Some familiar headlines:
OVERPRESCRIBING PROMPTED WARNING ON ANTI-DEPRESSANTS (NY Times, March 24, 2004) The FDA issues a public health advisory advising monitoring the use of antidepressants for warning signs of suicide.
ANTI-DEPRESSANTS SEEN AS EFFECTIVE FOR ADOLESCENTS (NY Times, June 2, 2004) – Results of a study supported by the National Institute for Mental Health support studies revealing that medication and cognitive behavioral therapy were effective in treating adolescent depression and reducing the risk of suicide.
Which headlines are right? It's no wonder the public is left feeling confused and unsure of what to believe and more importantly, unsure of what lifestyle changes to make, if any, to improve the emotional health of children and adolescents. With conflicting reports announced from the same or different studies or analysts, individuals understandably become skeptical.At its best, reports in the media help the public become aware of critical issues and they digest dense technical and statistical information that has relevance to every day life. As news reports contribute to awareness of problems, they also report attempts at solutions. An example: In regard to the headlines cited above on the use of antidepressants, follow-up news reports noted the tendency of drug companies to focus on positive results of trials while playing down trials with negative or inconclusive findings. Also reported was a proposal requiring that each drug trial at its start be listed in a public database or registry is being considered by the American Medical Association, the International Committee of Medical Journal Editors, and is endorsed by several drug companies.
At its worst, reports in the media of inaccurate or incomplete information can be harmful to one's health. It is important to become a critical and competent consumer of mental heath stories in the news.
Here are some questions to ask when sorting out the scientific results from the unsupported reports.
1. What is the goal of the story?
If a story appears in a newspaper or a magazine or on television that doesn't automatically make it true. The goal of the research may be to help the public, advance a new finding, or refute an established belief. However, the goal of the news organization is different. The media are in business to attract readers and to make money. Even good reporters don't always ask the right questions, don't know the whole history of the story or issue, and since they have deadlines to meet, they may emphasize what they consider to be the most attention-catching results of studies. There are always three levels of bias to consider when hearing any report: the reporter, the researcher, and the reader all have a particular subjective opinion or belief which colors how information is obtained and understood.
2. What is the origin of the report?
News information is gathered from different sources. Look for the origin of the story to determine whether it's derived from a scientifically designed study, a survey, a case history, an opinion poll, or an opinion. Does the story state whether the results are based on a specific sample of the population with a matched control group or was it a random phone survey or internet poll? Was the study based on a double-blinded, randomized controlled trial – which means that neither the researcher nor the trial participants know who is receiving the treatment or a placebo. The source of funding for the study and the number of participants are two important factors in deciding how important the findings are likely to be.
3. Are the results related to similar studies?
It is unusual for new results to spring up isolated from a foundation of previous research in the same or related fields. It's important to remember that scientific knowledge evolves carefully and slowly since it is based on step-by-step replication and verification of previous results. If findings reflect a significant difference from what is commonly known or has been previously established, the reader is advised to explore the information with a professional. Issues you might discuss include how the new research contradicts other findings in the field. There should be a carefully delineated explanation for the presumed causes for the difference.
4. What aspect of the study is being reported?
Although it is not possible to report on all aspects of a detailed or complex study, consumers should note whether they are being given only the sensational aspects or a comprehensive summary of the study. If changes in established procedures or behaviors are being recommended, it's important to know if these are based on results that have been replicated by other scientists. Any conclusions suggesting changes in one's life should specify the people to whom the results apply and indicate any limitations to the application of the findings.
5. Where was the study officially reported?
There are many different outlets for new research to be reported. Consumers should find out if the results were published in a recognized journal with a peer review system or delivered at a scientific meeting. If a report was accepted by a credible scientific or professional journal, the implication is it has undergone a high level of scrutiny. Journals that are included in the National Library of Medicine database, MedLine, which are accessed through the on-line service, PubMed, are nearly always peer-reviewed. Scientists often report preliminary results at scientific meetings, and sometimes those reports are picked up by the press. Sometimes, when more work has been done, it turns out that the initial impressions were in error. That is one reason why not all results that are reported at scientific meetings are eventually published in definitive form. Thus, it is always a good idea to be cautious in interpreting results that have not yet been published.
6. Who conducted the research?
Some people in the news become household names, but many credible researchers with academic careers are less well known to the public. However, the authors should have established credentials and the appropriate training and background in their field to carry out or discuss the research. Usually, the lead or senior authors have doctoral degrees, such as an M.D. or Ph.D. degree, indicating specific training in research. The site of the research and funding source are also of concern. Government agencies provide funding for research in areas in which they believe there is a particular need or they have a particular interest and the quality of those studies is usually the highest, because only the best proposals receive such funding. Other sources of money are also widely available including from companies that may have an interest in the results. Studies have shown that research funded by corporations is much more favorable to the corporation’s product than research funded by the National Institutes of Health.
7. How should readers use the informaation?
Keep in mind the length of time it takes to conduct research prior to its release to the public, the speed at which the information can change, and that researchers continually debate the issues. Therefore it's best to be cautious about making any lifestyle, treatment, or medication changes. If the study refers to a specific issue relevant to you or a member of your family or the results raise doubts in your mind, it is advisable to discuss the applicability of the findings to your individual situation with a mental health professional.