With Sobering Science, Doctor Debunks 12-Step Recovery

Interview with Lance Dodes

NPR

Originally posted March 23, 2014

Here is an excerpt:

There is a large body of evidence now looking at AA success rate, and the success rate of AA is between 5 and 10 percent. Most people don't seem to know that because it's not widely publicized. ... There are some studies that have claimed to show scientifically that AA is useful. These studies are riddled with scientific errors and they say no more than what we knew to begin with, which is that AA has probably the worst success rate in all of medicine.

It's not only that AA has a 5 to 10 percent success rate; if it was successful and was neutral the rest of the time, we'd say OK. But it's harmful to the 90 percent who don't do well. And it's harmful for several important reasons. One of them is that everyone believes that AA is the right treatment. AA is never wrong, according to AA. If you fail in AA, it's you that's failed.

The entire interview is here.

Religious upbringing associated with less altruism, study finds

By Susie Allen
University of Chicago News
Originally released November 5, 2015

Here is an excerpt:

Consistent with previous studies, in general the children were more likely to share as they got older. But children from households identifying as Christian and Muslim were significantly less likely than children from non-religious households to share their stickers. The negative relation between religiosity and altruism grew stronger with age; children with a longer experience of religion in the household were the least likely to share.

Children from religious households favored stronger punishments for anti-social behavior and judged such behavior more harshly than non-religious children. These results support previous studies of adults, which have found religiousness is linked with punitive attitudes toward interpersonal offenses.

The entire article is here. 

The Power of Nudges, for Good and Bad

By Richard Thaler
The New York Times - The Upshot
Originally published October 31, 2015

Here are two excerpts:

Whenever I’m asked to autograph a copy of “Nudge,” the book I wrote with Cass Sunstein, the Harvard law professor, I sign it, “Nudge for good.” Unfortunately, that is meant as a plea, not an expectation.

Three principles should guide the use of nudges:

■ All nudging should be transparent and never misleading.

■ It should be as easy as possible to opt out of the nudge, preferably with as little as one mouse click.

■ There should be good reason to believe that the behavior being encouraged will improve the welfare of those being nudged.

(cut)

Some argue that phishing — or evil nudging — is more dangerous in government than in the private sector. The argument is that government is a monopoly with coercive power, while we have more choice in the private sector over which newspapers we read and which airlines we fly.

I think this distinction is overstated. In a democracy, if a government creates bad policies, it can be voted out of office. Competition in the private sector, however, can easily work to encourage phishing rather than stifle it.

One example is the mortgage industry in the early 2000s. Borrowers were encouraged to take out loans that they could not repay when real estate prices fell. Competition did not eliminate this practice, because it was hard for anyone to make money selling the advice “Don’t take that loan.”

The entire article is here.

Doctors, Patients, and Nudging in the Clinical Context-Four Views on Nudging and Informed Consent

Ploug T and Holm S
Am J Bioeth. 2015 Oct;15(10):28-38.

Abstract

In an analysis of recent work on nudging we distinguish three positions on the relationship between nudging founded in libertarian paternalism and the protection of personal autonomy through informed consent. We argue that all three positions fail to provide adequate protection of personal autonomy in the clinical context. Acknowledging that nudging may be beneficial, we suggest a fourth position according to which nudging and informed consent are valuable in different domains of interaction.

The entire article is here.

Two Psychologists Charged in $25.2 Million Fraud Scheme Involving Psychological Testing in Gulf Coast States

FBI Press Release
Originally released October 22, 2015

Two clinical psychologists were charged today with participating in a $25 million Medicare fraud scheme involving psychological testing in nursing homes in Gulf Coast states.

Assistant Attorney General Leslie R. Caldwell of the Justice Department’s Criminal Division, U.S. Attorney Kenneth A. Polite of the Eastern District of Louisiana, Special Agent in Charge Michael J. Anderson of the FBI’s New Orleans Field Office and Special Agent in Charge C.J. Porter of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Dallas Regional Office made the announcement.

Beverly Stubblefield, Ph.D., 62, of Slidell, Louisiana, and John Teal, Ph.D., 46, of Jackson, Mississippi, were charged by a superseding indictment with conspiracy to commit health care fraud and conspiracy to make false statements related to health care matters. Two other defendants, Rodney Hesson, Psy.D., 46, and Gertrude Parker, 62, both of Slidell, were charged in the initial indictment returned in June 2015 in connection with a large-scale Medicare Fraud takedown, and were also charged in today’s superseding indictment.

According to the superseding indictment, Hesson and Parker owned and controlled Nursing Home Psychological Service (NHPS) and Psychological Care Services (PCS), each of which operated in Louisiana, Mississippi, Florida and Alabama. The superseding indictment alleges that NHPS and PCS contracted with nursing homes in these states to allow NHPS and PCS clinical psychologists, including Stubblefield, Teal and Hesson, to administer to nursing home residents psychological tests and related services that were not necessary and, in some instances, never provided.

According to the superseding indictment, between 2009 and 2015, NHPS and PCS submitted more than $25.2 million in claims to Medicare. Medicare paid approximately $17 million on those claims.

The entire pressor is here.

Believing What You Don’t Believe

By Jane L. Risen and David Nussbaum
The New York Times - Gray Matter
Originally published October 30, 2015

Here is an excerpt:

But as one of us, Professor Risen, discusses in a paper just published in Psychological Review, many instances of superstition and magical thinking indicate that the slow system doesn’t always behave this way. When people pause to reflect on the fact that their superstitious intuitions are irrational, the slow system, which is supposed to fix things, very often doesn’t do so. People can simultaneously recognize that, rationally, their superstitious belief is impossible, but persist in their belief, and their behavior, regardless. Detecting an error does not necessarily lead people to correct it.

This cognitive quirk is particularly easy to identify in the context of superstition, but it isn’t restricted to it. If, for example, the manager of a baseball team calls for an ill-advised sacrifice bunt, it is easy to assume that he doesn’t know that the odds indicate his strategy is likely to cost his team runs. But the manager may have all the right information; he may just choose not to use it, based on his intuition in that specific situation.

The entire article is here.

Believing What We Do Not Believe: Acquiescence to Superstitious Beliefs and Other Powerful Intuitions

By Risen, Jane L.
Psychological Review, Oct 19 , 2015

Abstract

Traditionally, research on superstition and magical thinking has focused on people’s cognitive shortcomings, but superstitions are not limited to individuals with mental deficits. Even smart, educated, emotionally stable adults have superstitions that are not rational. Dual process models—such as the corrective model advocated by Kahneman and Frederick (2002, 2005), which suggests that System 1 generates intuitive answers that may or may not be corrected by System 2—are useful for illustrating why superstitious thinking is widespread, why particular beliefs arise, and why they are maintained even though they are not true. However, to understand why superstitious beliefs are maintained even when people know they are not true requires that the model be refined. It must allow for the possibility that people can recognize—in the moment—that their belief does not make sense, but act on it nevertheless. People can detect an error, but choose not to correct it, a process I refer to as acquiescence. The first part of the article will use a dual process model to understand the psychology underlying magical thinking, highlighting features of System 1 that generate magical intuitions and features of the person or situation that prompt System 2 to correct them. The second part of the article will suggest that we can improve the model by decoupling the detection of errors from their correction and recognizing acquiescence as a possible System 2 response. I suggest that refining the theory will prove useful for understanding phenomena outside of the context of magical thinking.

The article is here.

Morality takes two: Dyadic morality and mind perception.

Gray, Kurt; Wegner, Daniel M.
Mikulincer, Mario (Ed); Shaver, Phillip R. (Ed), (2012). The social psychology of morality: Exploring the causes of good and evil. Herzliya series on personality and social psychology., (pp. 109-127). Washington, DC, US: American Psychological Association

Abstract

We propose that all moral acts are (at least implicitly) dyadic, involving two different people, one as a moral agent and one as a moral patient. The idea that people cleave the moral world into agents and patients is as old as Aristotle (Freeland, 1985), but out of this simple claim—that morality takes two—grows a theory of morality with a host of implications for psychology and the real world. Dyadic morality can help explain, for instance, why victims escape blame, why people believe in God, why people harm saints, why some advocate torture, and why those who do good become more physically powerful. In this chapter, we explore the idea of dyadic morality, its extensions and implications. In particular, we examine the following four tenets of dyadic morality: 1. Morality involves a moral agent helping or harming a moral patient. 2. Morality and mind perception are linked: Agency is tied to moral agents; experience is tied to moral patients. 3. Morality requires a complete dyad: An isolated moral agent creates a moral patient; an isolated moral patient creates a moral agent. 4. Morality requires two different people as agent and patient, which means that people are perceived as either agents or patients, both in moral acts and more generally, a phenomenon called moral typecasting. We first explore the link between mind and morality, then examine dyadic help and harm, then explain how moral dyads complete themselves, and finally consider moral typecasting. Why start first with mind perception? Perceptions of mind are tightly bound to moral judgments, and as we show, the structure of mind perception is split into two complementary parts that correspond to the two parts of morality. Perceptions of mind underlie the most fundamental of moral decisions: who deserves moral rights and who deserves moral responsibility.

A copy of the chapter is here.

The Strange Case of Anna Stubblefield

By Daniel Engber
The New York Times Magazine
Originally published October 20, 2015

Here are two excerpts:

Then there was a lull in the conversation after Wesley came back in, and Anna took hold of D.J.’s hand. ‘‘We have something to tell you,’’ they announced at last. ‘‘We’re in love.’’

‘‘What do you mean, in love?’’ P. asked, the color draining from her face.

To Wesley, she looked pale and weak, like ‘‘Caesar when he found out that Brutus betrayed him.’’ He felt sick to his stomach. What made them so uncomfortable was not that Anna was 41 and D.J. was 30, or that Anna is white and D.J. is black, or even that Anna was married with two children while D.J. had never dated anyone. What made them so upset — what led to all the arguing that followed, and the criminal trial and million-­dollar civil suit — was the fact that Anna can speak and D.J. can’t; that she was a tenured professor of ethics at Rutgers University in Newark and D.J. has been declared by the state to have the mental capacity of a toddler.

(cut)

Sitting at the keyboard, D.J. also seemed to have a lot to say. His messages were simple and misspelled at first, but his skill and fluency improved. Eventually he could hit a letter every second, and if Anna guessed the word before he finished typing, he would hit the ‘‘Y’’ key to confirm. Anna brought books for him to read, Maya Angelou and others, and discovered that he read like a savant — 10 pages every minute. (She turned the pages for him.) They discussed the possibility of his enrolling in a G.E.D. program.

As D.J. came into his own, Anna kept her mother posted on his progress. In the spring of 2010, Sandra asked if D.J. might like to give a paper for a panel she was organizing at a conference of the Society for Disability Studies in Philadelphia. The panel was on Article 21 of the United Nations Convention on the Rights of Persons With Disabilities, which lays out the right to freedom of expression and opinion. D.J. wasn’t sure he could do it, Anna said, but she convinced him he should try.

The entire article is here.

Note to readers: The article is long, detailed and (from my perspective) creepy. This case appears to demonstrate where compassion and personal values override good judgment, research, and professional responsibilities.