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Welcome to the nexus of ethics, psychology, morality, technology, health care, and philosophy
Showing posts with label Criticism. Show all posts
Showing posts with label Criticism. Show all posts

Thursday, August 16, 2018

Peer Review is Not Scientific

E Price
medium.com
Originally published June 18, 2018

Here are two excerpts:

The first thing I want all lovers of science to know is this: peer-reviewers are not paid. When you are contacted by a journal editor and asked to conduct a review, there is no discussion of payment, because no payment is available. Ever. Furthermore, peer reviewing is not associated in any direct way with the actual job of being a professor or researcher. The person asking you to conduct a peer review is not your supervisor or the chair of your department, in nearly any circumstance. Your employer does not keep track of how many peer reviews you conduct and reward you appropriately.

Instead, you’re asked by journal editors, via email, on a voluntary basis. And it’s up to you, as a busy faculty member, graduate student, post-doc, or adjunct, to decide whether to say yes or not.

The process is typically anonymized, and tends to be relatively thankless — no one except the editor who has asked you to conduct the review will know that you were involved in the process. There is no quota of reviews a faculty member is expected to provide. Providing a review cannot really be placed on your resume or CV in any meaningful way.

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The level of scrutiny that an article is subjected to all comes down to chance. If you’re assigned a reviewer who created a theory that opposes your own theory, your work is likely to be picked apart. The reviewer will look very closely for flaws and take issue with everything that they can. This is not inherently a bad thing — research should be closely reviewed — but it’s not unbiased either.

The information is here.

Wednesday, January 18, 2017

Rational judges, not extraneous factors in decisions

Tom Stafford
Mind Hacks
Originally published December 8, 2016

Here is an excerpt:

The main analysis works like this: we know that favourable rulings take longer than unfavourable ones (~7 mins vs ~5 mins), and we assume that judges are able to guess how long a case will take to rule on before they begin it (from clues like the thickness of the file, the types of request made, the representation the prisoner has and so on). Finally, we assume judges have a time limit in mind for each of the three sessions of the day, and will avoid starting cases which they estimate will overrun the time limit for the current session.

It turns out that this kind of rational time-management is sufficient to  generate the drops in favourable outcomes. How this occurs isn’t straightforward and interacts with a quirk of original author’s data presentation (specifically their graph shows the order number of cases when the number of cases in each session varied day to day – so, for example, it shows that the 12th case after a break is least likely to be judged favourably, but there wasn’t always a 12 case in each session. So sessions in which there were more unfavourable cases were more likely to contribute to this data point).

The article is here.

Friday, December 12, 2014

Culture Of Psychological Science At Stake

By Tania Lombrozo
NPR Cosmos and Culture
Originally published November 18, 2014

In a video released today at Edge.org, psychologist Simone Schnall raises interesting questions about the role of replication in social psychology and about what counts as "admissible evidence" in science.

Schnall comes at the topic from recent experience: One of her studies was selected for a replication attempt by a registered replication project, and the replication failed to find the effect from her original study.

An occasional failure to replicate isn't too surprising or disruptive to the field — what makes Schnall's case somewhat unique is the discussion that ensued, which occurred largely on blogs and social media. And it got ugly.

The entire NPR article is here.

Dr. Schnall's Edge Video is here.


Friday, July 25, 2014

A new tactic to halt child abuse in Maryland

Focus now on helping low-risk families instead of punishing

By Yvonne Wenger
The Baltimore Sun
Originally posted July 5, 2014

Baltimore is changing the way it handles cases of alleged child abuse and neglect — part of a broad social-services strategy that has been touted by Maryland officials but abandoned in some other states.

The new approach, which is designed to lessen the adversarial relationship between families and caseworkers, puts cases on different tracks depending on whether they are deemed high or low risk. The tiered response, used in 23 states, is regarded as a best practice by many child advocates.

The entire story is here.

Tuesday, December 31, 2013

The Meaning of Disgust: A Refutation

Strohminger, N. (in press). The Meaning of Disgust: A Refutation. Emotion Review

Abstract

Recently, McGinn (2011) has proposed a new theory of disgust.  This theory makes empirical claims as to the history and function of disgust, yet does not take into account contemporary scientific research on the subject.  This essay evaluates his theory for its merits as an account of disgust, and as a piece of scholarship more generally, and finds it lacking.

Introduction

In disgust research, there is shit, and then there is bullshit.  McGinn's (2011) theory belongs to the latter category.

The entire article is here.  And yes, there is some humor here.

Thursday, December 26, 2013

Debating DSM-5: diagnosis and the sociology of critique

By Martyn Pickersgill
Journal of Medical Ethics
J Med Ethics doi:10.1136/medethics-2013-101762

Abstract

The development of the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders—the DSM-5—has reenergised and driven further forward critical discourse about the place and role of diagnosis in mental health. The DSM-5 has attracted considerable criticism, not least about its role in processes of medicalisation. This paper suggests the need for a sociology of psychiatric critique. Sociological analysis can help map fields of contention, and cast fresh light on the assumptions and nuances of debate around the DSM-5; it underscores the importance of diagnosis to the governance of social and clinical life, as well as the wider discourses critical commentaries connect with and are activated by. More normatively, a sociology of critique can indicate which interests and values are structuring the dialogues being articulated, and just how diverse clinical opinion regarding the DSM can actually be. This has implications for the considerations of health services and policy decision-makers who might look to such debates for guidance.

The entire article is here.

Friday, September 20, 2013

Response to Critics of The Moral Landscape

By Sam Harris
His Blog
January 29, 2011

Here are two excerpts:

The problem posed by public criticism is by no means limited to the question of what to do about misrepresentations of one’s work. There is simply no good forum in which to respond to reviews of any kind, no matter how substantive. To do so in a separate essay is to risk confusing readers with a litany of disconnected points or—worse—boring them to salt. And any author who rises to the defense of his own book is always in danger of looking petulant, vain, and ineffectual. There is a galling asymmetry at work here: to say anything at all in response to criticism is to risk doing one’s reputation further harm by appearing to care too much about it.

These strictures now weigh heavily on me, because I recently published a book, The Moral Landscape: How Science Can Determine Human Values, which has provoked a backlash in intellectual (and not-so-intellectual) circles. I knew this was coming, given my thesis, but this knowledge left me no better equipped to meet the cloudbursts of vitriol and confusion once they arrived. Watching the tide of opinion turn against me, it has been difficult to know what, if anything, to do about it.

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For those unfamiliar with my book, here is my argument in brief: Morality and values depend on the existence of conscious minds—and specifically on the fact that such minds can experience various forms of well-being and suffering in this universe. Conscious minds and their states are natural phenomena, of course, fully constrained by the laws of Nature (whatever these turn out to be in the end). Therefore, there must be right and wrong answers to questions of morality and values that potentially fall within the purview of science. On this view, some people and cultures will be right (to a greater or lesser degree), and some will be wrong, with respect to what they deem important in life.

The entire blog post is here.


Wednesday, August 21, 2013

The End of Neuro-Nonsense

Is the age of mindless brain research already over?

By Daniel Engber
Slate
Originally published July 29, 2013

Brain-bashing, once an idle pastime of the science commentariat, went mainstream in June. At the beginning of the month, Slate contributor Sally Satel and Scott O. Lilienfeld published Brainwashed: The Seductive Appeal of Mindless Neuroscience, a well-informed attack on the extravagances of “neurocentrist” thought. We’re living in dangerous era, they warn in the book’s introduction. “Naïve media, slick neuroentrepreneurs, and even an occasional overzealous neuroscientist exaggerate the capacity of scans to reveal the contents of our minds, exalt brain physiology as inherently the most valuable level of explanation for understanding behavior, and rush to apply underdeveloped, if dazzling, science for commercial and forensic use.” In the United Kingdom, the neuro-gadfly Raymond Tallis—whose own attack on popular brain science, Aping Mankind, came out in 2011—added to the early-summer beat-down, complaining in the Observer that “studies that locate irreducibly social phenomena … in the function or dysfunction of bits of our brains are conceptually misconceived.”

The entire story is here.

Thanks to Tamler Sommers for this story.

Monday, August 12, 2013

Lost in the Forest -DSM-V Book Review

By Ian Hacking
London Review of Books
Vol. 35 No. 15 · 8 August 2013
pages 7-8 | 3428 words

The new edition of the DSM replaces DSM-IV, which appeared in 1994. The DSM is the standard – and standardising – work of reference issued by the American Psychiatric Association, but its influence reaches into every nook and cranny of psychiatry, everywhere. Hence its publication has been greeted by a flurry of discussion, hype and hostility across all media, both traditional and social. Most of it has concerned individual diagnoses and the ways they have changed, or haven’t. To invoke the cliché for the first time in my life, most critics attended to the trees (the kinds of disorder recognised in the manual), but few thought about the wood. I want to talk about the object as a whole – about the wood – and will seldom mention particular diagnoses, except when I need an example.

Many worries have already been aired. In mid-May an onslaught was delivered by the Division of Clinical Psychology of the British Psychology Society, which is sceptical about the very project of standardised diagnosis, especially of schizophrenia and bipolar disorders. More generally, it opposes the biomedical model of mental illness, to the exclusion of social conditions and life-course events.

The entire book review is here.

Thanks to Tom Fink for this review.

Saturday, May 18, 2013

New Efforts to Overhaul Psychiatric Diagnoses Spurred by DSM Turmoil

By Greg Miller
Wired Science
Originally posted May 17, 2013

Thousands of psychiatrists will descend on San Francisco this weekend for a meeting that will mark the release of the latest edition of the profession’s diagnostic guide, the Diagnostic and Statistical Manual of Mental Disorders, or DSM for short. This hugely influential book has been 14 years in the making, and it’s been dogged by controversies every step of the way.

To name just a few, there have been allegations of financial conflicts of interest, debates over whether internet addiction is really a thing (it is not, but “disordered gambling” is), arguments that the new diagnostic criteria will medicalize normal grief and temper tantrums, and lead to millions of people being falsely diagnosed with mental disorders.

With the new manual on the eve of its official debut, many experts are already looking beyond it. Some envision a future in which psychiatric diagnoses are based on the underlying biological causes instead of a description of a patient’s symptoms. Others caution that such a single-minded focus on biology ignores important social factors that contribute to mental illness. If there’s any area of agreement it’s this: There has to be a better way.


The DSM is used by doctors to diagnose patients, by insurance companies to decide what treatments to pay for, and by pharmaceutical companies and government funding agencies to set research priorities. The new edition, DSM-5, defines hundreds of mental disorders.

The fundamental problem, according to many of DSM’s critics, is that these definitions don’t carve nature at its joints.

“An obvious, easy example is schizophrenia,” said Peter Kinderman, a clinical psychologist at the University of Liverpool. “If you’re a 52-year-old man who hears voices, you’ll receive a diagnosis of schizophrenia. If you’re a 27-year-old woman with delusional beliefs, you’ll also receive a diagnosis of schizophrenia,” Kinderman said. “Two people can receive the same diagnosis and not have a single thing in common. That’s ludicrous scientifically.”

In most areas of medicine, diagnoses are based on the cause of illness. Heartburn and heart attacks both cause chest pain, but they’re different diagnoses because they have different underlying causes.

The entire story is here.

Psychiatry’s Guide Is Out of Touch With Science, Experts Say

By PAM BELLUCK and BENEDICT CAREY
The New York Times
Published: May 6, 2013

Just weeks before the long-awaited publication of a new edition of the so-called bible of mental disorders, the federal government’s most prominent psychiatric expert has said the book suffers from a scientific “lack of validity.”

The expert, Dr. Thomas R. Insel, director of the National Institute of Mental Health, said in an interview Monday that his goal was to reshape the direction of psychiatric research to focus on biology, genetics and neuroscience so that scientists can define disorders by their causes, rather than their symptoms.

While the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., is the best tool now available for clinicians treating patients and should not be tossed out, he said, it does not reflect the complexity of many disorders, and its way of categorizing mental illnesses should not guide research.

“As long as the research community takes the D.S.M. to be a bible, we’ll never make progress,” Dr. Insel said, adding, “People think that everything has to match D.S.M. criteria, but you know what? Biology never read that book.”

The entire story is here.

Friday, May 3, 2013

Transforming Diagnosis

By Thomas Insel on April 29, 2013
NIMH Director’s Blog

In a few weeks, the American Psychiatric Association will release its new edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This volume will tweak several current diagnostic categories, from autism spectrum disorders to mood disorders. While many of these changes have been contentious, the final product involves mostly modest alterations of the previous edition, based on new insights emerging from research since 1990 when DSM-IV was published. Sometimes this research recommended new categories (e.g., mood dysregulation disorder) or that previous categories could be dropped (e.g., Asperger’s syndrome).

The goal of this new manual, as with all previous editions, is to provide a common language for describing psychopathology. While DSM has been described as a “Bible” for the field, it is, at best, a dictionary, creating a set of labels and defining each. The strength of each of the editions of DSM has been “reliability” – each edition has ensured that clinicians use the same terms in the same ways. The weakness is its lack of validity. Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, the DSM diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever. Indeed, symptom-based diagnosis, once common in other areas of medicine, has been largely replaced in the past half century as we have understood that symptoms alone rarely indicate the best choice of treatment.

Patients with mental disorders deserve better. NIMH has launched the Research Domain Criteria (RDoC) project to transform diagnosis by incorporating genetics, imaging, cognitive science, and other levels of information to lay the foundation for a new classification system.

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That is why NIMH will be re-orienting its research away from DSM categories. Going forward, we will be supporting research projects that look across current categories – or sub-divide current categories – to begin to develop a better system.

The entire blog post is here.

Editorial note: The NIMH will no longer use DSM-5 diagnostic criteria.  There have also been numerous criticisms related to DSM-5.  And, given that HIPAA requires ICD diagnostic codes for billing, is there a reason for psychologists to purchase a DSM-5?

Ethical and practical implications of financial conflicts of interest in the DSM-5

By Lisa Cosgrove and Emily Wheeler
doi: 10.1177/0959353512467972
Feminism Psychology
February 2013 vol. 23 no. 1 93-106

Abstract

The revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM), scheduled for publication in May 2013 by the American Psychiatric Association (APA), has created a firestorm of controversy because of questions about undue industry influence. Specifically, concerns have been raised about financial conflicts of interest between DSM-5 panel members and the pharmaceutical industry. The authors argue that current approaches to the management of these relationships, particularly transparency of them, are insufficient solutions to the problem of industry’s capture of organized psychiatry. The conceptual framework of institutional corruption is used to understand psychiatry’s dependence on the pharmaceutical industry and to identify the epistemic assumptions that ground the DSM’s biopsychiatric discourse. APA’s rationale for including premenstrual dysphoric disorder in the DSM-5 as a Mood Disorder is reviewed and discussed.

Thanks to Ken Pope for sharing this abstract.

Wednesday, May 16, 2012

Diagnosing the D.S.M.

By Allen Frances
The New York Times - Opinion
Originally published May 11, 2012

At its annual meeting this week, the American Psychiatric Association did two wonderful things: it rejected one reckless proposal that would have exposed nonpsychotic children to unnecessary and dangerous antipsychotic medication and another that would have turned the existential worries and sadness of everyday life into an alleged mental disorder.

But the association is still proceeding with other suggestions that could potentially expand the boundaries of psychiatry to define as mentally ill tens of millions of people now considered normal. The proposals are part of a major undertaking: revisions to what is often called the “bible of psychiatry” — the Diagnostic and Statistical Manual of Mental Disorders, or D.S.M. The fifth edition of the manual is scheduled for publication next May.

I was heavily involved in the third and fourth editions of the manual but have reluctantly concluded that the association should lose its nearly century-old monopoly on defining mental illness. Times have changed, the role of psychiatric diagnosis has changed, and the association has changed. It is no longer capable of being sole fiduciary of a task that has become so consequential to public health and public policy.

The entire story is here.

Monday, May 14, 2012

Psychiatry Manual Drafters Back Down on Diagnoses

By Benedict Carey
The New York Times - Health
Originally published May 8, 2012

In a rare step, doctors on a panel revising psychiatry’s influential diagnostic manual have backed away from two controversial proposals that would have expanded the number of people identified as having psychotic or depressive disorders.

The doctors dropped two diagnoses that they ultimately concluded were not supported by the evidence: “attenuated psychosis syndrome,” proposed to identify people at risk of developing psychosis, and “mixed anxiety depressive disorder,” a hybrid of the two mood problems.

They also tweaked their proposed definition of depression to allay fears that the normal sadness people experience after the loss of a loved one, a job or a marriage would not be mistaken for a mental disorder.

But the panel, appointed by the American Psychiatric Association to complete the fifth edition of its Diagnostic and Statistical Manual of Mental Disorders, or D.S.M., did not retreat from another widely criticized proposal, to streamline the definition of autism.

Autism Criteria Critics Blasted by DSM-5 Leader

By John Gever, Senior Editor
MedPage Today
Origianlly Published May 8, 2012

The head of the American Psychiatric Association committee rewriting the diagnostic criteria for autism spectrum disorders took on the panel's critics here, accusing them of bad science.

Susan Swedo, MD, of the National Institute of Mental Health, said a review released earlier this year by Yale University researchers was seriously flawed. That review triggered a wave of headlines indicating that large numbers of autism spectrum patients could lose their diagnoses and hence access to services.

Swedo spoke at the American Psychiatric Association's (APA) annual meeting, in her role as chairperson of the work group developing new diagnostic criteria for neurodevelopmental disorders in DSM-5, the forthcoming fifth edition of the APA's Diagnostic and Statistical Manual of Mental Disorders.

She was especially incensed by reports in consumer media about the Yale group's study, led by a New York Times article with a "blaring" headline that read, "New Definition of Autism May Exclude Many, Study Suggests." The Yale study, according to the Times article, found that most patients with Asperger's syndrome and about 25% of those with overt autism would not qualify for those diagnoses under DSM-5.

Sunday, March 25, 2012

My Third Letter to the APA Trustees

A Poor Quality DSM-5 in Unacceptable

By Allen Frances, MD

DSM-5 press coverage has suddenly exploded—more than 100 stories from all around the world were published in just the last three weeks (see title and links below). The press is uniformly negative and extremely damaging to DSM-5, to APA, and to the credibility of psychiatry.

The APA responses have been few, unconvincing, and lacking in substance. Also troubling, 47 mental health organizations have expressed their opposition to DSM-5 by endorsing a petition requesting it to have a scientific review independent of APA. And many users are planning to boycott DSM-5 altogether by substituting ICD-10-CM (which will be freely available on the internet). It is fair to say that DSM-5 has become an object of general public and professional scorn.

What would Mel Sabshin be doing in this time of crisis? Of course, Mel never would have allowed APA to get into this mess—but once in any crisis he was an expert in damage control. Were he here today, Mel would certainly recommend that you immediately cut the DSM-5 losses to prevent its inflicting further damage on APA, on psychiatry, and most importantly on our patients.


Sunday, March 11, 2012

DSM-5 Critics Pump Up the Volume

By John Gever, Senior Editor, MedPage Today
Published: February 29, 2012

With crunch time looming for the ongoing revision of the psychiatry profession's diagnostic manual, critics hoping to stop what they see as destructive changes are taking their campaign to the consumer media.

In early February, British psychologists and psychiatrists unhappy with proposed changes in the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders -- the DSM-5, in its forthcoming incarnation -- staged a successful press conference in London, which generated news coverage around the world.

Meanwhile, the most prominent U.S.-based critic of DSM-5, Allen Frances, MD -- chairman of the task force that developed the fourth DSM edition in 1994 -- has become a regular contributor to the popular Huffington Post website. Last week, he suggested there that the government should force the APA to abandon some of the proposed changes.

And the explosion in social media has allowed other, less well-connected mental health professionals and interested laypeople to create their own platforms for airing concerns about DSM-5 -- starting websites and writing comments on others.

At least in part, the rising furor is driven by the DSM-5 revision schedule. The APA has committed to releasing the final version at its May 2013 meeting. Its internal process for ratifying it requires that it be in essentially final form this winter.

Thus, only a few months remain for critics to sway the DSM-5 leadership.

Thursday, February 16, 2012

Diagnosis of a DSM 5 News Cycle

By John Grohol
World of Psychology

As I was sitting around catching up on some mental health news on Saturday, I inadvertently stumbled upon another manufactured news cycle about the DSM 5. Considering no new significant research findings were released in the past week on the DSM-5 revision efforts, I was a little surprised.

This latest fake news cycle started on Thursday, apparently with the release of a Reuters news story from Kate Kelland. Kelland notes the newest concern comes from “Liverpool University’s Institute of Psychology at a briefing in London about widespread concerns over the manual.” There’s no link to the briefing. And I’m not sure what a “briefing” is — a press conference? (And since when is a press conference a news item? It’s not really equivalent to a new research study, is it?)

Kelland fails to note that Europe and the U.K. don’t actually use the DSM to diagnose mental disorders — it’s a U.S. reference manual for mental disorders diagnosis. So while it’s nice that some Europeans are expressing concern about this reference text, their concern isn’t exactly much relevant. Context is everything, and Reuters failed to provide any useful context in that article.

Sadly, Reuters is a brand name. And once you write an article under that brand name, it cascades down an entire news cycle. Let’s follow it for fun!


New Mental Health Manual is "dangerous" say Experts

By Kate Kelland
Health and Science Correspondence
Reuters

Millions of healthy people - including shy or defiant children, grieving relatives and people with fetishes - may be wrongly labeled mentally ill by a new international diagnostic manual, specialists said on Thursday.

In a damning analysis of an upcoming revision of the influential Diagnostic and Statistical Manual of Mental Disorders (DSM), psychologists, psychiatrists and other experts said new categories of mental illness identified in the book were at best "silly" and at worst "worrying and dangerous."

"Many people who are shy, bereaved, eccentric, or have unconventional romantic lives will suddenly find themselves labeled as mentally ill," said Peter Kinderman, head of Liverpool University's Institute of Psychology at a briefing in London about widespread concerns over the manual.

"It's not humane, it's not scientific, and it won't help decide what help a person needs."

The DSM is published by the American Psychiatric Association (APA) and has symptoms and other criteria for diagnosing mental disorders. It is used internationally and seen as the diagnostic "bible" for mental health medicine.
No one from the APA was immediately available for comment.

More than 11,000 health professionals have already signed a petition (at dsm5-reform.com) calling for the development of the fifth edition of the manual to be halted and re-thought.
Some diagnoses - for conditions like "oppositional defiant disorder" and "apathy syndrome" - risk devaluing the seriousness of mental illness and medical zing behaviors most people would consider normal or just mildly eccentric, the experts said.

At the other end of the spectrum, the new DSM, due out next year, could give medical diagnoses for serial rapists and sex abusers - under labels like "paraphilic coercive disorder" - and may allow offenders to escape prison by providing what could be seen as an excuse for their behavior, they added.

The entire story is here.