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Did you see that? How could you miss it?.

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Written by huehueteotl

November 27, 2012 at 7:37 am

“Strong evidence” for a treatment evaporates with a closer look: Many psychotherapies are similarly vulnerable.

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“Strong evidence” for a treatment evaporates with a closer look: Many psychotherapies are similarly vulnerable..

By James Coyne PhD
Posted:

Promoters of Triple P parenting enjoy opportunities that developers and marketers of other “evidence-supported” psychosocial interventions and psychotherapies only dream of. With a previously uncontested designation as strongly supported by evidence, Triple P is being rolled out by municipalities, governmental agencies, charities, and community-based programs worldwide. These efforts generate lots of cash from royalties and license fees, training, workshops, and training materials, in addition to the prestige of being able to claim that an intervention has navigated the treacherous path from RCT to implementation in the community.

With hundreds of articles extolling its virtues, dozens of randomized trials, and consistently positive systematic reviews, the status of the Triple P parenting intervention as evidence supported would seem beyond being unsettled by yet another review. Some of the RCTs are quite small, but there are public health level interventions, including one involving 7000 children from child protective services. Could this be an instance in which it should be declared “no further research necessary”? Granting agencies have decided not to fund further evaluation of interventions on the basis of a much smaller volume of seemingly less unanimous data.

But the weaknesses revealed in a recent systematic review and meta-analysis of the Triple P by Philip Wilson and his Scottish colleagues show how apparently strong evidence can evaporate when it is given a closer look. Other apparently secure “evidence supported” treatments undoubtedly share these weaknesses and the review provides a model of where to look. But when I took careful look, I discovered that Wilson and colleagues glossed over a very important weakness in the body of evidence for Triple P. They noted it, but didn’t dwell on it. So, weakness in the body of evidence for Triple P is much greater than a reader might conclude from Wilson and colleagues’ review.

 Wikipedia describes Triple P as

a multilevel parenting intervention with the main goal of increasing the knowledge, skills, and confidence of parents at the population level and, as a result, reduce the prevalence of mental health, emotional, and behavioral problems in children and adolescents. The program is a universal preventive intervention (all members of the given population participate) with selective interventions specifically tailored for at risk children and parents.

A Triple P website for parents advertises

the international award winning Triple P – Positive Parenting Program®, backed by over 25 years of clinically proven, world wide research, has the answers to your parenting questions and needs. How do we know? Because we’ve listened to and worked with thousands of parents and professionals across the world. We have the knowledge and evidence to prove that Triple P works for many different families, in many different circumstances, with many different problems, in many different places!

The Triple P website for practitioners declares

As an individual practitioner or a practitioner working within an organisation you need to be sure that the programs you implement, the consultations you provide, the courses you undertake and the resources you buy actually work.

Triple P is one of the only evidence-based parenting programs available worldwide, founded on over 30 years of clinical and empirical research.

Disappearing positive evidence

In taking stock of Triple P, Wilson and colleagues applied objective criteria in a way that readily allows independent evaluation of their results.

They identified 33 eligible studies, almost all of them positive in indicating that Triple P has positive effects on child adjustment.

  • Of the 33 studies, most involving media-recruited families so that participants in the trials were self-selected and more motivated than if they are clients referred from community services or involuntarily getting treatment mandated by child protection agencies.
  • 31/ 33 studies compared Triple P interventions with waiting list or no-treatment comparison groups. This suggests that Triple P may be better than doing nothing with these self-referred families, but doesn’t control for simply providing attention, support, and feedback. The better outcomes for families getting Triple P versus getting than wait list or no treatment may reflect families assigned to these control conditions registering the disappointment with not getting what they had sought in answering the media ads.
  • In contrast, the two studies involving an active control group showed no differences between groups.
  • The trials evaluating Triple P typically administered a battery of potential outcomes, and there is no evidence for any trials that particular measures were chosen ahead of time as the primary outcomes. There was considerable inconsistency among studies using the same instruments in decisions about which subscales were reported and emphasized. Not declaring outcomes ahead of time provides a strong temptation for selective reporting of outcomes. Investigators analyze the data, decide what measures puts Triple P in the most favorable light, and declare post hoc those outcomes as primary.
  • Selective reporting of outcomes occurred in the the abstracts of these studies. Only 4/33 abstracts report any negative findings and 32/33 abstracts were judged to give a more favorable picture of the effects of Triple P.
  • Most papers only reported maternal assessments of child behavior and the small number of studies that obtained assessments from fathers did not find positive treatment effects from the father’s perspective. This may simply indicate the detachment and obliviousness of the fathers, but can also point to a bias in the reports of mothers who had made more of an investment in getting treatment.
  • Comparisons of intervention and control groups beyond the duration of the intervention were only possible in five studies. So, positive results may be short-lived.
  • Of the three trials that tested population level effects of Triple P, two were not randomized trials, but had quasi-experimental designs with significant intervention and control group differences at baseline. A third trial reported a reduction in child maltreatment, but examination of results indicate that this was due to an unexplained increased in child maltreatment in the control area, not a decrease in the intervention area.
  • Thirty-two of the 33 eligible studies were authored by Triple-P affiliated personnel, but only two had a conflict of interest statement. Not only is there strong possibility of investigator allegiance exerting an effect on the reported outcome of trials, there are undeclared conflicts of interest.

The dominance of small, underpowered for quality studies

Wilson and colleagues noted a number of times in their review that many of the trials are small, but they do not dwell on how many, how small, or with what implications. My colleagues have adopted the lower limit of 35 participants in the smallest group for inclusion of trials in meta-analyses. The rationale is that any trial that is smaller than this does not have a 50% probability of detecting a moderate sized effect, even if it is present. Small trials are subject to publication bias in that if results are not claimed to be statistically significant, they will not to get published because the trial was insufficiently powered to obtain a significant effect. On the other hand, when significant results are obtained, they are greeted with great enthusiasm precisely because the trials are so small. Small trials, when combined with flexible rules for deciding when to stop a trial (often based on a peek at the data), failure to specify primary outcomes ahead of time, and flexible rules for analyses, can usually be made to appear to yield positive findings, but that will not be replicated. Small studies are vulnerable to outliers and sampling error and randomization does not necessarily equalize group differences they can prove crucial in determining results. Combining published small trials  in a meta-analysis does not address these problems, because of publication bias and because of all or many of the trials sharing methodological problems.

What happens when we apply the exclusion criterion to Triple P trials of <35 participants in the smallest group? Looking at table 2 in Wilson and colleagues’ review, we see that 20/23 of the individual papers included in the meta-analyses are excluded. Many of the trials quite small, with eight trials having less than 20 participants (9 -18) in the smallest group. Such trials should be statistically quite unlikely to detect even a moderate sized effect, and that so many nonetheless get significant findings attests to a publication bias. Think of it: with such small cell sizes, arbitrary addition or subtraction of a single participant can alter results. Figure 2 in the review provides the forest plot of effect sizes for two of the key outcome measures reported in Triple P trials. Small trials account for the outlier strongest finding, but also the weakest finding, underscoring sampling error. Meta-analyses attempt to control for the influence of small trials by introducing weights, but this strategy fails when the bulk of the trials are small. Again examining figure 2, we see that even with the weights, small trials still add up to over 83% of the contribution to the overall effect size. Of the three trials that are not underpowered, two have nonsignificant effects entered into the meta-analysis. The confidence intervals for the one moderate size trial that is positive barely excludes zero (.06).

Wilson and colleagues pointed to serious deficiencies in the body of evidence supporting the efficacy of Triple P parenting programs, but once we exclude underpowered trials, there is little evidence left.

Are Triple P parenting programs ready for widespread dissemination and implementation?

Rollouts of the kind that Triple P is now undergoing are expensive and consume resources that will not be available for alternatives. Yet, critical examination of the available evidence suggests little basis for assuming that Triple P parenting programs will have benefits commensurate with their cost.

In contrast to the self-referring families stayed in randomized trials, the families in the community are likely to be more socially disadvantaged, often single parent, and often coming to treatment only because of pressure and even mandated attendance. Convenience samples of self-referred participants are acceptable in the early stages of evaluation of an intervention, but ultimately the most compelling evidence must come from participants more representative of the population who will be treated in the community.

Would other evidence supported interventions survive this kind of scrutiny?

Triple P parenting interventions have the apparent support of a large literature that is unmatched in size by most treatments claiming to be evidence supported. In a number of articles and blog posts, I have shown that other treatments claimed to be evidence supported often have only weak evidence. Similar to Triple P, other treatments are largely evaluated by investigators who have vested financial and professional interests in demonstrating their efficacy, in studies that are underpowered, and with a high risk of bias, notably in the failure to specify which of many outcomes that are assessed are primary. Similar to Triple P, psychotherapies routinely get labeled as having strong evidence based solely on studies that involve comparisons with no treatment or waitlist controls. Effect sizes exaggerate the advantage over these therapies over patient simply getting nonspecific, structured opportunities for attention, support, and feedback under conditions of positive expectations. And, finally, similar to what Wilson and colleagues found for Triple P, there often large gaps between the way findings are depicted in abstracts for reports of RCTs and what can be learned from the results sections of the actual articles.

In a recent blog post, I also showed that American Psychological Association Division 12 Clinical Psychology had designated Acceptance and Commitment Therapy (ACT) as having strong evidence for efficacy n hospitalized psychotic patients, only to have that designation removed when I demonstrated that the basis for this judgment was two null flawed and small trials. Was that shocking or even surprising? Stay tuned.

In coming blog posts, I will demonstrate problems with claims of other treatments being evidence-based, but hopefully this blog provides readers with tools to investigate for themselves.

Written by huehueteotl

November 26, 2012 at 11:42 pm

You Are How You Eat: Fast Food and Impatience.

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Fast food is not only bad for your body, but may also harm your bank account.

Eating habits have shifted dramatically over the last few decades–fast food has become a multibillion dollar industry that has widespread influence on what and how we eat. The original idea behind fast food is to increase efficiency, allowing people to quickly finish a meal so they can move on to other matters. Researchers at the Rotman School of Management, however, have found that the mere exposure to fast food and related symbols can make people impatient, increasing preference for time saving products, and reducing willingness to save.

“Fast food represents a culture of time efficiency and instant gratification,” says Chen-Bo Zhong, who co-wrote the paper with colleague Sanford DeVoe to be published in a forthcoming issue of Psychological Science. “The problem is that the goal of saving time gets activated upon exposure to fast food regardless of whether time is a relevant factor in the context. For example, walking faster is time efficient when one is trying to make a meeting, but it’s a sign of impatience when one is going for a stroll in the park. We’re finding that the mere exposure to fast food is promoting a general sense of haste and impatience regardless of the context.”

In one experiment, the researchers flashed fast food symbols, such as the golden arch of McDonald’s, on a computer screen for a few milliseconds, so quick that participants couldn’t consciously identify what they saw. They found that this unconscious exposure increased participants’ reading speed in a subsequent task compared to those in a control condition, even when there was no advantage to finishing sooner. In another study, participants who recalled a time when they eat at a food restaurant subsequently preferred time-saving products — such as two-in-one shampoo — over regular products. A final experiment found people exposed to fast food logos exhibited greater reluctance for saving — choose a smaller immediate payment rather than opting for a much larger delayed payment.

“Fast food is one of many technologies that allow us to save time,” says Sanford DeVoe, “But the ironic thing is that by constantly reminding us of time efficiency, these technologies can lead us to feel much more impatience. A fast food culture that extols saving time doesn’t just change the way we eat but it can also fundamentally alter the way they experience our time. For example, leisure activities that are supposed to be relaxing can come to be experienced through the color glasses of impatience.”

The researchers point out that it’s impossible to know whether fast food in part caused the value for time efficiency in our culture or is merely a consequence of it — but it’s clear from their findings that exposure to fast food reinforces an emphasis on impatience and instant gratification. “Given the role that financial impatience played in the current economic crisis,” says Chen-Bo Zhong, “we need to move beyond counting calories when we examine the consequences of fast food as it is also influencing our everyday psychology and behavior in a wider set of domains than has been previously thought.”

Psychological Science, (in press)
Chen-Bo Zhong Sanford E. DeVoe.
Abstract Based on recent advancements in the behavioral priming literature, this paper explores how incidental exposure to fast food can induce impatient behaviors and choices outside of the eating domain. We found in three experiments that even an unconscious exposure to fast food symbols can automatically increase reading speed when under no time pressure and that thinking about fast food increases preferences for time-saving products while there are potentially many other product dimensions to consider. More strikingly, we found that the mere exposure to fast food symbols reduced people’s willingness to save and led them to prefer immediate gain over greater future return, ultimately harming their economic interest. Thus, the way we eat has far reaching influences (often unconscious) on behaviors and choices unrelated to eating.

Written by huehueteotl

March 28, 2010 at 5:04 pm

Posted in Psychology

Who Am I Without You? How a Romantic Breakup Affects Self-Concept

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When a romantic relationship ends, an individual’s self-concept is vulnerable to change, according to research in the February issue of Personality and Social Psychology Bulletin.

Self-concept is defined as a person’s sense of “me.” Romantic partners develop shared friends, activities and even overlapping self-concepts.

Using three studies, the researchers examined self-concept changes that can occur after a breakup. They found that individuals have reduced self-concept clarity after a breakup. This reduced clarity can contribute to emotional distress. The loss of the relationship has multiple psychological consequences, including the tendency for individuals to change the content of their selves and the feeling that their selves are subjectively less clear and even smaller.

Finding that there is a prevalence of self-change experienced when a romantic relationship ends provides a testament to the power of loss that impacts one’s sense of self.

“Not only may couples come to complete each others’ sentences, they may actually come to complete each others’ selves,” write authors Erica B. Slotter, Wendi L. Gardner, and Eli J. Finkel. “When the relationship ends, individuals experience not only pain over the loss of the partner, but also changes in their selves. This research is the first to demonstrate the unique contribution of reduced self-concept clarity to the emotional distress that individuals experience post-breakup.

Personality and Social Psychology Bulletin, Vol. 36, No. 2, 147-160 (2010)
DOI: 10.1177/0146167209352250 this version was published on February 1, 2010
Who Am I Without You? The Influence of Romantic Breakup on the Self-ConceptPersonality and Social Psychology Bulletin
Erica B. Slotter
Northwestern University, Evanston, IL, USA, ericaslotter2011@u.northwestern.edu

Wendi L. Gardner
Northwestern University, Evanston, IL, USA

Eli J. Finkel
Northwestern University, Evanston, IL, USA

Romantic relationships alter the selves of the individuals within them. Partners develop shared friends and activities and even overlapping self-concepts. This intertwining of selves may leave individuals’ self-concepts vulnerable to change if the relationship ends. The current research examines several different types of self-concept change that could occur after a breakup and their relation to emotional distress. Across three studies, using varied methodologies, the authors examined change in both the content (Study 1a and 1b) and the structure of the self-concept, specifically, reduced self-concept clarity (Studies 1 through 3). As predicted, individuals experienced self-concept content change and reduced self-concept clarity post-breakup. Additionally, reduced clarity uniquely predicted post-breakup emotional distress.

Key Words: self/identity • romantic relationships • breakup • self-concept clarity • emotional distress

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Written by huehueteotl

March 13, 2010 at 11:58 pm

Posted in Psychology

Massage Eases Anxiety, but No Better Than Simple Relaxation Does

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A new randomized trial shows that on average, three months after receiving a series of 10 massage sessions, patients had half the symptoms of anxiety. This improvement resembles that previously reported with psychotherapy, medications, or both. But the trial, published in the journal Depression and Anxiety, also found massage to be no more effective than simple relaxation in a room alone with soft, soothing music.

“We were surprised to find that the benefits of massage were no greater than those of the same number of sessions of ‘thermotherapy’ or listening to relaxing music,” said Karen J. Sherman, PhD, MPH, a senior investigator at Group Health Research Institute. “This suggests that the benefits of massage may be due to a generalized relaxation response.”

Massage therapy is among the most popular complementary and alternative medical (CAM) treatments for anxiety, she added. But this is the first rigorous trial to assess how effective massage is for patients with generalized anxiety disorder.

The trial randomly assigned 68 Group Health patients with generalized anxiety disorder to 10 one-hour sessions in pleasant, relaxing environments, each presided over by a licensed massage therapists who delivered either massage or one of two control treatments:

* Relaxation therapy: breathing deeply while lying down
* Thermotherapy: having arms and legs wrapped intermittently with heating pads and warm towels

All three treatments were provided while lying down on a massage table in a softly lighted room with quiet music. All participants received a handout on practicing deep breathing daily at home. Unlike the two control treatments, massage was specifically designed to enhance the function of the parasympathetic nervous system and relieve symptoms of anxiety including muscle tension.

Using a standard rating scale in interviews, the researchers asked the patients about the psychological and physical effects of their anxiety right after the 12-week treatment period ended and three months later, Dr. Sherman said.

All three of the groups reported that their symptoms of anxiety had decreased by about 40 percent by the end of treatment — and by about 50 percent three months later. In addition to the decline in anxiety, the patients also reported fewer symptoms of depression and less worry and disability. The research team detected no differences among the three groups; but the trial did not include a control group that got no treatment at all.

“Treatment in a relaxing room is much less expensive than the other treatments (massage or thermotherapy), so it might be the most cost-effective option for people with generalized anxiety disorder who want to try a relaxation-oriented complementary medicine therapy,” Dr. Sherman said.

Depression and Anxiety, 2010; DOI: 10.1002/da.20671
Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial.
Karen J. Sherman, Evette J. Ludman, Andrea J. Cook, Rene J. Hawkes, Peter P. Roy-Byrne, Susan Bentley, Marissa Z. Brooks, Daniel C. Cherkin

Keywords
massage • therapy • therapeutic use • clinical trials • randomized • generalized anxiety disorder • relaxation • breathing exercises

Abstract
Background: Although massage is one of the most popular complementary and alternative medical (CAM) treatments for anxiety, its effectiveness has never been rigorously evaluated for a diagnosed anxiety disorder. This study evaluates the effectiveness of therapeutic massage for persons with generalized anxiety disorder (GAD). Methods: Sixty-eight persons with GAD were randomized to therapeutic massage (n=23), thermotherapy (n=22), or relaxing room therapy (n=23) for a total of 10 sessions over 12 weeks. Mean reduction in anxiety was measured by the Hamilton Anxiety Rating Scale (HARS). Secondary outcomes included 50% reduction in HARS and symptom resolution of GAD, changes in depressive symptoms (Patient Health Questionnaire (PHQ-8)), worry and GAD-related disability. We compared changes in these outcomes in the massage and control groups posttreatment and at 6 months using generalized estimating equation (GEE) regression. Results: All groups had improved by the end of treatment (adjusted mean change scores for the HARS ranged from -10.0 to -13.0; P<.001) and maintained their gains at the 26-week followup. No differences were seen between groups (P=.39). Symptom reduction and resolution of GAD, depressive symptoms, worry and disability showed similar patterns. Conclusions: Massage was not superior to the control treatments, and all showed some clinically important improvements, likely due to some beneficial but generalized relaxation response. Because the relaxing room treatment is substantially less expensive than the other treatments, a similar treatment packaged in a clinically credible manner might be the most cost effective option for persons with GAD who want to try relaxation-oriented CAM therapies. Depression and Anxiety 0:1-10, 2010. © 2010 Wiley-Liss, Inc.

Written by huehueteotl

March 12, 2010 at 8:55 am

Posted in Psychology

Others May Know Us Better Than We Know Ourselves

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Since at least the days of Socrates, humans have been advised to “know thyself.” And through all the years, many, including many personality and social psychologists, have believed the individual is the best judge of his or her own personality.

Now a psychologist at Washington University in St. Louis has shown that we are not the know-it-alls that we think we are.

Simine Vazire, Ph.D., Washington University assistant professor of psychology in Arts & Sciences, has found that the individual is more accurate in assessing one’s own internal, or neurotic traits, such as anxiety, while friends are better barometers of intellect-related traits, such as intelligence and creativity, and even strangers are equally adept as our friends and ourselves at spotting the extrovert in us all, a psychology domain known as “extroversion.”

“I think that it’s important to really question this knee-jerk reaction that we are our own best experts,” says Vazire. “Personality is not who you think you are, it’s who you are. Some people think by definition that we are the experts on our personality because we get to write the story, but personality is not the story — it’s the reality. So, you do get to write your own story about how you think you are, and what you tell people about yourself, but there still is reality out there, and, guess what? Other people are going to see the reality, regardless of what story you believe.”

Personality, Vazire says, is pervasive in many things that we do — clothing choice, bedroom arrangement, Web site and Facebook profiles, for example. “Everything you touch you leave a mark of your personality,” she says. “You leave traces unintentionally. You give off hints of your personality that you don’t even see yourself.”

Vazire’s study is published in the February 2010 issue of the Journal of Personality and Social Psychology.

Personality is comprised of the underlying traits that drive behavior, Vazire says. The model she developed is called the self-other knowledge asymmetry (SOKA) model. To test it she called upon 165 volunteers who were given a number of different tasks. To obtain an objective measure of behavior, they took an IQ test; they all participated in a group discussion called a leaderless group discussion to see who emerged as the take-charge individual; and they took a Trier social stress test, in which trained experimenters with faux stern demeanors filmed participants in a narrow, cramped room, as they gave a two-minute public speaking exhibition on the topic of what I like and don’t like about my body. A sweat-inducer for many. Each participant also graded group members and him or herself on a 40-trait personality rating form.

Her model correctly predicted that self ratings would be more accurate for internal things, such as thoughts and feelings, sadness and anxiety, for example, than the ratings of friends and strangers.

“You probably know pretty well your anxiety level, whereas others might not be in the position to judge that because, after all, you can mask your inner feelings,” Vazire says. “Others, though, are often better than the self in things that deal with overt behavior.”

The self has difficulty in accurately judging itself in areas that are desirable or undesirable, what she calls evaluative traits. Intelligence, attractiveness, creativity are hard for the self to judge objectively because “there is so much at stake, meaning your life is going to be so much different if you are intelligent or not intelligent, attractive or not. Everybody wants to be seen as intelligent and attractive, but these desirable traits we’re not going to judge accurately in ourselves.”

The self is better at judging friends’ intelligence than its own “because it’s not that threatening to us to admit that our friends aren’t brilliant, but it’s more threatening to admit to ourselves that we’re not brilliant.”

Take attractiveness and your mirror. “We look in the mirror all the time, yet that’s not the same as looking at a photo of someone else,” Vazire says. “If we spent as much time looking at photos of others as we do ourselves we’d form a much more confident and clear impression of the other’s attractiveness than we would have of our own. Yet after looking in the mirror for five minutes we’re still left wondering, ‘Am I attractive or not?’ And still have no clue. And it’s not the case that we all assume that we’re beautiful, right?”

For some personality traits, she says we miss the point if we look at thoughts and feelings and ignore the behavior. Bullies, for instance, fit the SOKA model, because their thoughts and feelings tell them they’re insecure and want to be liked and admired, which is not a horrible, nasty notion. They cannot see their behavior as nasty and horrible, though, because their thoughts obscure their actions.

Similarly, if you think that you are warm and friendly, and your friends and family say even if you think along those lines, you don’t come across that way, you might pay more attention to your behaviors.

“I believe I’ve presented evidence that should make people think twice,” Vazire says. “On average, the people who know you best know you as well as you know yourself, no better, no worse than you. More importantly, there are things that both you know that they don’t know, and things that they know that you don’t know, and those lead to very interesting experiences and disagreements.”

Journal of Personality and Social Psychology 2010 Volume 98, Issue 2 (Feb) Pages 281-300
Who knows what about a person? The self–other knowledge asymmetry (SOKA) model.
Vazire, Simine

This article tests a new model for predicting which aspects of personality are best judged by the self and which are best judged by others. Previous research suggests an asymmetry in the accuracy of personality judgments: Some aspects of personality are known better to the self than others and vice versa. According to the self–other knowledge asymmetry (SOKA) model presented here, the self should be more accurate than others for traits low in observability (e.g., neuroticism), whereas others should be more accurate than the self for traits high in evaluativeness (e.g., intellect). In the present study, 165 participants provided self-ratings and were rated by 4 friends and up to 4 strangers in a round-robin design. Participants then completed a battery of behavioral tests from which criterion measures were derived. Consistent with SOKA model predictions, the self was the best judge of neuroticism-related traits, friends were the best judges of intellect-related traits, and people of all perspectives were equally good at judging extraversion-related traits. The theoretical and practical value of articulating this asymmetry is discussed. (PsycINFO Database Record (c) 2009 APA, all rights reserved)

Written by huehueteotl

February 28, 2010 at 3:44 pm

Posted in Psychology

Facebook Narcissism

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A 2008 University of Georgia study suggests that online social networking sites such as Facebook might be useful tools for detecting whether someone is a narcissist.

“We found that people who are narcissistic use Facebook in a self-promoting way that can be identified by others,” said lead author Laura Buffardi, a by then doctoral student in psychology who co-authored the study with associate professor W. Keith Campbell.

The researchers gave personality questionnaires to nearly 130 Facebook users, analyzed the content of the pages and had untrained strangers view the pages and rate their impression of the owner’s narcissism.

The researchers found that the number of Facebook friends and wallposts that individuals have on their profile pages correlates with narcissism. Buffardi said this is consistent with how narcissists behave in the real-world, with numerous yet shallow relationships. Narcissists are also more likely to choose glamorous, self-promoting pictures for their main profile photos, she said, while others are more likely to use snapshots.

Untrained observers were able to detect narcissism, too. The researchers found that the observers used three characteristics – quantity of social interaction, attractiveness of the individual and the degree of self promotion in the main photo – to form an impression of the individual’s personality. “People aren’t perfect in their assessments,” Buffardi said, “but our results show they’re somewhat accurate in their judgments.”

Narcissism is a trait of particular interest, Campbell said, because it hampers the ability form healthy, long-term relationships. “Narcissists might initially be seen as charming, but they end up using people for their own advantage,” Campbell said. “They hurt the people around them and they hurt themselves in the long run.”

The tremendous growth of social networking sites – Facebook now has 100 million users, for example – has led psychologists to explore how personality traits are expressed online. Buffardi and Campbell chose Facebook because it’s the most popular networking site among college students and because it has a fixed format that makes it easier for researchers to compare user pages.

Some researchers in the past have found that personal Web pages are more popular among narcissists, but Campbell said there’s no evidence that Facebook users are more narcissistic than others.

“Nearly all of our students use Facebook, and it seems to be a normal part of people’s social interactions,” Campbell said. “It just turns out that narcissists are using Facebook the same way they use their other relationships – for self promotion with an emphasis on quantity of over quality.”

Still, he points out that because narcissists tend to have more contacts on Facebook, any given Facebook user is likely to have an online friend population with a higher proportion of narcissists than in the real world. Right now it’s too early to predict if or how the norms of online self-promotion will change, Campbell said, since the study of social networking sites is still in its infancy.

“We’ve undergone a social change in the last four or five years and now almost every student manages their relationships through Facebook – something that few older people do,” Campbell said. “It’s a completely new social world that we’re just beginning to understand.”

Personality and Social Psychology Bulletin, Oct 2008; vol. 34: pp. 1303 – 1314.
Narcissism and Social Networking Web Sites.
Laura E. Buffardi and W. Keith Campbell

The present research examined how narcissism is manifested on a social networking Web site (i.e., Facebook.com). Narcissistic personality self-reports were collected from social networking Web page owners. Then their Web pages were coded for both objective and subjective content features. Finally, strangers viewed the Web pages and rated their impression of the owner on agentic traits, communal traits, and narcissism. Narcissism predicted (a) higher levels of social activity in the online community and (b) more self-promoting content in several aspects of the social networking Web pages. Strangers who viewed the Web pages judged more narcissistic Web page owners to be more narcissistic. Finally, mediational analyses revealed several Web page content features that were influential in raters’ narcissistic impressions of the owners, including quantity of social interaction, main photo self-promotion, and main photo attractiveness. Implications of the expression of narcissism in social networking communities are discussed.

Written by huehueteotl

February 18, 2010 at 10:05 pm

Posted in Psychology