Debunking Denialism

Defending science against the forces of irrationality.

Tag Archives: ADHD

The Anti-Psychiatry Propaganda of Nathan Shachar

The Anti-psychiatry propaganda by Nathan Shachar

Dagens Nyheter (the largest morning newspaper in Sweden) continues to promote pseudoscience. Last month, the newspaper decided to publish a full-page anti-immigration ad with flawed equivocations, ignorance of confounders and the deceptive framing of published statistics. Out of the ashes into the fire, Dagens Nyheter decided to publish a column filled with anti-psychiatry propaganda by Nathan Shachar. He has previously come under fire for his ignorant ADHD denialism, where he fear mongered about the side-effects of ADHD medications, butchered the complex etiology of ADHD and misrepresented scientific reports on ADHD rating scales.

In his latest pseudoscientific screed, Shachar continues to recycle common anti-psychiatry myths. He claims that the FDA and the Swedish counterpart (Medical Products Agency) is bought by pharmaceutical companies, but the FDA charges pharmaceutical companies to ensure fast and high-quality drug review process. He asserts that modern psychiatry holds that all psychiatric conditions are caused by “chemical imbalance”, when the scientific consensus position is that they result from a complex interaction between biological, psychological and social factors. Shachar makes a false comparison between “pure amphetamine” and ADHD medication, completely without insight that it differs in chemical nature, dosage and release rate. He bases his case against modern psychiatry on the writings of Janne Larsson, a member of the Scientology-based organization Citizens Commission on Human Rights (CCHR). Counter to the myths promoted by Shachar, several large-scale meta-analysis has found that antidepressants are more effective than placebo even when you take publication bias into account. He continues by showing that pharmaceutical companies sometimes behave unethical, but that is an issue of corporate ethics, not the science of psychiatry or the efficacy of psychiatric medication. Finally, he dismisses ADHD as merely a “maturity” issue, despite the well-known biological underpinnings of the condition. Read more of this post

Entertaining the Denialism of Yet Another Anti-Psychiatry Troll

anti-psychiatry category

Out of all the pseudoscience that are criticized on this website — from creationism and the anti-vaccine movement to anti-GM sentiments and alternative medicine — no subject has attracted more malicious attention from denialists trolls than the articles refuting anti-psychiatry. I often respond and end up in never-ending debates where they simply repeat the same arguments over and over again despite having had their errors explain to them in great detail with references to the scientific literature. When they fail their misguided war of attrition, they resort to verbal abuse by calling me fascist, pig, dickhead, Führer etc. and claim that I must consider individuals with mental conditions who receive evidence-based treatment to be “roadkill” (I do not). After a while this comes very tiresome, so those individuals have their comment privileges removed for violating the comment guidelines. However, they do not let this stop them from spouting their nonsense. They simply use proxies, new names and email addresses to continue with their behavior (while keeping the assertions exactly the same). Some even try to impersonate me. I ban the new identities or turn off comments. This makes things calm down for a while, but it starts back up again the next time I publish a post debunking anti-psychiatry.

Recently, a previously banned user now going by the name of Tin attempted to post an anti-psychiatry diatribe on an argument describing some common anti-psychiatry archetypes that scientific skeptics are likely to come across when they take on anti-psychiatry proponents online. Although using a new name and IP, he still used the same email address as he did when he was banned the first time, thereby giving it away and so the comment got caught by the spam filter. Usually I would not bother to write anything about it and just empty the spam queue, but some of the claims he made in that comment was absurdly wrong on so many different levels that it could be useful for other scientific skeptics to have access to a detail refutation of those assertions.

In his comment, Tin confuses a debate about the scientific details with a debate on the validity of the entire field and tosses in appeals to false balance. He also makes a number of other flawed arguments, such as calling Psychology Today an academic journal, when it is really just a magazine and blog website. He also asserts that antidepressants are not better than placebo despite the fact that meta-analyses taking publication bias into account show that they do outperform placebo in a clinically significant way. Tin even fails to understand that ICD-10 also has an ADHD diagnosis and that ADHD is diagnosed outside the U.S. Finally, the five papers that allegedly show that anti-psychiatry is based on evidence either do not support his position, directly contradicts his position or is irrelevant to the discussion. The rest of this article examines those anti-psychiatry claims in additional detail. Read more of this post

Swedish Comedian Magnus Betnér Promotes Anti-psychiatry Nonsense about ADHD on TV

Magnus Betnér is a Swedish stand-up comedian that now has his own TV show called Betnér Direkt. His style is strongly reminiscent of giants like George Carlin and Bill Maher, but he is bald, brutal and takes no prisoners in his social criticisms of things like anti-immigration, religious and social conservatism and general societal wrongdoings. He almost always push the envelope, making volatile sex jokes and is one of the first Swedish comedians who has taken support of feminism to an art form.

However, just like George Carlin and Bill Maher, he sometimes stays from the path of evidence-based reason. In his later years, George Carlin gave partial support for 9/11 truth ideas and Bill Maher has issues with vaccines and the germ theory of disease. To be fair, both George Carlin and Bill Maher has strongly criticized anti-science sentiments as well. Mill Maher personally help threw out 9/11 truthers that disrupted his shown and George Carlin often made fun of creationists. Betnér has also mocked creationists and poked fun at supporters of Zeitgeist, so what I will be discussion below maybe be a rare exception, but statements that I think should be challenged.

In the latest episode of Betnér Direkt (episode 7 of the first season), in the segment called Betnérs bud (a monologue at the end of the program), Betnér makes the following claims (2:27 ->, my translation):

We must stop diagnosing our children. A study revealed that it is more common with ADHD the later in the year you are born. Among reasons to get the diagnoses, “run around and climb on things” and that “they do not like school or homework” is mentioned. I see. You mean that what it takes to get the diagnosis is that you are a child! And stop calling that which you get for ADHD medicine. The medicine that the government prescribes is amphetamine. That is not medicine, that is breakfast [picture of a Swedish celebrity that has been in the news for taking drugs eating white powder as breakfast cereal]. It is fucking obvious that children become more effective if they get amphetamine! Do you know who also gets more effective if they get amphetamine? Everyone!

In other words, Betnér makes the central claims that (1) ADHD is an invalid diagnosis and that (2) medical treatment for ADHD is amphetamine, not medicine. These are fairly common claims in the anti-psychiatry play book and I will be discussing them each in turn.

ADHD is a legitimate and science-based condition

Singh (2008) outlines the major positions that exists with respect to ADHD. The first is the notion that ADHD is primarily caused by interacting biological factors. This means that medical treatment is reasonable as it attempts to adjust for the neurological issues facing individuals with ADHD. The second is the position that both biological and social factors are important in explaining the cause of ADHD. From this perspective, the diagnosis does not yet capture the full range of heterogeneity or complexity of the condition and so medication is accepted, but it also emphasizes behavioral therapies. The third perspective is that the primary factors influencing the development of ADHD is environmental factors and support preventative interventions, rather than psychotropic drugs. While all of these three scientific positions accepted that ADHD is a valid diagnosis, there is a fourth position which rejects it all together. The main proponents of this fourth perspective are scientologists and certain sophisticated sociologists. Read more of this post

Irresponsible Science Journalism on Swedish ADHD Report

Here we go again.

The Swedish Council on Health Technology Assessment has recently released a report on topics that included the reliability of tests used for ADHD diagnosis in Sweden. The basic gist of the report is that many of the tests have limitations if used exclusively alone, but that the current of practice of using many different rating scales together with critical clinical assessment is acceptable. The report says that (p. 26, my translation):

The diagnosis of children and young adults with ADHD is today carried out with the aid of several different rating scales, which each by themselves alone lacking scientific evidence. The rating scales are filled out by parents, teachers and the young adult it pertains to. We have not evaluated how the weighting between these different informants look. To make the diagnosis today, it requires additionally a clinical evaluation and an evaluation of the level of disability in the child/adult.

In conclusions, the results show that none of the diagnostic tests that have been evaluated can be used by itself to make the ADHD diagnosis. Instead, this report supports the current practice, that the foundation for the diagnosis is the clinical evaluation and that the diagnostic tests for ADHD should be used as a basis for the gathering of information that is then evaluated by the clinician.

Guess how Swedish media carried the story? By falsely claiming that little science supported the ADHD diagnosis. The sad part of this story is that the “Sveriges Radio” is a popular public radio station, and not some marginalized crackpot network. The journalist behind the story was in other words guilty of irresponsibly making sensationalist science journalism, bordering on anti-psychiatry, and confusing the valid scientific discussion with how to make diagnostic tools better with the pseudoscientific nonsense of anti-psychiatry. The comment section of the article is already bogged down by crackpots.

First rule of doing and reading science journalism: always read the original paper or report.

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