Merged Psychological conditions are illusory

[lomiller]

Wow, I guess my wikki-fu isn't so great.

Apparently neither was mine! A little more searching showed that even though the area activated is close to the speech/language area almost everyone has the left side of their brain dominate for these while in the first paper I linked dyslexic brains showed more activity in the right inferior frontal gyrus.

The thing I find interesting is that normal learners don't seem to be using this area nearly as much. It would be interesting to see if they are using the same area on the left side or someplace else entirely.

Why do people even need woo when real science is so weird and amazing?

Just so!

 

[JJM 777]

Yes but now you are saying that a difficulty in reading is caused by a difficulty in reading.

I didn´t say what _causes_ what.

But now I see your point. And the answer is: dyslexia is caused by brain damage (or lack of complete development) in the region that handles the task of reading. Just like cerebral palsy is caused by brain damage in any random part of the brain, and dementia is caused by brain damage a bit here and there around.

Dyslexia is not caused by dyslexia.
Cerebral palsy is not caused by cerebral palsy.
Dementia is not caused by dementia.

Happy now? End of topic?

 

[Drachasor]

It is a problem only in the context of making work and social life difficult- it doesn't do any direct physical or mental damage

Yes, they don't do direct physical or mental damage the same way not having an arm doesn't deal direct physical or mental damage. THEY ARE THE DAMAGE.

As you rightly point out, this damage causes people lots of problems.

and although there may be genetics underpinning it, this is nothing that can't be explained by natural variation.

You could say the same about genetic disorders, which are definitely caused by "natural variation." I don't see why that's an excuse to not treat something. Nature's a nasty piece of work, and there's no reason to respect something because it is "natural."

As you point out above, these problems, which ARE damage, inflict further damage on someone's life. Why shouldn't they be treated?

Up to 10% of children in the US apparently have it now even though it only gained wide acceptance as a medical condition in the 70s, although drugs were used before this to treat hyperactivity and a similar set of 'symptoms' have been called by various other names since the 1900s. The diagnostic methods used are arbitrary. The fact that stimulants work doesn't lend ADHD any credibility - smoking helps me concentrate, does this mean I have ADHD ?

These are disorders. They are damage or malfunctioning of some sort. You admit they cause disruption and unhappiness in life. If a particular treatment alleviates this problem whereas a placebo or other treatment does not, how can you conclude treatments don't matter?

You could make the same argument about how physics is meaningless and is just making crap. This would especially be true if you looked in the first hundred years or so of physics development. Psychology is an EXTREMELY young science, so naturally there has been a lot of upheaval and work in the past 100 years. Heck, for a significant portion of that time running experiments wasn't even done by a lot of people in the field. It's of course a tricky subject, but we're doing pretty well now in terms of experimental design and testing.

I don't know why ADHD has a bee in your bonnet so much, but it is real. There's been a lot of research into it and into what part of the brain it affects, how it affects thinking, etc, etc. While it isn't precisely understood, it is understood that people with ADHD have a great deal of difficulty focusing on tasks, making and executing plans, etc, etc. Far more so than the average person. Secondary symptoms vary. Do you have some evidence that it is defined arbitrarily? While diagnostic tests vary, it isn't like they aren't looking at something specific. The definition in the DSM-IV is as precise as that for depression, PTSD, or any of a number of other disorders.

Similarly for dyslexia. It is precisely defined. It is not the cause of all reading problems. It has particular treatments that work well for it.

Smoking doesn't have a significant stimulant. If it helps you concentrate, it is most likely because you are addicted to nicotine and need a fix. That has different symptoms and causes, even if there are at times some overlap. Addiction is also covered in the DSM-IV.

 

[Drachasor]

They can also pick up natural variation. Old age whilst a cause of death is not a medical condition either - it is natural.

"Old age" is not a cause of death. Heart failure is a cause of death. Kidney failure is a cause of death. A heart attack is a cause of death. Brain hemorrhaging is a cause of death. Stroke is a cause of death.

Getting old means your body starts wearing down because it doesn't repair itself as effectively anymore. That doesn't mean when it does fail there isn't a cause other than "gosh, he be old". And yes, having organs start to wear down IS a medical condition, a slew of them in fact, and to an extent it can be treated.

You are using the naturalistic fallacy here. Something isn't good or ok just because it is "natural." Since medicine is concerned with the health and well-being of the patient, anything that disrupts that is a medical concern (though some are certainly quite minor).

 

[Jonesboy]

No, please try to be affected by your brain, especially the visual cortex and the areas associated with processing written language and read the bit that says that "I am my brain". Now try to be affected by the parts of your brain (it's a struggle, I know, work with me here) dealing with logic and try to work out what that means.

One thing affects another thing, and by Newtons law, the other thing affects the first thing.

So if one of these things is the brain, what's the other thing?
And what is it like for us not be affected by the brain?

 

[Jonesboy]

Wrong again.

http://www.sciencedaily.com/releases/2010/12/101220163059.htm

People with Dyslexia process written information in a different part of the brain then “normal” learners. Furthermore, their ability to somewhat overcome this imparemtn can be directly linked to development in the area of the brain dyslexics process written inforamtion rather than the area where normal learners process that same information.

I understand a difficulty in the "process of information".
But what's dyslexia?

Also you said "People with Dyslexia process written information in a different part of the brain then “normal” learners"

It takes two to make a difference. But here you are privileging one over the other on the basis that it is different!!

 

[geni]

In my earlier posts I explained why these criteria are not infallible.

You may think you did.

So there is neurological evidence of all the conditions I mention ?

Not yet. However given the dirrection of progress in the field seems unwise to rule out the possibility.

Biologically speaking, yes crime is wonderful as long as one eades punishment.

non sequitur

Yes it is morally and socially wrong but that is off topic. Antisocial personality disorder is just a euphemism for criminal temperament.

Not really. "criminal temperament" is too ill defined to be useful.

You say being shy doesn't qualify as a personality disorder - the criteria for avoidant personality disorder essentially amount to extreme shyness and the anxiety it causes.

There is a lack of an equiverlence between shyness and extreme shyness.

The same could be said for narcissistics and schizoids and eccentricity - the criteria for these two just amount to two different types of eccentricity.

Which is a pretty meaningless statement. "Eccentricity" is such a vauge term that it not a useful description of what it going on. Carl Gustaf von Rosen was certianly eccentric but had nothing in common with those classified as SPD.

Ticking boxes isn't the same as diagnosis.

 

[Drachasor]

One thing affects another thing, and by Newtons law, the other thing affects the first thing.

So if one of these things is the brain, what's the other thing?
And what is it like for us not be affected by the brain?

Misapplication of Newton's law which is about physical FORCE (a technical term).

Trivial demonstration that it doesn't apply to everything: If I make a joke on a forum and someone reads it and laughs, I've affected them (or the post has), and there's no reaction that hits the post (or me).

 

[quarky]

Kids can't sit still in school. Is it a problem in the brain or a problem of school?
Do the antsy kids need drugs, or should they get out of school?

As technology evolves, the written word might become obsolete.
If it does, will dyslexia be cured?

As the i-phone becomes ubiquitous, will people with fat fingers or unsteady hands become 'at risk'? They will be at a disadvantage.

Was Genghis Khan a psychopath?
Or, maybe by today's standards?

Other than actual brain damage, we seem to be creating disorders by consensus.

 

[Humanzee]

Times change, problems changes, solutions change. Isn't the end result to try and make things better for as many people as we can? If creating a disorder by consensus improves lives how is that bad? Just asking.

 

[quarky]

Times change, problems changes, solutions change. Isn't the end result to try and make things better for as many people as we can? If creating a disorder by consensus improves lives how is that bad? Just asking.

I agree with your point, even if it wasn't very pointed.
It seemed to understand mine.


I'd say the crux of the dilemma lies in the "make things better" part of the equation.

I wonder if we (humans) have turned a corner. And we're making things worse?
I'm not sure.
We certainly get more and more removed from the interaction with natural systems that is our heritage.

Life in a cubicle is going to require some drugs.
And the mandatory piss test rules out the ones of long tradition.

 

[Drachasor]

Kids can't sit still in school. Is it a problem in the brain or a problem of school?
Do the antsy kids need drugs, or should they get out of school?

Since you seem to be talking about ADHD, it requires more than just "not being able to sit still." In fact, it doesn't even require that necessarily. I linked to the criteria required.

Here's the whole thing though:

I. Either A or B:

A. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is inappropriate for developmental level:

Inattention

• 1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
• 2. Often has trouble keeping attention on tasks or play activities.
• 3. Often does not seem to listen when spoken to directly.
• 4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
• 5. Often has trouble organizing activities.
• 6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
• 7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
• 8. Is often easily distracted.
• 9. Is often forgetful in daily activities.

B. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level: [/SIZE]

Hyperactivity

Child turned upside down on chair

• 1. Often fidgets with hands or feet or squirms in seat when sitting still is expected.
• 2. Often gets up from seat when remaining in seat is expected.
• 3. Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
• 4. Often has trouble playing or doing leisure activities quietly.
• 5. Is often "on the go" or often acts as if "driven by a motor".
• 6. Often talks excessively.

Impulsivity

• 7. Often blurts out answers before questions have been finished.
• 8. Often has trouble waiting one's turn.
• 9. Often interrupts or intrudes on others (e.g., butts into conversations or games).

II. Some symptoms that cause impairment were present before age 7 years.

III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).

IV. There must be clear evidence of clinically significant impairment in social, school, or work functioning.

V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Based on these criteria, three types of ADHD are identified:

IA. ADHD, Combined Type: if both criteria IA and IB are met for the past 6 months

IB. ADHD, Predominantly Inattentive Type: if criterion IA is met but criterion IB is not met for the past six months

IC. ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion IB is met but Criterion IA is not met for the past six months.

For reference, I hit A(1, 2, 4, 5, 7, 8, 9) and B(1, 3, 6, 7, 8, 9) -- I have some of the others, but not "often". And yes, II, III, IV, and V apply to me as well. Medication handles this all quite nicely.

 

[quarky]

I don't actually have a 'horse in this race'.
Possibly a touch of "Devil's advocate".

Sitting still in school would be a symptom of a disorder in my universe.
School is where we learn subservience and obedience.
It's often an obstacle to learning.

 

[Drachasor]

I don't actually have a 'horse in this race'.
Possibly a touch of "Devil's advocate".

Sitting still in school would be a symptom of a disorder in my universe.
School is where we learn subservience and obedience.
It's often an obstacle to learning.

Well thankfully it takes larger extremes than "capability to sit still" in order to qualify as a mental disorder.

 

[Dancing David]

No I do not believe congenital deafness/dumbness to be part of a continuum as it is clearly an abnormal and debillitating pathological state. Having had a relative who was dumb and unable to take food by mouth (although this wasn't congenital, it was the result of several strokes precipitated by a bout of rheumatic fever she suffered in childhood) and another who was born mentally handicapped because his mother had to give up warfarin during her pregnancy and refused a termination. I find your comparison frankly offensive.

yet you are the one who made the foolish continuum argument, there is a range of biological expression. You were making a statement that some things could not be disorders because there are ranges of biological expression. This argument fails in that at the outliers of a range you can have dysfunctional values. Sleeping 20 hours or sleeping 1 hour for example.

You ignore the fact that there are children who are one SD below average IQ, <85, and they are the slow learners they will never keep up with their peers in school, then there are those who are two SD below the mean IQ, <70 and they are the cognitively impaired, etc....

So perhaps you want to reconsider your offense?

I mean really your argument can also be applied to diabetes, they are blood sugars that are part of a range are they not? And yes actual congenital effects do fall around statistical means and so they do apply to ranges, you just happened to give two tragic examples of environmental/medical trauma.

 

[Dancing David]

I never dismissed it as a problem just as a medical condition. The comparison is anything but dead on - genuine illness or deformity doesn't compare with these problems and the comparison is blatantly offensive to sufferers of the former.
The onus is not on me to give evidence - I made a negative assertion.

Nope you made an incorrect metaphor. the fact that traits fall upon a spectrum does not mean they can't be dysfunctional.

 

[Dancing David]

And this social baggage is partly why the distinction is important. Medical conditions and disabilities give some alleviation of personal responsibility i.e. a schizophrenic (genuinely ill) who commits a violent crime generally goes to a secure hospital rather than jail. Should someone with ADHD be treated the same ? Criminal behaviour is a feature in a subcategory of so called ADHD and is known as known as oppositional defiant 'disorder' - essentially hooliganism by another name.

Excuse me, how many false dichotomies are you going to make, you are really misinformed.

Anxiety falls a long a spectrum, therefore debilitating anxiety is not a disorder?

You don't even know how to define 'criminal behavior' much less show it is part of ADD, you really need to consider that now you are being very offensive.

Where is this shown or demonstrated, eh? The fact that many people in prison may be classified as living with ADD is not the same as saying it is a subcategory of ADD.

And OOD is not ADD. They may be comorbid, there are adults and children who defy social mores to an extent which is harmful, why do you have a problem with that?

So where the fred do you get you information?

 

[Dancing David]

They can also pick up natural variation. Old age whilst a cause of death is not a medical condition either - it is natural.

And slow learners and the cognitively impaired individuals do not exist. After all it is 'natural variation'

You set up some bizarre false dichotomies. And are arguing from ignorance of how diagnostic categories work, then you set up some bizarre standard of what defines a 'medical' condition, Neurology is physical, variation in neurology is physical, but you are using an incoherent line in the sand to define dysfunctional.

 

[quadraginta]

It is a problem only in the context of making work and social life difficult- it doesn't do any direct physical or mental damage and although there may be genetics underpinning it, this is nothing that can't be explained by natural variation. Up to 10% of children in the US apparently have it now even though it only gained wide acceptance as a medical condition in the 70s, although drugs were used before this to treat hyperactivity and a similar set of 'symptoms' have been called by various other names since the 1900s. The diagnostic methods used are arbitrary. The fact that stimulants work doesn't lend ADHD any credibility - smoking helps me concentrate, does this mean I have ADHD ?

You do know that the stimulants which are used to treat ADHD do not affect those individuals the same way that they affect people who are not suffering from it, don't you? And that all 'stimulants' are not helpful in the treatment of ADHD. (Although it has been my experience that coffee tends to be very popular with ADHD sufferers. )

This one fact in itself is evidence that there is something going on which is not "normal". Dexedrine acts to calm down an ADHD child.

I sometimes wonder if the sad coincidence that a drug which is so efficacious for the treatment of ADHD is one which had developed such a bad rap in our society due to earlier abuse for an entirely different effect.

Pharmaceutical chemicals can have quite different effects in different people. This is one of the reasons there are so many label warnings. Sometimes these unanticipated effects are quite beneficial ... for some individuals.

Two of the most commonly prescribed anti-anxiety drugs are also, and primarily, anti-histamines, used to alleviate allergy symptoms. That is what they were developed to address. The benefit to anxiety patients was an unanticipated side-effect. People who do not suffer debilitating anxiety attacks might never know this, although they can get a bit drowsy.

One of them, hydroxyzine (aka Vistaril) is the basis for a 'second generation' anti-histamine, cetirizine (aka Zyrtec). It is marketed specifically for its non-drowsy effect. The reason that it doesn't have the same sedative effect as 'first generation' anti-histamines like its precursor hydroxyzine is that it doesn't cross the blood-brain barrier as easily. It also doesn't have the same beneficial effect for people suffering from debilitating anxiety.

Do you believe it is wrong to prescribe hydroxyzine to people who suffer from debilitating anxiety attacks?

After all, anxiety is just a spectrum.

 

[quadraginta]

<snip>

I'd say the crux of the dilemma lies in the "make things better" part of the equation.

I wonder if we (humans) have turned a corner. And we're making things worse?
I'm not sure.
We certainly get more and more removed from the interaction with natural systems that is our heritage.

<snip>

You know, for some of us our natural heritage isn't that far back. Our grandparents (Yeah, I'm talkin' about people our age, Quarky. ) were born in an era when this whole 'germ' thing had just managed general acceptance in the medical community, and most of the 'guy on the street' kinds of people still weren't too sure about the whole idea.

(My grandfather got his M.D. just in time to be practicing at a Navy hospital in Boston when the Spanish Flu pandemic hit. I'm not surprised he ended up as a forensic pathologist.)

That heritage you're talking about also includes an infant death rate so high that it was a common occurrence. It didn't happen in every family by then, but it happened enough that everyone had friends or family who had lost a child. Probably both.

Even after adjusting for infant and child death, the average lifespan of someone who was born at the end of the 19th century was still decades shorter than it is today.

That was the natural system. That was the heritage. I don't mind giving that up very much.

And along the way we have also learned how to cure or at least alleviate many other health problems which we were unable to before. Sometimes ones we hadn't even yet put a name to, that we didn't even know we could do anything about.

How do you propose that we pick and choose which ones to address? What is the scale we use to draw a line between "This is our heritage." and "This needs a cure."?

Some people used to become "demented" as they grew older. Now we know why. We even put a label on it. Alzheimer's disease.

We can't cure it yet. Should we stop trying because it's our heritage? It is a natural system, after all. Maybe we should just interact with it like we used to.