Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

spectator.co.uk

Post reply on HN
Print view View original

31–40 of 127 posts

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#31

Post by Angostura »

imperio59 wrote: post #26

The fact is psychiatry today still lacks tests or any proof of its claims of "chemical imbalance", which remains unproven. No one had established a profile for what a "balanced brain chemistry"looks like, nor do they test for any brain chemistry imbalance. Diagnosis is still left to the subjective assessment of the practitioner before prescribing powerful psychotropics that DO change brain chemistry in unpredictable…

This seems overly pessimistic to me, there are drugs that significantly improve patients wellbeing and do so consistently and repeatably, despite the fact that we don't have a complete understanding of the complete mechanism of action.

If I do a study showing that handwashing in surgeons measurably reduces risk of infection, does the fact that I don't know about microbes make lacking in scientific rigor and remove its scientific basis?

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#32

Post by sterlind »

hsyqiwgx wrote: post #12
hyperpape wrote: post #4

While this is fascinating and I'm glad to have read it, it doesn't substantiate that this experiment set back psychiatry. The fact that the DSM-IV was prompted or encouraged by the experiment is suggested, but there's no argument for it. Even beyond that, the article doesn't even hint at an argument that the DSM-IV set back psychiatry (except offering the bare assertion that reductionism is false). Of course, the DSM…

The DSM is controversial because it's only scientific until political groups take interest. The trans community lobbied and bothered academics over the DSM's definition for Trans people until the academics threw up their hands and decided their funding wasn't good enough to justify having a spine and so the definition in the DSM was changed with a minimum of real science to justify it. That's psychology as a field in…

For those missing context, "Gender Identity Disorder" in the DSM-IV, which described transgender identity itself as a mental illness, was replaced with "Gender Dysphoria" in the DSM-V, which was scoped specifically to the depression/pain of feeling socially in the wrong gender role, as well as the feeling of one's body being wrong.

The DSM does cite academic sources IIRC, but they're listed as a while for the book, rather than being referenced by specific sections or criteria, which is a common critique of the DSM in general. Additionally, Ray Blanchard, an academic who believes transgenderism is caused by "autogynephilia"/"autoandrophilia" (i.e. a sexual fetish caused by attraction to oneself as the desired gender), was a member of the committee who decided the DSM-V definition.

So no, OP, academics who didn't support trans politics weren't scared off by the community.. Ray Blanchard played a big role. As for the "minimum of real science," there's a lot of sociological and psychological work that goes into the DSM. Some of the pressure was certainly political/social, like the removal of homosexuality was decades ago, but there are sources listed in the back of the book, even if it takes some digging.

Disclaimer: am trans, am really done with justifying my existence but I felt I should share what I know.

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#33

Post by mjevans »

imperio59 wrote: post #26

The fact is psychiatry today still lacks tests or any proof of its claims of "chemical imbalance", which remains unproven. No one had established a profile for what a "balanced brain chemistry"looks like, nor do they test for any brain chemistry imbalance. Diagnosis is still left to the subjective assessment of the practitioner before prescribing powerful psychotropics that DO change brain chemistry in unpredictable…

It needn't even be chemical; any sort of differential test that proves a deviation from baseline measure and treatment that helps mediate a return to that profile would at least be good science and may good medicine.

Maybe someday we'll have wide access to inexpensive monitoring techniques that could fill this need.

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#34

Post by ttctciyf »

hyperpape wrote: post #4

While this is fascinating and I'm glad to have read it, it doesn't substantiate that this experiment set back psychiatry. The fact that the DSM-IV was prompted or encouraged by the experiment is suggested, but there's no argument for it. Even beyond that, the article doesn't even hint at an argument that the DSM-IV set back psychiatry (except offering the bare assertion that reductionism is false). Of course, the DSM…

Interestingly, the article makes no mention of the followup experiment where it seems a hospital invited a repetition and then claimed to have found 40 or so fake patients during the agreed period. Only to be told that the experimenters had sent none.

Or at least that's the version told in Adam Curtis' documentary The Trap (part 1)[1] which engages in Curtis's usual enthusiasm for fashioning a sweeping historical narrative out of somewhat sparse materials - in this case presenting the "Thud" experiment and its followup as a pivot point in the tale of how R. D. Laing's anti-psychiatry ironically led to the advent of the DSM IV era.

However that may be, if Curtis' account of the followup is correct it seems harder to argue the diagnostic prowess of the psychiatrists was not open to question, regardless of the status of the original experiment.

1: In the section beginning here: https://youtu.be/y97Ywl7RtUw?t=2204

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#35

Post by phkahler »

Angostura wrote: post #31
imperio59 wrote: post #26

The fact is psychiatry today still lacks tests or any proof of its claims of "chemical imbalance", which remains unproven. No one had established a profile for what a "balanced brain chemistry"looks like, nor do they test for any brain chemistry imbalance. Diagnosis is still left to the subjective assessment of the practitioner before prescribing powerful psychotropics that DO change brain chemistry in unpredictable…

This seems overly pessimistic to me, there are drugs that significantly improve patients wellbeing and do so consistently and repeatably, despite the fact that we don't have a complete understanding of the complete mechanism of action. If I do a study showing that handwashing in surgeons measurably reduces risk of infection, does the fact that I don't know about microbes make lacking in scientific rigor and remove it…

>> there are drugs that significantly improve patients wellbeing and do so consistently and repeatably,

No, there are not. A given drug may work consistently for some people, while having no effect, or detrimental effects on other people with the same diagnosis.

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#36

Post by unishark »

hyperpape wrote: post #4

While this is fascinating and I'm glad to have read it, it doesn't substantiate that this experiment set back psychiatry. The fact that the DSM-IV was prompted or encouraged by the experiment is suggested, but there's no argument for it. Even beyond that, the article doesn't even hint at an argument that the DSM-IV set back psychiatry (except offering the bare assertion that reductionism is false). Of course, the DSM…

It also implies the decline of psychoanalysis was a bad thing, when it's basically pseudoscience.

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#37

Post by JohnBooty »

unishark wrote: post #25
perl4ever wrote: post #14

The experiment sounds plausible, whether or not it happened or was done properly. But the claimed response of the hospitals also sounds perfectly reasonable to me. What do people expect? A virtually infinite number of things can cause symptoms which have some overlap with schizophrenia, and that's why today (I'm not an expert, but I'm assuming what I know of is representative) on intake they classify someone as "schi…

Generally these diagnoses require the symptoms to persist for 6 months plus be so severe they disrupt your life. And they are basically defined by clustering of symptoms. This is driven by welfare/insurance reasons. You need a diagnosis to get benefits. And while they often can't treat the underlying problem for schizophrenia and other diseases, they can definitely treat the symptoms. So if you have some of the same…

    And while they often can't treat the underlying problem 
    for schizophrenia and other diseases, they can 
    definitely treat the symptoms.
Yes. Let's not throw the baby out along with the bath water!

Psychiatry is far, far from perfect. It is a discipline that is still taking its tiniest of baby steps into the realm of actual usefulness.

I think any psychiatrist would be willing to openly admit this; that the mind is still largely a mystery to us and we have probably centuries of learning to do, due to the extreme difficulty of studying a living mind, much less performing repeatable experiments upon them.

And yet criticism of psychiatry so often misses the point! The medicines are sometimes hugely beneficial. Sometimes not. But I know lives that have been transformed for the better thanks to them.

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#38

Post by jamesrcole »

sterlind wrote: post #32
hsyqiwgx wrote: post #12

Earlier quoted context omitted.

The DSM is controversial because it's only scientific until political groups take interest. The trans community lobbied and bothered academics over the DSM's definition for Trans people until the academics threw up their hands and decided their funding wasn't good enough to justify having a spine and so the definition in the DSM was changed with a minimum of real science to justify it. That's psychology as a field in…

For those missing context, "Gender Identity Disorder" in the DSM-IV, which described transgender identity itself as a mental illness, was replaced with "Gender Dysphoria" in the DSM-V, which was scoped specifically to the depression/pain of feeling socially in the wrong gender role, as well as the feeling of one's body being wrong. The DSM does cite academic sources IIRC, but they're listed as a while for the book, r…

> So no, OP, academics who didn't support trans politics weren't scared off by the community.

Not saying you're wrong, but there's nothing in your comment that supports this claim, so can you elaborate?

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#39

Post by Jim_Heckler »

jamesrcole wrote: post #38
sterlind wrote: post #32

Earlier quoted context omitted.

For those missing context, "Gender Identity Disorder" in the DSM-IV, which described transgender identity itself as a mental illness, was replaced with "Gender Dysphoria" in the DSM-V, which was scoped specifically to the depression/pain of feeling socially in the wrong gender role, as well as the feeling of one's body being wrong. The DSM does cite academic sources IIRC, but they're listed as a while for the book, r…

> So no, OP, academics who didn't support trans politics weren't scared off by the community. Not saying you're wrong, but there's nothing in your comment that supports this claim, so can you elaborate?

> Additionally, Ray Blanchard, an academic who believes transgenderism is caused by "autogynephilia"/"autoandrophilia" (i.e. a sexual fetish caused by attraction to oneself as the desired gender), was a member of the committee who decided the DSM-V definition.

Re: David Rosenhan’s fraudulent Thud experiment set back psychiatry for decades

#40

Post by ALittleLight »

hyperpape wrote: post #4

While this is fascinating and I'm glad to have read it, it doesn't substantiate that this experiment set back psychiatry. The fact that the DSM-IV was prompted or encouraged by the experiment is suggested, but there's no argument for it. Even beyond that, the article doesn't even hint at an argument that the DSM-IV set back psychiatry (except offering the bare assertion that reductionism is false). Of course, the DSM…

Correct me if I'm wrong, but this is a review of a book that purports to make the case you're stating is not made here. That seems like a high bar for a review to me. Unless, do you mean you've read the book and the book fails to substantiate this claim?
Post reply on HN