Archive for March, 2010
Posted on March 27, 2010 - by David
Texas Rewrites Textbooks, But Will Kids Even Read Them?
Over the last several weeks, the preliminary approval of new social studies curriculum standards by the Texas State Board of Education on March 12th has turned into major national news. As the story goes, because Texas is one of the nation’s largest textbook purchasers, the standards it sets will impact the content of textbooks across the country as publishers try to meet the Lone Star state’s requirements. And why is this such a problem? Because a group of conservative board members pushed through a number of controversial revisions, and rejected many of the changes proposed by liberals in a 10 – 5 vote split down party lines.
These changes include:
- An emphasis on the Christian identity and values of the founding fathers and a shift away from teaching about the separation of church and state. (As a result, Thomas Jefferson get’s scratched off the list of thinkers who inspired revolutions in the 18th and 19th century, replaced, according to the New York Times, by St. Thomas Aquinas, John Calvin, and William Blackstone).
- Referring to the U.S government as a “constitutional republic” rather than calling it “democratic.”
- Using the term “free-enterprise system” in place of “capitalism” to avoid its negative connotations.
- Including in discussions of McCarthyism that “the later release of the Venona papers confirmed suspicions of communist infiltration in U.S. government.”
- A Greater focus on the conservative movement of the 70’s and 80’s
If you’re really interested in finding out about the revisions, I’d suggest you skip the major news outlets and check out this annotated version of the Board’s standards that was put together by writers at www.texastribune.org.
For your viewing pleasure, here’s a clip from ABC’s Nightline, highly critical of lame-duck board member Don McLeroy who seems to be the driving force in this “conservative bloc.”
And I couldn’t resist including the less reverent but more entertaining perspectives of Comedy Central’s Jon Stewart and Stephen Colbert.
| The Daily Show With Jon Stewart | Mon – Thurs 11p / 10c | |||
| Don’t Mess With Textbooks | ||||
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| The Colbert Report | Mon – Thurs 11:30pm / 10:30c | |||
| I’s on Edjukashun – Texas School Board | ||||
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If you watched the clips above or read any of the news articles out there, you probably picked up on the less than subtle jabs at some of the prominent conservative board members who have little or no background in education or history. The New York Times refers to Don McLeroy as “a dentist by training.” David Bradley is characterized as “a conservative from Beaumont who works in real estate.” Whether or not these are valid criticisms, they’re definitely easy shots, and it’s hard to blame journalists for taking them.
So what happens next? The Texas Education Agency website will post a document containing the revisions by mid-April, at which time an official 30- day public comment period will begin. But everyone seems to expect that when the Board reconvenes in May, the ratification of the new curriculum will occur without much further discussion.
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When I started to think about what these changes might actually mean to students, a thought occurred to me which wasn’t mentioned in any of the media coverage. I’m not sure how else to put this, so I’ll just say it… Most high school students will not read these textbooks. They will be able to pass U.S history with a minimal amount of reading if they pay a little bit of attention in class and maybe take some notes when the teacher reviews the material. All this hype is based on the assumption that students are actually reading what’s printed, but what if that’s not the case?
I’m pretty sure my experience with American history was not typical. I attended a large public high school in the suburbs of Philadelphia. There were around 750 students in my graduating class. In 11th grade, I took AP (advanced placement) U.S History. I believe there were only two sections of the class, so if each class had approximately 25 kids, that’s about 50 total for the year. That means over 90% of my classmates got some other, less rigorous education in our nation’s history, split up between classes designated as honors, college prep, career prep, and basic instruction. Besides the fact that we were (supposed to be) the best and the brightest of our class, we had real incentive to learn because we were all hoping to score a 4 or a 5 on the AP exam and receive college credit for our work in the class (BU actually gave me credit for 2 U.S history classes).
This class was no joke. Our main text, The American Pageant, was the fattest book in my locker, over a thousand pages long, and we were expected to have read a good chunk of it over the summer before we showed up to school. Its companion was The American Spirit, a book of primary source materials compiled by the authors of The American Pageant. Add to this occasional readings from After the Fact: The Art of Historical Detection, a collection of cases studies from American history designed to teach students to think critically about context and how “history” and “the facts” come into being. Of course there were also novels, biographies, and other historical texts which the ambitious or desperate-to-pull-his-grade-up-at-the-last-second student could read and write about for extra credit, and the various relevant news and magazine stories of that our teacher brought in from time to time.
There was a lot to read, and I didn’t come close to reading it all. I don’t think any of us did (except maybe our valedictorian, who google tells me is currently doing graduate work in quantum physics at Stanford – my head hurts just looking at it). I’m sure a lot of students were like me, and tried to cram as much of the textbook as possible into their minds in the few nights before the AP test in May. Throughout most of the year, I skimmed the textbook on some of the nights we had assigned reading (which was most nights), and neglected to even carry the massive thing home on others. I think I probably absorbed the majority of the information through the instruction and discussion which took place in class each day. I don’t think I’m generalizing too much from my own experience when I say that regardless of the level of the history class, the teacher’s particular methods and what he/she emphasizes has more of an impact on what students will learn than what is written in the textbook. A good teacher will acknowledge when there is controversy on a particular topic, present the various positions with as little bias as possible, and encourage students to think critically about the information before they jump to conclusions. Obviously, this is an ideal, and there’s no doubt that the political views of a history teacher are likely to become visible in the classroom, at least occasionally. In my class, we spent a good deal of time talking about current events, (which tend to be the most charged with emotion), and considering that this was the year that the Towers fell and the war in Afghanistan started, there was plenty to talk about. Interestingly, because we had so much to cover, we barely even got up to 1980 in our textbook, so the years of this “conservative resurgence,” which seem central to the Texas Board’s amendments, were passed over fairly quickly.
The point is, regardless of how influential the Texas Board of Education may be in the composition of new American History textbooks, the claims that they are determining what the rest of the nation’s kids will learn are exaggerated. As journalist Brian Thevenot of The Texas Tribune points out in “The Textbook Myth,’ (by FAR the best article I’ve read on this subject), technology has made it much easier for publishers to customize their content to meet the standards of different states, lessening the impact of Texas’s large market share. Even within Texas, new laws regarding digital materials may undermine the power of the conservatively-crafted textbook. Thevenot writes:
Because of their sheer buying power, large states with statewide textbook adoption processes did once indeed influence what went into the books, which used to be printed almost exclusively in national editions, Diskey and other industry experts said. But since the mid-1990s and the rise of the state curriculum standards and testing movement, publishers have increasingly been forced to customize their books for different states, as well as for larger school districts in the roughly 30 states without statewide adoptions. Simultaneously, advances in publishing and printing technologies allow far more customization at lower cost, much like large newspapers that issue several geographically customized editions every day.
What’s more, rapidly shifting politics and the digital revolution in instructional materials promises to dilute the power of state school boards even further — both here in Texas and nationally. Texas remains one of only two states that has shunned the national standards movement being pushed out of Washington, which, if it progresses as expected, would no doubt dwarf the market influence of even giant states. And here in Texas, new legislation that impinges on the board’s previously well-guarded curricular turf allows Commissioner of Education Robert Scott, who does not report to the board, to create a separate list of approved digital materials over which the board has no say. The new law only requires that schools buy one “classroom set” of board-approved textbooks, rather than one for every student.
As Thevenot’s article suggests, even the idea that the new curriculum standards will drastically alter what students in Texas learn seems suspect. I understand that there are several layers of administration from the state to the district to the individual school which prescribe and monitor what kids should be learning. I also understand that for a teacher, going against the grain or trying to squeeze in extra lessons on excluded or controversial subjects can be risky and complicated. But if a teacher wants to spend 10 minutes talking about a little known Latino figure like Oscar Romero, or allow an interested student to write a report about him, does the Texas Board of Education’s vote against including him in the curriculum do anything to prevent that?
Though I’m skeptical about the impact of these changes, I’m not saying that what’s going on in Austin doesn’t matter. Certainly, I believe the attempt to balance out the perceived liberal bias by unabashedly injecting a conservative slant into the new standards demonstrates a serious misunderstanding of what it means to teach history. And the idea of a governmental mandate that praise for America’s “limited form of government” be included in the history books strikes me as just a bit ironic. But there is one important domain that all of the conservative muscle of the Texas Board of Education can’t do much to reshape: the internet. I suspect that as time goes on, despite what teachers and administrators might hope, kids who have grown up online will rely more heavily on google and Wikipedia for the answers to their history questions than the textbooks that get handed out at school. Simply put, it takes more effort to flip through a thick book and scan for key information than it does to type the name of an important historical figure into a search engine and find this key information already neatly packaged in hyperlinked, outlined form. Will this make lazy students even lazier? Perhaps, but I think it also opens doors for those students who are curious about what really happened. If there is controversy over a certain subject, they won’t have to look that hard to find it, and after informing themselves, they can draw their own conclusions. The message to conservatives on the Texas State Board of Education – don’t be surprised if these historical conclusions aren’t the same ones you’re about to vote into law.
Posted on March 22, 2010 - by David
Not Sick: The 1973 Removal of Homosexuality from the DSM
81 Words, a 2002 episode of NPR’s This American Life that was recently rebroadcast, tells the story behind the removal of the homosexuality diagnosis from the DSM-II in 1973. You can download the audio or read a transcript of the show here: part 1, part 2.
The report is given by Alix Spiegel, whose grandfather, Dr. John P. Spiegel, was president-elect of the American Psychiatric Association in 1973 when this historic change took place. Alix describes the family myth – that grandpa had single-handedly changed the APA’s position on homosexuality and removed one of the major barriers to equal rights for homosexuals in America. The truth, she says, is actually much more complicated. Though he did play a role in this historic change, ‘grandpa’ was not the driving force his family believed him to be, nor were his motives simply those of dedicated psychiatrist and champion of human rights. In Alix Spiegel’s words:
… this version of events was discarded anyway. Discarded after the family went on vacation to the Bahamas to celebrate my grandfather’s 70th birthday. I remember it well. I also remember my grandfather stepping out from his beach front bungalow on that first day followed by a small well-built man, a man that later during dinner my grandfather introduced to a shocked family as his lover, David. David was the first of a long line of very young men that my grandfather took up with after my grandmother’s death. It turned out that my grandfather had had gay lovers throughout his life, had even told his wife-to-be that he was homosexual, two weeks before their wedding. And so in 1981 the story that my family told about the definition in the DSM changed dramatically.
According to Alix Spiegel, from the 40’s through the early 60’s, the APA was a very conservative organization, largely uninterested in “weighing in on the issues of the day.” In her interviews with psychiatrists who were members of the APA in 1970, when the forces behind the definition change began to take shape, she was told that the overwhelming majority of the APA believed that homosexuality was indeed a mental illness – “even the ones of us who were gay,” added Dr. John Fryer.
Fryer was not alone in the APA. Because homosexuals were not allowed to practice psychiatry, Fryer and others like him had to hide their sexual preference, but they began to meet informally at APA conventions, calling themselves the Gay PA. There may have been a sense of solidarity among them, but they were not questioning the official psychiatric stance on homosexuality. Fryer told Spiegel, “because of our own internalized homophobia, most of us probably agreed that it was OK to be a disease.”
The idea that homosexuality was a form of insanity rather than a ‘moral abomination’ was first put forth in the 19th century, and Spiegel notes that many homosexuals actually saw this as a step forward. In the early 70’s, psychoanalysis, Freud’s great gift to psychiatry, was still the dominant form of therapy and mode of theoretical understanding in the profession. The two psychoanalytic authorities on homosexuality were Dr. Irving Bieber and Dr. Charles Socarides. Bieber, who was later demonized by gay activists, actually became interested in the subject of homosexuality after working as an army psychiatrist during WWII, when soldiers who were found to be homosexual were dishonorably discharged. Bieber believed they should receive treatment instead of being discharged, and because of this position, he was never promoted from his rank of Captain during his four years of service. Returning home, he began to research and write about this topic, which culminated in the 1962 publication of Homosexuality: A Psychoanalytic Study. As Spiegel says, this book, which analyzes the work of 77 doctors and over 100 of their gay patients, “concluded that the cause of homosexuality was a combination of what they termed close-binding mothers – which is overprotective women who made their children weak and feminine – and detached, rejecting fathers.”
Of course, there was other data used to argue against the idea of homosexuality as a mental illness. Alfred Kinsey’s famous and highly controversial report on male sexuality, published in 1948, found that 37% of American men had had physical contact to the point of orgasm with another man. Some opponents of the diagnosis used Kinsey’s work to claim that an experience so common could not be reasonably considered pathological.
The work of Evelyn Hooker, a psychologist from UCLA, was first made public in 1956, and addressed one of the main criticisms leveled against psychiatrists like Dr. Irving Bieber, whose study subjects consisted only of homosexuals who were imprisoned, in mental hospitals, had been discharged from the military, or had otherwise sought treatment on their own. Hooker’s aim was to examine gay men who weren’t troubled by their own sexuality. She administered psychological tests to 30 homosexuals who had never sought therapy, as well as 30 heterosexuals who were matched for comparable age, IQ, and education. The disguised results were then given to three experienced psychiatrists who were asked to identify the homosexuals. They were unable to distinguish between the two groups, and categorized two-thirds of both groups as “perfectly well-adjusted, normally functioning human beings.”
In 1970, the APA held their convention in San Francisco, probably an ill-advised choice of location. Gay rights activists showed up, some of whom had apparently obtained press passes from people within the APA, and made their feelings known. Bieber was a particular target, and they effectively broke up the meeting where he was trying to give a talk. The ’71 convention was much the same story.
While there was obvious pressure coming from the gay community to change the DSM, there was also something happening inside the APA. It seems from Spiegel’s story that the psychiatrists of the Gay PA were for the most part content to gather in secret and accept the traditional designation of homosexuals as sick, but others had begun to mobilize. In Dr. John P. Spiegel’s Cambrige, MA home, a small group of psychiatrists, ‘the young turks,’ began to meet:
The young turks were all psychiatrists, all members of the APA and all liberal-minded easterners who had decided to reform the American Psychiatric Association from the inside. Specifically they had decided to replace all the grey-haired conservatives who ran the organization with a new breed of psychiatrist; more sensitive to the social issues of the day with liberal opinions on Kent State, Vietnam, feminism. They figured that once they got this new breed into office they could fundamentally transform American psychiatry. And one of the things this group was keen to transform was American psychiatry’s approach to homosexuality.
Spiegel is quick to clarify that this group and others like it by no means constituted a “homosexual cabal,” but “several of the key players were gay,” and the young turks were able to use their influential positions as members of the Committee for Concerned Psychiatry to propose candidates for office. Despite all the visible and colorful protests of the APA by gay activists, Spiegel maintains that if it weren’t for the internal changes set into motion by these psychiatrists, the DSM diagnosis would have gone untouched.
At the 1972 convention, the efforts of those working for change both inside and outside the APA were joined for the first time. Gay psychiatrist Dr. John Fryer, recently ousted from his job at UPenn and apparently unemployable due to the rumors of his homosexuality, was recruited by activists to give a speech about the damaging effects of the DSM diagnosis. Though he initially refused the offer, after being rejected by one university after another as he looked for a new job, Fryer accepted the second request on the condition that his identity remain a secret. He appeared as ‘Dr. Anonymous,’ wearing a loud suit several sizes too big, his face hidden behind a distorted Nixon mask, hair covered by a wig, speaking into a special microphone to alter his voice. “He explained to his fellow psychiatrists how these [81] words had harmed him, and others like him,” and when he was through, received a standing ovation.
Independent of the changes already underway on the inside, there was another chance encounter involving an APA psychiatrist and a gay activist which proved to be instrumental in this process. During a behavioral therapy conference in New York City in ‘72, Dr. Robert Spitzer, a member of the APA’s committee on nomenclature and subscriber to the standard psychiatric view of homosexuality, was sitting in a meeting when Ron Gold stood up and spoke out against psychiatry’s oppression of gays. Spitzer made a point of speaking to Gold after the meeting ; he wanted to express his annoyance at the inappropriateness of the interruption. But when Gold discovered that Spitzer was on the nomenclature committee – the group that first decides what should and shouldn’t end up in the DSM – the conversation went in a different direction. The two men parted ways with Spitzer agreeing to set up a meeting for Gold with the committee as well as a panel discussion at the next convention where gay activists could participate.
At the 1973 APA convention in Honolulu, a few months after the requested audience with the nomenclature committee left the psychiatrists at a loss as to what should be done about the diagnosis, “The old guard, Charles Socarides and Irving Bieber, publicly met the new school, Ronald Gold, Judd Marmor [a future president of the APA] and several other psychiatrists in front of a room filled to capacity.” The showdown was a resounding victory for the gay activists. Even Socarides admits that the reception to his speech, (which Gold referred to as “his ‘they’re betraying their mammalian heritage’ number”), hardly qualified as warm. “A lot of people booed,” he told Spiegel, “some people clapped.”
Perhaps the most surprising part of this story, the last shove leading to the change, came later that night in a Honolulu bar. Gold, as the hero of the day, was invited to a covert Gay-PA celebration, and decided to bring Spitzer, who still didn’t personally know of any gay psychiatrists, along with him. Spitzer was supposed to be playing the role of a closeted gay man, but when he realized some of the big names who had been part of this underground group for years, he was shocked, and started asking questions that gave his true identity away. A psychiatrist Gold described as “the grand dragon of the Gay PA” wanted Spitzer out of there, but Gold refused on the grounds that Spitzer was actually doing something to help homosexuals, while the Gay PA had done nothing. In the middle of this encounter, a man in full army uniform walked into the bar, looked around, and fell weeping into Gold’s arms. As Gold tells Spiegel:
Well I had no idea who he was. It turned out he was a psychiatrist, an army psychiatrist based in Hawaii who was so moved by my speech, he told me, that he decided he had to go to a gay bar for the first time in his life. And somehow or other he got directed to this particular bar and saw me and all the gay psychiatrists and it was too much for him, he just cracked up. And it was a very moving event, I mean this man was awash in tears. And I believe that that was what decided Spitzer, right then and there, let’s go. Because it was right after that that he said, ‘Let’s go write the resolution.’ And so we went back to Spitzer’s hotel room and wrote the resolution.
While obviously we don’t have the original text composed by Gold and Spitzer in Honolulu– perhaps scrawled on some long lost sheets of hotel stationary –I’m guessing that much of what was written that night ended up here, in this position statement proposing a change in diagnosis from homosexuality to ‘Sexual Orientation Disturbance’ with homosexuality bracketed. This change was to be put into effect for the 6th printing of the DSM II and read as follows:
302.0 Sexual orientation disturbance (Homosexuality)
This category is for individuals whose sexual interests are directed primarily toward people of the same sex and who are either disturbed by, in conflict with, or wish to change their sexual orientation. This diagnostic category is distinguished from homosexuality, which by itself does not constitute a psychiatric disorder. Homosexuality per se is one form of sexual behavior and, like other forms of sexual behavior which are not by themselves psychiatric disorders, is not listed in this nomenclature of mental disorders.
In this paper, Spitzer basically states that homosexuality is a normal variant of human sexuality. He writes that “for a mental or psychiatric condition to be considered a psychiatric disorder, it must either regularly cause subjective distress, or regularly be associated with some generalized impairment in social effectiveness or functioning,” and because many homosexuals do not meet these criteria, homosexuality should not be considered an illness. Spitzer clearly understood that this change was in part a political action, stating that “we will be removing one of the justifications for the denial of civil rights to individuals whose only crime is that their sexual orientation is to members of the same sex.” However, he writes that the removal of the homosexuality diagnosis does not amount to “saying that it is ‘normal’ or as valuable as heterosexuality,” and maintains that “this change should in no way interfere with or embarrass those dedicated psychiatrists and psychoanalysts who have devoted themselves to understanding and treating those homosexuals who have been unhappy with their lot.” The idea, in the end, was that if someone was bothered by their own homosexual thoughts, impulses, or behavior, the DSM still had them covered.
This initial change, officially announced by Dr. Alfred Friedman, president of the APA, on December 15, 1973, may have allowed psychoanalysts to continue treating gay patients for a time, but in less than 15 years, the DSM would be wiped clean of the last traces of the idea that homosexuality could be a mental illness. Spitzer’s original change had been rewritten as ‘ego-dystonic homosexuality’ for the DSM-III, but was removed altogether in 1987.
Dr. Charles Socarides, the most prominent player on the losing team, responded to the change in a 1978 article titled ‘The Sexual Deviations and the Diagnostic Manual,’ published in the American Journal of Psychotherapy. In protest of further proposed revisions for the soon to be published DSM-III, Socarides wrote, “these changes would remove from psychoanalysis and psychiatry entire areas of scientific progress, rendering chaotic fundamental truths about unconscious psychodynamics, as well as the interrelationship between anatomy and psychosexual identity.” In particular, Socarides objected to the fact that the heading ‘Sexual Deviations,’ under which the homosexuality diagnosis had once was fallen, was going to be entirely removed from the DSM-III. Proponents of this change pointed to reports like Kinsey’s, arguing that a phenomenon as common as homosexuality shouldn’t be understood as a deviation, but Socarides believed this was faulty reasoning:
To form conclusions as to the specific meaning of an event simply because of its frequency of occurrence is to the psychoanalyst scientific folly. Only in the consultation room, using the techniques of introspective reporting and free association, protected by the laws of medicine and professional ethics, will an individual, pressed by his suffering and pain, reveal the hidden (even from himself) meaning and reasons behind his acts.
When I read Socarides’ paper, I noticed that he repeatedly summons the name of science, even while his argument belies a dogmatic faith in psychoanalysis –an approach that has been waning in popularity for decades, suffering from the criticism that it lacks scientific validity. Regardless of who is right or wrong in this argument, (or any similar argument for that matter), what I find most interesting is how it is imperative for each party to claim the support of science. One of the last people Spiegel speaks to in her report is Ronald Bayer, a public health historian from Columbia who wrote a history of this change titled Homosexuality and American Psychiatry. Bayer tells Spiegel that “the nature of these controversies,” is that “both sides wrap themselves in the mantle of science and both sides charge that the other side is being unscientific.”
While developments in medicine and advances in genetic study and different brain imaging technologies have no doubt increased the importance of being aligned with “science” when it comes to psychiatric debate, this is not a new phenomenon, nor was it new in the ‘70’s. At the same time, stories like this one makes it plain that the progress of certain disciplines may be driven just as much by personal and political factors as it is by actual scientific progress. I wonder if the removal of the homosexuality diagnosis in 1973 wasn’t the beginning of the end for psychoanalysis, as well as the first move towards the more standardized, symptom-based diagnoses of the 1980 DSM-III. This seems reasonable, considering that Robert Spitzer was chairman of the task force responsible for creating the new edition and directed the development of the revised edition published in 1987 (DSM-III-R).
As the APA prepares for the publication of the DSM-V in 2013, I believe it’s worthwhile to keep this story in mind. Some of the proposed changes seem to have more to do with a desire to remove a stigmatizing label than real “scientific” evidence. And like homosexuality, the pathology of which was for a many years assumed but never proven, the scientific understanding of some of the older DSM diagnoses is not particularly strong. Studying the history of psychiatry can’t necessarily prove or disprove the validity of a diagnosis, but it may help us to remain cautious as we go forward.
Posted on March 17, 2010 - by David
Does Flu During Pregnancy Raise Schizophrenia Risk?
The authors of a study recently published in the journal Biological Psychiatry claim that influenza infection during pregnancy may play a role in the development of schizophrenia later in life.
The study subjects were monkeys. 
According to the abstract, twelve pregnant rhesus monkeys were infected with influenza early in the third trimester, and 7 healthy subjects were used as a control group. The brains of the babies were scanned using MRI after one year, and the researchers found that “exposed offspring had significantly smaller cingulate and parietal cortical gray matter and left parietal white matter than nonexposed offspring. Bilaterally, cingulate white matter was greater in exposed offspring than in controls.” (Gellner, Journal Watch Psychiatry) It is this finding that gets translated into a sentence like “The results showed ‘a significant effect’ which mirrored brain changes in schizophrenic humans” which I read in a short news clip on the Dallas-Fort Worth Fox News affiliate website, under the (only slightly misleading) title ‘Scientists Find Link Between Pregnant Women with Flu and Schizophrenia.’
The study’s main author, Sarah Short, chose her words a little more carefully:
“This was a relatively mild flu infection, but it had a significant effect on the brains of the babies,” Short said. “While these results aren’t directly applicable to humans, I do think they reinforce the idea, as recommended by the Centers for Disease Control and Prevention, that pregnant women should get flu shots, before they get sick.”
But obviously, the object of the study wasn’t merely to reinforce the idea that pregnant women should get flu shots. The hypothesis that flu infection during pregnancy might play a role in the development in schizophrenia was first put forth over 20 years ago, in a study involving a Finnish cohort born during the 1957 influenza pandemic. They found that “those exposed to the viral epidemic during their second trimester of fetal development were at elevated risk of being admitted to a psychiatric hospital with a diagnosis of schizophrenia,” but the results of similar studies have varied considerably. To date, only about half of the 25 research papers examining this phenomenon have confirmed these findings. Those who support this hypothesis often cite one of the more recent and “scientific” studies, which looked at maternal blood tests to confirm when and if those diagnosed with schizophrenia were exposed to the flu. The 2004 investigation found that “the risk of schizophrenia was increased 7-fold for influenza exposure during the first trimester.” If this is indeed true, it’s easy to understand why the authors considered it significant, but the finding that “there was no increased risk of schizophrenia with influenza during the second or third trimester,” conflicts with the earlier studies which claimed that risk of schizophrenia was increased with second trimester exposure. Based on the available data, it’s impossible to draw any conclusions about the relationship between schizophrenia and prenatal exposure to the flu, but obviously, as the recent publication of the monkey study demonstrates, researchers are still actively pursuing this track.
A few questions/criticisms about this study from someone with an admittedly (very) limited knowledge of neurology…
Is there a difference between contracting the flu virus in the typical way and forced infection, in terms of effects on the fetus?
If the available data points to first or second trimester exposure as a risk factor, what is the comparative value of this study considering the pregnant monkeys were infected during the third trimester?
What are other health effects for children of mothers who have the flu while pregnant? Has there been any research examining the relationship between prenatal exposure to influenza and any other mental illnesses?
If this really is a significant risk factor, wouldn’t it suggest that in developing countries where the flu vaccine is less readily available, there should be higher rates of schizophrenia?
A summary of the study by Asian News International (available on many websites) says that “rhesus monkey babies born to mothers who had the flu while pregnant had smaller brains and showed other brain changes similar to those observed in human patients with schizophrenia.” To my knowledge, schizophrenics do not have “smaller brains,” and from what I’ve read, nearly every region of the brain and every neurotransmitter has been implicated by one study or another in the etiology or progression of schizophrenia. It seems a bit misleading then to represent the changes observed in the monkey’s brains as “similar to those observed in human patients with schizophrenia.” This may be the fault of the news article and not the study authors, but I feel it’s important to point out that despite all our technology and the proliferation of research into the “biological basis” of schizophrenia, there is no test or scan, no specific brain changes that can be identified and used to diagnose schizophrenia.
Because so many potential genetic and neurological risk factors are being investigated and written about, there can be a false sense that we are approaching an understanding of what causes schizophrenia. But risk and vulnerability are merely that: factors which increase the possibility that a person exposed to the cause of schizophrenia will go on to develop the disease. In the first chapter of a 2007 book called Recovery from Schizophrenia, Norman Sartorius, former President of the World Psychiatric Association and former Director of the World Health Organization’s Division of Mental Health, writes:
“Despite advances in our knowledge about schizophrenia in the past few decades, nothing allows us to surmise that the causes of schizophrenia will soon become known, or that the prevention of the disorder will become possible in the immediate future.” (3)
Sure, I like monkeys, and I understand how biologically similar we are, but if we want to understand schizophrenia, perhaps we should be looking in the realm of what makes us human.
Posted on March 12, 2010 - by David
What’s Wrong With Young Adult Literature?
A few weeks ago, I attended a ‘Socratic Conversation’ at Boston University with Karen Siegemund, where we discussed her PhD dissertation, ‘At Least they Read,’ a detailed examination of the trends in the rapidly-expanding category of young adult literature.
Siegemund’s academic and professional expertise is extremely broad. Currently a lecturer in the Math Department at UMass Dartmouth, she also spent six years teaching middle school, and before that, worked for 18 years a scientist in the defense industry, logging over 200 days at sea aboard U.S and foreign civilian and navy vessels doing research and testing on underwater acoustics. She holds a BA in Applied Mathematics, a MA in International Relations, and a PhD in Education and American Culture. But perhaps most importantly for this subject, she is the mother of two teenage daughters.
You Are What You Read
In her introduction to the topic, Siegemund spoke of her own childhood, emphasizing the empowering message she received from her parents – that she was capable of accomplishing anything that she set her mind to. She also reflected on the importance of reading in constructing her identity. As a teenager, she read many of the modern staples- Dostoyevski, Dickens, Austen, the Brontes, through the twentieth century to Hemingway and Fitzgerald – but she also adored Nancy Drew. The characters became her friends and their trials became roadmaps for navigating an increasingly complicated and sometimes frightening world. Plus, it was fun. Looking back at the years following high school, she is able to say with pride that she fought hard to achieve success, and in a scientific niche that was pretty much closed to women for a long time. Now, she tries to share the same message she was given as a child with her daughters, as well as foster a love of reading. But in the process of trying to find new books for her daughters to read, she was disturbed not only by what is being published, but what librarians and bookstores are recommending. While the Nancy Drew series may not represent the pinnacle of literary achievement, Siegemund points out that these books at least give young girls a strong heroine to look up to – (the wikipedia entry has a pretty impressive list of women who cite Nancy as a major influence in their lives). But today’s most popular books, she worries, are offering models of behavior and identity that range from mediocre to horrendous.
Siegemund sees a conflict between the idea of reading as merely a necessary skill and the idea that the content of a book contributes to the content of one’s mind. She sums up her own position with the simple phrase, “you are what you read.” It seems that for a long time, this view was considered commonsense. She included this quote from T.S Eliot’s ‘Religion and Literature’ in her presentation:
The author of a work of imagination is trying to affect us wholly, as human beings, whether he knows it or not; and we are affected by it, as human beings, whether we intend to be or not. I suppose that everything we eat has some other effect upon us than merely the pleasure of taste and mastication; it affects us during the process of assimilation and digestion; and I believe that exactly the same is true of anything we read.
Vanity, Vapidity, and Victimization
Probably the most visible example of this new young adult literature is the “Gossip Girl” series, which was adapted for TV in 2007 and is currently in its third season. “Gossip Girl” was the first of several series like it to document the lives of ridiculously wealthy teenagers as they jockey for social position in their prep schools, and, well, have sex with each other. In a 2006 New York Times article, Naomi Wolfe took three of these series (“Gossip Girl” “A-List” and “Clique”) to task. Though she’s obviously critical of the pornographic element in these books, it’s not her biggest qualm:
And while the tacky sex scenes in them are annoying, they aren’t really the problem. The problem is a value system in which meanness rules, parents check out, conformity is everything and stressed-out adult values are presumed to be meaningful to teenagers.
In Karen Siegemund’s talk, the loss of the heroine of earlier modern fiction, who defied norms, persevered, and overcame adversity, emerges as one of young adult literature’s biggest faults. Naomi Wolfe, in her analysis of one of the “Clique” novels, makes a similar observation:
In the classic tradition of young adult fiction, Massie would be the villain, and Claire, the newcomer who first appears as an L.B.R., or “Loser Beyond Repair,” would be the heroine: she is the one girl with spunk, curiosity and age-appropriate preoccupations. Claire and her family live in the guesthouse of the wealthy Block family; Claire’s mother is friends with Massie’s mother, but her father seems to be employed by Massie’s father in an uneasily dependent relationship. In Jane Austen or Charlotte Brontë, that economic dependency on the “great house” would signal that the heroine stands in opposition to the values of that mansion. Yet Claire’s whole journey, in class terms, is to gravitate into the mansion. She abandons her world of innocence and integrity — in which children respect parents, are honest and like candy — to embrace her eventual success as one of the school’s elite, lying to and manipulating parents, having contempt for teachers and humiliating social rivals.
Of course, there are other young adult novels which attempt to treat issues more seriously, but even in these, the ideal female has the same body as the spoiled heroines of “Gossip Girl.” In an article titled ‘ “Meant to Be Huge”: Obesity and Body Image in Young Adult Novels,’ Catherine Quick applauds the fact that obesity is now visible in many young adult novels (apparently it wasn’t a decade ago), but complains that “thin is still represented as the absolute ideal for body image, and the fat person, although willing to accept fat as integral to identity, undoubtedly prefers thin. Fat is still viewed as a decidedly negative body type.” Quick looks at several novels, and finds that only a few offer examples of true self-acceptance:
A truly positive self-image, however, means embracing the so-called negative qualities wholeheartedly, seeing them not as a negative to be accepted and dealt with, but as a positive asset, the essence of an identity. While the other protagonists simply accept their abnormality and move on, Myrtle and Troy embrace it. They come to see their bodies as a legitimate form of beauty, perhaps an “alternative body style” that should be recognized more readily in the thin-obsessed world.
But even Catherine Quick’s message of “true self-acceptance” keeps the body as the source of identity. In other words, embracing one’s body is equivalent to embracing one’s true self. In reality, embracing a body-image that society disapproves of will probably be extremely difficult for most girls. Perhaps changing the message about what kind of body is ideal is less important than shifting the focus away from the body and on to other ways in which girls can define themselves.
Another trend Siegemund noticed in her reading was how commonly females are cast in the role of the helpless victim. Many of today’s young adult novels deal with sensitive issues like rape and abuse which were off-limits not too long ago. It’s not the depiction of these things that bothers her, but the fact that we don’t see any of the victims “rising up”; they don’t take action themselves but saved through the intervention of an outsider. The question becomes, what good is a story that puts a difficult subject on display if there is no message of empowerment for the reader to find?
At Least They Read
Siegemund is not so much concerned that these books are being written and published, but that they are being endorsed by many librarians and teachers. She recognizes that teens will probably always gravitate towards literature they see as “forbidden fruit,” and doesn’t believe this exploration is necessarily damaging. But when this formerly forbidden material receives an official stamp of approval, it sends a much different message.
One school librarian, Philip Charles Crawford, wrote an article in the Horn Book Magazine two years ago, advocating for whatever gets kids to read. “For me, it doesn’t really matter what they are reading. I don’t measure success by the types of books kids choose, only by the growing number of my students who actively choose to read. And high-appeal books like Gossip Girl have the potential to captivate resistant readers … and, possibly, help transform them into lifelong readers.”
In an article on ‘Racy Reading’ from 2005, Pam Spencer Holley, former president of the Young Adult Library Services Association, sounded off as another member of the “At Least They Read” club:
“Unless you read stuff that’s perhaps not the most literary, you’ll never understand what good works are,” says Holley. “But when you get them hooked on reading, then you can lead them so many other places, as far as books go.”
There’s obviously an awareness that reading today has to compete with TV, internet, and video games as entertainment, and it’s logical to want to make the literature as relevant and accessible as possible. But Holley’s argument is kind of a sad one. What about showing them a world that isn’t quite theirs historically and culturally, but where the characters still deal with many of the same concerns: love, ambition, loss, discrimination, etc. Won’t this make them more subtle and sophisticated readers and people? Is there anything to demonstrate that young readers of YAL do move on to other stuff? If kids aren’t convinced early on that it’s worth it to put a little work into reading, will they ever read anything that is remotely difficult?
While listening to Karen talk, I thought back to the reading I did in high school (1999-2003), and found that off the top of my head, I couldn’t name a single book I was assigned to read that had a female protagonist. With a little concentration, I was able to recall reading To Kill a Mockingbird, and I’m sure there were others with important female characters, but I can say with confidence that the majority of the books we read were centered around the lives of male protagonists. This led me to pose a question: did this burgeoning genre of young adult literature fill some vacuum that young female readers felt when they read stories focused on the opposite sex? I mean, I had Catcher in the Rye’s Holden Caulfield and The Great Gatsby’s Nick Carraway, and even separated by thousands of miles and a century and a half, I could still connect to Raskolnikov. Who did the girls have? The response surprised me a little. Siegemund and the other women in the room (mostly in their mid-twenties) told me they had connected to many of the same male characters that I had. The thought that only a female protagonist could teach them about their place in the world seems to have never crossed their minds. I told my sister, (an avid reader since childhood who is currently working on her Master’s at Columbia), about this experience, and she said she had never felt that the gender of the protagonist was an obstacle for her either. Now I obviously haven’t conducted an extensive survey, and my sample was small and hardly representative; all of my impromptu subjects were well educated and came from environments in which childhood reading was encouraged. But, if these few women, each successful in her own right, have all made lasting connections to characters of both genders, from various nations and historical periods, maybe this can teach us something about the flaws of the current trends. Perhaps by calling more attention to “gender issues” and creating a special body of literature primarily for girls, we are actually taking a step backwards from where feminists were originally trying to go. I’m not saying that girls and boys face exactly the same challenges, or that young adult literature shouldn’t deal with controversial subject matter. But if females are defined first and foremost by their bodies, if their identity crises are usually played out in sexual dramas, if they are shown to be catty, untrustworthy, and uncooperative, or as helpless victims, if their success is measured by the man or the handbag on their arm, if we focus on the fundamental differences between the genders, how will that help us arrive at the goal of real equality? How will that help girls develop true confidence and self-respect?
Posted on March 4, 2010 - by David
Are More Teens Getting High?
Apparently, the “decade-long decline” in teen drug use has come to an end. The results of the 2009 Partnership Attitude Tracking Study, (an annual survey administered by the Partnership for a Drug-Free America and MetLife Foundation), published this Tuesday show significant increases in the use of alcohol, marijuana, and ecstasy among 9-12 graders in the U.S. You can read a reprint of the AP article here.
I was a little skeptical of these results, so I decided to look at another well known annual study. One of the best sources of information on drug use in the United States has been the Monitoring the Future Survey, carried out by researchers from the University of Michigan since 1975. While the early summary of the 2009 MTF also found an increase in marijuana use, there are some pretty big differences between these two studies.
The PATS finds that 25% of 9-12 graders used marijuana in the past month (up from 19% in 2008), but the MTF shows a past-month rate of 20.6 % for 12th graders, and with the previous year’s rate at 19.4%, this is a much smaller increase. Keep in mind also that this is only the rate for 12th graders, the group of students with the highest prevalence rates across the board. MTF also collects data for 8th and 10th graders, and their rates of past-month marijuana use were 6.5% and 15.9%, respectively. Considering this, the results look drastically different.
While the 2009 PATS shows ecstasy (MDMA) use on the rise, the MTF shows virtually no change in annual prevalence of ecstasy use. While the PATS estimates that 10% of 9-12 graders have used ecstasy in the past year, MTF found that only 4.3% of 12th graders had used ecstasy in the past year, a figure that has been very consistent for the past 7 years. The PATS 30 day prevalence rate for ecstasy use was 6%, while MTF found that only 1.8% of high school seniors had used ecstasy in the past month.
As far as past-month use of alcohol, the results appear closer than the other categories, (PATS: 39% among 9-12 graders, MTF: 8th grade-14.9% 10th grade – 34% 12th grade 43.5%), but for the MTF, the 2009 and 2008 stats are practically identical whereas the 2009 PATS shows a significant increase.
So, discrepancies between studies aside, if there really has been an upswing in teen drug use, what can be done? The main message accompanying the PATS report seems to be that parents need to do more if they want to prevent their kids from developing a serious problem. Steve Pasierb, president and CEO of the Partnership belives that “these new PATS data should put all parents on notice that they have to pay closer attention to their kids’ behavior – especially their social interactions – and they must take action just as soon as they think their child may be using drugs or drinking.” The report links to resources for concerned parents who need guidance in confronting this issue. I found this snooping checklist kind of amusing.
They might as well have written “look anywhere and everywhere!”
They even have a section titled ‘Prepare to Be Called a Hypocrite’ with tips on how to avoid letting your kids use your own past experimentation against you. But even before I read this, a question occurred to me which I don’t think is addressed in the Partnership resources – what about the fact that plenty of parents are still regular users of marijuana and alcohol? I think that by their teens, most kids are aware of their parents substance use, and this can present a difficult contradiction to the message that groups like the Partnership for a Drug-free America want to send.
The Monitoring the Future Survey has collected follow up data on high school graduates, allowing them to build a valuable body of data on adult drug use. The following comes from the 2008 MTF, as the full 2009 report has not been released yet:
The adjusted lifetime prevalence figures are most striking for today’s 50-year-olds (the class of 1976), who were passing through adolescence near the peak of the drug epidemic. Some 86% reported trying an illicit drug (lifetime prevalence, adjusted), leaving only 14% or about one in every seven who reported never having done so (see Figure 4-1). Some 79% of 50-year-olds said they had tried marijuana, and almost three quarters (73%) said they had tried some other illicit drug, including 46% who have tried cocaine specifically. The adjusted lifetime prevalences for 45-year-olds (the class of 1981) are similar to 50-year-olds. Clearly, the parents of today’s teenagers and young adults are themselves a very drug-experienced generation.
The data does suggest that parents confronting their teens about drug use should indeed be prepared to called hypocrites, but I think it’s more important to look at what adults are actively using today:
- 30 day prevalence of any illicit drug use- age 35 (11%) age 40 (9%) age 45 (10%) age 50(12%)
- 30 day prevalence of marijuana use age 35 (8%) age 40 (7%) age 45 (6%) age 50 (7%)
- Daily use of alcohol- age 35(24%) age 40 (22%) age 45(21%) age 50(20%)
- 2-week prevalence of 5 or more drinks in a row- age 35(5%) age 40(7%) age 45(10%) age 50 (11%)
Actions speak louder than words, and the statistics seem to show that for plenty of kids, looking in the refrigerator, the liquor cabinet, or mom and dad’s own top dresser drawer is enough to justify not only experimentation, but regular use. The MTF literature would suggest that many of today’s parents are members of a generation that used even more heavily than today’s teens do, but overall, I see the trends as fairly consistent, especially when you consider daily users, the group that would likely experience the most problems. When the survey began in 1975, 6% of 12th graders were daily marijuana users, compared to 5.2% in 2009.
In closing, I can’t resist including this quote from the PATS report, where teen drug use gets couched in terms of an unacceptable national expense. Is it just me or does this sound a bit cold and impersonal?
“We’re very troubled by this upswing that has implications not just for parents, who are the main focus of the Partnership’s efforts, but for the country as a whole,” said Partnership Chairman Patricia Russo. “The United States simply can’t afford to let millions of kids struggle through their academic and professional lives hindered by substance abuse. Parents and caregivers need to play a more active role in protecting their families, trust their instincts and take immediate action as soon as they sense a problem.”
I think it’s important to note that even leaving all of pop culture aside, the nation’s official stance on this issue is not a clear one. Under federal law, marijuana is still a schedule I controlled substance (the designation given to drugs with high potential for abuse and no approved medical use), but in the last ten years, 20 states have passed laws either decriminalizing possession of marijuana or legalizing medical use. This presents an interesting contradiction. I’m not suggesting that changes in legality have led to this supposed “upswing” in use, but I do believe that convincing kids that marijuana is a dangerous drug will become increasingly difficult as the trend towards legalization continues.
From what I’ve observed, each study that shows a decrease becomes an occasion for celebration, while every apparent increase is a cause for major concern. And while people talk and write about these results, kids across the nation keep getting high at basically the same rate.
Posted on March 2, 2010 - by David
‘Analytical Rumination’:Depression as an Adaptive Response?
I read an article last week in the New York Times Magazine by Jonah Lehrer called Depression’s Upside, exploring the possibility that depression is an adaptive, evolved response which helps people focus cognitive resources on solving complex problems. The idea comes from a paper by Paul W. Andrews and J. Anderson Thomson, Jr. published in July of 2009 in the Psychological Review, titled The Bright Side of Being Blue: Depression as an Adaptation for Analyzing Complex Problems. Lehrer’s clever lede uses a description of Darwin’s own mental anguish to slide into yet another evolutionary explanation for the workings of the mind. The following paragraph describes the theoretical view from which the work springs:
In the late 1990s, Thomson became interested in evolutionary psychology, which tries to explain the features of the human mind in terms of natural selection. The starting premise of the field is that the brain has a vast evolutionary history, and that this history shapes human nature. We are not a blank slate but a byproduct of imperfect adaptations, stuck with a mind that was designed to meet the needs of Pleistocene hunter-gatherers on the African savanna. While the specifics of evolutionary psychology remain controversial — it’s never easy proving theories about the distant past — its underlying assumption is largely accepted by mainstream scientists. There is no longer much debate over whether evolution sculptured the fleshy machine inside our head. Instead, researchers have moved on to new questions like when and how this sculpturing happened and which of our mental traits are adaptations and which are accidents.
As Lehrer points out earlier in his article, the prevalence of depression poses a problem for those who are “trying to explain the features of the human mind in terms of natural selection.” The only solution for them seems to be to demonstrate that depression actually has evolutionary benefits. Meanwhile a disorder like schizophrenia is rare enough, and a case for its adaptive benefits would be so difficult to make, that I guess it’s easier for them to chalk it up to a kind of glitch in the system.
My first problem is that this point of view fundamentally disregards the symbolic reality of culture. Once again, I’ll quote from Liah Greenfeld’s essay, Nationalism and the Mind, to give background on the view of culture as an emergent phenomenon:
On the most general level, culture is the process of transmission of historical ways of life and forms of human association across generations and distances… In distinction to other animal species, such transmission of ways of life and social organization, in the case of humanity, is not genetic, but symbolic. Humans are the only biological species, the continuation of whose existence is dependent on symbolic transmission.
The products of this cultural process are stored in the environment within which our biological life takes place, but the process itself goes on inside us. In other words, culture exists dynamically, develops, regenerates, transforms only by means of our minds – which makes culture a mental process. Let me reiterate: culture is a symbolic and a mental process. The fact that it is a mental process means that it occurs by means of the mechanisms of the brain. The fact that it is a symbolic process means that its logic cannot be reduced to the logic of the brain mechanisms, that it is an emergent phenomenon and a reality sui generis. In other words: the neural processes by means of which the cultural process occurs serve only as boundary conditions outside of which it cannot occur, but are powerless to shape the nature and direction of the cultural process. In contrast, culture itself consistently directs the brain, by means of which it occurs, forcing brain mechanisms into patterns of organization and operation which (though, obviously, not impossible) are most improbable given all that we may know of the biological functioning of the brain. (15-16)
The idea of culture as an emergent phenomenon leads to a view of the human mind as the individualized process of culture, and this obviously clashes with the argument made by Andrews and Thomson which seeks to explain the human mind as a product of biological evolution. Nevertheless, their argument is based upon an implicit acceptance of the idea that problems in the cultural environment affect the function of the brain.
I think it’s best now to look at the paper itself. On page 6, they describe the theory one claim at a time:
“In summary, we hypothesize that depression is a stress response mechanism: (1) that is triggered by analytically difficult problems that influence important fitness-related goals; (2) that coordinates changes in body systems to promote sustained analysis of the triggering problem, otherwise known as depressive rumination; (3) that helps people generate and evaluate potential solutions to the triggering problem; and (4) that makes tradeoffs with other goals in order to promote analysis of the triggering problem, including reduced accuracy on laboratory tasks. Collectively, we refer to this suite of claims as the analytical rumination (AR) hypothesis.”
By calling depression “a stress response mechanism,” they make it analogous to any animal’s response to a problem (such as the presence of predator) in the physical environment. On page 4, they write that “negative emotions are stress response mechanisms – they are involuntary response to environmental challenges with important fitness consequences, and they evolved to coordinate changes in physiology, immune function, attention and cognition, physical activity and other body systems to meet those challenges.” This view both cuts out the cultural (therefore symbolic) aspect of emotion and fails to acknowledge that “environmental challenges” are cultural challenges – for humans, the most important and challenging terrain that must be navigated is not the physical but the cultural world. When they write that “different environmental stressors trigger different emotions…” the only way to make sense of this is to read “environmental stressors” as “cultural stressors. The “stressor” may be present in the physical environment – a boss, an ex-wife, a place of work – but it is the cultural significance attached to these things which can “trigger different emotions.” I think we can safely assume that the “stress response” of a rabbit exposed to a wolf has never been based on symbolic reality and has probably been consistent over thousands of years. But for humans, both what constitutes a complex problem, and responses to such complex problems, has not been consistent over time and between places.
The authors focus on social dilemmas as the classic example of a complex problem that triggers depression. But you can’t talk about social dilemmas just in terms of evolution, cutting out the symbolic process of culture. Otherwise, each culture and its particularities must represent a separate human evolution. They use sexual infidelity as an example of an evolutionary fitness-related social dilemma, but it doesn’t take an anthropologist or an historian to figure out that such a situation differs widely over time and from culture to culture. It’s like they’re moving between descriptions of humans as just another species of animals and humans as cultural beings without ever acknowledging the difference. On the one hand they write “if his wife gets pregnant…” and then they mention “access to mates.” So are we cultural beings with institutions like marriage or just animals who need mates? They are speculating about the social dilemmas of hunter-gatherer groups and trying to relate this to the depression of modern people who live in a radically different cultural environment, but they don’t seem to see the disconnect.
The core of their theory is the claim that depression can be seen as adaptive rather than a disorder, because the analytical rumination characteristic of depression actually leads people to solutions for their complex problems. I’d like to consider this view in relation to the view of Allan Horwitz and Jerome Wakefield as described in the Loss of Sadness. Horwitz and Wakefield believe that certain symptoms of depression are normal reactions to difficult life events, and can even lead to personal growth of some kind, but they don’t consider these reactions to be true cases of depression. They consider true depression to have no apparent cause or context, or to last longer and have more severe symptoms than “normal sorrow.” Andrews and Thomson, on the other hand, see no qualitative difference between major depression and subclinical depression, claiming that “…depressive symptoms are better characterized on a single continuum of severity, duration, and liability” (7). While there may be good reasons for the continuum view, I believe this allows Andrews and Thomson to make their adaptive response argument for depression on the basis of evidence drawn mostly from subclinical cases and even from subjects in which “depressed affect” was induced by sad music or film clips. I don’t doubt that for some people, rumination may lead to a better understanding of their problems which could in turn lead to resolution or avoidance of future problems, but critics are quick to point out that this is probably not the way it works for severely depressed people. Lehrer quotes Peter Kramer, Brown University professor of psychiatry and human behavior and author of Listening to Prozac, who wrote, “this study says nothing about chronic depression and the sort of self-hating, paralyzing, hopeless, circular rumination it inspires.”
Andrews and Thomson are clearly interested in proposing new methods of treatment for depression, and believe that therapies which facilitate the process of rumination may be effective in dealing with the underlying problems causing depression. They describe a method which involves “having patients write about their strongest thoughts and feelings about their depressive episode in a journal (25). Journal entries were later examined and coded for “avoidance and processing.” The study found that:
“…the peak in processing was also associated with a spike in depressive symptomatology. Thus, the authors viewed the temporary spike in depression as a positive sign of growth and insight during treatment. This suggests that depression may enhance processing that promotes growth and insight into problems and may facilitate the resolution of the episode. “ (26)
I simply don’t see what leads them to conclude that “depression may enhance processing,” except that this view fits with their hypothesis. It would seem more logical to me to conclude that the increase in processing of negative thoughts and emotions caused the “temporary spike in depression.” They also fail to acknowledge the huge difference between depressive rumination in isolation, and carefully facilitated processing which occurs in the context of therapy. “Analytical rumination” may very well be a common feature of depression, but there is no reason this has to be seen as an evolutionary adaptation, and I doubt that it often leads to the resolution of complex problems without some form of outside help that can orient this rumination towards action.
As their paper draws to a close, Andrews and Thomson restate their claims and review the evidence they’ve used to try to demonstrate that “depression evolved by natural selection, probably because it helped people analyze and solve the problems they were ruminating about.” (41) I have to say, I was extremely frustrated by the number of times that “social dilemmas” and “complex problems” were mentioned, without any real examination of what this means for a depressed person today, or any apparent consideration of differences between cultures and over time. Then, I read this little paragraph:
A design analysis does not require depressive rumination to be currently adaptive because modern and evolutionary environments may differ in important ways (Thornhill 1990, 1997). All that is required is that, on average, depressive rumination helped people analyze and solve the problems they were ruminating about in ancestral environments. Still, strong, replicable evidence that depression rumination currently helps people analyze and solve the problems they ruminate about would support the evolutionary argument, and more research is needed here. (41)
Wow. Now they say something about this? So how do these environments differ, and why? They move between their ideas of the evolutionary past and today without blinking an eye, implying continuity and giving the appearance that they are in fact arguing that depressive rumination is “currently adaptive,” and then with only a few pages left to go in the paper they throw this in? So what has the point of all this been?
In looking at ‘now and then,’ so to speak, they suggest that today, compared to the “ancestral environment,” there are more ways to distract oneself from depression and the “complex problems” which trigger it, meaning that we are robbed of the potential benefit of depressive rumination. However, nowhere do they consider the obvious possibility- that the problems that individuals in modern societies face are of a much different nature than those of the “evolutionary past.” In the end, they seem to be saying the same thing Horwitz and Wakefield say, only they take a much more circuitous and frustrating path to arrive at their final statement:
Depression is the primary emotional condition for which people seek help. The current therapeutic emphasis on antidepressant medications taps into the evolved desire to find quick fixes for pain. But learning how to endure and utilize emotional pain may be part of the evolutionary heritage of depression, which may explain venerable philosophical traditions that view emotional pain as the impetus for growth and insight into oneself and the problems of life. (43-44)
I guess by this point, I shouldn’t be surprised when our “venerable philosophical traditions” get reduced to byproducts of evolution, but it still leaves me shaking my head.
Exploring modern culture and its effects on the mind