74 results
Processing of social and monetary rewards in autism spectrum disorders
- Sarah Baumeister, Carolin Moessnang, Nico Bast, Sarah Hohmann, Pascal Aggensteiner, Anna Kaiser, Julian Tillmann, David Goyard, Tony Charman, Sara Ambrosino, Simon Baron-Cohen, Christian Beckmann, Sven Bölte, Thomas Bourgeron, Annika Rausch, Daisy Crawley, Flavio Dell'Acqua, Guillaume Dumas, Sarah Durston, Christine Ecker, Dorothea L. Floris, Vincent Frouin, Hannah Hayward, Rosemary Holt, Mark H. Johnson, Emily J. H. Jones, Meng-Chuan Lai, Michael V. Lombardo, Luke Mason, Bethany Oakley, Marianne Oldehinkel, Antonio M. Persico, Antonia San José Cáceres, Thomas Wolfers, Eva Loth, Declan G. M. Murphy, Jan K. Buitelaar, Heike Tost, Andreas Meyer-Lindenberg, Tobias Banaschewski, Daniel Brandeis, the EU-AIMS LEAP Group
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- Journal:
- The British Journal of Psychiatry / Volume 222 / Issue 3 / March 2023
- Published online by Cambridge University Press:
- 26 January 2023, pp. 100-111
- Print publication:
- March 2023
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Background
Reward processing has been proposed to underpin the atypical social feature of autism spectrum disorder (ASD). However, previous neuroimaging studies have yielded inconsistent results regarding the specificity of atypicalities for social reward processing in ASD.
AimsUtilising a large sample, we aimed to assess reward processing in response to reward type (social, monetary) and reward phase (anticipation, delivery) in ASD.
MethodFunctional magnetic resonance imaging during social and monetary reward anticipation and delivery was performed in 212 individuals with ASD (7.6–30.6 years of age) and 181 typically developing participants (7.6–30.8 years of age).
ResultsAcross social and monetary reward anticipation, whole-brain analyses showed hypoactivation of the right ventral striatum in participants with ASD compared with typically developing participants. Further, region of interest analysis across both reward types yielded ASD-related hypoactivation in both the left and right ventral striatum. Across delivery of social and monetary reward, hyperactivation of the ventral striatum in individuals with ASD did not survive correction for multiple comparisons. Dimensional analyses of autism and attention-deficit hyperactivity disorder (ADHD) scores were not significant. In categorical analyses, post hoc comparisons showed that ASD effects were most pronounced in participants with ASD without co-occurring ADHD.
ConclusionsOur results do not support current theories linking atypical social interaction in ASD to specific alterations in social reward processing. Instead, they point towards a generalised hypoactivity of ventral striatum in ASD during anticipation of both social and monetary rewards. We suggest this indicates attenuated reward seeking in ASD independent of social content and that elevated ADHD symptoms may attenuate altered reward seeking in ASD.
The prescriber’s guide to classic MAO inhibitors (phenelzine, tranylcypromine, isocarboxazid) for treatment-resistant depression
- Vincent Van den Eynde, Wegdan R. Abdelmoemin, Magid M. Abraham, Jay D. Amsterdam, Ian M. Anderson, Chittaranjan Andrade, Glen B. Baker, Aartjan T.F. Beekman, Michael Berk, Tom K. Birkenhäger, Barry B. Blackwell, Pierre Blier, Marc B.J. Blom, Alexander J. Bodkin, Carlo I. Cattaneo, Bezalel Dantz, Jonathan Davidson, Boadie W. Dunlop, Ryan F. Estévez, Shalom S. Feinberg, John P.M. Finberg, Laura J. Fochtmann, David Gotlib, Andrew Holt, Thomas R. Insel, Jens K. Larsen, Rajnish Mago, David B. Menkes, Jonathan M. Meyer, David J. Nutt, Gordon Parker, Mark D. Rego, Elliott Richelson, Henricus G. Ruhé, Jerónimo Sáiz-Ruiz, Stephen M. Stahl, Thomas Steele, Michael E. Thase, Sven Ulrich, Anton J.L.M. van Balkom, Eduard Vieta, Ian Whyte, Allan H. Young, Peter K. Gillman
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- Journal:
- CNS Spectrums / Volume 28 / Issue 4 / August 2023
- Published online by Cambridge University Press:
- 15 July 2022, pp. 427-440
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This article is a clinical guide which discusses the “state-of-the-art” usage of the classic monoamine oxidase inhibitor (MAOI) antidepressants (phenelzine, tranylcypromine, and isocarboxazid) in modern psychiatric practice. The guide is for all clinicians, including those who may not be experienced MAOI prescribers. It discusses indications, drug-drug interactions, side-effect management, and the safety of various augmentation strategies. There is a clear and broad consensus (more than 70 international expert endorsers), based on 6 decades of experience, for the recommendations herein exposited. They are based on empirical evidence and expert opinion—this guide is presented as a new specialist-consensus standard. The guide provides practical clinical advice, and is the basis for the rational use of these drugs, particularly because it improves and updates knowledge, and corrects the various misconceptions that have hitherto been prominent in the literature, partly due to insufficient knowledge of pharmacology. The guide suggests that MAOIs should always be considered in cases of treatment-resistant depression (including those melancholic in nature), and prior to electroconvulsive therapy—while taking into account of patient preference. In selected cases, they may be considered earlier in the treatment algorithm than has previously been customary, and should not be regarded as drugs of last resort; they may prove decisively effective when many other treatments have failed. The guide clarifies key points on the concomitant use of incorrectly proscribed drugs such as methylphenidate and some tricyclic antidepressants. It also illustrates the straightforward “bridging” methods that may be used to transition simply and safely from other antidepressants to MAOIs.
14 - Wonderwerk Cave, Northern Cape Province: An Early–Middle Pleistocene Paleoenvironmental Sequence for the Interior of South Africa
- from Part II - Southern Africa
- Edited by Sally C. Reynolds, Bournemouth University, René Bobe, University of Oxford
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- African Paleoecology and Human Evolution
- Published online:
- 19 May 2022
- Print publication:
- 09 June 2022, pp 142-160
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Summary
Localities in the interior of South Africa, such as Taung and Vaal River sites, were intensively researched after hominins were discovered (Péringuey, 1911; Dart, 1925a; Goodwin, 1928), but then neglected for the fossil-rich, dolomitic breccia sites in Gauteng Province (e.g., Cooke, 1963, 1967; Vrba, 1976; Brain, 1981, Brain and Sillen, 1988; Bamford, 1999; Pickering and Kramers, 2010; Herries and Shaw, 2011; Reynolds et al., 2011; Lee-Thorp and Sponheimer, 2013). Recently, knowledge of the interior region has increased, following excavations at Florisbad (Brink, 1988; Kuman et al., 1999; Toffolo et al., 2015), Taung, including Equus Cave (Scott, 1987; Klein et al., 1991; McKee and Tobias, 1994; Lee-Thorp and Beaumont, 1995; Johnson et al., 1997; Hopley et al., 2013; McKee, 2016), Canteen Kopje (Beaumont, 1990, 2004; McNabb and Beaumont, 2011; Smith et al., 2012; Lotter et al., 2016), Pniel (Beaumont, 1990; Kunneriath and Gaillard, 2010; Hutson, 2018), Erfkroon (Churchill et al., 2000a; Brink et al., 2015a), Bundu Farm (Kiberd, 2006; Hutson, 2018), Cornelia (Brink et al., 2012; Toffolo et al., 2019) and the Kathu Complex (Porat et al., 2010; Wilkins and Chazan, 2012; Wilkins et al., 2012; Walker et al., 2014; Lukich et al., 2019, 2020).
2229 A community-academic translational research and learning collaborative to evaluate the associations among biological, social, and nutritional status for adolescent women and their babies using electronic health records (EHR) data
- Jonathan Tobin, Amanda Cheng, Caroline S. Jiang, Mireille McLean, Peter R. Holt, Dena Moftah, Rhonda G. Kost, Kimberly S. Vasquez, Daryl L. Wieland, Peter S. Bernstein, Siobhan Dolan, Mayer Sagy, Abbe Kirsch, Michael Zinaman, Elizabeth DuBois, Barry Kohn, William Pagano, Gilles Bergeron, Megan Bourassa, Stephanie Morgan, Judd Anderman, Shwu H. Kwek, Julie Wilcox, Jan L. Breslow
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- Journal:
- Journal of Clinical and Translational Science / Volume 2 / Issue S1 / June 2018
- Published online by Cambridge University Press:
- 21 November 2018, pp. 77-78
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OBJECTIVES/SPECIFIC AIMS: To build a multisite de-identified database of female adolescents, aged 12–21 years (January 2011–December 2012), and their subsequent offspring through 24 months of age from electronic health records (EHRs) provided by participating Community Health. METHODS/STUDY POPULATION: We created a community-academic partnership that included New York City Community Health Centers (n=4) and Hospitals (n=4), The Rockefeller University, The Sackler Institute for Nutrition Science and Clinical Directors Network (CDN). We used the Community-Engaged Research Navigation model to establish a multisite de-identified database extracted from EHRs of female adolescents aged 12–21 years (January 2011–December 2012) and their offspring through 24 months of age. These patients received their primary care between 2011 and 2015. Clinical data were used to explore possible associations among specific measures. We focused on the preconception, prenatal, postnatal periods, including pediatric visits up to 24 months of age. RESULTS/ANTICIPATED RESULTS: The analysis included all female adolescents (n=122,556) and a subset of pregnant adolescents with offspring data available (n=2917). Patients were mostly from the Bronx; 43% of all adolescent females were overweight (22%) or obese (21%) and showed higher systolic and diastolic blood pressure, blood glucose levels, hemoglobin A1c, total cholesterol, and triglycerides levels compared with normal-weight adolescent females (p<0.05). This analysis was also performed looking at the nonpregnant females and the pregnant females separately. Overall, the pregnant females were older (mean age=18.3) compared with the nonpregnant females (mean age=16.5), there was a higher percentage of Hispanics among the pregnant females (58%) compared with the nonpregnant females (43.9%). There was a statistically significant association between the BMI status of mothers and infants’ birth weight, with underweight/normal-weight mothers having more low birth weight (LBW) babies and overweight/obese mothers having more large babies. The odds of having a LBW baby was 0.61 (95% CI: 0.41, 0.89) lower in obese compared with normal-weight adolescent mothers. The risk of having a preterm birth before 37 weeks was found to be neutral in obese compared with normal-weight adolescent mothers (OR=0.81, 95% CI: 0.53, 1.25). Preliminary associations are similar to those reported in the published literature. DISCUSSION/SIGNIFICANCE OF IMPACT: This EHR database uses available measures from routine clinical care as a “rapid assay” to explore potential associations, and may be more useful to detect the presence and direction of associations than the magnitude of effects. This partnership has engaged community clinicians, laboratory, and clinical investigators, and funders in study design and analysis, as demonstrated by the collaborative development and testing of hypotheses relevant to service delivery. Furthermore, this research and learning collaborative is examining strategies to enhance clinical workflow and data quality as well as underlying biological mechanisms. The feasibility of scaling-up these methods facilitates studying similar populations in different Health Systems, advancing point-of-care studies of natural history and comparative effectiveness research to identify service gaps, evaluate effective interventions, and enhance clinical and data quality improvement.
Structured lifestyle education for people with schizophrenia, schizoaffective disorder and first-episode psychosis (STEPWISE): randomised controlled trial
- Richard I. G. Holt, Rebecca Gossage-Worrall, Daniel Hind, Michael J. Bradburn, Paul McCrone, Tiyi Morris, Charlotte Edwardson, Katharine Barnard, Marian E. Carey, Melanie J. Davies, Chris M. Dickens, Yvonne Doherty, Angela Etherington, Paul French, Fiona Gaughran, Kathryn E. Greenwood, Sridevi Kalidindi, Kamlesh Khunti, Richard Laugharne, John Pendlebury, Shanaya Rathod, David Saxon, David Shiers, Najma Siddiqi, Elizabeth A. Swaby, Glenn Waller, Stephen Wright
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- Journal:
- The British Journal of Psychiatry / Volume 214 / Issue 2 / February 2019
- Published online by Cambridge University Press:
- 25 September 2018, pp. 63-73
- Print publication:
- February 2019
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Background
Obesity is a major challenge for people with schizophrenia.
AimsWe assessed whether STEPWISE, a theory-based, group structured lifestyle education programme could support weight reduction in people with schizophrenia.
MethodIn this randomised controlled trial (study registration: ISRCTN19447796), we recruited adults with schizophrenia, schizoaffective disorder or first-episode psychosis from ten mental health organisations in England. Participants were randomly allocated to the STEPWISE intervention or treatment as usual. The 12-month intervention comprised four 2.5 h weekly group sessions, followed by 2-weekly maintenance contact and group sessions at 4, 7 and 10 months. The primary outcome was weight change after 12 months. Key secondary outcomes included diet, physical activity, biomedical measures and patient-related outcome measures. Cost-effectiveness was assessed and a mixed-methods process evaluation was included.
ResultsBetween 10 March 2015 and 31 March 2016, we recruited 414 people (intervention 208, usual care 206) with 341 (84.4%) participants completing the trial. At 12 months, weight reduction did not differ between groups (mean difference 0.0 kg, 95% CI −1.6 to 1.7, P = 0.963); physical activity, dietary intake and biochemical measures were unchanged. STEPWISE was well-received by participants and facilitators. The healthcare perspective incremental cost-effectiveness ratio was £246 921 per quality-adjusted life-year gained.
ConclusionsParticipants were successfully recruited and retained, indicating a strong interest in weight interventions; however, the STEPWISE intervention was neither clinically nor cost-effective. Further research is needed to determine how to manage overweight and obesity in people with schizophrenia.
Declaration of interestR.I.G.H. received fees for lecturing, consultancy work and attendance at conferences from the following: Boehringer Ingelheim, Eli Lilly, Janssen, Lundbeck, Novo Nordisk, Novartis, Otsuka, Sanofi, Sunovion, Takeda, MSD. M.J.D. reports personal fees from Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, AstraZeneca, Janssen, Servier, Mitsubishi Tanabe Pharma Corporation, Takeda Pharmaceuticals International Inc.; and, grants from Novo Nordisk, Sanofi-Aventis, Lilly, Boehringer Ingelheim, Janssen. K.K. has received fees for consultancy and speaker for Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Servier and Merck Sharp & Dohme. He has received grants in support of investigator and investigator-initiated trials from Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Pfizer, Boehringer Ingelheim and Merck Sharp & Dohme. K.K. has received funds for research, honoraria for speaking at meetings and has served on advisory boards for Lilly, Sanofi-Aventis, Merck Sharp & Dohme and Novo Nordisk. D.Sh. is expert advisor to the NICE Centre for guidelines; board member of the National Collaborating Centre for Mental Health (NCCMH); clinical advisor (paid consultancy basis) to National Clinical Audit of Psychosis (NCAP); views are personal and not those of NICE, NCCMH or NCAP. J.P. received personal fees for involvement in the study from a National Institute for Health Research (NIHR) grant. M.E.C. and Y.D. report grants from NIHR Health Technology Assessment, during the conduct of the study; and The Leicester Diabetes Centre, an organisation (employer) jointly hosted by an NHS Hospital Trust and the University of Leicester and who is holder (through the University of Leicester) of the copyright of the STEPWISE programme and of the DESMOND suite of programmes, training and intervention fidelity framework that were used in this study. S.R. has received honorarium from Lundbeck for lecturing. F.G. reports personal fees from Otsuka and Lundbeck, personal fees and non-financial support from Sunovion, outside the submitted work; and has a family member with professional links to Lilly and GSK, including shares. F.G. is in part funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research & Care Funding scheme, by the Maudsley Charity and by the Stanley Medical Research Institute and is supported by the by the Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London.
2 - Relative and Other Values
- from Part One 1957-1997
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- Liverpool University Press
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- 27 November 2019
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- 17 August 2018, pp 14-31
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Summary
In Relatively Speaking (1965) there is a moment of sublime confusion which typifies the play and points to the thematic base beneath its glittering surface. Unfaithful husband Phillip thinks that Greg is his wife's lover and that he wants to marry her. But Greg is really the new boyfriend of Phillip's own exmistress, who announces that she has had a proposal of marriage. Phillip says ‘Infectious this marriage epidemic. I seem to be the only one who's developed immunity'.
We are at once given a snapshot of the entire play and of the agenda which was to form the basis of the Ayckbourn canon. The relationships between men and women and the particular strains which the process and state of marriage inflict are the subject matter of the plays. Whatever the unfortunate Phillip thinks he is immune to, he is inevitably to be confounded. In Ayckbourn's plays, no one is immune to marriage or at least to the pursuit of the conjoining of man and woman. To imagine that you can be safe is foolish; individuals married or single are open to ambush by predatory individuals in pursuit of marital bliss or desperate to escape its clutches.
We do, however, encounter unmarried couples in this comic world who have just met and are in the initial throes of love or lust. In Relatively Speaking we first meet Greg and Ginny together in her Chelsea flat. They are clearly lovers and he has asked her to marry him; innocent young love preparing for a happy future. But lurking, quite literally, under the bed is the worm in this love apple.
Greg finds a pair of slippers there, not his own, and not, despite Ginny's feeble suggestion, the property of the pet dog. The poor young man is too besotted to tumble to the notion that they might have been left behind by another lover, and that this might explain the innumerable bunches of flowers in the bathroom. Indeed, he is so infatuated, he believes her story that she is setting out to visit her parents, and decides to follow her. But he will not only arrive at Ginny's parents home to ask for her hand in marriage; he will fall into one of Ayckbourn's suburban traps. Ginny's real errand is to break off from her previous sexual partner, Phillip, an older married man, and demand the return of incriminating letters.
Part One 1957-1997
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- 27 November 2019
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5 - Sir Alan Ayckbourn
- from Part One 1957-1997
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- 27 November 2019
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- 17 August 2018, pp 61-66
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Summary
When the first edition of this book was written, it seemed necessary to justify Sir Alan Ayckbourn's status as a serious comic writer. Time has eliminated that necessity. His output is enormous and varied. At the time of writing this, he is directing the 78th play that he has written. Of course this imposes on his critic the responsibility of deciding how much of this to write about. Not all the plays are great works but it is not possible to include many fine ones in a small volume like this. In some ways deciding which plays merit inclusion is the hardest responsibility. Ayckbourn has constantly switched between his experimental work and the well-crafted pieces that he regularly returns to. Certain plays are interesting in spite of being flawed. They are either thematically or structurally noteworthy or they mark a point of development. But this means not being able to discuss, in any detail, works which many playwrights would envy: Time and Time Again, Absent Friends, Seasons Greetings, Body Language, Communicating Doors, Heroes Welcome, Neighbourhood Watch and Haunting Julia to name just a handful. However, before examining the genesis of Sir Alan Ayckbourn's talent and his influence on other dramatists, one play begs to be looked at, however briefly. Its title should attract us. Could Comic Potential (1998) provide some insights into the craft of writing comedy?
After all, the plot involves an apprentice playwright seeking advice from a past master, an embittered, veteran comedy writer. Although an experienced craftsman, the old man is now reduced to directing androids in hastily produced soap operas. When one of these robots is spotted laughing at some mistake in the production, we are once again set to follow a machine as it wrestles with becoming human. But the important idea in this situation is the implied definition of what it takes to be human. A sense of humour is particular to us; no animal has one. Comedy, asserts Ayckbourn, is core to our being. He also recognizes that, throughout history, it has often been seen as a dangerous, subversive thing. When the robot becomes good at doing comic business, the owner of the television company says,'Melt her down__She's unstable, next time she could kill someone'.
Dedication
- Michael Holt, University of Manchester
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3 - Technical Directions
- from Part One 1957-1997
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- Liverpool University Press
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- 27 November 2019
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- 17 August 2018, pp 32-46
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Summary
By Season's Greetings (1980), Alan Ayckbourn had a proven track record of West End success and an international reputation as a comic playwright. This and the plays that followed show a total command of technical and comedic resources. This chapter will survey some of them to analyse and demonstrate his craftsmanship.
Ayckbourn was by now regarded as capable of making a popular audience laugh whilst exploring his subjects with a kindly objectivity that could cast a dark shadow over the laughter. He was frequently compared to Neil Simon, the equally successful American comic dramatist. But it has often been pointed out that, though they are both theatrical craftsmen of great skill, they work in quite different ways.
Simon is the master of the one-liner joke; Ayckbourn tries to edit out such jokes. Laughter in the English writer's plays comes from what characters do because of who they are and because they are at the mercy of each other, and of circumstance. They cannot construct careful barbed verbal responses for selfprotection as Neil Simon's characters can. Simon's background is as a scriptwriter primarily focused on words; Ayckbourn's is as a director, and he relishes working with visual action and actors.
Alan Ayckbourn has always insisted that he is as much a theatre director as he is a playwright. He has been artistic director of the Stephen Joseph Theatre in Scarborough since 1970, with responsibility for directing the majority of plays mounted in any one season and for writing at least one play a year which will keep the organization solvent. It is this dual role that informs his plays and strengthens them technically. It has given him the opportunity to experiment to a quite remarkable degree. The plays written for the company question the Aristotelian unities of time and place with a mounting disregard for precedent. They become increasingly fluid in both location and time, shifting within both, and challenging the authority of the playwright to dictate narrative structure.
Ayckbourn is given less than due credit for these experiments for two reasons: subject matter and milieu remain largely within a particular set of parameters, and they are underpinned by a secure dramatic technique which arises out of his directing experience and consequently never undermines the actor.
Part Two 1998-2016
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- Liverpool University Press
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- 27 November 2019
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- 17 August 2018, pp 67-68
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4 - Facing Evil
- from Part One 1957-1997
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- Liverpool University Press
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- 27 November 2019
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- 17 August 2018, pp 47-60
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Summary
'Oh my god, we're going under Armageddon Bridge.'
'It's OK, we'll be OK.'
These lines from Way Upstream (1981) point to a change of direction for Ayckbourn. The play describes the holiday cruise of a collection of friends who have hired a boat ‘because', says Ayckbourn, ‘a vast proportion of Britons are stupid enough to believe they come from a seafaring race’ and surprisingly often ‘go out on the Broads and ram each other'. We shall start at Pendon, the location for most of Ayckbourn's plays. This is his universal middle England; somewhere lying perhaps in Berkshire, a ‘non-town', its chance of an individual personality swamped by too close a proximity to London but affording a prosperous middle-class comfort for most of its residents. It is his natural dramatic milieu, the ideal place to bring the lives and loves of theatre's middle-class audiences under the microscope. But we are warned clearly enough in the scene list that this play involves no ordinary location. The action is set on the River Orb, aboard the cabin cruiser Hadforth Bounty. We shall journey into Gessing Lock, pass through Stumble Lock, before ducking under Armageddon Bridge and emerging with an optimistic sense of freedom at the head of the river.
The voyage from realism to allegory was a daring departure for the playwright who had by 1981 established his credentials as a keen observer of the battlefields of marriage and small-town morality. But Way Upstream suffered at the hands of critics at the time of production, who generally saw it as technically overdemanding and morally ambivalent. Perhaps the most damaging of remarks came from a loyal and acute observer of the Scarborough output, Robin Thornber. Writing in his Guardian review, he observed that ‘philosophically, it's a plug for the soggy centrism of the Social Democratic Party'. It was a recognition that Ayckbourn had moved into new territory, that his purpose was larger than mere observation of domestic frailty. But, though at the time Thornber's remark linking this foray to political movements seemed apt and relevant, it was essentially a misunderstanding of the intent behind the allegory.
7 - Space Stories
- from Part Two 1998-2016
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- Liverpool University Press
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- 27 November 2019
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- 17 August 2018, pp 72-78
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The stages that Ayckbourn has worked on have had a profound effect on the plays that he has written. The first theatre was a temporary structure in a large high-ceilinged room above a library. Seating was in tiered blocks against three of the walls and another smaller block of seats was sandwiched between the doors on the fourth. The stage was square with access to the acting area available only through the room's two doors, both located on the same side of the square.
This meant that action across the stage was inhibited. Entering by one door and exiting by the only other tends to keep the actor hugging the edge of the area. Actors would feel much more comfortable heading for the central acting space, and playing there. The result is that the early Ayckbourn plays are plays of arrival and departure. They are set in domestic environments with simple entrances and exits. This gives them a stability of action. The characters interact with each other in what is frequently a domestic interior with escape only into the offstage hall or kitchen. This limitation served the young Alan Ayckbourn well. So many of his earliest plays are driven by the claustrophobia of the sitting room or small garden. Once a character enters into the social area, they have to cope as best they can no matter what trap is sprung there. This is the dramatic imperative of plays such as Relatively Speaking, Absent Friends, and The Norman Conquests. Absurd Person Singular has a different trap in each act with the Christmas social gathering capturing the guests every year. Of course Ayckbourn is inventive enough to disguise the limitations with plays such as Bedroom Farce. He divides the stage into three bedrooms but there is still the implied imprisoning of the protagonists in each area by social obligation. With the limited opportunity to exit, a wild cannon such as Trevor in Bedroom Farce or Norman in The Norman Conquests can impose dreadful obligations when, having arrived, they have no imperative to leave. In plays written for the Library Theatre you enter into the space and you depart. There is almost no opportunity to pass through.
Alan Ayckbourn
- Michael Holt
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- Liverpool University Press
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- 27 November 2019
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Alan Ayckbourn is, after Shakespeare, Britain's most performed playwright and acknowledged as one of its most skilful directors. In 50 years he has written more than seventy plays and directed three times that number emerging as a formidable dramatist of international renown. Dismissed at first as a "mere boulevadier", he is now seen as an outstanding modern comic playwright, exploring themes of social and political importance with a bleak eye and a capacity to construct comedy out of the experience of the middle class audience. This book explores the range of his work which covers light comedy, farce, theatrical cartoon, musicals and plays for children. It defines the early influences and the developing themes, concentrating on Ayckbourn's technical skills and his challenges to Aristotelian unities. It traces the playwright's journey from observer of middle class dilemmas through moral and ethical commentator, and on to his concentration on fantasist behaviour and the nature of long term relationships. The comic eye which lies at the heart of this work is explored as a product of both dramatic technique and theatrical experiment.
8 - Selling Out
- from Part Two 1998-2016
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- Liverpool University Press
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- 27 November 2019
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- 17 August 2018, pp 79-88
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Summary
In 1973 Ayckbourn wrote his first trilogy of plays, The Norman Conquests. It was to be a further twenty-eight years before he wrote another when in 2001 he produced Damsels in Distress. Staging three plays on one set, with a company of seven players sharing all the roles, must have suited his requirements as an Artistic Director with budgetary limitations. It is the sort of imposed limitation that inspires this playwright. As we shall see, this combination of elements was to prove problematic when the plays transferred to the West End in 2002. Alan Ayckbourn had not planned a trilogy.
I started working on two linked plays in October of last year [2000], but a few days before Christmas, I realised that one of them was horribly wrong. Then I realised that the other just wasn't worth doing at all, and ditched them both.… I thought: ‘Wow, You're not secure in this process even now.’ But my maturity meant I could bin both original plays. I remember pressing the delete key on my computer and thinking: ‘Now what have I done?'
The two pieces he then wrote, GamePlan and FlatSpin, were announced under the generic title Damsels in Distress. However, during rehearsals, the writer declared that he had another play in mind, RolePlay. So the two plays developed into a trilogy. With the title of the last one Ayckbourn summarized their shared theme. The Damsels in Distress plays have plots led by a female protagonist put under pressure by adopting a false persona. It has always been his ambition to write a good comedy thriller. Snake in the Grass (2002), Communicating Doors (1994), are two obvious attempts. In the pre-publicity for Damsels in Distress, Ayckbourn talked of his admiration for screen thrillers and his desire to explore the genre.
Most of my stuff, if you read the synopses, sounds very dark. I always say to the press office: ‘Do stress the jolly side - because I wouldn't want to watch a woman having a nervous breakdown for an entire evening.’ But look at the plot of Some Like it Hot: ‘Two musicians witness a vicious mob-killing in a garage and go on the run.’ It sounds incredibly sombre - but what the threat does, of course, is set up the comedy. The humour is born out of the thrill.
6 - Theatres, Producers and the Unexpected
- from Part Two 1998-2016
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- Liverpool University Press
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- 27 November 2019
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- 17 August 2018, pp 69-71
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Summary
By the millennium, Alan Ayckbourn had written fifty-six plays and was at the height of his creativity. It had taken many years for his work to be seen as an important contribution to the canon of English drama. The early dismissing of him as being a mere ‘boulevardier', a writer of popular but trivial comedies, had all but disappeared. His reputation was now one of an accessible dramatist with steel-edged observation and an eye on the social Zeitgeist. His plays were lauded for their dramatic skill, funny set pieces, structural innovation and above all, for their bleak undertones. Of course any dramatist with this artistic longevity will go in and out of fashion. Some plays were greeted more enthusiastically than others. A few were dismissed.
He seemed unstoppable, writing at least one play a year and in some years even more. They were eagerly anticipated by West End management and even more keenly by small to medium scale regional theatres. Audiences for dark comedy clearly trusted this playwright. A new Ayckbourn play was a guaranteed income booster, a quality only surpassed in many cases by the theatre's yearly pantomime production. The restructuring of the school curriculum had led to the demise of the other box office guarantee - the annual Shakespeare production. The Ayckbourn play with its small cast and manageable technical requirements became even more important to the regions.
His continued development from 1968 to the year 2000 and beyond was sustained by a number of factors. He was fortunate in his venues, his management and in his allies. Throughout his career these elements developed and altered. After 2000 some were to change dramatically. They are worth identifying because they influenced his output in surprising ways.
Since 1971 Alan Ayckbourn had been artistic director of the Scarborough Theatre-in-the-Round. To a great extent he had control over the programming of the theatre's output, contributing both as a playwright, and as director of his own and other new work. As a small regional venue, the Stephen Joseph Theatre was subject to the same economic constraints as elsewhere and the necessity to provide a new play each year for the company fed Ayckbourn's insatiable artistic drive.
Select Bibliography
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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9 - Changes
- from Part Two 1998-2016
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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Alan Ayckbourn saw the Damsels in Distress productions as a unity. The plays, together with their Scarborough acting company, transferred to London's West End, receiving critical acclaim. But the London management found it difficult to promote the package. Audiences, they thought, were confused by the performance schedule. Some plays, they said, were not as well liked as others and the lack of star names didn't help. They took the decision to reduce the three plays to a single one, without consulting the playwright. It was an unacceptable decision for him and caused a rift with his long time London producer, Michael Codron. This was an event with profound consequences. Ayckbourn had been providing hit comedies at the rate of one a year for twenty-seven years - most of them produced by Codron. It was an arrangement both partners found comfortable and beneficial. It had been very significant for both. The important thing to note is the effect this had on Ayckbourn's writing. After the death of his agent, Margaret Ramsay in 1991, and the loss of his producer, Ayckbourn was now without two important artistic guides. It could have been disastrous. But, arguably, the rupture caused by Damsels in Distress had a beneficial effect. It changed the nature of Alan Ayckbourn's plays. He no longer played the role of darling of the West End theatre and, freed from that obligation, found a new direction. He decided to concentrate his work at Scarborough and in future, without first seeking a West End showcase, his own company would undertake national tours.
From this time he tackles different themes, moving away from the pursuit of marital bliss as a subject and into other areas. From 2002 the plays sometimes end at surprising points; they use multiple protagonists; they play more daringly with genre in a search for the perfect mix of comedy and tragedy. There are of course some complete disasters, some retreats into comfortable territory and some plays that are only partially successful. But at their best they are more mature and intellectually daring than the early successes.
There are some real surprises. Snake in the Grass (2002) had a cast of three women. Ayckbourn explains:
On the one level it can be taken as a piece of ‘spook theatre'. But underneath it's actually a story about abuse in childhood.
1 - Not Alan Ayckbourn
- from Part One 1957-1997
- Michael Holt, University of Manchester
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In Anger and After (1962), John Russell Taylor describes Alan Ayckbourn as ‘a twenty three year old actor… whose play Standing Room Only showed more than promise, if less than complete achievement'. It might seem surprising that Alan Ayckbourn should be included in a survey of British play writing from 1956 to 1962, the period when English theatre discovered the kitchen sink and reinvigorated itself. In fact, this was his fourth professionally produced play, and was to be shortly followed by two others mounted in London's West End. Russell Taylor's influential book was a much admired critical survey but, even in its second edition in 1969, the judgement on Ayckbourn was unchanged - ‘a less than complete achievement - the same might be said of his later West End comedy success Relatively Speaking'.
Ayckbourn is rarely linked with the generation of playwrights that included Osborne, Wesker, Arden, Pinter and Delaney. But he started writing in 1959 at the time when the new wave of writers was just emerging and, indeed, many of them shared Margaret Ramsey as literary agent. Ayckbourn was alarmed at a party to see several of his fellow young literary bloods wearing badges saying ‘I am not Alan Ayckbourn'. Clearly this young playwright was already deemed an outsider and for much of his career he suffered from a critical prejudice that it took many plays written over many years to shake.
It is easy to see why he was dismissed so early on. The cultural revolution that followed Look Back in Anger pursued its own theatrical orthodoxy. The old theatre establishment - its playwrights and actors, its subject matter and audience, its commercial and management structure - was viewed with great suspicion. Alan Ayckbourn did not fit easily into the new order. Neither he nor his characters had an overtly political agenda. His plays were not set in a working-class environment; indeed, they clearly described middle-class settings and preoccupations. Most suspicious of all, he apparently aspired to writing ‘well made’ plays and was promising to have great commercial potential. Resolutely sticking to comedy as his chosen genre, he quickly found star actors and managements eager to snap up his plays. It seems all too obvious that, in the cultural climate of the 1960s, he would be labelled as the inheritor of the lightweight boulevardier mantle recently worn by Terence Rattigan, Peter Ustinov and Enid Bagnold.
10 - A Short Intermission
- from Part Two 1998-2016
- Michael Holt, University of Manchester
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- Alan Ayckbourn
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- 27 November 2019
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By 2005 Sir Alan Ayckbourn was enjoying renewed national and international acclaim. In the preceding two years, he had written and directed ten plays, including premieres of his work in Scarborough and New York. He had simultaneously been fulfilling the duties of artistic director at the Stephen Joseph Theatre. He was writing within his preferred genre of comedy, tempering it with an ever deepening well of tragedy. This had always been his aim, but now there was a sense of not being constrained by either genre. Every play could go where it needed. The complexity of his last three major plays, Sugar- daddies, Drowning on Dry Land and Private Fears in Public Places, demonstrated that he was on course and promised yet greater work.
In February 2005 Sir Alan Ayckbourn suffered a major stroke. It was a quite catastrophic blow, shocking the theatre world. But he took up the challenge. His driving artistic energy was channelled into his recovery. After a seven-week period in hospital and some further time undergoing treatment, he was holding meetings with theatre staff at his home, determined not to be defeated. It was undoubtedly a hard struggle, but with some unexpected rewards. Perhaps the most perceptive observation on the period of illness came from Alan Strachan, director and friend ‘confinement to a hospital bed brought unfamiliar thoughts and sensations. An observer of others all his life, he could now only observe himself.’ Ayckbourn has been eloquent on the consequences of the stroke and the recovery period too. In particular, he has spoken on numerous occasions of the debt he owed his wife, Heather Stoney, during the convalescent process. She had always acted as his secretary and assistant, but was now seen by her husband with renewed gratitude and affection.
This period of self-assessment changed his output. Some of the plays, post 2006, are more reflective, and focus on the importance of memories. Ayckbourn's work begins to contain themes of reconciliation with loved ones as he discusses love's transient and changing nature. Plays assert the necessity of emotional self-examination and explore the frailty of the happy ending. And they look, too, at romance in the digital world as it changes around us. Some of these ideas had been explored previously but the later plays are the result of the playwright's own brush with mortality.