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Study This with Dr. Brian v.1

By Dr. Brian Russell • on June 25, 2009

Study this: New research suggests that psychotherapy is better than prescription drugs, which can have serious side effects and be addictive, for the long-term treatment of insomnia. The study participants who experienced the best results received a relatively short course of a prescription sleep medication combined with psychotherapy, after which the drug was discontinued in favor of psychotherapy only. One of my colleagues, Dr. Anne Owen, is an expert in the psychotherapeutic treatment of insomnia in Lawrence, Kansas, and she actually conceptualizes healthy sleeping as a skill that can be successfully taught and learned in therapy. Many chronic insomnia sufferers engage in self-defeating behaviors such as reading, eating, or watching television in bed or staying in bed for extended periods of time without sleeping. If you’re having trouble sleeping, I recommend seeking out a psychologist in your area who has expertise in treating insomnia. You may learn that you’ve developed some bad sleep habits and be able to develop some healthier “sleep skills” of your own, which this latest research suggests may help you more than pills, at least in the long run. (And as always, both starting and stopping a prescription drug regimen should be done under a doctor’s supervision.) (May 19, 2009)

Study this: On the subject of pain relief, new research has revealed that poking people non-invasively with toothpicks is about equally effective as acupuncture in treating pain. That could mean one or a combination of two things: 1) acupuncture’s effect is pure placebo (i.e. it’s all psychological — people think it’ll help them, so they perceive that it does), and/or 2) it’s not really about the “puncture” of the skin; it’s about stimulating certain nerve endings at the skin’s surface that somehow dulls or dilutes other (pain) nerve responses.

Another new study revealed a brief questionnaire that’s supposed to be extremely accurate at identifying people who are at high risk for developing Alzheimer’s early in the disease process. In the reported study, the questionnaire correctly identified 88% of the participants who went on to develop full-blown Alzheimer’s, but that brings up an important issue about psychological (or any diagnostic) testing. “Sensitivity” refers to a test’s ability to identify people who are positive for some trait, in this case, Alzheimer’s risk. Identifying 88% of the people who had that trait in the reported study is fairly good sensitivity, but for the test to be really useful, it must also have “specificity,” and I haven’t heard about its specificity yet. “Specificity” refers to the test’s ability to exclude people who are negative for the trait. See, I could easily make a test that would assess Alzheimer’s risk with 100% sensitivity by simply asking the person, “Are you a human being?” and if he/she says yes, then he/she gets flagged as “positive” for high Alzheimer’s risk. That way, 100% of the people who went on to develop Alzheimer’s would’ve had a “positive” result on my test. Of course the test would be meaningless though because it would also flag many people who really were not at elevated risk for Alzheimers. In other words, it would have no specificity whatsoever. Assuming that this new test has both good senstivity and good specificity, it’s a good development in Alzheimer’s research, but it’s one that will become much more useful when more effective early interventions are available. (May 16, 2009)

Dr. Brian Russell is a licensed psychologist, attorney at law and familiar national television pundit on psychological, legal and cultural issues.