Inattention to details

Neuroskeptic has excellent coverage of the recent headline-making study on the genetics of ADHD that was overly-hyped as the ‘first direct genetic link’ to the disorder and overly-slammed as a drug company ploy.

For example, BBC News has a report on the study where you can see researcher Anita Thapar making some unrealistic claims for the significance of the interesting-but-preliminary study while the science-retardant child psychologist Oliver James counters by cherry picking evidence (and not even very accurately).

Neuroskeptic does a great job of untangling the actual import of the research and discusses why the finding of copy-number variations or CNVs in about 16% of the ADHD kids compared to 7.5% of the controls is neither a ‘direct genetic link’ nor evidence against the idea that the condition is ‘socially constructed’.

However, I was particularly drawn by Thapar’s comments that discovering the genetic component “should address the issue of stigma.”

The common idea is that if we can demonstrate a particular mental disorder is a ‘brain disease’ or the result of a biological dysfunction people who have the condition will be less stigmatised due to a vague notion that their behaviour ‘is not their fault’.

Unfortunately, studies to date have shown that biological explanations for mental disorder actually increase stigma in public, patients and mental health professionals because the affected people are typically seen as more unpredictable and dangerous than when social or psychological explanations are given.

It is genuinely important that we understand the genetic influences to behavioural problems, including those that get classified as ADHD, and this new study is a small but important step toward that aim.

But we kid ourselves if we think this evidence automatically decreases stigma and we do society a disservice if we make our acceptance and compassion for people with behavioural difficulties dependent on certain types of scientific explanation.
 

Link to excellent Neuroskeptic piece on genetics and ADHD study.

8 thoughts on “Inattention to details”

  1. Great points. There is also another dimension to the argument that Thapar makes.

    “Medicalization” of a syndrome (by showing some biological model of causation or origin) is perhaps not an effective remedy for stigmatization but I think it _is_ effective at legitimizing diagnosis and treatment in many people’s minds.

    Psychologically manifested illness is still somehow not quite real illness in many people’s minds, until someone says they see something “lighting up” in a brain picture or “linked to a gene.” It seems to me that such rhetoric often causes a syndrome to cross over a threshold from “all in your mind” to “real illness.”

  2. “Unfortunately, studies to date have shown that biological explanations for mental disorder actually increase stigma in public, patients and mental health professionals because the affected people are typically seen as more unpredictable and dangerous than when social or psychological explanations are given.”

    Uh… I had read a blog post by Dan Ariely where he argued for a somewhat opposing thesis.

    “What we found was that participants who were told that the girl had suffered from OCD since childhood found the clip less funny, laughed out loud from it less, and were less likely to recommend it to others than other participants. They also felt worse for the student and thought she deserved a smaller fine for inadvertently setting off the sorority house’s fire alarm than if they were either told beforehand that the student had suffered from stress since childhood (or received no justification at all). Participants who were told she had OCD also thought she seemed more likeable, intelligent, and creative. But they also thought that she seemed like a bigger loner and more antisocial.”

    See here:http://danariely.com/2010/08/02/how-we-view-people-with-medical-labels/

  3. Ariely’s study looks at a different question. i.e. the effect of explaining someone’s behaviour as mental illness – not, the effect of explaining someone’s mental illness as biological.

    1. All I could think of when I read your comment, Vaughan, was “Now who’s ‘cherry-picking’?”

      1. Where is the cherry-picking? I would agree that they are distinct concepts. Also, it isn’t clear, I think, that the relative degree of stigma attached to disorders such as OCD would generalize to other mental disorders/psychiatric diagnoses. People with OCD aren’t necessarily (as likely to be) viewed, regardless of diagnostic label or perceived etiology, as dangerous, not-quite-human, frightening, etc..

        I have/have had several somewhat to highly stigmatized psychiatric diagnoses, for which biological explanations either are or aren’t commonly accepted. I’ve also had to disclose these diagnoses at odd intervals to various people, and deal with the fallout. I would agree with Vaughan’s assessment, and was similarly struck by what seemed to me the incredibly naive and simplistic commentary on/perception of stigma.

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