Meta-analysis of psychological interventions for chronic low back pain.

The purpose of this meta-analysis of randomized controlled trials was to evaluate the efficacy of psychological interventions for adults with noncancerous chronic low back pain (CLBP). The authors updated and expanded upon prior meta-analyses by using broad definitions of CLBP and psychological intervention, a broad data search strategy, and state-of-the-art data analysis techniques. All relevant controlled clinical trials meeting the inclusion criteria were identified primarily through a computer-aided literature search. Two independent reviewers screened abstracts and articles for inclusion criteria and extracted relevant data. Cohen's d effect sizes were calculated by using a random effects model. Outcomes included pain intensity, emotional functioning, physical functioning (pain interference or pain-specific disability, health-related quality of life), participant ratings of global improvement, health care utilization, health care provider visits, pain medications, and employment/disability compensation status. A total of 205 effect sizes from 22 studies were pooled in 34 analyses. Positive effects of psychological interventions, contrasted with various control groups, were noted for pain intensity, pain-related interference, health-related quality of life, and depression. Cognitive-behavioral and self-regulatory treatments were specifically found to be efficacious. Multidisciplinary approaches that included a psychological component, when compared with active control conditions, were also noted to have positive short-term effects on pain interference and positive long-term effects on return to work. The results demonstrated positive effects of psychological interventions for CLBP. The rigor of the methods used, as well as the results that reflect mild to moderate heterogeneity and minimal publication bias, suggest confidence in the conclusions of this review.     

Suicide and Homicide Rates in Canada and the United States

Suicide and homicide rates by age were analyzed for Canada and the United States, indicating that suicide is higher in Canada and that homicide is higher in the United States. Results indicated a positive association between homicide and suicide rates in the United States but these two rates of death were not significantly associated in Canada. Holinger (1987) had associated the relative size of the cohort to the rates of suicide and homicide in young people in the United States. The more current data in both countries did not support Holinger's results. Using the measure devised by Easterlin (1980) and Ahlburg and Schapiro (1984) –that is, the proportion of youths aged 15–24 relative to adults aged 25–64–the correlation between the size of the youth cohort and the suicide rate of youths aged 15–24 was negative. It is concluded that the two patterns in these two countries may be explained from a historical perspective.     

The decision to check in multialternative choices and limited sensitivity to default

Given the rapid proliferation of smartphone applications and data aggregation websites, in many situations people can use decision aids to guide their choices. For example, they may consider whether to use a navigation device to check the fastest route or whether to use a price comparison website to find the cheapest deal. In what circumstances will subjects use a costly comparison decision aid (which I refer to as “checking”) to choose for them? In six studies, I investigate the impact of the number of available alternatives and checking's attractiveness on the decision to check. While at first increasing the attractiveness of checking led to higher checking rates, a further increase in the number of available alternatives (and thus checking's attractiveness) did not increase the checking rate. Surprisingly, even when checking had a 40% higher expected value compared with not checking, the observed checking rate was below 45%, contrary to risk and ambiguity aversion predictions. Furthermore, labeling the checking alternative as the default had no impact on its choice rate. I find large individual differences in decisions to check. Surprisingly, subjects' initial decisions had high predictive power over their subsequent checking rates, even after 100 trials with full feedback. I propose two simple learning models that capture well the aggregated results.