Panning for the gold in health research: Incorporating studies’ methodological quality in meta-analysis

Background: Systematic reviews now routinely assess methodological quality to gauge the validity of the included studies and of the synthesis as a whole. Although trends from higher quality studies should be clearer, it is uncertain how often meta-analyses incorporate methodological quality in models of study results either as predictors, or, more interestingly, in interactions with theoretical moderators.

Objective and methods: We survey 200 meta-analyses in three health promotion domains to examine when and how meta-analyses incorporate methodological quality.

Results: Although methodological quality assessments commonly appear in contemporary meta-analyses (usually as scales), they are rarely incorporated in analyses, and still more rarely analysed in interaction with theoretical determinants of the success of health promotions. The few meta-analyses (2.5%) that did include such an interaction analysis showed that moderator results remained significant in higher quality studies or were present only among higher quality studies. We describe how to model quality interactively with theoretically derived moderators and discuss strengths and weaknesses of this approach and in relation to current meta-analytic practice.

Conclusions: In large literatures exhibiting heterogeneous effects, meta-analyses can incorporate methodological quality and generate conclusions that enable greater confidence not only about the substantive phenomenon but also about the role that methodological quality itself plays.     

Countertransference as object of empirical research?

Abstract

The concept of countertransference as a robust cornerstone of psychoanalytic work has gained momentum over the last five decades. It is a prime example of elastic concepts covering the range from microprocesses to global clinical phenomena. Empirical research on the treatment process has for a long time – and for good reasons – avoided even trying to measure countertransference. We report here on various efforts for approaching a methodology for measuring it. The paper organizes the various approaches in terms of stages of research.     

Perspectives on Systems Change Among Local Change Agents: A Comparative Study

Community organizers and activists draw on multiple traditions of community building and collective action in attempts to galvanize change. The diversity of perspectives on social change processes indicates corresponding differences in perspectives on systems and what is required to change them. Twenty‐two in‐depth interviews with community organizers and activists in the Midwestern USA were conducted to identify differences in perspectives on systems change efforts. Four models used by organizers were identified: action/issue‐centric, identity‐centric, relationship‐centric, and organizing‐development. Strategies for recruitment, issue selection, leadership determination, and action were compared across models. Analyses revealed that some models might be better suited to action on certain issues (e.g. identity‐centric models when organizing around homelessness), whereas others may have advantages for use in certain settings (e.g. relationship‐centric models in congregations). These findings suggest that practitioners and scholars should pay close attention to contextual factors and focal issues when determining strategies for creating systems change. Copyright © 2014 John Wiley & Sons, Ltd.     

Developing mixed methods research in sport and exercise psychology: Critical reflections on five points of controversy

ObjectivesTo stimulate debate in sport and exercise psychology about the nature of mixed methods research as currently practiced and how this approach might develop in the future.DesignAn exploration of five points of controversy relating to mixed methods research.MethodA presentation of critical reflections on the following. (1) Mixing methods as a non-debate, (2) Purists, pragmatists and mixing paradigms, (3) Integrating findings and representational forms, (4) Judgment criteria and mixed methods research, and (5) Power, politics and what counts in mixed methods research.ResultsThe examples provided of mixed methods research in action indicate that a number of problematic issues regarding both process and product have been neglected.ConclusionsMixed methods research offers a number of conceptual, practical and pedagogical challenges that need to be addressed if this form of inquiry is to develop its full potential in sport and exercise psychology.     

The lived experiences of individuals with Tourette syndrome or tic disorders: A meta‐synthesis of qualitative studies

There is a growing body of qualitative literature describing the lived experiences of people with tic disorders (TDs). The aim of this paper was to conduct a systematic review of this literature, synthesizing the perspectives of individuals on their experiences. Meta‐synthesis methodology was utilized to review and draw together findings from 10 articles, from which key concepts were extracted, and over‐arching themes generated. Six themes were identified to encompass the experience of TDs, including (1) cultural, semantic issues of the condition; (2) negative experiences in organizations and treatment; (3) the value and negative impact on interpersonal relationships; (4) personal identity in the constant presence of TDs; (5) concerns for the future; and (6) strategies to control and manage the observable presence of tics. Adaptive coping strategies were found to encompass continuous social adaptation, strategies to manage tics and social perceptions, self‐acceptance, advocacy, and support from others. The results highlighted the significant role of social and cultural issues related to understanding and stigma, which underpinned many of the lived experiences. Implications for clinical practice in supporting individuals with TDs were also highlighted.     

On the statistical and theoretical basis of signal detection theory and extensions: Unequal variance, random coefficient, and mixture models

Basic results for conditional means and variances, as well as distributional results, are used to clarify the similarities and differences between various extensions of signal detection theory (SDT). It is shown that a previously presented motivation for the unequal variance SDT model (varying strength) actually leads to a related, yet distinct, model. The distinction has implications for other extensions of SDT, such as models with criteria that vary over trials. It is shown that a mixture extension of SDT is also consistent with unequal variances, but provides a different interpretation of the results; mixture SDT also offers a way to unify results found across several types of studies.     

Distribution-free tests of stochastic dominance for small samples

One variable is said to “stochastically dominate” another if the probability of observations smaller than x is greater for one variable than the other, for all x. Inferring stochastic dominance from data samples is important for many applications of econometrics and experimental psychology, but little is known about the performance of existing inferential methods. Through simulation, we show that three of the most widely used inferential methods are inadequate for use in small samples of the size commonly encountered in many applications (up to 400 observations from each distribution). We develop two new inferential methods that perform very well in a limited, but practically important, case where the two variables are guaranteed not to be equal in distribution. We also show that extensions of these new methods, and an improved version of an existing method, perform quite well in the original, unlimited case.