The Scientific Review of Mental Health Practice

Objective Investigations of Controversial and Unorthodox Claims in Clinical Psychology, Psychiatry, and Social Work


Recent Papers of Interest

Beutler, L. E. (2004). The empirically supported treatments movement: A scientist-practitioner’s response. Clinical Psychology: Science and Practice, 11, 225–229.

Beutler responds to an article by American Psychological Association president-elect Ronald Levant by criticizing Levant’s sharp distinction between clinical scientists and practitioners, as well as Levant’s apparently unwillingness to take issue with clinical psychologists who maintain that intuition and subjective impressions should be weighted more heavily than scientific findings. Beutler argues that Levant grossly overestimated the importance of relationship factors in psychotherapeutic outcome, and he points to evidence that both relationship factors and specific techniques contribute substantially to the efficacy of psychotherapy. He further contends that Levant’s claims to the contrary, many psychotherapy studies have been conducted on patients with multiple diagnoses. Hence, Beutler argues, such studies are more generalizable to real-world patients than Levant had maintained. Finally, Beutler questions Levant’s contention that clinical judgment and experience should be accorded equal weight along with controlled scientific evidence in evaluating the efficacy of psychotherapies. As Beutler notes, clinical judgment and experience, although useful for certain purposes, are vulnerable to a host of cognitive biases.

Bornstein, R. F. (2003). The Scientific Review of Mental Health Practice: Implications for psychology and psychoanalysis. Psychoanalytic Psychology, 20, 717–726.

Bornstein offers a thoughtful and critical discussion of the rationale of The Scientific Review of Mental Health Practice (SRMHP), reviews the articles in the journal’s first issue, and examines the implications of SRMHP for the field of psychoanalysis. He criticizes SRMHP for its lack of inclusion of psychoanalytically oriented scientists on its editorial board and expresses concerns that the journal may be unduly biased against articles supportive of psychoanalysis. Nevertheless, he concludes that SRMHP need not represent a threat to psychoanalysis provided that the editor is willing to consider rigorous empirical research and literature reviews on psychoanalytic topics irrespective of their findings and conclusions (Editor’s Note: Dr. Bornstein has recently been added to the SRMHP editorial board).

Chan, A. W., Hróbjartsson, A., Haahr, M. T., Gotzsche, P. C., & Altman, D. G. (2004). Empirical evidence of selective reporting of outcomes in randomized trials: Comparison of protocols to published articles. Journal of the American Medical Association, 291, 2457–2465.

In this important but unsettling article, Chan and his coauthors examine the magnitude of selective reporting of treatment outcomes in randomized controlled medical trials in Denmark from 1994 to 1995. Using 122 journal outcomes with 3,736 outcome measures, they found substantial evidence for selective reporting of results. Fifty percent of efficacy outcomes went unreported, as did 65% of harmful outcomes. Hence, reported results tend to be biased in favor of positive outcomes. Interestingly, 86% of respondents (article authors) denied the existence of selective reporting despite clear evidence to the contrary. The authors’ findings suggest that selective reporting may represent an even graver threat to the interpretation of treatment outcome literatures than the “file drawer effect” (the tendency for articles with negative findings to remain unpublished).

Eigenmann, P. A., & Haenggeli, C. A. (2004). Food colourings and preservatives: Allergy and hyperactivity. Lancet, 364, 823–824.

The authors comment on a recently published controlled study by Bateman and colleagues (Archives of Disease in Childhood, 2004, 89, 506–511), which suggested potential benefits of a diet without artificial food colorings and benzoate preservative for 3-year-old children with hyperactivity (roughly equivalent to attention-deficit/hyperactivity disorder or ADHD). In this study, effects for this diet were observed by parents but were not evident on more objective psychological tests. Eigenmann and Haenggeli argue that the results of this study are difficult to interpret in view of Bateman et al.’s inadequate assessment of ADHD, the exclusion of over 90% of the original example, and the potential role of observational bias on the part of parents. Nevertheless, they suggest that shortterm dietary interventions may prove helpful in a selected sample of ADHD children, although these interventions should be carefully monitored.

Herschell, A. D., McNeil, C. D., & McNeil, D. W. (2004). Clinical child psychology’s progress in disseminating empirically supported treatments. Clinical Psychology: Science and Practice, 11, 267–288.

The authors note that the dissemination of empirically supported treatments (ESTs) has been slower for childhood than adult psychological disorders. They review several obstacles standing in the way of effective dissemination, including many clinicians’ reluctance to embrace treatment manuals. They argue that the use of treatment manuals can be helpful, but that rigid adherence to such manuals may produce negative outcomes. In addition, Herschell and colleagues discuss strategies for enhancing the dissemination of childhood ESTs to practitioners, including investigation of effective dissemination techniques, increasing the quantity of treatment outcome research conducted on childhood disorders commonly seen in clinics, establishing bidirectional partnerships between researchers and practitioners, and adopting more extensive use of novel technologies (e.g., interactive CDs) for enhancing dissemination. See also responses in this same issue by (a) Ollendick and Davis, (b) Silverman and Kurtines, (c) Weisz, Chu, and Polo, (d) Shirk, (e) Weingardt, and (f) Chorpita, (g) Lane and Addis, and (h) Rothbaum.

Loftus, E. F. (2004). Memories of things unseen. Current Directions in Psychological Science, 13, 145–147.

Loftus briefly reviews the status of recent paradigms for implanting false memories, such as the familial-narrative false-informant (“lost in the mall”) procedure, imagination inflation, and the insertion of school class photographs of participants into photographs of fictional events (the lattermost technique was developed by Steve Lindsay and his colleagues). She also discusses some of the differences between false and true memories, including subjective confidence in the accuracy of these memories and the perceived vividness of these memories, but notes that these differences are often weak in magnitude or absent. She concludes by pointing out that false memories and false beliefs can have pernicious consequences, including membership in cult groups.

McNally, R. J., Lasko, N. B., Clancy, S. A., Macklin, M. L., Pitman, R. K., & Orr, S. P. (2004). Psychophysiological responding during script-driven imagery in people reporting abduction by space aliens. Psychological Science, 15, 493–497.

McNally and his colleagues examine the psychophysiological responsivity of purported “alien abductees” using measures of heart rate, skin conductance, and left frontalis electromyography (EMG). Purported abductees were asked to listen to idiographically derived taperecorded scripts of their reported abduction episodes (along with tape recordings of other stressful, positive, and neutral events they had experienced). Control participants (nonabductees) were asked to listen to the same recordings. The authors found that purported abductees displayed significantly more psychophysiological arousal to audiotaped scripts of their own abduction encounters than to comparison scripts. Moreover, this difference was more marked among “abductees” than among control participants. Remarkably, purported abductees’ psychophysiological reactions to their own abduction scripts were comparable to the reactions of patients with posttraumatic stress disorder (PTSD) to their own trauma scripts. These findings suggest that the traumatic memories of purported alien abductees are just as subjectively “real” as those of patients with PTSD.

Morgan III, C. A., Hazlett, G., Doran, A., Garrett, S., Hoyt, G., Thomas, P., Baranowski, M., & Southwick, S. (2004). Accuracy of eyewitness testimony for persons encountered during exposure to highly intense stress. International Journal of Law and Psychiatry, 27, 265–279.

The authors examined the accuracy of eyewitness identification among 530 individuals enrolled in military survival school training who were either interrogated in a stressful manner or a nonstressful manner. Both interrogations were approximately 40 minutes in duration. Using several methods of eyewitness identification (live line-up, photo-spread, sequential photo), identification of the interrogators was significantly more accurate in the low-stress than high-stress interrogation. For the highstress condition, the rates of false-positive identifications of the interrogator ranged from 51–68%. The authors also reported nonsignificant associations between the confidence and accuracy of identifications, mirroring many findings in previous eyewitness research. The authors conclude by noting that “contrary to the popular conception that most people would never forget the face of a clearly seen individual who had physically confronted them and threatened them for more than 30 minutes, a large number of subjects in this study were unable to correctly identify their perpetrator” (p. 274).

Neimark, J. (2004, August). Are recovered memories real? Discover, 73-77.

Neimark reviews the recent research of Harvard psychologist Richard J. McNally and his colleagues on the memories of purported alien abductees. As she points out, this research demonstrates that such individuals are especially prone to “memory illusions” in list learning paradigms. In addition, their work (see also description of McNally et al., 2004, Psychological Science, immediately above) indicates that purported abductees are just as physiologically reactive to scripts of their reported abduction experiences as are PTSD patients who are exposed to scripts of their wartime combat experiences. Neimark quotes Washington University psychologist Henry L. Roediger III as saying that “[p]eople never capture anything literally,” and goes on to discuss the work of McNally and Steven Southwick demonstrating that even traumatic memories (e.g., of wartime combat or school shootings) can change dramatically over time. She also reviews recent neurophysiological work in rodents suggesting that repeated recall of a memory actually alters this memory. As she notes, this work holds out the possibility of developing psychopharmacological agents to treat individuals with PTSD and other conditions marked by traumatic memories.

Nock, M. K., Goldman, J. L., Wang, Y., & Albano, A. M. (2004). From science to practice: The flexible use of evidence- based treatment procedures in clinical settings. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 777–780.

The authors briefly discuss methods for modifying manualized evidence-based treatment procedures (or “empirically supported treatments”), which have been criticized by some authors as rigid and inflexible. They present a successful case of a 10-year-old boy with panic disorder who was administered panic control treatment (PCT), an evidence-based treatment procedure developed by David Barlow and his colleagues. They illustrate how they adapted this treatment to the child’s developmental level and the mothers’ level of treatment involvement. Nock and his colleagues suggest that clinicians can benefit from implementing evidence-based treatments but modifying them appropriately in accord with scientific considerations.

Wegner, D. M., Wenzlaff, R. M., & Kozak, M. (2004). Dream rebound: The return of suppressed thoughts in dreams. Psychological Science, 15, 232–236.

Wegner and his coauthors asked participants to spend five minutes before going to sleep writing about two other people, one for whom they have harbored romantic feelings but never been involved with (a “crush”) and another for whom they are fond but never harbored romantic feelings for (a “noncrush”). Prior to the writing task, some participants were randomly assigned to actively suppress thoughts of both persons, others were randomly assigned to think about both persons, and still others were randomly assigned to think about whatever they wished. Wegner et al. found that thinking about a person before going to sleep resulted in greater amounts of dreaming about this person, as ascertained by both dreamers’ self-reports and independent raters’ coding of their dream reports. Nevertheless, this effect was most pronounced in the suppression condition, suggesting that active efforts to inhibit thoughts before going to sleep can produce paradoxical rebound effects. The suppression effects did not, however, differ for “crush” versus “noncrush” target individuals.

You can read the full text of this article in
The Scientific Review of Mental Health Practice, vol. 3, no. 2 (Fall/Winter 2004-05).
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