Module 6 Flashcards
According to Stricker (2002), what are 4 ways in which S-Ps can integrate science into practice?
- In the process of doing clinical work, they display a questioning attitude and search for confirmatory evidence
- Apply research findings directly to practice
- Evaluate their individual practices
- Produce research themselves
What is the difference between EBP and EBT?
EBT starts with a treatment and examines whether it works for a certain disorder, whereas EBP starts with the client and examines what research evidence will assist the practitioner in achieving the best outcome for this client.
What are the 3 elements of EBP?
- Research evidence
- Clinical expertise
- Client values
All set within an organisational/environmental context of the practice
According to EBP, what 4 processes should you go through with a client?
- Psychological assessment
- Case formulation
- Therapeutic relationship
- Interventions
What are the 6 steps of EBP?
- Assess
- Ask the right question
- Access the evidence
- Appraise the evidence
- Apply the evidence
- Audit the clinical practice
What does equipoise mean?
In an RCT, treatment in any group should be consistent with competent care and there should be genuine uncertainty among experts as to which treatment (or control) is preferred
According to the NHMRC, what are the 5 levels of research evidence?
I Systematic review of RCTs
II RCT
III-1 Pseudo-RCT (eg: alternate allocation)
III-2 Cohort studies
III-3 Comparative studies with hsitorical control
IV Case series
What are the 4 main review bodies?
- Cochrane
- NICE (UK)
- APS
- WHO
Moriana et al. (2017): What disorders had excellent agreement among the four organisations?
- Generalised anxiety
- Specific phobias
- Bulimia nervosa
- OCD
Moriana et al. (2017); What disorders had good agreement among the four organisations?
- Anorexia
- Schizophrenia
- ADHD
What reasons did Moriana et al. (2017) propose for the discrepencies between organisations?
- Procedures or committees are biased
- Different RCTs and meta-analyses are reviewed
- Different criteria
- Reviews are made at different time periods
What are 2 recommendations Moriana et al. (2017) made?
- Unify the criteria for assesing evidence
- Improve the coordination between orgnaisations
What are some of Healy’s (and others) critiques of systematic reviews and clinical trials?
- Ghost writing of BigPharma
- Lack of access to data
- Only publishing positive results
- Greater funding for different research
- Negative outcomes attributed to first arm of study
- RCTs are based on specific experimental groups and may lack ecological validity
In PBE, who determines the efficacy of the treatment?
Practitioner
In POR, who derives the research questions?
The community
What are some of the benefits of POR?
- Naturalistic
- Ecologically valid
- Allows for two-way learning
What are 3 alternatives to EBP?
- Practice-based evidence (PBE)
- Practice-oriented research (POR)
- Research practice networks (PRN)
What are 2 strengths of the Nuremberg Code?
- It’s based on natural law and human rights that have universal application
- It’s articulation of informed consent
What are some of the deficiencies of the Nuremberg Code?
- Its origin as a response to Nazi medicine
- Emphasis on consent didn’t fit Nazi crimes
- Emphasis on informed consent as most important aspect of ethical research
After the 1954 Resolution, what was the essential feature of all versions of the Declaration of Helsinki?
Balancing the need to generate useful medical and therapeutic knowledge with the need to protect the health and interests of research participants.
What are some of the strengths of the Declaration of Helsinki?
- Most well known and widely available guideline on medical research ethics
- Sound basic structure
- Recognition of the need to ensure that research produces genuine medical advance, not repetitious or imitative work
What are some of the weaknesses of the Declaration of Helsinki?
- Politicised (eg: weakening the centrality of informed consent to permit a wider range of research)
- Internal contradictions and vagueness
The Belmont Report sought to tie together the provisions for human research ethics under 3 broad principles. What were they?
- Respect for persons
- Beneficence
- Justice
What does Respect for persons relate to?
Informed consent
What does Beneficence relate to?
Do no harm
What does Justice relate to?
Making sure subjects aren’t exploited
Inventing data
Fabrication
Twisting data
Falsification
Incorrect methodology, statistical procedures etc.
Incompetence
Poor record keeping or project monitoring
Careless work habits
Deliberate misreporting of data
Intentional bias
Publishing different components of the same data in different journals
Questionable publication practices/authorship
Not following federal research policy, not providing informed consent etc.
Failure to follow the regulations of science
Harassment or exploitation
Difficult or stressful work environment
Lack of consideration of existing conflicts of interest
Dishonest act indirectly related to being a researcher
What is the main reason why junior academics inadvertently plagiarise?
Inexperience, tied to a lack of education
What is the main reason for research misconduct in senior academics? What type of misconduct do they often do?
- Linked to pressure for frequent high-level research output
- Fabrication of data, falsification of findings
Franco et al: What were some of the benefits of their analytic strategy?
- They had a known population of conducted studies, and therefore a full account of what is published and unpublished
- TESS studies undergo rigorous peer review
- All survey experiments were conducted by the same firm, thus the studies are remarkably similar
- TESS requires studies to have statistical power, meaning failure to get significant results is not due to insufficient sample
What were the main findings of Franco et al. study on publication bias?
- There is a strong relationship between the results of a study and whether it was published (40% increase in probability of being published from moving from null to strong results)
- So few studies with null results are even written up
Franco et al: What are 2 problems associated with not writing up null results?
- Researchers may be wasting time and resources conducting studies that have already been done where the treatments weren’t efficacious
- If future research obtains significant results by chance, then the published literature on the topic will erroneously suggest stronger effects
Franco et al: What can be done to reduce publication bias going forward?
- Better understand the motivations of researchers who choose to pursue projects as a function of results
- 2-stage review
What 4 situations can cause ethical drift?
- Intense competition for your resources eg: time
- There is little tangible reward for making an ethical decision and acting on it
- You perceive others acting in ways that are ethically compromised
- You are coerced by others to act unethically
What traits and behaviours are negatively associated with burnout?
- Extraversion
- Openness
- Agreeableness
- Conscientiousness
- Task-focused coping
What are 4 interventions for psychologists to better value themselves?
- CBT
- Positive psychology
- Mindfulness
- ACT
What are some barriers for psychologists seeking help?
- Social stigma
- Treatment concerns
- Fear of exposing emotion
- Anticipated risks
- Self-disclosure
