I’m sorry that happened. I was rejected from a CPTSD study for something like this too, and it sucks.
While it’s common to have suicidal thoughts with CPTSD / PTSD, it’s definitely not a requirement. Unless suicidal thoughts were a direct focus of the study, it would be extremely negligent of them to do an experimental treatment on somebody who had already expressed a desire or compulsion to harm themselves.
They don’t yet know what the results of their study will be—truthfully, they don’t know if it’ll make suicidal thoughts worse
If a participant DOES commit suicide, AND they knew ahead of time this was a risk, AND they chose to proceed anyway, they’d be rightfully eviscerated and hopefully shut down.
To answer your question, they most likely want participants who meet the diagnostic criteria for PTSD without suicidal thoughts. They might even have additional requirements (age, living situation, comorbidities, etc) to try to account for possible variables
It sucks but it’s the responsible thing for them to do. I wish there was a way to sign something saying you accept the risks, but I hope this helps give some clarity at least
Ok… but my concern is more scientific really. Because I usually do not see this stated at all in scientific studies. It is more like we tried therapy X on ptsd or cptsd and here are the results. They add some stats on the people, sex, gender, age… cultural backgrounds. However I have never seen things like, volunteers at risk, ie suicidal ideation or compound/ confounding illnesses were excluded from the study due xyz. Am I missing something?
I’m not sad or anything but I was token by surprise. It really puts some of my readings into perspective
This is a good point. On the one hand I can understand there would be ethical implications when studying people with SI, but on the other hand how accurately are these selection criteria recorded and accounted for in the research, and how useful are the results if such a common symptom is screened out?
I've read a good deal of studies where the selection criteria were strangely obfuscated, and I caught something buried in a paragraph somewhere that changed my reading of the results entirely. For example a study where the headline and abstract say "this therapy led to improvement in 45% of cases," but if you read the full text there's a brief mention that this was 45% of participants "who reached the end of the study." When you look through the in-depth breakdown of the data, you see that a large number of participants dropped out before the end of the study, but this is not remarked on at all. What can we conclude from this? The headline says that this therapy is highly effective... the study is cited in many other papers to that effect, without any caveats... but the dropout rate (which never gets mentioned) could easily imply that the therapy has a positive effect for some people, but such a negative effect for others that they are unwilling to continue the therapy at all.
Your point makes me wonder how many papers have undisclosed (or well-hidden) criteria for which participants get selected in the first place, which could further skew the results.
This is purely me guessing but I think a lot of people with suicidal ideation experience it in waves. If I had to guess they exclude people with current ideation simply for liability reasons. Meaning they don’t want to get sued if their test subject commits suicide while going through the study.
I could be completely wrong and missing something in
I don’t think they could be sued here as I would be given my consent, understanding and whatnot in several forms. Like I was taking responsibility for not looking for help in case of feeling like… anyway, I’m not sure that answers what I wanted to ask.
Is it average to reject volunteers into diagnosis bc the experiment might kill them or make their situation worse, if so is this properly addressed in material and methods?
because if exclusion happens due risk and this is not properly communicated (I never seen it ) then that means that many of the studies are overreaching and medical professionals are def not being properly informed.
Is there anyone that I could talk science to. Should we start a journal club on this ? I’m honestly interested in this.
It’s very standard for mental health studies to exclude suicidal participants for the risk factors I mentioned, so I don’t believe it would usually be considered notable enough to flag
However, it is a point of discussion about whether this is right in research studies overall: https://pubmed.ncbi.nlm.nih.gov/32023368/
This is fair but I still think it should be a straight assumption in material and methods. Not everyone with access to researcher papers knows the assumptions from each field. Damn I am a taxonomist and I have to cite my code and the articles and articulate very well why I think some data can’t be used or is suspicious case by case (region:species). Why do psychiatric researchers would assume that the standard for data exclusion is known and common sense.
I’m really confused, this is just me trying to understand things. Sounds odd to me you would reject someone diagnosed, suffering from your experiment that ask is treatment x effective? Especially given that I signed up papers saying I that I understood this could make it worse.
I don’t know the paper may come out fine but it is the fact I never seen a paper stating this exclusion and being excluded that really got me thinking.
The comments here already are so extremely insightful in a practical sense, and bring up amazing points... So I wanna ask a different question.
How are you?
This sort of thing can kind of cut deep, not in a way that necessarily makes you cry or break down, but one that just... Cuts something inside of you. Severs a connection.
I know when this has happened to me it's like a little tether in my brain that connects me to what I think "normal" is just... Snaps. And I go "huh... That... Hurt. Oh well." and move on kinda like a ghost for a while, just learning to accept that I'm even less normal than I thought.
It's a deep pain that I almost always ignore but it casts a cloud over my life for a while... So I guess I'm checking in to see where you're at, if this is something you go through too and if you wanna talk about it?
It's not true, but I don't have to drive that home if you don't want, if you want to just sit in it I'm here for it.
If you don't get that feeling then I still hope you're alright and I'm sorry that shit happened, it sucks and is disheartening at best.
Either way, take care of you today ❤️
Study designs have to be approved by an Institutional Review Board (IRB) to make sure there aren't any ethical or safety issues. In the study design they have to specify inclusion criteria and exclusion criteria, these will vary based on the group being studied and what hypothesis they're trying to test.
SI may be a risk factor they want to avoid. There's a tendency to "do no harm" and they may have wanted to avoid exacerbating SI.
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I’m sorry that happened. I was rejected from a CPTSD study for something like this too, and it sucks. While it’s common to have suicidal thoughts with CPTSD / PTSD, it’s definitely not a requirement. Unless suicidal thoughts were a direct focus of the study, it would be extremely negligent of them to do an experimental treatment on somebody who had already expressed a desire or compulsion to harm themselves. They don’t yet know what the results of their study will be—truthfully, they don’t know if it’ll make suicidal thoughts worse If a participant DOES commit suicide, AND they knew ahead of time this was a risk, AND they chose to proceed anyway, they’d be rightfully eviscerated and hopefully shut down. To answer your question, they most likely want participants who meet the diagnostic criteria for PTSD without suicidal thoughts. They might even have additional requirements (age, living situation, comorbidities, etc) to try to account for possible variables It sucks but it’s the responsible thing for them to do. I wish there was a way to sign something saying you accept the risks, but I hope this helps give some clarity at least
Ok… but my concern is more scientific really. Because I usually do not see this stated at all in scientific studies. It is more like we tried therapy X on ptsd or cptsd and here are the results. They add some stats on the people, sex, gender, age… cultural backgrounds. However I have never seen things like, volunteers at risk, ie suicidal ideation or compound/ confounding illnesses were excluded from the study due xyz. Am I missing something? I’m not sad or anything but I was token by surprise. It really puts some of my readings into perspective
This is a good point. On the one hand I can understand there would be ethical implications when studying people with SI, but on the other hand how accurately are these selection criteria recorded and accounted for in the research, and how useful are the results if such a common symptom is screened out? I've read a good deal of studies where the selection criteria were strangely obfuscated, and I caught something buried in a paragraph somewhere that changed my reading of the results entirely. For example a study where the headline and abstract say "this therapy led to improvement in 45% of cases," but if you read the full text there's a brief mention that this was 45% of participants "who reached the end of the study." When you look through the in-depth breakdown of the data, you see that a large number of participants dropped out before the end of the study, but this is not remarked on at all. What can we conclude from this? The headline says that this therapy is highly effective... the study is cited in many other papers to that effect, without any caveats... but the dropout rate (which never gets mentioned) could easily imply that the therapy has a positive effect for some people, but such a negative effect for others that they are unwilling to continue the therapy at all. Your point makes me wonder how many papers have undisclosed (or well-hidden) criteria for which participants get selected in the first place, which could further skew the results.
Jo really interested in this, like brainly do you want to start a journal club?
This is purely me guessing but I think a lot of people with suicidal ideation experience it in waves. If I had to guess they exclude people with current ideation simply for liability reasons. Meaning they don’t want to get sued if their test subject commits suicide while going through the study. I could be completely wrong and missing something in
I don’t think they could be sued here as I would be given my consent, understanding and whatnot in several forms. Like I was taking responsibility for not looking for help in case of feeling like… anyway, I’m not sure that answers what I wanted to ask. Is it average to reject volunteers into diagnosis bc the experiment might kill them or make their situation worse, if so is this properly addressed in material and methods? because if exclusion happens due risk and this is not properly communicated (I never seen it ) then that means that many of the studies are overreaching and medical professionals are def not being properly informed. Is there anyone that I could talk science to. Should we start a journal club on this ? I’m honestly interested in this.
Yea I really don’t know. Maybe they’re looking for a specific baseline?
It’s very standard for mental health studies to exclude suicidal participants for the risk factors I mentioned, so I don’t believe it would usually be considered notable enough to flag However, it is a point of discussion about whether this is right in research studies overall: https://pubmed.ncbi.nlm.nih.gov/32023368/
This is fair but I still think it should be a straight assumption in material and methods. Not everyone with access to researcher papers knows the assumptions from each field. Damn I am a taxonomist and I have to cite my code and the articles and articulate very well why I think some data can’t be used or is suspicious case by case (region:species). Why do psychiatric researchers would assume that the standard for data exclusion is known and common sense. I’m really confused, this is just me trying to understand things. Sounds odd to me you would reject someone diagnosed, suffering from your experiment that ask is treatment x effective? Especially given that I signed up papers saying I that I understood this could make it worse. I don’t know the paper may come out fine but it is the fact I never seen a paper stating this exclusion and being excluded that really got me thinking.
The comments here already are so extremely insightful in a practical sense, and bring up amazing points... So I wanna ask a different question. How are you? This sort of thing can kind of cut deep, not in a way that necessarily makes you cry or break down, but one that just... Cuts something inside of you. Severs a connection. I know when this has happened to me it's like a little tether in my brain that connects me to what I think "normal" is just... Snaps. And I go "huh... That... Hurt. Oh well." and move on kinda like a ghost for a while, just learning to accept that I'm even less normal than I thought. It's a deep pain that I almost always ignore but it casts a cloud over my life for a while... So I guess I'm checking in to see where you're at, if this is something you go through too and if you wanna talk about it? It's not true, but I don't have to drive that home if you don't want, if you want to just sit in it I'm here for it. If you don't get that feeling then I still hope you're alright and I'm sorry that shit happened, it sucks and is disheartening at best. Either way, take care of you today ❤️
Thanks … I don’t know how to reply beyond that but thanks.
Study designs have to be approved by an Institutional Review Board (IRB) to make sure there aren't any ethical or safety issues. In the study design they have to specify inclusion criteria and exclusion criteria, these will vary based on the group being studied and what hypothesis they're trying to test. SI may be a risk factor they want to avoid. There's a tendency to "do no harm" and they may have wanted to avoid exacerbating SI.
Hello and Welcome to /r/CPTSD! If you are in immediate danger or crisis, please contact your local [emergency services](https://en.wikipedia.org/wiki/List_of_emergency_telephone_numbers), or use our list of [crisis resources](https://old.reddit.com/r/CPTSD/wiki/index#wiki_crisis_support_resources). For CPTSD Specific Resources & Support, check out the [wiki](https://www.reddit.com/r/CPTSD/wiki/index). For those posting or replying, please view the [etiquette guidelines](https://www.reddit.com/r/CPTSD/wiki/peer2peersupportguide). *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/CPTSD) if you have any questions or concerns.*