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 [[email protected]] > 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/ > > > > --- > You are currently subscribed to tips as: [email protected]. > To unsubscribe click here: > http://fsulist.frostburg.edu/u?id=13509.d0999cebc8f4ed4eb54d5317367e9b2f&n=T&l=tips&o=12790 > or send a blank email to > leave-12790-13509.d0999cebc8f4ed4eb54d5317367e9...@fsulist.frostburg.edu > > ________________________________ > > This e-mail message (including any attachments) is for the sole use of > the intended recipient(s) and may contain confidential and privileged > information. 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