Dissent Over DSM-5

I liked this article by Gary Greenberg about one psychiatrist’s criticism of the upcoming DSM (Diagnostic and Statistical Manual) revision. The DSM is the diagnostic manual of the American Psychiatric Association.

This paragraph stood out for me:

This new disease reminded Frances of one of his keenest regrets about the DSM-IV: its role, as he perceives it, in the epidemic of bipolar diagnoses in children over the past decade. Shortly after the book came out, doctors began to declare children bipolar even if they had never had a manic episode and were too young to have shown the pattern of mood change associated with the disease. Within a dozen years, bipolar diagnoses among children had increased 40-fold. Many of these kids were put on antipsychotic drugs, whose effects on the developing brain are poorly understood but which are known to cause obesity and diabetes. In 2007, a series of investigative reports revealed that an influential advocate for diagnosing bipolar disorder in kids, the Harvard psychiatrist Joseph Biederman, failed to disclose money he’d received from Johnson & Johnson, makers of the bipolar drug Risperdal, or risperidone. (The New York Times reported that Biederman told the company his proposed trial of Risperdal in young children “will support the safety and effectiveness of risperidone in this age group.â€) Frances believes this bipolar “fad†would not have occurred had the DSM-IV committee not rejected a move to limit the diagnosis to adults.

Emphasis added. Hundreds of thousands of children given brain-damaging drugs because . . . well, one big reason is that Harvard allows its faculty to do what Biederman did. Forced to choose between Harvard and drug company money, Biederman would choose Harvard. I am glad Professor Ross Anderson, a Cambridge computer science professor, turned down an industry request to censor a student, but I am sorry he said the person making the request had “a deep misconception of what universities are and how we work.”

American Psychiatric Association incompetence.

Via The Browser.

Which Should You Trust: Scientific Literature or Anecdote?

In a comment on a BMJ paper critical of alternative medicine (the author submitted a fictional abstract to a conference then criticized the program committee for not rejecting it), a retired chemist named Joe Magrath said:

The scientific literature tells us that acupuncture, cupping and reflexology are all nonsense.

I haven’t looked into it but I’ll take his word for it.

Around the time Magrath said that, James Fallows said this:

During our years in Malaysia in the 1980s, and more recently in China, my wife and I became unlikely converts to a lot of Asian medical practices. I had serious back pain cured by an acupuncturist (who used needles the size of aluminum baseball bats) in Kuala Lumpur. In her book, my wife describes how the gruesome-seeming therapy of fire-cupping, applied in an all-night massage parlor in the city of Yueyang, snapped her out of a serious bout of the flu. Sure, she had big red welts on her back for the next ten days, but her fever was gone!

Which do you believe?

Do Fermented Foods Shorten Colds?

Alex Chernavsky writes:

I had an interesting experience recently. On Thursday afternoon, I started feeling a little run-down. Then I began to sneeze a lot, and my nose really started to run. I thought I was coming down with a cold. I took an antihistamine and felt a little better. I woke up Friday morning with a mild sore throat (the sneezing/runny nose had stopped). Within a couple of hours, my throat wasn’t sore anymore — and I haven’t felt sick since then. In summary, I believe I had a cold that lasted less than 24 hours. This almost never happens to me. Typically, my colds last at least a week, and usually more (and I usually get two or three colds per year). There is only one other time in my adult life [he’s in his forties] when I can remember having a very short-duration cold.

Maybe it’s the fermented foods I’m eating. After I started reading your blog, I began to brew my own kombucha, and I drink it every day. I also sometimes eat kim chee, fermented dilly beans, fermented salsa, umeboshi plums, and coconut kefir.

This was the first cold he’s gotten since he started eating lots of fermented foods in June. I believe the correlation reflects causation — the fermented foods improve his immune function. The microbes in the food keep the immune system “awake”. I also believe that Alex’s colds would become even less noticeable if he improved his sleep.

Another Mysterious Mental Improvement

This graph shows results from a test of simple arithmetic (e.g., 7-3, 4*8) that I did once or twice most days. Starting in August, I improved about 9% (from 600 to 550 msec/problem).

I don’t know why I got faster. In early September I moved from Berkeley to Beijing. After the move there was an especially sharp decrease. The increase in October was due to an experiment in which I reduced flaxseed oil/day.

I noticed the decrease after I got to China. At first, I thought it was due to a dietary change — perhaps more walnuts. I stopped eating walnuts and the improvement didn’t go away. So it’s not walnuts. It’s not butter; for the first few months in China, I ate the same butter as in Berkeley.

I can’t think of any plausible conventional explanation (e.g., blueberries). Here are the most plausible explanations I can think of:

1. Less aerobic exercise. In China I get much less aerobic exercise than in Berkeley.

2. Less vitamins. In China I consume less vitamins than in Berkeley.

3. Warmer. My Beijing apartment is warmer than my Berkeley apartment. Showers in Beijing are warmer than baths in Berkeley.

In each case the change (e.g., less exercise) could have started in Berkeley. The last one (warmer) is not just the strangest, it’s also the most plausible. Unlike the other two, evidence supports it. Fact 1: When I started heavy-duty cold showers my scores started to get worse. Fact 2: When I stopped cold showers, the scores returned to their pre-cold-shower level. Fact 3: When I moved to China it was very hot, which would explain the sharp decline at that time.

My Theory of Human Evolution (Caganers)

A nativity scene in Barcelona:

He is known in Catalan as the caganer. That translates most politely as ‘the defecator’ – and there he is, squatting under a tree with his trousers down.

At the nearby Christmas market amid the sprigs of holly and Santa hats rows of miniature, crouching country boys are lined up for sale.

Innocuous-looking from the front, their buttocks are bare and each one has a small, brown deposit beneath.

“It’s typical of Catalonia. Each house buys one for Christmas,” explains Natxo with a smile and a shrug as he shops. “I don’t know why (we do it), it’s just a tradition.”

Without Christmas, there would be much less demand for these intricate items. I believe the evolutionary reason for festivals and ceremonies is that they create demand for hard-to-make goods. This helps the most skilled artisans (good sources of innovation) make a living and hone their skills.

Via Marginal Revolution. Christmas: an evolutionary explanation.

Rich and Poor Students: How to Distinguish

At Tsinghua University, there is a great range of wealth among students. Some are from very rich families, some from very poor. I asked a friend how to distinguish rich students and poor ones.

“At the student store, rich students buy things that cost more than 15 yuan [2 dollars],” she said.

I asked another student the same question.

“By their shoes,” he said, “especially sports shoes.” Poor students wear Chinese brands you’ve never heard of. Rich students wear American brands.

Like my friend’s answer, this surprised me. At the Beijing Zoo, I paid $10 for Nike shoes that cost $100 in America. Yet when visiting America, Chinese people I know have bought Nike shoes, because genuine Nike cost less in America than in China. So the American shoes of the rich students are probably genuine (> $100) and the Chinese-brand shoes of the poor students cost less than $10 ($5?).

Unexpected Christmas Presents

This year I got two:

1. I taught a class about R and data analysis. On Christmas, one of my students wrote, “Thanks for what you taught us on the class. I love your class. I learnt a lot!” I hadn’t taught it before. A few weeks ago I had been abashed to discover a midterm exam from Phil Spector’s R class at Berkeley. I know Phil and like and respect him. His students had learned a lot more than mine, it seemed. I had consoled myself by thinking that I couldn’t answer some of the questions.

2. Cleaning a cupboard, also on Christmas, I found a “gift” derived from buying a water heater in March. (Buy the water heater, get the “gift”.) It looked like an ordinary glass teapot, which is why I had put it in semi-storage. When I opened the box I discovered it wasn’t. It has a basket where you put the tea and hot water; when the tea is ready you press a button that releases the water into the bottom of the teapot, stopping the brewing. I drink a lot of tea. A month ago I barely knew these things existed. Then I bought one and thought it was wonderful — but small. The uncovered one is the perfect size.

Chinese Economics Joke

Person A to Person B: “See that piece of shit? If you eat it I’ll give you 100 million yuan.”

Person B eats the shit.

But Person A doesn’t want to give him 100 million yuan. He says to Person B: “How about I eat shit too? Then we’ll be even.”

Person B agrees.

Person A eats some shit. “Now we’re even,” he says.

They have just increased GDP by 200 million yuan.

Three Observations About Walking and Learning

1. Studying Chinese-character flashcards while walking on a treadmill is as pleasant as drinking something when thirsty. Unlike actual thirst and drinking, the pleasure lasts a long time and the desire is under your control (to turn it on, you start walking; to turn it off, you stop).

2. What is the opposite of betrayal? There is no antonym. The opposite is so rare it isn’t even obvious what it is. Betrayal is when your friend becomes your enemy; the opposite is when your enemy becomes your friend. Living in China and not knowing Chinese was not exactly my enemy but it was certainly negative. This treadmill discovery turns it into a positive: Chinese becomes an inexhaustible source of dry knowledge that I can enjoy learning.

3. Learning is the central theme of experimental psychology and perhaps all academic psychology. Psychology professors have done more experiments about learning than anything else. Practically all of those experiments have been about efficiency of learning: The amount of learning (e.g., percent correct) in Condition A is compared with the amount of learning in Condition B, where A and B “cost” about the same. As a result, we know a great deal about what controls efficiency of learning, at least in laboratory tasks. I think many psychologists are surprised and disappointed that this research has had little effect outside academia. I have never heard a good answer to the question of why. If you’d asked me a month ago I would have said it’s because they haven’t discovered large non-obvious effects. That’s true, but says nothing about how to discover them.

My treadmill experience suggests a more helpful answer: Hedonics matter. Learning exactly the same material can be more or less pleasant. When Learning X is pleasant, it is learned easily; when Learning X is unpleasant, it is learned with difficulty or not at all. In the real world, hedonic differences matter more than efficiency differences. If they want to improve real-world learning, psychologists have been measuring the wrong thing. It is a hundred times easier and ten times more “objective” (= “scientific”) to study how much has been learned than to study how pleasant was the experience. But that doesn’t mean it is better to study.

Michel Cabanac, a physiologist, strikes me as someone on the right path. Cabanac has studied how the pleasantness of this or that experience goes up or down to help us properly self-regulate. A simple example is that cold water feels more pleasant when we feel hot than when we feel cold. A common example is that exactly the same food becomes less pleasant during a meal. The food doesn’t change; we change.