Paul: Of course.
But then the proper conclusion is "the medications have not yet been shown
to be effective," not "the medications have no treatment effect." There is a
world of difference between the two. Again, there is a fundamental difference
here between an epistemic claim, which refers to our state of knowledge about
the state of nature, and an ontological claim, which refers to the state of
nature itself.
...Scott
Scott O. Lilienfeld, Ph.D.
Department of Psychology, Room 473
Emory University
36 Eagle Row,
Atlanta, Georgia 30322
slil...@emory.edu; 404-727-1125
-----Original Message-----
From: Brandon, Paul K [mailto:paul.bran...@mnsu.edu]
Sent: Tuesday, September 20, 2011 11:51 AM
To: Teaching in the Psychological Sciences (TIPS)
Subject: Re: [tips] CHRONICLE: Are Psychiatric Medications Making Us Sicker?
Scott--
I think that Mike Williams' point is (at least it should be) that we should
assume that a treatment is not effective until it has been proven to be
effective. In the case of psychiatric treatment, this is a high hurdle because
of the difficulty of carrying out a double blind (or even single blind)
experimental design.
On Sep 20, 2011, at 6:20 AM, Lilienfeld, Scott O wrote:
> Mike Williams wrote that "The other medications, including all the
> antidepressants, have no treatment effect." Mike later says, when describing
> the effecs of such medicatiions, that "there is nothing there."
>
> Mike, I had thought your very point was because most studies of
> antidepressants aren't conducted in a strictly double-blind fashion (because
> of medication side effects...although you didn't address active placebo
> studies), we cannot draw clear-cut conclusions from them.
>
> But Mike, you are now saying that we can conclude with confidence that
> antidepressants have no treatment effect. One can't have things both ways -
> if the studies are categorically "invalid" (not merely imperfect) as you
> asserted in previous messages, then one can't draw conclusions from them one
> way or the other. Mike, I don't follow your logic here.
>
> Mike, you also never responded to my points or Jim Clark's questions
> regarding your earlier claims that "all" of the dependent measures in
> antidepressant studies come from either clients or therapists themselves.
> When I pointed out (with references to meta-analyses) that this assertion was
> false, you merely continued to reiterate your previous points without
> acknowledgng our criticisms.
>
> I have to confess that I'm finding this TIPS discussion regarding
> antidepressant and therapeutic efficacy increasingly troubling. It seems to
> be more of a discussion of ideology than science. It also seems to be marked
> by the kind of dichotomous, categorical claims (e.g., studies of therapeutic
> efficacy are "invalid", antidepressants "have no treatment effect," "there is
> nothing there," "ECT is pure behavior therapy," "ECT is a punishment
> condition," "the Beck Depression Inventory..is not a measure of mood") that
> we would rightly criticize in our students.
>
> Again, I am somewhat skeptical of many claims of strong antidepressant
> efficacy myself, so have no particular agenda in this debate. But shouldn't
> we be refraining from drawing extremely strong conclusions from large,
> extreme complex bodies of literature that we all agree are challenging to
> interpret given various methodological limitations?
>
> I also worry that this discussion is mixing up epistemic with
> ontological assertions. It's one thing to say "I think that studies of
> antidepressant medication are inconclusive because of methodological flaws
> (and that many people have overstated the strength of evidence for their
> efficacy)" but another to say "It's clear that antidepressant medications
> don't work." One is an assertion about the evidence for claim X, the other is
> an assertion about the verimissilude of claim X. These are two entirely
> different assertions, and Mike wants to be able to make both of them. I
> don't think he can.
>
> ....Scott
> ________________________________________
> From: Mike Wiliams [jmicha5...@aol.com]
> Sent: Tuesday, September 20, 2011 2:47 AM
> To: Teaching in the Psychological Sciences (TIPS)
> Subject: [tips] CHRONICLE: Are Psychiatric Medications Making Us Sicker?
>
> Reading this article brought back many memories and disillusionment
> with clinical trials. However, I believe there are opportunities to
> study what a placebo is, and how this condition influences our
> dependent measures.
>
> The only psychotropic medications that work are those that sedate
> patients who are anxious, manic, or actively psychotic. They actually
> help people because they chemically suppress the worst symptoms. They
> don't cure people and they are associated with so many adverse side
> effects that no one can take them day in and day out without becoming
> a zombie.
>
> The other medications, including all the antidepressants, have no
> treatment effect. The effects represents the manipulation of the
> patients to endorse positive changes on the dependents measures. As a
> result of the expectation biases I described before, the patients
> endorse change on the measures but their mood stays the same.
> Anyone who describes placebo as a treatment effect is just trying to
> extract something positive from ingesting these chemicals when there
> is nothing there.
>
> The positive change endorsed by the subjects is not a positive change.
> The validity of the depression measures have been compromised by the
> expectation bias. The Beck Depression Scale is now a measure of
> expectation bias and not a measure of mood.
>
> ECT is pure behavior therapy: "Mr. Smith, we understand that you are
> unhappy. We will continue to induce seizures until you feel better."
> After a few seizures, Mr. Smith endorses positive change on the Beck
> Depression Inventory. The psychiatrist stops inducing seizures.
>
> ECT is a punishment condition.
>
> Just to belabor the point: There are no double blinded studies of
> psychotropic meds and any psychotherapy interventions. Given this
> situation, we are currently ruminating about the significance of
> noise.
>
> Mike Williams
>
> Are Psychiatric Medications Making Us Sicker?
> By John Horgan
> Several generations of psychotropic drugs have proven to be of little or no
> benefit, and may be doing considerable harm.
> http://chronicle.com/article/Are-Psychiatric-Medications/128976/
>
>
>
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