Category: Technology

Gaming, Wearables and Big Data: Psychology’s Hi-Tech Future

sluapaLeave a comment

Simulated therapy training. Apps that monitor behavior and stand-in therapy. Vast streams of data shaped into undeniable patterns. According to a report by psychologists on the cutting edge of technology development, these could be familiar practice adds in the not-distant future.

Jason Satterfield, PhD, director of behavioral medicine UCSF Medical Center spoke of how hi-tech training could help equip clinicians to help meet the demands of truly integrated behavioral health care, otherwise known as the patient-centered medical home.

“The average primary care physician has a panel of 2,500 patients … [and] would need to work 21.7 hours per day just to do [treatments], and 7.4 hours per day for prevention, to deliver best standards of care,” he said. Meanwhile, 70 percent of of health care expenditures are due to chronic illness, and one in four of those patients will have diagnosable mental illness.

Newer tools may help clinicians to treat more people more efficiently and effectively. These include social networking using podcasts and online discussion panels, MOOCs (massive open online courses), and e-mentoring and supervision. “Smart care” tools might remind clinicians when it’s time to do a test or when a patient’s record indicates an intervention. Actors could play patients in simulated online scenarios.

To further help access, “extender and augmenter” apps can that help boost the lessons of cognitive behavioral therapy between sessions. For example, one mobile phone app called Addiction CHESS, currently in development, helps people in recovery for substance abuse, buzzing if they’re approaching a behavioral trigger and delivering appropriate messages. There’s also a “panic button” to call for help and therapists after hours.

That said, “There are lots of studies on digital health and ehealth tools, but if you build it, it doesn’t mean people will use it. Folks are too overwhelmed; there are too many choices and too many things to do. As psychologists we need to think about motivation,” Satterfield said.

One way may be through gamification of virtual therapy. People get drawn into games because they’re tapping into the psychology of motivation and rewards, like badges and scores, limiting play time and setting challenges just above your level of ability to add just enough fun.

“What if we had our training programs set up that way? Not to make light of them, but if they were fun and easy to use, and  where people were bored and could take out a pad and do their CBT exercises — how awesome would that be?” he said.

Assessment is critical to helping clinicians and supervisors of care managers make decisions, but can take up much of the time they have with patients, said Patricia Areán, PhD, of the University of Washington.

“We don’t know how our patient is doing until they walk into our office, and [sometimes] don’t even see patients once a week. We also have to rely on self report, which is guided by how person feels that day,” she said. “What if we could capture all of this information before you see your patient? Data collected in real time and presented in a really efficient way gives us the time to do treatments we need to do to make our patients feel better.”

Mobile phones and wearables may be the vehicles. Smartphone apps can give clinicians clues as to how patients are faring by collecting activity and social data, listening for voice data and changes, looking for typing errors and giving quick mood surveys or memory tests, and being on the lookout for texts and emails that get no response. Plus, they could help reach groups that currently lack access; minorities use mobile health apps more than Caucasians, according to Pew surveys, she said. Wearable sensors have grown 110 percent since 2011, and older adults are more likely to use these devices than any other demographic.

“It’s a combination of data points that will really come up with a signal for people on whether they are really doing better or worse,” Areán said.

All of this personal and public health data and electronic health records are generating enormous amounts of useful information, said Kari Stephens, PhD, who teaches biomedical informatics at the University of Washington, but the challenge lies in ” getting this data wrangled and unburying ourselves,” she said.

Government and other groups are spending millions of dollars to create information-sharing networks that have great value for behavioral scientists, she said, including the National Institutes of Health BD2K (big-data-to-knowledge) project,  the Patient-Centered Outcomes Research Institute’s clinical data repository network, the research-focused NIH Collaboratory, and the FDA’s Mini-Sentinel, which monitors the safety of medical products.

“Big data is correlational, not causal. … and messy and that’s OK, as long it’s mediated by human interpretation,” she said. “Lots of reporting pieces can help us figure out how behavioral health specialists are supporting evidence-based care. Imaging mapping a patient to providers to see how well each provider consults across a team. We also need to be thinking out of the box when we pioneer new ways to do research” with data.

Other big data boons on the horizon: cloud services, actigraphy, consumer data clouds, genomic profiling, and discovering new neurocognitive measures. Psychologists are integral to designing and implementing these tools, and supervising real world change in practice and policy, she said.

 

Psychologists Can Help Reduce Racial Profiling in Policing

Amy NovotneyLeave a comment

Psychologists know the statistic well: Although blacks constitute only 12 percent of America’s population, they represent 40 percent of the nation’s prison inmates. Stanford University social psychologist Jennifer Eberhardt, PhD, has been studying the consequences of the psychological association between race and crime for more than a decade. Her findings, which she shared Saturday during a plenary address on race and policing in America, reveal the startling ways that race influences us, even when we don’t think it does.

In one seminal study, for example, participants were subliminally primed with a series of black or white faces on a computer screen, and then watched as blurry pictures of guns and knives came into focus. Eberhardt found that participants — no matter their race — tended to recognize the weapons quicker when exposed to black faces in the primer versus white faces.

More recently, her research has shown that informing white people about the disproportionate incarceration rate of blacks makes them likely to support the expansion of harsh punitive policies, such as California’s Three Strikes Law and similar measures in other states.

Despite the pervasiveness of society’s association between blacks and crime, our behavior in response to those unconscious racial biases can be changed, Eberhardt said. Research has shown, for example, that more training — particularly in the use of firearms — can help police officers overcome racial biases.

She also pointed to the potential role of technology in addressing racial biases, noting that mandating police officer use of body cameras can help improve police relations with the public.

“We need to begin to think about this footage as data, not just as courtroom evidence,” she said. “We can look across the thousands of these videotapes to examine, in the aggregate, whether officers do indeed approach African-Americans in a different way than other groups — whether there’s a more negative tone or pitch to the voice, and whether that can predict whether the interaction is going to escalate. The footage can also be used to more fully appreciate the interactions where things go right and where officers have been able to skillfully de-escalate conflict.”

 

Cyberbullying: R U 4 real ????

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When kids communicate online, their relationships in real life may help them determine whether someone is cyberbullying.

Emoticons, writing in all caps and using acronyms can influence adolescents’ perceptions of what their peers write, helping replace other cues like tone of voice and facial expressions that might help them interpret meaning in real life. Still, an offline relationship guides how kids might interpret ambiguous sentences such as, “I’ll find you after school. :-) ”

Michal Bak, a graduate student at the University of Victoria, British Columbia, presented a pilot study on how young people process information online during a symposium entitled “Cyber Aggression – Perceptions, Behaviors and Influential Factors.” While knowing a writer helps, research in the field so far suggests that other things come into play, such as social status, when kids react to what’s put online, he said.

“Social status cues may be more prominent in online settings, because adolescents can obtain additional info like followers, positive comments, likes and up-votes,” Bak said. The 30 youngsters he and his team interviewed often couldn’t recall receiving ambiguous messages, but “sometimes emoticons tend to obscure the message, and we find that students tend to hide their real intentions using them,” he said.

More people may be liable to come to a victim’s defense in real life, too, according to work from Nicole Summers, a graduate student at Carleton University. She and her research colleagues are studying moral disengagement in cyber aggression.

Looking at almost 500 emerging adults in Canada ages 16 to 20, she and her colleagues found that over 88 percent of them reported having read insults or mean comments in social media forums at least once in the past year, and over 35 percent of participants witnessed these behaviors weekly. Those who had higher levels of moral disengagement – such as believing one couldn’t help, blaming or dehumanizing the bullying victim, or disregarding help – were more likely to have pro-bullying behaviors such as enjoying reading mean online posts.

“In [real life] social situations you can be an insider, meaning somebody who goes along with bullying, but being online you’re always an outsider. You don’t have to disengage online, because you’re already disengaged to begin with,” she said.

When it comes to online versus social aggression, gender may make a difference, said Megan Lamb, a graduate student at Carleton University. In her study of 429 students ages 11 to 18 in rural eastern Canada, 86 percent reported using social aggression against a friend, and 92 percent reported being socially victimized by a friend in the past school year. The bullying happened online, too, and there was a strong relationship to bullying or being victimized in both arenas. About half of all students reported using cyber aggression against a friend in the past school year, and 67 percent reported being victimized.

Girls reported using and being victims of face-to-face social aggression more than boys. However, boys and girls did not differ much in how often they engaged in cyber aggression.

“Boys are often less comfortable using social aggression, but because cyber aggression is more anonymous, maybe [they] feel more comfortable using that,” she said.

‘Tweet it Off:’ Leveraging Social Media for Health Behavior Change

Lea WinermanLeave a comment

More than 72 percent of online adults — and 89 percent of online young adults — belong to at least one social network, according to a 2013 Pew Research Center survey. The average Facebook user spends more than 40 minutes per day surfing the site, according to the company’s CEO.

Given stats like these, the broad reach of Facebook, Twitter and other sites could provide a new tool to help more people lose weight and make other health behavior changes, according to University of Massachusetts Medical School psychologist Sherry Pagoto, PhD, an expert in the behavioral aspects of obesity control and cancer prevention.

iStock_000054305248_MediumPagoto, who presented her research here, was interested in translating an evidence-based weight loss program called the Diabetes Prevention Program (DPP) into something that could be shared via social networks. The DPP trains “lifestyle coaches” to help people at risk for diabetes learn to eat more healthily and increase their physical activity. The Centers for Disease Control and Prevention  runs the program at more than 700 sites throughout the U.S., through a partnership with local organizations like the YMCA.

An online program could potentially treat many more people, according to Pagoto. In an initial study, she organized 45 participants who wanted to lose weight into four groups. One group participated in a traditional 12-week in-person DPP. Another participated in a combined in-person program and Twitter group. A third participated in just a Twitter group. And the fourth also participated in the in-person and Twitter program, but with the additional factor that the participants suffered from depression.

In the Twitter program, trained facilitators logged in daily to tweet links to content from the program, as well as generate discussion among participants. The participants would also support each other – one participant, for example, tweeted a picture of doughnuts from her office kitchen with the caption “look what my office does for Halloween!” and others chimed in to encourage her to resist the temptation.

In the end, Pagoto found that the Twitter program worked for patients who were not depressed — the Twitter-only participants lost as much weight as the in-person and the Twitter-plus-in-person ones – but it was not effective for the depressed patients.

In a follow-up study, Pagoto tested a Facebook version of the program, this time also providing incentives to some participants to post more often. She wanted to see if encouraging these “superusers” would help everyone lose more weight. That study just ended, Pagoto said, but early data suggest that the program did help participants lose weight, though the effect of the superusers was unclear.

So far, all of Pagoto’s studies have used closed, private groups. But one of the advantages of Facebook and Twitter is the way in which popular groups, posts and memes can spread exponentially. So in future research, Pagoto wants to open up her studies and allow her participants to invite friends into the groups throughout the study.

“There are IRB issues to figure out” and methodological ones too, she said. But the payoff could be worth it. “It has the ability to take on a life of its own.”

Stop pathologizing the selfie trend

Amy NovotneyLeave a comment

While many may roll their eyes at the news articles over Kim Kardashian tweeting a selfie with Hilary Clinton on Thursday, psychologist Pamela Rutledge, PhD, says selfies are more than just a narcissistic trend with a newly accessible technology.

“Selfies are an extraordinary documentation of the process of life,” Rutledge told attendees Friday at a symposium on the use of media and technology for good.

Before launching into her talk, Rutledge, director of the Media Psychology Research Center and a psychology professor at Fielding Graduate University, asked everyone to pull out their phones and take a selfie with those sitting around them.Selfie blog photo

“You have just created a moment that you will be able to look back on and re-experience, and you’ll remember the emotional feeling you had, whether it was funny, or maybe a little bit of discomfort because you don’t do this kind of thing,” Rutledge said.

While admitting that people — particularly teens and young adults — take a lot of “stupid” selfies, Rutledge explained that the photos are often part of a young person’s exploration of self, and can even serve as a way to cultivate mindfulness.

She recommended that psychologists stop pathologizing the selfie trend and instead embrace its use and encourage people to take photos of themselves in moments of gratitude, courage, struggle, achievement and even silliness.

“There are so many moments worth capturing and revisiting,” she said. “If you capture them regularly as a visual journal, you’ll have an extraordinary little journey through what it was like to be you.”

Mobile technology in private practice — keep up or get left behind

Amy NovotneyLeave a comment

An estimated 97,000 mobile health apps are now available worldwide, aiming to help us track our diet and exercise, monitor our moods, even monitor our chronic diseases. Yet many of these apps — including some which claim to address mental health issues — are not regulated, nor is there much evidence of their effectiveness, cautioned speakers at a symposium Friday on the use of apps and text-messaging in the practice of psychology.

“We’re scientists — we need to have evidence that something works before we use it with our clients,” said Marlene Maheu, PhD, executive director of the TeleMental Health Institute in San Diego.

Telehealth blog photoTo help practitioners figure out the safest and most effective apps to recommend to their clients, the speakers recommended examining these key questions when evaluating a mobile health app:

  • Will it meet your clients’ or patients’ needs and is it appropriate?
  • Is the app from a reputable source?
  • Is there an established evidence-base for the app, including research on the intervention underlying the app, as well as specifically associated with the app itself?
  • What are the user ratings and how often is the app downloaded?
  • Does it meet regulatory requirements based on its intended use?
  • If a client’s health information is going to be transmitted to you or another party, does the app meet data and privacy requirements, particularly related to HIPAA?

Finally, test the app yourself before endorsing it with your clients, said David Luxton, PhD, a research health scientist at the Naval Health Research Center in San Diego. He also recommended examining the list of U.S. FDA approved mobile health devices.

“It you’re not familiar with these technologies today as a clinician, it’s time to start paying attention because our patients are demanding them,” Luxton said.

 

Ask My Mom: Can Video Games Help Brain Power?

Jim SliwaLeave a comment

Growing up in the ’70s and ’80s, I was part of the first generation of video game players. I spent many an afternoon playing Space Invaders or waiting in line at the local electronics store for the latest offering from Atari. That obsession continued into college with all-night sessions of Super Mario Brothers. But after graduation, my interest in video games faded for the better part of a decade, only to be refueled by a defining influence in my life: My mom.

400536409_3b18c7d9b2_oTo say my mother is an avid gamer is an understatement. She owns multiple gaming consoles, including several iterations of Sony’s Playstation and an X-box. She is on a first-name basis with the salespeople at the local video game store, where at any given time she is probably on a presale list for another title. Her preference is fantasy-based role playing games, the type with titles like Final Fantasy or Dragon Age. When I go to visit I her, I often spend hours watching her diving in dungeons for more treasure or going up against a monster boss. Did I mention she’s 74?

My family tolerates and even encourages my mother’s gaming obsession because we kid that it’s helping her to stave off dementia. Turns out we may be right.

Research presented in a symposium today at the APA convention by Chandramallika Basak, PhD, and her colleagues at the University of Texas, Dallas, suggests that regular playing of strategy role-playing video games can increase cognition and memory compared to people who simply train their brains with written word games and crossword puzzles. The psychologists focused their research on one game: Rise of Nations. In this real-time strategy computer game, players acquire territory upon which they build, defend and expand their nation.

After playing the game for approximately 20 hours over six to eight weeks, participants scored significantly better on a number of cognitive tests than a control group whose members simply trained on word games. They also continued to have better visual memory updating 45 days after they stopped playing.

There are two paths to success in this game. Combat mode relies on the player to conduct military campaigns. Wonder mode rewards players for developing resources and building important structures, known as wonders, such as a Colossus, a pyramid or (in future ages) even a supercollider. The researchers had expected that given a choice, older adults would  choose to play in Wonder mode, but participants preferred to play in combat mode. This may not have been the best choice because the researchers found better results in those who played Wonder mode.

Which leaves me wondering — perhaps I should introduce Mom to Rise of Nations.