• The dark side of competition: How competitive behaviour and striving to avoid inferiority are linked to depression, anxiety, stress and self-harm.

      Gilbert, Paul; McEwan, Kirsten; Bellew, Rebecca; Mills, Alison; Gale, Corinne; University of Derby (British Psychological Society, 2009-06)
      This study was guided by the social rank theory of depression and aimed to explore the relationship between depression, anxiety, stress and self‐harm with striving to avoid inferiority, feelings of shame and styles of attachment. Participants diagnosed with depression (n=62) completed a series of questionnaires measuring striving to avoid inferiority, fears of missing out, being overlooked and active rejection, attachment, social rank and psychopathologies. Striving to avoid inferiority was significantly linked to social rank variables and anxious attachment. Mediator analyses revealed that the relationship between striving to avoid inferiority and depression was mediated by the social rank variable of external shame, and also anxious attachment. These findings suggest that elevated competitive behaviour can have a ‘dark side’. When people feel insecure in their social environments, it can focus them on a hierarchical view of themselves and others, with a fear of rejection if they feel they have become too inferior or subordinate. This may increase vulnerability to depression, anxiety and stress.
    • ‘A definite feel-it moment’: Embodiment, externalization and emotion during chair-work in compassion-focused therapy

      Bell, Tobyn; Montague, Jane; Elander, James; Gilbert, Paul; University of Derby (Wiley, 2019-07-08)
      Chair-work is an experiential method used within compassion-focused therapy (CFT) to apply compassion to various aspects of the self. This is the first study of CFT chair-work and is focused on clients’ lived experiences of a chair-work intervention for self-criticism. Twelve participants with depression were interviewed following the chair-work intervention and the resulting data was examined using Interpretative Phenomenological Analysis (IPA). Three superordinate themes were identified: ‘embodiment and enactment’, ‘externalizing the self in physical form’ and ‘emotional intensity’. The findings suggest the importance of accessing and expressing various emotions connected with self-criticism, whilst highlighting the potential for client distress and avoidance during the intervention. The role of embodying, enacting and physically situating aspects of the self in different chairs is also suggested to be an important mechanism of change in CFT chair-work. The findings are discussed in terms of clinical implications, emphasizing how core CFT concepts and practices are facilitated by the chair-work process.
    • A descriptive study of feelings of arrested escape (entrapment) and arrested anger in people presenting to an emergency department following an episode of self-harm.

      Clarke, Martin; McEwan, Kirsten; Ness, Jennifer; Waters, Keith; Basran, Jaskaran; Gilbert, Paul; Derbyshire Healthcare NHS Foundation Trust; Nottinghamshire Healthcare NHS Foundation Trust; Cardiff University; University of Derby (Frontiers, 2016-09-14)
      To explore the role of elevated feelings of anger and desires to escape (fight/flight), which are experienced as inhibited, blocked, and arrested (i.e., arrested anger and arrested flight/escape leading to feelings of entrapment). This descriptive study developed measures of arrested anger and arrested flight and explored these in the context of a recent self-harm event in people presenting to a Hospital’s Emergency Department (ED).
    • Design and evaluation: end users, user datasets and personas

      Marshall, Russell; Cook, Sharon; Mitchell, Val; Summerskill, Steve; Haines, Victoria; Maguire, Martin C.; Sims, Ruth; Gyi, Diane E.; Case, Keith; Loughborough University (Elsevier Ltd and The Ergonomics Society, 2013-04-08)
      Understanding the needs and aspirations of a suitable range of users during the product design process is an extremely difficult task. Methods such as ethnographic studies can be used to gain a better understanding of users needs, but they are inherently time consuming and expensive. The time pressures that are evident in the work performed by design consultancies often make these techniques impractical. This paper contains a discussion about the use of 'personas', a method used by designers to overcome these issues. Personas are descriptive models of archetypal users derived from user research. The discussion focuses on two case studies, the first of which examines the use of personas in the car design process. The second examines the use of personas in the field of 'inclusive design', as demonstrated by the HADRIAN system. These case studies exemplify the benefits 'data rich' personas contribute as opposed to 'assumption based' personas. © 2013 Elsevier Ltd and The Ergonomics Society.
    • A design ergonomics approach to accessibility and user needs in transport

      Marshall, Russell; Gyi, Diane E.; Case, Keith; Porter, J. Mark; Sims, Ruth; Summerskill, Steve; Davis, Peter; Loughborough University (Taylor & Francis, 2009)
      This paper describes research carried out into the area of accessibility and 'design for all'. The Accessibility and User Needs in Transport (AUNT-SUE) project was initiated to develop and test sustainable policies and practice that would deliver effective socially inclusive design and operation in transport and the public realm. Loughborough University's role in the project focuses on the provision of data on users that is accessible, valid, and applicable and a means of utilising the data to assess the accessibility of designs during the early stages of development. These needs have led to the development of the authors' inclusive design tool called HADRIAN. Data were collected on 100 people the majority of whom are older or have some form of impairment. These data include size, shape, capability, preferences and experiences with a range of daily activities and transport related tasks. These are partnered with a simple task analysis system. The system supports the construction of a task linked to a CAD model of a design to be evaluated. The task is then carried out by the virtual individuals in the database. Accessibility issues are reported by the system allowing excluded people to be investigated. Thus HADRIAN supports designers and ergonomists in attempting to 'design for all' by fostering empathy with the intended users, meeting their data needs through an accessible and applicable database and providing a means of gaining some of the feedback possible with a real user trial at a much earlier stage in the design process.
    • 'Design for all': methods and data to support designers

      Sims, Ruth; Loughborough University (Ruth Elise Sims, 2003)
      If designers are to meet the needs of the growing population of older and disabled people then data on size, shape, posture and capabilities will be increasingly important. This thesis details a methodology for the collection of anthropometry, joint constraints, reach range, postural capability and task specific information, to create a unique database of `individuals'. These data were then used in the development of a computer-based design tool (HADRIAN), to allow design professionals to estimate the percentage of people who could be accommodated by a design. Having complete data sets for individuals is vital to enable multivariate analysis, as opposed to traditional univariate percentile data. Following a review of the literature two interview surveys were conducted with 32 design professionals and 50 older and disabled people. The majority of designers were aware of the philosophy of `design for all', but rarely considered the approach due to perceived time and financial costs. With respect to older and disabled people it was found that nearly all experienced problems completing basic activities of daily life, and that improvements to existing designs could improve quality of life. Activities such as being able to cook a meal, and use the bath were reported as being particularly important. Firstly, a pilot study was conducted with 8 participants to assess the different data collection options. Data were then collected on 100 people, with the majority being older and/or disabled, and encompassing a wide range of capabilities. From these data it was possible to see that the anthropometric data showed a range beyond 15` and 99`h percentile for each dimension when compared to existing anthropometry data, and a breadth of variation in task specific behaviours. Validation trials were then conducted to compare the actual task performance of 10 of the 100 `individuals' with that predicted by HADRIAN, with postures and task capabilities being correctly predicted for open-access reach-and-lift tasks. This gives some confidence that it is possible to predict postures and capabilities from the data collected.
    • The design of compassionate care.

      Crawford, Paul; Brown, Brian; Kvangarsnes, Marit; Gilbert, Paul; University of Nottingham; De Montfort University; Aalesund University College; University of Derby (Wiley, 2014-05-19)
      Aims and objectives To investigate the tension between individual and organisational responses to contemporary demands for compassionate interactions in health care. Background Health care is often said to need more compassion among its practitioners. However, this represents a rather simplistic view of the issue, situating the problem with individual practitioners rather than focusing on the overall design of care and healthcare organisations, which have often adopted a production-line approach. Design This is a position paper informed by a narrative literature review. Methods A search of the PubMed, Science Direct and CINAHL databases for the terms compassion, care and design was conducted in the research literature published from 2000 through to mid-2013. Results There is a relatively large literature on compassion in health care, where authors discuss the value of imbuing a variety of aspects of health services with compassion including nurses, other practitioners and, ultimately, among patients. This contrasts with the rather limited attention that compassionate practice has received in healthcare curricula and the lack of attention to how compassion is informed by organisational structures and processes. We discuss how making the clinic more welcoming for patients and promoting bidirectional compassion and compassion formation in nursing education can be part of an overall approach to the design of compassionate care. Conclusions We discuss a number of ways in which compassion can be enhanced through training, educational and organisational design, through exploiting the potential of brief opportunities for communication and through initiatives involving patients and service users, as well as practitioners and service leaders.
    • Design programmes to maximise participant engagement: a predictive study of programme and participant characteristics associated with engagement in paediatric weight management

      Nobles, James; Griffiths, Claire; Pringle, Andy; Gately, Paul; Leeds Beckett University (Springer Science and Business Media LLC, 2016-07-19)
      Approximately 50 % of paediatric weight management (WM) programme attendees do not complete their respective programmes. High attrition rates compromise both programme effectiveness and cost-efficiency. Past research has examined pre-intervention participant characteristics associated with programme (non-)completion, however study samples are often small and not representative of multiple demographics. Moreover, the association between programme characteristics and participant engagement is not well known. This study examined participant and programme characteristics associated with engagement in a large, government funded, paediatric WM programme. Engagement was defined as the family’s level of participation in the WM programme. Secondary data analysis of 2948 participants (Age: 10.44 ± 2.80 years, BMI: 25.99 ± 5.79 kg/m2, Standardised BMI [BMI SDS]: 2.48 ± 0.87 units, White Ethnicity: 70.52 %) was undertaken. Participants attended a MoreLife programme (nationwide WM provider) between 2009 and 2014. Participants were classified into one of five engagement groups: Initiators, Late Dropouts, Low- or High- Sporadic Attenders, or Completers. Five binary multivariable logistic regression models were performed to identify participant (n = 11) and programmatic (n = 6) characteristics associated with an engagement group. Programme completion was classified as ≥70 % attendance. Programme characteristics were stronger predictors of programme engagement than participant characteristics; particularly small group size, winter/autumn delivery periods and earlier programme years (proxy for scalability). Conversely, participant characteristics were weak predictors of programme engagement. Predictors varied between engagement groups (e.g. Completers, Initiators, Sporadic Attenders). 47.1 % of participants completed the MoreLife programme (mean attendance: 59.4 ± 26.7 %, mean BMI SDS change: -0.15 ± 0.22 units), and 21 % of those who signed onto the programme did not attend a session. As WM services scale up, the efficacy and fidelity of programmes may be reduced due to increased demand and lower financial resource. Further, limiting WM programme groups to no more than 20 participants could result in greater engagement. Baseline participant characteristics are poor and inconsistent predictors of programme engagement. Thus, future research should evaluate participant motives, expectations, and barriers to attending a WM programme to enhance our understanding of participant WM engagement. Finally, we suggest that session-by-session attendance is recorded as a minimum requirement to improve reporting transparency and enhance external validity of study findings.
    • Developing your leadership skills

      Bryson, David; Human Sciences Research Centre (Taylor and Francis, 2018-10-17)
      Leading a team with a small or large number of people can be difficult and it requires time and experience to develop and apply the necessary skills. This paper includes a number of learning activities designed to start you off on the road to becoming a leader and to hone those skills through reflection.
    • Development and evaluation of an intervention to improve further education students' understanding of higher education assessment criteria: three studies

      Jessen, Anna; Elander, James (2011-12-01)
      This paper reports three studies about preparing Further Education (FE) students for the transition to Higher Education (HE) by improving their understanding of HE assessment criteria. In study 1, students and tutors in both FE and HE were interviewed for a qualitative analysis of their understandings and expectations about assessment criteria. In study 2, students in FE and HE completed questionnaires measuring self-rated understanding and ability about assessment criteria, and beliefs about essay writing. Studies 1 and 2 both showed that FE students were more confident than HE students about their understanding and ability in relation to assessment criteria, but FE students’ understandings suggested more surface approaches to learning and more naïve epistemological beliefs. In study 3, a workshop intervention to improve FE students’ understandings of HE assessment criteria was evaluated in a comparative longitudinal trial. The intervention reduced FE students’ self-rated understanding and ability, and promoted more sophisticated beliefs about essay writing, by comparison with students who received standard tuition. We concluded that interventions to develop more realistic understandings of what is required in academic writing could be used to prepare FE students more effectively for the transition to HE.
    • Development and evaluation of task based digital human modeling for inclusive design

      Marshall, Russell; Summerskill, Steve; Case, Keith; Gyi, Diane E.; Sims, Ruth; Loughborough University (Taylor and Francis, 2010)
      HADRIAN is a digital human modeling (DHM) system that is currently under development as part of an EPSRC funded project in the UK looking at accessible transport. The system is a partner tool to the long established SAMMIE DHM system and aims to address issues with the lack of applicability of DHM tools to inclusive or universal design problems. HADRIAN includes a database of 102 manikins based directly upon data taken from real people, many of whom are older or with disabilities and who span a broad range of anthropometry, age, and joint mobility. This database is combined with a task analysis tool that provides an automated means to investigate the accessibility of a workstation or environment. This paper discusses the issues and subsequent refinement of the tool that resulted from validation using an ATM design case study. In addition the results from a second validation are presented. This second study examines the accessibility of a Docklands Light Railway station in London. The results highlight that whilst physical simulations can be made with a generally good degree of accuracy there are still many opportunities to be explored in the cognitive and emotional areas that can be used to inform designers of accessibility issues during virtual assessments.
    • The development and part validation of a U.K. scale for mathematics anxiety

      Hunt, Thomas E.; Clark-Carter, David; Sheffield, David; University of Derby; Staffordshire University (Sage, 2011)
      There is a paucity of information surrounding maths anxiety levels in the British undergraduate student population, and, due to terminological issues, existing measures of maths anxiety may not be appropriate measures to use with this population. The current study, therefore, reports on the development and validation of a new maths anxiety scale. Using a large sample of British undergraduates, the 23-item Mathematics Anxiety Scale–UK (MAS-UK) is shown to be a reliable and valid measure of maths anxiety. Exploratory factor analysis indicated the existence of three factors, highlighting maths anxiety as a multidimensional construct. Confirmatory factor analysis revealed a good-fitting model. Normative data on maths anxiety in a British undergraduate student population are provided, along with comparisons between academic undergraduate subject areas and genders. The MAS-UK may represent an easily administrable, reliable, and valid tool for assessing maths anxiety in British and potentially European undergraduate student populations.
    • Development and validation of a short-form Pain Medication Attitudes Questionnaire (PMAQ-14)

      Elander, James; Said, Omimah; Maratos, Frances A.; Dys, Ada; Collins, Hannah; Schofield, Malcolm B.; University of Derby (International Association for the Study of Pain, 2017-03-01)
      Attitudes to pain medication are important aspects of adjustment to chronic pain. They are measured by the 47-item Pain Medication Attitudes Questionnaire (PMAQ). To measure those attitudes more quickly and easily, we developed and evaluated a 14-item PMAQ using data from three separate surveys of people with pain in the general population. In survey 1, participants (n=295) completed the 47-item PMAQ and measures of pain, analgesic use, analgesic dependence and attitudes to self-medication. For each of the seven PMAQ scales, the two items that best preserved the content of the parent scales were identified using correlation and regression. The 2-item and parent scales had very similar relationships with other measures, indicating validity had been maintained. The resulting 14-item PMAQ was then completed by participants in survey 2 (n=241) and survey 3 (n=147), along with the same other measures as in survey 1. Confirmatory factor analysis showed that the 14-item PMAQ retained the 7-factor structure of the 47-item version, and correlations with other measures showed it retained the validity of the 47-item version. The PMAQ scale Need was the most significant independent predictor of analgesic dependence in each of four separate multiple regression analyses. This short form of the PMAQ allows attitudes to pain medications to be measured in a valid and more efficient way.
    • Development and validation of the forms of self-criticizing / attacking and self-reassuring scale - Short form.

      Sommers-Spijkerman, Marion; Trompetter, Hester; ten Klooster, Peter; Schreurs, Karlein; Gilbert, Paul; Bohlmeijer, Ernst; University of Twente; University of Derby (American Psychological Association, 2017-08-10)
      Studies investigating the effectiveness of compassion-focused therapy (CFT) are growing rapidly. As CFT is oriented toward helping people deal with internal processes of self-to-self-relating, having instruments to measure these processes is important. The 22-item Forms of Self-Criticizing/Attacking and Self-Reassuring Scale (FSCRS) has been found a useful measure. In the present study, a 14-item short form of the FSCRS (FSCRS-SF) suited to studies requiring brief measures was developed and tested in a Dutch community sample (N = 363), and cross-validated in a sample consisting of participants in a study on the effectiveness of a guided self-help compassion training (N = 243). Confirmatory factor analysis (CFA) indicated acceptable to good fit of the FSCRS-SF items to a three-factor model. Findings regarding internal consistency were inconsistent, with Study 1 showing adequate internal consistency for all subscale scores and Study 2 demonstrating satisfactory internal consistency only for the reassured self (RS) subscale score. Furthermore, the results showed that the FSCRS-SF subscale scores had adequate test–retest reliability and satisfactory convergent validity estimates with theoretically related constructs. In addition, the FSCRS-SF subscale scores were found to be sensitive to changes in self-to-self relating over time. Despite mixed findings regarding its reliability requiring further investigation, the FSCRS-SF offers a valid and sensitive measure which shows promise as a complimentary shorter version to the original FSCRS suited to nonclinical populations. Given that the FSCRS is increasingly used as a process and outcome measure, further research on this short form in nonclinical and clinical populations is warranted.
    • Development and validation of the satisfaction with treatment for pain questionnaire (STPQ) among patients with sickle cell disease

      Bij, Deepali; Kapadi, Romaana; Schofield, Malcolm B.; Osias, Arlene; Khalid, Nosheen; Kaya, Banu; Telfer, Paul; Elander, James; University of Derby (Wiley, 2019-06-23)
      A brief measure of patient satisfaction with treatment for pain is needed to help improve the treatment of painful episodes caused by sickle cell disease (SCD), especially during and after the transition from paediatric to adult care. Focus groups of 28 adolescent and adult patients were consulted about the content, clarity and relevance of 30 potential items, resulting in an 18-item version. This was validated by analysing questionnaire responses from 120 patients aged 12-53 years. Confirmatory factor analysis and item analysis indicated five subscales with high internal reliability: ‘Communication and Involvement’ (6 items, α=0.87); ‘Respect and Dignity’ (3 items, α=0.82); ‘Pain Control’ (3 items, α=0.91); ‘Staff Attitudes and Behaviour’ (4 items, α=0.88); and ‘Overall Satisfaction’ (2 items, α=0.85); plus a Total Satisfaction score (18 items, α=0.96). High negative correlations with the Picker Patient Experience Questionnaire, a measure of problem experiences, indicated good convergent validity. Lower satisfaction scores among patients aged over 18 years, those admitted via the emergency department, those treated by non-specialist hospital staff, and those reporting more breakthrough pain indicated good concurrent validity. The questionnaire provides a convenient brief measure that can be used to inform and evaluate improvements in healthcare for adolescent and adult patients with SCD, and could potentially be adapted for other painful conditions.
    • Development and validation of the student attitudes and beliefs about authorship scale: a psychometrically robust measure of authorial identity

      Cheung, Kevin Yet Fong; Stupple, Edward J. N.; Elander, James; University of Derby (Taylor and Francis, 2015-04-22)
      One approach to plagiarism prevention focuses on improving students’ authorial identity, but work in this area depends on robust measures. This paper presents the development of a psychometrically robust measure of authorial identity - the Student Attitudes and Beliefs about Authorship Scale. In the item generation phase, a pool of items was developed and assessed for content validity by subject matter experts. In the exploratory phase, data from 439 higher education students were used to identify a latent variable model with three factors: ‘authorial confidence’, ‘valuing writing’ and ‘identification with author’. In the confirmatory phase, data from 306 higher education students were used to test the three-factor model's reliability and validity. The three-factor structure was confirmed, and the results showed the SABAS has a stronger psychometric basis than previously available measures. This measure of authorial identity can be used with confidence in research and pedagogy to help students improve their authorial identity.
    • Development of a compassion-based training for cancer (CforC) curriculum for female breast cancer patients in stages I-III and cancer survivors. Origins, rationale and initial observations.

      Wahl, Julia; Sheffield, David; Maratos, Frances A.; Archer, Stephanie; University of Derby; Imperial College London (Elsevier, 2018-07-20)
      Compassion is an intrinsic trait and is linked to psychological and physiological well-being. It can be trained and improved through a systematic contemplative training programme. The purpose of this paper is to present a new training programme for cancer patients and survivors (CforC) that was designed and tested in a pilot study. We review the potential benefits of CforC which include attention regulation, self-regulation, mental awareness, and acceptance of physical sensations (including pain experiences). We also consider limitations. Results of the pilot suggest that the current intervention is feasible and provides potential psychological benefits for female breast cancer patients/survivors. Future research may benefit from examining other potential effects of the CforC programme, including emotional and physical outcomes in cancer patients and survivors, and the application of the intervention to other populations of chronically ill patients.
    • Development of a compassion-focused and contextual behavioural environment and validation of the Therapeutic Environment Scales (TESS).

      Veale, David; Miles, Sarah; Naismith, Iona; Pieta, Maria; Gilbert, Paul; King's College London; University of Derby (Cambridge University Press, 2016-01-02)
      Aims and method The aims of the study were to develop a scale sensitive enough to measure the interpersonal processes within a therapeutic environment, and to explore whether the new scale was sensitive enough to detect differences between settings, including a community based on compassionate mind and contextual behaviourism. The Therapeutic Environment Scales (TESS) were validated with 81 participants in three different settings: a specialist service for anxiety disorders, a specialist in-patient ward and a psychodynamic therapeutic community. Results TESS was found to be reliable and valid. Significant differences were seen between the services on the dimensions of compassion, belongingness, feeling safe, positive reinforcement of members' acts of courage, extinction and accommodation of unhelpful behaviours, inconsistency and high expressed emotion. These processes were over time associated with improved outcomes on a specialist service for anxiety disorders. Clinical implications The TESS offers a first step in exploring important interpersonal relationships in therapeutic environments and communities. An environment based on a compassionate mind and contextual behaviourism offers promise for the running of a therapeutic community.
    • Development of a striving to avoid inferiority scale.

      Gilbert, Paul; Broomhead, Claire; Irons, Christopher Paul; McEwan, Kirsten; Bellew, Rebecca; Mills, Alison; Gale, Corinne; Knibb, Rebecca C.; University of Derby; Kingsway Hospital (British Psychological Society, 2007-09)
      Social rank theory suggests that mood variation is linked to the security a person feels in his/her social domain and the extent to which they are sensitive to involuntary subordination (e.g. feeling defeated and feeling inferior). Previous studies looking at rank‐related and competitive behaviour have often focused on striving for dominance, whereas social rank theory has focused on striving to avoid inferiority. This study set out to develop a measure of ‘Striving to Avoid Inferiority’ (SAIS) and assess its relationship to other rank and mood‐related variables. We hypothesized two factors: one we called insecure striving, relating to fear of rejection/criticism for ‘not keeping up’, and the second we called secure non‐striving, relating to feeling socially acceptable and valued regardless of whether one succeeds or not. This scale was given to 207 undergraduates. The SAIS had good psychometric properties, with the two factors of insecure striving and secure non‐striving strongly supported by exploratory factor analysis. Both factors were significantly (though contrastingly) related to various fears of rejection, need for validation, hypercompetitive attitudes, feeling inferior to others, submissive behaviour and indicators of stress, anxiety and depression. Striving to avoid inferiority was a significant predictor of psychopathologies, especially where individuals perceived themselves to have low social rank.