Hi James M. Clark Professor of Psychology 204-786-9757 204-774-4134 Fax [email protected]
>>> Mike Wiliams <[email protected]> 14-Sep-11 1:10:07 PM >>> >Outpatients still get dry mouth and constipation. What underlies my criticism is that humans will reason their way through a study and if they are given basic information like side effects, they will infer the presence of treatment or placebo. All the great research guides assume that the subjects are passive agents of the treatment research design. The idea that they would interact with the design causes great problems in our own inferences. I generalize to all studies simply because I cannot think of a way anyone, including myself, can get around the problem. When problems like this exist the very human researchers put their collective heads in the sand and say its not so. We can never be confident that any study of a psychological intervention ever worked. We have to accept that none of these interventions will ever meet an objective standard of empirical support. Constipation trumps all. ******************* Jim - a couple of observations. 1. Mike W. appears to leap from side effects ("constipation") being inevitable and detectable in drug studies to "any study of a psychological intervention" without recognizing that the notion of "side effects" would be irrelevant to many forms of psychological intervention. For such non-drug interventions, it would seem to me that he would have to argue that participants can always distinguish whether they are in the treatment group or the control group, no matter what the form of the control group. But wouldn't some sorts of Control (e.g., talking therapies) be difficult to identify as neutral for all but knowledgeable clients familiar with effective psychotherapies? After all, there are therapists who are convinced that certain ineffectual therapies work, so why wouldn't participants think the same? 2. Looking just at the participant side of things, Mike W.'s model would seem to require a sort of double placebo effect. That is, there is a placebo effect when given an inert pill that has no side effects, but this effect is enhanced when the placebo has side effects noticeable by the patient. This would appear to lead to the prediction that pills with greater side effects will be more effective than those without. Is there any evidence for this position? 3. On the criterion side, not all outcomes are subjective in nature are they? What is known, for example, about suicide rates for people with depression who are treated versus not treated in various ways? And are there not objective criteria for diverse disorders, such as social anxieties or various phobias? I mean the person either approaches and touches a spider or not after treatment, right? And someone with anger management and aggression tendencies either gets into fights or not. ... 4. It is not obvious to me that the problems Mike W. identifies are in fact insurmountable (at least in theory). Could not, for example, a placebo be created that itself produced noticeable side effects, but without the active ingrediant in the treatment drug? Or, is it not possible to determine whether participants, observers, or whoever guessed what condition participants were in and see if this contributed to the outcome measures? The latter approach would apply to both medication and psychological interventions. 5. Science is full of examples of things that people said were impossible to do. And certainly if we were able to inquire of people even a few centuries ago about today's scientific knowledge, I would fully expect them to be astounded and say "that's impossible to know." Suggests to me that history is not supportive of the pessimistic "it can't be done" position Mike W. endorses. Take care Jim --- You are currently subscribed to tips as: [email protected]. To unsubscribe click here: http://fsulist.frostburg.edu/u?id=13090.68da6e6e5325aa33287ff385b70df5d5&n=T&l=tips&o=12664 or send a blank email to leave-12664-13090.68da6e6e5325aa33287ff385b70df...@fsulist.frostburg.edu
