Ioana Alina Cristea

Ioana Alina Cristea
University of Pavia | UNIPV · Department of Brain and Behavioral Sciences

Ph.D.

About

164
Publications
95,229
Reads
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4,688
Citations
Citations since 2016
126 Research Items
4552 Citations
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Introduction
I am Assistant Professor at the Department of Brain and Behavioral Sciences, University of Pavia, Italy and Research Affiliate at the Meta-Research Innovation Center at Stanford University, USA (METRICS). I am trained as a clinical psychologist and cognitive behavioral psychotherapist and have previously worked at the Universities of Pisa and Padova, Italy, Stanford University, USA and Vrije Universiteit, the Netherlands. My interests are transparency, rigor, and waste in mental health and psychological research. I use meta-analytic and meta-epidemiological tools to appraise the efficacy and safety of psychological and pharmacological interventions for mental disorders, as well to document the systematic effects of diverse strains of bias, such as conflict of interest, financial or not.
Additional affiliations
April 2016 - September 2016
University of Padova
Position
  • Visiting Scientist
December 2008 - January 2015
Università di Pisa
Position
  • Researcher

Publications

Publications (164)
Article
Objective To assess the patterns and time trends in overall survival and progression-free survival treatment effects across randomized controlled trials (RCTs) in oncology. Study design and setting A PUBMED search for oncology network meta-analyses (NMAs) was carried (to September 30th, 2021). Relevant hazard ratios were extracted for systemic tre...
Article
Data sharing is gradually becoming a requirement across all fields of science, owing to its key benefits in verifying the reproducibility of findings and reusing existent data for new purposes. Although meta-research studies are complex, time-consuming and hinge on the availability of data produced and curated by others, there has been little focus...
Article
The high global prevalence of depression, together with the recent acceleration of remote care owing to the COVID-19 pandemic, has prompted increased interest in the efficacy of digital interventions for the treatment of depression. We provide a summary of the latest evidence base for digital interventions in the treatment of depression based on th...
Article
Full-text available
Alongside the growing concerns regarding predatory journal growth, other questionable editorial practices have gained visibility recently. Among them, we explored the usefulness of the Percentage of Papers by the Most Prolific author (PPMP) and the Gini index (level of inequality in the distribution of authorship among authors) as tools to identify...
Article
Full-text available
Background The treatment of depression in patients with somatic disorders is crucial, given its negative impact on quality of life (QoL), functioning, and even on the somatic disease prognosis. We aimed to examine the most updated evidence on the effects of psychotherapy in patients with depression and somatic disorders, including HIV, oncological,...
Article
We assessed whether the most highly cited studies in emotion research reported larger effect sizes compared with meta-analyses and the largest studies on the same question. We screened all reports with at least 1,000 citations and identified matching meta-analyses for 40 highly cited observational studies and 25 highly cited experimental studies. H...
Article
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Florian Naudet and co-authors discuss strengthening requirements for sharing clinical trial data.
Article
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Publisher's note: This Perspective is one of the two winning Essays of the "Reimagine biomedical research for a healthier future"Essay challenge, launched by the Health Research Alliance in partnership with PLOS. This publication is coordinated with that of the other winning Essay in PLOS Biology. The competition was intended to spark a discussion...
Article
Full-text available
Traditionally, the cerebellum has been linked to motor coordination, but growing evidence points to its involvement in a wide range of non-motor functions. Though the number of studies using transcranial magnetic stimulation (TMS) to investigate cerebellar involvement in cognitive processes is growing exponentially, these findings have not yet been...
Article
The effects of psychotherapies for depression have been examined in several hundreds of randomized trials, but no recent network meta‐analysis (NMA) has integrated the results of these studies. We conducted an NMA of trials comparing cognitive behavioural, interpersonal, psychodynamic, problem‐solving, behavioural activation, life‐review and “third...
Article
Full-text available
Though a plethora of functional magnetic resonance imaging (fMRI) studies explored the neurobiological underpinnings of borderline personality disorder (BPD), findings across different tasks were divergent. We conducted a systematic review and activation likelihood estimation (ALE) meta-analysis on the fMRI studies conducted in BPD patients compare...
Preprint
Letter to the editor in reference to Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of Psilocybin versus Escitalopram for Depression. The New England journal of medicine 2021;384:1402-11.
Article
During the COVID-19 pandemic, the rush to scientific and political judgements on the merits of hydroxychloroquine was fuelled by dubious papers which may have been published because the authors were not independent from the practices of the journals in which they appeared. This example leads us to consider a new type of illegitimate publishing enti...
Article
The development of psychological interventions follows 2 possible pathways (Table). The top-down pathway centers on individual founders as “bricoleurs” building on a diversity of sources, including case observations, cultural or religious notions, selected psychological theories, and empirical findings, to formulate assumptions about processes that...
Article
To the Editor Fraguas et al¹ report a meta-analysis of school-based antibullying interventions for prevention of bullying. We have several concerns regarding the methodology and reporting.
Article
Full-text available
Background: Though aberrant face processing is a hallmark of autistic spectrum disorder (ASD), findings on accompanying brain activity are divergent. Therefore, we conducted an activation likelihood estimation (ALE) meta-analysis of studies examining brain activity during face processing. Methods: We searched PubMed and PsycINFO using combinatio...
Preprint
We assessed whether the most highly-cited studies in emotion research report larger effect sizes compared with meta-analyses and the largest studies on the same questions. We screened all reports with at least 1000 citations and identified matching meta-analyses for 40 highly-cited observational and 25 highly-cited experimental studies. Observation...
Preprint
Full-text available
Context : Convergent analyses in different disciplines support the use of the Percentage of Papers by the Most Prolific author (PPMP) as a red flag to identify journals that can be suspected of questionable editorial practices. We examined whether this index, complemented by the Gini index, could be useful for identifying cases of potential editori...
Article
Full-text available
In the coronavirus disease 2019 (COVID-19) pandemic, a large number of non-pharmaceutical measures that pertain to the wider group of social distancing interventions (e.g. public gathering bans, closures of schools, workplaces and all but essential business, mandatory stay-at-home policies, travel restrictions, border closures and others) have been...
Article
Background Mindfulness applications are popular tools for improving well-being, but their effectiveness is unclear. We conducted a meta-analysis of randomized controlled trials (RCTs) that employed a mindfulness meditation app as the main intervention to improve users’ well-being and mental-health related outcomes. Methods A systematic search was...
Article
Full-text available
Borderline Personality Disorder is a severe condition that affects self and interpersonal dimensions and emotional and behavioral regulation. Since the last decades of the 20th century, an impressive amount of research and clinical contributions on BPD came from specific fields such as psychiatry, clinical psychology, psychopharmacology, and, more...
Article
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In neuroimaging studies, small sample sizes and the resultant reduced statistical power to detect effects that are not large, combined with inadequate analytic choices, concur to produce inflated or false-positive findings. To mitigate these issues, researchers often restrict analyses to specific brain areas, using the region of interest (ROI) appr...
Article
Full-text available
We aimed to assess whether Nobel prizes (widely considered the most prestigious award in science) are clustering in work done in a few specific disciplines. We mapped the key Nobel prize-related publication of each laureate awarded the Nobel Prize in Medicine, Physics, and Chemistry (1995–2017). These key papers mapped in only narrow sub-regions of...
Preprint
During the COVID-19 pandemic, the rush to scientific and political judgments on the merits of hydroxychloroquine was fuelled by dubious papers which may have been published because the authors were not independent from the practices of the journals in which they appeared. This example leads us to consider a new type of illegitimate publishing entit...
Article
Background Cognitive bias modification (CBM) therapies, including attention bias modification, interpretation bias modification, or approach and avoidance training, are prototypical examples of mechanistically derived treatments, but their effectiveness is contentious. We aimed to assess the relative effectiveness of various CBM interventions for a...
Preprint
Full-text available
Background: Though aberrant face processing is a hallmark of autistic spectrum disorder (ASD), findings on accompanying brain activity are divergent. Therefore, we conducted an activation likelihood estimation (ALE) meta-analysis of studies examining brain activity during face processing. Methods: We searched PubMed and PsycINFO using combinations...
Article
Full-text available
Background Depression is one of the leading causes of disability worldwide. Internet- and computer-based interventions (IBIs) have been shown to provide effective, scalable forms of treatment. More than 100 controlled trials and a growing number of meta-analyses published over the past 30 years have demonstrated the efficacy of IBIs in reducing sym...
Article
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There is no comprehensive meta-analysis of randomised trials examining the effects of Eye Movement Desensitization and Reprocessing (EMDR) on post-traumatic stress disorder (PTSD) and no systematic review at all of the effects of EMDR on other mental health problems. We conducted a systematic review and meta-analysis of 76 trials. Most trials exami...
Article
Background Care-as-usual (CAU) is often used as a control condition in psychotherapy research, but it may vary considerably what that entails, ranging from no treatment, to routine treatment in primary care, general medical care, perinatal care, and specialized mental health care. Methods We conducted a meta-analysis of trials comparing psychother...
Article
To the Editor Dr Murray and colleagues¹ reported that randomized clinical trials (RCTs) supportive of the authors’ main hypotheses were no more likely to be cited, viewed, or discussed than those not supportive of main hypotheses, ostensibly providing reassurance that null findings are of equal public and scientific interest as positive findings.¹...
Article
A seminal Lancet series focused on increasing value and reducing waste in biomedical research, providing a transferrable template to diagnose problems in research. Our goal was to document how some of these sources of waste apply to mental health and particularly psychological treatments research. We synthesize and critically evaluate empirical fin...
Preprint
In a meta-analysis of twenty-seven randomized trials, VR-based distraction interventions for procedural pain demonstrated reductions in pain intensity, assessed either real-time or retrospectively, compared to treatment as usual. Though effects appeared generally large, they were associated by high heterogeneity, with all predictive intervals inclu...
Article
Background Virtual reality (VR) may enhance the effectiveness of psychological interventions for acute pain. We conducted a meta-analysis to assess the efficacy and safety of VR-based interventions for pain associated with medical procedures. Methods We searched PubMed, EMBASE, the Cochrane Library, and PsycINFO until June 17th 2018. We identifi...
Article
We conducted an audit of 60 clinical psychology journals, covering the first 2 quartiles by impact factor on Web of Science. We evaluated editorial policies in 5 domains crucial to reproducibility and transparency (prospective registration, data sharing, preprints, endorsement of reporting guidelines and conflict of interest [COI] disclosure). We e...
Article
Full-text available
Background In November 2017, the Food and Drug Administration (FDA) approved a version of a second-generation antipsychotic, aripiprazole, embedded with a sensor (Abilify MyCite). Objective To systematically review the evidence supporting the FDA’s approval of digital aripiprazole and how that evidence was disseminated in the scientific literature...
Article
Though it is widely believed that psychotherapy changes biology, this contention is largely based on observational data, subject to confounding. We report the first systematic review and meta-analysis of biological variables assessed, as outcomes or predictors of response, in randomized controlled trials of psychotherapy for adult depression. Fifty...
Article
Full-text available
Objective Cognitive‐behavior therapy (CBT) is considered the “golden standard” psychotherapy for generalized anxiety disorder (GAD) but, at this point, we have little information about differences among various CBT approaches. Method We conducted a randomized controlled trial to compare three CBT protocols for GAD: (a) Cognitive Therapy/Borkovec's...
Article
Background: Research suggests that Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with autonomic nervous system dysregulation, but the findings were mixed. Method: We conducted a literature review and meta-analysis to quantify the effect of ADHD on vagally-mediated heart rate variability (HRV). PsycINFO, PubMed, Web of Science and Sc...
Preprint
Though it is widely believed that psychotherapy changes biology, this contention is largely based on observational data, subject to confounding. We report the first systematic review and meta-analysis of biological variables assessed, as outcomes or predictors of response, in randomized controlled trials of psychotherapy for adult depression. Fifty...
Preprint
Full-text available
A seminal Lancet series focussed on increasing value and reducing waste in biomedical research, providing a transferrable template to diagnose problems in research. Our goal was to document how some of these sources of waste apply to mental health and particularly psychological treatments research. We synthesize and critically evaluate empirical fi...
Article
Full-text available
Introduction One potential source of bias in randomised clinical trials of psychological interventions is researcher allegiance (RA). The operationalisation of RA differs strongly across studies, and there is not a generally accepted method of operationalising or measuring it. Furthermore, it remains unclear as to how RA affects the outcomes of tri...
Article
Full-text available
In 2014, one of us (JPAI) wrote a viewpoint article coining the term “stealth research” for touted biomedical innovation happening outside the peer‐reviewed literature in a confusing mix of “possibly brilliant ideas, aggressive corporate announcements, and mass media hype”. These reflections were prompted by Theranos, a medical diagnosis start‐up c...
Article
The waiting list is an inadequate benchmark for estimating the effectiveness of psychotherapy for depression - Volume 28 Issue 3 - Ioana A. Cristea
Article
Full-text available
The original version of this article unfortunately contained a mistake. The affiliation “Department of Clinical Psychology and Psychotherapy, Babes-Bolyai University, Cluj-Napoca, Romania” was wrongly affiliated to John P. A. Ioannidis. The correct affiliations for John P. A. Ioannidis are 1, 3, 4, 5, 6. In addition the name of Ioana-Alinea Cristea...
Article
In Reply We thank Weissman for bringing further discussion points in reference to our Viewpoint on improving disclosure of financial conflict of interests (COIs) in research on psychosocial interventions.¹ We regret the inadvertent ambiguity, but we had not suggested that the measurement of interpersonal difficulties was developed or marketed by We...
Article
In this metareview, we argue that in the era of the evidence-based health practice, cognitive-behavior therapy (CBT) is the gold standard in psychotherapy for several reasons: (1) it is the most researched form of psychotherapy; (2) overall, no psychotherapy has proven superior to CBT; on the contrary, if there are differences, typically they favor...
Article
Full-text available
PurposeTo study the landscape of funding in intensive care research and assess whether the reported outcomes of industry-funded randomized controlled trials (RCTs) are more favorable. Methods We systematically assembled meta-analyses evaluating any type of intervention in the critical care setting and reporting the source of funding for each includ...
Preprint
This study examined if the most influential journals in clinical psychology have editorial policies implementing open science practices, such registration of the study before it was conducted, data sharing or disclosure of competing interests. Our findings suggest great heterogeneity in journal policies and scarce enforcement.
Article
Full-text available
We report a meta-analysis of virtual reality (VR) interventions for anxiety and depression outcomes, as well as treatment attrition. We included randomized controlled trials comparing VR interventions, alone or in combination, to control conditions or other active psychological interventions. Effects sizes (Hedges’ g) for anxiety and depression out...
Article
Full-text available
P values represent a widely used, but pervasively misunderstood and fiercely contested method of scientific inference. Display items, such as figures and tables, often containing the main results, are an important source of P values. We conducted a survey comparing the overall use of P values and the occurrence of significant P values in display it...
Data
Box plots with standard errors for the total significant P values by Journal-Year cohorts. Four outliers (> 30 P values), all from 2017, are not displayed. Median represented by a line on each bar. (TIF)
Data
Proportion of significant P values and 95% confidence intervals across all display items with countable P values in Science 2017. (TIF)
Data
Robustness analysis. (DOCX)
Data
Descriptive statistics for the total number of countable P values across display items for each Journal-Year unit. (DOCX)
Data
Proportion of significant P values and 95% confidence intervals across all display items with countable P values in Nature 1997. (TIF)
Data
Proportion of significant P values and 95% confidence intervals across all display items with countable P values in PNAS 2017. (TIF)
Data
Proportion of significant P values and 95% confidence intervals across all display items with countable P values in PNAS 1997. (TIF)
Data
Robustness analysis. Proportion of significant P values and 95% confidence intervals by Journal-Year cohorts excluding 15 display items (all in 2017) with uncertainty about counting. (TIF)
Data
Descriptive statistics for the total number of significant P values across display items for each Journal-Year unit. (DOCX)
Data
Proportion of significant P values and 95% confidence intervals across all display items with countable P values in Science 1997. (TIF)
Data
Proportion of significant P values and 95% confidence intervals across all display items with countable P values in Nature 2017. (TIF)
Data
Extracted data for all screened articles. (XLSX)
Preprint
In this viewpoint we discuss a potential financial conflicts of interest relevant to psychosocial interventions and suggest ways to improve disclosure.
Article
Industry-associated financial conflict of interest (COI) has been documented to distort the outcomes and interpretations of trials,¹ meta-analyses,² and guidelines³ of medical treatments. As a result, COI disclosures are now often required from authors whose work is published in biomedical journals. Enforcement of disclosure policies is still subop...
Article
Full-text available
Assessment of researchers is necessary for decisions of hiring, promotion, and tenure. A burgeoning number of scientific leaders believe the current system of faculty incentives and rewards is misaligned with the needs of society and disconnected from the evidence about the causes of the reproducibility crisis and suboptimal quality of the scientif...
Article
Full-text available
Objectives To explore the effectiveness of data sharing by randomized controlled trials (RCTs) in journals with a full data sharing policy and to describe potential difficulties encountered in the process of performing reanalyses of the primary outcomes. Design Survey of published RCTs. Setting PubMed/Medline. Eligibility criteria RCTs that had...
Data
Supplementary information: e-Table 1: results of reanalyses for three ineligible studies published in The BMJ after the policy but submitted before
Article
Full-text available
In this paper, we argue that CBT is the gold-standard psychological treatment—as the best standard we have in the field currently available—for the following reasons: (1) CBT is the most researched form of psychotherapy. (2) No other form of psychotherapy has been shown to be systematically superior to CBT; if there are systematic differences betwe...
Chapter
This chapter analyzes the current state of the art of various psychotherapies for major depressive disorder (MDD) in adults, through the lens of David and Montgomery's psychotherapy classification system. These include evidence-based psychotherapies, intervention-driven psychotherapies, theory-driven psychotherapies and investigational psychotherap...
Article
Aims Leucht et al . in 2012 described an overview of meta-analyses of the efficacy of medication in psychiatry and general medicine, concluding that psychiatric drugs were not less efficacious than other drugs. Our goal was to explore the dissemination of this highly cited paper, which combined a thought provoking message with a series of caveats....