Some colleagues and I are carrying out a study of NIMH grant proposals. It has been an eye-opening experience.
Lots of these researchers propose to systematically torment mice or rats or monkeys and then use all sorts of gee-whiz technologies to study the effects on their brains, or on gene expression.
It seems to me they’ve just said it. In order to put these animals into a state they say is comparable to “mental illness” in humans, they had to systematically torment them. These mice or rats or monkeys were fine before the researchers got hold of them.
Here’s my modest proposal: instead of pouring more billions into brain-based or gene-based research of “mental illness,” why don’t we just assume that being systematically tormented is a bad thing, and if mice or rats or monkeys are being tormented put a stop to it?
Well done. In the Nineteenth Century, with none of the modern-day classes of psychiatric drugs, patients who today would be diagnosed with schizophrenia, depression, or bipolar disorder had better outcomes than they do now.
Se also chapters 10-13 of my book Madness and Genetic Determinism:
I enjoyed reading this. I also enjoyed our recent little dust-up on Twitter with Kolker.
āto be sure, no studies have ever suggested that abuse does cause schizophrenia.ā
In fact, there are so many studies showing this we now have systematic reviews of the systematic reviews.
Kolker’s mendacity knows no bounds. But what from someone who dismisses the plight of individuals who were raped, sodomized, and had God knows what else done to them when they were small and defenseless with sneering remarks about “blaming Mommy and Daddy?”
“There are many, āmanyā established differences between ADHD brains and non-ADHD brains.”
In fact there are none. There is no abnormality of brain structure that can be used to diagnose ADHD. There is no abnormality of brain function that can be used to diagnose ADHD. And this is after more than eighty years of brain-imaging studies, going all the way back to Charles Bradley’s experiments on children at the Bradley Home.
Psychiatric genetics is a gigantic multibillion-dollar fraud.
The fundamental assumption of family studies — that familial equals genetic — is false.
The fundamental assumption of twin studies — the equal environment assumption — is false.
The fundamental assumption of adoption studies — that adoption randomizes environmental variation — is false.
Linkage studies and candidate-gene studies have failed to find a single gene for any of those condition called “mental illnesses.”
Genome-wide-association studies are pseudoscientific nonsense. You screen the entire genome looking for single-nucleotide polymorphisms (not actual genes) correlated with the index condition, and if you don’t find a correlation you just keep increasing the sample size until you do. Although it never seems to work the other way around — you never hear these guys saying “Well maybe uf we looked at another population this correlation would disappear.” It’s like you and I betting on the outcome of a coin toss, with this stipulation — heads I win, tails we keep on flipping until it comes up heads.
And the legacy media (which is heavily dependent on drug company advertising to stay afloat) never mentions how absurdly tiny these claimed “effect sizes” are — one in a hundred, on in five hundred, one in two thousand. How can a gene correlated with a one in a hundred chance of developing a condition serve as a target for drug development?
There is no gene for ADHD. And how could there be? There are literally hundreds of reasons why any given child might have problems with inattention and hyperactivity. How could there be a common neural substrate, or a common genetic substrate, underlying all these disparate problems?
Billions of dollars spent on neuroimaging studies and genome-wide association studies of “mental illness” and not one patient in a clinic anywhere in the world has benefited. You don’t have to take my word for that. That’s what Thomas Insel said when he stepped down as head of the NIMH in 2017. It’s time we stopped throwing money down this particular balck hole and started talking about real-world solutions to real-world problems.
I use a timekeeping metaphor. You can kick a sundial around the yard and it still will do what a sundial is designed to do. You can’t do that with a fine watch. But, properly handled, a fine watch can do so much more than a sundial.
This proliferation of diagnostic labels in the DSM reminds of of the proliferation of epicycles in the Ptolemaic model of the universe. It’s a sign you’re on the wrong track.
When I was writing my first book, I was uncertain about whether or not to include the information about the trauma Joanne Greenberg (author of I Never Promised You a Rose Garden) experienced as a child. It sounded bad, but not horrible. I finally decided to include that information and let the reader make up his mind about its significance.
I am sure there are people who have experienced worse trauma but who never were diagnosed with schizophrenia. On the other hand, after three years at Chestnut Lodge, Greenberg went on to become a professor and a famous author.
It could be that creative, sensitive people are more likely than others to be diagnosed with schizophrenia — after all, if your life is unbearable, and there is no realistic prospect of that changing, it’s actually a pretty neat trick to be able to escape into a world of one’s own making. And I cannot rule out the possibility that the ability to do this may be in part genetically-based. But to whatever extent that is the case, instead of regarding these genes as disease genes, we ought to regard them as gifts that require proper stewardship by the individual and society at large.
“Actually there is no OVERWHELMING evidence that childhood abuse causes schizophrenia.”
Where is the evidence for a genetic cause of the complaints that fall under the diagnostic label of “schizophrenia?” They’ve spent billions of dollars looking and the evidence isn’t there.
Where is the evidence for a common neural substrate underlying the complaints that fall under the diagnostic label of “schizophrenia?” They’ve spent billions of dollars looking and the evidence isn’t there.
Where is the evidence for the role of child sexual abuse and other adverse childhood experiences in causing these complaints? EVERYWHERE you look. Can you show me one study that has looked for a correlation and not found one?
“itās obvious that there are other causes for schizophrenia than childhood abuse, which seems to put too much of the blame for the illness on parents.”
Agreed. I already mentioned the huge excess of schizophrenia cases among Holocaust survivors.
BTW, one major risk factor for a diagnosis of schizophrenia is losing a parent at an early age. In plain English, if the parent cannot be there for the child because the parent is DEAD, that is a major risk factor for a diagnosis of schizophrenia. Is that “blaming the parents?”
“Bad things indeed do happen, and can drive certain people crazy. I knew a man who had a psychotic breakdown because he feared his wife was having an affair and heād lose his family. But most people facing divorce donāt react that way.”
Can’t argue with that. I’d like to know what else happened to this fellow that made it so easy for him to go over the edge.
“I also think thereās a huge difference between being pessimistic and realistic.”
If I understand you correctly, you are saying we cannot do anything about child sexual abuse and other adverse childhood experiences. Can we do something about the human gene pool? What did you have in mind?
It’s time to put an end to all the flatulent babbling about “hacking the software of life” and replace it with a sense of awe and wonder at the complexity of the human organism — the product of over five hundred million years of evolution.
“Genes (or large mutigenic structural variants, such as CNVs) that confer competitive disadvantages and social vulnerabilities may predispose to extreme social defeat in children and adolescents but they do not cause schizophrenia.”
Agreed. CNV number variants are a known risk factor for low IQ, which in turn may be a risk factor for bullying, social isolation, etc. So if anything, they’ve discovered a risk factor for these pernicious social factors, which in turn are risk factors for the complaints we group under the diagnostic label “social anxiety,” “ADHD,” “schizophrenia,” etc.
I’m also reminded of the 22q deletion, which is a known risk factors for a diagnosis of schizophrenia, with a ten-so-thirty-fold increase in absolute risk of a diagnosis. This falls short of Kenneth Kendler’s criterion of a 100-fold odds ratio needed to call something “a gene for,” and the great majority of people born with this deletion are never diagnosed with schizophrenia, but this still is a phenomenon that demands explanation.
We know the 22q deletion causes a whole host of physical deformities, which in turn may be risk factors for the pernicious social influences mentioned above. It is not “a gene for schizophrenia,” by any means.
“But what hard evidence is there for other causes of psychosis?”
I am glad you asked. There is OVERWHELMING evidence that the complaints that fall under the diagnostic rubric of schizophrenia are caused — not triggered, caused — by child sexual abuse, physical abuse, emotional abuse, and every other category of adverse childhood experience. The correlation is robust, reliable, and dose-dependent. It cuts across income brackets, ethnic identiies, and national boundaries. There are so many studies we now have systematic reviews of the systematic reviews.
As if all this were not enough, the connection between trauma and psychosis has been confirmed in a macabre way. In the 1990’s, there was a huge excess of Holocaust survivors in mental hospitals in Israel.
What common sense tells us is true: bad things happen, and they can drive you crazy.
“Also, it is very optimistic to believe that we can combat psychosis by changing cultural dislocation, urban environment, family, social, cultural, religious, educational, geographical and political factors. Thereās no reason to think this will ever happen.”
@Marie: Why shouldn’t we ignore them? Can you point to a single patient in a clinic anywhere in the world who has benefited from a century of psychiatric genetics research?
You could probably find genetic variation for any trait, if you looked hard enough, and so what? When John Snow found that tainted drinking water caused cholera, the authorities didn’t commission a study on the genetics of cholera resistance. They cleaned up the water supply, and everyone benefited, whether he personally was genetically susceptible to cholera or not.
We know what causes the complaints that fall under the diagnostic rubric of schizophrenia — child sexual abuse, physical abuse, emotional abuse, and every other category of adverse childhood experience. Unlike the human gene pool, these are factors we CAN change. Let’s work on that.
I predict one day we will look back on the era of genome-wide association studies the way we now look back on Medieval scholastics debating how many angels can dance on the head of a pin.
You look for a correlation, and if you don’t find one you just increasing the sample size until you do. Although it never seems to work the other way around. When they find a correlation, you never hear these guys say “Well maybe if you looked at another population, this correlation would disappear.”
It’s like betting on the outcome of a coin toss, with this stipulation: heads I win, tails e keep flipping until it comes up heads.
It’s a con game that would embarrass a used-care salesman.
Well of course. Which is more stigmatizing — telling people these problems with living that fall under the diagnostic label of “schizophrenia” are just more extreme versions of the confusion, fear, sadness, and anger we all feel, and the perfectly understandable reactions of NORMAL brains to ABNORMAL stress and trauma — or telling people these are the products of ABNORMAL brains of people who were “born that way?”
We’ve spent zillions of dollars on neuroimaging studies of ADHD, and not one patient in the world has benefited.
We’ve spent zillions of dollars on genome-wide association studies of ADHD, and not one patient in the world has benefited.
There is no abnormality of brain structure that can be used to diagnose ADHD.
There is no abnormality of brain function that can be used to diagnose ADHD.
There is no gene for ADHD.
And how could there be? There are literally hundreds of reasons why a child or an adult might have problems with inattention or hyperactivity. Far better to identify the cause of a person’s distress and address that, than to attribute that person’s problems to some mythical disease entity, the existence of which has never been demonstrated.
There is also no evience of any long-term benefit of drugging kids for something called “ADHD.”
The MTA study was far and away the largest and far and away the longest randomized controlled trial of the effects of stimulant drugs on children. And the only long-term effect the researchers were able to document — the ONLY one — was that the drugs stunted the kids’ growth. Ad they didn’t “catch up.” By the time of the sixteen-year-follow-up, the drugged kids were an average of TWO INCHES shorter than the undrugged ones.
That doesn’t explain why Mexico outlawed cannabis fourteen years before the United States did.
Anyway, I didn’t say anything about making cannabis illegal. I don’t even get into the debate anymore. I just think people ought to know the hazards of the drugs they are taking.
The claim about Chinese doctor can be found in Alex Berenson’s Tell Your Children. I gave my copy to our friend, so you’ll have to look up the citation yourself.
Schizophrenia is not even a coherent diagnostic category. The vast majority of diagnosed cases of “schizophrenia” are due to perfectly understandable reactions to overwhelming trauma and abuse:
The symptoms of schizophrenia may also be reactions to drugs (legal or illegal), and perhaps some other causes as well — head injury, heavy medical toxicity, etc.
Some colleagues and I are carrying out a study of NIMH grant proposals. It has been an eye-opening experience.
Lots of these researchers propose to systematically torment mice or rats or monkeys and then use all sorts of gee-whiz technologies to study the effects on their brains, or on gene expression.
It seems to me they’ve just said it. In order to put these animals into a state they say is comparable to “mental illness” in humans, they had to systematically torment them. These mice or rats or monkeys were fine before the researchers got hold of them.
Here’s my modest proposal: instead of pouring more billions into brain-based or gene-based research of “mental illness,” why don’t we just assume that being systematically tormented is a bad thing, and if mice or rats or monkeys are being tormented put a stop to it?
Report comment
Well done. In the Nineteenth Century, with none of the modern-day classes of psychiatric drugs, patients who today would be diagnosed with schizophrenia, depression, or bipolar disorder had better outcomes than they do now.
Se also chapters 10-13 of my book Madness and Genetic Determinism:
https://www.amazon.com/Madness-Genetic-Determinism-Mental-Illness-ebook/dp/B07V3W2Y7Y?ref_=ast_author_dp
Report comment
Jay:
I enjoyed reading this. I also enjoyed our recent little dust-up on Twitter with Kolker.
āto be sure, no studies have ever suggested that abuse does cause schizophrenia.ā
In fact, there are so many studies showing this we now have systematic reviews of the systematic reviews.
Kolker’s mendacity knows no bounds. But what from someone who dismisses the plight of individuals who were raped, sodomized, and had God knows what else done to them when they were small and defenseless with sneering remarks about “blaming Mommy and Daddy?”
Report comment
“There are many, āmanyā established differences between ADHD brains and non-ADHD brains.”
In fact there are none. There is no abnormality of brain structure that can be used to diagnose ADHD. There is no abnormality of brain function that can be used to diagnose ADHD. And this is after more than eighty years of brain-imaging studies, going all the way back to Charles Bradley’s experiments on children at the Bradley Home.
Psychiatric genetics is a gigantic multibillion-dollar fraud.
The fundamental assumption of family studies — that familial equals genetic — is false.
The fundamental assumption of twin studies — the equal environment assumption — is false.
The fundamental assumption of adoption studies — that adoption randomizes environmental variation — is false.
Linkage studies and candidate-gene studies have failed to find a single gene for any of those condition called “mental illnesses.”
Genome-wide-association studies are pseudoscientific nonsense. You screen the entire genome looking for single-nucleotide polymorphisms (not actual genes) correlated with the index condition, and if you don’t find a correlation you just keep increasing the sample size until you do. Although it never seems to work the other way around — you never hear these guys saying “Well maybe uf we looked at another population this correlation would disappear.” It’s like you and I betting on the outcome of a coin toss, with this stipulation — heads I win, tails we keep on flipping until it comes up heads.
And the legacy media (which is heavily dependent on drug company advertising to stay afloat) never mentions how absurdly tiny these claimed “effect sizes” are — one in a hundred, on in five hundred, one in two thousand. How can a gene correlated with a one in a hundred chance of developing a condition serve as a target for drug development?
There is no gene for ADHD. And how could there be? There are literally hundreds of reasons why any given child might have problems with inattention and hyperactivity. How could there be a common neural substrate, or a common genetic substrate, underlying all these disparate problems?
Billions of dollars spent on neuroimaging studies and genome-wide association studies of “mental illness” and not one patient in a clinic anywhere in the world has benefited. You don’t have to take my word for that. That’s what Thomas Insel said when he stepped down as head of the NIMH in 2017. It’s time we stopped throwing money down this particular balck hole and started talking about real-world solutions to real-world problems.
Report comment
@Birdsong @Rasx:
I use a timekeeping metaphor. You can kick a sundial around the yard and it still will do what a sundial is designed to do. You can’t do that with a fine watch. But, properly handled, a fine watch can do so much more than a sundial.
Report comment
This proliferation of diagnostic labels in the DSM reminds of of the proliferation of epicycles in the Ptolemaic model of the universe. It’s a sign you’re on the wrong track.
Report comment
I don’t like to say “I told you so,” but…
https://www.baltimoresun.com/opinion/op-ed/bs-ed-op-0625-pregnancy-antidepressants-20170619-story.html
Report comment
[Duplicate Comment]
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[Duplicate Comment]
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Well said.
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@Steve & @Birdsong:
When I was writing my first book, I was uncertain about whether or not to include the information about the trauma Joanne Greenberg (author of I Never Promised You a Rose Garden) experienced as a child. It sounded bad, but not horrible. I finally decided to include that information and let the reader make up his mind about its significance.
I am sure there are people who have experienced worse trauma but who never were diagnosed with schizophrenia. On the other hand, after three years at Chestnut Lodge, Greenberg went on to become a professor and a famous author.
It could be that creative, sensitive people are more likely than others to be diagnosed with schizophrenia — after all, if your life is unbearable, and there is no realistic prospect of that changing, it’s actually a pretty neat trick to be able to escape into a world of one’s own making. And I cannot rule out the possibility that the ability to do this may be in part genetically-based. But to whatever extent that is the case, instead of regarding these genes as disease genes, we ought to regard them as gifts that require proper stewardship by the individual and society at large.
Report comment
@Marie:
“Actually there is no OVERWHELMING evidence that childhood abuse causes schizophrenia.”
Where is the evidence for a genetic cause of the complaints that fall under the diagnostic label of “schizophrenia?” They’ve spent billions of dollars looking and the evidence isn’t there.
Where is the evidence for a common neural substrate underlying the complaints that fall under the diagnostic label of “schizophrenia?” They’ve spent billions of dollars looking and the evidence isn’t there.
Where is the evidence for the role of child sexual abuse and other adverse childhood experiences in causing these complaints? EVERYWHERE you look. Can you show me one study that has looked for a correlation and not found one?
“itās obvious that there are other causes for schizophrenia than childhood abuse, which seems to put too much of the blame for the illness on parents.”
Agreed. I already mentioned the huge excess of schizophrenia cases among Holocaust survivors.
BTW, one major risk factor for a diagnosis of schizophrenia is losing a parent at an early age. In plain English, if the parent cannot be there for the child because the parent is DEAD, that is a major risk factor for a diagnosis of schizophrenia. Is that “blaming the parents?”
“Bad things indeed do happen, and can drive certain people crazy. I knew a man who had a psychotic breakdown because he feared his wife was having an affair and heād lose his family. But most people facing divorce donāt react that way.”
Can’t argue with that. I’d like to know what else happened to this fellow that made it so easy for him to go over the edge.
“I also think thereās a huge difference between being pessimistic and realistic.”
If I understand you correctly, you are saying we cannot do anything about child sexual abuse and other adverse childhood experiences. Can we do something about the human gene pool? What did you have in mind?
Report comment
@GPM: I agree.
It’s time to put an end to all the flatulent babbling about “hacking the software of life” and replace it with a sense of awe and wonder at the complexity of the human organism — the product of over five hundred million years of evolution.
Report comment
@GPM & Steve:
“Genes (or large mutigenic structural variants, such as CNVs) that confer competitive disadvantages and social vulnerabilities may predispose to extreme social defeat in children and adolescents but they do not cause schizophrenia.”
Agreed. CNV number variants are a known risk factor for low IQ, which in turn may be a risk factor for bullying, social isolation, etc. So if anything, they’ve discovered a risk factor for these pernicious social factors, which in turn are risk factors for the complaints we group under the diagnostic label “social anxiety,” “ADHD,” “schizophrenia,” etc.
I’m also reminded of the 22q deletion, which is a known risk factors for a diagnosis of schizophrenia, with a ten-so-thirty-fold increase in absolute risk of a diagnosis. This falls short of Kenneth Kendler’s criterion of a 100-fold odds ratio needed to call something “a gene for,” and the great majority of people born with this deletion are never diagnosed with schizophrenia, but this still is a phenomenon that demands explanation.
We know the 22q deletion causes a whole host of physical deformities, which in turn may be risk factors for the pernicious social influences mentioned above. It is not “a gene for schizophrenia,” by any means.
Report comment
@Marie:
“But what hard evidence is there for other causes of psychosis?”
I am glad you asked. There is OVERWHELMING evidence that the complaints that fall under the diagnostic rubric of schizophrenia are caused — not triggered, caused — by child sexual abuse, physical abuse, emotional abuse, and every other category of adverse childhood experience. The correlation is robust, reliable, and dose-dependent. It cuts across income brackets, ethnic identiies, and national boundaries. There are so many studies we now have systematic reviews of the systematic reviews.
As if all this were not enough, the connection between trauma and psychosis has been confirmed in a macabre way. In the 1990’s, there was a huge excess of Holocaust survivors in mental hospitals in Israel.
What common sense tells us is true: bad things happen, and they can drive you crazy.
“Also, it is very optimistic to believe that we can combat psychosis by changing cultural dislocation, urban environment, family, social, cultural, religious, educational, geographical and political factors. Thereās no reason to think this will ever happen.”
That sounds incredibly pessimistic.
Report comment
@Marie: Why shouldn’t we ignore them? Can you point to a single patient in a clinic anywhere in the world who has benefited from a century of psychiatric genetics research?
You could probably find genetic variation for any trait, if you looked hard enough, and so what? When John Snow found that tainted drinking water caused cholera, the authorities didn’t commission a study on the genetics of cholera resistance. They cleaned up the water supply, and everyone benefited, whether he personally was genetically susceptible to cholera or not.
We know what causes the complaints that fall under the diagnostic rubric of schizophrenia — child sexual abuse, physical abuse, emotional abuse, and every other category of adverse childhood experience. Unlike the human gene pool, these are factors we CAN change. Let’s work on that.
Report comment
Jay:
I’ve got your book on order.
I predict one day we will look back on the era of genome-wide association studies the way we now look back on Medieval scholastics debating how many angels can dance on the head of a pin.
You look for a correlation, and if you don’t find one you just increasing the sample size until you do. Although it never seems to work the other way around. When they find a correlation, you never hear these guys say “Well maybe if you looked at another population, this correlation would disappear.”
It’s like betting on the outcome of a coin toss, with this stipulation: heads I win, tails e keep flipping until it comes up heads.
It’s a con game that would embarrass a used-care salesman.
Report comment
I don’t like to say “I told you so,” but…
https://www.baltimoresun.com/opinion/op-ed/bs-ed-op-0625-pregnancy-antidepressants-20170619-story.html
Report comment
Well of course. Which is more stigmatizing — telling people these problems with living that fall under the diagnostic label of “schizophrenia” are just more extreme versions of the confusion, fear, sadness, and anger we all feel, and the perfectly understandable reactions of NORMAL brains to ABNORMAL stress and trauma — or telling people these are the products of ABNORMAL brains of people who were “born that way?”
I don’t like to say “I told you so,” but…
https://www.amazon.com/gp/product/B07V3W2Y7Y/ref=dbs_a_def_rwt_hsch_vapi_tkin_p1_i2
Report comment
We’ve spent zillions of dollars on neuroimaging studies of ADHD, and not one patient in the world has benefited.
We’ve spent zillions of dollars on genome-wide association studies of ADHD, and not one patient in the world has benefited.
There is no abnormality of brain structure that can be used to diagnose ADHD.
There is no abnormality of brain function that can be used to diagnose ADHD.
There is no gene for ADHD.
And how could there be? There are literally hundreds of reasons why a child or an adult might have problems with inattention or hyperactivity. Far better to identify the cause of a person’s distress and address that, than to attribute that person’s problems to some mythical disease entity, the existence of which has never been demonstrated.
There is also no evience of any long-term benefit of drugging kids for something called “ADHD.”
The MTA study was far and away the largest and far and away the longest randomized controlled trial of the effects of stimulant drugs on children. And the only long-term effect the researchers were able to document — the ONLY one — was that the drugs stunted the kids’ growth. Ad they didn’t “catch up.” By the time of the sixteen-year-follow-up, the drugged kids were an average of TWO INCHES shorter than the undrugged ones.
I don’t like to say “I told you so,” but…
https://www.amazon.com/gp/product/B09Z7LLCKP/ref=dbs_a_def_rwt_hsch_vapi_tkin_p1_i1
Report comment
That doesn’t explain why Mexico outlawed cannabis fourteen years before the United States did.
Anyway, I didn’t say anything about making cannabis illegal. I don’t even get into the debate anymore. I just think people ought to know the hazards of the drugs they are taking.
Report comment
The claim about Chinese doctor can be found in Alex Berenson’s Tell Your Children. I gave my copy to our friend, so you’ll have to look up the citation yourself.
Report comment
Schizophrenia is not even a coherent diagnostic category. The vast majority of diagnosed cases of “schizophrenia” are due to perfectly understandable reactions to overwhelming trauma and abuse:
https://www.amazon.com/gp/product/B07V3W2Y7Y/ref=dbs_a_def_rwt_hsch_vapi_tkin_p1_i0
The symptoms of schizophrenia may also be reactions to drugs (legal or illegal), and perhaps some other causes as well — head injury, heavy medical toxicity, etc.
Report comment