Echoes Archives - World of Psychology

Since Newsweek published its article on antidepressants last week, we’ve seen a wide range of opinions posted about it online.

Psych Central blogger and journalist Christine Stapleton asks, Am I treating my depression with expensive Tic Tacs? She reacted strongly to the main premise of the article — that antidepressants are nothing more than expensive Tic Tacs. It’s a personal but very real reaction from someone who has battled depression and has found relief in antidepressants — like millions of other Americans. Indeed, it echoes my own arguments. Research can inform us about many things in general, but they can never tell us anything about how a specific individual will benefit (or not).

Christine posted a followup entry today, Antidepressants: JAMA, Newsweek and balanced journalism, where she says, “I am even more convinced that circulation trumped sound journalism in the Newsweek article.” Indeed. If Newsweek was looking for balanced and insightful journalism, this was not the piece to do that.

Therese Borchard added her voice to the “antidepressants work” argument in her blog entry, Newsweek: Do Antidepressants Work? For Many People, YES!. She said it eloquently:

For folks like me, though, who are/were hanging on to life by a very thin and fraying thread, antidepressants can save lives. They have certainly given me back my life.

I think it’s relatively absurd to suggest to people who have been helped by antidepressants that they could have simply taken a sugar pill and experienced the same positive effects. That’s not been their experience. But maybe you don’t buy into the appeals to emotion and personal experiences.

Finally, the editor-in-chief of Psychiatric Times (and occasional Psych Central contributor) Ronald Pies, MD wrote an editorial entitled, Newsweek’s Topsy-Turvy Take on Antidepressants earlier this week. In it, Dr. Pies demonstrates the numerous flaws in the evidence that Newsweek relied upon:

Both the Kirsch and Fournier studies are “meta-analyses” of various individual antidepressant trials. Meta-analyses suffer from all the problems common to such “number-crunching” methods: if the individual studies are flawed, the meta-analysis is flawed. For example, the Kirsch meta-analysis looked only at studies carried out before 1999. The much-publicized Fournier study examined a total of 6 antidepressant trials (n=718) using just 2 antidepressants, paroxetine and imipramine. Two of the imipramine studies used doses that were either subtherapeutic (100 mg/day) or less than optimal (100 to 200 mg/day). Moreover, the design of the Fournier study intentionally excluded individual studies involving a “placebo washout” phase, which attempts to reduce the number of placebo-responders receiving active medication. By excluding such studies, the Fournier meta-analysis may have reduced the difference between placebo and antidepressant response rates.

The challenge of a mainstream publication like Newsweek doing any kind of fair and balanced job with a controversial issue such as this is immense. How do you keep perspective and summarize decades’ worth of research in a consumer-friendly format?

In most cases, it’s a daunting and near-impossible task. I don’t think a publication like Newsweek can do anything but present a one-sided view to such controversies, because of their complexity. That’s what mainstream media does — boil down complex issues into black-and-white “sides.” And while they pretend they don’t take a side, simply counting the amount of words given to one over the other demonstrates clearly that a bias in such articles exists.

I can’t say it any better than Dr. Pies in this closing to his editorial:

Yes, antidepressants are “oversold” in those Big Pharma ads, adorned with chirping birds and fluttering butterflies — in truth, antidepressants don’t work as well or as specifically as we’d like. Given the frequent side effects of many antidepressants, it is usually wise to initiate treatment with psychotherapy, in cases of mild-to-moderate, non-melancholic depression. Alas, psychotherapy is often difficult for patients to obtain or afford. Despite Newsweek’s supposedly “depressing news” about antidepressants, psychiatrists have good reason to keep these medications in their armamentarium — and patients with severe unipolar depression8 have good reason to consider taking them.

It’s worth the read: Newsweek’s Topsy-Turvy Take on Antidepressants

Who Uses Internet Dating? Ever wonder who uses Internet dating services like Match.com and eHarmony.com? The answer may surprise you. I think, “Well, gee, everybody uses them!” But that’s not the case. There’s a particular psychological profile that researchers have discovered of users of Internet dating services.

The researchers (Kim et al., 2009) surveyed 3,345 people in the U.S., of which 1,588 (47.5 %) were men and 1,757 (52.5 %) were women. Ages ranged from 19 to 89 with a mean of 48 years old. They gathered their data using a number of standardized questionnaires and psychological measures.

The researchers found that people who are more “sociable are more likely to use Internet dating services than are those who are less sociable. This finding challenges the stereotypical profiling of
Internet daters as being just lonely and socially anxious people.”

Indeed, that finding confirms the idea that Internet dating is firmly in the mainstream now. While that may have not been the case 10 years ago, times have changed and using the Internet as a means of finding a prospective partner is no longer thought of as unusual. The researchers finding in this regard is not unique — previous research has come to the same conclusion, so it’s considered a robust research finding. For people who are already sociable, using the Internet as a dating method is just one more tool at their disposal.

But not all sociable folks consider the use of Internet dating. If you have high self-esteem and consider romantic relationships to be an important part of your life, you’re more likely to use Internet dating. If you have low self-esteem and consider romantic relationships not to be an important part of your life, you’re also more likely to use Internet dating.

So the researchers found that if you have low self-esteem and put some value on to your romantic relationships, you’re actually less likely to use Internet dating.

The researchers explain the findings this way:

If the success of romantic relationships is the domain of self worth, one may try to increase the prospect of success and avoid failure in romantic relationships. In the context of Internet dating, when sociable people consider romantic relationships to be an important domain for self-worth, those with high self-esteem will be more likely than those with low self esteem to use Internet dating services.

The reason is that when sociable people consider romantic relationships to be an important domain for self-worth, those with high self-esteem will find it comfortable to present themselves to a multitude
of anonymous people, whereas those with low self-esteem will be more likely to experience a higher level of stress just thinking about disclosing and promoting themselves on the Internet. Less confident individuals may not want their negative self-views publicized or viewed by others.

To reduce such negative feelings and protect their self-worth, those with low self-esteem will adopt avoidance strategies and distance themselves from Internet dating services.

Makes sense. High self-esteem folks feel like they have little to lose by trying Internet dating. Low self-esteem folks have more to lose, since more of their own self-value is tied up in the process — unless they say, “Ah, yeah, it’s nice to have a partner, but whatever. I’m also just fine without one.”

The upshot is that Internet dating is no longer the domain of the desperate nor those with low self-esteem (if it ever was).

The New York Times has a related article about the science (or lack thereof) behind the sites that claim such science helps you make better choices about dating. I think the science of such sites is ultimately of limited value, since no amount of data is going to predict whether two people will experience that indefinable quality of a “spark” on a first date. Without that, there will be no relationship.

Technology Review also weighed in this past week about the overwhelming number of choices of online dating and the research that has shown the more choices we have, the harder it can be sometimes to make a decision (“cognitive overload”). That’s why the sites try their best to offer you a way to limit the results displayed, but ultimately can fail in paring things down enough to make a difference to your brain.

Reference:

Kim, M., Kwon, K-N & Lee, M. (2009). Psychological Characteristics of Internet Dating Service Users: The Effect of Self-Esteem, Involvement, and Sociability on the Use of Internet Dating Services. CyberPsychology & Behavior, 12(4). DOI: 10.1089=cpb.2008.0296.

Echoes

Newsweek’s Take on Antidepressants: More Reactions

Who Uses Internet Dating?