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961.
John M Davis William J Giakas Jie Qu Pavan Prasad Stefan Leucht 《Philosophy, ethics, and humanities in medicine : PEHM》2011,6(1):1-13
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 (To reduce to zero, one would also have to show that some of the unpublished studies find placebo better than drug and have substantial systematic or methodological bias).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. 相似文献
962.
Traditionally, characterizations of the macrolevel functional organization of the human cerebral cortex have focused on the left and right cerebral hemispheres. However, the idea of left brain versus right brain functions has been shown to be an oversimplification. We argue here that a top-bottom divide, rather than a left-right divide, is a more fruitful way to organize human cortical brain functions. However, current characterizations of the functions of the dorsal (top) and ventral (bottom) systems have rested on dichotomies, namely where versus what and how versus what. We propose that characterizing information-processing systems leads to a better macrolevel organization of cortical function; specifically, we hypothesize that the dorsal system is driven by expectations and processes sequences, relations, and movement, whereas the ventral system categorizes stimuli in parallel, focuses on individual events, and processes object properties (such as shape in vision and pitch in audition). To test this hypothesis, we reviewed over 100 relevant studies in the human neuroimaging and neuropsychological literatures and coded them relative to 11 variables, some of which characterized our hypothesis and some of which characterized the previous dichotomies. The results of forward stepwise logistic regressions supported our characterization of the 2 systems and showed that this model predicted the empirical findings better than either the traditional dichotomies or a left-right difference. 相似文献
963.
Over the last 20 years psychotherapy and family therapy have been inundated with a plethora of empirically validated treatments for particular disorders. That trend will increase. Psychotherapists will increasingly be exhorted and ultimately required to integrate empirical data and multicultural competence into their practice. Additionally, individual psychotherapy's default dominance of psychotherapeutic discourse needs to integrate and come to theoretical and clinical terms with the implications of the growing body of research demonstrating the validity and value of a multisystemic perspective. This article (and its companion article) presents a comprehensive, integrative, multisystemic, and empirically informed psychotherapeutic perspective to help therapists and psychotherapy trainers successfully address these challenges-Integrative Problem Centered Metaframeworks (IPCM) Therapy. This first article presents and illustrates IPCM's theoretical foundation, core concepts, and "case formulating" components. It delineates a Blueprint for the practice and teaching of 21st century psychotherapists who can meld science and art into best practice. 相似文献
964.
A handful of prior adoption studies have confirmed that the cross-sectional relationship between child conduct problems and parent-child conflict at least partially originates in the shared environment. However, as the direction of causation between parenting and delinquency remains unclear, this relationship could be better explained by the adolescent's propensity to elicit conflictive parenting, a phenomenon referred to as an evocative gene-environment correlation. In the current study, the authors thus examined the prospective relationship between conduct problems and parent-child conflict in a sample of adoptive families. Participants included 672 adolescents in 405 adoptive families assessed at 2 time points roughly 4 years apart. Results indicated that parent-child conflict predicts the development of conduct problems, whereas conduct problems do not predict increases in parent-child conflict. Such findings suggest that evocative gene-environment correlations are highly unlikely to be an explanation of prior shared environmental effects during adolescence. Moreover, because the adolescents in this study do not share genes with their adoptive parents, the association between conduct problems and parent-child conflict is indicative of shared environmental mediation in particular. Implications of the findings are discussed. 相似文献
965.
Feeney MC Roberts WA Sherry DF 《Journal of comparative psychology (Washington, D.C. : 1983)》2011,125(3):308-316
Integrated what-where-when memory, sometimes called 'episodic-like' memory, has been shown to occur in a number of animals, including food-storing birds and rodents. It is not always clear in these studies, however, what aspect of "when" is remembered. We examined memory for what, where, and when in black-capped chickadees Poecile atricapillus in a procedure designed to dissociate memory for elapsed time (how long ago) from memory for a point in time, the sense of "when" implied in most discussions of episodic or episodic-like memory. Chickadees searched for food in multiple trials that each involved a two-phase procedure. In Phase 1, birds found preferred mealworms in half the sites on one side of an aviary and less preferred sunflower seeds in half the sites on the other side of the aviary. In Phase 2, following a retention interval, birds searched in the aviary with fresh sunflower seeds placed in the sites that held seeds in Phase 1 but either fresh or degraded mealworms in the sites that held mealworms in Phase 1. Whether a site held fresh or degraded worms depended on either when during the day Phase 1 had occurred (Group When), how long ago Phase 1 had occurred (Group HLA), or both (Group When + HLA). Chickadees in all three groups were able to discriminate where and when palatable worms were to be found, but there were temporal limitations on the use of HLA and When + HLA cues that were not found for the use of When cues. 相似文献
966.
The goal of the current study was to examine how the presence of a best friend might serve as protection against the effect of negative experiences on global self-worth and the hypothalamic-pituitary-adrenocortical axis (HPA axis). A total of 103 English-speaking male (n = 55) and female (n = 48) participants from Grade 5 (M = 10.27 years) and Grade 6 (M = 11.30 years) completed booklets about their experiences that occurred 20 min previously and how they felt about themselves at the moment, and they provided saliva multiple times per day over the course of 4 consecutive days. Having a best friend present during an experience significantly buffered the effect of the negativity of the experience on cortisol and global self-worth. When a best friend was not present, there was a significant increase in cortisol and a significant decrease in global self-worth as the negativity of the experience increased. When a best friend was present, there was less change in cortisol and global self-worth due to the negativity of the experience. 相似文献
967.
968.
William F. Arsenio 《Journal of abnormal child psychology》2010,38(5):627-632
This discussion summarizes some of the key conceptual and methodological contributions of the four articles in this special
section on social information processing (SIP) and aggression. One major contribution involves the new methodological tools
these studies provide for future researchers. Eye-tracking and mood induction techniques will make it possible for SIP researchers
to study attentional and emotion-related processes across the six SIP steps. In addition, the STEP-P instrument will open
up the study of emotionally-charged aspects of preschoolers’ early SIP. A second contribution is how these articles emphasize
the dynamic interplay of emotional and cognitive processes in the emergence of children’s and adolescents’ aggressive tendencies.
Finally, implicit developmental themes are raised by several of these studies. Discussion concludes with suggestions for future
research, including a focus on the positive (i.e., non-disruptive) role of emotions, and on the connections between moral
development and aggression. 相似文献
969.
In this study lateral differences in tympanic membrane temperature (TTy) were explored as a correlate of either impulsive or cautious responding in Go–No-Go tasks. Thirty-two women and men performed two sustained attention to response tasks (Go–No-Go tasks). Those with warmer right in comparison to left tympanic membranes were more cautious, and those with warmer left in comparison to right tympanic membranes were more impulsive. This finding is in line with previous research and theory indicating a hemispheric bias for active and passive behavior. TTy may be a useful addition to the techniques employed by neuropsychologists. 相似文献
970.