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Biomedical subjects

Chris Barker

Publications and source records attributed to Chris Barker.

11 recordsLinked to original sources

A virtual reprise of the Stanley Milgram obedience experiments.

BACKGROUND: Stanley Milgram's 1960s experimental findings that people would administer apparently lethal electric shocks to a stranger at the behest of an authority figure remain critical for understanding obedience. Yet, due to the ethical controversy that his experiments ignited, it is nowadays impossible to carry out direct experimental studies in this area. In the study reported in this paper, we have used a similar paradigm to the one used by Milgram within an immersive virtual environment. Our objective has not been the study of obedience in itself, but of the extent to which participants would respond to such an extreme social situation as if it were real in spite of their knowledge that no real events were taking place. METHODOLOGY: Following the style of the original experiments, the participants were invited to administer a series of word association memory tests to the (female) virtual human representing the stranger. When she gave an incorrect answer, the participants were instructed to administer an 'electric shock' to her, increasing the voltage each time. She responded with increasing discomfort and protests, eventually demanding termination of the experiment. Of the 34 participants, 23 saw and heard the virtual human, and 11 communicated with her only through a text interface. CONCLUSIONS: Our results show that in spite of the fact that all participants knew for sure that neither the stranger nor the shocks were real, the participants who saw and heard her tended to respond to the situation at the subjective, behavioural and physiological levels as if it were real. This result reopens the door to direct empirical studies of obedience and related extreme social situations, an area of research that is otherwise not open to experimental study for ethical reasons, through the employment of virtual environments.

Adult↗

Effect of long-cycle structured intermittent versus continuous HAART on quality of life in patients with chronic HIV infection.

OBJECTIVE: To examine the effect of repeated, long-cycle structured intermittent versus continuous HAART on health-related quality of life (HRQL) and symptom distress in patients with chronic HIV infection and plasma HIV RNA of less than 50 copies/ml. DESIGN: Prospective survey of adult patients (n = 46) enrolled in a randomized clinical trial evaluating intermittent versus continuous HAART on immunological and virologic parameters. Patients (n = 23) randomized to structured intermittent therapy received serial cycles of 4 weeks on/8 weeks off HAART. OUTCOME MEASURES: HRQL was measured by the physical and mental health summary scores of the Medical Outcomes Study HIV Health Survey (MOS-HIV). Symptom distress was measured by the Symptom Distress Scale. Patients completed initial questionnaires prior to randomization and at weeks 4, 12, and 40 of the trial via a touch screen computer in an outpatient clinic. RESULTS: Baseline demographic and clinical characteristics were equivalent in both treatment groups. Although the mental health summary score declined significantly over time for the structured intermittent group, linear mixed modeling ANOVA indicated no significant difference across time for MOS-HIV summary and Symptom Distress Scale scores between the two treatment arms. CONCLUSION: In this small sample, repeated long-cycle structured intermittent therapy may not provide HRQL or symptom distress advantage compared to continuous HAART in patients with chronic HIV infection over 10 months of treatment. Further research in a heterogenous chronic HIV population and longer follow-up period is warranted.

Adult↗

An experimental study on fear of public speaking using a virtual environment.

This paper examines a necessary condition for successful exploitation of a virtual environment (VE) in therapeutic intervention for fear of public speaking. The condition is that clients experience a degree of anxiety in the VE that is similar to what they would have been expected to experience in a similar real world setting. We refer to this as a "presence" response. The experimental study involved 20 people who were confident public speakers and 16 who were phobic, assessed on a standard psychological scale. Half of each group spoke within a VE depicting an empty seminar room, and the other half within the same room but populated by a neutrally behaving virtual audience of five people. Three responses were measured--a questionnaire-based measure of anxiety, a measure of self-focused attention on somatic responses, and actual heart rate. On all responses, the people with phobia showed a significant increase in signs of anxiety when speaking to the virtual audience compared to the empty room, whereas the confident people did not. The result was strong in spite of the relatively low representational and behavioral fidelity of the virtual characters.

Adult↗

Couples' experiences of the support process in depression: a phenomenological analysis.

This qualitative, phenomenological study examined how partners attempted to support a depressed spouse and how each member of the couple experienced the support process. Participants were nine people who were or had been depressed, who were interviewed jointly with their partners on two separate occasions. The interviews, analysed using interpretative phenomenological analysis, yielded 10 themes, grouped into two domains. The first domain related to the challenges couples faced over the trajectory of a depressive episode, and the second related to issues in the support process, as experienced by each member of the couple. Couples' accounts of the support process were characterized by a pervasive sense of bewilderment and struggle. The findings underline the importance of including the partner in psychological interventions for depression.

Adaptation, Psychological↗

Patients' experiences of GP consultations for psychological problems: a qualitative study.

BACKGROUND: The vast majority of patients with psychological problems are seen solely by their GP, but little is known about patients' perspectives regarding the variety of consultation skills that may be used in routine GP consultations with these patients. AIM: To identify which aspects of GP consultations patients presenting with psychological problems experience as helpful or unhelpful. DESIGN: Qualitative study. SETTING: Nine general practices in north central London. METHOD: Twenty patients, who had discussed psychological problems as a significant part of their index GP consultation, were asked in detail using the tape-assisted recall (TAR) method, about aspects of the consultation they had experienced as helpful or unhelpful. RESULTS: All patients described how the relationship with the GP helped or hindered them in discussing their problems; this was central to their experience of the consultation. An underlying attitude of genuine interest and empathy, within a continuing relationship, was highly valued. Patients also described how the GP helped them make sense of, or resolve their problems, and supported their efforts to change. CONCLUSION: These patient accounts suggest that routine GP consultations for psychological problems can have a powerful impact, at least short-term. The GP role in providing a safe place where patients feel they are listened to and understood should not be underestimated, particularly in the mental health context. Further research is required to investigate the longer-term impact of different GP behaviours on patient health outcomes. The TAR method has potential applications in primary care research and in the training of GPs and other health professionals.

Adult↗

Quality criteria under methodological pluralism: implications for conducting and evaluating research.

Many community psychologists adhere to a methodological pluralist orientation to research; however, it is often unclear what such a position means in practice. This paper draws out the practical implications of methodological pluralism for community research. It proposes four sets of criteria for how research might be appraised under a pluralistic ethos: criteria applicable to all research, research-relevant community psychology values and principles, criteria specifically applicable to quantitative research, and criteria specifically applicable to qualitative research. The paper also addresses how pluralistic community research may be conducted, at each of three levels: integrating methods within a single study, using different approaches within a research program, and pluralism in the field as a whole.

Community Mental Health Services↗

Using a communication audit to improve communication on clinical placement in pre-registration nursing.

This article describes a novel communication audit conducted with those concerned with the practice placements of pre-registration Nursing students. The study, uniquely, addressed all who were involved in communication concerning placement in what is described as an organisational analysis. The aim of the audit was to identify levels of satisfaction and dissatisfaction with present communication processes and to identify points for improvement. The audit used the Hogard-Barker Communication Audit of Practice a customized version of a well established tool, devised to cover issues relevant to practice placements. A key feature of the tool is the opportunity for participants to identify the amount of communication they are receiving on particular topics and issues against the amount they would like to receive. Participants in the audit included students, assessor mentors, ward managers, clinical facilitators and link tutors. Overall there was considerable dissatisfaction with what was perceived to be the insufficient amount of communication received on a number of topics including allocations, the curriculum, students' learning outcomes and commitments in terms of college work. In addition to identifying points for improvement the audit provides a baseline against which progress can be assessed through a future audit.

Consumer Behavior↗

24-hour cover.

Explore the source record for details and available documents.

Animals↗

Health beliefs and communication in the travel clinic consultation as predictors of adherence to malaria chemoprophylaxis.

OBJECTIVES: The objectives were, first, to determine whether adherence to malaria prophylaxis could be predicted by (i) health beliefs specified by the Health Belief Model and the Theory of Planned Behaviour, and (ii) communication during the consultation in a travel clinic; and secondly, to examine the impact of the consultation in changing travellers' health beliefs. DESIGN: A prospective study using regression analysis. METHODS: The participants were 130 consecutive travellers attending a travel medicine clinic. Health beliefs were measured pre- and post-consultation. The consultations were coded from audiotape using the Roter Interaction Analysis System and a content analysis method recording discussion about malaria and prophylaxis. Adherence was assessed by a follow-up telephone interview. RESULTS: Perceived susceptibility to malaria, perceived benefits of medication and intentions to adhere increased significantly as a result of the consultation, and the perceived permanent nature of side effects reduced significantly. At follow-up (N = 107), 62% reported full adherence, 25% partial adherence and 12% poor/no adherence. A multinomial logistic regression analysis revealed that perceived benefits of medication, length of stay, health professional discussion about adherence and travellers' questions and statements independently predicted reported adherence. CONCLUSIONS: Health beliefs and communication significantly predicted adherence in this setting. The findings also suggested qualitative differences between travellers who adhered fully, partially or poorly. Although the clinic consultation had a positive impact, emphasizing benefits of medication and resolving potential barriers to adherence could improve adherence in the population.

Adolescent↗

Psychotherapy and social support: integrating research on psychological helping.

Psychotherapy interactions and social support conversations have many similarities, as well as some important differences. Researchers studying these two manifestations of psychological helping--often known as formal and informal helping--usually apply a separate set of concepts and methods to each and tend to locate their work in separate bodies of literature. This paper argues that such a division of the field is unnecessary and unproductive. It outlines several ways in which the two bodies of literature might inform each other and argues for conceptual integration of the two fields.

Biomedical Research↗