ADVANCING BACKWARDS

The proposal of Friman, Hayes, and Wilson (1998) that the concept of emotion be incorporated into behavior analysis is questioned. Their proposal is undermined by the problem of the verification of private events by others. A focus on private events, as exemplified by the proposal of Friman et al., can lead to a reversion to notions of agency and the autonomous individual. Also, the anchoring of hypothetical constructs to the behavioral data language is ill advised.     

The Impact of Behaviorism on Our Culture: Some Evidence and Conjectures

Current interest among behaviorists in public policy is contrasted with the minimal impact of behaviorism on contemporary American culture, in order to provide baseline information against which future developments might be compared.

     

Contingency management in the people's republic of China

The behavioral contingencies that have been implemented in the attempt by the People's Republic of China to achieve two of its national goals are described. The goals are the modernization and increased productivity of industry and a significant decrease in the birth rate. Changes from past practices in the industrial sphere involving a shift from noncontingent to contingent consequences are outlined. The use of a variety of consequences as a means of reducing the birth rate is described.     

Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?

Antidepressants, in particular newer agents, are among the most widely prescribed medications worldwide with annual sales of billions of dollars. The introduction of these agents in the market has passed through seemingly strict regulatory control. Over a thousand randomized trials have been conducted with antidepressants. Statistically significant benefits have been repeatedly demonstrated and the medical literature is flooded with several hundreds of "positive" trials (both pre-approval and post-approval). However, two recent meta-analyses question this picture. The first meta-analysis used data that were submitted to FDA for the approval of 12 antidepressant drugs. While only half of these trials had formally significant effectiveness, published reports almost ubiquitously claimed significant results. "Negative" trials were either left unpublished or were distorted to present "positive" results. The average benefit of these drugs based on the FDA data was of small magnitude, while the published literature suggested larger benefits. A second meta-analysis using also FDA-submitted data examined the relationship between treatment effect and baseline severity of depression. Drug-placebo differences increased with increasing baseline severity and the difference became large enough to be clinically important only in the very small minority of patient populations with severe major depression. In severe major depression, antidepressants did not become more effective, simply placebo lost effectiveness. These data suggest that antidepressants may be less effective than their wide marketing suggests. Short-term benefits are small and long-term balance of benefits and harms is understudied. I discuss how the use of many small randomized trials with clinically non-relevant outcomes, improper interpretation of statistical significance, manipulated study design, biased selection of study populations, short follow-up, and selective and distorted reporting of results has built and nourished a seemingly evidence-based myth on antidepressant effectiveness and how higher evidence standards, with very large long-term trials and careful prospective meta-analyses of individual-level data may reach closer to the truth and clinically useful evidence.     

The 9th annual INDUS-EM 2013 Emergency Medicine Summit, “Principles,Practices, and Patients,” a level one international meeting,Kerala University of Health Sciences and Jubilee Mission Medical College and Research Institute,Thrissur, Kerala,India, October 23–27, 2013

INDUS-EM is India’s only level one conference imparting and exchanging quality knowledge in acute care. Specifically, in general and specialized emergency care and training in trauma, burns, cardiac, stroke, environmental and disaster medicine. It provides a series of exchanges regarding academic development and implementation of training tools related to developing future academic faculty and residents in Emergency Medicine in India. The INDUS-EM leadership and board of directors invited scholars from multiple institutions to participate in this advanced educational symposium that was held in Thrissur, Kerala in October 2013.     

Collegiate contingencies

We discuss contemporary trends and developments that affect colleges and universities and describe several central contingencies that have given rise to, maintain, and operate in response to these trends and developments. We identify the differential impacts of these contingencies on faculty, students, and administrators in various types of higher education institutions. These contingencies are sources of conflict between and among these three groups within the academy that, we argue, cause significant instability in contemporary academe. We discuss prominent domains of this dis-equilibrium and propose several general interventions to address the sources of the instability.