Post Of The Week – Saturday 21st February, 2015

1) Relative And Absolute Risk

This isn’t strictly speaking a piece of Psychology but it’s a very good example of how statistics sometimes mislead. In this video, David Spiegelhalter from Cambridge explains how claims about increased risk for a particular action or intervention are not necessarily what they seem.

There’s a job to be done in making the public more scientifically and statistically literate so that we can have a sensible debate about risky behaviours and about appropriate interventions.

2) Plain Packaging

For a while, I have been tracking news about plain packaging for cigarettes. Governments across the world have been looking at the effect of plain packaging legislation in Australia. All of the evidence suggests that plain packaging reduces smoking.

You can see from the quote at the bottom of this piece that the tobacco manufacturers are fighting a strong rearguard action against this claim. How tobacco companies fight back is dealt with in this polemical piece by John Oliver. It’s probably best not to watch this if you are offended by a bit of swearing.

3) Number Needing To Be Prevented

When we look at therapies for depression, we look at Number Needing Treatment as a measure of the effectiveness of a therapy. Essentially, NNT tells you how many extra people you would need to treat with any given therapy for one extra person to get better. The same principles can be applied to prevention of negative effects of taking controlled substances.

This abstract gives figures for number needing to be prevented. In other words, for various categories, it works out how many  people would need to be prevented from using cannabis for there to be one fewer case of psychosis. This begs the question both of what the risk of using cannabis is and of what it is about cannabis which might cause psychosis. David Shukman gives a balanced view of what is known here.

4) Anti-Depressants And Serotonin

The story about how anti-depressants work is simple. SSRIs such as prozac work by preventing the reuptake of serotonin. More serotonin is available between synapses meaning that parts of the brain which are not functioning well when someone is depressed start to work again, leading to a reduction of symptoms. The problem with this account is that the drugs work immediately on serotonin levels but it takes a couple of weeks for the symptoms of depression to be affected. We normally get round this by saying that there is more to depression than low serotonin. We place low levels of serotonin in a network of as yet unspecified brain mechanisms which might explain how and why we get depressed.

This article, based on work by Paul Andrews at McMaster University suggests that we need to go further. Its starting point is that there is no direct evidence that depression is the result of low serotonin. People with depression may actually have excessive serotonin as a result of the brain reorganising itself to deal with life changes and other difficulties. Antidepressants interfere with this process, which explains why people often feel worse after they have started taking them. They improve afterwards because the brain effectively recruits the effect of the antidepressants in a battle which it is already fighting. As with much else in Psychology, this comes back to a question of classification. Andrews does not see depression as an illness. Most forms of depression, on this view, are natural but uncomfortable reactions to distressing events.

5) Bethlem Hospital Art

This report from the BBC shows some of the art produced at the world’s oldest mental hospital. It explains powerfully what is possible for people labelled as mentally ill. The journalist, Joe Inwood, is a former student of mine.

6) Uberization Of Health Care

The premise of this article is that health care systems exist to serve the interests of health care providers rather than service users. Just as the uber app has changed the way people travel so that regulations about how taxis operate have had to change, so online health resources will change the way in which we look after ourselves.

7) John Ioannidis

We listen to a radio programme featuring John Ioannidis when we study features of science in A2 Psychological Research And Scientific Method. Here he is in a longer interview.

8) Childcare Costs

The cost of childcare is going up. Quite why this has happened is not entirely clear but it is having an impact on parents’ ability to go to work.

This article explains the problem but not the solution.

9) Aaron Beck Speaks …

We’ll be starting abnormality in AS in a couple of weeks. Our course requires us to divide explanations and therapies into different approaches. Aaron Beck explains in this video how someone working within the cognitive framework will use ideas from the psychodynamic approach to understand the experience of patients. Simple but brilliant.


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