Thread by @drlouisehansen

Inaccurate or Misleading Psychological and Psychiatric Terms to Avoid:
Chemical imbalance. Thanks in part to the success of direct-to-consumer marketing campaigns by drug companies, 1/17

the notion that major depression and allied disorders are caused by a “chemical imbalance” of neurotransmitters, such as serotonin and norepinephrine, has become a virtual truism in the eyes of the public (France et al., 2007; Deacon and Baird, 2009). 2/17

This phrase even crops up in some academic sources; for example, one author wrote that one overarching framework for conceptualizing mental illness is a “biophysical model that posits a chemical imbalance” (Wheeler, 2011, p. 151). 3/17

Nevertheless, the evidence for the chemical imbalance model is at best slim (Lacasse and Leo, 2005; Leo and Lacasse, 2008). One prominent psychiatrist even dubbed it an urban legend (Pies, 2011). 4/17

There is no known “optimal” level of neurotransmitters in the brain, so it is unclear what would constitute an “imbalance.” Nor is there evidence for an optimal ratio among different neurotransmitter levels. Moreover, although serotonin reuptake inhibitors, 5/17

such as fluoxetine (Prozac) and sertraline (Zoloft), appear to alleviate the symptoms of severe depression, there is evidence that at least one serotonin reuptake enhancer, namely tianepine (Stablon), is also efficacious for depression (Akiki, 2014). 6/17

The fact that two efficacious classes of medications exert opposing effects on serotonin levels raises questions concerning a simplistic chemical imbalance model. 7/17

Antidepressant medication. Medications such as tricyclics, selective serotonin reuptake inhibitors, and selective serotonin and norepinephrine reuptake inhibitors, are routinely called “antidepressants.” Yet there is little evidence these are more efficacious for treating 8/17

mood disorders than for several other conditions, such as anxiety-related disorders (e.g., panic disorder, obsessive-compulsive disorder; Donovan et al., 2010) or bulimia nervosa (Tortorella et al., 2014). Hence, their specificity to depression is doubtful. 9/17

Their name derives more from historical precedence—the initial evidence stemmed from research on depression (France et al., 2007)—than from scientific evidence. So the term “antidepressant” is potentially misleading (Antonuccio and Healy, 2012; Kramer, 2011). 10/17

Love molecule. Over 6000 websites have dubbed the hormone oxytocin the “love molecule” (e.g., Morse, 2011). Others have named it the “trust molecule” (Dvorsky, 2012), “cuddle hormone” (Griffiths, 2014), or “moral molecule” (Zak, 2013). 11/17

Nevertheless, data derived from controlled studies imply all of these appellations are woefully simplistic (Wong, 2012; Jarrett, 2015). Most evidence suggests that oxytocin renders individuals more sensitive to social information (Stix, 2014), both positive and negative. 12/17

For example, although intranasal oxytocin seems to increase within-group trust, it may also increase out-group mistrust (Bethlehem et al., 2014). In addition, among individuals with high levels of trait aggressiveness, oxytocin boosts intimate partner violence propensity. 13/17

Comparable phrases applied to other neural messengers, such as the term “pleasure molecule” as a moniker for dopamine, are equally misleading (see Landau et al., 2008; Kringelbach and Berridge, 2010, for discussions). 14/17

If names be not correct, language is not in accordance with the truth of things.” (Confucius, The Analects) 15/17

Source: Lilienfield, S., Sauvigne, K., Lynn, K., Cautin, R, Latzman, R., & Waldman, I. (2015). Fifty psychological and psychiatric terms to avoid: a list of inaccurate, misleading, misused, ambiguous, and logically confused words and phrases. 16/17

Adapted to be Twitter friendly. This thread does not include the whole article. To read the whole article click here. | doi.org/10.3389/fpsyg.… 17/17