On 9/23/11 1:00 AM, Teaching in the Psychological Sciences (TIPS) digest
wrote:
Although it's probably futile to do so, since you have beeen consistently
ignoring all contrary evidence to your claims (e.g. all the people who have
pointed out that many treatment studies include objective observational
measures and manipulation checks),
I have not ignored any of these. There are no objective observational
measures if all the observers know who is being treated. Please name a
measure that is not influenced by expectation. The effect size for
anti-depressant treatments was established using the BDI (self-report)
and the
Hamilton (other report), both measures that can be influenced by the
expectations. My hypothesis is that the treatment effect may simply be
the result of expectations, a factor well-known to influence dependent
measures. How can you ignore this?
I'll point out here that there is a long history of demonstrated placebo
effects on non-self-report measures, including:
heart rhythm
blood pressure
sensorimotor impairment
gastric acid secretion in ulcer patients
ACC, prefrontal, orbitofrontal, and amygdala activation
dopamine levels
immune system functioning
asthma symptoms
bronchitis symptoms
respiratory depression
I'm not sure what the point is here. Are these cited as evidence
placebo is biological, or that there are measures that are not
influenced by
expectation? These are not measures used to measure the outcome of
psychotropic medications. All the measures used to asses the
effects of psychological treatment outcome are self-report or observer
measures.
These are good examples of
dependent measures that are influenced by expectation bias in studies of
medication to treat heart disease, high blood pressure etc.
This manipulation of expectation is the reason placebo conditions were
invented in the first place. I have never seen a study of depression
or any other psychological treatment that included these measures.
I think any reasonable point I made has either been well taken or masked
by these curves. I have to admit that the posing such extreme qualifiers
as "all" and "every" usually generates irritation and disbelief. The
fact is that it is all and every study. I feel like Diogenese in modern
times,
looking for one, true, double-blinded study of psychological treatment.
Mike
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