Should We Treat Depression with drugs or psychological interventions? A Reply to Ioannidis

We reply to the Ioannidis's paper "Effectiveness of antidepressants; an evidence based myth constructed from a thousand controlled trials." We disagree that antidepressants have no greater efficacy than placebo. We present the efficacy from hundreds of trials in terms of the percentage of patients with a substantial clinical response (a 50% improvement or more symptomatic reduction). This meta-analysis finds that 42-70% of depressed patients improve with drug and 21%-39% improve with placebo. The response benefit of antidepressant treatment is 33%-11% greater than placebo. Ioannidis argues that it would be vanishingly smaller because systematic biasing in these clinical trials would reduce the drug-placebo difference to zero. Ioannidis' argument that antidepressants have no benefit is eroded by his failures of logic because he does not present any evidence that there are a large number of studies where placebo is substantially more effective than drug. (To reduce to zero, one would also have to show that some of the unpublished studies find placebo better than drug and have substantial systematic or methodological bias). We also present the empirical evidence showing that these methodological concerns generally have the opposite effect of what Ioannidis argues, supporting our contention that the measured efficacy of antidepressants likely underestimates true efficacy. Our most important criticism is Ioannidis’ basic underlying argument about antidepressants that if the existing evidence is imperfect and methods can be criticized, then this proves that antidepressant are not efficacious. He presents no credible evidence that antidepressants have zero effect size. Valid arguments can point out difficulties with the data but do not prove that a given drug had no efficacy. Indeed better evidence might prove it was more efficacious that originally found. We find no empirical or ethical reason why psychiatrists should not try to help depressed patients with drugs and/or with psychotherapeutic/behavioral treatments given evidence of efficacy even though our treatment knowledge has limitations. The immense suffering of patients with major depression leads to ethical, moral, professional and legal obligations to treat patients with the best available tools at our disposal, while diligently and actively monitoring for adverse effects and actively revising treatment components as necessary.     

A Computer-Aided Affective Content Analysis of Nanotechnology Newspaper Articles

This paper explores the application of an affective content analysis to a selection of nanotechnology news articles gathered from selected newspapers. Thematic content analyses dominate current efforts to mine large text collections of popular science media; the addition of an affective analysis element can yield useful information to supplement future content analysis efforts. Using Whissell’s Dictionary of Affect in Language, the analysis rates news articles gathered over a twenty-two year period for their pleasantness, activeness, and imagery, determining the mean affective tone in each category for the entire collection, four ‘content themes’ (business, national security, health, and environment), and the change in affective tone over the twenty-two year period these articles represent. Whereas the entire collection analyzed as a whole rates very similarly to the average found for everyday English language use and the ‘content themes’ show similar results, the change in affective tone over the years has been both significant and striking. A sample of results from three years of the twenty-two year period is then qualitatively explored to demonstrate to the reader the connection between the quantitative results of the Dictionary and the qualitative effect of the article’s word use and phrasing. The paper ends with a review of the technique’s success, implications for policymaking and public dialogue, and avenues for future use.     

Effects of motivating operations on problem and academic behavior in classrooms

The current study examined the effects of motivating operations on problem behavior and academic engagement for 2 students with autism. Classroom sessions were preceded by periods in which the participants had access or no access to the items functionally related to their problem behavior. Results suggested that presession access may result in lower levels of problem behavior and higher levels of academic engagement during classroom instruction.     

Dimensions of acculturation: associations with health risk behaviors among college students from immigrant families

In the present study, we examined a bidimensional model of acculturation (which includes both heritage and U.S. practices, values, and identifications) in relation to hazardous alcohol use, illicit drug use, unsafe sexual behavior, and impaired driving. A sample of 3,251 first- and second-generation immigrant students from 30 U.S. colleges and universities completed measures of behavioral acculturation; cultural values (individualism, collectivism, and self-construal); ethnic and U.S. identity; and patterns of alcohol and drug use, engagement in potentially unsafe sexual activities, and driving while (or riding with a driver who was) intoxicated. Results indicate that heritage practices and collectivist values were generally protective against health risk behaviors, with collectivist values most strongly and consistently protective. Nonetheless, heritage identifications were positively associated with sexual risk taking for Hispanics. U.S. practices, values, and identifications were not consistently related to risk behavior participation. Results are discussed in terms of bidimensional approaches to acculturation, the immigrant paradox, and implications for counseling practice.     

Perceiving affordances for joint actions

Two individuals acting together to achieve a shared goal often have an emergent set of afforded behavioral possibilities that may not easily reduce to either acting alone. In a series of experiments we examined the critical boundaries for transitions in behavior for individuals walking through an aperture alone or alongside another actor as a dyad. Results from experiment 1 indicated that an intrinsically scaled critical boundary for behavioral transitions was different in individuals than in dyads performing a similar task. Experiment 2 demonstrated that observers are perceptually sensitive to the difference in action parameters for the dyad, while still maintaining perceptual sensitivity about the boundaries of action relative to individuals. In experiment 3, we determined that observers' perception of critical action boundaries for individuals and dyads has a similar informational basis (eye-height scaling). In experiment 4, we demonstrated that observers were able to perceive critical action boundaries for other dyads independently of membership. Together, these results suggest that individuals are sensitive to the affordances related to a joint action, and that this process may not entirely reduce to the perception of the affordances for each individual.     

The Answer Doesn’t Seem to Change, so Maybe We Should Change the Question: A Commentary on Lachance-Grzela and Bouchard (2010)

This article comments on Lachance-Grzela and Bouchard (2010), which reviews research published 2000–2009 on the division of household labor. I argue that while Lachance-Grzela and Bouchard summarize the general state of knowledge on this topic, their review highlights what is missing from research on the division of household labor. To move beyond questioning why women perform the majority of housework requires a different set of questions, using a variety of data collection and analysis techniques, and a clear eye toward broader social theory.     

Gender Differences in Responding to Conflict in the Workplace: Evidence from a Large Sample of Working Adults

This investigation tested for gender effects in conflict behaviors by examining the ratings made by the bosses, peers, and subordinates of over 2,000 working adults participating in leadership development programs conducted in the U.S.; the effects of two confounding factors—age and organizational status—were controlled in all analyses. Consistent with predictions derived from a gender role analysis, women were rated as significantly more likely to engage in almost every constructive behavior. Also as predicted, men were rated as more likely to engage in active destructive behaviors. Rater gender had no effect for peers and subordinates, but female bosses made more positive ratings of targets than male bosses. In general, bosses rated targets somewhat higher on passive responses.     

Differing effects of systemically administered rapamycin on consolidation and reconsolidation of context vs. cued fear memories

Rapamycin, an inhibitor of the mammalian target of rapamycin (mTOR) kinase, has attracted interest as a possible prophylactic for post-traumatic stress disorder (PTSD)-associated fear memories. We report here that although rapamycin (40 mg/kg, i.p.) disrupted the consolidation and reconsolidation of fear-potentiated startle paradigm to a shock-paired context, it did not disrupt startle increases to a 4-sec odor cue, even though post-training increases in amygdala mTOR activity were prevented by rapamycin (also 40 mg/kg, i.p.). Thus, while rapamycin may prove useful in retarding the development of some PTSD-associated memories, its relative ineffectiveness against cued fear memories may limit its clinical usefulness.