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The Effects of a Supported Employment Program on Psychosocial Indicators
for Persons with Severe Mental Illness
William M.K. Trochim
Running Head: SUPPORTED EMPLOYMENT
This paper describes the psychosocial effects of a program of supported employment (SE) for persons with severe mental illness. The SE program involves extended individualized supported employment for clients through a Mobile Job Support Worker (MJSW) who maintains contact with the client after job placement and supports the client in a variety of ways. A 50% simple random sample was taken of all persons who entered the Thresholds Agency between 3/1/93 and 2/28/95 and who met study criteria. The resulting 484 cases were randomly assigned to either the SE condition (treatment group) or the usual protocol (control group) which consisted of life skills training and employment in an in-house sheltered workshop setting. All participants were measured at intake and at 3 months after beginning employment, on two measures of psychological functioning (the BPRS and GAS) and two measures of self esteem (RSE and ESE). Significant treatment effects were found on all four measures, but they were in the opposite direction from what was hypothesized. Instead of functioning better and having more self esteem, persons in SE had lower functioning levels and lower self esteem. The most likely explanation is that people who work in low-paying service jobs in real world settings generally do not like them and experience significant job stress, whether they have severe mental illness or not. The implications for theory in psychosocial rehabilitation are considered.
The Effects of a Supported Employment Program on Psychosocial Indicators for Persons with Severe Mental Illness
Over the past quarter century a shift has occurred from traditional institution-based models of care for persons with severe mental illness (SMI) to more individualized community-based treatments. Along with this, there has been a significant shift in thought about the potential for persons with SMI to be "rehabilitated" toward lifestyles that more closely approximate those of persons without such illness. A central issue is the ability of a person to hold a regular full-time job for a sustained period of time. There have been several attempts to develop novel and radical models for program interventions designed to assist persons with SMI to sustain full-time employment while living in the community. The most promising of these have emerged from the tradition of psychiatric rehabilitation with its emphases on individual consumer goal setting, skills training, job preparation and employment support (Cook, Jonikas and Solomon, 1992). These are relatively new and field evaluations are rare or have only recently been initiated (Cook and Razzano, 1992; Cook, 1992). Most of the early attempts to evaluate such programs have naturally focused almost exclusively on employment outcomes. However, theory suggests that sustained employment and living in the community may have important therapeutic benefits in addition to the obvious economic ones. To date, there have been no formal studies of the effects of psychiatric rehabilitation programs on key illness-related outcomes. To address this issue, this study seeks to examine the effects of a new program of supported employment on psychosocial outcomes for persons with SMI.
Over the past several decades, the theory of vocational rehabilitation has experienced two major stages of evolution. Original models of vocational rehabilitation were based on the idea of sheltered workshop employment. Clients were paid a piece rate and worked only with other individuals who were disabled. Sheltered workshops tended to be "end points" for persons with severe and profound mental retardation since few ever moved from sheltered to competitive employment (Woest, Klein & Atkins, 1986). Controlled studies of sheltered workshop performance of persons with mental illness suggested only minimal success (Griffiths, 1974) and other research indicated that persons with mental illness earned lower wages, presented more behavior problems, and showed poorer workshop attendance than workers with other disabilities (Whitehead, 1977; Ciardiello, 1981).
In the 1980s, a new model of services called Supported Employment (SE) was proposed as less expensive and more normalizing for persons undergoing rehabilitation (Wehman, 1985). The SE model emphasizes first locating a job in an integrated setting for minimum wage or above, and then placing the person on the job and providing the training and support services needed to remain employed (Wehman, 1985). Services such as individualized job development, one-on-one job coaching, advocacy with co-workers and employers, and "fading" support were found to be effective in maintaining employment for individuals with severe and profound mental retardation (Revell, Wehman & Arnold, 1984). The idea that this model could be generalized to persons with all types of severe disabilities, including severe mental illness, became commonly accepted (Chadsey-Rusch & Rusch, 1986).
One of the more notable SE programs was developed at Thresholds, the site for the present study, which created a new staff position called the mobile job support worker (MJSW) and removed the common six month time limit for many placements. MJSWs provide ongoing, mobile support and intervention at or near the work site, even for jobs with high degrees of independence (Cook & Hoffschmidt, 1993). Time limits for many placements were removed so that clients could stay on as permanent employees if they and their employers wished. The suspension of time limits on job placements, along with MJSW support, became the basis of SE services delivered at Thresholds.
There are two key psychosocial outcome constructs of interest in this study. The first is the overall psychological functioning of the person with SMI. This would include the specification of severity of cognitive and affective symptomotology as well as the overall level of psychological functioning. The second is the level of self-reported self esteem of the person. This was measured both generally and with specific reference to employment.
The key hypothesis of this study is:
HO: A program of supported employment will result in either no change or negative effects on psychological functioning and self esteem.
which will be tested against the alternative:
HA: A program of supported employment will lead to positive effects on psychological functioning and self esteem.
The population of interest for this study is all adults with SMI residing in the U.S. in the early 1990s. The population that is accessible to this study consists of all persons who were clients of the Thresholds Agency in Chicago, Illinois between the dates of March 1, 1993 and February 28, 1995 who met the following criteria: 1) a history of severe mental illness (e.g., either schizophrenia, severe depression or manic-depression); 2) a willingness to achieve paid employment; 3) their primary diagnosis must not include chronic alcoholism or hard drug use; and 4) they must be 18 years of age or older. The sampling frame was obtained from records of the agency. Because of the large number of clients who pass through the agency each year (e.g., approximately 500 who meet the criteria) a simple random sample of 50% was chosen for inclusion in the study. This resulted in a sample size of 484 persons over the two-year course of the study.
On average, study participants were 30 years old and high school graduates (average education level = 13 years). The majority of participants (70%) were male. Most had never married (85%), few (2%) were currently married, and the remainder had been formerly married (13%). Just over half (51%) are African American, with the remainder Caucasian (43%) or other minority groups (6%). In terms of illness history, the members in the sample averaged 4 prior psychiatric hospitalizations and spent a lifetime average of 9 months as patients in psychiatric hospitals. The primary diagnoses were schizophrenia (42%) and severe chronic depression (37%). Participants had spent an average of almost two and one-half years (29 months) at the longest job they ever held.
While the study sample cannot be considered representative of the original population of interest, generalizability was not a primary goal -- the major purpose of this study was to determine whether a specific SE program could work in an accessible context. Any effects of SE evident in this study can be generalized to urban psychiatric agencies that are similar to Thresholds, have a similar clientele, and implement a similar program.
All but one of the measures used in this study are well-known instruments in the research literature on psychosocial functioning. All of the instruments were administered as part of a structured interview that an evaluation social worker had with study participants at regular intervals.
Two measures of psychological functioning were used. The Brief Psychiatric Rating Scale (BPRS)(Overall and Gorham, 1962) is an 18-item scale that measures perceived severity of symptoms ranging from "somatic concern" and "anxiety" to "depressive mood" and "disorientation." Ratings are given on a 0-to-6 Likert-type response scale where 0="not present" and 6="extremely severe" and the scale score is simply the sum of the 18 items. The Global Assessment Scale (GAS)(Endicott et al, 1976) is a single 1-to-100 rating on a scale where each ten-point increment has a detailed description of functioning (higher scores indicate better functioning). For instance, one would give a rating between 91-100 if the person showed "no symptoms, superior functioning..." and a value between 1-10 if the person "needs constant supervision..."
Two measures of self esteem were used. The first is the Rosenberg Self Esteem (RSE) Scale (Rosenberg, 1965), a 10-item scale rated on a 6-point response format where 1="strongly disagree" and 6="strongly agree" and there is no neutral point. The total score is simply the sum across the ten items, with five of the items being reversals. The second measure was developed explicitly for this study and was designed to measure the Employment Self Esteem (ESE) of a person with SMI. This is a 10-item scale that uses a 4-point response format where 1="strongly disagree" and 4="strongly agree" and there is no neutral point. The final ten items were selected from a pool of 97 original candidate items, based upon high item-total score correlations and a judgment of face validity by a panel of three psychologists. This instrument was deliberately kept simple -- a shorter response scale and no reversal items -- because of the difficulties associated with measuring a population with SMI. The entire instrument is provided in Appendix A.
All four of the measures evidenced strong reliability and validity. Internal consistency reliability estimates using Cronbach's alpha ranged from .76 for ESE to .88 for SE. Test-retest reliabilities were nearly as high, ranging from .72 for ESE to .83 for the BPRS. Convergent validity was evidenced by the correlations within construct. For the two psychological functioning scales the correlation was .68 while for the self esteem measures it was somewhat lower at .57. Discriminant validity was examined by looking at the cross-construct correlations which ranged from .18 (BPRS-ESE) to .41 (GAS-SE).
A pretest-posttest two-group randomized experimental design was used in this study. In notational form, the design can be depicted as:
R O X O
R O O
R = the groups were randomly assigned
O = the four measures (i.e., BPRS, GAS, RSE, and ESE)
X = supported employment
The comparison group received the standard Thresholds protocol which emphasized in-house training in life skills and employment in an in-house sheltered workshop. All participants were measured at intake (pretest) and at three months after intake (posttest).
This type of randomized experimental design is generally strong in internal validity. It rules out threats of history, maturation, testing, instrumentation, mortality and selection interactions. Its primary weaknesses are in the potential for treatment-related mortality (i.e., a type of selection-mortality) and for problems that result from the reactions of participants and administrators to knowledge of the varying experimental conditions. In this study, the drop-out rate was 4% (N=9) for the control group and 5% (N=13) in the treatment group. Because these rates are low and are approximately equal in each group, it is not plausible that there is differential mortality. There is a possibility that there were some deleterious effects due to participant knowledge of the other group's existence (e.g., compensatory rivalry, resentful demoralization). Staff were debriefed at several points throughout the study and were explicitly asked about such issues. There were no reports of any apparent negative feelings from the participants in this regard. Nor is it plausible that staff might have equalized conditions between the two groups. Staff were given extensive training and were monitored throughout the course of the study. Overall, this study can be considered strong with respect to internal validity.
Between 3/1/93 and 2/28/95 each person admitted to Thresholds who met the study inclusion criteria was immediately assigned a random number that gave them a 50/50 chance of being selected into the study sample. For those selected, the purpose of the study was explained, including the nature of the two treatments, and the need for and use of random assignment. Participants were assured confidentiality and were given an opportunity to decline to participate in the study. Only 7 people (out of 491) refused to participate. At intake, each selected sample member was assigned a random number giving them a 50/50 chance of being assigned to either the Supported Employment condition or the standard in-agency sheltered workshop. In addition, all study participants were given the four measures at intake.
All participants spent the initial two weeks in the program in training and orientation. This consisted of life skill training (e.g., handling money, getting around, cooking and nutrition) and job preparation (employee roles, coping strategies). At the end of that period, each participant was assigned to a job site -- at the agency sheltered workshop for those in the control condition, and to an outside employer if in the Supported Employment group. Control participants were expected to work full-time at the sheltered workshop for a three-month period, at which point they were posttested and given an opportunity to obtain outside employment (either Supported Employment or not). The Supported Employment participants were each assigned a case worker -- called a Mobile Job Support Worker (MJSW) -- who met with the person at the job site two times per week for an hour each time. The MJSW could provide any support or assistance deemed necessary to help the person cope with job stress, including counseling or working beside the person for short periods of time. In addition, the MJSW was always accessible by cellular telephone, and could be called by the participant or the employer at any time. At the end of three months, each participant was post-tested and given the option of staying with their current job (with or without Supported Employment) or moving to the sheltered workshop.
There were 484 participants in the final sample for this study, 242 in each treatment. There were 9 drop-outs from the control group and 13 from the treatment group, leaving a total of 233 and 229 in each group respectively from whom both pretest and posttest were obtained. Due to unexpected difficulties in coping with job stress, 19 Supported Employment participants had to be transferred into the sheltered workshop prior to the posttest. In all 19 cases, no one was transferred prior to week 6 of employment, and 15 were transferred after week 8. In all analyses, these cases were included with the Supported Employment group (intent-to-treat analysis) yielding treatment effect estimates that are likely to be conservative.
The major results for the four outcome measures are shown in Figure 1.
Insert Figure 1 about here
It is immediately apparent that in all four cases the null hypothesis has to be accepted -- contrary to expectations, Supported Employment cases did significantly worse on all four outcomes than did control participants.
The mean gains, standard deviations, sample sizes and t-values (t-test for differences in average gain) are shown for the four outcome measures in Table 1.
Insert Table 1 about here
The results in the table confirm the impressions in the figures. Note that all t-values are negative except for the BPRS where high scores indicate greater severity of illness. For all four outcomes, the t-values were statistically significant (p<.05).
The results of this study were clearly contrary to initial expectations. The alternative hypothesis suggested that SE participants would show improved psychological functioning and self esteem after three months of employment. Exactly the reverse happened -- SE participants showed significantly worse psychological functioning and self esteem.
There are two major possible explanations for this outcome pattern. First, it seems reasonable that there might be a delayed positive or "boomerang" effect of employment outside of a sheltered setting. SE cases may have to go through an initial difficult period of adjustment (longer than three months) before positive effects become apparent. This "you have to get worse before you get better" theory is commonly held in other treatment-contexts like drug addiction and alcoholism. But a second explanation seems more plausible -- that people working full-time jobs in real-world settings are almost certainly going to be under greater stress and experience more negative outcomes than those who work in the relatively safe confines of an in-agency sheltered workshop. Put more succinctly, the lesson here might very well be that work is hard. Sheltered workshops are generally very nurturing work environments where virtually all employees share similar illness histories and where expectations about productivity are relatively low. In contrast, getting a job at a local hamburger shop or as a shipping clerk puts the person in contact with co-workers who may not be sympathetic to their histories or forgiving with respect to low productivity. This second explanation seems even more plausible in the wake of informal debriefing sessions held as focus groups with the staff and selected research participants. It was clear in the discussion that SE persons experienced significantly higher job stress levels and more negative consequences. However, most of them also felt that the experience was a good one overall and that even their "normal" co-workers "hated their jobs" most of the time.
One lesson we might take from this study is that much of our contemporary theory in psychiatric rehabilitation is naive at best and, in some cases, may be seriously misleading. Theory led us to believe that outside work was a "good" thing that would naturally lead to "good" outcomes like increased psychological functioning and self esteem. But for most people (SMI or not) work is at best tolerable, especially for the types of low-paying service jobs available to study participants. While people with SMI may not function as well or have high self esteem, we should balance this with the desire they may have to "be like other people" including struggling with the vagaries of life and work that others struggle with.
Future research in this are needs to address the theoretical assumptions about employment outcomes for persons with SMI. It is especially important that attempts to replicate this study also try to measure how SE participants feel about the decision to work, even if traditional outcome indicators suffer. It may very well be that negative outcomes on traditional indicators can be associated with a "positive" impact for the participants and for the society as a whole.
Chadsey-Rusch, J. and Rusch, F.R. (1986). The ecology of the workplace. In J. Chadsey-Rusch, C. Haney-Maxwell, L. A. Phelps and F. R. Rusch (Eds.), School-to-Work Transition Issues and Models. (pp. 59-94), Champaign IL: Transition Institute at Illinois.
Ciardiello, J.A. (1981). Job placement success of schizophrenic clients in sheltered workshop programs. Vocational Evaluation and Work Adjustment Bulletin, 14, 125-128, 140.
Cook, J.A. (1992). Job ending among youth and adults with severe mental illness. Journal of Mental Health Administration, 19(2), 158-169.
Cook, J.A. & Hoffschmidt, S. (1993). Psychosocial rehabilitation programming: A comprehensive model for the 1990's. In R.W. Flexer and P. Solomon (Eds.), Social and Community Support for People with Severe Mental Disabilities: Service Integration in Rehabilitation and Mental Health. Andover, MA: Andover Publishing.
Cook, J.A., Jonikas, J., & Solomon, M. (1992). Models of vocational rehabilitation for youth and adults with severe mental illness. American Rehabilitation, 18, 3, 6-32.
Cook, J.A. & Razzano, L. (1992). Natural vocational supports for persons with severe mental illness: Thresholds Supported Competitive Employment Program, in L. Stein (ed.), New Directions for Mental Health Services, San Francisco: Jossey-Bass, 56, 23-41.
Endicott, J.R., Spitzer, J.L. Fleiss, J.L. and Cohen, J. (1976). The Global Assessment Scale: A procedure for measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766-771.
Griffiths, R.D. (1974). Rehabilitation of chronic psychotic patients. Psychological Medicine, 4, 316-325.
Overall, J. E. and Gorham, D. R. (1962). The Brief Psychiatric Rating Scale. Psychological Reports, 10, 799-812.
Rosenberg, M. (1965). Society and Adolescent Self Image. Princeton, NJ, Princeton University Press.
Wehman, P. (1985). Supported competitive employment for persons with severe disabilities. In P. McCarthy, J. Everson, S. Monn & M. Barcus (Eds.), School-to-Work Transition for Youth with Severe Disabilities, (pp. 167-182), Richmond VA: Virginia Commonwealth University.
Whitehead, C.W. (1977). Sheltered Workshop Study: A Nationwide Report on Sheltered Workshops and their Employment of Handicapped Individuals. (Workshop Survey, Volume 1), U.S. Department of Labor Service Publication. Washington, DC: U.S. Government Printing Office.
Woest, J., Klein, M. and Atkins, B.J. (1986). An overview of supported employment strategies. Journal of Rehabilitation Administration, 10(4), 130-135.
Table 1. Means, standard deviations and Ns for the pretest, posttest and gain scores for the four outcome variables and t-test for difference between average gains.
Figure 1. Pretest and posttest means for treatment (SE) and control groups for the four outcome measures.
The Employment Self Esteem Scale
Please rate how strongly you agree or disagree with each of the following statements.
|1. I feel good about my work on the job.|
|2. On the whole, I get along well with others at work.|
|3. I am proud of my ability to cope with difficulties at work.|
|4. When I feel uncomfortable at work, I know how to handle it.|
|5. I can tell that other people at work are glad to have me there.|
|6. I know I'll be able to cope with work for as long as I want.|
|7. I am proud of my relationship with my supervisor at work.|
|8. I am confident that I can handle my job without constant assistance.|
|9. I feel like I make a useful contribution at work.|
|10. I can tell that my co-workers respect me.|
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Copyright ©2006, William M.K. Trochim, All Rights Reserved
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Last Revised: 10/20/2006
For many postgraduate students, a Ph.D. thesis will be their magnum opus – the zenith of their academic achievement. And with such a significant amount of time and effort being invested, it’s important that study topics are chosen wisely. Hence, it’s comforting to know that the world of academic research is a far more inclusive, eclectic and remarkably unusual place than one might first assume. However left-field a particular subject might seem, there are almost certainly countless other research papers that wipe the floor with it in the weirdness stakes. Here are 30 of the very strangest.
30. Ovulation: A Lap Dancer’s Secret Weapon
To investigate the theory that estrus – the interval of amplified fertility and sexual awareness often referred to as “heat” in mammals – is no longer present in human females, researchers turned to an unlikely source: lap dancers. A team from the University of New Mexico led by evolutionary psychologist Geoffrey Miller enlisted the help of 18 professional dancers. These dancers documented their ovulatory cycles, shift patterns and the amount of tips they received over the course of 60 days. Published in 2007 in the journal Evolution and Human Behavior, “Ovulatory cycle effects on tip earnings by lap dancers: economic evidence for human estrus?” noted a distinct correlation between estrus and greater income from gratuities, representing what the researchers called “the first direct economic evidence for the existence and importance of estrus in contemporary human females.”
29. Which Can Jump Higher, the Dog Flea or the Cat Flea?
Froghoppers aside, fleas are the overachieving long jumpers of the animal kingdom. Fleas have body lengths of between 0.06 and 0.13 inches but can leap horizontal distances more than a hundred times those figures. But were all fleas created equal in the jumping stakes? To find out which would triumph between the dog- and cat-dwelling varieties, researchers from the Ecole Nationale Vétérinaire de Toulouse, France meticulously recorded the leaping efforts of a collection of both species of flea. Published in 2000, the resulting paper, “A comparison of jump performances of the dog flea, Ctenocephalides canis, and the cat flea, Ctenocephalides felis felis,” declared the dog flea the winner. Yes, the canine-inclined insect jumps both higher and further than its feline-partial opponent. In 2008 the research team scooped the Annals of Improbable Research’s Ig Nobel Prize in the biology category – the Ig Nobel Prizes being awards that recognize the feats of those who “make people laugh… and then think.”
28. On Ethicists and Theft
Death row pardons, lottery wins and rain on your wedding day – all (arguably non-ironic) subjects referenced by Alanis Morissette in her 1996 single “Ironic.” One topic that would probably merit inclusion – despite the research not being published until 2009 (in Philosophical Psychology) – is the revelation that books on ethics are more liable to be absent from the shelves of university libraries than comparable books on other philosophical subjects. “Do Ethicists Steal More Books?” by University of California, Riverside professor of philosophy Eric Schwitzgebel revealed that the more recent, esoteric ethics books “of the sort likely to be borrowed mainly by professors and advanced students of philosophy” were “about 50 percent more likely to be missing” than their non-ethics counterparts. However, Professor Schwitzgebel believes this is a good thing, as “the demand that ethicists live as moral models would create distortive pressures on the field.”
27. Wet Underwear: Not Comfortable
Even babies know it: wet underwear is uncomfortable. Yet precisely why this is so is a question that went unanswered by hard science until 1994, when the journal Ergonomics published “Impact of wet underwear on thermoregulatory responses and thermal comfort in the cold.” The authors were Martha Kold Bakkevig of SINTEF Unimed in Trondheim, Norway and Ruth Nielson at Kongens Lyngby’s Technical University of Denmark. Bakkevig and Nielson had investigated “the significance of wet underwear” by monitoring the skin and intestinal warmth, as well as weight loss, of eight adult male subjects wearing wet or dry underwear in controlled cold conditions. Apart from the obvious “significant cooling effect of wet underwear on thermoregulatory responses and thermal comfort,” the research also discovered that the thickness of the underwear exerted a greater effect on these factors than the material used to make the garment. So now you know.
26. Do Woodpeckers Get Headaches?
In much the same way that we’d presume dragons don’t get sore throats, it would be a reasonable assumption that woodpeckers don’t suffer from headaches – but assumptions are a poor substitute for the authoritative grip of scientific fact. Published in 2002 in the British Journal of Ophthalmology, “Cure for a headache” came courtesy of Ivan Schwab, an ophthalmologist at the University of California, Davis. Schwab’s paper details the raft of physiological traits that woodpeckers have developed to avoid brain damage and bleeding or detached eyes when hammering their beaks into trees at up to 20 times a second, 12,000 times a day. In addition to a very broad but surprisingly squishy skull and sturdy jaw muscles, the woodpecker has a “relatively small” brain – which probably explains a lot.
25. Booty Calls: the Best of Both Worlds?
Compromise, according to U.S. poet and author Phyllis McGinley at least, is what “makes nations great and marriages happy.” It’s also the backbone of the booty call, if research published in 2009 is anything to go by. Appearing in The Journal of Sex Research, “The ‘booty call’: a compromise between men’s and women’s ideal mating strategies,” was written by researchers from the department of psychology at New Mexico State University. The study analyzed the booty-calling behavior of 61 students from the University of Texas at Austin. What’s more, it confirmed its central thesis that “the booty call may represent a compromise between the short-term sexual nature of men’s ideal relationships and the long-term commitment ideally favored by women.” Lead researcher Dr. Peter K. Jonason, now working at the University of Western Sydney, shared follow-up papers in 2011 and 2013, for The Journal of Sex Research and Archives of Sexual Behavior, respectively.
24. Mosquitoes Like Cheese
The mosquito is a formidable and destructive pest. And while it’s known that exhalation of carbon dioxide by its victims acts as a highly compelling invitation to dinner, other smelly signals have been less well documented. Published in The Lancet, Bart Knols’ 1996 research, “On human odor, malaria mosquitoes, and Limburger cheese,” changed that. The entomologist described how Anopheles gambiae, Africa’s most prolific malaria-spreading mosquito, exhibited a keen partiality for biting human feet and ankles. Crucially, the research also showed that these mosquitoes can be attracted to Limburger cheese, a stinky fromage that shares many characteristics with the whiff of human feet, offering potential use as a synthetic bait for traps. Interestingly, Knols is one of the few people to have won an Ig Nobel (for entomology in 2006) and a Nobel Peace Prize (shared in 2005 as part of the International Atomic Energy Agency).
23. Weighing Up Lead and Feathers
It doesn’t require a degree in physics – or philosophy – to understand that a pound of lead and a pound of feathers weigh the same. Yet the question of whether or not they feel the same is rather less straightforward. To examine this, researchers from the department of psychology at Illinois State University enlisted the help of 23 blindfolded volunteers, recording their perceptions of the weight of either a pound of lead or a pound of feathers contained within boxes of precisely the same shape and size. Published in 2007, the paper – “‘Which feels heavier – a pound of lead or a pound of feathers?’ A potential perceptual basis of a cognitive riddle” – discovered that participants rated the pound of lead as seeming weightier with an “above chance” frequency. The suggestion is that factors such as the “muscular forces” required to handle an object could also play a role in perceptions of weight.
22. Cat Food – Yummy?
Despite their notorious penchant for fully, or sometimes partially, dead rodents in their mouths, cats are surprisingly fussy eaters. What’s more, the pet food industry has found that kitties themselves represent unreliable and expensive test subjects in the pursuit of more appealing cat food flavors. Professor Gary Pickering of the department of biological sciences at Brock University in Ontario, Canada detailed a better option in 2009: the human palate. “Optimizing the sensory characteristics and acceptance of canned cat food: use of a human taste panel” describes the bizarre methodology for human tasters to “profile the flavour and texture of a range of cat food products” – including evaluating “meat chunk and gravy/gel constituents.” The impact of this on the number of job applications to the beer- and chocolate-tasting industries remains to be seen.
21. The Unhidden Dangers of Sword Swallowing
While “cat food taster” is unlikely to appear on anybody’s dream job list, at least that profession is unencumbered by the daily risk of serious injury. Sword swallowing, on the other hand, though occupying a similar position on the league table of tastiness, is a rather more hazardous occupation. In order to establish just how hazardous, radiologist Brian Witcombe and world champion sword swallower Dan Meyer analyzed the “technique and complications” of 46 members of the Sword Swallowers’ Association International. Published in 2009 in the British Medical Journal, their research, “Sword swallowing and its side effects,” found that performers had a heightened chance of injury when “distracted or adding embellishments” – as in the case of one unfortunate swallower who lacerated his throat after being disturbed by a “misbehaving macaw on his shoulder.” In 2007 Witcombe and Meyer together received the Ig Nobel Prize in medicine in view of the pair’s “penetrating medical report.”
20. Beer Bottle vs. Human Skull
Common weekend warrior tales would suggest that a beer bottle makes a good weapon in the event of a bar brawl. But would a full or an empty bottle inflict the most damage, and would that damage include fracturing a human skull? These important questions were answered in 2009 by a team of researchers from the University of Bern with their seminal paper, “Are full or empty beer bottles sturdier and does their fracture-threshold suffice to break the human skull?” Dr. Stephan Bolliger and his colleagues tested the breaking energy of full and empty beer bottles using a drop tower. Moreover, they discovered that a “full bottle will strike a target with almost 70 percent more energy than an empty bottle,” but that either is capable of breaking a human skull. Good to know. In a great twist of irony, Dr. Bolliger and co. picked up a 2009 Ig Nobel Prize in the “Peace” category.
19. The Propulsion Parameters of Penguin Poop
The titles of scientific research papers can sometimes be fairly impenetrable to the layman; other times they may take a more direct approach. Published in 2003, “Pressures produced when penguins pooh – calculations on avian defecation” certainly belongs to the latter category. The paper’s authors, Victor Benno Meyer-Rochow of the then International University Bremen (now Jacobs University Bremen) and Eötvös Loránd University’s Jozsef Gal, decided to address the question of how much internal pressure penguins generate for poop-firing purposes. With knowledge of just a few parameters – including the thickness of and distance covered by the fecal matter – the researchers were able to calculate that the birds employed pressures of up to 60 kPa (kilopascal) to eject their bodily waste. The project was inspired by a blushing Japanese student who, during a lecture, asked Dr. Meyer-Rochow how the penguins “decorated” their nests.
18. Lady Gaga and Pop Art
Lady Gaga clearly sees herself as something of an artist: her third album is called Artpop, and last year she voiced her desire to “bring art culture into pop in a reverse Warholian expedition.” But does anyone else agree? In 2012 University of Cambridge student Amrou Al-Kadhi decided to write a few words – 10,000 to be precise – on the subject for his final year undergraduate dissertation. The paper, looking at Lady Gaga’s place in the history of pop art and her role as a voice of cultural criticism, initially encountered some resistance from the Cambridge history of art department. However, after several meetings, the provision of a barrage of YouTube links to Gaga videos such as “Telephone” (which apparently demonstrated her postmodern aesthetic) and “a bit of work,” permission for Al-Kadhi to undertake the research was granted.
17. Even Chickens Prefer Beautiful People
A 2002 research paper by Stefano Ghirlanda, Liselotte Jansson and Magnus Enquist at Stockholm University decided to make inroads into the question – most likely contemplated by very, very few people – of whether “Chickens prefer beautiful humans.” The study saw six chickens trained to “react to” images of an ordinary male or female face. They were then tested on a series of images ranging from the average face to a face with exaggerated male or female characteristics, and a group of 14 (human) students were given the same test. Perhaps surprisingly, the chickens “showed preferences for faces consistent with human sexual preferences.” The researchers claim this offers evidence for the hypothesis that human preferences stem not from “face-specific adaptations” but from “general properties of nervous systems” – perhaps overlooking the possibility that their human test group just had very unusual tastes.
16. Erase Bad Memories, Keep Good Ones
Painful, embarrassing, or traumatic memories have an annoying habit of accumulating over the course of an average lifetime. As Courtney Miller, assistant professor at the Florida campus of The Scripps Research Institute, puts it, “Our memories make us who we are, but some of these memories can make life very difficult.” With that in mind, Miller led a team of researchers to try and find out whether certain unwanted memories – specifically, drug-related ones – could be erased without damaging other memories. Published in 2013, “Selective, Retrieval-Independent Disruption of Methamphetamine-Associated Memory by Actin Depolymerization” found that, in mice at least, this kind of bespoke amnesia is entirely possible. How? By means of inhibiting the formation of a particular molecule in the brain. “The hope is,” said Miller, “that our strategies may be applicable to other harmful memories, such as those that perpetuate smoking or post-traumatic stress disorder.”
15. The Rectal Route to Curing Hiccups
When beset by a flurry of hiccups, a few minutes of putting up with the involuntary jolting is usually sufficient to get them to subside. However, other times they can become a far more unmanageable problem, beyond the healing scope of even the oldest of wives’ tales. In such situations there’s a surprising but highly effective cure. Published in 1990, “Termination of intractable hiccups with digital rectal massage” details the case of a 60-year-old patient whose seemingly non-stop hiccups were brought to an immediate halt by a massaging finger in the rectum. A second occurrence a few hours later was curbed in a similar fashion. The research from the Bnai Zion Medical Center in Israel notes that “no other recurrences were observed.” The inspiration for the report was Dr. Francis Fesmire, who penned a medical case report with the same title in 1988 and with whom the researchers shared an Ig Nobel in 2006. Fesmire passed away in 2014, and one fitting epitaph from an entertainment-oriented research magazine mused, “Dr. Fesmire found joy and fame by putting his finger on – nay, in – the pulse of his times.”
14. Can Pigeons Tell a Picasso From a Monet?
Theirs is a list dominated by flying, pecking and defecating, and pigeons can now add “appreciation of fine art” to their skill set. Published in 1995, “Pigeons’ discrimination of paintings by Monet and Picasso” came courtesy of Shigeru Watanabe, Junko Sakamoto and Masumi Wakita at Keio University in Japan. And sure enough, the paper presents evidence that pigeons are indeed able to distinguish between works by the two artists. The birds were trained to recognize pieces by either Monet or Picasso; and crucially they then demonstrated the ability to identify works by either creator that had not been shown to them during the training period. Not bad for rats with wings. Professor Watanabe – who went on to explore paddy birds’ appreciation of the spoken word – put the paper into context, saying, “This research does not deal with advanced artistic judgments, but it shows that pigeons are able to acquire the ability to judge beauty similar to that of humans.”
13. The Nature of Navel Lint
It’s a phenomenon that most people will be familiar with: small balls of lint accumulating in the belly button. Still, until fairly recently the mechanism behind this process lacked a satisfactory explanation from the realm of science. Fortunately, that all changed in 2009 when Georg Steinhauser, a chemist and researcher at the Vienna University of Technology, published a research paper entitled “The nature of navel fluff.” After gathering 503 samples of navel lint, Dr. Steinhauser concluded that the culprit behind this common occurrence is hair on the abdomen, which dislodges small fibers from clothing and channels them into the belly button. As the Austrian himself has pointed out, “The question of the nature of navel fluff seems to concern more people than one would think at first glance.”
12. The Effects of Cocaine on Bees
The effects of cocaine on human body movement can be observed in nightclubs the world over on just about any given weekend. And as it turns out, the tediously familiar overestimation of dancing prowess is not just limited to humans. In a 2009 paper entitled “Effects of cocaine on honey bee dance behavior,” a team of researchers led by Gene Robinson, entomology and neuroscience professor at the University of Illinois at Urbana-Champaign, analyzed how honey bees are affected by low doses of cocaine. Honey bees are known to perform dances when they locate an abundant food source; and the team found that administering the drug prompted bees to circle about 25 percent quicker as well as dance more exuberantly and for longer. The bees also exaggerated the scale of their bounty. No surprise there then.
11. Fruit Bat Fellatio
Though its contents are difficult at first to make out, the grainy black and white image above actually depicts two bats engaged in some X-rated nocturnal activity. And that’s precisely the topic that a group of researchers from China and the U.K. chose to explore in their 2009 paper, “Fellatio by fruit bats prolongs copulation time.” The group looked at the copulatory behavior of the short-nosed fruit bat and observed that “females were not passive during copulation but performed oral sex.” More interestingly, the researchers also discovered that the longer the bats spent engaged in fellatio, the longer the copulation itself lasted – and that when fellatio was absent, pairs spent much less time mating.
10. The Possibility of Unicorns
It’s a question that has plagued the internet for decades: could unicorns really exist? The short answer, at least, is no. Still, King’s College London philosophy undergraduate Rachael Patterson decided to investigate whether a full dissertation on the more theoretical aspects of the subject would yield the same conclusion. Her paper, “The Possibility of Unicorns: Kripke v Dummett,” picks up on previous theses by British philosopher Michael Dummett and American logician and philosopher Saul Kripke. Why? In order to see if any more rainbow-hued light could be shed on this important question, of course. Reassuringly, perhaps, neither Kripke nor Dummett claim that these mythical creatures live in reality – although Dummett does posit the idea that in another world they might.
9. Does Country Music Make You Suicidal?
Country music is one of the most popular genres of music in the United States, with a huge audience that encompasses all age ranges. Yet given its recurrent themes of wedded disharmony and excessive drinking, Steven Stack of Wayne State University and Auburn University’s Jim Gundlach decided to probe whether country music might have an influence on municipal suicide rates in America. Published in 1992, their research paper, “The Effect of Country Music on Suicide,” actually discovered a strong link between the amount of country music radio airplay in any particular city and the suicide rate among the white population in that area. The reaction was mixed: Stack and Gundlach initially received hate mail, but in 2004 they won the Ig Nobel Prize for medicine.
8. Do Cabbies Have Bigger Brains?
The notoriously demanding exam that London’s black cab drivers must pass is called the “Knowledge” – and with good reason. Covering around 25,000 streets inside a six-mile radius of central London, the test generally requires three to four years of preparation and multiple attempts at the final exam before success is achieved. University College London neuroscientist Eleanor Maguire was inspired to take a closer look at this feat of memory after researching similar examples in the animal kingdom. Published in 2000, the resulting study, “Navigation-related structural change in the hippocampi of taxi drivers,” discovered that “cabbies” had physically larger posterior hippocampi – the areas of the brain responsible for spatial memory – than their non-cabbie counterparts. Professor Maguire’s follow-up study (with Dr. Katherine Woollett) in 2011 confirmed that trained cabbies were better at remembering London landmarks but not as good at recalling complex visual information compared to the unsuccessful trainees.
7. Shrews: To Chew or Not to Chew?
Ever felt so hungry that you could eat a horse? How about a shrew? While such scenarios are never likely to present themselves to the average person, scientists can be an altogether more experimental bunch. Take 1995 paper, “Human digestive effects on a micromammalian skeleton,” by Brian Crandall and Peter Stahl, anthropologists working at the State University of New York. Said paper investigated what would happen to a shrew – which was first skinned, disemboweled, parboiled and cut into segments – if it was swallowed, sans chewing, by a human. Interestingly, many of the rodent’s smaller bones “disappeared” on their transit through the human digestive system, while other portions of the skeleton showed “significant damage” despite the lack of chewing – a promising result to those studying human and animal remains. Following this peculiar paper, Brian Crandall became a science educator hoping to motivate future generations of (hungry) scientists.
6. Gay Dead Duck Sex
In 1935 Austrian physicist Erwin Schrödinger tried to highlight the absurdity of newly developed aspects of quantum theory. In his thought experiment, the strange quantum properties of a system are drawn on to suspend a hypothetical cat in a state of being simultaneously dead and alive. Sixty-six years later, a new piece of research saw the cat replaced by two ducks, in far less paradoxical though no less opposing states of life and death – but now with the crucial addition of gay sex. Published in 2001, “The first case of homosexual necrophilia in the mallard Anas platyrhynchos” describes Kees Moeliker’s bizarre experience. The Dutch ornithologist witnessed a male duck administering a 75-minute raping of the corpse of another male duck, freshly deceased after flying into a window. More recently, Moeliker has presided over an annual commemorative event and public conversation on how to make sure birds stop flying into windows. The event’s name? Dead Duck Day.
5. Love and Sex With Robots
“Intimate Relationships With Artificial Partners” – ludicrous science fiction, or serious science fact? According to the paper’s author, and British International Master of chess, Daniel Levy, “It may sound a little weird, but it isn’t.” Levy earned a Ph.D. from Maastricht University for his thesis, which covered sociology, psychology, artificial intelligence and robotics, among other fields. He conjectured that human-robot love, marriage and even consummation are “inevitable” by 2050. Roboticist Ronald Arkin from Atlanta’s Georgia Institute of Technology points out, “Humans are very unusual creatures. If you ask me if every human will want to marry a robot, my answer is probably not. But will there be a subset of people? There are people ready right now to marry sex toys.”
4. A Better Approach to Penile Zipper Entrapment
Unfortunately, the horror injury that befalls Ben Stiller’s character Ted, in 1998’s There’s Something About Mary, often traverses the realm of fiction to bestow real-world agony upon boys and men who wish they’d opted for a button fly. A 2005 paper by Dr. Satish Chandra Mishra from Charak Palika Hospital in New Delhi, India looked at reported methods of intervention for this most unpleasant of problems and found that many common approaches either take too long or can actually make the circumstances worse. The researchers’ paper, “Safe and painless manipulation of penile zipper entrapment,” details instead a “quick, simple and non-traumatic” method using wire cutters and a pair of pliers – though “painless” does seem a highly ambitious adjective in this particular context.
3. Flatulence As Self-Defense
The idea of a correlation between fear and bodily emissions of one variety or another is not surprising, but a 1996 paper by author Mara Sidoli detailed a much more extreme example of this relationship. In “Farting as a defence against unspeakable dread,” Sidoli described the miserable tale of Peter, a “severely disturbed adopted latency boy” who endured a difficult and traumatic early life. Despite various setbacks in his later growth, Peter demonstrated “considerable innate resilience.” However, he also developed what Sidoli called a “defensive olfactive container,” using his flatulence “to envelop himself in a protective cloud of familiarity against the dread of falling apart, and to hold his personality together.” With such a vivid and prose-rich approach to scientific research, it should come as no surprise that SIdoli scooped the Ig Nobel for literature in 1998.
2. Harry Potter = Jesus Christ
Putting an end, once and for all, to the notion that literary theory sometimes lacks real-world application, “Jesus Potter Harry Christ” is a thesis by Ph.D. student Derek Murphy that looks at “the fascinating parallels between two of the world’s most popular literary characters.” What’s more, after successfully exceeding his Kickstarter funding goal of $888, Murphy’s thesis has been transformed into a commercially available book, published in 2011, which won the Next Gen Indie Book Award for Best Religious Non-Fiction that same year. Though the idea of analyzing the similarities between J.K. Rowling’s boy wizard creation and the Son of God might seem like a frivolous endeavor, Murphy – who is currently doing his Ph.D. at Taiwan’s National Cheng Kung University – assures his public that the book’s contents are “academic and heavily researched.” Now, where’s the fun in that?
1. Rectal Foreign Bodies
Published in the journal Surgery in 1986, “Rectal foreign bodies: case reports and a comprehensive review of the world’s literature” does exactly what it says on the tin. The research, by doctors David B. Busch and James R. Starling, based in Madison, Wisconsin, looked at two cases of patients with “apparently self-inserted” anal objects, as well as available documentation on the subject.
Other factors taken into account included the patient’s age and history and the number and type of objects removed. The resulting list of 182 foreign bodies makes for an eye-watering read: of particular note are the dull knife (“patient complained of ‘knife-like pain’”) and the toolbox (“inside a convict; contained saws and other items usable in escape attempts”). The doctors’ paper was recognized for its literary value with an Ig Nobel Prize in 1995. One person’s pain is clearly another’s pleasure.