Meadowlands hospital neuroscientist fired over controversial autism treatment

By Susan K. Livio
The Star Ledger
Originally published January 10, 2012

Philip DeFina, PhD

The neuroscientist who would have overseen a controversial therapy for children with autism has been fired by Meadowlands Hospital Medical Center in Secaucus and, in a separate action, his nomination to a state commission on brain research has been delayed.

Philip DeFina was part of an ambitious plan by Meadowlands to offer hyperbaric oxygen therapy to children diagnosed with autism. The therapy, typically used to treat burns and other wounds by energizing dying tissue, required approval from the state Department of Health and Senior Services. Meadowlands would have been the first hospital in the state to offer the experimental treatment.

But the application ran into strong opposition, and questions were raised in a Nov. 27 Star-Ledger article in which traditional medical and psychological experts said the treatment offers families false hope while draining bank accounts because the experimental therapy is not covered by insurance. Some families say it has helped their children, and argued that if a method is safe and seems to be effective, it should be given a chance even if it hasn’t been thoroughly vetted through research.

The article also described DeFina’s doctorate in clinical psychology from Fielding Graduate University. The school, a mainly online university with monthly in-person sessions, is the only one to receive national accreditation from the American Psychological Association. DeFina’s experimental treatments with neurologist Jonathan Fellus for coma and brain injury have fetched as much as $100,000 from the families of patients who have not improved using traditional means. Fellus remains at Meadowlands.

There rest of the article is here.

UConn Investigation Finds That Health Researcher Fabricated Data

By Tom Bartlett
The Chronicle of Higher Education
Originally published January 11, 2012

Dipak K. Das

A three-year investigation by the University of Connecticut has found that the director of its Cardiovascular Research Center falsified and fabricated data at least 145 times, in some cases digitally manipulating images using PhotoShop.

The researcher, Dipak K. Das, is best known for his work on resveratrol, a compound present in grapes and other foods that some research suggests can have beneficial effects on the heart and could slow aging, though recent studies have cast doubt on the latter claim.

The university has begun a process to dismiss Das, who has tenure.

Das has been quoted regularly in news articles, usually talking about resveratrol, and his papers have been cited often, as the blog Retraction Watch points out. But the importance of his research is unclear.

David Sinclair, a professor of pathology at Harvard University who is known for his discovery that resveratrol appears to extend the life of mice and fruit flies, said he had not heard of Das. “I’ve not worked with him,” Sinclair wrote in an e-mail. “Looking through it, the work is generally not published in leading molecular-biology journals.”

The entire article is here.

Another article from The New York Times is here.

What Opinions Can Psychologists Give About Persons They Have Never Met?

What Opinions Can Psychologists Give About Persons Whom They Have Never Met?

Massachusetts Appeals Court rules that judge was wrong to order mentally ill woman to have an abortion and to then be sterilized

By Peter Schworm
The Boston Globe

The Massachusetts Appeals Court today reversed a probate judge’s decision to order a schizophrenic woman to undergo an abortion and to then be sterilized, saying the woman had consistently expressed her opposition to the practice as a Catholic.

In October, the state Department of Mental Health filed a petition to have the woman’s parents named as guardians for the woman, who is only known as “Mary Moe,’’ so they could give consent for an abortion, according to the court.

Norfolk Probate and Family Court Judge Christina Harms, declared that the 32-year-old woman was not competent to make a decision about an abortion, citing “substantial delusional beliefs,” and concluded she would choose to abort her pregnancy if she were competent.

Earlier this month, Harms ordered that the woman’s parents be appointed as coguardians and that Moe could be “coaxed, bribed, or even enticed ... by ruse” into a hospital where she would be sedated and an abortion would then be performed, the ruling stated.

The judge also ordered the facility that performed the abortion to sterilize the woman “to avoid this painful situation from recurring in the future.”

The Appeal Court’s decision, released today, reversed the sterilization order in unusually strong terms.

“No party requested this measure, none of the attendant procedural requirements has been met, and the judge appears to have simply produced the requirement out of thin air,” wrote Appeals Court Judge Andrew Grainger.

The entire story is here.

U.S. to Force Drug Firms to Report Money Paid to Doctors

By ROBERT PEAR
The New York Times - Money and Policy
Originally published 1/16/2012

WASHINGTON — To head off medical conflicts of interest, the Obama administration is poised to require drug companies to disclose the payments they make to doctors for research, consulting, speaking, travel and entertainment.

Many researchers have found evidence that such payments can influence doctors’ treatment decisions and contribute to higher costs by encouraging the use of more expensive drugs and medical devices.

Consumer advocates and members of Congress say patients may benefit from the new standards, being issued by the government under the new health care law. Federal officials said the disclosures increased the likelihood that doctors would make decisions in the best interests of patients, without regard to the doctors’ financial interests.

Large numbers of doctors receive payments from drug and device companies every year — sometimes into the hundreds of thousands or millions of dollars — in exchange for providing advice and giving lectures. Analyses by The New York Times and others have found that about a quarter of doctors take cash payments from drug or device makers and that nearly two-thirds accept routine gifts of food, including lunch for staff members and dinner for themselves.

The entire article is here.

Research misconduct in the UK: Time to Act

By Fiona Godlee, Editor in Chief, and Elizabeth Wager, Chair
British Medical Journal

Research misconduct can harm patients, distort the evidence base, misdirect research effort, waste funds, and damage public trust in science. Countries all over the developed world are now recognising the need to set up systems to deter, detect, and investigate research misconduct. Why does the United Kingdom have no plans to do the same?

As Aniket Tavare outlines in the linked feature (doi:10.1136/ bmj.d8212), high profile cases of misconduct have led the United States, Canada, Sweden, Norway, and Poland, among others, to create formal mechanisms for overseeing research integrity. In most countries responsibility lies with the institutions, but oversight varies greatly, and it is unclear which systems are most effective and efficient. None is perfect—the remit of the US Office of Research Integrity is limited to publicly funded health research; Australia’s recently established Research Integrity Committee is already being criticised for lacking teeth. But each system shows that the problem has been acknowledged, that institutions accept primary responsibility, and that governments and funders are seriously committed to tackling misconduct openly and with a range of statutory powers.

In contrast, the UK has no official national body. The UK Research Integrity Office was established in 2006 and has done some useful things. But its function has always been advisory, and now that the major funders represented by Research Councils UK (RCUK) have decided not to continue the funding, it relies on voluntary funding from institutions. The Research Integrity Futures Working Group, set up by RCUK and Universities UK (UUK) and other bodies, has also apparently come to nothing. The working group’s report commissioned in 2009 called for an independent advisory body, similar to the

UK Research Integrity Office but operating across all research sectors and with a stronger monitoring and preventive function. But RCUK pleaded budget cuts and decided not to implement the  recommendations.  It says it is working with UUK on a “concordat” to take some aspects forward, but two years on nothing has been announced.

The entire editorial can be found in the public domain.

BMJ 2012;344:d8357 doi: 10.1136/bmj.d8357

Should Forensic Psychiatrists Conduct Psychological Testing?

Frank Dattilio, Ph.D., ABPP, Bob Sadoff, M.D., Eric Drogin, J.D., Ph.D., ABPP, 

and Tom Gutheil, M.D.

Journal of Psychiatry & Law (Vol. 39, #3), Spring 2012

Most forensic experts have encountered at least one civil or criminal case in which a forensic psychiatrist has independently conducted psychological testing.

In some instances, the psychiatrist will consult a psychologist on the interpretation of test outcomes, while in others he or she may simply rely on one of the many computerized scoring programs that provide a "canned" analysis and narrative interpretation of results.

Predictably, this phenomenon has occasionally stirred controversy regarding the clinical, ethical, and legal dimensions of appropriateness of selection, skillfulness of administration, accuracy of scoring, validity of interpretation, sufficiency of training, and codified scope of forensic practice.

The primary purpose of this article is to address the ambiguous nature of psychiatrists employing psychological testing in their forensic work, and to arrive at a definitive answer as to whether or not forensic psychiatrists should offer services in this domain.

Key to making this determination will be a review of what differentiates psychological tests from other forms of assessment, such as appraisals, rating scales, and inventories.

 Also addressed are jurisdictionally based legal and ethical issues and a review of what would constitute adequate training and supervision.

[end excerpt]

A clear distinction needs to be made between what constitutes a 'psychological test' versus an 'appraisal,' 'rating scale,' or 'technique.'   Rating scales, such as the Zung Depression Scale or the Beck Anxiety Inventory, have no standardized format for administration and lack complexity in scoring and interpretation.  Projective techniques (i.e., Draw a Person, etc.) are so variably conducted that their best use is typically in support of psychotherapy formulations as opposed to forensic application.  However, these terms are often interchangeable with the terms 'psychological test' or 'psychodiagnostic test.

[another excerpt]

Forensic psychiatrists without access to--and proper review of--administration manuals may be eroding the reliability of psychological test results from the outset.

[another excerpt]

When asked about psychological tests in court, most psychiatrists respond by saying that they have not been trained to administer, score, or interpret psychological tests and that it would be inappropriate and unethical for them to administer them without proper training.  Furthermore, most psychiatrists do not comment on testing because they are not able to provide a comprehensive or valid response due to their lack of expertise.

[another excerpt]

It is our opinion that psychiatrists should never administer psychological tests without intensive training and supervision.  Once again, proper training and education remain critical and, without such training, they should not attempt to incorporate psychological testing into their own examination procedures.  Forensic psychiatrists would need to become familiar with the nuances of standardization and how important it is to the test results and interpretations.  It may also be essential when administering psycho-logical tests to take certain notes regarding observations.  Some of these notes and observations are generated by individuals who administer the tests and score them, interpreting the results on a regular basis, which, obviously, can only come from being very familiar with the tests administered and with scoring.

[another excerpt]

The issue at hand is not one of territoriality--as some might surmise--but rather one of forensic standards and professional ethics, particularly as they pertain to protecting the public.  The appropriate selection, administration, scoring, and interpretation of psychological tests require extensive training and supervision, of a sort that cannot be obtained during a weekend seminar or on the basis of casual, incidental supervision.  Proper testing in forensic cases calls for a thorough grounding in test construction and assessment procedures as well as a firm knowledge of instrumental reliability and validity.  Cross examination on such notions as 'standard error of measurement,' 'confidence intervals,' and 'normative populations' is fair game.  Test users unfamiliar with core psychometric principles expose their reports and testimony to negative scrutiny, imperil the work of retaining counsel, haphazardly affect the fate of litigants, and run the risk of allegations of unethical behavior.  In keeping with the current trend in professional training and development, psychological testing should be viewed as a 'competency'.

The author note provides the following contact information: Frank M. Dattilio, Ph.D., ABPP, Department of Psychiatry, Harvard Medical School, MMHC-Shattuck, 180 Morton St., Jamaica Plain, MA 02130. E-mail: frankdattilio@cs.com.

Thanks to Ken Pope for the information and excerpts.

The Application of Virtue Ethics to the Practice of Counseling Psychology

Virtue Ethics in Counseling Psych

This dissertation can be found in the public domain here.

NJ school district moves to fire teacher who made anti-gay Facebook comments

By Star Ledger Staff

 

It was three months ago when anti-gay comments posted on Facebook by a Union High School teacher caused a nationwide controversy. Now, those comments may cost the instructor her job.

The Union Township school board announced today it has filed tenure charges against Viki Knox, the longtime teacher and faculty adviser to the high school’s Bible study group.

Board president Francis R. Perkins said the charges were formally filed in late December after a three-month investigation of Knox’s conduct, the first step in what could be a lengthy and costly process to fire her.

"Every student, no matter what race, creed color or sexual orientation ought to be able to come to school and feel comfortable in a learning environment that’s welcoming and nurturing," Perkins said.

Knox, 50, who has been on paid administrative leave, could not be reached. Sandy Oxfeld, Knox’s attorney, said he would have no comment on the case while it is in litigation.

The move by the Union school board has rekindled a broader issue of free-speech rights of teachers in the growing age of social media.

The entire story is here.