Meehl, P.E. (1973). Why I do not attend case conferences. In P.E. Meehl, Psychodiagnosis:
Collected papers. Minneapolis: The University of Minnesota Press.
- Buddy-buddy syndrome.
- "All evidence is equally good."
- Reward everything--gold and garbage alike.
- Tolerance of feeble inferences (irrelevancies).
- Failure to distinguish between an inclusion test and an exclusion test.
viz., p(h/d) = 1; p(d/h) = 1, ~d --> ~h
i.e., a sufficiency vs. a necessariness test
- Failure to distinguish between mere consistency of a sign and differential weight of a sign.
- Ignorance (or repression) of statistical logic.
- Forgetting Bayes' Theorem.
- Forgetting about unreliability when interpreting score changes or difference scores.
- Reliance upon inadequate behavior samples for trait attribution.
- Inadequate consideration of whether and when the (fact-->fact) linkage is stronger or weaker than the (multiple-fact-->diagnosis-->fact) linkage.
- Failing to understand probability logic as applied to the single case.
- Inappropriate task specification.
- Asking pointless questions.
'And therefore?'
- Ambiguity of professional roles.
Why should we listen to the nurse?
- Some common fallacies.
- Barnum effect.
"You often appear outgoing and sociable to people who don't know you well, but you are secretly insecure and shy."
- Sick-sick fallacy.
[cf. Kinsey on oral-genital practices.]
- "Me too" fallacy.
"Real" hallucination seems to require a special talent, or taint.
- Uncle George's pancakes fallacy.
Funny, how long those suckers would last up there in the dry attic. Wonder what their R-value was?
- Multiple Napoleans fallacy.
Is it madness to imagine oneself Bill Gates?
- Crummy criterion fallacy. [3pp.]
Which was the independent, and which the dependent, variable once again?
- "Understanding it mkes it normal."
Surely you can find an example, and post it to the newsgroup.
- Assumption that content and dynamics explain why this patient is abnormal. [5pp.]
D = [C-->R]
p(C)>>p(D)>p(R)
- Hidden decisions.
The ideal patient: Y.A.V.I.S.
- The spun-glass theory of the mind.
Surely you can find an example, and post it to the newsgroup.
- Identifying the softhearted with the softheaded. [4 pp.]
Meehlian roulette: two guns, six bullets, one chance
- Neglect of overlap.
e.g, the Midwestern Multiphasic Tennis-Ball Projection Test
- Ad hoc fallacy.
- "Doing it the hard way."
Ready to try an actuarial table?
- Social scientist's anti-nosology bias.
Have you acquired this? Ready to give it up?
- Double standard of evidential morals. [8 pp.]
n Cognizance, n Nurturance
- Anti-nosological bias:
- "Formal diagnoses are extremely unreliable."
- "We should be interested in understanding the patient rather than labeling him."
cf. Rosenhan (1973), Davis (1976, 1979)
- "Formal diagnoses are prognostically worthless."
And suicide prediction.
- "Diagnosis does not help with treatment."
What about in the case of bipolar illness?
Suggestions for Improvement
We can select, if we have a rather small numner of trainees in a program, applicants falling in the (++) cell of a cognizance-nurturnace fourfold table (Meehl, 1973, p. 283).
"Most people's thoughts..."
cf., cont., organic, 'functional' diseases (see chart, p. 287).
(pseudo)scientific terminology, e.g.
- superego lacunae
- intrapsychic ataxia
- anhedonia
Glossary
Meehl's often not an easy writer, and you should probably read this in sections, allowing time to return to his ideas. You'll encounter many unfamiliar acronyms. It helps to have a dictionary handy, too.
- EST: electric shock therapy (cf. ECT), a treatment for psychotic depression consisting in the induction of an epileptoid seizure in the patient by administering an electric charge to the head.
- MMPI: The Minnesota Multiphasic Personality Inventory
- nosology: The science or art of the classification of diseases.
- primum non nocere: Latin, "first, do no harm."
- specific etiology:
the necessary (but rarely sufficient) causal
factor in the development of a condition, the "differentiating causal agent" (Meehl, 1973, p. 248), e.g., the mutated X-chromosome preventing normal metabolism of phenylalanine in PKU syndrome, pre-pubertal sexual activity in Freud's "seduction theory."