Our prophet, Muhammed (s.a.s), refers to satans, as a cause of diseases. Many modern scholars interpret those expressed revelations/knowledge, as referring to microbes, as the content does fit. But I tend to interpret it in the first sense of the word satans, too. i.e: I do notice the possibility of psychosomatic illnesses, irrespective of whether other such concomitant variables (microbic infection, etc.), exist in the specific case.
Psychology may improve health, and even avoid problems, in many cases. And vice versa, too. The page about anti-abuse strategies is then relevant, if we acknowledge, as the Quran does, the existence of such creatures as genies, and other possible subliminal intrusions, with the developments in technology.
A point I notice, is that, psychology rivals medicine, rather than only psychiatry. As widely perceived, psychiatry corresponds to abnormal-psychology, only. It is about varieties of psychological-problems, and the clinical visits. The psychology is wider than abnormal-psychology. (Love, opinions, attitude-change, social-support/organizations, leadership, perception, etc.)
On this page, I present a term-paper I had written twelve years, ago. I plan discussing a lot more. This is the first step. Wait for further relief.
At this site, a very important point is my anti-plagiarism. This term-paper of mine is tangentially relevant, if I interpreted the comment of the professor (assist.prof.), on it, next to the assigned grade, that she had written on the page where there was the conclusion section of my paper. She had written, as I remember: "Pretentious. Suggestive of being taken from somewhere else."
But from where? And what does that word "pretentious" mean? When coupled with what it suggested her, it might not possibly mean that she thought I was necessarily wrong. She must mean a published-source. Right? She could think of it as published somewhere, but she could not imagine myself having written it?
Is it quality work, or is it not? If it is valuable, the grade could have been AA (90-100 range), instead of BB (80-84 range) - that is, unless she has lowered my grade upon her false-guess.
It is a review paper, any way, and I have already referred in that paper, to tens of published sources, when due. What is the sense of suggesting a possibility of an unreferred source?
And after reading them, do not I have a right to express my sympathy towards a neglected paper? I do not think it is "as if wearing big-size shoes," at all - if that is what she means. Even her own remark ensures this, because she could imagine it as published somewhere else - but not by myself. Therefore, I guess, I was supposed to "shut up, and (may only) listen (to the big people)" even when I was supposed to write (as I did) that term-paper myself. I think that has the flavor of a paradox. (I may discuss this further, as relevant to my educational ideas. i.e: How we develop, and certify our worth.)
As I have stated, the issue of plagiarism is an important theme, I discuss at this site. The relevant pages include:
The concern here, about plagiarism, is serious. But this section, in the middle of this page, rather may help as a case study, too. i.e: How would you avoid stress, when, if, confronted with such a situation?
The arguments I have listed, may help, as they are firm, in control, against the problem-situation (cf. hardiness). Let me think further, too, though.
For example, do not neglect where to cut it short, too. e.g: If she means to insist that I should necessarily not write my opinions, keeping a low-profile, even when I would like to express my opinions, in my term-paper, should I attempt to re-educate a third-world professor? Forget it! She may, or may not be meaning that. But, those who mean that, I think, insist in that self-importance, defying any logic. I would not talk with such people - unless in presence of (unbiased, or less-biased) third-party people. Such a loss of grade-points, is not probably reversible, either. In the current educational establishment, it is possibly a major issue. Instead, as a relief, in the world-view that I offer at this site, we form networks for education, and testing, where every lecture hour, stands by itself, and mostly, it is easily repeatable. Getting rid of unfavorite lecturers/students is implicit, for every individual, with his/her own preference, or neglect.
A fine (and funny) point is that, this subsection recasts itself, as a case study, after noticing that it is a possible stressor, in the middle of a page, about TypeA personality, stress, and CHD. :-))
The printed/submitted document is the "PSY481pw.DOC" (Date-time: Nov.23,1992 08:10). I must not have modified it, when I first HTML'ized it in 1997. Here, I publish it verbatim, instead of removing even the typos, or rewriting sentences. After all, let's first register the existing document, here. I may do more, afterwards.
Mention the term "psychosomatic illness" and one of the first associations you will get is the coronary heart disease ( CHD ). In fact, CHD is not completely ( at least directly ) a psychosomatic problem, but its prevalence in the western nations coupled with a generally accepted psychological risk factors for it, makes the CHD one of the first examples.
Continuing with the association game, if you mention CHD, stress, and personality, the immediate associations you get are "Type A personality", "Hardy personality", and "Living habits" ( this last to mean eating fatty foods, not exercising and/or smoking, etc. ). So what are these ? We will see that these are not well-defined, concrete constructs. There is much debate in the research community on what subcomponents they include, how to measure them, and even if they are of any use at all. This paper will not present the reader with the consensus of the scientific community because there is no such thing around. Rather, the approach will be to give a taste of the relevant literature on one aspect of the link between your heart and your brain.
Your Heart: Heart is the organ concerned with pumping blood to the body. There are certain accessory aids to it in maintaining an optimal circulation of the blood. The most important aid is that of the large muscles of the legs which, on contracting, squeeze the veins in the legs, effectively relieving the heart of about one third of its work when the legs are used actively, as in cycling, swimming, or jogging (White, 1982). A further help of such activities is that physical fitness buffers the adverse effects of stressful life events at causing illness (Brown, 1991), which could be also cardiovascular among others.
A second important aid is the elasticity of the aorta, the large artery that receives a jet of blood from the heart every time the heart contracts and converts these jets into a much smoother, more efficient flow of blood. When the hardening of the aorta wall develops as a result of arteriosclerosis, the advantage of the natural elasticity is lost (White, 1982).
A third aid is a freely moving diaphragm that is unimpeded by abdominal fat. When the diaphragm moves up and down, as in breathing, this helps to bring blood up from below as well as to bring air into lungs (White, 1982).
A fourth aid is the arterial system's ability to adjust to the changing demands of different organs. Like after a meal, the blood supply to the gastrointestinal tract has greater priority than the skeletal muscles, whereas during exercise the situation is reversed (White, 1982).
Coronary Heart Disease ( CHD ) : CHD is one of the greatest killers in the industrialized nations. It is caused by atherosclerosis (the most common and most important kind of arteriosclerosis) of the coronary arteries, the small but vital blood vessels that supply the heart muscle with blood and oxygen. Young and middle-aged men are generally more prone to atherosclerosis before the menopause up to which women are well-protected by female hormones (White, 1982).
There are two degrees of involvement to CHD. In the first, the blocking of coronary arteries results in ischemia (lack of adequate blood supply) of the heart muscle which may cause angina pectoris (oppressive pain across the front of the chest). Angina is a warning on the patient to stop exertion bcause of the possibility of a cardiac standstill or a ventricular fibrillation, a fatal irregularity of the heart rate. Some patients with angina pectoris may live for years and may completely recover in the course of months or years, owing to the development of the heart's collateral circulation.
The next degree of involvement by atherosclerosis of the coronary arteries is usually due to the complication of a blood clot that completely obstructs one of the main arterial branches, causing a scar, or infarct, in the heart muscle. Such a scar, like a broken bone, takes 3 or 4 weeks to heal; during this time the patient should be at complete rest (White, 1982).
Type A Personality: A Quasi-Definition : "any person who is aggressively involved in a chronic incessant struggle to achieve more and more in less and less time ... the most significant trait of the Type A man is his habitual sense of time urgency or 'hurry sickness'." ((M.Friedman, Rosenman, 1974, chap. 6) quoted in H.S.Friedman, Hall, Harris, 1985, p.1300)
H.Friedman, Hall, and Harris (1985) quote some expressive aspects of a Type A person, too ( so that you can know one when you see one ) : "walks briskly; alert face; very alive eyes; possibly a tense, teeth- clenching, jaw-grinding facial set; smile is a 'lateral extension', not an oval; laugh is rarely a belly laugh; looks at others unflinchingly in the eye; sits on edge of chair; hands gesture with fist or pointed finger; may squirm or move about with impatience; explosive, accelerating speech; clipped words, firm handshake; loud and/or vigorous voice; general expression of vigor." (Originally in Rosenman, 1978). However, they go on to comment that such definitions come largely out of personal, clinical impressions, with very little theoretical coherence, little use of the literature on nonverbal communicaion, and limited empirical validation. Specifically, they call for research for nonverbal expressive style (e.g: Allport, 1961; Ekman, 1978) to be integrated into Type A research.
Because of Type A being a construct which, probably includes more than one component (and probably interacts with other constructs), several different researchers have chosen to stick-to/emphasize somewhat different constructions. Lack of a precise, unchanging definition for Type A behavior seems to be annoying a few researchers : "We cannot modify the definition of Type A after every study as more is discovered about coronary proneness. Otherwise, it is analogous to claiming that depression is a cause of heart disease and then claiming, as the results come in, 'Oh, I meant an angry depression, I meant a hurried depression, I meant an anxious depression.'" (Friedman and Booth-Kewley, 1988, p.383).
Is Type A Construct Really Useful ? : Type A behavior is modestly ( a risk factor of about 2 (Booth-Kewley, & Friedman, 1987, p.355)) but reliably related to CHD ( and other occlusive diseases ). The size of effect is comparable to that of other disease risk factors which include such biological ("hard") factors like smoking, and cholesterol level. A second reason why this much an explanatory power should not be discarded is the prevalence of CHD and related diseases ( Booth-Kewley & Friedman, 1987; later Matthews (1988) challenged this conclusion ( that of a modest, but reliable relation ) with a meta-analysis having different assumptions than this one. But Friedman, & Booth-Kewley (1988) defended their initial assumptions in the 1987 meta-analysis ).
Unexpected results : One curious point about the findings is that the Type A-disease relations found in prospective studies were much smaller than those found in cross-sectional studies, and this was the case for both the JAS and the SI measures of Type A (Booth-Kewley & Friedman, 1987; Matthews, 1988). This is possibly because Type A behavior is related to morbidity (probably, acting as a precipitating factor) but not mortality through CHD (see Matthews, 1988, p.378 for a discussion of other possible causes).
Another curious point is that the average strength of the observed relation between Type A behavior and disease has decreased in recent years, but no definite explanation for this decrease is apparent. (Booth-Kewley, & Friedman, 1987; Matthews, 1988). It may be in part more skeptical investigators are now studying the issue or that more failures to replicate are now being accepted for publication. Or possibly, the phenomenon itself may be changing (Booth-Kewley, & Friedman, 1987).
Measurement of Type A Style and Related Problems : There are two especially popular Type A measurements : the Structured Interview (SI, an interview-setting-based measurement in which the observer rates the expressive cues of the interviewee ) seems to assess speech characteristics, general responsivity to provocation, and possibly a desire to exert social control, whereas the Jenkins Activity Survey (JAS, a self-report inventory; (jenkins, Zyzanski, and Rosenman, 1979) cited in (Friedman and Booth-Kewley, 1987b)) seems to measure a rapid and competitive living style but neglects affect. ( (Matthews, 1982) cited in (Friedman and Booth-Kewley, 1987b, p.784)).
SI is a much better predictor than is JAS. This is probably because one or two subscales of the JAS are invalid and because only SI assesses aspects of nonverbal expressive style. For example, they assess hostility (which many consider to be the most important component of Type A patter; see below) to different extents : JAS includes only one item on anger in measuring Type A, whereas SI will capture the hostile expressive cues during the interview (Booth-Kewley and Friedman, 1987; Matthews, 1988,p.378). Studies using self-report measures of angry, alienated personality characteristics, most frequently the Cook-Medley Hostility Scale (1954) have demonstrated a relationship between these characteristics and CHD and associated disorders (e.g. Barefoot, Dahlstrom, and Williams, 1983 cited in Robbins, Spence, and Clark, 1991).
The depression-cardiovascular disease relation also seems to be controversial : Two meta-analyses ( Booth-Kewley, & Friedman, 1987; Matthews, 1988), with different meta-analytical assumptions had contrasting conclusions. The Booth-Kewley, and Friedman (1987) study found the relation to be of comparable strength to SI Type A variable, and suggested much more attention should be directed toward this variable. Later, Matthews (1988) challenged the significance of the relation, but again Friedman, and Booth-Kewley (1988) defended their initial conclusion and they also cite European studies with similar findings. That study has been finding a depressed, "vital exhaustion" to be predictive of heart attack (Appels, Hoppener, & Mulder, 1987 cited in Friedman, & Booth-Kewley, 1988 ). The results obtained by Friedman, & Booth-Kewley (1987b) indicate that depression, anxiety, or both may relate to CHD independently of and in addition to Type A behavior.
A study of the correlates of JAS items concluded that the JAS measures a heterogeneous mixture of constructive commitment and self- defeating drivenness (Hansson et al., 1983 cited in Friedman, Hall, & Harris, 1985). The hard-driving and competitive aspects of the Type A personality may be somewhat related to CHD but the speed and job- involvement aspects probably are not. Not the pace but anger and hostility do seem to be predictive (Booth-Kewley, & Friedman, 1987). And the general attempts to slow down the pace of life, to decrease the risk, may thus be misguided (Friedman, Harris, & Hall, 1984 cited in Friedman, Hall, & Harris, 1985).
Analyses of JAS scores by Pred, Spence, and Helmreich (1986; cited in Robbins, Spence, and Clark, 1991) also found two relatively independent factors labeled Achievement Strivings (AS) and Impatience and Irritability (II). Furthermore, a study, based on these factors, found that AS but not the II was significantly correlated in academic scientists with number of publications and frequency of citations by others to their work ( Helmreich, Spence, and Pred, 1988 cited in Robbins, Spence, and Clark, 1991). A similar result was found in college students with grade point average whereas their II scores but not the AS scores were significantly correlated with scores on a self-report measure of minor physical illness ( Spence, Helmreich, & Pred, 1987 cited in Robbins, Spence, and Clark, 1991 ).
The critical link to heart disease involves hostility. It may be that a hostile interpersonal orientation coupled with competitive social situations produces a continuous angry arousal and tension which in turn increase the likelihood of heart disease. This illness-prone orientation is clearly observable in general expressive style and specific nonverbal behaviors (Friedman, Hall, & Harris, 1985). However, the link may turn out to be not one of strict inclusion; Williams et al. (1980 cited in Friedman, & Booth-Kewley, 1987b) found that Type A behavior and Cook- Medley Hostility scale (1954) were independently related to coronary atheroscleosis.
Still, such findings had some researchers conclude that Type A pattern may be of little use and that attention can more profitably be paid to the correlates of the components making up the purported construct (Robbins, Spence, and Clark, 1991). But such a conclusion based on JAS-findings may be unwarranted. Not enough is known about whether different personality variables like Type A, depression, and hostility are independent or redundant in their associations with CHD. Also, meta-analyses based on a small number of prospective studies suggested that neither age, smoking, cholesterol level, blood pressure, nor education is an important mediator of the Type A-disease relation ( Booth-Kewley and Friedman, 1987. And when these analysts were concluding like this, they already knew findings similar to that cited in Robbins et al. study. ).
A more fruitful approach, however, rather than abolishing the construct or reconceptualizing it in terms of a simple, gross hostility dimension, could be to refine the Type A/Type B distinction, and employ a multidimensional classification in terms of relevant dimensions such as hardiness, expressiveness, coping skillsusual environment, as well as Type A because the consistency or match among a person's motivation, emotional responsivity, social skills, and social environment may be the relevant predictor of health (Friedman, Hall, & Harris, 1985).
In a study on these lines, Friedman et al. (1985) classified subjects into 4 categories according to their JAS Type A and Affective Communication Test (ACT, a short self-report scale of positive emotional/nonverbal expressiveness or charisma; Friedman, Prince, Riggio, & DiMatteo, 1981; Riggio, & Friedman, 1982). In defense of their using JAS instead of SI as a measure of Type A behavior, the researchers state that these are "correlated" ( which, I hope, means "highly correlated" because otherwise it does not make sense ) at the extremes.
On a priori grounds, Friedman and colleagues designated the Type A-high charisma (high ACT) and Type B-low charisma groups as healthy groups, and the other two groups as unhealthy groups because these latter two were supposed to have a mismatch in their dimensions. ( Meanwhile, the researchers had raters rate, of a video-taped interview, the subject's a)silent videotapes b)full videotapes(audio plus video) c) audiotape, original speech d)audiotape content-filtered speech e)transcript(verbal) conditions. )
The results have confirmed the prediction : those groups expected to be healthy were in fact healthier on various indices. The associated characteristics with the four categories are :
They see themselves as charismatic, hard- driving, fast-moving, job-involved, and internally controlled, and they have the skills to be successful; they are hardy, integrated, and coherent ( Antonovsky, 1979; Kobasa, & Puccetti, 1983; Moss, 1973 all 3 cited in this study ).
They see themselves as playing a less visible social role, appear healthy, alert, yet relaxed, and are comfortable being less driven.
They see themselves as socially less powerful but they have the strong instrumental motives that require a more ascendant social style. Hannson et al. (1983; cited in this study) argue that pursuit of instrumental goals may require exactly the kind of skills that unhealthy Type As lack.
Despite their self-report as personally charismatic, they do not appear that way. They are not seen as dominant. They are the highest in external locus of control. Perhaps they are motivated to be the center of attention but have poor social skills, poor coping behaviors, or other unattractive traits that lead to frustration. They seem nervous, inhibited, and tense. Their words sounded relatively most friendly, whereas their tone of voice sounded relatively least friendly. The researchers of this study, think whether the unhealthy high ACT ( charisma ? ) Type Bs are sometimes as dynamic and as socially competent as their ACT scores would suggest, or instead infuse into their ACT responses strong urges to be charismatic, which they cannot put into practice due to social anxiety, poor social skills, or neurotic traits not yet measured. Their ACT scores may therefore reflect thwarted motives and high emotionality, which do not achieve suitable expression. I think these results may carry a bias mentioned in the discussion section ( they did not mention it as a bias in fact, but as something that made their results even more remarkable ) : Behaviors that characterize Type A individuals are said to emerge mainly in challenging, stressful situations (Dembroski, Caffrey, et al., 1978 cited in the study), and their situation was not. So, as they conclude, I would echo, more research should be directed at this combination.
Unfortunately, as I have been looking through the literature, the ideas in this paper seem to be less and less considered/remembered as time passes. People have got into easier debates of "component" identification, and such.
Beyond Type A and CHD: A "Disease-Prone" Personality ? : Taking a broader perspective, Friedman, and Booth-Kewley (1987a) undertook a meta-analysis of whether there was a general disease prone personality. They selected five widespread chronic diseases (asthma, headaches, ulcers, arthritis, and heart disease) whose etiology is not well understood, and looked for the study results with five selected personality variables (anxity, depression, anger/hostility/aggression, anger/hostility, and extraversion). They concluded that the existing evidence did not appear to support the idea of different diseases linked with different traits. However, personality consistently appeared to have a causal role across research domains, across diseases, and across a wide variety of methods.
One particular example they cite o support their idea of general disease-prone personality is also related to our previous discussion of Type A behavior-CHD relationship. They tell that in the Friedman et al. (1984) study, which had been a successful effort to reduce Type A characteristics through psychological counseling. Over a three-year period, those receiing the counseling had a significantly reduced rate of recurrence of nonfatal myocardial infarctions. Th interesting point is, rather being directly linked to "hurry sickness", the psychological intervention consisted of extensive instruction in progressive muscle relaxation, modification of exaggerated emotional reactions, self- management, and establishment of new values and goals, all of which Friedman and Booth-Kewley (1987a) note, would also have been effective in dealing with anxiety, hostility, and depression (in addition to Type A personality).
The Hardy Personality: The Psychological Good Guy : If you are tired of hearing (or reading) about how psychological factors are bad for your health (which you should, by now), then it is time to tell that not every psychological factor is actually bad for your health.
One such good guy is the hardy personality. Hardy people deal with stressful situations in ways that mitigate the otherwise expected adverse effects.
Allred and Smith (1989) assessed the cognitive and physiological responses of high and low hardy male undergraduates to a challenging task under high and low evaluative threat. Hardy subjects endorsed more positive self-statements than did low hardy subjects in the high threat condition.
Rhodewalt, and Agustsdottir (1984; cited in Hull et al., 1987) found that hardy individuals do not experience life events that are qualitatively different from those experienced by nonhardy individuals, but they are likely to perceive the events they do experience as positive and themselves in control. If hardy individuals perceive events as uncontrollable or as moderately controllable and undesirable, they also show psychological distress.
Wiebe (1991) found that hardiness moderates stress and this occurs through an adaptive stress appraisal process. Hardiness was associated with less adverse affective and psychophysiological stress responses. High hardy subjects displayed increased frustration tolerance by making more attempts on unsolvable tasks whereas they did not reliably make more attempts on the solvable tasks or completed these tasks more successfully which suggests that the frustration tolerance scores found reflected increased persistence in the face of difficulty, rather than differences in ability or task involvement.
One very important finding in the Wiebe (1991) study, at least for one half of the opulation, is that hardiness had no effect among women. However, they suggest, this finding may be an artifact of the achievement-oriented nature of the task. They cite MacDougall, Dembroski, and Krantz (1981) who had found that although female subjects did not display Type A/B differences in cardiovascular reactivity to standard laboratory stressors, such differences did emerge in response to challenging interpersonal stressors.
The Components of Hardiness : Hardiness is a construct that has been put together from three components that had been previously shown to be related to successful coping in stressful situations. These are (Kobasa, Maddi, & Kahn, 1982) :
tendency to involve oneself in whatever one is doing or encounters. (Antonovsky, 1974; Lazarus, 1966)
tendency to feel and act as if one is influential (rather than helpless) in the face of the varied contingencies of life. (Averill, 1973; Lefcourt, 1973)
belief that change rather than stability is normal in life and that the anticipation of changes are interesting incentives to growth rather threats to security.
Subjects scoring low on commitment and control components have been reported to have an "unhealthy" attributional style (i.e., making internal, stable, global attributions for negative events, and external, unstable, specific attributions for positive events) compared with subjects scoring high (Hull, Van Treuren, & Propsom, 1988 cited in Wiebe, 1991)
A Treatise On The Unity of Hardiness : Hull, Van Treuren, and Virnelli (1987) criticized the hardiness construct/mixture on several basis. One problem with hardiness (as was also the case with Type A behavior) is the problem of measurement. As offered by Kobasa, they report the subscales are not equally effective: commitment seems to be best predictor, control next, and challenge is not useful at all. Also another problem is that in correlational analyses (Rich, & Rich, 1985; Schlosser, & Sheeley, 1985 both cited in Hull et al., 1987), it turned out that the challenge subscale is unrelated to the commitment and control scales, although the latter two scales are correlated at modest levels.
Later, Contrada (1989) took that issue again and concluded that the stress-dampening effects of hardiness in his study were largely attributable to the challenge component! He suggests adding new items to the Security scale (which is used to measure challenge component), congruent with the definition of the challenge component noting that some of the existing items may be somewhat indirectly measuring that definition ( e.g: "The more able person has a greater responsibility of the welfare of the less able" and "There are no conditions which justify endangering the health, food, and shelter of one's family or of oneself", p.901).
So after scrutinizing these studies, I was convinced that, if one wants to measure the hardiness, the sound way seems to be to measure commitment with the short form developed by S.C. Kobasa and S.R. Maddi (personal communication, November 1, 1982 cited in Hull et al., 1987). For control, the Locus of Control Scale is suggested as a reasonable choice (Rotter, 1966; Rotter et al., 1962 both cited in Hull et al., 1987). And the challenge subcomponent, as said, should be measured with a strengthened version of the Security scale.
Value on Health : The scores on the Value on Health Scale constructed by Costa, Jessor, and Donovan (1989) was found to be significantly related to greater involvement in health-enhancing behaviors ( e.g., regular physical exercise, seatbelt use, and attention to healthy diet) in their validation study with adolescents. From their findings, the researchers conclude that value on health seems to be an important target for prevention/intervention efforts with that age group. I believe, their conclusions has a special validity given the fact that CHD and related diseases are seen in young and middle-aged people. Even if this scale may turn out to apply only to adolescents, one should remember that nicotine dependence, and excessive body fat are two cumulative factors that are strongly related to CHD. So, this is just another link between personality and CHD (which should not be discarded, even if does not happen to be related to stress).
As if you had not already noticed it, let me summarize the state of the research front in a single word: confusion.
For this confusion to be settled, first of all, researchers (both Type A behavior, and hardiness people) should agree on an operationalization of these constructs, and conceive a standard, widely accepted way of measuring these constructs.
Second, the integrative, multidimensional research strategy suggested by Friedman et al. (1985) should be put into action. It is very apparent that this kind of research will require quite a lot of resources, but that is the way it is, sorry. In lack of that, Booth- Kewley and Friedman (1987) did a meta-analysis of the existing studies, a poor man's substitute. Matthews (1988) challenged their findings pointing out that the results of a meta-analysis can be very much assumption dependent, but I am still convinced that in need of such broad-viewed studies, a meta-analysis is not something to be written off as assumption dependent because I am positive for Friedman and Booth- Kewley's (1988) idea that assumptions are there anyway. The thing special about a meta-analysis is that its assumptions are explicit and the debate on assumptions between the two sides of this debate is, I believe, a case for the point.
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