I seem to recall a publication about 20 years ago to this effect; something like 'Listening to Prozac but hearing placebo'.
On Sep 13, 2011, at 1:24 AM, Mike Wiliams wrote: > Hello All. > > When I was a grad student, we were conducting a clinical trial of Imipramine > vs Xanex in the treatment of severe depression. The study was > conducted on an inpatient research unit in the hospital. The patients lived > there and I noticed that they would sit in the day room in > the evenings and discuss their treatment. Although the medications were > assigned randomly and the researchers did not know the assignment, > the patients with dry mouth and constipation knew they were taking the > medications. Those given placebo knew this because they did not suffer > constipation and dry mouth (the anticholinergic side effects). The patients > knew which treatment they were receiving and they communicated > this to the investigators because the investigators constantly monitored the > side effects. The constant monitoring of side effects > unblinds the study. > > This happens in every clinical trial of psychotropic medications. > > This problem is even more obvious in every clinical trial of psychotherapy. > All these studies are invalid. > > I could explain why they are invalidated by referring to the gigantic > literature on expectation biases. > > Since all the dependent measures involve a judgement by the patient or the > investigator that the disorder got better or worse, they are > all influenced by the expectation bias that the treatment worked. I think > many subjects want to help the researchers and they endorse > small positive changes on the dependent measures. The people who get placebo > behave consistent with this because they know they never > got treatment. > > All the investigators have to do is anonymously survey the subjects. The > results will blow their minds. To my knowledge, this obvious, > simple assessment has never been made. > > Now you may be able to understand why the treatment effect size today for > antidepressants is the same as the placebo effect for some > studies in the past - its all noise. > > Mike Williams > > ______________________________________________________ > > Hi Mike: > > This is a very interesting point but I am not sure that I follow > the argument completely. Please expand your argument, dotting > the 'i's and crossing the 't's. > > Ken > > On 9/12/2011 3:00 AM, Mike Wiliams wrote: > >> Clinical Psychology psychotherapy and psychotropic medication >> therapies will never have sufficient empirical support simply >> because the >> subjects are never blind to the treatment condition. > ************************* > All the > >> investigators are doing is training the subjects to endorse >> change on the >> dependent measures. > ************************** > That's why the meta-analyses conclude that > >> any therapy is effective. I have never seen an analysis that >> addressed this research problem. It's similar to the obesity >> researchers who never notice that their entire field is based on >> the dieting behavior of young women. >> >> >> >> Mike Williams >> Drexel University >> >> > --------------------------------------------------------------- > Kenneth M. Steele, ph.d.steel...@appstate.edu > Professor > Department of Psychologyhttp://www.psych.appstate.edu > Appalachian State University > Boone, NC 28608 > USA > > > --- > You are currently subscribed to tips as: paul.bran...@mnsu.edu. > To unsubscribe click here: > http://fsulist.frostburg.edu/u?id=13438.3b5166ef147b143fedd04b1c4a64900b&n=T&l=tips&o=12612 > or send a blank email to > leave-12612-13438.3b5166ef147b143fedd04b1c4a649...@fsulist.frostburg.edu --- You are currently subscribed to tips as: arch...@jab.org. To unsubscribe click here: http://fsulist.frostburg.edu/u?id=13090.68da6e6e5325aa33287ff385b70df5d5&n=T&l=tips&o=12616 or send a blank email to leave-12616-13090.68da6e6e5325aa33287ff385b70df...@fsulist.frostburg.edu
