Full paper: http://www.ehps.net/ehp/issues/2007/v9iss3_August2007/EHP_Aug07_Coyne&Palmer.pdf I'm sure I've seen others discuss this on here, but cannot find any thread about it. It focuses on claims that psychological therapies increase life-span for cancer patients, but it also makes general points relevant to CFS. I was going to quote relevant sections, but it's only four pages long, and is almost all relevant. These are the five main points, and I quoted the final three in full, as they seem particularly relevant. 1. Primary sources, even classics, often go unread. 2. Critical appraisal skills and the ability to apply basic standards for interpreting clinical trials are in short supply in psychology. 3. Findings that are in sync with cultural beliefs and values can take on a life of their own, and dethroning these findings does not make one popular. In the case of the claims made by Spiegel and his colleagues, as well as later commentators, the idea that patients should view their illness as a personal responsibility to be overcome through the hard work of psychotherapy appealed to strongly held values, particularly in North American culture. Of course, the study ought to have shown that patients can extend their lives. Didn’t we know that already, even if there had not yet been a study? Skeptics risk being seen as rejecting what we already know and as undermining the coping efforts of patients. 4. Numerous groups had a vested interest in the results of studies being seen as having positive outcomes. We often think of “conflict of interest” as more a circumscribed issue than it most likely is in practice. Beliefs are shaped by needs as much as evidence. As Lesperance and Frasure-Smith (1999) pointed out “Prevention of mortality has always been one of the most important factors in determining the allocation of funding for research and clinical activities.” Findings that psychotherapy prolongs the lives of cancer patients is extremely useful, even vital for advancing the claims of diverse groups, ranging from researchers seeking funding for psychoneuroimmunology studies to promoters of the virtues of mind control and positive thinking, most recently seen in the huge popularity of Rhonda Byrne’s 2006 book, The Secret. Those who see a benefit for the credibility of their own claims are going to have a stake in promoting and protecting the claim that psychotherapy promotes survival. 5. A persistent champion can play a key role in promoting the value of an intervention in the face of contrary evidence. Spiegel and his colleagues repeated claims that the original study had shown that psychotherapy prolongs life over two dozen times in journal articles, as well as in numerous presentations to lay and professional audiences, and even on national television. As was discovered by Bernard Fox and others, critics were excoriated (cf. Goodwin et al., 1999). Moreover, one might have assumed that a consistent pattern of failed attempted replications would have caused a reevaluation of the original study. However, champions of the original study countered these new results by reinterpreting other studies as positive and of equivalent value (Spiegel & Giese-Davis, 2003), despite these studies not being designed to test whether psychotherapy improved survival and also having confounded psychosocial intervention with improved medical care (Coyne et al., 2007). There was a distinct bracket creep in what was considered relevant evidence, allowing portrayal of the overall subsequent literature as being mixed, rather than more uniformly negative. This is the conclusion: What larger lessons are to be learned? First, we need to read original sources. We encourage prospective authors to read carefully the studies they cite, even when there is near unanimity in secondary sources about the nature of findings being reported. Second, we encourage scholars to acquire and apply the critical skills needed to appraise the claims they find in published articles. These skills are sorely needed, and critical application of them can be an important contribution to the literature. But yes, if you take on the task of challenging entrenched, but erroneous, claims you must be prepared to take some heat.