Slate Star Codex

Less [adjective] than Zeus

Confounder Of The Day: How Sexy Your Parents Were

One of the more interesting mental health results is the differing prevalence of psychiatric disorders depending on the age of the patient’s parents. This month’s JAMA Psychiatry includes a study from Denmark that conducts one of of the largest and most rigorous analyses of this effect and finds that a whole host of psychiatric diseases are more common in people born of young mothers and old fathers.

The young mother effect should be pretty straightforward. Poor women are more likely to have children at a younger age and some psychiatric diseases are more common among the poor. Women with psychiatric disorders can be more impulsive, which results in more unprotected sex and teenage pregnancy and hence children at a younger age; the children then inherit these genes and get psychiatric disorders of their own. No surprises here.

The old father effect has a potentially more interesting explanation. The male reproductive system, unlike the female reproductive system, produces gametes throughout the reproductive lifetime. Presumably older people have more time for mutations to accumulate. Some of these mutations are random, the result of passing cosmic rays or environmental toxins. Others are theorized to be a result of sex cells undergoing “selfish spermatogonal selection”, a hypothesized sorta-cancer-like process in which some sperm progenitor cells develop “selfish” mutations that increase their relative prevalence in the testes at the cost of the quality of sperm they produce – greater paternal age provides more time for this process to happen. The children of older fathers therefore end up with a higher mutational load and more likelihood of mental disorders – not to mention a host of other issues like lower IQ, less physical ability, decreased health, et cetera. It’s very plausible and according to the Danish study the child of a 45 year old father is 1.5x more likely to develop schizophrenia and 1.8x more likely to develop autism compared to the child of a 25 year old father – not a subtle effect!

But the JAMA Psychiatry study references another study, this one really clever, that casts doubt upon this finding. Petersen et al, also from Denmark (which keeps really good track of its mental health and so hosts a disproportionate number of epidemiological psych studies) proposes a much more prosaic explanation.

They find that the mental health of a child depends less on how old her father was when she was born than on how old her father was when he had his first child. In fact, after adjusting for the former effect, the latter completely disappears! For example, if Bob had Child 1 at age 20 and Child 2 at age 40, and Dan had Child 1 at age 39 and Child 2 at age 40, Dan’s second child is at higher risk for mental disorders than Bob’s, even though they both have fathers of the same age – and Bob’s younger child is at no higher risk of disorders than his eldest.

Petersen et al don’t do a great job of coming out and saying it, but I think they hypothesize that the impairments associated with mental disorders – or just the poorly functioning genes that put someone at risk for mental disorders – make it harder for a man to find a partner and start having kids. To be crass about it, if a man has dysfunctional tendencies his value on the marriage market goes down and he’s got to wait longer before he finds people willing to have children with him.

This is sad on a general level. It suggests that guys suffering from mental disorders are unlucky in love in the same way they’re probably unlucky in a lot of other things. And it means society loses what could have been a useful piece of advice for cutting psychiatric disease.

But it’s nice and liberating on a personal level. Here I am at thirty years old, unmarried, childless, and there is no way I am going to try to have kids for the next four years while I’m doing my residency. There are a couple of people in my class right now having babies – women, in fact! – and the idea of doing two of the most stressful and time-consuming things you can go through simultaneously makes my head spin. Now I get to feel a little less guilty about waiting.

Someone Writes An Anti-Racist FAQ

The Anti-Racialist Q&A – inspired by my own Anti-Reactionary FAQ and written by blogger The Prussian on SkepticInk – is an astounding essay.

It’s astounding because it is a piece of writing about race that is so good that I actually have specific criticisms of it. I didn’t even realize how strange this was until about my tenth nitpick, when I noticed that I was nitpicking individual arguments instead of shouting at my computer “WHY ARE YOU SO STUPID?! WHY?! WHY?!”

It’s astounding because I have no idea what the author’s political leanings are even though he seems to go through great trouble to explain them. One minute he will seem like a raging leftist, the next he will be talking about how racism is just as stupid as global warming alarmism. Or talking about how racism keeps people of all skin colors from uniting in brotherhood against the real enemy, Muslims.

It’s astounding because I think it was meant to actually convince people. It’s written in a style of “I can see where you’re coming from, but have you considered X?” I thought I was the only person who had figured out that this worked better than “YOU ARE DUMB AND I HATE YOU. NOW PLEASE AGREE WITH ME.”

But I think the most astounding part is that it might be one of the first things I’ve ever read to argue against racism (NO GOULD AND LEWONTIN DON’T COUNT).

I mean, I’ve read a lot of articles condemning racism, and accusing people of racism, and being very upset about the racism inherent in society. But this might be the first one I’ve ever read to argue against it.

That is worthy of note. It is the exact opposite of the attitude in Cowpox of Doubt, like someone who says “Homeopathy? I guess the responsible thing to do is to read dozens of studies before I form an opinion on it”. This may not be a very practical philosophy or a good way to win friends, but it’s an impressive signal of epistemic virtue if nothing else.

I won’t say the FAQ gets everything right – just for one example, if I’d written it I would have dropped the whole “race doesn’t exist” thing as too complicated a question to be worth debating without a longer diversion into philosophy than most people would be willing to entertain.

But it’s pretty good for a first attempt at the genre.

Prussian deserves more traffic for having written something so ambitious, and I don’t have the energy to enforce the censorship I would need for a good comments thread about race, so please take your comments on his Q&A there, not here.

Do You Believe Me, Doc?

[Content warning: psychiatrists having ethically complicated conversations with patients]

I recently attended the Michigan Psychiatric Society conference. It was all downhill after I heard the name of the first poster presentation. The study – investigating the tendency of anti-Parkinsons medication Requip® to cause nightmares as a side effect – was titled “Requip For A Dream”. I didn’t stay long enough to see whether that won the poster contest, but if it didn’t there is no God.

But I also attended a couple of forums and Q&A sessions, and in one of them a doctor asked the question:

“What do I say when one of my psychotic patients – who is telling me how he is Jesus, or is being pursued by the FBI, or something like that – glares at me and asks ‘You don’t believe me, do you?’”

The lecturer, who was a very prestigious psychiatrist of some sort, said that his standard response was “I believe that what you are seeing and experiencing is real to you.”

This is the sort of nice, pat answer I would expect from a clever and prestigious psychiatrist. It ticks all the boxes. It is kind and compassionate. It doesn’t technically lie. It doesn’t validate the patient’s delusions. And it acknowledges the patient’s emotions without being dismissive or confrontational.

On the other hand, if I was that patient it would enrage me.

Let me distinguish this from a very very similar concept where I think this answer is exactly correct. Suppose someone is having hallucinations, like believing there are spiders crawling all over him. He asks “You don’t believe me, do you?” I think the exactly correct answer is to say “I one hundred percent believe that you are experiencing spiders crawling all over you, that their appearance and features are extremely convincing, and that you’re not making this up. But there are not real spiders on you.”

And if you responded to the guy who thought he was Jesus with “I one hundred percent believe you are feeling a strong, almost irresistible urge to believe you are Jesus. But I don’t think you are actually him,” that would remove most of the creepiness for me (I also don’t think it would be very popular with patients).

But somehow this guy’s phrasing pressed my buttons. It wasn’t just that he wasn’t answering the question. It was that he was denying that the question was the sort of thing that needed to be answered, denying that there was a real fact-of-the-matter about Jesus at all, or denying that it was worth worrying about.

But if you’re worried you’re psychotic, that’s probably the most important question to you. The reason this came up at a big conference is that it’s a really common question. Psychotic people ask it a lot. If you’re psychotic, then the fact that you believe these strange things no one else believes has become one of the central things in your life. And to you it’s less important that the person be Validating And Accepting than that you settle this problem that is tearing your life apart.

And this answer isn’t even subtle about what it’s doing. It’s like “Obviously I don’t believe you, but I’m going to avoid saying so in so many words, and I bet you won’t even notice or care. You’ll just be grateful I’m acknowledging you at all”. It’s condescending, is what it is.

I’m not psychotic (I think). And I’m probably more concerned with there being a Real-World-With-Truth-Values than the average person. So maybe the prestigious expert is, as is often the case with prestigious experts, right. But I really don’t want to follow his advice. It would leave too bad a taste in my mouth.

I haven’t decided what I am going to say in its place. But in a perfect world, where I get exactly the right patient, the response I would really like to give is: “If you were me, would you believe it?”

I think, in this fantasy, if I picked the right patient they would laugh and say “Nope!”. Because psychotic people are smarter than they are usually given credit for, and also usually have good senses of humor, and at least we would both establish where we stood in a non-confrontational way.

And it’s always interesting how often deluded people know in the back of their head that their delusions are wrong, or at least questionable. Like I can just ask people “I’m here to do a psychiatric evaluation of you. Do you have any strange beliefs I should know about?” and they’ll say “Well, I believe I’m being pursued by the FBI.” I ask “Are you being pursued by the FBI?” They say “Yeah.” I asked once, because I was very curious and making things up as I went along, “Then why did you bring it up so quickly when I said I was a psychiatrist looking for symptoms of mental disease?”

My patient didn’t have a good answer for that. I didn’t get the impression it was some very logical “Well, I realize statistically most people who think they’re pursued by the FBI are psychotic, so I’ll just mention it, even though I personally am not.” It seemed more like another example of people, whether psychotic or not, being kind of garage-dragon-y.

This brings me to the other question I get from people a lot, which is “Do you think I’m crazy?” I think the Officially Correct Answer here is to say “Of course not”, which isn’t very convincing precisely because it’s obviously the Officially Correct Answer psychiatrists give to everyone. Even worse (but surprisingly common) is “Crazy isn’t a technical term”. Thanks. I’m sure that must be very reassuring.

Again, a fantasy answer I would like to give if I have exactly the right patient is “If you’re asking that question, don’t worry.” Which I think is sort of true. If you’re in a psychiatric hospital, and your conclusion is that maybe this means you might be crazy, you have some pretty good reality-based thinking going on. If you’re in a psychiatric hospital, and your conclusion is that maybe this means the FBI has found out you’re Jesus and is trying to stop you, that’s the guy who’s in trouble.

And again I worry that I might be getting too clever. Probably some of these patients aren’t very smart, or aren’t very cynical, and a simple “No, of course not” would be reassuring in a way a weird self-referential answer wouldn’t. So far I have just given some version of the simple answer. But when there’s someone I know well, and who’s especially jaded, and I doubt the simple answer would go over well, I really want to try something less cliched and more honest.

But even that’s not the answer I fantasize about giving later on, when I have my own practice and patients whom I’ve known for years and I can pick out the ones who are a lot like I was when I was younger and seeing a psychiatrist. For them the answer will be “Yes, of course. So am I. So is everyone. The interesting question isn’t whether you’re crazy, it’s whether you function anyway. Let’s try to work on that.”

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The Cowpox of Doubt

I remember hearing someone I know try to explain rationality to his friends.

He started with “It’s important to have correct beliefs. You might think this is obvious, but think about creationists and homeopaths and people who think the moon landing was a hoax.” And then further on in this vein.

And I thought: “NO NO NO NO NO NO NO!”

I will make a confession. Every time someone talks about the stupidity of creationists, moon-hoaxers, and homeopaths, I cringe.

It’s not that moon-hoaxers, homeopaths et al aren’t dumb. They are. It’s not even that these people don’t do real harm. They do.

(although probably less than people think; people rarely stop conventional treatment in favor of homeopathy, and both a popular website and a review article have a really hard time finding more than a handful of people genuinely harmed by it. Moon hoaxes seem even less dangerous, unless of course you are standing near Buzz Aldrin when you talk about them.)

What annoys me about the people who harp on moon-hoaxing and homeopathy – without any interest in the rest of medicine or space history – is that it seems like an attempt to Other irrationality.

(yes, I did just use “other” as a verb. Maybe I’ve been hanging around Continental types too much lately.)

It’s saying “Look, over here! It’s irrational people, believing things that we can instantly dismiss as dumb. Things we feel no temptation, not one bit, to believe. It must be that they are defective and we are rational.”

But to me, the rationality movement is about Self-ing irrationality.

(yes, I did just use “self” as a verb. I don’t even have the excuse of it being part of a philosophical tradition)

It is about realizing that you, yes you, might be wrong about the things that you’re most certain of, and nothing can save you except maybe extreme epistemic paranoia.

Talking about moon-hoaxers and homeopaths too much, at least the way we do it, is counterproductive to this goal. Throw examples of obviously stupid false beliefs at someone, and they start thinking all false beliefs are obvious. Give too many examples of false beliefs that aren’t tempting to them, and they start believing they’re immune to temptation.

And it raises sloppiness to a virtue.

Take homeopathy. I can’t even count the number of times I’ve heard people say: “Homeopaths don’t realize beliefs require evidence. No study anywhere has ever found homeopathy to be effective!”

But of course dozens of studies have found homeopathy to be effective.

“Well, sure, but they weren’t double-blind! What you don’t realize is that there can be placebo effects from…”

But of course many of these studies have been large double-blinded randomized controlled trials, or even meta-analyses of such.

“Okay, but not published in reputable journals.”

Is The Lancet reputable enough for you?

“But homeopaths don’t even realize that many of their concoctions don’t contain even a single molecule of active substance!”

But of course almost all homeopaths realize this and their proposed mechanism for homeopathic effects not only survives this criticism but relies upon it.

“But all doctors and biologists agree that homeopathy doesn’t work!”

Have you ever spent the five seconds it would take to look up a survey of what percent of doctors and biologists believe homeopathy doesn’t work? Or are you just assuming that’s true because someone on your side told you so and it seems right?

I am of course being mean here. Being open-minded to homeopaths – reading all the research carefully, seeking out their own writings so you don’t accidentally straw-man them, double-checking all of your seemingly “obvious” assumptions – would be a waste of your time.

And someone who demands that you be open-minded about homeopathy would not be your friend. They would probably be a shill for homeopathy and best ignored.

But this is exactly the problem!

The more we concentrate on homeopathy, and moon hoaxes, and creationism – the more people who have never felt any temptation towards these beliefs go through the motions of “debunk”-ing them a hundred times to one another for fun – the more we are driving home the message that these are a representative sample of the kinds of problems we face.

And the more we do that, the more we are training people to make the correct approach to homeopathy – ignoring poor research and straw men on your own side while being very suspicious of anyone who tells us to be careful – their standard approach to any controversy.

And then we get people believing all sorts of shoddy research – because after all, the world is divided between things like homeopathy that Have Never Been Supported By Any Evidence Ever, and things like conventional medicine that Have Studies In Real Journals And Are Pushed By Real Scientists.

Or losing all subtlety and moderation in their political beliefs, never questioning their own side’s claims, because the world is divided between People Like Me Who Know The Right Answer, and Shills For The Other Side Who Tell Me To Be Open-Minded As Part Of A Trap.

This post was partly inspired by Gruntled and Hinged’s You Probably Don’t Want Peer-Reviewed Evidence For God (actually, I started writing it before that was published – but since Bem has published evidence showing psi exists, I must have just been precognitively inspired by it). But there’s another G&H post that retrocausally got me thinking even more.

Inoculation is when you use a weak pathogen like cowpox to build immunity against a stronger pathogen like smallpox. The inoculation effect in psychology is when a person, upon being presented with several weak arguments against a proposition, becomes immune to stronger arguments against the same position.

Tell a religious person that Christianity is false because Jesus is just a blatant ripoff of the warrior-god Mithras and they’ll open up a Near Eastern history book, notice that’s not true at all, and then be that much more skeptical of the next argument against their faith. “Oh, atheists. Those are those people who think stupid things like Jesus = Mithras. I already figured out they’re not worth taking seriously.” Except on a deeper level that precedes and is immune to conscious thought.

So we take the intelligent Internet-reading public, and we throw a bunch of incredibly dumb theories at them – moon-hoaxism, homeopathy, creationism, anti-vaxxing, lizard people, that one guy who thought the rapture would come a couple years ago, whatever. And they are easily debunked, and the stuff you and all your friends believed was obviously true is, in fact, obviously true, and any time you spent investigating whether you were wrong is time you wasted.

And I worry that we are vaccinating people against reading the research for themselves instead of trusting smarmy bloggers who talk about how stupid the other side is.

That we are vaccinating people against thinking there might be important truths on both sides of an issue.

That we are vaccinating people against understanding how “scientific evidence” is a really complicated concept, and that many things that are in peer-reviewed journals will later turn out to be wrong.

That we are vaccinating people against the idea that many theories they find absurd or repugnant at first will later turn out to be true, because nature doesn’t respect our feelings.

That we are vaccinating people against doubt.

And maybe this is partly good. It’s probably a good idea to trust your doctor and also a good idea to trust your climatologist, and rare is the field where I would feel comfortable challenging expert consensus completely.

But there’s also this problem of hundreds of different religions and political ideologies, and most people are born into ones that are at least somewhat wrong. That makes this capacity for real doubt – doubting something even though all your family and friends is telling you it’s obviously true and you must be an idiot to question it at all – a tremendously important skill. It’s especially important for the couple of rare individuals who will be in a position to cause a paradigm shift in a science by doubting one of its fundamental assumptions.

I don’t think that reading about lizard people or creationism will affect people’s ability to distinguish between, let’s say, cyclic universe theory versus multiverse theory, or other equally dispassionate debates.

But if ever you ever need to have a true crisis of faith, then any time you spend thinking about homeopathy and moon hoaxes beyond the negligible effect they have on your life will be time spent learning exactly the wrong mental habits.

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Links For April 2014

Why did a secretive and moderately unethical giant Korean corporation purchase a big tract of land on the Canadian tundra, declare it was for an unspecified agricultural project, and then never grow any crops there? Hint: they recently bought a very well preserved mammoth specimen and sent it to one of their cloning labs.

The weird story of how a UFO cult built a clinic to surgically reverse female genital mutilation in Burkina Faso, and how they accuse the Catholic Church of thwarting them. Bonus: the head UFO cultist at the clinic was my college genetics professor.

Tips For Surviving If You Find Yourself In An English Folk Ballad (h/t Peter Scott)

There’s a lot of talk about Bitcoin use in Kenya. While it’s a little bit of an exaggeration to say that one third of Kenyans have Bitcoin wallets, the country’s combination of reliance on a mobile-phone based money-transfer service and high level of cross-border remissions makes it very fertile ground for cryptocurrency use. Also, how come Kenya can have a mobile-phone based money-transfer service and we can’t?

Awareness Weeks where speakers and artists earnestly tell people not to stigmatize certain groups may result in increased stigma of those groups, especially self-stigma. This does not surprise me. (h/t Kate Donovan)

Norway’s army, like America’s, has a problem with sexual harassment. Their solution was to encourage “a common mode where gender stereotypes had disappeared, or at least are less obvious” by making men and women share rooms and encouraging similar hairstyles. Norwegian women report a major decrease in sexual harassment.

This seems very implausible, but I include it because the study seems sufficiently meticulous: people have more positive emotions towards words typed primarily with the right hand. This must explain why everyone hates stewardesses but loves lollipops.

Article finds that 90% of academic papers are never cited, suggests up to 50% are never read by anyone except their authors and the peer reviewers. [EDIT: Likely exaggerated]

Study finds that 100% of children don’t like clowns, think they are scary. If this is true, how did clowns even come to exist? Was there this period when everyone thought clowns were happy and funny, and then some people put them in horror movies and made jokes about how scary they were and ruined them for the rest of us? Or were clowns always scary, but for some reason the circus industry was so bad at responding to market incentives that they adopted them anyway?

No, the government can’t save $400 million by changing its font.

Legalization of medical marijuana does not seem to increase, may decrease crime. I look forward to seeing a similar study of recreational marijuana in a couple of years, but in the meantime there’s always poorly controlled reports.

13th century philosopher Robert Grosseteste theorized physical mechanisms by which the ten nested crystal spheres of the universe might form. Scientists put his theories to the (mathematically simulated) test and find that small variations in the initial parameters can produce anything from ten crystal spheres to unstable spheres to infinite spheres to spheres that interlock through each other. Getting the ten nested spheres of our own (medieval vision of the) universe requires very careful fine-tuning. Then again, so do our own physical theories.

Laws are changing soon to permit Kickstarter style crowdfunded investment in new companies for as little as $100. I feel like this should be bigger news and in the long run might be one of the most important economic events of the decade.

Article: Science Compared Every Diet, And The Winner Is Real Food. So it is a combination of obvious – “real food” is better than “processed food” – and useless – what is “real food”? Is pasta real food? A turkey and cheese sandwich? A home-made cookie? For those of us who can’t eat apples straight off the tree three times a day, give us a little more guidance, please.

A Redditor wants advice on how to meet new people. But instead of posting on r/socialskills, he accidentally posts on r/socialism. The results are exactly what you would expect.

The Thirty Most Unnecessary Uses Of Quotation Marks In History.

Costs of sequencing a genome have been dropping even faster than Moore’s Law for computer chips. Not sure how worried we should be about the pace seeming to level off in recent years.

Garden path sentences are one that momentarily mislead your language parser, for example “The girl told the story cried”. When you get to “cried”, you realize something must have gone wrong somewhere and have to double back and try alternate interpretations of the structure until you realize it meant “The girl [who was] told the story”. They’re a cool way to observe the hidden mechanisms of your brain at work. Here are twenty-one of them.

There’s a big debate in medical education between the people who think residents need strict limitations on the number of hours they can work to protect them from exploitation and to protect their patients from sleep deprivation-related mistakes – and the people who think dammit, I worked hundred hour weeks and that’s the only way to turn someone into a real doctor. The former group is in the ascendant now, but they’ve been dealt a big blow with a recent study finding limited duty hours do not improve patient safety. Meanwhile, even under the “strictly limited duty hour” rules, I worked seventy-five hours last week.

Scientists discover brain area that causes Catholicism.

RAINN, the most important anti-rape charity, comes out against the concept of rape culture. In some sense, I agree. On the other hand, I think their position that it is all due to individual rapists being jerks is, while technically correct, denying the idea that people are influenced by a culture at all. I think my position would be that, while there is not a deliberate nationwide culture of excusing or promoting rape the way some people would have it, cultural factors affect the incidence of that crime the same as of every other type of crime and need to be considered. Also, in the process of investigating this I discovered that the largest organization for fighting false rape accusations really likes RAINN and urges all its members to donate to them. This is heartwarming in the same way as those pictures of cats and dogs snuggling with each other.

Oxytocin, previously lauded as the “cuddle hormone” and the “trust hormone”, reveals its dark side as a study finds it makes people more likely to lie to help a group. This comes a few years after a study finding that it can make people more racist. Overall this isn’t as big a conflict as people seem to think. It seems to active a sort of innate moral system, but the innate moral system just wants you to protect your in-group no matter what, which comes at the cost of broad principles (like honesty) and the out-group (like different races). Not especially paradoxical. But it does mean that my biggest nightmare has come true – someone has figured out a way to condemn cuddling as racist.

If we are to believe charts, the incidence of autism has more than doubled – not since 1900, or 1970, but in the last fourteen years, so that now 1/68 kids gets born with autism. But are we to believe the charts? The CDC finds that half the children born with autism now have normal or above-average intelligence, compared with only a third ten years ago and probably an infinitesmal fraction fifty years ago, which means probably people are more willing to diagnose it even absent severe limitations. I continue to get extremely annoyed that we use the same condition name to cover everything from such profound mental retardation that many of those who have it never learn language or are able to live without constant supervision to people who are slightly geekier than average and can find a few sensations they don’t like on a checklist. This seems possibly medically correct but socially prone to exactly the pathological and interminable debates we actually find ourselves in.

I’ve long suspected that obesity is partly genetic, and now we have probably found one of the genes involved. Seems to be involved in carbohydrate digestion, and and can change your odds of being obese by up to eight times. And it’s a copy-number variant, which is interesting because I’ve seen studies suggesting a lot of interesting things (eg aggression) are copy-number variants, and most modern genetic testing attempts don’t pick that up (they are limited to SNPs). If copy-number variants turn out to be really important, that could rescue some of them “none of our genetic testing ever finds genes that have a large effect on interesting psychosocial things even though we know they’re there” problem.

I’ve talked about how many promising medical ideas just sort of sit there, either unresearched or unadopted. Here’s an article in ACP Internist where an Idaho doctor suggests we add bacteriophage therapy to that list.

It’s generally assumed that lifting women out of poverty will also save them from violence because they will have more options. But in at least some cases, women who are wealthier or better-educated than their husbands are at greater risk of violence than poorer and less educated women. Ozy adds: “This is true in the US too, but might be reporting bias.”

Article confirms the obvious – children identified as “gifted” early on then grow up to become successful people who discover inventions, run businesses, or make amazing works of art. One might argue that the vast majority of value coming from an education system comes from what it does for gifted kids – giving them that tiny extra push they might need to cure cancer, invent nuclear fusion, or become the next Shakespeare will have more positive impact than a million construction workers becoming slightly smarter construction workers. And there’s a lot of evidence that even small interventions to help these children have spectacular effects – gifted children who are allowed to skip grades are 60% more likely to get doctorates and patents, and more than twice as likely to get STEM Ph.Ds, than a control group of equally gifted children who weren’t. And so in response to this state of affairs, schools: don’t let gifted children skip grades, refuse to stratify children by ability because it might offend someone, and allocate less than 1/2000th the funding for gifted education as it does to special education for low performers. China cannot take us over quickly enough.

Poooossibly related: according to the survey of student boredom 98% of kids are bored in school and 66% bored every day, including 33% bored because the work is too easy and 25% bored because the work is too hard.

Anagrammatron somehow finds tweets that are anagrams of each other.

Boycotting people and organizations who are intolerant of homosexuals may be illiberal, it may have chilling effects, and it may alienate exactly the people you are trying to convince – but at least it works, right?

Libertarian Police Department. This might be the closest I have ever come to literally ROTFL.

One of my old articles, Who By Very Slow Decay, ended up on Reddit recently. And some of the comments by other medical people managed to horrify even me, who wrote the original.

You know the paper’s going to be good because it’s called Biomarkers and Long-Term Labor Market Outcomes. And sure enough, they find that higher levels of creatine do better in the labor market, even when controlling for everything else. And I just heard from some of my psychiatrist friends that there are a couple of preliminary studies finding creatine to be pretty effective against depression (warning: everything is effective against depression in preliminary studies).

Researchers who discovered Ecstasy causes Parkinson’s disease retract their finding after realizing they accidentally used meth in the study instead of Ecstasy. I have a lot of respect for them for admitting it. Also, apparently meth causes Parkinson’s.

Slate Star Codex reader Thomas Eliot has a Kickstarter up for a Cthulhu-themed board game which you may check out and donate to if it suits your fancy.

You know how they found that caloric restriction increased lifespan, and then they found that it didn’t, and then they found that actually it did, and then they found that actually no it really didn’t? Well, now it does.

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Going Loopy

[content warning: mild ideohazards about rumination that might make people who have anxiety disorders have anxiety disorders more effectively, in the bad sense of "effectively"]

[epistemic status: more crackpottish than usual for this blog. Wild speculation.]

I.

If the brain had been designed by an amateur, it would enter a runaway feedback loop the first time it felt an emotion.

Think about it. You see a butterfly. This makes you happy. Being happy is an unexpected pleasant surprise. Now you’re happy that you’re happy. This makes you extra happy. Being extra happy is awesome! This makes you extra extra happy. And so on to as much bliss as your neurons are capable of representing.

Or you stub your toe. This makes you sad. Being sad sucks and makes you less productive and less fun to be around. This means being sad is an unexpected negative event, which sounds like a good reason to be sadder. Being even sadder is going to ruin your night even more, so you get sadder still, and so on until you become suicidally depressed over a single lousy toe.

In the real world, either those feedback loops usually don’t happen, or they converge and stop at some finite point. I would not be surprised to learn that a lot of evolutionary innovation and biochemical complexity goes into creating a STRONG BARRIER against conditioning on your own internal experience. Sometimes it fails.

A guy named Wegner conducted a famous psych experiment where he asked a bunch of participants to sit in a room alone and try not to think about a bear with sunglasses. Of course, that was pretty much all they could think of. They seem to have gotten into a feedback loop where “desire not to think of a bear with sunglasses” -> “thought of a bear with sunglasses” -> “frustration” -> “stronger desire not to think of…” -> “more thoughts of…” and so on.

One of my professor’s work – and my college thesis – expanded the field of bear-with-sunglasses-ology to note that people with obsessive compulsive disorder are found to be much worse at this task than the general population. This is not surprising. OCD seems to be pretty much exactly this scenario, except instead of trying not to think of a bear with sunglasses, you’re trying not to think about how you’re dirty-contaminated, or how maybe you left the stove on, or how what if your car just hit somebody then where would you be? OCDers get stuck in feedback loops where their worry about their obsessive thought is itself a form of the obsessive thought and so both justifies and intensifies their worry.

I also remember a study where a guy with a sleep lab offered participants a cash reward if they could go to sleep more quickly than usual; the end result was that all of them took much longer to go to sleep than usual. Strong desire to go to sleep -> actually a strong anti-sedating emotion -> worry that you won’t get the prize -> stronger desire to go to sleep -> even less sedated -> so on.

There seems to be an element of this in most anxiety disorders. Someone goes outside, something bad happens. Next time they go outside, they feel anxious. The usual STRONG BARRIER against conditioning upon internal experience is AWOL for some reason. The patient finds the experience of becoming anxiety very negative; therefore their belief that “going outside leads to bad things” is justified. Eventually they are so anxious about possibly becoming anxious that they just stay in their house all the time.

(hey, this is kind of Lob’s theorem! If you know that, if you’re anxious about being anxious you would be anxious, then you’re anxious. Maybe.)

But the most clear-cut example is panic disorder. Someone gets anxious for some reason. They get the standard somatic correlates of anxiety – racing heartbeat, sweating, etc. This is a scary situation to be in, not least because it mimics all sorts of terrible medical conditions like heart attacks. This makes the person more anxious, which increases the somatic correlates, and so on.

II.

A lot of CBT seems to be about manually breaking these feedback loops. But I’m just as interested in what we accidentally do to manually increase them. I worry that making mental self-reference slightly easier and more mentally accessible can lead to a big increase in feedback loop size.

I am misophonic – it means I can’t tolerate certain noises. Ten years ago, I would not have used the word “misophonic”, and I would not even have said I have low noise tolerance. I would have said “Hey, that TV is bothering me, can you turn it off?”

I didn’t start thinking about it on a meta-level until one of my roommates told me “Wow, Scott, you seem to be really super sensitive to noise.” And then gave me a little bit of grief over it, which made it stick in my brain. Ever after that I modeled myself as a person who was super sensitive to noise.

And that made my noise sensitivity much, much worse. I hypothesize that maybe, instead of just noise -> distraction, this created a longer feedback loop. Something like noise -> anxiety that I, as a person sensitive to noise, am going to be distracted -> this anxiety is itself distracting -> noticing that I am distracted and being anxious that this distraction will continue as long as the noise continues -> further distraction -> and so on.

(it’s worth noting here that I have obsessive compulsive disorder and that noise sensitivity is a classic feature of the condition)

I had precisely the same experience on this post when I said I was triggered by certain kinds of feminist and social justice rhetoric. I didn’t really think of it that way until I wrote that sentence. I mean, it was true that I heard the rhetoric and then I felt upset and scared, it was just that I had never thought of it as a part of my identity before, or connected it to the word “trigger”. Well, as soon as I did that, the problem got about three times worse, and continues to get worse. I think this nice little crystallized concept of “trigger” might allow my brain to feed back its anxiety more effectively, like “Yup, this thing triggers you, better start feeling anxious about feeling anxious about feeling anxious about…” and that made it go from “a thing that bothers me but which I can cope with” to “giant psychological disaster”.

(now I wonder about typical mind stuff. Do people without OCD have this same experience of anxiety about anxiety about anxiety…? For example, when I was young I was afraid of the dark, not because I believed in ghosts, but because I expected to hear a sound or see something blown around by the wind which I would mistake for a ghost and then have to deal with waves of terror rushing through my body until I figured out what it was, and this was sufficiently bad that I slept with the lights on as a child. Is this the sort of thing other people could imagine feeling, or is it really unusual?)

But this sort of thing is comparatively small fish. I’m more worried about the effect of our entire rich emotional vocabulary. Like, we just sort of invented the concept of being “stressed out” sometime in the last century. Did that make people more stressed out about being stressed out? Did the movement for people to become more introspective and talk about their feelings more (that was a thing, right? That’s why old people are so stoic and young people are so touchy-feely?) make people more likely to fall into feedback loops?

What happens when you give people a psychological diagnosis like “depression”? I’ve always heard that it makes people feel better, because now they know there’s an explanation for what they’re experiencing and it’s not their own fault. But I don’t know if I’ve seen any studies proving this, and even if there were I’d expect them to suffer from the general bias to confirm things that everyone knows are true. What if it just makes people be depressed about how depressed they are, and then go “There’s that depression again, guess this means I’m not getting any better” and become depressed about that?

III.

This whole essay is a little crackpottish, but now I’m moving from things that merely can’t yet be supported by evidence to things that actively contradict it. But I think about this a lot, and it’s my blog, so shut up and listen anyway.

I notice that the class of mental disorders that seem to involve feedback loops – depression, OCD, anxiety – are also the class of mental disorders effectively treated with serotonergic drugs.

One of the most powerful serotonergic drugs in existence is LSD. And as I have learned from – let’s say long boring journal articles – the main effect of LSD is to make you literally loopy. Your thoughts loop in and become about themselves, your sense of time becomes cyclic, everything you see becomes a fractal or a spiral or both. And you end up in an extreme emotional feedback loop to infinity – either a “good trip” or a “bad trip”.

This just-so story is not quite as convincing as I would like because SSRIs and LSDs both increase serotonin but have opposite effects on loopiness. But “serotonin” is a wide and complicated category, and like I said above, I bet the brain has a lot of different mechanisms to finely adjust how self-referential your thoughts are allowed to get.

I will get crackpottier still: maybe the parameter being adjusted is some kind of “allowed size of loop”, so that usually you can finish an entire train of thought and then maybe reflect back on items in the train. Small amounts of LSD decrease the loop size, so that individual thoughts can refer to themselves. And large amounts of LSD (the journal articles I read were very comprehensive) decrease the loop size to zero, and the perfect pure consciousness people claim to experience is just a loop looping in on itself forever, empty of content.

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Dermatology Quiz: Answers

The first statement on yesterday’s quiz was true. Because Americans sit on the left side of the car when they drive, if they drive a lot they get more UV light to the left of their faces than the right. Therefore, they get more left-sided skin cancer. This picture of a truck driver, linked in yesterday’s comments, provides a good demonstrations of the effect of UV on skin:

On the other hand, you probably shouldn’t avoid sun exposure entirely, since it seems to protect against cancer – I previously was skeptical of a Vitamin D/cancer link, but sun exposure might operate through Vitamin D-independent pathways.

The second statement was false. At least, it was supposed to be. I tried to invent a distractor answer I was pretty sure was false. Commenter Kolya came up with a really sneaky argument for why it might be true. This just goes to show how easy it is to confound something. Please be reassured that I am not really that tricky.

The third statement was true. See Treatment of depression with onabotulinumtoxin A: a randomized, double-blind, placebo-controlled trial. 52% of botox group responded to treatment vs. 15% of the placebo group (who got injected with nothing; sucks to be them) with effect lasting at least six weeks.

The likely explanation is the “facial feedback hypothesis”, which posits that the brain uses facial musculature as a sort of “notepad” for emotions – if one part of the brain decides to feel happy, it makes the face smile, and then other parts of the brain can check whether the face is smiling a couple minutes later and figure out if they are supposed to be feeling happy. As silly as it sounds, if you paralyze the muscles that frown, that makes it harder to feel sad. Even better, the same treatment improves mood in healthy people without depression.

I actually didn’t realize that last part until I started writing this post. I wonder if the Botox effect is susceptible to happiness set point or not. I could easily see it not being so, which would make it one of the most powerful happiness-boosting interventions that exists and a little less creepy than giving your usual oral or IV drugs to make people happier.

Botox costs $400 a pop and lasts for months. I wonder how that compares to poverty relief, health care, and malaria nets in the utilitarian calculus.

Darnit, just once I want to learn an interesting medical fact that doesn’t end up as a plan to drug the entire population.

(but think how pretty everyone would be!)

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Dermatology Pop Quiz

My dermatology lecture this morning presents: one of those Two Truths and a Lie games. You choose which two you think are true and – special house rule – give explanations for why. The explanations do not require specialized medical knowledge beyond the level of a smart amateur. Answers tomorrow-ish.

1. Significantly more Americans get skin cancer on the left half of the face than on the right half.

2. People who had acne as children live on average four years longer than those who did not.

3. In very early studies, Botox has shown great promise as a treatment for depression.

(this is one of those shorter posts I was threatening)
(judging from the comments, this was way too easy. Grumble.)

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Housekeeping Post April 2014

1. I am on an inpatient medicine rotation for the next two months, which means I will be working about twice as hard as normal. The last time I was on one of these, I managed about a blog post a week. I am going to try to do better this time by posting much shorter things and by splitting up link posts into short posts with a couple of links each. I might also cheat by reposting some stuff from my old blog. Or I might just disappear for two months.

2. Many people noticed Ozy deleted zir blog and are wondering if ze’s okay. The answer is yes. Ze had a brief panic attack of the “I never want to interact with anyone ever again” variety, as one does from time to time, but is mostly recovered now.

3. Please do not send me blog comments by email. When many people try this, I end up with lots of email. This creates guilt about not responding in a way that comments don’t, and makes it harder to find important emails among comment-related ones. If you want to comment without your opinion being public, you can comment anonymously. If you want to comment without your opinion being public but with me knowing it’s you, you can comment under a pseudonym and email me once to tell me what the pseudonym is.

4. If you need advice on a medical problem, I am a terrible terrible terrible person to ask. If you need advice on a psychiatric problem, I am a single-terrible person to ask. My advice will probably be “see a psychiatrist” – not because I don’t want to help you, but because I can’t prescribe drugs to you over the Internet and they can. I would like to write up some advice for people with psychiatric issues, but I guess not in the next two months.

5. I had a list of things to remember to include in this post. Number five was “Facebook”, but I can’t remember what it was supposed to mean. So please be aware that something has happened regarding Facebook, or you need to do something on Facebook, or that Facebook is important in some way. Thanks.

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My New OKCupid Profile

http://www.okcupid.com/profile/Aithrobates

(read it before you accuse me of narcissism or opportunism by linking to it here)