November 16, 2013
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Why should scientific skeptics care about refuting anti-psychiatry? Compared with other forms of pseudoscience, such as creationism or climate change denialism, anti-psychiatry has received considerably less skeptical attention. Yet anti-psychiatry is a dangerous pseudoscience that causes real harm. Like alternative medicine quacks, anti-psychiatry exploits vulnerable people and by denying the existence of psychiatric conditions or dismissing them as harmless, proponents of anti-psychiatry deny the suffering of human beings.
After debunking the claims made by the anti-psychiatry proponent Tin, this person continued to make a long list of assertions about psychiatry. When your opponent blasts you with multiple, long texts, it is very difficult to ensure that you responded to every single assertion (I am sure I accidentally missed some in this post, and I’m sure I will be hearing about it too). To a certain extent, that is the goal of this kind of shotgun approach (sometimes called the Gish Gallop in honor of the young earth creationist Duane Gish who frequently used this technique): make as many flawed and unsupported assertions as possible in an attempt to overwhelm the opposition. If any claim is forgotten or not decisively refuted due to time or space, declare victory. This is also related to what is known as the asymmetry of pseudoscience: it takes a few seconds to make a pseudoscientific claim, but anywhere from ten minutes to several hours to research and refute one of the claims in detail. In that sense, scientific skepticism is always an uphill battle. However, once the refutation is out there online, anyone who comes across a similar claim can find it with a search engine and review the material in the references. So although I have little hope that the arguments and evidence I present will convince a ingrained anti-psychiatry proponent, it is still worth doing. Read more of this post
April 14, 2012
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A while back, I cam across an interesting study published in the American Journal of Psychiatry. Bridge et. al. (2005) looked at the number of new cases of emergent suicidality during a clinical psychotherapy trial for depression in adolescents and what important predictors were at play. Emergent suicidality can be defined as an increase in the rate of suicide, suicidal attempts, preparation for suicide and suicidal thoughts during the early stages of treatment, although definitions sometimes varies across studies (Meyer et. al. 2010).
The general message of the Bridge et. al. study was that the rate of emergent suicidality in the drug-free psychotherapy trial was 12.5% (this was not attributable to the therapy itself). They also found that the strongest predictor of emergent suicidality was the level of self-reported suicidal thoughts at the baseline rather than what was recorded during the intake interview. So the more suicidal thoughts you have at the start of psychotherapy, the more likely you are to experience suicidality during the psychotherapy treatment.
In this clinical trial, which enrolled subjects similar to those enrolled in pharmacotherapy clinical trials, rates of emergent suicidality in patients receiving psychotherapy but no pharmacotherapy were comparable to rates observed in antidepressant trials. Self-reported suicidality in the week before intake predicted the onset of emergent suicidality to a much greater extent than did interview-rated suicidality, indicating that self-report may be a necessary component to the assessment of adolescent suicidal risk.
This is an important finding, because it casts a shadow of doubt over studies purporting to show an increase level of suicidality during treatment with antidepressants. Read more of this post