Jousting With Straw Men: Comment on Westen, Novotny, and Thompson-Brenner (2004).

Empirically supported treatments (ESTs) do not cure every patient, and the randomized trial is not a flawless methodology. Upon these often-noted and widely accepted points, D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004a; see record 2004-15935-005) built a critique of ESTs and EST research. However, important work developing effective, clinically relevant treatments for serious problems was omitted from the Westen et al. (2004a) review. Little documentation was offered for the purported "assumptions" of EST methodology that Westen et al. (2004a) criticized; and different review standards were applied to studies supporting versus those disagreeing with Westen et al.'s (2004a) views. Finally, the correlational research designs proposed as a remedy by Westen et al. (2004a) have far more serious weaknesses than randomized trials, thoughtfully applied to real-world clinical care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the Need for a New Psychotherapy Research Paradigm: Comment on Westen, Novotny, and Thompson-Brenner (2004).

Basic, process, and outcome research have the potential to inform clinical practice. However, as D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004; see record 2004-15935-005) observed in their timely analysis, the current dominant paradigm for psychotherapy outcome research--the randomized clinical trial--is not fulfilling this potential. The field's reliance on the medical model and manual-based interventions has contributed to the gap between research and clinical practice. Greater collaboration between practitioners and researchers, a focus on therapeutic principles rather than treatment packages, and systemic changes in how scholarly efforts are reinforced are needed to shift the current research paradigm. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirically Supported Psychotherapies: Comment on Westen, Novotny, and Thompson-Brenner (2004).

D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004; see record 2004-15935-005) suggested that efforts to identify empirically supported treatments are misguided because they are based on assumptions that are not appropriate for some types of treatment and patients. The authors of this comment argue that Westen and colleagues are simply incorrect when they assert that empirically supported treatments require that psychopathology must be highly malleable, that treatments must be brief, or that the samples studied are unrepresentative of the kinds of patients typically encountered in clinical practice--comorbidity is common in many clinical trials. Randomized controlled trials remain the most powerful way to test notions of causal agency. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Healthy Dose of Criticism for Randomized Trials: Comment on Westen, Novotny, and Thompson-Brenner (2004).

D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004; see record 2004-15935-005) identified many important concerns in their critique of methods typically used in randomized controlled trials (RCTs) of psychotherapy outcome and by extension in methods of identifying empirically supported therapies (ESTs). Some of the concerns would be mitigated if empirical support of treatments were assessed multidimensionally (separating favorability of results from definitiveness of research methods used) and continuously rather than categorically. Other concerns can and should be addressed within the existing framework of RCTs and ESTs, including consideration of inclusion criteria other than a single Axis I condition, experimental evaluation of some of the procedural assumptions codified in psychotherapy manuals, and far more detailed reporting of RCT results. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The Potential Role of Drug Onset Cues in Drug Dependence and Withdrawal: Reply to Bardo (2004), Bossert and Shaham (2004), Bouton (2004), and Stewart (2004).

In responding to commentaries (M. Bardo, see record 2004-10475-002; J. Bossert and Y. Shaham, see record 2004-10475-003; M. Bouton, see record 2004-10475-004; J. Stewart, see record 2004-10475-005) on their original article (see record 2004-10475-001), the authors agree that the basic mechanisms underlying intra-administration associations may be extensible to a much wider range of phenomena, including both other examinations of conditioned drug effects (e.g., conditioned place preference) and human psychological disorders. The authors also address the concerns of a number of the commenting authors regarding discrepancies in the literature concerning the effects of drug priming in both human and animal studies of reinstatement of drug self-administration. Finally, the authors accept and endorse the calls by several of these commenting authors for further studies required to generate additional support for their model of conditioned drug effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Decreasing Effect Sizes for Effectiveness Studies- Implications for the Transport of Evidence-Based Treatments: Comment on Curtis, Ronan, and Borduin (2004).

The most important finding from the N. M. Curtis, K. R. Ronan, and C. M. Borduin (2004) meta-analysis for the broader field is likely the difference in effect sizes between multisys- multisystemic therapy efficacy versus effectiveness studies. This difference has important implications for research on the transport of evidence-based treatments to community practice settings. For example, factors rarely considered in efficacy research (e.g., funding structures, organizational climate, program maturity, site characteristics) are emerging as important determinants of treatment fidelity and, in turn, clinical outcomes for practice in real-world settings. Current research is clearly demonstrating that evidence-based practices can be successfully transported, but much remains to be learned regarding the optimal parameters of such transport. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating Life-Impairing Problems Beyond PTSD: Reply to Cahill, Zoellner, Feeny, and Riggs (2004).

This reply to the comment by Cahill, Riggs, Zoellner, and Feeny (2004; see record 2004-95166-018) on the article by Cloitre, Koenen, Cohen, and Han (2002; see record 2002-18226-001) reiterates that an important goal of treatment research among chronically traumatized populations is to address problems that impair life functioning, including not only posttraumatic stress disorder but also emotion regulation difficulties and interpersonal problems. The need for further research on symptom exacerbation and drop-out rates in exposure-based treatment for child abuse survivors is discussed. An ongoing follow-up study is described, which is designed to assess the relative utility of STAIR and modified PE individually versus their combination in meeting "good outcome" standards as defined above. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reaping the Benefits of Pursuing Self-Esteem Without the Costs? Reply to DuBois and Flay (2004), Sheldon (2004), and Pyszczynski and Cox (2004).

The commentaries on J. Crocker and L. E. Park's (2004) review suggested that Crocker and Park exaggerated the costs of pursuing self-esteem (K. M. Sheldon, 2004), that it is impossible not to pursue self-esteem (T. Pyszczynski & C. Cox, 2004), and that it is possible to pursue self-esteem in healthy ways, reaping the benefits without the costs (D. L. DuBois & B. R. Flay, 2004). In addressing the comments, the authors first clarify (a) what it means to pursue self-esteem, (b) the connection between having and pursuing self-esteem, and (c) what it means to let go of the pursuit of self-esteem. They then highlight points of overall agreement and disagreement between their view and those expressed in the commentaries and, finally, end with a discussion of future research directions to address the areas of disagreement and to shed further light onto the costs and benefits of pursuing self-esteem. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On the Merits of Clinical Judgment: Comment.

Comments on the article by D. Westen and J. Weinberger (see record 2004-19091-002), which criticized academic clinical psychologists for being cynical about clinical judgment and clinical practice. In our view, it seems unlikely that more than a few academic clinical psychologists believe that they have little to learn from clinical practice or experience. In this comment, we examine the arguments about clinical judgment made by Westen and Weinberger (2004). Westen and Weinberger (2004) conflate the effect of training with the effect of experience. Westen and Weinberger (2004) do not mention that the value of training in psychology has been well-supported by research. While Westen and Weinberger (2004) make positive comments about the types of feedback that clinicians receive, for a number of reasons, including the Barnum effect, psychologists can be misled by feedback. Westen and Weinberger (2004) also argue that "psychotherapists tend to have much more direct and immediate feedback than most other medical practitioners, who may prescribe a medication or perform a procedure and not see the patient again for a year" (p. 603). But when psychologists make a diagnosis or describe a personality trait, they frequently do not receive "direct and immediate feedback" on whether they are right or wrong. In contrast, physicians often receive highly valid feedback. Finally, in discussing the value of ratings made by clinicians, Westen and Weinberger (2004) observe that "empirically, we have found surprisingly little evidence of theory-driven observational bias in using clinician-report methods" (p. 601). The issue is important because Westen and Weinberger argue in favor of using clinician ratings to construct diagnostic criteria. If clinicians' ratings are biased, then the criteria will be biased. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

On False Premises and the Hypnotic Enhancement Effect: Reply to Schnall (2004).

Replies to the comments by E. Schnall (see record 2004-13299-016) on the current author's original article (see record 2003-05896-014), which examined whether adding hypnosis enhances cognitive-behavioral pain treatments. Here, the author addresses Schnall's critique point-by-point, and concludes that--Schnall aside--a a voluminous body of research has clearly established that both hypnosis and cognitive-behavioral treatments are useful for reducing pain, and all evidence from a small but growing literature currently suggests that there is no benefit in adding one procedure to the other. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarification on Psychological Treatments and Psychotherapy.

In this article, the author responds to a set of comments (see record 2005-11834-009; 2005-11834-010; 2005-11834-011) on his original article, "Psychological Treatments" (see record 2004-21168-001). The author responds to each comment. Hal Arkowitz (2005) misread the proposed distinction between "psychological treatments" and "psychotherapy" by presuming that the author was implying that the former is evidence based and the latter is not. Kwekkeboom et al. (2005), representing the nursing profession, noted quite correctly that nurses often deliver psychological treatments on the frontlines of primary care and are independently licensed to provide nursing services, including many approaches that could be categorized as "psychological." Ahmed and Boisvert (2005) agreed that psychological treatments are a core strength of psychology and also go on to provide additional interesting examples and to identify other areas of practice in which psychologists may be uniquely qualified. Overall, the author notes that only certain well-defined pathologies will be included in any health care system, and treatment for these conditions will increasingly need to be based on evidence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Koss and Figueredo (2004).

Reports errors in "Change in Cognitive Mediators of Rape's Impact on Psychosocial Health Across 2 Years of Recovery" by Mary P. Koss and Aurelio José (Journal of Consulting and Clinical Psychology, 2004 [Dec], 72 [6], 1063-1072). Several errors are present on pp. 1,068-1,071 that stem from incorrect numbers for final predicted values in the text and in Figure 2. The correct starting and ending values are provided in Table 1. Also, the statement in the last paragraph of p. 1,071, point (b), should be corrected to state that the present results suggest an impact of rape on global distress and PTSD that was still detectable after 2 years, whereas both starting and final predicted values for SAS were within the normal range. (The following abstract of the original article appeared in record 2004-21587-016.) A previously published cross-sectional model of cognitive mediation of rape's impact on health (M. P. Koss, A. J. Figueredo, & R. J. Prince, 2002) was replicated longitudinally. Rape survivors (n = 59) were assessed 4 times at 3-24 months postrape. Growth curve analysis demonstrated significant change in all mediators and outcomes. Previously reported effects of Characterological Self-Blame, Behavioral Self-Blame, and Maladaptive Beliefs on Psychosocial Distress were partially cross-validated in intercept and slope data. The results suggest that Characterological Self-Blame sets the initial level of Psychosocial Distress and that reduction in Behavioral Self-Blame drives recovery. These effects on distress were wholly mediated through self-blame's association with alterations in beliefs about self and others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

John W. Jacobson (1949-2004).

Obituary [John W. Jacobson; 1949-2004]. John W. Jacobson, born October 13, 1949, passed away on May 8, 2004, at the age 54, prematurely ending a distinguished career of over 25 years. John was a fellow of the American Psychological Association's Divisions 25 (Behavior Analysis) and 33 (Mental Retardation and Developmental Disabilities), the American Association on Mental Retardation, and the International Association for the Scientific Study of Intellectual Disabilities, as well as a board-certified behavior analyst. He was Division 33's president (1995-1996), treasurer (2000 -2004), and an active member of its executive council for many years. He was a visible supporter of many other professional organizations, an outspoken advocate of evidence-based practice, and a driving force in obtaining formal recognition of behavioral psychology as a subspecialty. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Establishment of a diazepam preference in human volunteers following a differential-conditioning history of placebo versus diazepam choice: Reply to Bouton (2002), Carroll (2002), Kelly (2002), Stewart (2002), and Vuchinich (2002).

The 6 submitted commentaries (see records 2002-12827-003, 2002-12827-004, 2002-12827-005, 2002-12827-006, 2002-12827-007, 2002-12827-008) on the authors' study examining the establishment of diazepam as a conditioned reinforcer were generally supportive of the need to characterize environmental determinants of drug self-administration while emphasizing the need for more research. The comments discuss several important topics, including clarifying the mechanisms responsible for the switch in drug preference the authors reported, comparing the strengths of various procedures used to confer reinforcing efficacy onto a drug, opportunities for collaborative research, and practical applications of differential conditioning to the treatment of drug abuse. The authors suspect that future work on this topic will incorporate the issues discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perverse Spite: The Possessive Gleam in the Mother's Eye and the Struggle to Own One's Soul: Reply to Stern (2004).

In this response to Jeffrey Stern's (2004) (see record 2004-21113-016) commentary on my article, "Giving the Devil His Due: Spite and the Struggle for Individual Dignity" (P. Shabad, 2000) (see record 2000-00917-004), I suggest that in emphasizing the conscious vindictiveness of explicit spite, Stern minimizes the perverse aspects of "cutting off one's nose to spite one's face" as a means of avenging oneself against powerful others. The underlying impetus of perverse spite is to break free from the prison of subtle developmental contingencies and unconscious seductions surrounding maternal possessiveness. When the child's self-assertive strivings are blocked because of the shame and fear of premature separateness, the inward obsessional churning of resentment becomes a fertile ground for perverse spite. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Kenneth Lucien Dion (1944-2004).

Presents an obituary for Kenneth Lucien Dion (1944-2004). His unexpected death on November 16, 2004, of a heart attack, came at a time when Dion was at the height of his career, having just started work on several new programs of research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nursing and Psychological Treatments.

Presents a comment on "Psychological Treatments" (see record 2004-21168-001) by D. H. Barlow. In his article, Barlow pointed to the need "to solidify the identification of psychology as a health care profession" by changing the terminology of practice in the health care context from psychotherapy to psychological treatments and suggested that the only persons qualified to carry out such interventions are doctoral-level psychologists. Unfortunately, there was no discussion of the health care professionals who already provide psychological treatments in health care settings and their contribution to the evidence base supporting such treatment. The authors find several aspects of the article to be problematic. Overall, the authors feel that suggesting that psychology should claim treatment of psychological disorders and psychological components of physical disorders in health care settings as exclusively its own domain ignores the research and clinical contributions of others. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

More on Trieb: Reply to Mills (2004).

The author replies to J. Mills's (2004) (see record 2004-21113-019) comment on his article "Triebe and Their Vicissitudes: Freud's Theory of Motivation Reconsidered" (G. Frank, 2003) (see record 2003-09630-008). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Elsesser et al. (2004).

Reports an error in the article "Attention, Heart Rate, and Startle Response During Exposure to Trauma-Relevant Pictures: A Comparison of Recent Trauma Victims and Patients With Posttraumatic Stress Disorder," (see record 2004-13593-012) by Karin Elsesser, Gudrun Sartory, and Axel Tackenberg (Journal of Abnormal Psychology, 2004, Vol. 113, No. 2, pp. 289-301), Table 1 contained an error. On p. 293, the values in the "Control," "Without ASD," and "Total" columns of the "Attentional bias score" row of Table 1 are incorrect. The correct values for the Attentional bias score row are: 10.68 (49.89); 8.08 (42.46); and 1.96 (42.57). These are written in bold and presented in a chart in the correction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)