescence

Holistic face perception, i.e. the mandatory integration of featural information across the face, hasbeen considered to play a key role when recognizing emotional face expressions (e.g., Tanaka et al.,2002). However, despite their early onset holistic processing skills continue to improvethroughout adolescence (e.g., Schwarzer et al., 2010) and therefore might modulate theevaluation of facial expressions. We tested this hypothesis using an attentional blink (AB)paradigm to compare the impact of happy, fearful and neutral faces in adolescents (10–13 years)and adults on subsequently presented neutral target stimuli (animals, plants and objects) in a rapidserial visual presentation stream. Adolescents and adults were found to be equally reliable whenreporting the emotional expression of the face stimuli. However, the detection of emotional butnot neutral faces imposed a significantly stronger AB effect on the detection of the neutral targetsin adults compared to adolescents. In a control experiment we confirmed that adolescents ratedemotional faces lower in terms of valence and arousal than adults. The results suggest a protracteddevelopment of the ability to evaluate facial expressions that might be attributed to the latematuration of holistic processing skills.