The Monoamine Hypothesis, Placebos and Problems of Theory Construction in Psychology, Medicine, and Psychiatry ABSTRACT: Can there be scientific theories in psychology, medicine or psychiatry? I approach this question through an in-depth analysis of a typical experiment for clinical depression involving the monoamine hypothesis, drug action, and placebos. I begin my discussion with a reconstruction of Adolph Grünbaum's conceptual analysis of 'placebo,' and then use his notion of "intentional placebo" to discuss a typical experiment using the monoamine hypothesis, two drugs and a placebo. I focus on the theoretical aspects of the experiment, especially on the notion of causal explanation. I then raise five conceptual and methodological problems for theory construction. These problems focus on questions of the causal efficacy of placebos and drugs; ad hoc versus ceteris paribus explanations in biomedicine and psychology; and the falsifiability of the monoamine hypothesis. I conclude by pointing out the need for further, rigorous philosophical analysis concerning the possibility of theory construction in psychology, medicine, or psychiatry. I. Introduction Can there ever be scientific theories in psychology, medicine, or psychiatry? I argue that one approach to answering this question consists of investigating the nature of such purported theories and I focus on the monoamine hypothesis of clinical depression. (1) By a careful examination of a typical experiment involving the action of drugs and placebos for the cure of clinical depression-an experiment founded upon the monoamine hypothesis-I raise a number of methodological and conceptual problems that may lead one to conclude that rigorous scientific theories in these three disciplines may never be forthcoming, or at least that the state of scientific research in these areas is still in very rudimentary shape and in need of much logical and philosophical analysis. In addition, because no such biomedical theories may be forthcoming, I also undercut Adolf Grünbaum's analysis of the concept of a placebo, an analysis that makes the definition of "placebo" relative to a biomedical theory in the first place. I begin in section 2 by discussing Grünbaum's detailed analysis of what a placebo is. I then use his idea of a generic intentional Placebo and discuss one of many similar experiments concerning the phenomenon of clinical depression, experiments that use the monoamine hypothesis and the notion of a generic intentional placebo. This experiment is described in section 3. In section 4 I analyze the results of this study and in section 5 I offer concluding remarks.
Cognitive Behavioral Therapy appears to be a new treatment, although its roots can be traced to Albert Ellis’s Reason and Emotion in Psychotherapy, published in 1962. Cognitive therapy assumes that thoughts precede actions and false self-beliefs cause negative emotions. It is now known that most depression treatments have cognitive components to them, whether they are recognized or not. In the 1970’s many psychologists began using cognitive components to describe depression. From there, they developed cognitive forms to treat depression with impressive results (Franklin, 2003).
Psychodynamic approaches often come under a lot of criticism as they fail to be explicit about the underlying bases of the theory. Cognitive theories are not very comfortable with explaining emotions and behavioural theories have difficulty explaining the mechanisms of improvements.
Kaplan, H. I., Sadock, B. J., & Grebb, J. A. (1994). Synopsis of psychiatry: behavioral sciences,
Ernst, E., & Resch, K. L. (1995). Concept of true and perceived placebo effects. British Medical
Jeremy Laurance’s article “Ketamine: a cure for depression?” published in The Independent in October 2012, sanctions the use of a drug of abuse called ketamine for the treatment of depression. The author supports this theory by stating a study completed by Robert Dunman, a professor of Psychiatry and Neurobiology at Yale University School of Medicine in Boston. The following paragraph will summarise the main points of the article and discuss the evidence used by the author.
Many argue against Gold and Lichtenberg’s beliefs. Others believe that giving the patient a placebo is denying them of a “real” treatment and that it “is unethical, if not illegal.”1 Many people also believe tha...
...ss violence is still likely to struggle in the aftermath. The shocking intensity of the terror inherent in this type of victimization is such that its imprint will never fully fade. Craig Scott spoke the truth of all survivors of mass violence as, without exception, the impact is unquestionably life-changing.
Antidepressants are a prescription drug now used by people of all ages. They have become a part of society, therefore, taking antidepressants is not frowned upon. Antidepressants are used to make people feel “happier” and not to feel sadness. This is shown in the dystopian society in the book Brave New World written by Aldous Huxley in 1932. In that society the people use soma, a well-known drug, to make them feel no pain and are conditioned to think soma fixes everything. Helmholtz and Bernard two main characters, do not take it because they want to be able to see the world for what it is. They also do not want soma to change how they feel; they want to appreciate nature. In addition Lenina and Henry love taking soma because then they cannot feel any pain, they are just happy all the time. In our society, people think that antidepressants will make them feel no pain and that these medications will fix all of their problems. Antidepressants have a negative impact on society today as well as in the book Brave New World.
Through my extensive research on depression I have learned a lot of new things. I have learned about the many forms of depression and treatment for depression. I have also learned a little about what is believed to go on chemically in the brain of a clinically depressed person. I was also able to partially determine what sort of role genetics, chemicals and personal influences in the brain. Though I was unable to determine exactly how environmental and personal stress can cause a chemical imbalance in a person, I was even able to speculate about this issue and determine some theories of my own on why and how this may happen.
This paper will examine the complicated roles a counselor has related to the use of prescribed medication in treating mental health issues. The first section will explore the boundaries and ethical implications for a counselor surrounding the recommendation and prescription of psychotropic medication. The next section will include the counselor’s role in client education about medication. The third section will relate to the details of client referral when medication is warranted.
Beck, A. (1978). Cognitive therapy of depression (The Guildford Clinical Psychology and psychopathology series). New York, N.Y : Guildford Press.
The placebo effect has been one of the most interesting but irritating topics within biomedical science for over the past 60 years. Through this speech I wish to inform and educate while I discuss the placebo effect and cover what it is, how it works and why that is.
Depression is a mental illness, which affects millions of Americans each year. Currently there are many prescription drugs, called anti-depressants that have been proven to successfully treat it. The causes of depression are somewhat of a medical enigma, however, it is known that depression is associated with a change in the brains chemistry involving the function of neurotransmitters (Reichert). This chemical change occurs in healthy brain’s, which experience sadness, but ends after the unpleasant stimulus is removed. In people suffering from depression this chemical change does not correspond to any particular stimulus. Symptoms of depression are often incapacitating and include severe and extended sadness, feelings of worthlessness, feelings of emptiness, irritability and anxiety (Reichert, Spake).
The biological approach is useful in regards to treatment. This approach has led to many forms of treatments. The cognitive approach is also useful and has made important contributions to the field of psychology, particularly that for the treatment of depression. The cognitive approach has been applied successfully in therapy. One of the core expectations of the cognitive approach is that mental processes influence our behavior. A further similarity between the two approaches is that both are seen as deterministic approaches. The biological approach believes that behavior is determined by functions of neurons and the structure and functions of the brain. It aims to ‘predetermine’ our behavior so therapy can be developed to aid abnormal behavior. The cognitive approach outlines the importance of schemas and stereotypes. Schemas are seen to be important in an individual’s behavior. We acquire schemas through direct experiences. Another way we acquire schemas is through social interaction. Through interactions we also learn stereotypes. These schemas and stereotypes determine the way we interpret a situation. Furthermore, both the biological and cognitive approaches use scientific methods. Both approaches believe that behaviour should be tested and measured in a systematic
Bio-Psychologists study the principles of biology as it relates to the comprehension of psychology in the field neuroscience that underlies ones emotions, ideology, and actions (Brittanica). Based upon the conduction of research, the relationship between the brain and ones behavior extends to the physiological process in one’s intellect. Scientists are cognizant that neurotransmitters function as a significant role in mood regulation and other aspects of psychological problems including depression and anxiety. A biological perspective are relevant to psychology in three techniques including: the comparative method, physiology, and the investigation of inheritance (Saul Mc. Leod).