The medical research council’s approach to allegations of scientific misconduct

The UK’s Medical Research Council (MRC) introduced a specific policy and procedure for inquiring into allegations of scientific misconduct in December 1997; previously cases had been considered under normal disciplinary procedures. The policy formally covers staff employed in MRC units, but those in receipt of MRC grants in universities and elsewhere are expected to operate under similar policies. The MRC’s approach is stepwise: preliminary action; assessment to establish prima facie evidence of misconduct; formal investigation; sanctions; and appeal. Strict time limits apply at all stages. The procedure will be evaluated after two years. The indications so far are that the procedure is robust, and its clarity and transparency have been an asset to all parties. The MRC is also convinced that it is equally important to achieve a working culture that fosters integrity. Thus education and training in good research practices are fundamental to the prevention of research misconduct. This paper was presented at a symposium, Scientific Misconduct: An International Perspective, organized by The Medical University of Warsaw, 16 November, 1998.     

HOW PSYCHIATRIC TREATMENTS CAN ENHANCE PSYCHOLOGICAL DEFENSE MECHANISMS

Psychological defense mechanisms are a powerful and often unappreciated force safeguarding mental health. Although rarely directed in this way, the most common forms of psychiatric treatment—psychotherapy and antidepressants—can enhance psychological defense mechanisms. Psychotherapy, through both specific and nonspecific factors, induces positive perspective shifts favoring positive cognitive distortions, including adaptive classical defense mechanisms and healthy attribution biases. Antidepressants, by altering very basic emotional information processing, such as facial expression recognition and emotional memories, also foster positive cognitive distortions. By shifting perceptions and thoughts in a positive direction, psychotherapy and antidepressants improve the capacity to dissociate from negative emotional stimuli.Brad Bowins, M.D., FRCP(C), is a staff psychiatrist at the University of Toronto Health Service and he is in private practice.     

Authors and publication practices

Although authors are usually considered to be the main perpetrators of research and publication misconduct, any person involved in the process has the potential to offend. Editors may breach ethical standards particularly with respect to conflicts of interest. In the same way that authors are now required to declare competing interests, notably commercial affiliations, financial interests and personal connections, so must editors. Editors can influence the chances of acceptance or rejection of a paper by reviewer selection. Reviewers should also be ready to disclose conflicts of interest. They must ensure that their reviews are evidence based and free from destructive criticism driven by self interest. It seems likely that ultimately we will progressively move towards 'open' peer review in which both the authors and the reviewers are known to each other. There is an urgent need for increased transparency of the relationship between editors and owners. The events of the last few years indicate that unless this interface is fully understood by all parties, conflicts may arise. There is also a need for a radical overhaul in the relationship between journals, journal editors and the biomedical industry. It is now increasingly accepted that all clinical trials should be registered in a centrally held database and that protocols should include the primary and secondary outcome measures and the intended approach to data analysis thereby avoiding opportunistic post hoc analyses. However, the even more radical proposal that journals should cease to publish clinical trials sponsored by industry deserves wider debate.     

The internal family and the facts of life

Primitive defensive mechanisms innvolving splitting and projections are an essential process in the development of the infant. However, if these persist into adult life unmitigated by more depressive processes involving introjection and awareness of secure good objects they are shown to be inadequate to the task of coping with life crises, based as they are on the denial and distortion of reality. In this paper, I describe two patients who were seen in very different treatment settings and in whom such mechanisms were predominant. These began to fail when the patients were faced with difficult external events. These caused feelings of panic about impending mental disintegration. I then show how these patients sought to re-establish their primitive defensive structures.     

The uses of humor in life,neurosis and in psychotherapy: Part 1

Abstract

Joy and sadness, the comic and the tragic, making jokes and telling jokes, have been known in life, literature, the theater, and art since the dawn of civilization. Following in the footsteps of classical antiquity, Freud added to the philosophical analysis of humor the insights offered by the psychoanalytic method. The bridge was the cathartic method of treating neuroses, where discharge of affect was one of the foundations of technique, and the cathartic, or discharge, function of humor. Freud's analysis of humor, that “A joke … is the most social of all mental functions that aim at a yield of pleasure” introduces Freud's first explicit formulation of an interpersonal approach to the human situation in health and disorder.