And further, one might distinguish between simply drawing a conclusion and using it as a guide to action.
On Sep 20, 2011, at 12:02 PM, Lilienfeld, Scott O wrote: > 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 > [email protected]; 404-727-1125 > > > > > -----Original Message----- > From: Brandon, Paul K [mailto:[email protected]] > 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 [[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.d0999cebc8f4ed4eb54d5317367e9b >> 2f&n=T&l=tips&o=12790 or send a blank email to >> leave-12790-13509.d0999cebc8f4ed4eb54d5317367e9b2f@fsulist.frostburg.e >> du >> >> ________________________________ >> >> 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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