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5. Conducting the binomial test In 2004, the FDA released a report suggesting that a particular class of antidepressants (selective serotonin reuptake inhibitors or SSRIs) may increase the risk of suicidality in adolescents. The concern led to a black box warning on SSRIs and other antidepressants for users younger than 25. The issue spurred a debate in the psychiatric research community concerning the core issue of whether suicidality, a measure of suicidal tendencies, accurately represents how likely an adolescent is to commit suicide. The reason suicidality was at the core of the debate was that the number of suicides among teenagers is low. So, to be able to detect a difference in the number of suicides among those taking SSRIs and those taking a placebo, for example, requires a huge sample size. Thus, using the number of actual suicides was not possible, and researchers had to look at a measure of the possibility of suicide instead, or suicidality. Since the black box warning was added, the number of prescriptions for SSRIs for adolescents has decreased, while the number of suicides among adolescents has actually increased, suggesting that the antidepressants were actually preventing suicides and the original concern was unfounded. (Source: Karen L. Spittler, SSRIs and Suicide-What Effect Has the Black Box Warning Had? NeuroPsychiatry Review 9, no. 9 [2008], http://www.neuropsychiatryreviews.com/08sept/SSRISuicide.html) Suppose the rate of suicide among all people aged 15-24 in 2002 is one in 8,000. Then suppose a researcher wants to use the binomial test to test whether the suicide rate among a sample of people aged 15-24 who take SSRIs is different than the rate among all people aged 15-24 in 2002. The null hypothesis would be: O Ho: For those aged 15-24 who take SSRIs, p p(suicide)-0.000125 Ho: For those aged 15-24 who take SSRIs, p p(suicide) 0.0125 O Ho: For those aged 15-24 who take SSRIs, p- p(suicide) 0.5 O Ho: For those aged 15-24, p p(suicide) 0.0125

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