No Genetic Influence on Childhood Behavior Problems

Kermit Cole
15
83

DNA analysis by researchers from King’s College in London finds no relation between genetics and behavior problems in 2,500 12-year-old twin pairs.

Abstract →

Trzaskowski, M., Dale, P., Plomin, R.; No genetic influence for childhood behavior problems from DNA analysis. Journal of the American Academy of Child & Adolescent Psychiatry. 2013 Oct;52(10):1048-1056.e3. doi: 10.1016/j.jaac.2013.07.016. Epub 2013 Aug 3.

Of further interest:
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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected]

15 COMMENTS

  1. This description is a total misrepresentation of the content of the journal article. While I agree with the motivation to disprove genetic claims about behavior problems (a sub-set of mental illnesses), we cannot achieve that by misrepresenting work.

    The paper cited here concludes that a DNA analysis of _unrelated_ individuals does not find any sites in the genome that significantly influence the trait. The authors then do a standard twin study which shows a fairly standard heritability result. Then they hypothesize that the difference between there results (heritability for the twins and no heritability for unrelated individuals) might be explained by the mechanism of how behavioral traits are produced from the information in the genome.

    These authors do not question the assumption that behavioral problems are heritable. They do not interpret their result to mean that behavior problems are not heritable, because the twins studies _appear_ to show incontrovertibly that behavior problems are heritable.

    Indeed, if the twin study is done carefully, their interpretation may well be useful. HOWEVER, I believe that the twin study was not done properly. I believe the elephant in the room is that the diagnostics is subjective and that the diagnosing clinician typically assumes these issues are genetic when making the diagnosis. There twins result may well be a case of garbage in, garbage out. If you assume something when designing your experiment, your results will necessarily recapitulate your assumption.

  2. Good point! Tom, I appreciate your important clarification. My interpretation is that this study lends further, particularly scientifically rigorous credence to Jay Joseph’s central point (I’m paraphrasing here): “if mental disorders are genetic diseases, they are genetic diseases with no genes.”

    I’d like to see more people asking, with regard to genetic research on mental disorders, “so what?” Let’s suppose a given mental disorder is moderately heritable. So what? Let’s suppose a few identified genes appear to confer a small but specific risk for the development of a given mental disorder. So what? What is the practical value of such knowledge? What are clinicians, patients, families, policy-makers, etc. able to do with such information? Why should we invest millions of taxpayer dollars in such research?

    • Brett

      You have also made some excellent points. Imagine if the billions of dollars spent on this bogus research were spent on figuring out how we have to change society in ways to eliminate the traumas and psychological stress that creates the very symptoms that they want to label as genetic diseases.

      Brett, I am glad you are posting here. I have always found your comments educational. Your 2013 journal article titled “The Biomedical Model of Mental Disorder” that was posted in this column earlier this year was very thorough. I had some problems with some of the wording and construction (discussion for another time) but if I were to go into battle against Biological Psychiatry this article would definitely be one of the weapons I would bring with me.

      Richard

      • Brett, Richard,

        I am sure that you have already noticed this thought based on your comments, but it seems that this obsession with the “genetic origins of mental illness” is eugenics redux. For that very reason, the notion of “genetic screening” for “mental illness” has to be fiercely opposed.

      • Hi Richard. It’s good to hear from you. I always appreciate your perspective and I’m glad for your presence here as well. This isn’t the place, but I’d love to hear your critical feedback on my biomedical commentary article. I’m definitely not finished thinking/writing/talking about this subject and I’d be very glad to hear your thoughts! Feel free to shoot me an email if you’re so inclined.

        Best,

        Brett

  3. Very good point. When we discovered simple genetic diseases the applications were astounding: think cystic fibrosis, Tay-Sachs, sickle cell anemia, etc. So, naturally, we thought that discovering the genetics of complex diseases would be equally as impactful. But, even if we consider the poster-child of discovery for complex diseases, age-related macular degeneration, where we know ~80% of the involved genes, we still haven’t figured out how to apply this knowledge to diagnostics, prevention, and treatment.

    I like Jay Joseph’s thesis. It would be equivalent to say that mental disorders are not genetic. I actually disagree. I think mental disorders are not even diseases. While it isn’t necessary to have an objective biological test for every disease (some are defined by exclusion), it is necessary to have a reliable algorithm. While the DSM has fake algorithms, they are by no means reliable, and psychiatrists don’t use the DSM anyway. So, the whole diagnostic processes is a sham.

    I’m not saying that emotional distress is not real. It most certainly is. But, distress should be honored not pathologized.

    IMHO, studying the genetics of diseases that are subjectively defined is absurd. And, if I ever sit on a panel that reviews applications for these studies, I will do my best to get them rejected. However, these proposals simply have to cite the number of people ‘afflicted’ with various mental disorders and the amount of money our society spends on ‘treating’ the afflicted, and the motivation for the study is plain. Everyone wants to improve the situation. Unfortunately, it seems that most researchers skip over the obvious answers, forget about Occam’s razor, and keep looking in unproductive directions.

    If only the powers that be would realize that the best way to save money on mental health is to stop spending money on harmful treatments.

    • I am always amazed at the amount of money being spent studying the one and only thing about a person that we have no capacity to change: his or her DNA! Especially when it comes to “mental health” problems, there are SO many other variables that we CAN change! Even in the physical realm, you have sleep, food, toxins, pain, physical injury to the brain, drugs, deep breathing… Then there are the stress-related variables (abuse, neglect, grinding poverty, dead-end jobs), and social/environmental variables (noise, pollution, racism, sexism, family relationships, loneliness), and there are spiritual variables, too. Apparently, the ongoing practice of meditation can change your brain structure. And biofeedback allows us to alter our brainwave patterns intentionally. All of these things are 100% within human control, and yet we waste billions of dollars and huge amounts of time studying stuff that is unavoidably fixed at birth.

      And even those billions have yielded pitiful results!! When the best you can claim is that a third of “mental disorders” MAY be associated with a range of thousands of alleles, the chances that you’re going to come up with a genetic explanation for anything are obviously beyond remote.

      One more thing: Just because something is shown to have genetic underpinnings doesn’t make it a disease. I am quite sure that some of those labeled “ADHD” by the system are programmed genetically to be more active and less tolerant of boredom. As Brett says, “So what?” Any trait that occurs in 6-10% of the population obviously has some survival value. I would suggest that we NEED some people who are more active and less tolerant of boredom. Those are the ones who push the stodgy and controlling members of society outside of their comfort zones to consider things that might otherwise never be considered.

      Species survival depends on genetic diversity. We all have different genetic substrates, and that’s how it’s supposed to be. Time to stop wasting our energy on discovering the obvious fact that we’re all genetically different, and time to put in a lot more energy into figuring how we can value our differences and make a society where being different isn’t considered a disease.

      — Steve

  4. At Tom’s mention of cystic fibrosis

    I’ve been a sick person since infancy. Pre-kindergarten, I spent week after week at Children’s Hospital in Boston where cystic fibrosis was considered. After so many tests (many of which were traumatizing) I was finally diagnosed with bronchial asthma (which I mysteriously no longer have but do still have an original symptom which is a feature of CF).

    Because of neglect and abuse I ended up in foster care and the “mental” system. All at the same time, I was diagnosed with a sleep disorder, cardiac condition, depression and borderline personality disorder.

    I think the underlying primary disease / condition, that I likely was born with, causes such stress that my symptoms were continually mistaken for so-called “mental illness”.

    Is there not a word for that, when genuine disease in the body manifest its symptoms that are (mis)diagnosed as “mental”, mood or behavioral “disorders”??

    Oh yeah, then there’s those 2 months when I was 11 years old in a damn-near coma – bedridden – so sick with mono that I swear to God, I think I survived sepsis (and nothing can convince me otherwise). And, I’m pretty sure I’ve diagnosed myself correctly that it was mono that damaged my heart.

    Another quote from Tom’s comment, “If only the powers that be would realize that the best way to save money on mental health is to stop spending money on harmful treatments.”

    And I’m thinking, if only they would realize *how to diagnose correctly* in order to completely avoid unnecessary, injurious treatments (which includes the absence of right treatment, making it a double affliction).

    • mjk,

      You might consider finding an MD that is willing to diagnose cystic fibrosis without confirming genetic evidence. Even though it is not widely known, it is entirely possible to have cystic fibrosis and not have two recessive copies of the gene thought to cause it. This is one of those genetic mysteries that we do not quite understand, but it is certainly possible; rare, but possible. Good research doctors should know this.

      • I’ve reached the point that without a medical malpractice attorney, I will not seek medical attention, for anything, ever again. I get sick every time from even antibiotics. I just have no reason and no ability to trust. There’s NO faith and no trust, whatsoever.

        I consider myself to be sacred. People do not know how to handle me. If they knew (and I’ve got tears in my eyes) oh, what a different world it would be.

  5. Just like a poster suggested above, I too am mystified by this emphasis on genetic research. Think what we could be doing with that money instead! Getting people off the street, providing supportive housing, good food, decent medical care and counselling are a few things that spring to mind.

    The grimmer possible outcomes from this genetic research (and I have no doubt that genetics makes a person more likely to break down from an environmental stressor) are:

    – pre-emptively targeting youths deemed at risk (just like NIMH tried to do with its thankfully doomed Violence Initiative)
    – ever-expanding market for antipsychotic drugs
    – pressure for women to abort SZ-likely fetuses
    – central registry of those like to develop SZ
    – profound despair and hopelessness on the part of those deemed likely to develop mental illness
    – a few even more dim possibilities that I don’t feel like discussing

      • I agree that the potential here is disturbing. However, I cannot call this Nazi eugenics which was essentially a selective breading program applied to humans where observed traits drove decision making by the state. What we have now is some type of modern eugenics driven by a desire to eradicate disease and by our meager understanding of how multiple regions of the genome can interact to produce risk of disease. These discussions are necessarily probabilistic, since having some risk of a disease does not guarantee getting it.

        Unfortunately, these nuances are probably lost on psychiatry. I fear that Francesca is right. Psychiatry will probably peddle their 22 schizophrenia-implicated genomic regions as well predictive of disease risk, even though the recent study (http://www.nature.com/ng/journal/v45/n10/full/ng.2742.html) says that 8300 regions together account for only 32% of the risk. This means that the mere 22 discovered regions probably account for some very small percentage of the risk… probably this number didn’t make it into the paper, because it was so unimpressive.

        While most geneticists look on this as a marginal result, I fear that psychiatrists will use it to motivate ‘preventative treatment’ and to sell new drugs that are coincidentally related to these genetic regions, while failing to refine their etiological understanding of this so-called disease.

  6. “Preventative treatment.” Now there’s a concept that should strike fear into our hearts. If our social policy re: mental health is ultimately based on the fear of violence (and I believe that it is) then, really, everybody should be on antipsychotics. Except for oddball circumstances where they actually cause violence, in most cases they act as one would expect major tranquilizers (their original name) to act. Antipsychotics would make anybody less likely to be violent because they make you less likely to be able to act at all. They call it the “Thorazine shuffle” for good reason.

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