Mental Illness and Crime, Yet Again

As if on cue, a major study about the relationship (if any) between mental disorder and crime has appeared just when everyone's talking about that.

Although having said that, people seem to be interested in that issue most of the time nowadays, in the UK at any rate, with schizophrenia topping the list of supposedly scary syndromes.

So - should we be worried?

The new research, from Australian team Morgan et al, surveyed everyone born in the state of Western Australia between 1955 and 1969. About 1.6 million people lived there over the course of the study so this was a big project.

By linking local records of arrests over the period 1985 to 1996 to the database of psychiatric diagnosis, the researchers were able to examine disorder-crime correlations in the entire population - meaning that there was no possibility of bias.

So what happened? Here's some highlights:

• 32% of psychiatric patients had been arrested at least once. Unfortunately, it's not clear what the rate was in the general population, but that falls into the range of overall arrest rates in most countries.
• 11% of those arrested had a psychiatric diagnosis. This rose to 20% of arrests for violent offences.
• 0.8% of suspects had schizophrenia, rising to 1.7% for violent offences.
• The number of arrests in people without a disorder fell over the period 1985-1996, reflecting the well-known fact that people commit fewer crimes as they get older. However, in psychiatric patients, there was no change over time.
• For murder, 30% of suspects had a psychiatric history while 3% had a diagnosis of schizophrenia.
• Both substance abuse and personality disorders were associated with higher arrest rates than schizophrenia, but schizophrenia in turn was higher than depression, anxiety, and other miscellaneous disorders.
• Although only 1.7% of violent offenders had schizophrenia, those with the disorder were somewhat more likely to involve strangers, and to take place in public places, and less likely to target family and partners.

Overall this confirms that the great majority of crimes, including violent ones, are not committed by people with mental illness, and that your chance of getting 'murdered by a lunatic' is incredibly low. This strikes me as the only statistic that matters to most people.

There's a long-standing debate over whether people with various disorders are more likely to commit crimes than they would be if they didn't have one, the relative risk. While interesting, this is a purely academic question. What the rest of us need to know is the absolute risk, and this is low.

Morgan VA, Morgan F, Valuri G, Ferrante A, Castle D, and Jablensky A (2012). A whole-of-population study of the prevalence and patterns of criminal offending in people with schizophrenia and other mental illness. Psychological medicine, 1-12 PMID: 23234722

The Two Problems With Science

There's lots of concern at the moment over mistakes, misconduct and misbehaviour in science.

This concern is a good thing. There are serious, systemic problems with modern science as I and many others have long argued.

However, I worry that much of the recent discussion has failed to distinguish between two fundamentally distinct problems. On the one hand, we have outright fraud - i.e. making up data, or otherwise lying, breaking the basic rules of science.

On the other hand we have questionable practices such as: publication bias, p-value fishing, the File Drawer, sample size peeking, post-hoc storytelling, and all of the other dark arts that can lead to false positive science. These are permissible, even encouraged, by the current rules of doing and publishing science.

These two problems are similar in some ways - they're both "bad science", they both lead to failures to replicate, etc. - but in underlying essence they're very different, so much so that I'm not sure they can be usefully discussed in the same breath.

Fraud and questionable practices are different in terms of their harms. Fraud is a more serious act and it causes local harm, introducing major errors into the record. But in terms of its overall effects, I believe questionable practices are worse, as they systematically distort science: ensuring that, in some cases, it is difficult to publish anything but errors.

Fraud and questionable practices call for different solutions. Broadly speaking, fraudsters break the rules, so to stop them we need to enforce those rules, via deterrence, detection, and punishment - like with any criminal act. With questionable practices, it's the opposite: here the problem is the rules (or the lack of them), and the solution is to reform the system.

It's been suggested that fraud and questionable practices share a common cause in the "pressure to publish", the "publishing environment", the "culture" of modern science etc. But while this is a good explanation for questionable practices, I don't think this can explain fraud, any more than, say, the desire for money can explain theft.

Yes, thieves desire money, and yes they steal in order to get money, but everyone else wants money as well, yet most of us don't steal, so that's not an explanation. Frauds fake data to produce publications. But all scientists are under pressure to produce good publications and they always have been - which is why fraud is not new - what's changed recently is the criteria for a 'good' publication.

Now in retrospect, I blurred these distinctions somewhat with my own 9 Circles of Scientific Hell, in which I placed 6 questionable practices and 2 forms of misconduct on the same scale of "sinfulness". In fact there are two distinct hierarchies. In my defence though, that was a cartoon.

I think finance offers a great analogy here.

In finance, you have some people who break the rules. Bernie Madoff is the current poster boy for this. Such people harm others by outright criminal acts. But then we have the people who play by the rules, and still cause harm. The global financial crisis was in essence caused by all of the major American banks going all-in on a bet, and losing. Yet no-one broke the rules: the regulations allowed banks to gamble. The problem was not rule-breaking, but the rules (or lack thereof).

Here's the curious thing: the financial crisis did more harm than Madoff's scam, even though what Madoff did - theft by fraud - was more immoral than what the bankers did - gambling unwisely.

That's confusing to our ethical sense and our emotions (who should we feel more angry at? Who's 'worse'?) but it's really no surprise: precisely because what the banks did was above board, everyone did it so the damage was huge. If it had been illegal for banks to gamble all their money at once, individual banks might still have broken that rule, locally, but it's unlikely that the system would have been threatened.

Maybe you can see where I'm going with this: everyone following bad rules is often worse than individuals breaking good rules.

Science has its share of fraud. Hauser, Smeesters, Fujii - they broke good rules against such deceit. They are the Bernie Madoffs of science. But then there's 'questionable practices' like publication bias, p-value fishing, the File Drawer, and all the rest, which are allowed, but which are universally acknowledged to be bad for science. Scientists using these dark arts (and I don't know any who never do) may be the Lehman Brothers of science.

The Coming Age of Fetal Genomics

It's 2020. A young woman and her partner have just found out that she's pregnant with her first child. and they're going to be parents.

They're overjoyed, of course. But they're also worried. They've seen the adverts warning parents-to-be about the risk of de novo mutations - genetic mistakes that occur inside sperm or egg cells, and affect the child. These mutations, the ads say, are much more common than previously believed and they can cause all kinds of problems: intellectual disabilities, autism, infertility, mental illness, heart malformations - pretty much anything.

The scariest part? Because these are new mutations, out of the blue, they can affect any family. A clear family history is no protection. They don't discriminate by race or lifestyle. It's just the luck of the draw - except that older parents are at much higher risk, especially older fathers. In the case of our couple, she's 28 and he's 32. Perfectly normal for this day and age - but very old in biological terms. Humans evolved to be grandparents by 32, not parents. "The stakes couldn't be higher. Why leave it to chance?"

So they don't. Instead, they buy a $100 test kit, they each provide a small blood sample and send it off to one of the companies offering fetal genome testing. At the testing lab, they can separate out the mother's DNA from that of the fetus, both of which are present in the mother's blood. By comparing the fetal genome to the mother's and father's, it's easy to spot de novo mutations. If a certain gene doesn't match either the mother or the father's sequence, it's mutated.

A few days later the results are back. There are several mismatches detected. Most are benign - they're not predicted to have any biological effects. But there's one, a deletion of a few thousand bases in a gene involved in brain development. This deletion is predicted to raise the risk of epilepsy and autism from 1% to 10% apiece.

The parents now have a decision to make. The mutation is a one off, it's not inherited. If they conceive again... roll the dice again... and it'll be gone. Do they terminate?

Like the adverts say, "Some people disagree with this, but we say there's only one person who really matters: your baby."

*

This is likely to become possible in the next few years.

A paper just published in Nature reports on the Non-invasive prenatal measurement of the fetal genome. The technique relies on the fact that the blood of a pregnant woman contains DNA: hers, obviously, but also that of the unborn child. This cell-free DNA can be extracted and genotyped.

This has been possible for a few years, but until now, only fairly crude genetic information could be detected. An extra chromosome, such as in Down syndrome, is pretty easy to spot. This technique is already used to diagnose Down's syndrome and a few other disorders prenatally.

But those diseases are just the low-hanging fruit at the tip of the iceberg, if you see what I mean. To gather the kind of detailed genomic information that could diagnose thousands of disorders is harder: the fetal and maternal genomes are mixed up, and the challenge is to tease them apart. But according to the Stanford geneticists behind the Nature paper, and other teams, it's now possible as early as the first trimester.

What makes the new method so revolutionary is that it is, as the title of the paper says, non-invasive. It's already possible to sequence a fetal genome, but it takes a surgical procedure involving inserting a needle into the womb, and a degree of risk. It's not something you can just sit down and do - but blood samples are. So cell-free DNA will make fetal genomics a personal choice, a commercial product.

The resolution's still not 100%, but inevitably, it will become cheaper, faster and more accurate as technology advances. This year we're expected to see the cost of reading a whole human genome falling below $1000. Fetal genomes will be more expensive, but not enormously so. In 5 or 10 years, it's likely to be affordable.

*

What will happen? I think there'll be demand for such services. Most parents won't do it, but enough people will that it will be a major issue. Just look at countries where boys are more valued than girls: a lot of sex-selective abortion happens. Today, it's limited to gender, because it's easier to determine a fetus's sex than its genome. In 5 or 10 years, they'll both be easy.

With demand will come companies to supply these services and, inevitably, advertizing. I doubt these adverts will be on TV, because there will be opposition to the whole idea and boycotts of broadcasters who run them. But we'll be getting spam emails about it. People will worry even over the harmless mutations: a variant won't need to be really associated with a disease, just believed to be, to make people panic.

Socially, it's likely to be divisive. The anti-abortion types will obviously not approve. But it will drive a wedge between those who support abortion but oppose "discriminatory" abortion against the disabled, and those who support the right to terminations 'for any reason, or none'.

Politically, there will be pressure to regulate this, but legally, it'll be tricky. I can't see how you'd prove that any given abortion is motivated by genetic concerns, so unless you ban abortion outright, that won't work. Banning fetal (or all) genomics except under medical supervision might be possible, but people could always go (or send a few drops of blood) abroad to get around that.

I'm not sure where I'll stand on this, but it looks very likely that we'll each have to make a decision in the coming years.

Fan HC, Gu W, Wang J, Blumenfeld YJ, El-Sayed YY, and Quake SR (2012). Non-invasive prenatal measurement of the fetal genome. Nature PMID: 22763444

This Is Your Brain On Ethics - Really

A new study published in Social Cognitive and Affective Neuroscience offers a look at the neural correlates of ethical decision making: Differential Neural Circuitry and Self-Interest in Real versus Hypothetical Moral Decisions

There have been quite a few studies using neuroimaging to measure activations associated with tackling hypothetical moral dilemmas but what makes the new paper interesting is that the participants were faced with a real moral choice. Well, mostly real.

The task was called "Your Pain, My Gain". The participants were put in the MRI scanner and given £20 at the start of the experiment. Then they could spend some of the money to help save another person from getting electric shocks. The more they spent, the less severe the pain administered to the victim. Video footage of the victim receiving the shocks was then played to the decider, and the process repeated.

Selfish people could choose to keep more of the cash, if they could handle the guilt of knowing that they were shocking their poor victim. At the end of the study, the remaining sum was multiplied by a random factor of between 1 and 10, meaning that there was, potentially, £200 at stake - a serious amount of money.

Actually, the task was a sham - as these experiments usually are. All of the 'shock' videos were pre-recorded, there was no victim, so the decision to keep the money had no effect. But the experimenters tried to make it as believable as possible (out of 18 volunteers, 4 were skeptical, and they were excluded).

There was also a comparison task, which was the same idea, but the participants were told it was purely hypothetical, and would have no real consequences.

The fMRI data showed (although note, some of these did not use multiple comparisons correction) that both the 'real' and hypothetical tasks activated a 'shared moral network':

Although both the hypothetical and the real tasks also led to different patterns of individual activation as well - the authors write:

hypothetical moral decisions mapped closely onto the imagination network, while real moral decisions elicited activity in the bilateral amygdala and anterior cingulate—areas essential for social and affective processes.

Hmm. To be honest the results are a bit messy but the method is extremely interesting. I've written before about the need to keep it real when it comes to stimuli in fMRI experiments so this is important: hypothetical moral dilemmas are no substitute for the real thing. Personally I'm holding out for someone to replicate the Milgram experiment in the MRI scanner although I'm not sure anyone would get ethical approval for that nowadays...

Feldmanhall O, Dalgleish T, Thompson R, Evans D, Schweizer S, and Mobbs D (2012). Differential Neural Circuitry and Self-Interest in Real versus Hypothetical Moral Decisions. Social cognitive and affective neuroscience PMID: 22711879

Rich People May Not Be So Unethical

There was quite the stir a few weeks back about a psychology paper claiming that rich people aren't very nice: Higher social class predicts increased unethical behavior.

The article, in PNAS, reported that upper class individuals were more likely to lie, cheat, and break traffic laws.

However, these results have been branded "unbelievable" in a Letter to PNAS just published. Psychologist Gregory Francis notes that the paper contains the results of 7 seperate experiments, and they all found statistically significiant socioeconomic effects on unethical behaviour.

Those 7 replications of the effect "might appear to provide strong evidence for the claim" - one study good, 7 studies better, right? - but Francis says that actually, it's too good to be believed.

Each of the studies was fairly small, and the effects they found were modest, and only just significant. So the observed power of the studies - the probability that a study of that size would detect the effect that they did, in fact, find - was only about 50-88% in each case.

Think of it this way: if you took a pack of cards and discarded half of the black ones, then shuffled the remainder, a random card from the deck would most likely be red. But even so, it would be unlikely that you'd pick seven reds in a row.

The chances of all 7 studies finding a positive result - even assuming that the effect claimed in the paper was real - is just 2%, by Francis's calculations.

Ow.

He concludes "The low probability of the experimental findings suggests that the data are contaminated with publication bias. Piff et al. may have (perhaps unwittingly) run, but not reported, additional experiments that failed to reject the null hypothesis (the file drawer problem), or they may have run the experiments in a way that improperly increased the rejection rate of the null hypothesis (4)".

What might have happened? Maybe there were more than 7 studies and only the positive ones were published. Maybe the authors peeked at the early data before settling on the sample size, or took other outcome measures that showed no effect and went unreported. See also the 9 Circles of Scientific Hell.

Or maybe not. Piff et al respond in their own Letter, firmly denying that they ran any other unpublished experiments, and saying that they "scrutinized our data collection procedures, coding protocols, experimental methods, and debriefing responses. In no case have we found anything untoward." They go on to criticize the method Francis used to get his magic 2% figure, which they point out relies on some debatable assumptions.

Even if you buy the 2% figure, it doesn't mean that the true effect is zero; it might be real, but exaggerated. Ultimately it all becomes rather murky and subjective, which is why I think we need preregistration of research, which would prevent any possibility of such data fiddling, and also remove the possibility of false accusations of it... but that's another story.

Francis, G. (2012). Evidence that publication bias contaminated studies relating social class and unethical behavior Proceedings of the National Academy of Sciences DOI: 10.1073/pnas.1203591109

Plagiarism In Translation - A Dilemma

Last week I caught a plagiarist.

In a research paper published recently in a minor journal, I realized that the authors had directly copied several sentences from the Introduction to an earlier paper that I'd been reading recently. Even the references from the original were cloned. Given the context, it's extremely unlikely that they had permission.

This is an open and shut case of plagiarism. There's no dispute that plagiarism is bad. So I was about to write to the editor of the journal and the original authors when I looked up who the culprits were Polish.

This has happened before. A while back I detected plagiarism on a similar scale, again a very clear cut case, from some Brazilian authors.

I haven't reported either case. That's what this post is about.

Why not? It's nothing to do with the idea that in "other cultures", copying is regarded differently, so we need to make allowances for foreigners. That doesn't convince me. No, my concern is that as a native English speaker I have an unfair advantage over scientists from other parts of the world.

500 years ago Latin was the international language of science; a hundred years ago it was German, in many fields. Today, most scientific journals and all of the high-impact ones require papers to be written in English. That's the way it is, and there's no changing it, but I don't think it's fair.

Worse, many journals don't just demand English, they expect perfect English. Many editors and peer reviewers will throw out papers with clumsy phrasing or grammatical errors, regardless of where the authors are from, because "It's not my job to teach you English". In my own reviews I don't do this - if a paper is scientifically sound but the English is poor then I'll rewrite it. But I think I'm in a minority.

So you can see why non-Anglophones are tempted to copy and paste. Who knows exactly how common it is, but given that I've found two examples without specifically looking for it, it must be widespread.

Suppose you need a  "boilerplate" summary of some well-worn but complicated issue for your Introduction. And you do, nowadays, although they add little to most papers. You could write it yourself and the English might be bad, or you could copy it from a similar paper in a good journal and be sure...

Is that plagiarism? Yes. Is it illegal? Quite possibly, depending on the jurisdiction. But is it morally wrong? I don't think so.

You might say that it's stealing, and hence wrong. But is it so different to copying someone's paragraph, changing a few words and swapping some around, until it's "different" enough to pass a plagiarism check? All you've added in that case is your own linguistic coat of paint; you've still stolen the car. Yet even English speakers do that and get away with that all the time. Indeed, the banal, boilerplate "original" plagiarized text in my two examples could have started out that way.

I'd stress than I would have been writing to the journal in a flash if I thought there was any question of plagiarism of data, or of novel ideas, but there isn't.

I'm absolutely not encouraging this solution to the language problem. It really is a bad idea, because you'll probably get caught. The best scenario for you would be that the journal's plagiarism checker spots it and your paper won't get published. If you're unlucky, it will get through, and then one day down the line you'll end up on Retraction Watch. Don't do it, however tempting it may be.

But I can't feel any indignation at those who do it. It's hardly classy, but it's not malicious, selfish or damaging to science, and as such I struggle to accept that it's wrong. Which is why I have not reported my two cases.

I expect some people will disagree, so please feel free to comment. I may change my mind.

When Prophecy Failed

I've just been reading the classic psychology book When Prophecy Fails.

Published in 1956, it tells the inside story of a group that believed the world was about to end - and what they did when it didn't. Here's a good summary over at Providentia.

The investigators, led by social psychologist Leon Festinger, infiltrated a small group (too amateurish to be called a 'cult' - see below) surrounding a Chicago woman called Dorothy Martin, or "Marian Keetch" as they dubbed her to protect her identity.

Martin, a classic 50s housewife, had a long-standing interest in the occult and dianetics. One day, she woke up with a strange sensation in her arm, and soon decided that she was receiving messages from spiritually advanced extraterrestrials by 'automatic writing'.

After several months of rather generic religious guidance, the aliens informed her that a flood would destroy Chicago, and much of the US, on the 21st December 1954. This was part of a cosmic plan to "cleanse" the earth. She, and a number of other believers, would be evacuated by UFOs shortly before the calamity.

Festinger and co learned of the group through a newspaper ad warning of impending doom; spying a  chance to field-test his ideas, Festinger assembled a crack team of sociology and psychology students to go undercover. Considering that the group only had perhaps 10 real core members, plus another 20 or so less committed sympathizers, the fact that no fewer than 4 investigators became involved is rather remarkable.

When the 21st dawned and Chicago remained, the core members of the group were upset, but rationalized the failure - the spacemen had called it off, because of the positivity shown by the group. In the days following the non-event, the previously secretive group became eager to spread the word. The media picked up the story a few days before the 21st, but the group refused interviews and actively avoided trying to convert people. Afterwards, that all changed. But the group broke up shortly afterwards.

Festinger et al's slant on this was that it supported their cognitive dissonance theory; essentially, having to face up to the fact that they'd been wrong would have been painful, so instead they chose to believe that they'd been fundamentally right all along, and sought confirmation for this by trying to get more members. They make much of the fact that those individuals who'd made more concrete commitments to the group (e.g. by selling their possessions or losing their jobs) were subsequently more faithful.

I wasn't convinced by this, though. Apart from the fact that it's just an isolated case, the group did, after all, break up, just a few weeks after the prophecy failed. While Martin herself seemed genuinely unfazed (and went on to lead a long life in much the same paranormal vein), there's little evidence that the rest remained believers for more than a few days, even the most committed.

When Prophecy Fails is an amazing human interest story, though. The group is just adorably naive and homely. It's all charmingly 1950s and about as far from the deadly fanaticism of the 1990s Heaven's Gate group as you can imagine.

It's full of details like the spirit of Jesus solemnly telling the group to take a break for coffee; the declaration that some new mountains formed following the rearrangement of North America would be called the "Argone range" (in honour of the fact that the Rockies etc. "are gone"); and the high school pranksters who phoned the group and announced that they have "a flood in their bathroom, do you want to come over and see it?" - they did.

Indeed, I couldn't help feeling that the least savory thing about this group was the investigators themselves.  Festinger et al notably don't discuss the ethics of their study at all, unlike Stanley Milgram in his classic work from the same era.

Was it ethical? At least some of the investigators actively lied to gain entrance to the group, by making up stories of their own 'paranormal' experiences. Other than that, the observers seemed scrupulously careful not to encourage the group in their beliefs - but the very fact that they were there, going along with it, was surely in itself a kind of tacit encouragement. Martin herself sounds like her head was far enough in the clouds that she was impervious to any such social influences but I'm not sure about the other members.

There's also the issue of whether it was unethical to publish the inner secrets of the group just two years after the event; they did disguise the names, but remember, this was all national news when it happened. It would have been easy to work out people's real identities with a bit of digging.

Overall, I found the book's story fascinating; but I'm not sure I agree with the book.

Free Will: A Dangerous Idea?

The British Journal of Social Psychology has published a fiery rebuke to psychologists who argue that belief in free will makes people more ethical.

Recent much-publicized studies have claimed that scepticism about free will makes people behave less morally. "Disbelief in Free Will Increases Aggression and Reduces Helpfulness" as the title of one of hese papers puts it.

In his article (free pdf), British 'independent researcher' James B. Miles says that these experiments are flawed, because they didn't distinguish between determinism (lack of free choice) and fatalism (lack of the ability to change events).

More fundamentally, though, Miles says that free will is used to justify things, such as punishment and poverty, that would otherwise be seen as scandalous -

Western law recognizes that the penal system is so harmful to the existing life and future opportunities of persons that to convict requires evidence beyond a reasonable doubt. Yet libertarians provide no objective evidence whatsoever for the existence of free will, and therefore no apparent justification for the mass poverty and brutal punishments that belief in libertarian free will often brings with it. The leading legal theorist Stephen J. Morse freely admits that harsh prison conditions and execution are only morally tolerable where the presumption of free choice exists...

...In June 2009, the Joseph Rowntree Foundation published research showing that up to 83% of Britons think that ‘virtually everyone’ remains in poverty in Britain not as the result of social
misfortune or biological handicap but through choice (Bamfield & Horton, 2009, p. 23; 69% of those surveyed agreed with the statement and an additional 14% were unsure but did not disagree.) Because of their belief in the fairness of ‘deserved inequalities’, such respondents were discovered to have become almost completely unconcerned with the idea of promoting greater equality while at the same time asserting that Britain was a beacon of fairness that offered opportunities for all...

...Free will may just be the primary excuse many use to legitimize a contempt for the poor that would exist independent of their professed belief in free will, but free will assertion nonetheless provides the ethical fig leaf for such contempt that would be far harder to rationalize (and therefore tolerate) without the myth of free will.

This is a polemical piece (remarkably so, for an academic journal), and clearly this is only one side of the story, but it's hard to deny that he has a point: there's a dark side to the belief in free will. If you doubt free will, and yet praise the myth of it, as some scientists seem to be doing, you need to accept that you're condemning some people (prisoners, most obviously) to suffer as a result "through no fault of their own".

Personally, I think the great majority of people do believe in free will and always will - the arguments against it have been around for millenia, they're as convincing as they'll ever be, and they haven't convinced most people, however irrational that might make most people. So I think the debate over belief in free will is academic; it's not going away.

 Miles JB (2011). 'Irresponsible and a Disservice': The integrity of social psychology turns on the free will dilemma. The British journal of social psychology / the British Psychological Society PMID: 22074173

Do Brain Scans Sway Juries?

Does seeing a criminal's brain affect jury decisions?

Edith Greene and Brian Cahill ask this question in a new study which put volunteers in the position of jurors in a murder trial. The 'defendant' was guilty, but the question was: should they get life in prison, or death?

It turned out that seeing brain scans didn't have much of an effect - but it's not clear how far the results would generalize.

208 mock-jurors were randomly assigned to get different kinds of mitigation information about the accused. Sometimes, all they were told was that he had been diagnosed with schizophrenia, depression and a substance misuse disorder. Others were also given neuropsychological test scores showing that he did poorly on various tests of reasoning and cognition. Finally, some were shown brain scans on top of all that, scans which were described as showing left frontal lobe damage.

All these materials were based on a real 2007 court case.

What happened? When the defendent was said to have been assessed as probably "dangerous" in future, people who were only told his diagnosis of schizophrenia usually sent him to the chair. But when they were given his psychological test scores - showing that he suffered from cognitive impairments - they were far more lenient. Seeing the neuroimages had no effect on top of that.

If the guy was described as posing a low risk of future violence, the verdicts were lenient, no matter what else they were told about him. In the real case, by the way, he got life.

This suggests that brain scans don't exert a seductive allure on jury decisions, at least not over-and-above psych test scores. But I'm not sure how representative the results are. The 'jurors' were all psychology undergrads. Most were Hispanic (63%) females (67%). Are psychology students especially resistant to the allure of brain scans - and/or especially vulnerable to the allure of psychological test scores? No-one knows, but it's surely plausible.

On some level, neuroimaging evidence clearly can influence people's decisions, like any other evidence; lawyers wouldn't bother presenting it otherwise. The question is how much of an impact it has, but that is surely going to depend on the details of the case as well as the juror's background; I'm not sure how much a study like this one, focussing on one example, will be able to tell us.


Greene E, and Cahill BS (2011). Effects of Neuroimaging Evidence on Mock Juror Decision Making. Behavioral Sciences and the Law PMID: 22213023

Do You Have Free Will?

I mean you, specifically.

I'm not asking whether people have free will. I think they do - except you. You're the one person on earth who doesn't have it.

If you disagree - how would you convince me that you do have it?

Alternatively, if you're one of the people who doesn't believe in free will - I agree with you, people don't have it... except me. I'm special.

-

This might seem like one of those thought experiments that only philosophers could care about, but it's of more everyday importance than the general question of 'whether we have free will'. That's an interesting debate, but really it doesn't change anything. If we have it, we always have, and if we don't, we never will. Either way, here we are, and we'd better get on with our lives.

On the other hand, the question of whether an individual has free will has real consequences. It can even be a matter of life or death. It comes up in court cases. Lawyers and psychiatrists don't use the words "free will", they'll talk about responsibility or capacity or sound minds, but what they mean, in essence, is what the rest of us mean by the term free will.

In some of these cases, free will is what you want - if, say, psychiatrists want to confine you to a hospital, and you say you don't want to be there. Other times it's the reverse - if you've committed a crime, and your defense is that some kind of mental or neurological illness made you do it, then you're arguing that you don't have it (or didn't, at the crucial moment.)

But while lots of people have opinions on the abstract "Free Will" question, I don't think many people pay attention to the issue of their own free will or lack of it - until they end up in court. We just assume that if everyone else has it, so do we, and vice versa.

Yet how can we be so sure? Everyone accepts that people differ in regards to how much free will they have. Wwhen people say "I believe people have free will", they don't really mean all people - they surely make an exception for babies, people in a coma, people having a seizure, and probably children, people with dementia, people with severe mental illness... Likewise, people who don't believe in free will recognize that there's a difference between a normal adult and one of those people.

But where do we draw the line, and how do you know which side you're on? This seems to me the most important questions to be asking about free will.

Potential Personal Genomics

A while ago I wrote about how new findings in genetics could herald a new kind of "eugenics", based not around selective breeding to ensure that "bad" genes aren't passed on, but rather based on using fetal genetic testing to choose which variants enter the gene pool in the first place.

I said-

In the near future, we might be able to routinely sequence the genome of any unborn child shortly after conception

But I didn't realize that this may be really very near indeed. Two recent reports have shown that it's possible to sequence fetal DNA from a maternal blood sample. In one case it was used to diagnose a 35 week fetus with a genetic deletion on chromosome 12 seemingly associated with autism, developmental delay and shortness.

In this case it was inherited from the father (which is why they decided to test for it), but this approach could equally be used to screen for the de novo mutations that account for much disease, as I discussed in the last post.

This is big. Currently, the main way to get fetal DNA is through amniocentesis, i.e. inserting a needle into the womb. It's a substantial and not entirely safe medical procedure. A blood sample would be an order of magnitude cheaper and safer, but most of all it would be something you could do at home.

No longer would you need to go to a hospital and discuss everything with a doctor. You could take some blood, send it off anonymously to a sequencing company, and get the results in an email. It would take it out of the hands of professionals and open up a space for individual choice.

The cost of whole-genome sequencing has been falling exponentially and many think it will fall below the $1000 mark within a few years. Combine that with fetal DNA testing and we might see moderately well-off parents able to sequence fetal DNA within the next decade.


When this happens I think the personal genomics industry will suddenly become extremely "hot". At the moment you can sequence your own DNA for a few thousand $ if you want. The results may be interesting but they're of little obvious use. Whatever your genes are, you're stuck with them.

But as soon as we're talking about potential human genomes, it'll kick things up a notch. Media interest and political controversy is sure to follow. Personally I think it'll the debate will begin in earnest when we start seeing selective abortions on the basis of genes for "normal" variants rather than "disease" genes.

It's one thing to not want a child with blindness, or a high risk of leukaemia. But as a society I don't think we're ready for not wanting a child because they're predicted to be a B student rather than an A student, or brunette rather than blonde. At some point soon, though, we'll have to decide what we think about that.

Peters D, Chu T, Yatsenko SA, Hendrix N, Hogge WA, Surti U, Bunce K, Dunkel M, Shaw P & Rajkovic A (2011). Noninvasive prenatal diagnosis of a fetal microdeletion syndrome. The New England journal of medicine, 365 (19), 1847-8 PMID: 22070496

Srebniak M, Boter M, Oudesluijs G, Joosten M, Govaerts L, Van Opstal D, & Galjaard RJ (2011). Application of SNP array for rapid prenatal diagnosis: implementation, genetic counselling and diagnostic flow. European journal of human genetics : EJHG, 19 (12), 1230-7 PMID: 21694736

To Catch A Predator... With A Brain Scanner?

With the help of an MRI scanner and some child pornography, a new study claims to be able to tell whether someone is a paedophile: Assessment of Pedophilia Using Hemodynamic Brain Response to Sexual Stimuli.

It was an fMRI study of 24 self-identified paedophiles (recruited through a clinic offering anonymous treatment) and 32 male controls. Everyone was shown a series of images of naked men, women, boys and girls. The neural response to child vs. adult images was the main outcome measure.

Respect to the authors for getting that past the ethics committee.

The blob-o-grams above show that the paedophile's brains reacted differently to the control brains, when shown images of naked children, which is not surprising because the brain is what makes you a paedophile (and everything else.)

However, what's more interesting is that by comparing each individual's brain activity to the average activity of the paedophile group and the control group, it was possible to diagnose people as paedophiles or not with high accuracy (90+%).

Plotting the "typical paedophile"-ness of the neural response to girls vs women and boys vs men, the paedophiles (triangles) form a clear cluster. There were also some differences between homosexual and heterosexuals in both groups.

The statistics seem kosher: they used leave-one-out cross-validation to avoid the error of double dipping.

What's not clear is whether this was measuring sexual attraction as such. All it's measuring is how much each person's activity correlated with the paedophile group average. Maybe it's picking up on the shame paedophiles feel over being reminded of what they've done. Maybe the controls were just averting their eyes when the child porn came on.

However, you could say that if you're just interested in the practical business of catching paedophiles, that's academic. More concerning is the question of whether it would be possible to fool the technique. A recent study showed that it's easy to fool a brain scan designed to detect lying.

But let's suppose it does work out. Would that be a good thing? What is "a paedophile", anyway? Is it someone's who's attracted to children, or someone who acts on that attraction?

For example, there are people who are caught with child porn, and who admit they downloaded it, but who deny being attracted to children. The Who shredder Pete Townsend and comedian Chris Langham being two British examples. Both admit downloading illegal images, but say it was for 'research purposes'.

Now it might be possible, using fMRI, to find out if they're telling the truth. Let's suppose it was doable.

So what? Downloading child pornography is a crime - whatever your motivation. Being attracted to children is legal, in itself. So from a legal perspective it should make no difference at all in cases like this.

Of course, we don't in fact go around seeing things from a purely legal perspective. We care whether someone is attracted to children or not. But should we care? Is that fair? You don't choose your sexual orientation. What you choose is whether to break the law by commiting the crime.

There are surely people out there - no-one knows how many - who are attracted the children, and never act on it. Do we want to be able to "catch" them?

Edit: The original version of this post linked to the wrong paper, an older paper by the same authors. This has been fixed now.

Ponseti, J., Granert, O., Jansen, O., Wolff, S., Beier, K., Neutze, J., Deuschl, G., Mehdorn, H., Siebner, H., & Bosinski, H. (2011). Assessment of Pedophilia Using Hemodynamic Brain Response to Sexual Stimuli Archives of General Psychiatry DOI: 10.1001/archgenpsychiatry.2011.130

New Mutations - New Eugenics?

True or false: you inherit your genes from your parents.


Mostly true, but not quite. In theory, you do indeed get half of your DNA from your mother and half from your father; but in practice, there's sometimes a third parent as well, random chance. Genes don't always get transmitted as they should: mutations occur.

As a result, it's not true that "genetic" always implies "inherited". A disease, for example, could be entirely genetic, and almost never inherited. Down's syndrome is the textbook example, but it's something of a special case and until recently, it was widely assumed that most disease risk genes were inherited.

Yet recent evidence suggests that many cases of neurological and psychiatric disorders are caused by uninherited, de novo mutation events. Here are two papers from the last few weeks about schizophrenia(1,2) - but the story looks similar for autism, intellectual disabilities, some forms of epilepsy, ADHD, and others. Indeed they're often the same mutations.

Biologically, a given mutation is what it is, whether it's de novo or inherited. But on a social and a psychological level, I think there are crucial differences, and in particular I think that if it turns out that de novo mutations are important in disease, we're going to see attempts to take these variants out of circulation - far more so than in the case of the very same genes, were they inherited.

The old eugenics movement was based on the idea that if we stop people with bad genes from breeding - by sterilization, voluntary or otherwise, say - we'll be able to eliminate diseases and other undesirable traits. This idea is now generally regarded as extremely unethical, but many of its opponents have shared with the eugenicists the belief that it could work.

But if de novo mutations are what cause the majority of disease, then this approach would be pointless. Sterilizing certain people, or encouraging the healthy ones to have more children, would never be able to eliminate the 'bad genes' because new ones are being created every generation, pretty much at random.

So the de novo paradigm ought to be welcomed by opponents of eugenics. It wasn't just morally wrong - it was biologically misguided too.

But hang on. This is the 21st century. We have in vitro fertilization (IVF), and you can analyze the genes of an IVF embryo before you decide to make it into a child. In the near future, we might be able to routinely sequence the genome of any unborn child shortly after conception.

From there, it would be a small step to allowing parents to decide not to have children with de novo mutations.

This would be, in its effects, a form of eugenics - in the sense that it would produce the effect that the old eugenicists wanted. No more 'bad' variants, or not nearly as many. Opinions will differ as to whether it's morally different. But I would have said that politically, it's a lot more likely to happen.

I can't see forced sterilization returning any time soon. But if you were expecting a baby and you knew that it was not just carrying your and your partner's DNA, but had also suffered a mutation - might you not want to avoid that?

Psychologically, it matters that it did not inherit the variants. It would be a big step to decide that your child should not inherit part of your own DNA. Of course, some variants are obviously harmful, like one that raises the risk of cancer, and I can't see how anyone would want to pass those on. But think about the grey areas - a variant for social anxiety, mild autistic symptoms, obesity, a personality trait.

You might well feel that carrying that variant is what makes you, you; and so it would be natural for your child to have it. You might decide that if it was good enough for you (and all your ancestors), it's good enough for your children. You might well resent the very idea that it's a 'bad gene' at all, as an attack on your own self-worth.

But none of that applies if it's a de novo mutation. Indeed, quite the opposite - all those same considerations would probably lead you to want your children to carry as close as possible to a carbon copy of your DNA, with no random changes. It was good enough for you.

My point is that I think there will be much more support for the idea of genetic screening or other action against de novo variants than against inherited ones. More people will want it, it will be more socially acceptable, and used more widely. I'm not saying this would be a good or a bad thing, just making a prediction. In the future, diseases and traits that are primarily caused by de novo mutations will increasingly selected against.

The Ethics of Forgetfulness Drugs

Drugs that could modify or erase memories could soon be possible. We shouldn't rush to judge them unethical, says a Nature opinion piece by Adam Kolber, of the Neuroethics & Law Blog.

The idea of a pill that could make you forget something, or that could modify the emotional charge of a past experience, does seem rather disturbing.

Yet experiments on animals have gone a long to revealing the molecular mechanisms behind the formation and maintanence of memory traces. Much of the early work focussed on dangerously toxic drugs but recently more targeted approaches have appeared.

Kolber argues that we should not shy away from research in this area or brand the whole idea unethical. Rather we should consider the costs and benefits on a case-by-case basis.

The fears about pharmaceutical memory manipulation are overblown. Thoughtful regulation may some day be appropriate but excessive hand-wringing now over the ethics of tampering with memory could stall research into preventing post-traumatic stress in millions of people. Delay could also hinder people who are already debilitated by harrowing memories from being offered the best hope yet of reclaiming their lives.

He says that

Given the close connection between memory and a sense of self, some bioethicists...worry that giving people too much power to alter their life stories could ultimately weaken their sense of identity and make their lives less genuine.

These arguments are not persuasive. Some memories, such as those of rescue workers who clean up scenes of mass destruction, may have no redeeming value. Drugs may speed up the healing process more effectively than counselling, arguably making patients more true to themselves than they would be if a traumatic experience were to dominate their lives.

This is a complex issue. I can see his point, although I'm not sure the rescue worker example is the best one. A rescue worker, at least a professional one, has chosen to do that kind of work. The experiences that are part of that job are ones they decided to have - or at least that they knew were a realistic possibility - and that may be an expression of their identity.

The argument is perhaps more convincing in the case of someone who, quite unexpectedly, suffers an out-of-the-blue trauma. In this case, the trauma has nothing to do with their lives; if it interferes with their ability to function, it might "stop them from being themselves".

Kolber ends by quoting a fascinating story from Time magazine in 2007, which I didn't catch at the time:

Take a scenario recounted by a US doctor in 2007 (ref. 9). The doctor had biopsied a suspected cancer patient and sent a tissue sample to a pathologist while the woman was still in the operating room. Thinking she was completely sedated, the pathologist announced a bleak prognosis over the intercom.

The patient, who had received only local anaesthesia, heard the news and began to shriek, “Oh my God. My kids!” An anaesthesiologist standing by quickly injected her with propofol, a sedative that causes some people to forget what happened a few minutes before they were injected.

When the woman woke up, she had no memory of hearing her prognosis.

Kolber A (2011). Neuroethics: Give memory-altering drugs a chance. Nature, 476 (7360), 275-6 PMID: 21850084

A Ghostwriter Speaks

PLoS ONE offers the confessions of a former medical ghostwriter: Being the Ghost in the Machine.


The article (which is open access and short, so well worth a read) explains how Linda Logdberg became a medical writer; what excited her about the job; what she actually did; and what made her eventually give it up.

Ghostwriting of course has a bad press at the moment and it's recently been banned by some leading research centres. Ghostwriting certainly is concerning, because of what it implies about the process leading up the publication.

However, it doesn't create bad science. A bad paper is bad because of what it says, not because of who (ghost)wrote it. Real scientists can write bad papers without a ghostwriter's help.

When pharmaceutical companies pay a ghostwriter, they are not doing this to get access to special dark arts that real scientists are innocent of. As far as I can see, it's just more efficient to use a specialist writer to do your scientific sins, when you're doing it all the time.

Rather like every evil sorcerer has an apprentice to do the day-to-day work of sacrificing animals and mixing potions.

Logdberg says:

My career came to an end over a job involving revising a manuscript supporting the use of a drug for attention deficit-hyperactivity disorder (ADHD), with a duration of action that fell between that of shorter- and longer-acting formulations.

However, I have two children with ADHD, and I failed to see the benefit of a drug that would wear off right at suppertime, rather than a few hours before or a few hours after. Suppertime is a time in ADHD households when tempers and homework arguments are often at their worst.

...Attempts to discuss my misgivings with the [medical] contact met with the curt admonition to ‘‘just write it.’’ But perhaps because this particular disorder was so close to home, I was unwilling to turn this ugly duckling of a ‘‘me-too’’ drug into a marketable swan.

Many scientists will recall being in that kind of situation, albeit in a different context.

When writing a grant application, for example, you are almost literally trying to sell your proposed research to the awarding committee, on several levels. You need to sell the importance of the scientific question; the likely practical benefits of the research; the chance of success using your methods; what makes you the right person to do this work, and so on.

Writing a paper is much the same, although in this case you're selling research you've already done, and the data you collected.

Turning ugly ducklings into fundable, or publishable, swans, is part and parcel of modern science. Of course, the ducklings are not always as ugly as in the case Logdberg describes, but they are rarely as beautiful as they eventually end up.

Logdberg, L. (2011). Being the Ghost in the Machine: A Medical Ghostwriter's Personal View PLoS Medicine, 8 (8) DOI: 10.1371/journal.pmed.1001071

Do We Need Placebos?

A news feature in Nature asks whether placebo controls are always a good idea: Why Fake It?

The piece looks at experimental neurosurgical treatments for Parkinson's, such as "Spheramine". This consists of cultured human cells, which are implanted directly into the brain of the sufferer. The idea is that the cells will grow and help produce dopamine, which is deficient in Parkinson's.

Peggy Willocks, a 44 year old teacher, took part in a trial of the surgery in 2000. She says it helped stave off the symptoms for years, but the development of Spheramine was axed in 2008 after a controlled trial found it didn't work any better than a placebo.

The placebo was "sham surgery" i.e. putting the patient through a full surgical procedure, and making holes in their skull, but without doing anything to their brain.

It's cheap and easy to do a placebo controlled trial of a drug - all you need is a sugar pill. But with neurosurgery, it's clearly a lot more involved. A placebo has to be believable. Convincing sham surgery is expensive, time-consuming, and it has real risks, albeit small ones.

Is it ethical to put patients through that?

That, I think, can only be decided on a trial-by-trial basis. It depends on the likely benefits of the treatment, and whether the trial is scientifically sound. Obviously, it'd be wrong to do sham surgery as part of a flawed trial that won't tell us anything useful.

The Nature article, however, goes further than this, and suggests that placebo controlled trials may be unsuitable for testing these kinds of treatments, failing to detect a real benefit in some patients:

There are hints from some of the failed phase II trials that patients followed up beyond study endpoints might tell a more positive story. Some say, therefore, that sham controls are sinking the prospects of valuable drugs.

Anders Björklund, a neuroscientist at Lund University in Sweden who is collaborating with [Roger Barker of Cambridge], says that sham surgery can lead researchers to throw out a strategy prematurely if the trial fails because of technical or methodological glitches rather than a true lack of efficacy.

A patient advocate agrees:

According to Perry Cohen, who leads a network of patient activists called the Parkinson Pipeline Project, that’s exactly what is happening. He had always questioned the need for sham surgery, he says, but after the string of phase II failures, “We started saying, ‘Hey, this is a problem. These trials failed, but we know they are working for some people.’”

...Cohen [says] that patients have different priorities and that researchers must take these into account. Researchers use placebo controls to weed out false positives. But for patients, the real ogre is the false negatives — which can sink a therapy before it has been optimized.

I'm not sure about this. If I had Parkinson's, I would certainly hate to miss out on the genuine cure because a trial had failed to recognize that it worked. But equally, I would not be happy to be given a rubbish treatment that would have failed a placebo controlled trial, but never got one, because of arguments like this.

Placebo controlled trials can fail to detect benefits if they are too short, too small, methodologically flawed, or whatever. Certainly, a trial can be placebo controlled, and still crap. But the answer is surely to do better trials, not no trials.

It may well be that we shouldn't rush to do placebo controlled trials until later in the development process, when the technique has been properly refined. But the history of medicine is littered with treatments that "we know work for some people" - that didn't.

Katsnelson, A. (2011). Experimental therapies for Parkinson's disease: Why fake it? Nature, 476 (7359), 142-144 DOI: 10.1038/476142a

Ban These Sick Ape-Man Frankensteins

According to a new report, urgent action is required to stop scientists creating a monstrous race of apes with fully functional human brains (just as Christine O'Donnell warned us about those mice), thus causing Planet Of The Apes to come true.

OK, that's not quite what the Academy of Medical Sciences said. But judging from most of the media coverage, you might think it was.

The report is actually about "Animals containing human material" and it notes that under British law, experiments of this kind are covered by generic animal research rules, but there are no special animal-human regulations.

Should there be?

I think there should be. We as a society allow experiments on animals or animal embryos that we don't allow on humans, even on human embyros. Clearly, we need to decide what we're going to do about organisms that have both human and animal DNA, or whatever. This doesn't mean restricting it - to clear up the rules could also facilitate such research, by making it explicit what is allowed.

However, we should tread carefully here. This is an area where our intuitions can lead us astray.

Although we have absolutely no idea how to make an animal-human "hybrid", or even whether it's possible at all, the very idea of it has many people worried. It's probably a case of the uncanny valley and lots of cultural baggage (Planet of the Apes et al).

So, for whatever reason, we have a hang-up about making monstrous ape-men. Fair enough. So long as we remember that this is entirely hypothetical, and that it might, for all we know, be literally impossible.

Yet other things in this debate are very real. Over-zealous regulation of research could easily end up delaying, say, a cure for Alzheimer's for, say, 10 years. That would be dooming tens of millions of people to suffering and death.

The problem is, that's hard to picture. It's hard to imagine how bad Alzheimer's is unless you have personal experience. Even if you do, it's hard to multiply that badness by ten million anonymous, hypothetical people. "One ape-man is a tragedy; a million deaths is a statistic".

Delaying science is easy to do (for politicians), and hard to picture why it's bad. Whereas "a monstrous ape-man" is the exact opposite. Easy to imagine - just look at the media interest in this story - yet nowhere close to being reality.

This is a problem. The human mind and the way we think about these issues is a problem. Even when that mind is safely inside a nice normal human skull.