Other Research Papers by Tim I Williams
Two studies examine the experience of 'earworms', unwanted catchy tunes that repeat. Survey data ... more Two studies examine the experience of 'earworms', unwanted catchy tunes that repeat. Survey data show that the experience is widespread but earworms are not generally considered problematic, although those who consider music to be important to them report earworms as longer, and harder to control, than those who consider music as less important. The tunes which produce these experiences vary considerably between individuals but are always familiar to those who experience them.
Involuntary musical imagery (INMI) is the subject of much recent research interest. INMI covers a... more Involuntary musical imagery (INMI) is the subject of much recent research interest. INMI covers a number of experience types such as musical obsessions and musical hallucinations. One type of experience has been called earworms, for which the literature provides a number of definitions. In this article, we consider the origins of the term earworm in the German language literature and compare that usage with the English language literature. We consider the published literature on earworms and conclude that there is merit in distinguishing between earworms and other types of INMI described in the scientific literature: for example, musical hallucinations and musical obsessions. We also describe other experiences that can be considered under the term INMI. The aim of future research could be to ascertain similarities and differences between types of INMI with a view to refining the classification scheme proposed here.
Musicae Scientiae, 2013
The experience of earworms, a type of involuntary musical imagery, may reflect a systematic failu... more The experience of earworms, a type of involuntary musical imagery, may reflect a systematic failure in mental control. This study focused on how individual differences in each of two factors, schizotypy, or “openness to experience”, and thought suppression might relate to the appearance of the involuntary musical image (earworm). Schizotypy was measured by Raine’s schizotypal personality questionnaire (SPQ; Raine, 1991) and thought suppression was measured by the White Bear Suppression Inventory (WBSI; Wegner & Zanakos, 1994). Each was found to contribute independently to the overall experience of involuntary musical imagery. Schizotypy was correlated with the length and disruptiveness of earworms, the difficulty with which they were dismissed and the worry they caused, but was not correlated with the frequency of such intrusive imagery. In turn, schizotypy was predicted by suppression and intrusion components of WBSI. The WBSI is associated with the length, disruptiveness, difficulty dismissing and interference but not with the worry caused or the frequency of earworms. The assumption of “ownership” of earworms was also found to affect the extent to which the earworms were considered worrying. Multiple regression analysis showed that both schizotypy and the WBSI predicted the difficulty with which unwanted musical images were dismissed, but that the WBSI accounted for additional variance on top of that accounted for by schizotypy. Finally we consider how earworm-management might relate to wider cognitive processes.
British Journal of Occupational Therapy, 2013
Introduction: Young-onset dementia affects about 1 in 1500 people aged under 65 years in the Unit... more Introduction: Young-onset dementia affects about 1 in 1500 people aged under 65 years in the United Kingdom (UK). It is associated with loss of employment, independence and an increase in psychological distress. This project set out to identify the benefits of a 2 hours per week structured activity programme of gardening for people with young-onset dementia.
Method: A mixed methods (qualitative and quantitative) study of therapeutic gardening for people with young-onset dementia, measuring outcomes for both participants with young-onset dementia and their carers, was used. Twelve participants were recruited from a county-wide mental health service for older adults, based on onset of dementia being before the age of 65 years (range 43–65 years). Of these, two participants dropped out and one died during the project. Measures included the Mini Mental State Examination (MMSE), Bradford Well-Being Profile, Large Allen Cognitive Level Screen (LACLS) and Pool Activity Level (PAL).
Findings: Over a 1-year period the carers of the people with young-onset dementia found that the project had given participants a renewed sense of purpose and increased well-being, despite cognitive functioning continuing to decline during this period.
Conclusion: This study suggests that a meaningful guided activity programme can maintain or improve well-being in the presence of cognitive deterioration.
Which Words are Hard for Autistic Children to Learn?
Mind & Language, Nov 2013
Motivated by accounts of concept use in autistic spectrum disorder (ASD) and a computational mode... more Motivated by accounts of concept use in autistic spectrum disorder (ASD) and a computational model of weak central coherence (O'Loughlin and Thagard, 2000) we examined comprehension and production vocabulary in typically-developing children and those with ASD and Down syndrome (DS). Controlling for frequency, familiarity, length and imageability, Colorado Meaningfulness played a hitherto unremarked role in the vocabularies of children with ASD. High Colorado Meaningful words were underrepresented in the comprehension vocabularies of 2- to 12-year-olds with ASD. The Colorado Meaningfulness of a word is a measure of how many words can be associated with it. Situations in which high Colorado Meaningfulness words are encountered are typically highly variable, and words with High Colorado Meaningfulness often involve extensive use of context. Our data suggest that the number of contexts in which a particular word can appear has a role in determining vocabulary in ASD. This suggestion is consistent with the weak central coherence theory of autism.
The code of practice: strengthening the legalist philosophy
International journal of law and psychiatry, 1988
Legalism revived: new mental health legislation in England
International journal of law and psychiatry, 1983
Search by Subject Search using Medical Subject Headings (< b> MeSH&... more Search by Subject Search using Medical Subject Headings (< b> MeSH</b>), a controlled vocabulary for indexing life sciences content.< br/> Note that some records do not have MeSH. These include Patents and the latest PubMed and PubMed Central records.
Journal of autism and developmental disorders, 2007
While deficits in social interaction are central to autism, the sibling relationship has been fou... more While deficits in social interaction are central to autism, the sibling relationship has been found to provide a key medium for the development of such skills. Naturalistic observations of sibling pairs including children with autism and controls with Down syndrome were made across two time periods, twelve months apart. Consistent with the evidence on typically developing children, the amount and rate of initiations of both prosocial and agonistic interaction increased, but further analysis suggested that these interactions were stage-managed by the typically developing children. Results show social interaction and imitation in children with autism and the special role that sibling interactions can play. Longitudinal research on the acquisition of social skills in children with developmental disabilities is needed.
Randomized controlled trial of full and brief cognitive-behaviour therapy and wait-list for paediatric obsessive-compulsive disorder
Background: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) r... more Background: Reviews and practice guidelines for paediatric obsessive-compulsive disorder (OCD) recommend cognitive-behaviour therapy (CBT) as the psychological treatment of choice, but note that it has not been sufficiently evaluated for children and adolescents and that more randomized controlled trials are needed. The aim of this trial was to evaluate effectiveness and optimal delivery of CBT, emphasizing cognitive interventions.
Methods: A total of 96 children and adolescents with OCD were randomly allocated to the three conditions each of approximately 12 weeks duration: full CBT (average therapist contact: 12 sessions) and brief CBT (average contact: 5 sessions, with use of therapist-guided workbooks), and wait-list/delayed treatment. The primary outcome measure was the child version of the semi-structured interviewer-based Yale-Brown Obsessive Compulsive Scale. Clinical Trial registration: http://www.controlled-trials.com/ISRCTN/; unique identifier: ISRCTN29092580.
Results: There was statistically significant symptomatic improvement in both treatment groups compared with the wait-list group, with no significant differences in outcomes between the two treatment groups. Controlled treatment effect sizes in intention-to-treat analyses were 2.2 for full CBT and 1.6 for brief CBT. Improvements were maintained at follow-up an average of 14 weeks later.
Conclusions: The findings demonstrate the benefits of CBT emphasizing cognitive interventions for children and adolescents with OCD and suggest that relatively lower therapist intensity delivery with use of therapist-guided workbooks is an efficient mode of delivery.
Early Identification of Stimulant Treatment Responders, Partial Responders and Non-Responders using Objective Measures in Children and Adolescents with Hyperkinetic Disorder
Background: The aim of this study was to evaluate stimulant medication response following a singl... more Background: The aim of this study was to evaluate stimulant medication response following a single dose of
methylphenidate (MPH) in children and young people with hyperkinetic disorder using infrared motion
analysis combined with a continuous performance task (QbTest system) as objective measures. The hypothesis
was put forward that a moderate testdose of stimulant medication could determine a robust treatment
response, partial response and non-response in relation to activity, attention and impulse control measures.
Methods: The study included 44 children and young people between the ages of 7–18 years with a
diagnosis of hyperkinetic disorder (F90 & F90.1). A single dose-protocol incorporated the time course effects of
both immediate release MPH and extended-release MPH (Concerta XL, Equasym XL) to determine comparable
peak efficacy periods post intake. Results: A robust treatment response with objective measures reverting to
the population mean was found in 37 participants (84%). Three participants (7%) demonstrated a partial
response to MPH and four participants (9%) were determined as non-responders due to deteriorating activity
measures together with no improvements in attention and impulse control measures. Conclusion: Objective
measures provide early into prescribing the opportunity to measure treatment response and monitor adverse
reactions to stimulant medication. Most treatment responders demonstrated an effective response to MPH on
a moderate testdose facilitating a swift and more optimal titration process.
Williams Syndrome: The extent of agreement between parent and self report of psychological symptoms
ABSTRACT – Background and Objectives: People with Williams syndrome (WS) have been
reported by t... more ABSTRACT – Background and Objectives: People with Williams syndrome (WS) have been
reported by their carers to have problems with attention, anxiety and social relationships. People
with WS have been shown to report their anxieties. This study extends our knowledge of
how people with WS see themselves in terms of behaviour and social relationships.
Methods: A survey using self and parent report forms of the Strengths and Difficulties
Questionnaire.
Results: Both parents and individuals with WS (N = 31) reported difficulties in emotional
disorder and hyperactivity symptoms and strengths in prosocial behaviours such as
altruism and empathy. They disagreed about peer problems.
Conclusions: People with WS understand some but not all of their difficulties. In particular
they fail to recognize their social difficulties which may lead them to be vulnerable
to exploitation.
Earworms (‘stuck song syndrome’): Towards a natural history of intrusive thoughts
Two studies examine the experience of ‘earworms’, unwanted catchy tunes that repeat.
Survey data ... more Two studies examine the experience of ‘earworms’, unwanted catchy tunes that repeat.
Survey data show that the experience is widespread but earworms are not generally
considered problematic, although those who consider music to be important to them
report earworms as longer, and harder to control, than those who consider music as less
important. The tunes which produce these experiences vary considerably between
individuals but are always familiar to those who experience them. A diary study confirms
these findings and also indicates that, although earworm recurrence is relatively
uncommon and unlikely to persist for longer than 24 h, the length of both the earworm
and the earworm experience frequently exceed standard estimates of auditory memory
capacity. Active attempts to block or eliminate the earworm are less successful than
passive acceptance, consistent with Wegner’s theory of ironic mental control.
A randomised controlled trial of cognitive behavioural treatment for obsessive compulsive disorder in children and adolescents
Cognitive behaviour therapy (CBT) for young
people with obsessive compulsive disorder (OCD) has
b... more Cognitive behaviour therapy (CBT) for young
people with obsessive compulsive disorder (OCD) has
become the treatment of first choice. However, the literature
is largely based on studies emphasising exposure and
response prevention. In this study, we report on a randomised
controlled trial of CBT for young people carried
out in typical outpatient clinic conditions which focused on
cognitions. A randomised controlled trial compares 10
sessions of manualised cognitive behavioural treatment
with a 12-week waiting list for adolescents and children
with OCD. Assessors were blind to treatment allocation. 21
consecutive patients with OCD aged between 9 and
18 years were recruited. The group who received treatment
improved more than a comparison group who waited for
3 months. The second group was treated subsequently
using the same protocol and made similar gains. In conclusion,
CBT can be delivered effectively to young people
with OCD in typical outpatient settings.
What is the function of nail biting: An analog assessment study
Behaviour Research and Therapy, 2007
"Objective: To compare the frequency of nail biting in 4 settings (interventions) designed to eli... more "Objective: To compare the frequency of nail biting in 4 settings (interventions) designed to elicit the functions of nail
biting and to compare the results with a self-report questionnaire about the functions of nail biting.
Design: Randomised allocation of participants to order of conditions.
Setting: University Psychology Department.
Subjects: Forty undergraduates who reported biting their nails.
Interventions: Left alone (boredom), solving maths problems (frustration), reprimanded for nail biting (contingent
attention), continuous conversation (noncontingent attention).
Main Outcome measures: Number of times the undergraduates bit their nails.
Results: Nail biting occurred most often in two conditions, boredom and frustration.
Conclusion: Nail biting in young adults occurs as a result of boredom or working on difficult problems, which may reflect
a particular emotional state. It occurs least often when people are engaged in social interaction or when they are
reprimanded for the behavior."
Conference posters by Tim I Williams
Background: Participants with autism have a higher incidence of unusual reading skills compared
w... more Background: Participants with autism have a higher incidence of unusual reading skills compared
with typically developing populations. In particular they often show good reading accuracy and poor
reading comprehension. The processes behind this pattern of abilities are not well studied. In this
study participants with autism, severe intellectual disability and reading skills better than their use of
spoken language were tested (1) on non-word reading to determine whether their reading used a
phonological decoding route and (2) to determine whether they could use their reading skills to
learn new words. 34
Methods: 5 participants with autism and severe intellectual disabilities took part. They were all
using written materials to aid communication.
Results: Two of the participants were able to read non-words accurately. One participant did not
read words out loud. Three of the participants (including the participant who did not read aloud)
were able to read novel words and associate these with novel objects. One participant was tested
on a more rigorous test of learning new words.
Conclusions: Some of the participants in this study were able to demonstrate good grapheme
phoneme decoding skills. In addition the ability of some of the participants to learn new words
rapidly from printed materials suggests that people with both autism and intellectual disabilities
could benefit from the use of written materials as a form of augmentative communication and
thereby learning a wider vocabulary.
• The left hand graph shows the cumulative distribution of upset/crying events, also known as the... more • The left hand graph shows the cumulative distribution of upset/crying events, also known as the devil's staircase.
Commissioners increasingly require value for money evidence on interventions affecting high cost ... more Commissioners increasingly require value for money evidence on interventions affecting high cost individuals. Evaluating benefits for single cases presents a problem for statistical analysis because the data may be serially dependent and non-normally distributed. The Tau-U statistic is available via a web calculator and offers opportunities to clinicians and researchers for assessing the extent of changes in level and slope between phases of a single case design. This paper will present data from a series of A-B (simple evaluations) designs to show how the Tau-U statistic can be used to inform clinical decision making.
Drafts by Tim I Williams
Background: Animal phobias in young people with autism spectrum disorders and intellectual disabi... more Background: Animal phobias in young people with autism spectrum disorders and intellectual disability can impede access to the community and cause risky behaviours. Previous studies have suggested that CBT including systematic desensitization and modelling are effective for people with learning difficulties. Methods of adapting treatment to people with little spoken language are not well characterised nor are the ethical issues around the young person and the animals during treatment.
Aims: To describe (1) adaptations to systematic desensitization when communication is impaired and (2) the ethics of involving animals in interventions.
Method: Treatment was planned based on the use of a systematic desensitization with a hierarchy of feared situations using visual symbols and schedules to communicate with the participants.
Results: Five young people with autism, severe intellectual disabilities and minimal language were successfully treated for dog phobia.
Conclusions: The treatment of specific animal phobias is possible with the use of minimal language provided that a variety of stimuli approximating to the feared objects are available and the safety of all participants is respected. Further work is required to develop sufficiently flexible treatment protocols.
OCD by Tim I Williams
Pathways to Inflated Responsibility Beliefs in Adolescent Obsessive-Compulsive Disorder: A Preliminary Investigation
Background: An inflated sense of responsibility is characteristic of obsessive-compulsive
disord... more Background: An inflated sense of responsibility is characteristic of obsessive-compulsive
disorder (OCD). No previous studies have investigated its origins. Five potential pathways to
inflated responsibility beliefs have been proposed; these are tested in this study. Method: A
novel measure, the Origins Questionnaire for Adolescents (OQA), was developed to assess
experiences on these five pathways. Reliability of the OQA was investigated. The experiences
on the five pathways to inflated responsibility beliefs of sixteen adolescents with a history of
OCD were compared to sixteen adolescents with no history of OCD. Parents also reported on
adolescents’ experiences on the five pathways. Results: Inter-rater reliability was high. The
internal consistency of the subscales were only partly satisfactory. The groups differed on one
pathway; the clinical group reported a higher sense of responsibility for significant incidents with
a negative outcome prior to onset of OCD. Conclusions: An inflated sense of responsibility, in
combination with the occurrence of specific incidents, might act as a vulnerability factor for
development of OCD. Future research should consider how to measure the subtle effects of
experiences of responsibility over the course of development.
Uploads
Other Research Papers by Tim I Williams
Method: A mixed methods (qualitative and quantitative) study of therapeutic gardening for people with young-onset dementia, measuring outcomes for both participants with young-onset dementia and their carers, was used. Twelve participants were recruited from a county-wide mental health service for older adults, based on onset of dementia being before the age of 65 years (range 43–65 years). Of these, two participants dropped out and one died during the project. Measures included the Mini Mental State Examination (MMSE), Bradford Well-Being Profile, Large Allen Cognitive Level Screen (LACLS) and Pool Activity Level (PAL).
Findings: Over a 1-year period the carers of the people with young-onset dementia found that the project had given participants a renewed sense of purpose and increased well-being, despite cognitive functioning continuing to decline during this period.
Conclusion: This study suggests that a meaningful guided activity programme can maintain or improve well-being in the presence of cognitive deterioration.
Methods: A total of 96 children and adolescents with OCD were randomly allocated to the three conditions each of approximately 12 weeks duration: full CBT (average therapist contact: 12 sessions) and brief CBT (average contact: 5 sessions, with use of therapist-guided workbooks), and wait-list/delayed treatment. The primary outcome measure was the child version of the semi-structured interviewer-based Yale-Brown Obsessive Compulsive Scale. Clinical Trial registration: http://www.controlled-trials.com/ISRCTN/; unique identifier: ISRCTN29092580.
Results: There was statistically significant symptomatic improvement in both treatment groups compared with the wait-list group, with no significant differences in outcomes between the two treatment groups. Controlled treatment effect sizes in intention-to-treat analyses were 2.2 for full CBT and 1.6 for brief CBT. Improvements were maintained at follow-up an average of 14 weeks later.
Conclusions: The findings demonstrate the benefits of CBT emphasizing cognitive interventions for children and adolescents with OCD and suggest that relatively lower therapist intensity delivery with use of therapist-guided workbooks is an efficient mode of delivery.
methylphenidate (MPH) in children and young people with hyperkinetic disorder using infrared motion
analysis combined with a continuous performance task (QbTest system) as objective measures. The hypothesis
was put forward that a moderate testdose of stimulant medication could determine a robust treatment
response, partial response and non-response in relation to activity, attention and impulse control measures.
Methods: The study included 44 children and young people between the ages of 7–18 years with a
diagnosis of hyperkinetic disorder (F90 & F90.1). A single dose-protocol incorporated the time course effects of
both immediate release MPH and extended-release MPH (Concerta XL, Equasym XL) to determine comparable
peak efficacy periods post intake. Results: A robust treatment response with objective measures reverting to
the population mean was found in 37 participants (84%). Three participants (7%) demonstrated a partial
response to MPH and four participants (9%) were determined as non-responders due to deteriorating activity
measures together with no improvements in attention and impulse control measures. Conclusion: Objective
measures provide early into prescribing the opportunity to measure treatment response and monitor adverse
reactions to stimulant medication. Most treatment responders demonstrated an effective response to MPH on
a moderate testdose facilitating a swift and more optimal titration process.
reported by their carers to have problems with attention, anxiety and social relationships. People
with WS have been shown to report their anxieties. This study extends our knowledge of
how people with WS see themselves in terms of behaviour and social relationships.
Methods: A survey using self and parent report forms of the Strengths and Difficulties
Questionnaire.
Results: Both parents and individuals with WS (N = 31) reported difficulties in emotional
disorder and hyperactivity symptoms and strengths in prosocial behaviours such as
altruism and empathy. They disagreed about peer problems.
Conclusions: People with WS understand some but not all of their difficulties. In particular
they fail to recognize their social difficulties which may lead them to be vulnerable
to exploitation.
Survey data show that the experience is widespread but earworms are not generally
considered problematic, although those who consider music to be important to them
report earworms as longer, and harder to control, than those who consider music as less
important. The tunes which produce these experiences vary considerably between
individuals but are always familiar to those who experience them. A diary study confirms
these findings and also indicates that, although earworm recurrence is relatively
uncommon and unlikely to persist for longer than 24 h, the length of both the earworm
and the earworm experience frequently exceed standard estimates of auditory memory
capacity. Active attempts to block or eliminate the earworm are less successful than
passive acceptance, consistent with Wegner’s theory of ironic mental control.
people with obsessive compulsive disorder (OCD) has
become the treatment of first choice. However, the literature
is largely based on studies emphasising exposure and
response prevention. In this study, we report on a randomised
controlled trial of CBT for young people carried
out in typical outpatient clinic conditions which focused on
cognitions. A randomised controlled trial compares 10
sessions of manualised cognitive behavioural treatment
with a 12-week waiting list for adolescents and children
with OCD. Assessors were blind to treatment allocation. 21
consecutive patients with OCD aged between 9 and
18 years were recruited. The group who received treatment
improved more than a comparison group who waited for
3 months. The second group was treated subsequently
using the same protocol and made similar gains. In conclusion,
CBT can be delivered effectively to young people
with OCD in typical outpatient settings.
biting and to compare the results with a self-report questionnaire about the functions of nail biting.
Design: Randomised allocation of participants to order of conditions.
Setting: University Psychology Department.
Subjects: Forty undergraduates who reported biting their nails.
Interventions: Left alone (boredom), solving maths problems (frustration), reprimanded for nail biting (contingent
attention), continuous conversation (noncontingent attention).
Main Outcome measures: Number of times the undergraduates bit their nails.
Results: Nail biting occurred most often in two conditions, boredom and frustration.
Conclusion: Nail biting in young adults occurs as a result of boredom or working on difficult problems, which may reflect
a particular emotional state. It occurs least often when people are engaged in social interaction or when they are
reprimanded for the behavior."
Conference posters by Tim I Williams
with typically developing populations. In particular they often show good reading accuracy and poor
reading comprehension. The processes behind this pattern of abilities are not well studied. In this
study participants with autism, severe intellectual disability and reading skills better than their use of
spoken language were tested (1) on non-word reading to determine whether their reading used a
phonological decoding route and (2) to determine whether they could use their reading skills to
learn new words. 34
Methods: 5 participants with autism and severe intellectual disabilities took part. They were all
using written materials to aid communication.
Results: Two of the participants were able to read non-words accurately. One participant did not
read words out loud. Three of the participants (including the participant who did not read aloud)
were able to read novel words and associate these with novel objects. One participant was tested
on a more rigorous test of learning new words.
Conclusions: Some of the participants in this study were able to demonstrate good grapheme
phoneme decoding skills. In addition the ability of some of the participants to learn new words
rapidly from printed materials suggests that people with both autism and intellectual disabilities
could benefit from the use of written materials as a form of augmentative communication and
thereby learning a wider vocabulary.
Drafts by Tim I Williams
Aims: To describe (1) adaptations to systematic desensitization when communication is impaired and (2) the ethics of involving animals in interventions.
Method: Treatment was planned based on the use of a systematic desensitization with a hierarchy of feared situations using visual symbols and schedules to communicate with the participants.
Results: Five young people with autism, severe intellectual disabilities and minimal language were successfully treated for dog phobia.
Conclusions: The treatment of specific animal phobias is possible with the use of minimal language provided that a variety of stimuli approximating to the feared objects are available and the safety of all participants is respected. Further work is required to develop sufficiently flexible treatment protocols.
OCD by Tim I Williams
disorder (OCD). No previous studies have investigated its origins. Five potential pathways to
inflated responsibility beliefs have been proposed; these are tested in this study. Method: A
novel measure, the Origins Questionnaire for Adolescents (OQA), was developed to assess
experiences on these five pathways. Reliability of the OQA was investigated. The experiences
on the five pathways to inflated responsibility beliefs of sixteen adolescents with a history of
OCD were compared to sixteen adolescents with no history of OCD. Parents also reported on
adolescents’ experiences on the five pathways. Results: Inter-rater reliability was high. The
internal consistency of the subscales were only partly satisfactory. The groups differed on one
pathway; the clinical group reported a higher sense of responsibility for significant incidents with
a negative outcome prior to onset of OCD. Conclusions: An inflated sense of responsibility, in
combination with the occurrence of specific incidents, might act as a vulnerability factor for
development of OCD. Future research should consider how to measure the subtle effects of
experiences of responsibility over the course of development.