The powerful placebo effect: fact or fiction?

In 1955, Henry K. Beecher published the classic work entitled "The Powerful Placebo." Since that time, 40 years ago, the placebo effect has been considered a scientific fact. Beecher was the first scientist to quantify the placebo effect. He claimed that in 15 trials with different diseases, 35% of 1082 patients were satisfactorily relieved by a placebo alone. This publication is still the most frequently cited placebo reference. Recently Beecher's article was reanalyzed with surprising results: In contrast to his claim, no evidence was found of any placebo effect in any of the studies cited by him. There were many other factors that could account for the reported improvements in patients in these trials, but most likely there was no placebo effect whatsoever. False impressions of placebo effects can be produced in various ways. Spontaneous improvement, fluctuation of symptoms, regression to the mean, additional treatment, conditional switching of placebo treatment, scaling bias, irrelevant response variables, answers of politeness, experimental subordination, conditioned answers, neurotic or psychotic misjudgment, psychosomatic phenomena, misquotation, etc. These factors are still prevalent in modern placebo literature. The placebo topic seems to invite sloppy methodological thinking. Therefore awareness of Beecher's mistakes and misinterpretations is essential for an appropriate interpretation of current placebo literature.     

The 1992 ethics code: boon or bane?

Discusses the 1992 version of the American Psychological Association (APA) Ethical Principles of Psychologists and Code of Conduct that marks the first major revision since 1981. It has a table of contents that facilitates location of standards about specific topics and it is the 1st code to be divided into 2 sections. These include a set of principles that are aspirational, representing the professional ideals, and a set of enforceable standards that are intended to be used as compelling rules. The most controversial standard pertains to sexual relationships with former psychotherapy clients. Standards related to other topics for the first time, such as the practice of forensic psychology and bartering, distinguish the 1992 APA code from its predecessors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recall of interrupted tasks under stress: A phenomenon of memory or of learning?

The study proposed to answer three questions: "1. Is superior recall of successes in an intelligence test situation (S-recall) a function of selective forgetting (repression) of failures or selective learning in favor of successes? 2. Is superior recall of failures in this situation (F-recall) a function of selective remembering or selective learning in favor of failures? 3. Is there a mnemonic reaction to the test as a whole?" Findings indicate that: "1. Both the S- and f-recall tendencies were due to a selective learning rather than a selective remembering mechanism. 2. A repression was demonstrated for S-recallers with regard to the stress situation as a whole. 3. A comparable process of enhanced retention of the total stress situation was not demonstrated for F-recallers; rather the effect here was due to enhanced registration." Implications of results are discussed. It is suggested that "experimental tests of repression… fulfill a criterion of cognitive relevance of test materials." 23 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epenthetic vowels in Japanese: A perceptual illusion?

In 4 cross-linguistic experiments comparing French and Japanese listeners, we found that the phonotactic properties of Japanese (a reduced set of syllable types) induce Japanese listeners to perceive "illusory" vowels inside consonant clusters in vowel-consonant-consonant-vowel (VCCV) stimuli. In Experiments 1 and 2, a continuum of stimuli ranging from no vowel (e.g., ebzo) to a full vowel between the consonants (e.g., ebzo) was used. Japanese, but not French participants, reported the presence of a vowel [u] between consonants, even in stimuli with no vowel. A speeded ABX discrimination paradigm was used in Experiments 3 and 4 and revealed that Japanese participants had trouble discriminating between VCCV and VCuCV stimuli. French participants, in contrast, had problems discriminating items that differed in vowel length ( ebuzo vs ebuuzo), a distinctive contrast in Japanese but not French. It is concluded that models of speech perception have to be revised to account for phonotactically based assimilations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The age decrement in outstanding scientific contributions: Fact or artifact?

Lehman in Age and Achievement provides data in the form of works cited in histories of art, science, and other fields and finds that they "very frequently indicate that many fewer significant contributions are made in the later decades of life than in earlier periods… . Taken at their face value, these studies indicate a drastic reduction in the output of outstanding works in the later part of the life span." But the "apparent decline in the output of significant works in the later decades of life may be merely a reflection of the behavior of historians and others with regard to their treatment of historical epochs. The present paper addresses itself to the examination of citation practices of historians and anthologists as they are related to the study of aging… . A more reasonable interpretation of the facts seems to be that, as the total output of science has increased, the percentage of literature cited by historians has declined." The trend toward increase in scientific literature "has necessitated a change in the behavior of historians." 18 refs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Stunned myocardium"--laboratory curiosity or clinically relevant phenomenon of myocardial failure?

Reversible contractile dysfunction ("myocardial stunning") now is recognized in laboratory animals as well as in the clinic. The precise mechanism(s) responsible for this transient decrease in myocardial contractility is at present unknown. However substantial body of experimental evidence suggest failure in calcium homeostasis due to free radicals injury and calcium overload in ischemic/reperfused myocardium.     

The source of execution-related dual-task interference: Motor bottleneck or response monitoring?

The present study assessed the underlying mechanism of execution-related dual-task interference in the psychological refractory period (PRP) paradigm. The motor bottleneck hypothesis attributes this interference to a processing limitation at the motor level. By contrast, the response monitoring hypothesis attributes it to a bottleneck process that not only selects the appropriate response but also monitors its execution. In two experiments, participants performed ballistic movements of different distances in Task 1 and a choice reaction time task in Task 2. In each experiment, a propagation effect of movement distance on reaction time in Task 2 indicated substantial execution-related interference. To determine the locus of this effect, we manipulated stimulus-response compatibility in Task 2. In line with the motor bottleneck hypothesis, the compatibility effect was partially absorbed during movement execution of Task 1. The results support a motor bottleneck mechanism rather than response monitoring as the source of execution-related dual-task interference. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does emotion processing require attention? The effects of fear conditioning and perceptual load.

This study examined the impact of perceptual load on the processing of unattended threat-relevant faces. Participants performed a central letter-classification task while ignoring irrelevant face distractors, which appeared above or below the central task. The face distractors were graded for affective salience by means of aversive fear conditioning, with a conditioned angry face (CS+), an unconditioned angry face (CS?), and a neutral control face. The letter-classification task was presented under conditions of both low and high perceptual load. Results showed that fear conditioned (i.e., CS+) angry face distractors interfered with task performance more than CS? angry or neutral face distractors but that this interference was completely eliminated by high perceptual load. These findings demonstrate that aversively conditioned face distractors capture attention only under conditions of low perceptual load. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Questionnares: Use or Abuse?

The author opines that if the percentage of return on mail questionnaire studies using psychologists as subjects is declining, he should not be surprised. He states that although his position is not unique, he receives perhaps 10 requests per year. Out of wishes to advance science and help colleagues he usually complies with such requests for information, but finds that it has been rare, in his experience, to receive an acknowledgment for my efforts, and rarer still, to receive any feedback or report of findings of a study. He feels that such a practice on the part of researchers shows a decided lack of professional courtesy and will perhaps ultimately lead to scientific inquiries being ignored or dealt with perfunctorily and dismissed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Loneliness: Paradox or artifact?

Comments on the article by R. Kraut et al (see record 1998-10886-001) regarding associations between Internet use and depression and social interaction. The author examines a methodological flaw in the data: the researchers inadvertently selected participants whose social contacts (high school students graduating, their parents, and people with very high levels of community involvement) were likely to decline during the course of the study, even without Internet access. Therefore, it is possible that the reported increases in loneliness and depression would have occurred even had no Internet access been provided. Furthermore, because those participants with the greatest loss of social contacts might fill their now empty hours with Internet usage, the observed negative correlation between social contact and Internet usage might indicate that isolation leads to Internet usage—a causal relationship opposite to that posited by the researchers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Arbiter: Psychologist or psychiatrist?

Presents the author's views on the tenor of the negotiations between the American Psychological Association's (APA's)Committee on Relations with Psychiatry and its opposite number from the American Psychiatric Association. His concern stems primarily from what is considered to be ambivalence on the part of the group as it is expressed in their negotiations with the psychiatrists, as well as the official position of the American Psychological Association. To be more specific: While we consider ourselves competent to handle our affairs as scientists and teachers, and would resent any intrusion in these areas, we appear to be less sure of ourselves in the area of practice, and much more explicitly, private practice. He points to the Ethical Standards of Psychologists (1953) that state, under Principle 2.51-4: The psychologist who engages in psychotherapy is obligated to assist his client, in obtaining professional help for all important aspects of his problem which fall outside the boundaries of the psychologist's competence. Most frequently this principle will require that adequate provision be made for the diagnosis and treatment of medical problems. As a commentary on this principle it is stated: To this end, psychologists doing psychotherapy may be expected to establish and maintain effective inter-communication with a psychologically-oriented physician. The usual and most desirable interpretation of this principle is that the clinical psychologist will establish an effective working relationship with a psychiatrist. He feels that while one can enthusiastically endorse the principle, it becomes changed in the commentary, so that the competence of the psychology practitioner is questioned. In effect the commentary acknowledges the psychiatrist's greater competence in the psychological, as well as the medical sphere. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The object-based Simon effect: Grasping affordance or relative location of the graspable part?

Reaction time is often shorter when the irrelevant graspable handle of an object corresponds with the location of a keypress response to the relevant attribute than when it does not. This object-based Simon effect has been attributed to an affordance for grasping the handle with the hand to the same side. Because a grasping affordance should differentially affect keypress responses only when they are made with different hands, we conducted three experiments that measured the object-based Simon effect for frying pan stimuli using between- and within-hand response sets. When the relevant stimulus dimension was color, neither the object-based Simon effect nor the location-based Simon effect varied across response sets. When upright-inverted orientation judgments were made for the frying pan and for nongraspable stimuli derived from it, there again was no significant difference in size of the between- and within-hand Simon effects for any of the stimuli. The results provide evidence that the Simon effect for graspable frying pan stimuli is because of relative location of the handle and not to a grasping affordance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The "social deprivation-satiation effect": An outcome of frequency or perceived contingency?

Evaluated the contributions of frequency and contingency of reinforcement to the deprivation-satiation phenomenon. 72 3rd and 4th graders heard the word good either twice (deprivation) or 16 (satiation) times either contingently upon some action on their part, contingently upon some action of the E's, or noncontingently (at random). This was followed by a discrimination test under continuous reinforcement with the word good. All Ss showed high performance except the group exposed to the high frequency of noncontingent reinforcement. A postexperimental interview revealed that all groups except the high-frequency noncontingent group had interpreted the E's approval words as having been contingent on their behavior during treatment. Results support E. Y. Babad's (1972) thesis that the perceived contingency of reinforcement is a more powerful determinant of its subsequent reinforcement effectiveness than is its frequency per se. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The overcitation of examples of poor performance: Fad, fashion, or fun?

Comments on the article by J. J. Christensen-Szalanski and L. R. Beach (see record 1984-21471-001) that suggests that they have uncovered a bias, the propensity to cite experimental publications that demonstrate deficiencies in judgment and decision making over studies that demonstrate competence. This bias indicates what holds psychologists' interest. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Payment or repayment? The problem of private practice.

"From Freud on, it has been recognized that there is always a 'masochistic element' in neurotic and functionally psychotic individuals… . We need to be very sure that, in the fees which are charged for that otherwise doubtful service known as psychotherapy, we do not fall into the trap of merely gratifying this need for punishment on the part of the patient… . We need to be very certain… that 'therapy' does not become merely a form of expiation, much as electrically induced convulsions or hospitalization (with its overtones of imprisonment) does for others, who cannot afford 'psychotherapy."' The greatest weakness and defect of private practice "lies precisely in the fact that it offers as treatment what, in reality, is the very essence of the disease itself, namely continued privacy and personal withdrawal. Now we are coming to see that the way to feel better is to be better, in the ethical and interpersonal sense of the term." The neurotic's insecurity "stems from real guilt, which can be satisfactorily resolved only by radical openness and restitution." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Learning curves: Facts or artifacts?

"It is our purpose in this paper to show that the arbitrary choice of a cutoff point in the dichotomizing of continuous response distributions can impose significant constraints upon the shape of resulting learning curves, and that this can form the basis of misleading theoretical interpretations. We have chosen for illustration of this point the use of time-on-target scores as indicants of the level of skill attained in tracking tasks. However, we believe that the principles developed are quite general and apply to many learning situations." 18 references. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rhinotillexomania: psychiatric disorder or habit?

BACKGROUND: Conditions once considered bad habits are now recognized as psychiatric disorders (trichotillomania, onychopagia). We hypothesized that nose picking is another such "habit," a common benign practice in most adults but a time-consuming, socially compromising, or physically harmful condition (rhinotillexomania) in some. METHODS: We developed the Rhinotillexomania Questionnaire, mailed it to 1000 randomly selected adult residents of Dane County, Wisconsin, and requested anonymous responses. The returned questionnaires were analyzed according to age, sex, marital status, living arrangement, and educational level. Nose picking was characterized according to time involved, level of distress, location, attitudes toward self and others regarding the practice, technique, methods of disposal, reasons, complications, and associated habits and psychiatric disorders. RESULTS: Two hundred fifty-four subjects responded. Ninety-one percent were current nose pickers although only 75% felt "almost everyone does it"; 1.2% picked at least every hour. For 2 subjects (0.8%), nose picking caused moderate to marked interferences with daily functioning. Two subjects spent between 15 and 30 minutes and 1 over 2 hours a day picking their nose. For 2 others, perforation of the nasal septum was a complication. Associated "habits" included picking cuticles (25%), picking at skin (20%), biting fingernails (18%), and pulling out hair (6%). CONCLUSION: This first population survey of nose picking suggests that it is an almost universal practice in adults but one that should not be considered pathologic for most. For some, however, the condition may meet criteria for a disorder-rhinotillexomania.     

Vascular dementia: dead or alive?

Allergic respiratory inflammation in target organs does not occur in any atopic (genetically susceptible) subject, since other not fully characterized factors can influence the subsequent development of overt clinical disease. Here are presented some recent developments in experimental animal and human research that can offer a new "non-classical" interpretation about the way by which allergens are recognized and allergic inflammation persists. These aspects of the immunopathogenesis of allergic diseases can now be viewed as organ-specific pathways, acting independently from other peripheral lymphoid organs. This is a consequence of new knowledge about the function of, and molecular interactions by, intraepithelial gammadelta T cells and CD1+ dendritic cells. The allergic subject, unlike the normal one, is equipped at the mucosal surface by particular T cell and antigen-presenting cell (APC) subsets that enable them to recognize undenatured proteic and non-proteic (glycolipidic) external structures of aerodispersed particles, presented in the context of CD1 molecules. Once initiated, the mucosal allergic reaction cannot be turned off in atopic individuals because CD4+ allergen-specific T cells lack surface Fas receptor. This defect, that impairs the so-called activation-induced programmed cell death (determined by Fas/FasL interaction), is caused by the local Th2-type cytokine milieu.     

Feeling controlled in marriage: A phenomenon specific to physically aggressive couples?

Spouses in maritally happy nonaggressive (H; n?=?21), distressed nonaggressive (DNA; n?=?16), and distressed aggressive (DA; n?=?20) marriages were interviewed about their perceptions of their spouse as controlling. Four areas of spousal control were assessed: involvement in decision making, relationships with family and friends, freedom to plan activities independently, and sense of competence and self-respect. Overall, as expected, spouses in happy marriages reported feeling less controlled than spouses in the 2 distressed groups. Few gender differences were obtained, with the exception that wives in aggressive marriages were more likely to report that their husbands controlled their sense of competence and self-respect. Differences between the DA and DNA groups depended on the specific area of control. Wives in the aggressive couples were significantly more likely than their husbands to state that their spouse's aggression was an attempt to control them. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Models for psychiatry: icons or effigies?

Toulmin notes that a good model takes us beyond the phenomena from which we began [67]. It also tempts us. Models demand that we attempt to represent the dynamic relationships between variables. When we use them, we risk insulating our findings from empirical disproof [68]. Self-certifying myths, like articles of faith, need to yield to the demands of science. Psychiatric theory and practice need to yield to the demands of experience. We need to move away from ethereal assumptions to tangible mastery of the understanding of behavior. Freud, in The Interpretation of Dreams [69], writes, "Analogies of this kind are only intended to assist us in our attempt to make the complications of mental functioning intelligible. We are justified, in my view, in giving free rein to our speculations so long as we retain the coolness of our judgment and do not mistake the scaffolding for the building. We have been obliged to build. If we are not wholly in error, other lines of approach are bound to lead us into much the same region and the time may come when we shall find ourselves more at home in it!"