Raising Awareness for the Replication Crisis in Clinical Psychology by Focusing on Inconsistencies in Psychotherapy Research: How Much Can We Rely on Published Findings from Efficacy Trials?

Current best practices and future opportunities for reproducible findings using large-scale neuroimaging in psychiatry

Research into the brain basis of psychopathology is challenging due to the heterogeneity of psychiatric disorders, extensive comorbidities, underdiagnosis or overdiagnosis, multifaceted interactions with genetics and life experiences, and the highly multivariate nature of neural correlates. Therefore, increasingly larger datasets that measure more variables in larger cohorts are needed to gain insights. In this review, we present current "best practice" approaches for using existing databases, collecting and sharing new repositories for big data analyses, and future directions for big data in neuroimaging and psychiatry with an emphasis on contributing to collaborative efforts and the challenges of multi-study data analysis.

Increasing Value and Reducing Waste of Research on Neurofeedback Effects in Post-traumatic Stress Disorder: A State-of-the-Art-Review

Post-Traumatic Stress Disorder (PTSD) is often considered challenging to treat due to factors that contribute to its complexity. In the last decade, more attention has been paid to non-pharmacological or non-psychological therapies for PTSD, including neurofeedback (NFB). NFB is a promising non-invasive technique targeting specific brainwave patterns associated with psychiatric symptomatology. By learning to regulate brain activity in a closed-loop paradigm, individuals can improve their functionality while reducing symptom severity. However, owing to its lax regulation and heterogeneous legal status across different countries, the degree to which it has scientific support as a psychiatric treatment remains controversial. In this state-of-the-art review, we searched PubMed, Cochrane Central, Web of Science, Scopus, and MEDLINE and identified meta-analyses and systematic reviews exploring the efficacy of NFB for PTSD. We included seven systematic reviews, out of which three included meta-analyses (32 studies and 669 participants) that targeted NFB as an intervention while addressing a single condition-PTSD. We used the MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2 and the criteria described by Cristea and Naudet (Behav Res Therapy 123:103479, 2019, https://doi.org/10.1016/j.brat.2019.103479 ) to identify sources of research waste and increasing value in biomedical research. The seven assessed reviews had an overall extremely poor quality score (5 critically low, one low, one moderate, and none high) and multiple sources of waste while opening opportunities for increasing value in the NFB literature. Our research shows that it remains unclear whether NFB training is significantly beneficial in treating PTSD. The quality of the investigated literature is low and maintains a persistent uncertainty over numerous points, which are highly important for deciding whether an intervention has clinical efficacy. Just as importantly, none of the reviews we appraised explored the statistical power, referred to open data of the included studies, or adjusted their pooled effect sizes for publication bias and risk of bias. Based on the obtained results, we identified some recurrent sources of waste (such as a lack of research decisions based on sound questions or using an appropriate methodology in a fully transparent, unbiased, and useable manner) and proposed some directions for increasing value (homogeneity and consensus) in designing and reporting research on NFB interventions in PTSD.

The use of hyperbaric oxygen for veterans with PTSD: basic physiology and current available clinical data

Post-traumatic stress disorder (PTSD) affects up to 30% of veterans returning from the combat zone. Unfortunately, a substantial proportion of them do not remit with the current available treatments and thus continue to experience long-term social, behavioral, and occupational dysfunction. Accumulating data implies that the long-standing unremitting symptoms are related to changes in brain activity and structure, mainly disruption in the frontolimbic circuit. Hence, repair of brain structure and restoration of function could be a potential aim of effective treatment. Hyperbaric oxygen therapy (HBOT) has been effective in treating disruptions of brain structure and functions such as stroke, traumatic brain injury, and fibromyalgia even years after the acute insult. These favorable HBOT brain effects may be related to recent protocols that emphasize frequent fluctuations in oxygen concentrations, which in turn contribute to gene expression alterations and metabolic changes that induce neuronal stem cell proliferation, mitochondrial multiplication, angiogenesis, and regulation of the inflammatory cascade. Recently, clinical findings have also demonstrated the beneficial effect of HBOT on veterans with treatment-resistant PTSD. Moderation of intrusive symptoms, avoidance, mood and cognitive symptoms, and hyperarousal were correlated with improved brain function and with diffusion tensor imaging-defined structural changes. This article reviews the current data on the regenerative biological effects of HBOT, and the ongoing research of its use for veterans with PTSD.

The effect of perinatal interventions on parent anxiety, infant socio-emotional development and parent-infant relationship outcomes: A systematic review

Background

Infants of parents with perinatal anxiety are at elevated likelihood of experiencing disruption in the parent-infant relationship, as well as difficulties with socio-emotional functioning in later development. Interventions delivered in the perinatal period have the potential to protect the early dyadic relationship and support infants' ongoing development and socio-emotional outcomes. This review primarily aimed to examine the efficacy of perinatal interventions on parent anxiety, infant socio-emotional development/temperament, and parent-infant relationship outcomes. Secondarily, the review sought to understand how interventions focused principally on one member of the dyad affected the outcomes of the other, and which intervention components were common to successful interventions.

Method

Five electronic databases as well as manual search procedures were used to identify randomised controlled trials according to a PICO eligibility criteria framework. Risk of bias assessments were undertaken, and a narrative synthesis was conducted. The review was pre-registered on PROSPERO (CRD42021254799).

Results

Twelve studies were analysed in total, including five interventions focused on the adult, and seven interventions focused on the infant, or the infant's relationship with their parent. Interventions incorporating cognitive behavioural strategies for affective disorders showed reductions in parent anxiety (N = 3), and interventions focusing on altering distorted maternal internal representations showed positive change in parent-child dyadic interactions, and infant outcomes (N = 2). Evidence that interventions focused on one partner of the dyad led to improved outcomes for the other partner was limited. However, evidence was of mixed methodological quality.

Conclusions

It is important to integrate both parents and infants into treatment programmes for perinatal anxiety. Implications for clinical practice and future intervention trials are discussed.

Introduction: Replication of Crises: Interdisciplinary Reflections on the Phenomenon of the Replication Crisis in Psychology

The replication crisis has preoccupied psychology for over a decade and has led to many reform proposals. In this Special Issue, we argue that a reflexive discussion of both the replication crisis and possible reforms is crucial. With the plural ‘replication of crises’ in the title, we want to make clear that the current crisis is more than one. What is perceived as a crisis varies depending on the scientific field, theoretical background, and epistemological perspective. As a consequence, this Special Issue aims to promote both an intra-disciplinary dialogue between scientific and theoretical psychology, and an inter-disciplinary dialogue between psychology, the humanities and the social sciences. The individual contributions focus on three central questions: (1) What is specific about the replication crisis in psychology? (2) What are the connections between the replication crisis in psychology and that in other scientific fields? (3) What are possible underlying causes of the replication crisis in psychology, and what are the opportunities for improvement? Although each of the articles offers a unique and sometimes challenging perspective to understanding the replication crisis, they all share the assumption that we need to reflect in order to learn and improve.

The Use of Research Methods in Psychological Research: A Systematised Review

Research methods play an imperative role in research quality as well as educating young researchers, however, the application thereof is unclear which can be detrimental to the field of psychology. Therefore, this systematised review aimed to determine what research methods are being used, how these methods are being used and for what topics in the field. Our review of 999 articles from five journals over a period of 5 years indicated that psychology research is conducted in 10 topics via predominantly quantitative research methods. Of these 10 topics, social psychology was the most popular. The remainder of the conducted methodology is described. It was also found that articles lacked rigour and transparency in the used methodology which has implications for replicability. In conclusion this article, provides an overview of all reported methodologies used in a sample of psychology journals. It highlights the popularity and application of methods and designs throughout the article sample as well as an unexpected lack of rigour with regard to most aspects of methodology. Possible sample bias should be considered when interpreting the results of this study. It is recommended that future research should utilise the results of this study to determine the possible impact on the field of psychology as a science and to further investigation into the use of research methods. Results should prompt the following future research into: a lack or rigour and its implication on replication, the use of certain methods above others, publication bias and choice of sampling method.

Growth mindsets and psychological distress: A meta-analysis

We investigated if growth mindsets-the belief in the malleable nature of human attributes-are negatively related to psychological distress and if they are positively related to treatment value and active coping. In the meta-analysis, we included articles published between 1988 and 2019, written in English, that reported on mindsets as well as a qualifying dependent variable and included information required to calculate an effect size. With a random effects approach, meta-analytic results (k = 72 samples, N = 17,692) demonstrated that mindsets relate, albeit with minimal effects, to distress, treatment and coping. Specifically, there is a negative relation between growth mindsets and psychological distress (r = -0.220), a positive relation between growth mindsets and treatment value (r = 0.137) and a positive relation between growth mindsets and active coping (r = 0.207). Differences in mindset domain, assessment method of mindsets and timing of assessments moderated effects. There were not differences based on operationalization of psychological distress outcome or sample characteristics (i.e., developmental stage, diagnostic status, ethnicity). We discuss theoretical and practical applications of the findings.

Testing Robustness of Child STEPs Effects with Children and Adolescents: A Randomized Controlled Effectiveness Trial

A critical task in psychotherapy research is identifying the conditions within which treatment benefits can be replicated and outside of which those benefits are reduced. We tested the robustness of beneficial effects found in two previous trials of the modular Child STEPs treatment program for youth anxiety, depression, trauma, and conduct problems. We conducted a randomized trial, with two significant methodological changes from previous trials: (a) shifting from cluster- to person-level randomization, and (b) shifting from individual to more clinically feasible group-based consultation with STEPs therapists. Fifty community clinicians from multiple outpatient clinics were randomly assigned to receive training and consultation in STEPs (n= 25) or to provide usual care (UC; n= 25). There were 156 referred youths-ages 6-16 (M= 10.52, SD = 2.53); 48.1% male; 79.5% Caucasian, 12.8% multiracial, 4.5% Black, 1.9% Latino, 1.3% Other-who were randomized to STEPs (n= 77) or UC (n= 79). Following previous STEPs trials, outcome measures included parent- and youth-reported internalizing, externalizing, total, and idiographic top problems, with repeated measures collected weekly during treatment and longer term over 2 years. Participants in both groups showed statistically significant improvement on all measures, leading to clinically meaningful problem reductions. However, in contrast to previous trials, STEPs was not superior to UC on any measure. As with virtually all treatments, the benefits of STEPs may depend on the conditions-for example, of study design and implementation support-in which it is tested. Identifying those conditions may help guide appropriate use of STEPs, and other treatments, in the future.