Paul Brandon writes: >I seem to recall a publication about 20 years >ago to this effect; something like 'Listening >to Prozac but hearing placebo'.
To which there was a critical response "Listening to Meta-Analysis but Hearing Bias" that is worth a close reading: file:///C:/Users/dell/Documents/C%20Files/MISC%20PSYCHIATRY/Drugs%20and%2 0psychiatry/KleinListening%20to%20Meta-Analysis%20But%20Hearing%20Bias.ht m Allen Esterson Former lecturer, Science Department Southwark College, London allenester...@compuserve.com http://www.esterson.org ----------------------------------------------------- From: Brandon, Paul K <paul.bran...@mnsu.edu> Subject: Re: Clinical training: Boulder and Denver Date: Tue, 13 Sep 2011 13:37:14 +0000 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: arch...@jab.org. To unsubscribe click here: http://fsulist.frostburg.edu/u?id=13090.68da6e6e5325aa33287ff385b70df5d5&n=T&l=tips&o=12637 or send a blank email to leave-12637-13090.68da6e6e5325aa33287ff385b70df...@fsulist.frostburg.edu
