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7. Preventing Hung Juries About Therapy Studies.

Author

Klein, Donald F.

Abstract

Presents a series of arguments that emphasize the importance of comparatively evaluating psychotherapies with appropriate pharmacotherapy and pill placebo. The lack of a pill-placebo arm has rendered moot those studies that compared pharmacotherapy directly with psychotherapy because of the lack of an internal sample defining calibration with regard to medication responsivity. Discusses the issue and makes recommendations. (KW)

Published
1996

19. Relationship between separation anxiety disorder, parental panic disorder, and atopic disorders in children: a controlled high-risk study

Author

Slattery, Marcia J., Klein, Donald F., Mannuzza, Salvatore, Moulton, John L., III, Pine, Daniel S., and Klein, Rachel G.

Subjects
Separation anxiety (Child psychology) -- Research, Panic disorders -- Research, Parent and child -- Psychological aspects, Allergy in children -- Research, Asthma in children -- Research, Family and marriage, Psychology and mental health
Published
2002

22. Harmful dysfunction, disorder, disease, illness, and evolution

Author

Klein, Donald F.

Subjects
Mental illness -- Analysis, Psychology, Pathological -- Analysis, Clinical psychology -- Research, Psychology and mental health
Abstract

Can psychiatric disorders be conceptualized as 'harmful dysfunctions' (J. C. Wakefield, 1992a, 1992b, 1999; S. O. Lilienfeld & L. Marino, 1995)? Wakefield's (1992a) central concept of disorder as 'harmful dysfunction' is discussed by placing it in the context of a complementary discussion of disease, illness, the sick role, and evolution (D. F. Klein, 1978). S. O. Lilienfeld and L. Marino (1995) contended that proper biological function cannot be determined. This argument obscures the key significance of involuntary impairment of evolved functions. The claim that the Roschian concept has no counterpart in reality is incorrect and does not support the conclusion that dysfunctions are irreducibly evaluative and therefore arbitrary. J. C. Wakefield's (1999) views in this area are supplemented. The role of monothetic and polythetic categorization, extremal terms, and the concept of normality in nosology is considered. This analysis refutes the implication that deviance and illness are equivalent. The resolution of this debate is practically relevant to emphasizing areas of research investment, such as therapeutics.

Published
1999

27. Relationship between cingulo-insular functional connectivity and autistic traits in neurotypical adults

Author

Martino, Adriana Di, Shehzad, Zarrar, Kelly, Clare, Roy, Amy Krain, Gee, Dylan G., Uddin, Lucina Q., Gotimer, Kristin, Klein, Donald F., Castellanos, F. Xavier, and Milham, Michael P.

Subjects
Autism -- Research, Health, Psychology and mental health
Abstract

Objective: The Social Responsiveness Scale--Adult Version (SRS-A) measures autistic traits that are continuously distributed in the general population. Based on increased recognition of the dimensional nature of autistic traits, the authors examined the neural correlates of these traits in neurotypical individuals using the SRS-A and established a novel approach to assessing the neural basis of autistic characteristics, attempting to directly relate SRS-A scores to patterns of functional connectivity observed in the pregenual anterior cingulate cortex, a region commonly implicated in social cognition. Methods: Resting state functional magnetic resonance imaging scans were collected for 25 neurotypical adults. All participants provided SRS-A ratings completed by an informant who had observed them in natural social settings. Whole brain-corrected connectivity analyses were then conducted using SRS-A scores as a covariate of interest. Results: Across participants, a significant negative relationship between SRS-A scores and the functional connectivity of the pregenual anterior cingulate cortex with the anterior portion of the mid-insula was found. Specifically, low levels of autistic traits were observed when a substantial portion of the anterior mid-insula showed positive connectivity with the pregenual anterior cingulate cortex. In contrast, elevated levels of autistic traits were associated with negative connectivity between these two regions. Conclusions: Resting state functional connectivity of the pregenual anterior cingulate cortex-insula social network was related to autistic traits in neurotypical adults. Application of this approach in samples with autism spectrum disorders is needed to confirm whether this circuit is dimensionally related to the severity of autistic traits in clinical populations.

Published
2009

36. Critiquing McNally's reply

Author

Klein, Donald F.

Subjects
Cognitive therapy -- Evaluation, Panic disorders -- Care and treatment, Benzodiazepines -- Therapeutic equivalency, Meta-analysis -- Evaluation, Psychotherapy -- Evaluation, Psychology and mental health
Abstract

McNally's assertions on the efficiency of cognitive-behavior therapy (CBT) in yielding larger effect sizes compared to drug treatments with antidepressants such as benzodiazepines were erroneous. McNally based his assertions on meta-analytical documentation which disregards randomization during the comparison of treatments. Furthermore, McNally failed to cite the results of studies by Shear et al. which indicates the similarity of CBT with nondirective counseling in the treatment of panic disorders.

Published
1996

37. Discussion of 'Methodological controversies in the treatment of panic disorder.' (response to article by R.J. McNally, Journal of Consulting and Clinical Psychology, vol. 64, p.88)

Author

Klein, Donald F.

Subjects
Panic disorders -- Care and treatment, Behavioral health care -- Analysis, Imipramine -- Physiological aspects, Medical case management -- Analysis, Psychology and mental health
Abstract

R.J. McNally's criticisms on the logic of psychotherapy analysis based on the pill placebo-case management for the treatment of panic disorder (PD) is erroneous. McNally did not consider the historical data on the efficacy of imipramine case management when he commented on the inability of the experiment to satisfy the two criteria of pill placebo case management. Furthermore, analysis on the validity of treatment trials also indicated the inability of a proven drug to exhibit significant variability in efficacy compared to placebo during the treatment of PD.

Published
1996

48. Classifying Depression

Author

QUITKIN, FREDERICK M., STEWART, JONATHAN W., MCGRATH, PATRICK J., and KLEIN, DONALD F.

Published
2001

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