How close is evidence to truth in evidence-based treatment of mental disorders?

Möller, Hans‐Jürgen

doi:10.1007/s00406-011-0273-8

Cited by 6 publications

(5 citation statements)

References 75 publications

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“…En poursuivant cette réflexion, d'autres inquiétudes se dessinent. Il apparaît que l'EBM en psychiatrie a inévitablement une influence quant aux procédures thérapeutiques étudiées, à celles considérées efficaces, et donc à celles offertes aux patients (Möller, 2012). Cela est vrai pour les traitements psychopharmacologiques, et peut-être même plus pour les psychothérapeutiques ; la psychothérapie présente de nombreuses et importantes barrières intrinsèques (itérative, multiétapes, avec des buts variés), et extrinsèques (coût, temps) à l'étude empirique (Falkum, 2009 ;Moller et Maier, 2010 ;Norcross, Beutler et Levant, 2006).…”

Section: L'evidence-based Medicine Peut-il Prendre Compte De La unclassified

“…Par exemple, une thérapie cognitivo-comportementale court terme manualisée est plus facilement étudiable empiriquement qu'une thérapie éclectique long terme, et sera donc reconnue plus valide, légitime. Il en découle que l'EBM, de par son impact sur le discours autour des traitements, en ce sens où le concept détermine ce qui compte comme efficace ou « prouvé par la science », a des conséquences subséquentes sur l'organisation des soins de santé mentale et les politiques publiques (Möller, 2012).…”

Section: L'evidence-based Medicine Peut-il Prendre Compte De La unclassified

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L’evidence-based medicine, un projet épistémologique et éthique en porte-à-faux avec la psychiatrie ?

Thibault¹

2020

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Section: L'evidence-based Medicine Peut-il Prendre Compte De La unclassified

L’evidence-based medicine, un projet épistémologique et éthique en porte-à-faux avec la psychiatrie ?

Thibault¹

2020

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“…Thus, for example, the concept of “evidence” in psychiatry is more complex than usually assumed [47]. …”

Section: Limitations and Conclusionmentioning

confidence: 99%

The psychiatric interview: validity, structure, and subjectivity

Nordgaard

Sass

Parnas

2012

Eur Arch Psychiatry Clin Neurosci

182

130

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There is a glaring gap in the psychiatric literature concerning the nature of psychiatric symptoms and signs, and a corresponding lack of epistemological discussion of psycho-diagnostic interviewing. Contemporary clinical neuroscience heavily relies on the use of fully structured interviews that are historically rooted in logical positivism and behaviorism. These theoretical approaches marked decisively the so-called “operational revolution in psychiatry” leading to the creation of DSM-III. This paper attempts to examine the theoretical assumptions that underlie the use of a fully structured psychiatric interview. We address the ontological status of pathological experience, the notions of symptom, sign, prototype and Gestalt, and the necessary second-person processes which are involved in converting the patient’s experience (originally lived in the first-person perspective) into an “objective” (third person), actionable format, used for classification, treatment, and research. Our central thesis is that psychiatry targets the phenomena of consciousness, which, unlike somatic symptoms and signs, cannot be grasped on the analogy with material thing-like objects. We claim that in order to perform faithful distinctions in this particular domain, we need a more adequate approach, that is, an approach that is guided by phenomenologically informed considerations. Our theoretical discussion draws upon clinical examples derived from structured and semi-structured interviews. We conclude that fully structured interview is neither theoretically adequate nor practically valid in obtaining psycho-diagnostic information. Failure to address these basic issues may have contributed to the current state of malaise in the study of psychopathology.

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“…Rather, all one has to believe is that the evidence supports the belief that it will, regardless of whether it happens or not (Joyce, 2011; §1.1, above). In such cases, the evidence supporting the belief is misaligned with reality (Warman et al, 2007; Möller, 2012). Clearly this is a slippery slope.…”

Section: Some Relevant Considerations About Beliefmentioning

confidence: 99%

A non-linear dynamical approach to belief revision in cognitive behavioral therapy

Kronemyer

Bystritsky

2014

Front. Comput. Neurosci.

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Belief revision is the key change mechanism underlying the psychological intervention known as cognitive behavioral therapy (CBT). It both motivates and reinforces new behavior. In this review we analyze and apply a novel approach to this process based on AGM theory of belief revision, named after its proponents, Carlos Alchourrón, Peter Gärdenfors and David Makinson. AGM is a set-theoretical model. We reconceptualize it as describing a non-linear, dynamical system that occurs within a semantic space, which can be represented as a phase plane comprising all of the brain's attentional, cognitive, affective and physiological resources. Triggering events, such as anxiety-producing or depressing situations in the real world, or their imaginal equivalents, mobilize these assets so they converge on an equilibrium point. A preference function then evaluates and integrates evidentiary data associated with individual beliefs, selecting some of them and comprising them into a belief set, which is a metastable state. Belief sets evolve in time from one metastable state to another. In the phase space, this evolution creates a heteroclinic channel. AGM regulates this process and characterizes the outcome at each equilibrium point. Its objective is to define the necessary and sufficient conditions for belief revision by simultaneously minimizing the set of new beliefs that have to be adopted, and the set of old beliefs that have to be discarded or reformulated. Using AGM, belief revision can be modeled using three (and only three) fundamental syntactical operations performed on belief sets, which are expansion; revision; and contraction. Expansion is like adding a new belief without changing any old ones. Revision is like adding a new belief and changing old, inconsistent ones. Contraction is like changing an old belief without adding any new ones. We provide operationalized examples of this process in action.

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How close is evidence to truth in evidence-based treatment of mental disorders?

Cited by 6 publications

References 75 publications

L’evidence-based medicine, un projet épistémologique et éthique en porte-à-faux avec la psychiatrie ?

L’evidence-based medicine, un projet épistémologique et éthique en porte-à-faux avec la psychiatrie ?

The psychiatric interview: validity, structure, and subjectivity

A non-linear dynamical approach to belief revision in cognitive behavioral therapy

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