A Critical Analysis of Clinical Research - Assignment Example

Critical Analysis of Clinical Research College Name ABSTRACT The two articles by Ironson and Taylor present two treatments for post traumatic depression disorder. Both the study looks at the effect of EMDR and exposure therapy on traumatic patients. The study by Ironson has 22 participants whereas the study conducted by Taylor has more than 60 participants. The study by Ironson is conducted with patient from various races and the other study has patients from many social dimensions. The first study has proved that two treatments were equally effective on patients. While the study by Taylor showed that only exposure therapy was more effective on patients. The study by Ironson is better due to its effectiveness, lower dropout and better clinical significance. Article Analysis Here, two articles are compared to see the effect of two treatments in relevance to the post traumatic depression disorder. Ironson and Taylor explain about the two therapies on post traumatic depression which is EDMR and exposure therapy. Ironson explains about the effectiveness of Eye Movement Desensitisation and Reprocessing (EMDR) while Taylor talks about comparative efficacy of exposure therapy. Ironson explains about EMDR treatments for post traumatic stress where 22 patients participated. In the second article, during the study more than 200 were selected and over 150 patients were interviewed out of which above 60 got involved in the study. So the participation of more patients in the study done by Ironson directs that outcome of the treatment can be more qualitative. In the first study, there were 22 participants who were of mixed race who showed significant improvement after one active session of treatment. In the study by Taylor, there was population diversity as it has participant of various age and from different social dimension like home makers, students,singles and unemployed people. The trauma undergone by these people can be varied and it can give more explainable outcome rather than being too restrictive. As per (Ironson,2002,113-128 ) “ Fort – two percent were employed full – time or part – time outside of the home , 15% were students and 5% were home – makers”. Seven out of ten people had 70 % reduction in depression symptoms and were maintained for a three month time period due to follow up”. It can be understood that the study was initiated with a preparatory exercise where the participants were given breathing and relaxation exercise which could have had a positive effect on the patients. Within the treatment, the trauma related memories were retrieved to encourage full emotional re- experience. During the process, the patients were asked to indicate their SUDS score which was recorded by the study panel. In the study presented by Taylor , the exposure therapy and relaxation training were given to the patients. They have undergone many kind of trauma like homicide, physical assault, social anxiety disorder, panic, accidents, sexual assault and depression. As per (Taylor,2003,330-38) “It should be noted that, one study found higher drop outs among those assigned to EMDR”. In the study by Ironson , the panel of investigators heading included senior authors and clinical psychology doctors which is advantageous. The PTSD scale was also shown in the article which increases the scientific validity of the study. The treatment was manualized and fidelity checks were conducted under the supervision of toe therapists. There was a 28 item questionnaire developed to assess the symptoms which makes the study more credible as it gives a more accurate outcome of the symptoms. The score of PTSD and BSD before and after the treatment of six sessions shows a mean difference which is lower that indicted reduction in symptom at 70%. The follow up of the entire client who finished treatment were not possible as some were not located later and only 12 of them underwent follow up process. The study indicated that difference in mean were not identified successfully due to limitation still it did not show much variation which means the treatment was efficient in the study conducted by Ironson. However, the drop out was higher in the treatment because around 3 people left after active session. The treatment result was that the both were successful in reducing symptom in PTSD and depression. Effects size after 3 active sessions were 1.53 for the both EMDR completers and intent to treat samples. For PE completers 2.18 and 1.54 for intenders and ultimately it is found that both the treatments were equally effective among participants. In the study presented by Taylor, there were more than 60 participants and structural clinical interview DSM IV and participant meeting the criteria were given relaxation training and treatment sessions were videotaped .The effect of the extraneous treatment were classified on the basis they had consulted an external mental health professional. The study showed that all the treatments was effective on the patients but in various degrees. Also, the study mentions that there were rare cases of symptoms worsening. From both the study, Ironson’s study showed that the treatment gave similar effect on the patient and the symptoms were lower and there were not any case of worsening of symptoms. Also the EMDR had more rapid effect and the criteria for clinical significance were met. The EMDR had lower drop out and lower subjective unit of distress. While Taylor concluded that the exposure therapy was more effective than EMDR and was good with improvement and avoidance in re – experiencing. So on this basis, it can be recommended that the study presented by Ironson was more effective than the Taylor’s study because in the former care both the treatment showed equal positive effect with less dropout and more criteria clinical significance. . When one look at the articles, it can be found that the study by Ironson looks more comprehensible , had a structured study pattern, elaborate study with 22 participants and lesser dropouts. The tables and figures present in the article are more scientific and professional and also it has followed all the requisites of a medical research study. The most important part of the study by Taylor was that it was not intending to study the mechanism of treatment but wanted to identify important treatment ingredients. So the study done by Ironson looks more of innovative in their study and was productive as well with their efficient results. The study by Taylor does show that the exposure therapy is studied well by the team and advantages and disadvantages were looked in to and that makes it a good study. However ,with equal efficiency with both treatments, preparatory exercise, lesser drop out, lack of worsening of symptoms , follow ups, and better clinical significance the study presented by Ironson is more effective. The study also did maintain the treatment gains at follow up during both the treatments. Also, the positive point is that all the participants took part in the three preparatory sessions which make the study results more effective. Both the patients completed the treatment and the intended to treat sample showed significant improvement in symptoms. When the study results were compared with other sessions conducted by Wilson and Foa it was almost equal which shows it is more effective and successful than the study conducted by Taylor. And in the study by Ironson ,nine of ten participants achieved 70% reduction in symptoms and for all these reasons the study conducted by Ironson is far better than Taylor. References Ironson, G. (2002). Comparison of two treatment on Traumatic Stress. Journal of Clinical Psychology, 58(1), 113-128. Taylor, S. (2003). Comparative Efficacy , Speed and Adverse Effect of Three PTSD treatment. Journal of Consulitng and Clinical Psychology, 71(2), 330-338. Read More