My Breakfast With "Scientism"

One morning, I awoke convinced that science was the only source of knowledge. I had developed a case of spontaneous scientism.

The first challenge I faced was deciding what to eat for breakfast. Muesli, or cornflakes? Which would be the more scientific choice? I decided to go on the internet to look up the nutritional value of the different cereals, to see which one would be healthiest.

My computer was off. So first I'd need to turn it on - but how? From past experience, I suspected that pressing the big green power button on the front would do it - but then I remembered, that's merely anecdotal evidence. I needed scientific proof.

So I made a mental note to run a double-blind, randomized controlled trial of "turning my computer on" tomorrow.

Lacking nutritional data, I decided to pick a cereal by taste. I like muesli more than cornflakes. At last, a choice! Muesli it is, I thought - until I realized that I didn't actually know which one I preferred more. I had a gut feeling I liked muesli, but that's not science. What if, in fact, I hated muesli? Science couldn't tell me, at least not yet.

Another mental note: conduct cereal taste preference study, day after tomorrow. No breakfast for me, today.

By now, I was hungry, confused and annoyed. "This is getting ridiculous!", I tried to exclaim to no-one in particular - but then I realized - I could not even speak because I knew next to nothing scientific about the English language.

Sure, I had vague intuitions about how to put words together to express meaning, but that's just unscientific hearsay that I'd picked up as a child (no better than a religion, really!) In order to communicate, I'd need to study some proper science about semantics and grammar... but, oh no, how could I even read that literature?

Faced with the impossibility of doing anything whatsoever purely guided by science, I decided to go back to bed... yet with no scientific basis for controlling my own muscles, I collapsed where I stood, bashing my head on the breakfast table as I fell. 

Luckily, the bump on the noggin cured me of my strange obsession, and I lived to tell the tale.

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Many people will tell you that "scientism", the belief that science is the only way to know anything, is a serious problem, a misunderstanding that threatens all kinds of nasty consequences.

It's not, because it doesn't exist - no-one believes that. If they did, they would end up like the unfortunate narrator in my story.

Everyday, we make use of many sources of information, from personal experience and learning to simply looking at things, whether they be right in front of your eyes or on TV. This is knowledge, and no-one thinks that we ought to replace it with "science", if that were even possible.

"Scientism" is a fundamentally unhelpful concept. Scientists are often wrong, and sometimes they're wrong about things that other non-scientists are right about. But each such case is different and must be judged on its own merits.

Neither Drugs Nor Therapy Prevent Psychosis

Neither medication nor psychotherapy is effective in improving the prognosis for youngsters considered to be at high risk of developing psychosis, according to a major study just published.

The idea of identifying and treating young people at risk of becoming psychotic - because of a family history of schizophrenia, or because they're showing some mild symptoms - has become very fashionable lately. But can we really do anything to pre-empt the disorder?

In this trial, 115 "ultra-high risk" Australian subjects were randomized to three different treatment conditions, or if they didn't agree to treatment, they were just followed up to see what happened.

The treatments didn't work. Here's the smoking gun, showing the proportion who didn't go psychotic over time:

This shows all four of the subject groups did pretty much the same in terms of their likelihood of becoming psychotic. Neither cognitive therapy, nor the antipsychotic drug risperidone (at a low dose) had any effect: those given 'supportive therapy' (basically: sympathetic chats) and a placebo pill did just as well.

There probably wasn't even a placebo effect: none of the three treatment groups did better than people who got no treatment at all (monitoring group), although people weren't randomly assigned to that group, so that's a little less clear.

Is this a surprise? Yes, if you believed the early studies to examine this question which claimed great things for drugs and therapy. But the current findings are no shock if you've been following the (much larger) recent trials - for example the British one from earlier in the year, which found zero benefit of cognitive therapy.

Early small trials have a nasty habit of not working out in the long run.

The other lesson here is that even "ultra-high risk" folks usually don't get psychotic: only about 10-20% of them, in fact, became ill in the first two years of this study; the British results I mentioned are very similar.

So is this really "ultra high"? Relatively, yes it is; even a 10% risk is far higher than the chance that a random person on the street would have. But in absolute terms, perhaps not.

A concern here is that rounding these folks up, labelling and 'treating' them might make their lives worse, or even increase the risk of psychosis. That's not just my opinion: that's what the very cognitive therapists who eagerly run these trials believe (or ought to, if they're being consistent with their own theories).

One of the key ideas in cognitive accounts of psychosis is that the belief and fear that one is 'going crazy', or that you're otherwise abnormal, is itself a major source of stress that actually leads to worsening of symptoms.

What could be scarier than being told you're at "ultra high risk"?

Preventing psychosis is a great idea in theory. But most bad ideas are.

McGorry, P., Nelson, B., Phillips, L., Yuen, H., Francey, S., Thampi, A., Berger, G., Amminger, G., Simmons, M., Kelly, D., Thompson, A., and Yung, A. (2012). Randomized Controlled Trial of Interventions for Young People at Ultra-High Risk of Psychosis The Journal of Clinical Psychiatry DOI: 10.4088/JCP.12m07785

Search Trends Reveal The Most Suicidal States

US states with more Google searches for suicide-related things actually have a higher suicide rate, according to a study just out.

Researchers Gunn and Lester write that, across the 50 US states,

The association between suicide rates and the search volume for ‘‘commit suicide’’ was significant and positive[r=0.31, p=0.01]... ‘‘how to suicide’’ was marginally significant and positive [r=0.21, p=0.07]... Finally, ‘‘suicide prevention’’ was significant and positive [r=0.61, p=0.001].

This seems pretty convincing although it's hard to know whether this represents suicidal people making the searches, as opposed to people searching in response to local suicides that already happened.

The fact that "suicide prevention" was the closest correlated with suicides while "how to suicide" was weakest makes the latter seem more plausible to me.

Previous suicide-search research has given mixed findings:

Sueki (2011) looked at variations in the volume of Google searches about suicide and depression in Japan by month from 2004–2012 and found that the monthly search volume for‘‘suicide’’and‘‘suicide method’’was not significantly correlated with the monthly suicide rate. However, searches for‘‘depression’’ were positively associated with the monthly suicide rate especially with a time lag of 1–3 months.

Over the past couple of years there's been a flurry of studies based on analyzing Google and Twitter trends. What's interesting to me is that we're really in the early days of this, when you think about likely future technologies. What will happen when everyone's wearing a computer 24/7 that records their every word and move, and even what they see?

Eventually, psychology and sociology might evolve (or degenerate) into no more than the analysis of such data...

Gunn III, J., & Lester, D. (2012). Using google searches on the internet to monitor suicidal behavior Journal of Affective Disorders DOI: 10.1016/j.jad.2012.11.004

The Case Of The Missing Parasites

Collembola or "Springtails" are a common group of bugs - they're technically not insects although much like them - found all over the world.

There's no evidence that these critters are parasites for humans - except for one strange scientific report claiming to have found Collembola body parts in skin scrapings from people diagnosed with delusional parasitosis - a psychiatric disorder characterised by the belief that one is infested with parasites.

According to said 2004 paper by Altschuler et al, these patients are not delusional after all. This paper has been popular in the delusional parasitosis community.

However, insect expert Matan Shelomi says that Altschuler et al's best photo of the so-called Springtails was probably Photoshopped. He explains that in the only pic to clearly show anything resembling a 'bug' (there were many others, but none look convincing), the raw microscope image shows nothing but a blurry blob.

Altschuler et al claimed to have enhanced the contrast, but when Matan did that, there was still no visible critter. However, in the published image, a rather sinister bug is clearly seen. How did it get there?

Either the image contrast was somehow selectively enhanced just for the 'bug' part - which, of course, presumes that the bug was there, and is quite invalid - or more likely,

The level of detail present in Altschuler et al.’s enhanced image, particularly in the areas of the legs and a very odd pair of stripes along the abdomen, does not appear when contrast is applied equally. Such detail, however, can easily be created using functions such as Burn, Dodge, and Colorize on Photoshop®,when applied to select portions of the image manually as if via paintbrush.

However, Shelomi says, even if such fraud is proven, there may be nothing anyone can do: the journal the original paper was published in has since folded, so it would be impossible to retract it, and the author runs an independent non-profit and is hence not subject to scientific misconduct regulations.

Thanks very much to @benmeg for sending me a copy of this paper.

Shelomi M (2012). Evidence of Photo Manipulation in a Delusional Parasitosis Paper. The Journal of parasitology PMID: 23198757

The Onion Makes Mental Illness Ridiculous

Despite being entirely fictional, The Onion offer some of the most perceptive political analysis anywhere.

Less well known, but likewise brilliant, is its coverage of mental health. The Onion's approach is to satirize the beliefs and perceptions that characterize psychiatric illness. The result is hilarious, but also insightful and, in a weird way, empathetic:

Local Anorexic Still Way Too Fat

Despite years of intense dieting and vigorous exercise, local anorexic Lisa Kimmel is still way too fat, it was reported Monday... Though Kimmel could stand to lose a few pounds in nearly every area of her body, worst of all are her arms. "I've got this totally disgusting flab on the back of my arms that swings back and forth when I move," said Kimmel, wearing an oversized Champion sweatshirt to conceal her obesity. "My arms totally look like my grandmother's."

Making matters worse is the fact that Kimmel's mother wants her to be overweight, constantly trying to get her to eat fatty foods like ravioli, mashed potatoes and broiled chicken with the skin still on. Other family members, as well as Kimmel's friends and doctors, also entreat her to eat because they want her to be fat, repulsive and unliked.

Pharmaceutical Company Says Its New Anti-Depressant Is 'Worthless And Dumb'

At a press conference Monday, Peter Cafazzo, CEO of Brunley-Hunt Pharmaceuticals (BHP), introduced his company's latest anti-depressant, Cyntrex, a product he described as "a totally stupid waste of time that probably nobody will ever want ever." ...

According to reports, top BHP researchers began having doubts about the drug during the early development stages, when they realized they couldn't do anything right ever ever ever, and that none of the pharmaceutical-industry leaders cared whether they lived or died. But work on the project continued, despite BHP's growing conviction that Cyntrex would be the worst product in pharmaceutical history.

Is The Government Spying On Paranoid Schizophrenics Enough?

Panelists discuss ways to care for the nation's paranoid schizophrenics, such as hiding cameras in their homes or audio transmitters in their ears. e.g. "We need to hide cameras everywhere they go, in the street, in their homes, in the eyes of people at the stores where they shop."

Some people might see this as making fun of the mentally ill, but I don't: it's making fun of the illness.

Suffering from a psychiatric disorder is a tragedy, but the disorder itself, and the distorted cognitions associated with it are, well, ridiculous. It's ridiculous to see yourself as fat when you're dangerously underweight. It's laughable to think you're worthless when you're successful and respected.

Coming to realize the absurdity of such beliefs is an important part of recovery, and an explicit goal of cognitive behavioural therapy although therapists don't tend to emphasize the funny side, it is certainly there.