In short: Like homeopathy complementary/alternative therapies such as acupuncture and chiropractic lack plausibility and efficacy, despite claims to the contrary. Placebo and other psychological effects of treatments may explain their popularity.

1. PS409
Psychology, Science,
& Pseudoscience
Dr Brian Hughes
School of Psychology
brian.hughes@nuigalway.ie @b_m_hughes

2. Case Studies:
Examples of Psychology-related
Pseudoscience

3. Case Studies from
Outside Mainstream Psychology:
1. Complementary and alternative
medicine/therapies

4. CAM efficacy: Acupuncture
Plausibility issues:
Qi, yin, yang, meridians
Poor inter-rater agreement
Empirical issues:
Cochrane Library: 16 reviews
3 reviews for pain:
63 trials; 4,096 participants
No effect
1 review for smoking cessation:
24 trials
No effect

5. CAM efficacy: Acupuncture
Adverse effects
(Noeheim & Fonnebo, 1995; Yamashita et al., 1998)
Exaggerations?
Anaesthesia
Chinese authenticity vs. Western
romanticism
Impact on health in China
Endorsement by health insurers
Actuarial logic rather than concern for
efficacy
Endorsement by medical authorities
Populism or evidence?

6. CAM efficacy: Acupuncture
Ireland China India Cuba
Annual health $2,496 $278 $82 $251
spend per
capita*
Life expectancy 75/81 70/74 61/63 75/80
(M/F), yrs
Child mortality 7/5 27/36 81/89 8/7
(M/F), per 1000
Adult mortality 105/60 158/99 275/202 131/85
(M/F), per 1000
TB cases, per 11 101 168 10
100,000
Last polio case 1965 1999 2006 1962
reported
*“International Dollars” = US dollars, corrected for purchasing power parity
(i.e., figure shown refers to amount purchased in terms of US market values)
Source: WHO

7. CAM efficacy: Acupuncture
“Approved” by the BMA
Reasons given:
Popularity among physicians
Popularity among public
Reported efficacy for, e.g., back pain
(citing Ernst & White, 1998)
2000

8. CAM efficacy: Chiropractic
Plausibility issues:
Form-function relationship,
subluxations, bodily intelligence,
homuncularity
Empirical issues:
Cochrane Library: 1 review
Dysmenorrhoea
5 trials, 236 participants
No effect
Other frequently cited review:
Shekelle et al. (1992)
No chiropractic among
successful trials

9. CAM efficacy: Chiropractic

10. CAM efficacy: Chiropractic
Other reviews
Pain: Ernst (2003); Gay et al.
(2005); Lisi et al. (2005)
50 trials
No effect
Asthma: Ernst & Harkness (2001)
2 separate studies
No effect

11. CAM efficacy: Chiropractic
Cost-benefit analysis?
Adverse effects of chiropractic
1 per 2 million manipulations
(Powell et al., 1993)
1 per 400,000 manipulations
(Dvorak, 1985)

12. Placebos
Inert substances that cause symptom relief
“My headache went away after having a sugar pill”
Substances/procedures that cause changes in a
symptom not directly attributable to specific or real
pharmacological/curative action
“My headache went away after I had my hip operation”
Any therapy that is deliberately used for its non-
specific psychological or physiological effects
“My headache went away after I had my bath”
After Ogden (2004)

13. Placebos
Patient characteristics
Treatment characteristics
Convincingness
e.g., ultrasound for pain (Hashish et al., 1988)
Seriousness
e.g., placebo heart surgery (Cobb et al., 1959; Diamond et al., 1960)
Patient-treatment interaction characteristics
Expectancy effects
e.g., Beta-blocker Trial (Horwitz et al., 1990)

14. Acupuncture placebos: Sham needles

15. From:
Kienle & Kiene
(1997)

16. Complementary and alternative
medicine/therapies

17. PS409
Psychology, Science,
& Pseudoscience
Dr Brian Hughes
School of Psychology
brian.hughes@nuigalway.ie @b_m_hughes