Ioana A Cristea
@IoanaA_Cristea
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Associate Professor @Unipd | Affiliate @METRICStanford | Scholar @FulbrightPrgrm | #Metaresearch #Openscience #Psychotherapy | @ERC_Research DECOMPOSE
Joined September 2013
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I was interested in the psychotherapy in psychedelic-assisted psychotherapy before it became mainstream. This summer I joined two of the psychotherapy researchers I respect most (
@pimcuijpers
and
@joarhalvorsen
) to write this viewpoint out now
@JAMAPsych
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John Ioannidis is the kindest, most generous scientist I met. He is the scientist who will ALWAYS take your e-mail, no matter who u r. He works with undergrads, exploring ideas. He never says a demeaning or puts anyone down. He never rolls his eyes to a stupid question.
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161
1K
Is this true? I mean apart from the silliness of the analogy, I was not aware falling offered any kind of anti-fall immunity/protection the way being infected does (partial, incomplete whatever, but still there). Are we sure misleading analogies are useful communication?
“Many kids have already fallen off their bikes, so why are helmets still necessary?”
COVID can happen more than once, and just because you had an easy time of it the first go-around doesn’t mean you aren’t at risk for a much worse case!
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As announced yesterday by
@ERC_Research
& president
@mleptin
, my project "Disentangling psychological interventions for mental disorders into a taxonomy of active ingredients" (joyful acronym
#DECOMPOSE
) was selected for an
#ERC
Starting Grant
#ERCStG
.
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Non-stop relenting systematic attacks, many of which absurd and completely unfair, can get you down. People can also break. So while you add to the outrage, consider that everyone deserves to be judged based on what they did over a long period of time, not a single event.
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I have been waiting for this piece since March. I thought of writing it myself. Stop preventing family from seeing
#COVID
patients. It is cruel, unnecessary, & discards everything we learnt, the hard way, about palliative care.
@ammarwarraich
@bmj_latest
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He is not a gate-keeper and he is not an elitist. He dissuaded me from projects in which individuals would be targeted even tangentially. Naming names is not his trademark and not his character. But he is also HUMAN. and might really be exasperated and at wits end.
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The more I (try to) do meta-analyses, the more I discover zombie trials. Forget p-hacking, hARKing and good old outcome switching or even its shadier cousin, outcome non-reporting. Forget publication bias. How many studies are simply made up?
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Time to let the dream of neuroimaging revolutionizing mental health diagnosis go (similarly to genetics).
"However, even all neuroimaging measures combined will unlikely explain sufficient variance in depression for these markers to have diagnostic value"
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I’m lost. Is it correct to interpret this argument as masks are an excuse to test less, which thus leads to missing more cases, which thus leads to less absences from school? Because along these lines, not testing at all fixes the issue altogether.
Why?
If, as these critics themselves are claiming, lifting mask mandates means more kids are tested and so more kids test positive, that STILL means lifting mandates causes more missed days of school — even if it only changes detection not transmission!
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Just WOW. The gist of this opinion is basically that even if we do not have clinically relevant data, we should go ahead and vaccinate kids ASAP based on safety and surrogates.
More viewpoints like this and I see myself morphing into an anti-vaxx parent.
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Our paper on the efficacy of direct and indirect psychotherapy for suicidal ideation and suicide attempts in
@JAMAPsych
. Enormous effort led by
@WvBallegooijen
. This is a very important paper that should and will change clinical practice.
This meta-analysis found that both direct and indirect psychotherapy interventions led to significant reductions in suicidal ideation and suicide attempts.
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Bashing
#metaanalysis
is as fashionable as ever, as always with hands up in the air. In response to a thread moaning the lack of added value of meta-analyses over individual studies, I realized I know of *many* meta-analyses that literally overturned whole fields.
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TFW when you are finally getting excited about submitting a manuscript and you remember about the cover letter.
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So if your neuroscience has delivered little, but psychosocial research has delivered a lot, should this not be reflected in funding priorities? The current funding priorities are a lopsided image of this situation.
"...it is still not possible to cite a single neuroscience or genetic finding that has been of use to the practicing psychiatrist" Read the discussion on
#neuroscience
in
#psychiatry
in
#BJPBulletin
Article:
Commentary:
@CambUP_Psych
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Finally, new job announcement. Incoming Associate Professor of Clinical Psychology
@UniPadova
where I will start my
@ERC_Research
funded Starting Grant
#ERCStG
and hopefully not move for a while. I am looking forward to turning a page and starting a LOT of new research projects.
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@VPrasadMDMPH
Oh Jesus Christ super dodgers?? Please get off that high moral horse before it throws you off…or more correctly as you say luck runs out.
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Early birthday present from
@TheLancetPsych
, who have commissioned and published an extremely kind, generous and embarrassingly flattering profile of me. Thank you, editors, for this and for all your support and patience.
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I join the circle of trolls. This is insane & from an actual publication. We need to stop evangelizing policy suggestions from researchers in fields not related to public health or those who had really modest scientific publication records on related issues in pre-COVID times.
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#ZeroCovid
is also this. But hey a cherry-picked comment in the Lancet said elimination does wonder for civil liberties. Also in Australia big public events are possible. And people go to concerts!
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My new & very likely most important paper of 2020
@TheLancetPsych
#network
#metaanalysis
on the efficacy of cognitive bias modification for
#anxiety
or
#depression
in clinical or subclinical patients
(1st author
@liviu_fodor
, w/
@pimcuijpers
@Toshi_FRKW
)
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Twitter has focused mostly on a very glaring error of using the standard error in place of the standard deviation, but there are many other methodological problems in this recent meta-analysis of psilocybin for depression.
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I don't usually share personal info on twitter to prevent the worlds from colliding, but I would like to share I will be joining the Department of Brain and Behavioural Sciences
@unipv
as tenure-track assistant professor (Ricercatore tipo B) as of October 2019.
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@ricpuglisi
@icksx
@borghi_claudio
@salvataglia
@corradoformigli
Il prof. Ioannidis che ha guardato Piazza Pulita manderà una sua risposta alla redazione. Per ovvie ragioni, non posso fargli io da portavoce. La prego di non farmi troppa pubblicità, che sa com'è Twitter e io sono solo una ricercatrice, non voglio entrare in dibattiti politici.
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In 2023, let's give
#psychotherapy
for
#mental
disorders the status it deserves when examining and regulating novel or "breakthrough" treatments. Our latest comment (
@NaudetFlorian
@joarhalvorsen
Lisa Cosgrove)
@TheLancetPsych
lays out arguments for this
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We just got a paper rejected because an editorial assessment was that our humor was ‘quite dry’ (this is a special satirical issue) and I think this is the pinnacle of my career. I also want this epitaph ‘Humor: too dry’.
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So let me get this straight: there r people here who agonize & lose sleep over the collapse of science due to...p-hacking, "Questionable research practices", but think racism, sexism etc r maybe not cool but definitely matter of "perspective", "divergent opinions"
#bropenscience
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Very important paper
@ScienceMagazine
We CAN and SHOULD conduct randomized trials of non-pharmacological interventions (e.g., social distancing) in the
#SARSCoV2
pandemic. Why haven't we?
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Maybe it's not the
#depression
that is resistant to treatment/difficult to treat/tenacious (?), maybe it's the (pharmacological) treatments that are modestly effective or maybe it's that other effective treatments are not disseminated enough?
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@MetaEvidence
Yeah, exactly, stay in your lane, generally don't bother the old order. Plus you are a woman, so know your place. And never promote your blog, only male academics, young and old, are allowed to incessantly link their blogs.
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@BallouxFrancois
As someone whose half of everything is separated by borders, I just can’t believe this is all cast in terms of ‘holidays abroad’. How about those of us who have family (1st degree relatives)? What is the roadmap for us?
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Thank you
@EABCT
!
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Out
@TheLancetPsych
our paper on assessment of
#suicide
in trials of psychotherapy for
#depression
, led by brilliant PhD candidate
@MiguelClara_
& Master student J Cecconi, w/
@MathiasHarrer
@pimcuijpers
@KaryotakiEirini
@claudio_gentili
@WvBallegooijen
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And please stop w/ " lead by examples" of New Zeeland, Australia etc:
"A “zero covid” goal is neither realistic nor sustainable for most countries. Instead, public health needs to increase its investment into assessing the harms of policy options from different perspectives"
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The biggest problem with evaluating MDMA-assisted psychotherapy (and psychedelics generally) is that strong advocacy undermines equipoise thus making trials difficult to run and since blinding is generally impossible creating negative expectations for control participants.
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Most of the Twitter discussion on "what is a
#conflictofinterest
#COI
, really?" is much less interesting or relevant than it appears. Once again, it proves the perils of always picking the brains of the same visible people, even 4 issues outside of their expertise/knowledge.
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This will be unpopular but I believe we are drowning in fake/sloppy/ghost-written/predatory research, journals and researchers. I believe the situation is so dire that even bans against individuals/institutions/publishers could be considered
5
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Rejected letter to the editor (w/
@NaudetFlorian
@EikoFried
) regarding a recent trial of
#ketamine
for (leniantely defined) treatment-resistant depression
#TRD
@APAPubJournals
#AmericanJournalofPsychiatry
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Very good summary in Nature.
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I am recruiting my first PhD student on the
@ERC_Research
funded research project DECOMPOSE at the
@UniPadova
. The focus of the project is identifying active ingredients of psychological interventions for severe mental disorders.
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When will
@TheLancet
commission a similar piece about novel & emerging psychosocial treatments
#psychotherapy
for
#depression
?
Advantages: no life-threatening serious adverse effects, more efficacious options, & definitely more than "evidence exists"
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I "coordinated" with several people, Vinay Prasad, including on Twitter DMs. Mostly it's just mocking ridiculous takes and/or exchanging research ideas. I assume both of these are not ok and should be brought to the immediate attention of the Party Committee?
@amillerphd
I think Prasad and Makary do, and Prasad, Pegden & Baral definitely coordinate since they’ve co-authored a bunch of op eds. Most of them just play off each other, like Munro & Hoeg, and Oster/Munro/Hoeg, Oster/Gandhi, etc.
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Many valid things here, but why the constant belittling of those, who based on the evidence and in good faith, reached different conclusions? Why this positioning of “real scientists” have “consensus”, the others are “fringe”, “pseudoscience” etc
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Unpopular opinion: word-limits are great. They particularly cut from the introduction and discussion, both of which should be very short. For many findings, the research letter with a detailed methods appendix is the best format.
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It took me a while to understand the task of the
#metaresearcher
in the
#SARSCoV2
pandemic: sit on the sidelines and wait for rushed, sloppy, hastily planned, fragmented, overlapping studies to accumulate. Then systematically study them to discover nothing is new.
#classicCovid
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With every
#randomized
#trial
#RCT
I review, I become even more convinced that mandatory prospective registration
#preregistration
is insufficient. To be able to assess a trial, we need access to the full study protocol and statistical analysis plan (SAP).
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As editor and a reviewer, who says yes more than no to review requests, yes, you should do what the reviewer asked. Yes, often most of it. Standing your ground, contrary to what you heard here, should be an exception. You should also be grateful for reviewer comments. Sorry.
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Our paper not just proposing but also delineating how preregistration could work for observational research (including 1st and foremost routinely collected data like
#EHR
) in the
@bmj_latest
. Led by
@NaudetFlorian
@sabineIk11
w/
@chiragjp
@NDevito1
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Somebody please pull the break on the psychedelic revolution before it resets our brains to forget how industry bias works.
@Nature
published a set of 12 comments ("outlook") "editorially independent, produced with financial support from a third party"
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The more I read, the more I get worried about psychedelic assisted psychotherapy breaking all the rules of running trials.
" Potential participants can include current and past patients of the researchers"
Current patients? For a trial you are running? Where is the equipoise?
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@skepticalzebra
As someone who grew up knowing very well what border control meant and who before the EU needed a visa for every one of the limited travels I took, the levity with which border control is tossed around without even acknowledging it is a terrible thing is very sad
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Very unpopular opinion: stop out of office replies. Aren't we all grown up to assume that smb who doesn't reply probably has reasons? Why surrender to the tyranny of e-mail responding? Why share private life events to justify non-response?
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More evidence student evaluations are really reliable and yeah we should totally give them disproportionate weight in academic evaluation, promotion & other career-related decisions :
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The "hammer and dance" guy (no background in virology, immunology, epidemiology or public health) is back (I at least had completely forgot about him) with predictions liked by leading scientists in virology and public health...who said expertise is not democratic?
#COVID
ー19
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55 (yes, fifty-five) reviewers invited between myself (handling editor) and the managing editor, we secured 1 one paragraph review (study looks ok, but does not bring much) and 1 one sentence review (study is perfect). Paper in review for >140 days.
#peerreview
#AcademicTwitter
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New
#metaanalysis
out (w/
@pimcuijpers
@KaryotakiEirini
@claudio_gentili
@steven_hollon
) in Neuroscience & Biobehavioral Reviews re:
#biomarkers
evaluated in randomized trials of
#psychotherapy
for
#depression
(Thank u
@EikoFried
@TimDalgleish
for posting)
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Our (w/
@MiguelClara_
@KaryotakiEirini
@pimcuijpers
) letter to the editor just out in World Psychiatry attempts to quantify the impact of selective outcome reporting in psychotherapy trials for depression
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The Italian schools of cognitive therapy are organizing a (virtual, on Zoom) debate on April 8th between Bruce Wampold & myself on- you guessed it- the role of "common" (nonspecific) factors in
#psychotherapy
#research
. Free & in English. Please share
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Sorry this will be unpopular in my modest followship but I really don’t care. Parents who do not underscore ur caregiver difficulties in responses to do things, you are maintaining an unfair status-quo and harming the rest of us.
#AcademicTwitter
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Wow, huge pragmatic randomized RCT
@JAMA_current
for outpatients w/ frequent suicidal ideation for non-fatal/fatal self-harm, 2 low-intensity online interventions, neither was effective, but strong signal dialectical behavior based might INCREASE risk
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I am recruiting *TWO* PhD students
@UniPadova
to work on my
@ERC_Research
funded project on identifying and testing active components of psychological interventions (& other meta-research projects). Share & contact me if interested
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Is noone concerned the psychedelic revolution is touted by the same KOLs (=key opinion leaders) whose extensive ties to the industry basically spurned the transparency revolution (leading to Sunshine acts, investigations of industry bias, conflict of interest) > a decade ago?
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Who said you cannot publish
#negative
#results
in big journals? No effect of multi-nutrient supplementation or food-related behavioral activation in preventing
#depression
in
#overweight
adults w/ subsyndromal
#depression
sympt
#MooDFOOD
#RCT
@JAMA_current
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My worry beyond a single paper is that we are losing our rationality re: psychedelics and are willing to look over flaws, difficult to fix issues, unknowns, vague, meaningless boilerplate statements ("rewires the brain") instead of rationally evaluating it as another treatment.
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Great editorial
@JAMAPediatrics
by
@apsmunro
&
@SaulFaust
, emphasizing that long-term effects and children's well-being SHOULD also matter, not just their role in the transmission chain. You'd think we'd have heard this sooner. I certainly did not.
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Jokes about the sheer stupidity of this aside, I hope noone has any doubts about some of the
#zerocovid
crowd. Some of these are academics…and clearly cannot use non-black and white reasoning
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Ok I backtrack everything I said, something is *VERY* rotten in the state of Open Science. This doesn't just look very bad, this *IS* very bad. Some serious soul-searching or even better some serious psychoanalysis is needed here.
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From the “bye-bye equipoise” series,
@guardian
advertorial...oops exclusive for a drug of unknown efficacy (if anything, we know it doesn’t work in hospitalized patients) that could lead to massive over treatment & probably be unsustainable at large scale
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2 very well-spent hours that made my Saturday brighter and reminded me, again, why I think John Ioannidis and
@VPrasadMDMPH
are two shining exemplars of nuanced, divergent and sophisticated thinking on complicated issues (Yes, I said it).
Episode 3.14 is out now!
2 hours w/ Dr. John Ioannidis - COVID-19, meta-research, + more
& cancer clinical trial eligibility w/ Dr. Mary-Elizabeth Percival
Back us on Patreon!
Sign up for our mailing list:
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TFW u got a paper th was a gargantuan effort accepted in a major journal, but it's not on
#Covid_19
/anyth related, so it feels small, irrelevant & underwhelming. & u r ashamed of contacting th research office ab a press release, even if it's ur new dep & u know all ab leaning in
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I am not an epidemiologist, but I do understand the concepts of absolute risk and cost-benefits enough to say that comparing the risks from the COVID vaccine to those from oral contraception is completely inappropriate.
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Regression...oops I mean machine learning 1, biomarkers for depression 0
"No informative individual-level MDD biomarker—even under extensive ML optimization in a large sample of diagnosed patients—could be identified".
Maybe give up?
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@sdbaral
The first axiom of closing borders is that it is always more appealing when you and your family are within those borders.
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I decided to step off the treadmill by resigning from the editorial board of a journal. Main reason were the amount of work involved (for a substantial proportion of manuscripts, I had to both edit and review), impossibility of finding reviewers, fast turnarounds.
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I like to think I am difficult to surprise but rectal ketamine passed that bar.
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Esketamine was a pathbreaker for a new standard "clinically but not statistically significant".
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Actually, my great grandparents were rural teachers trying to convince people to let kids attend school instead of doing choirs like farm labor.
Genuine q for ppl more concerned about schools being closed than covid: are you aware mandatory schooling is barely a century old in this country?
Maybe ur all grandparents had highschool, but what about ur great-grandparents?
Yes, education is important. But it’s a pandemic!
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After having harassed me, accused me of plagiarism, trolling, blocked me & complained to people I work with, as well as twice 2 my boss that I need to be "educated", James Coyne also manages to retweet content directly addressed to me. My response ofc not visible as I am blocked.
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Oh wait, wait, where have we seen this (lazy, self-sufficient, arrogant) argument before? If you don't like to be insulted, just leave. If you don't like to be harassed, just leave. If you don't like a certain culture, don't engage. Don't worry, there is also a dude to replace u.
@JuliaEberlen
@EikoFried
@jamesheathers
@Jade_Pickering
That is just it: there are no terrible or good groups. Just like you will not become good friends with everyone in the world, you will not become good 'friends' with all facebook groups. Pick your poison. But please, by Meehl, stop complaining about flavors you do not like.
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I am recruiting two post-doctoral researchers
@Unipd
.
First, in my
@ERC_Research
funded
#ERC_StG
DECOMPOSE to disentangle and test the active ingredients of psychological treatments for severe
#mental
disorders, using
#metaanalysis
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I thought the balance of benefits to harms became more sensitive when dealing with young populations. I thought public health was about risk mitigation. I also thought you could not become a key opinion leader on scientific issues with little expertise & few publications.
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Seriously though, how actionable is advice like quarantine for 2 weeks after you go to a party? Or (not in this article) like have sex with a mask on (not that kind)? What is the point of behavioral prescriptions for which adherence is unlikely?
Labor Day weekend parties are going to be risky. I spoke with
@taraparkerpope
from the
@nytimes
about you can make them safer:
🌴Get outside
↔️Get more space
😷Wear your masks
2️⃣Quarantine for 2 weeks afterwards
Stay safe & make good choices, everyone.
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Meanwhile our brave men the data thugs fantasize about how the punishment for misconduct is not *severe* enough
“My goal is that institutions should focus on what they can do to increase research integrity, not on the integrity of their researchers.”
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Why is Lykos Therapeutics, the new owner of MAPS, actively removing records from , particularly in the wake of
@US_FDA
priority review of MDMA-assisted psychotherapy for PTSD? Is it to prevent public scrutiny before approval?
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The photo really was not necessary. It’s not like people need to recognize her on the street and stay away or the police is looking for her.
Cancer researcher faked data for 24 images in work funded by NIH grants: ORI.
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I am sorry but this
@WIRED
article is a pretty sloppy caricature of John Ioannidis.
@dhfreedman
(whose
@TheAtlantic
article is how I told my parents who I was going to do my
@FulbrightPrgrm
with), sadly has not kept up w/ John's work or meta-research 1/
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FDA advisory committee documents for meeting on June 5th on MDMA for PTSD:
@US_FDA
@FDAadcomms
Some points I think are very interesting.
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Recognition of the necessity of solving or at least addressing the social determinants of mental disorders, incl severe disorders, simply put if you are unemployed & homeless, the solution is not antipsychotics.
Over the past week, I’ve been asking researchers “If you were to travel 10 years into the future, how would you know that current
#mentalhealth
research efforts have succeeded?” A few of the answers:
(1/2)
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Our meta-analysis the effectiveness of
#VirtualReality
tx 4
#anxiety
&
#depression
outc in
@SciReports
. 39 trials, mostly small & high/uncertain risk of bias, large ESs vs ctrl, no benefits 4
#attrition
, no benefit vs active tx
@liviu_fodor
@pimcuijpers
0
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Very pleased to have joined the editorial board of
#SysRevsJ
@BioMedCentral
@MedicalEvidence
as (one of the) Associate Editor(s). This is a journal I endorse, respect & recommend 4
#systematic
#reviews
,
#metaanalysis
and other forms of
#evidence
synthesis
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The solo voices w/ no choir. I just can't do it anymore with the moralistic, scolding, infantilizing rhetoric. In Italy it includes prime examples like "our grandparents were asked 2 go 2 war, we were asked to stay at home" (1st lockdown) or "it's just one holiday season" (now)
I was asked today how I would respond to someone who told me that they were planning on travelling for the holiday season.
My answer: non-judgmental individualized concrete plans about how to mitigate risks.
I'm not in business of judging people.
Just not what i signed up for.
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Our viewpoint
@pimcuijpers
& T. Vecchi out in
@JAMAPsych
. We discuss what we see as two distinct approaches in
#psychotherapy
development: a founder-driven, top-down pathway, and a mechanistic, bottom-up one.
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Now that
@bmj_latest
@bmj
& others are *finally* interested in letters to the editor, I hope they also cover ours out in the
@TheLancet
critiquing ‘that’ review about emergent treatments of
#depression
(w/
@EikoFried
@NaudetFlorian
A Braillon L Cosgrove)
3
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Maybe science journalism should rely less on who is more active, more vocal and more followed on Twitter or on who is more prominent in a research community/movement & go back to the good old-fashioned Pubmed search. Maybe ask the people who have been actually researching COI?
1
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Very happy to announce I have joined the Editorial Advisory Board
@TheLancetPsych
. Cannot wait for all of your submissions!
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2023 is the year (I hope) I touched the rock bottom of my productivity & the highest ideas to implementation ratio. I achieved little, though my idea box is full. I have a lot of funding, but struggle not to waste it. The reality of small children, 2 working parents, little help
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What is the evidence for scolding and moralizing as public health strategies? Ever worked? If you are treated like a child, are you not more likely to act as one? If the right message did not get through, maybe it's not the receiver's fault? Just two cents from a psychologist.
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