Everything you ever wanted to know (Ted Bunn, Berkeley Cosmology)

Nature vs. Nurture in Music Recommenders. I recently wrote a post on FmH in response to reports about new software algorithms to pigeonhole the formal qualities of pieces of music to make recommendations based on analytic conclusions about your tastes. In short, I stated that a more subtle, sophisticated and ultimately more pleasing recommendation engine already existed — social recommenders like last.fm (audioscrobbler), which I use, which point you to new music based on the listening experience of a body of users whose tastes are similar to yours. Here is a more elaborate discussion of the strengths and weaknessess of the two approaches, which weblogger Steve Krause neatly contrasts as ‘nature vs. nurture.’

Readers will notice that I had no commentary on the State of the Union. My reasoning is much the same as Ed’s. He and I share the dubious distinction, it seems, of being quite opinionated authors of weblogs with very small audiences and no broader notice (sorry, Ed!), a situation accentuating the concern about preaching to the choir. The polarization of the weblogging world, moreover, is just mirroring the process in society as a whole. Timothy Leary once said something like, “You are only as young as the last time you changed your mind.” However, call it arrogant or closeminded if you like, but I believe in my opinions, and I am confident that those who share my viewpoint have a monopoly on balance, as Ed defines it — maximal truth and minimal misinformation. Although I am sure the right wingnuts feel the same, I have no insecure need to entertain their madness politely. As someone once said, my mind isn’t so open that any ol’ thing can fly in.

Just as I become viscerally ill if I have to listen to Dubya for more than a soundbite’s worth of tortured incoherency, illogic and deception, I am relieved that I am barely exposed, except in the odd comment here and there, to rightwing dissent against my views (although, in another sense, I miss it, since, to coin a saying, the contempt of the contemptible is a compliment). I would love to hear if readers have any counterexamples of recent meaningful exchange across the ideological gulf, in the weblogging sphere or elsewhere — where they are listening to each other or perhaps (shudder) even influencing each other’s viewpoints…

Addendum: Dennis Fox responds, in part:

Read the entire post.

Concern in the Republican ranks?? So what do the Republicans do about it? They give you a new boss who’s the same as the old boss, just billing him as a ‘fresh face’ and a reformer. Boehner (and don’t you dare pronounce it ‘boner’) just weeks ago refused to give back #30,000 he had received from the Indian tribes at Abramoff’s behest; he was distributing checks from the tobacco lobby to members of Congress on the floor several years ago; and he is so intimately connected to the lobbyists that he sleeps with one. When René Magritte captured the essence of surrealism by hanging a picture of a pipe with the legend “Ceci n’est pas une pipe”, he created a profound sense of disquiet. When the Republicans do it, it is business as usual.

Rep. Charles Rangel (D.-NY): “If there’s one thing that George Bush has done that we should never forget, it’s that for us and for our children, he has shattered the myth of white supremacy once and for all…” (New York Sun, 9/23/05, via micheline)

And:

…and that’s only the beginning…

Links:

• Albert’s AOL homepage
• Fascism in America: Are We There Yet? (Counterpunch, 2005)
• The Black Panther Party’s Take on Stew

Project Censored‘s “I Want to Know” Project (via Common Dreams)

Emphasis added; it is disingenuous to bill this trend as a defeat for anti-Americanism, as the italicized sentence concedes. Anti-Americanism is alive and well, in Canada, Germany and the rest of the world, with few exceptions. The proximal cause of contemporary anti-Americanism is the Bush regime, after the preceding decade of benevolence and goodwill the U.S. and the rest of the world enjoyed. The real defeat of anti-Americanism will be to turn the Republicans out of office in the U.S.

The point of signing the petition, of course, is that you will get endless political spam from the Kerry organization. But you can put his address in the junkmail filter, of course.

“…A free, open source, interactive hypnosis program… It includes features such as voice recognition, speech synthesis, subliminal messages, completely customizable scripts (featuring a unique scripting language), videos, audio, and lots more. Its purpose is to simulate a real hypnosis session as much as possible.”

I woke up this morning wondering how a Hamas government is ever going to convene in one room, given the likelihood that Israeli intelligence efforts would be devoted to finding out the place and time of such a gathering for — shall we say? — undiplomatic purposes.

The discovery of mirror neurons is centrally important to the understanding of the neural basis of the social brain, of empathy and interpersonal perception, as embodied in the “theory of mind” concept. Mirror neurons are crucially important to, as Ramachandran puts it,

The essay is badly edited; for example, Ramachandran is quoted as referring to mirror neurons as ‘Dalai Llama (sic) neurons’; and later refers to ‘starving pheasant’ when I am sure he intended ‘starving peasant’. Also, take a look at the vignette of the ‘brain in the vat’ Ramachandran poses at the end of the essay, and see if you don’t think it has already been better put by the Wachowski brothers in The Matrix, as the dilemma of the ‘red pill’ vs. the ‘blue pill’, such powerful shorthand that it has entered the pop-culture vernacular wholesale.

Earlier versions of this story led with Kerry’s reported vow to filibuster, but that may have been wishful thinking on the media’s part. Kerry does not now appear so determined. The cloture vote and consequent confirmation are a much more anticlimactic way to go, and much more inevitable, given the loyal opposition’s spineless posturing (in an anatomical sense an oxymoron, but let’s not let that stop the Democrats).

And this is news? …by which I mean, shouldn’t it have been this way all along? It dramatizes how utterly inaccessible this administration has been to the public and the execrable state of American “democracy.” Lest you think this represents a significant change, however, keep in mind that, even if questions are not prescreened, the audiences allowed into his personal appearances are… (Yahoo! News)

…and biologist PZ Myers, self-professed “godless liberal” whose weblog Pharyngula is attracting alot of complimentary attention, is not happy. He does make a stab at characterizing the logical fallacies in Vonnegut’s recent statements on NPR in support of intelligent design, but the piece starts with a long preface lamenting Vonnegut’s apparent cognitive decline, as if that were the real explanation for his blasphemy.

If one is to be critical of Vonnegut’s unreasonableness, one must do it in a reasonable manner. Myers is flirting with ad hominem-ism and undercutting his own position here, IMHO. Although I think it is clear that I am across the culture-wars divide from those who profess to creationism, I also know that it is sometimes from reasoned faith. To refute intelligent design, one must engage with the more thoughtful adherents rather than just ridicule the least reasoned arguments.

Moreover, it is often said that people become more like themselves as they decline cognitively. One would be hard pressed to suggest that Vonnegut took a new unreasonable position as he aged. Even a beloved author may have opinions at odds with those of readers who cherish his work, it goes without saying. Vonnegut had a term for that; don’t you suppose he would call the community of Vonnegut fans a granfalloon?

Short answer: I doubt it.

A good roundup of the derisive reaction to the laughable ‘Indigo Child’ concept, about whose New York Times coverage I commented previously on FmH. ‘Delusional parenting” and ‘psychological child abuse” are among the responses… (I Speak of Dreams)

I had received this or something like it several times in recent months and was glad Ed Fitzgerald reposted it in his consistently wonderful weblog unfutz. He uses it to riff on the fact that, despite the reminder of the progress we have made in material well-being over the last 100 years, we are in the midst of the rightwing dismantling of the century’s progress in personal freedoms. Point well-taken, but I was searching for it for a different reason. The mother of a friend of mine, who had celebrated her 100th birthday last summer, passed away last week. I wanted to send her this text to complement the more personal reflections on her mother’s 100 years:

…to Quackery and Pseudoscience (Photon in the Darkness)

Update: Lost whale dies after rescue bid (BBC)

The legendary purveyor of hard to find, controversial, unusual books, whose catalogues I have been getting for years, is folding. Loompanics offerings have included books about identity change and dropping off the map, anarchsim, anti-corporate issues, the politics of privacy, self-defense, survivalism and self-sufficiency, lockpicking and other illegal activities, confidence scams, outlaw history, and getting revenge. Great for those seeking practical advice or just daydreaming (I won’t tell you which category I fit into…). They are offering all their stock at 50% off if you want a last chance. [thanks to the null device via walker]

A proposal from Mind Hacks, given the approach of February 14th: “All you need is a few well-connected neuroimaging buddies and probably four or five hundred pounds to afford the scanning time. Sit yourself in the scanner looking at picures of your beloved, or maybe listening to the song that was playing when you first met. Some quick image analysis later, and a trip to the printers, and – viola! – you have a customised Valentines Day card showing your brain and the activity of your brain as you contemplate the love of your life. The inscription? ‘Thinking of you’ should do it!”

Update: Lost whale dies after rescue bid (BBC)

Addendum: Ray Everett-Church:

In many cases, you no longer even need a high school degree to attend these schools, if you can pay the tuition. My question is, why bother to attend at all? Next trend, if it doesn’t already exist, and which would undoubtedly entail even higher tuition bills, would be to deliver transcripts and diploma immediately to you in the mail after you matriculate.

Nobody bothered to tell these patients in advance that their tried-and-true method of obtaining their prescription medications, through their state’s Medicaid program, would no longer work for them… The ineptitude of this ‘reform’ boggles our minds in the healthcare field.

Three New Mice-Phones Unveiled (Personal Tech Pipeline ) The weblogger likes them because they are so economical of space and so, well, Maxwell Smart in their stealthiness. Somehow, I think someone who thinks they will be reclaiming desktop space by combining their mouse and their phone has bigger problems to deal with. Perfect example of the absurdities of the ‘converge-everything’ movement. Replace your thoughtfully-designed, ergonomic and utterly serviceable phone and mouse with one device which works unacceptably poorly in both regards. Useless for any purpose except that you will succeed in impressing the plethora of visitors to your home office who live and breathe in the legacy of Get Smart!

This Jerusalem Post piece reports that the Israeli Air Force is trained for a strike against Iranian nuclear facilities. The reserve colonel who led the 1981 strike against Iraq’s reactor at Osirak believes that an assault is possible despite the obvious lessons that Iran would have gleaned from the Iraqi experience, dispersing and probably hardening its facilities. The 1981 strike initiated what has come to be referred to as the Begin Doctine, Israel’s assertion of the right to make a preemptive strike to prevent any of its Arab neighbors from attaining nuclear weapons capability.

“To help you strategically plan the best use of your limited sick days. Print out and save.” (52 Projects)

Usse this Google hack to easily access forbidden sites.

Some surprising results follow when you search for the names of Dubya and his top advisors in the genome database. (Seed)

Seed Magazine coverage of this year’s prizes for the demise of the un-fittest.

This University of Texas website is a wonderful compendium of neuroscience lectures from a variety of sources. Requires a broadband connection.

I was recently pointed to the Wikipedia article on this fascinating Japanese phenomenon. Hikikomori is a Japanese term referring to acute social withdrawal by adolescents or young adults.

Middle class affluence allows many families to support their isolative child indefinitely. There may be a contribution from the particularly Japanese codependent collusion (amae) between mother and son, making an effective response to the isolationism more difficult. And the decreasing job security in the Japanese corporate environment, combined with extreme performance pressure, may contribute to making social withdrawal rampant.

There appears to be considerable debate about whether hikikomori should be considered a sociological or psychological phenomenon. A variety of psychological diagnoses could contribute to its phenomenology, including anxiety disorders including agoraphobia and social phobia (social anxiety disorder); avoidant personality disorder; and depression. I think the social vs. psychological debate is a specious one, as there is likely a coalescence of internal and social factors at play here. There are a number of so-called “culture-bound syndromes” in which a behavioral symptom pattern appears to be particularly prevalent, and unique, in a given culture. These include amok, latah, wendigo, etc. I usually see them as variants of common psychiatric disturbances brought to the fore by the particular social stresses of a given culture.

These are the findings of a study by a group of researchers at the pharmaceutical firm Eli Lilly. I haven’t read the study, only the press coverage to which this link points, but their findings are summarized thus: “Of the 866 patients who stopped treatment, 36% (315/866) did so because the treatment was felt not to be effective or because their symptoms worsened. Only 12% of patients who stopped treatment early did so because of adverse events such as dizziness, fatigue, vomiting or weight gain.” They make the point that discontinuation due to patient perception of poor response tends to occur early in the course of treatment and that patients who experience an early response were 80% more likely to complete treatment.

I would point out the likelihood of significant bias in this industry-sponsored study. Eli Lilly are the manufacturers of Zyprexa [olanzapine], one of the most-used ‘atypical’ [new-generation] antipsychotic medications which were touted as wonder drugs solving all the substantial toxicity issues of the older generation of antipsychotics, until we recognized that worrisome side effects such as drastic weight gain and glucose intolerance were common with this newer generation of agents. It is in Lilly’s interest in selling antipsychotic medications, of course, to establish, as the current study concludes, that side effects are not as worrisome as they are usually considered and that treatment should be more aggressive from the outset. But of course patient discontinuation early in the course of treatment is not likely to be from concern about side effects, because the worrisome metabolic changes caused by these medications are insidious and slow to develop!

I agree with the need for treating terrifying psychotic symptoms with alacrity to relieve distress and establish a treatment alliance. Certainly a schizophrenic patient beset by tormenting voices or paranoid ideation will not stick with treatment that does not offer rapid relief. However, I suspect the crucial variable which the study does not address is that patients who do not perceive that their treatment is effective are often patients with one particular symptom of severe psychotic illness — anosognosia, the denial of illness and lack of recognition of need for treatment at all. A patient cannot recognize benefit from a medication treatment if s/he does not recognize the symptoms and the need for treatment in the first place. Psychiatrists are very familiar with psychological denial, but I also think anosognosia has a neurologically-based, organic component as part of the brain dysfunction in schizophrenia and other psychotic illnesses, although this is controversial within my field.

In any case, it is emphatically not drug treatment, aggressive or not, which treats this symptom. Instead of funding research trying to sell more drug doses, Eli Lilly should be endowing a foundation for the dying art of talking to the sickest of our patients, creating and maintaining a relationship allowing skillful and sustained entry into the world of a terrified and tormented soul. This is itself the most important healing tool.

Those English; always masters of understatement!

There are several aspects of this effort to ‘cure’ worth examining further. To be blunt, this is an example of one of those studies where a distinction will not likely make a difference. While recipients of ‘the pill’ (the beta blocker propranolol) show lower scores on physiological arousal measures in PTSD, that is very different than changing the meaning of the experience or the distress associated with remembering it, stopping the person’s life from being dominated dysfunctionally by the consequences of their trauma, etc. — true measures of ‘cure.’ There is a big difference between trying to prevent the memories of a trauma from being encoded in the first place, at the time of the experience, in the distinctive chaotic and unmanageable way in which we think traumatic memories are laid down; and trying to affect the reexperiencing. This is about as much a cure as saying that you are ‘curing’ a broken bone by giving enough of a painkiller so that it no longer hurts when the sufferer moves the limb. Or curing a brain tumor by giving enough aspirin that the patient no longer feels any headaches. You get my drift.

Moreover, the study seems based on the implicit notion that the distress experienced when a trauma victim remembers the events, e.g. when talking about them in therapy, re-encodes the memories traumatically and plays a role in their reinforcement and perpetuation. To the contrary; this flies in the face of the fact that ‘the talking cure’ — talking about the trauma and reexperiencing it in measured ways with a therapist skilled in helping the sufferer master the modulation of the memories and their impact — is part of the solution rather than part of the problem; in fact, it is the only therapeutic approach with ‘curative’ benefit to PTSD patients.

The modest positive clinical results achieved with blunting the physiological arousal, however do have one benefit. They get more research funding for these bastions of trauma research. The war in Iraq, in which US forces face with futility an interminable insurgency in which civilians are indistinguishable from enemy combatants, there are no front lines and no distinction between safe zones and the war front, is a factory for the manufacture of PTSD, exactly as was the Vietnam War which marked the founding of the modern industry of psychiatric treatment of and research into PTSD. Traumatology was a languishing backwater of psychiatric study and treatment, despite the consciousness-raising perspective of the women’s movement into the exploitation and power differentials in sexual and domestic relationships, until revitalized and animated by joining with the arguably very different area of study of returning Vietnam veterans. Researchers who can plausibly claim they have a chance of treating the epidemic of traumatized vets returning from Central Asia will have it made for the rest of their research careers.

Unlike the futility of treating with beta blockers months or years afterward, modulating the physiological arousal associated with traumatic experience may prevent memories from being encoded in the damaging and inaccessible traumatic mode in the first place, but you cannot exactly get medication to people rapidly enough to make that difference in most trauma sitautions — rapes, car crashes, witnessing violent crimes, natural disasters, industrial accidents, etc. The one situation in which this is possible is with soldiers going into battle. There is much DoD-funded research interest in prophylactic measures with beta blockers and other therapeutic agents, which if successful will turn our forces even more into automatons insulated from any compunctions about or consequences of their actions.

As implausible as the promise of a ‘cure’ held out by the present study is, it does serve as an opportunity to underscore that a traumatic memory is not just a memory of a traumatic event. PTSD develops when certain — but not any — devastatingly disturbing experiences in some — but not any — individuals swamp the human organism’s coping strategies so thoroughly that it is put into a state of physiological arousal outside the bounds of what our machinery evolved to handle, beyond the evolutionary preparedness of the organism and its usual ‘flight or fight’ stress mechanisms. Even the proverbial scenario of the caveman confronted by the sabertooth tiger is within the bounds of expectable human experience.

This ‘outside the bounds’ factor used to be one of the diagnostic criteria for psychiatrists to classify a patient as having PTSD, but it has been dropped in subsequent iterations of the diagnostic criteria. The concept of PTSD has been broadened to the point where it is meaningless when applied by naive clinicians or patients interested in a convenient explanation for their distress or dysfunction. This has been particularly puissant in the sexual trauma arena. Trauma clinics and victim support groups are shared cheek-by-jowl by patients on the one hand who have undergone unendurable experiences of repeated brutal inhuman sexual violations, often under conditions of virtual captivity by people violating the basic trust of their parental or caretaker roles; and on the other hand those who once experienced a single inadvertent brush of the hand or suggestive glance from a babysitter or neighbor. PTSD has become synonymous with being ‘bummed out once in awhile by something negative that once may or may not have happened to me’. Of course, trauma is in the eye of the beholder, true PTSD sufferers have no choice about organizing their life around the terror, while many carrying the diagnosis, or their caregivers, have in effect opted in. This unwarranted expansion of the PTSD concept to the point where it is utterly meaningless is driven by ‘secondary gains’ for both clinicians and patients that have nothing to do with maximizing therapeutic efficacy.

Addendum (looking for feedback): do FmH readers like these extended pieces on mental health-related news? Longtime readers know I have a few pet peeves in the field I air over and over again, the bastardization and cooptation of the PTSD concept being one of them. You have heard them from me before, and I do tend to get pretty didactic and polemic. Not that there are many comments about any of my posts, but the silence is deafening after one of these psychiatric diatribes. They are of some use to me in blowing off steam, but do you get anything out of them? Among other things, I mean them as an insider’s cautionary tales for those of you who are consumers of mental health services. Of course, I may not get any feedback in response to this query because my readers may have not have gotten this far, having long since stopped reading this post far above…

Addendum II: Thanks to walker for reminding me about Warnock’s Dilemma, described thus by Wikipedia: “Warnock’s Dilemma, named for its progenitor Bryan Warnock, points out that a lack of response to a posting on a mailing list, Usenet newsgroup, or Web forum does not necessarily imply that no one is interested in the topic,” and goes on to posit six other possible explanations for reader nonresponse.

There are several aspects of this effort to ‘cure’ worth examining further. To be blunt, this is an example of one of those studies where a distinction will not likely make a difference. While recipients of ‘the pill’ (the beta blocker propranolol) show lower scores on physiological arousal measures in PTSD, that is very different than changing the meaning of the experience or the distress associated with remembering it, stopping the person’s life from being dominated dysfunctionally by the consequences of their trauma, etc. — true measures of ‘cure.’ There is a big difference between trying to prevent the memories of a trauma from being encoded in the first place, at the time of the experience, in the distinctive chaotic and unmanageable way in which we think traumatic memories are laid down; and trying to affect the reexperiencing. This is about as much a cure as saying that you are ‘curing’ a broken bone by giving enough of a painkiller so that it no longer hurts when the sufferer moves the limb. Or curing a brain tumor by giving enough aspirin that the patient no longer feels any headaches. You get my drift.

Moreover, the study seems based on the implicit notion that the distress experienced when a trauma victim remembers the events, e.g. when talking about them in therapy, re-encodes the memories traumatically and plays a role in their reinforcement and perpetuation. To the contrary; this flies in the face of the fact that ‘the talking cure’ — talking about the trauma and reexperiencing it in measured ways with a therapist skilled in helping the sufferer master the modulation of the memories and their impact — is part of the solution rather than part of the problem; in fact, it is the only therapeutic approach with ‘curative’ benefit to PTSD patients.

The modest positive clinical results achieved with blunting the physiological arousal, however do have one benefit. They get more research funding for these bastions of trauma research. The war in Iraq, in which US forces face with futility an interminable insurgency in which civilians are indistinguishable from enemy combatants, there are no front lines and no distinction between safe zones and the war front, is a factory for the manufacture of PTSD, exactly as was the Vietnam War which marked the founding of the modern industry of psychiatric treatment of and research into PTSD. Traumatology was a languishing backwater of psychiatric study and treatment, despite the consciousness-raising perspective of the women’s movement into the exploitation and power differentials in sexual and domestic relationships, until revitalized and animated by joining with the arguably very different area of study of returning Vietnam veterans. Researchers who can plausibly claim they have a chance of treating the epidemic of traumatized vets returning from Central Asia will have it made for the rest of their research careers.

Unlike the futility of treating with beta blockers months or years afterward, modulating the physiological arousal associated with traumatic experience may prevent memories from being encoded in the damaging and inaccessible traumatic mode in the first place, but you cannot exactly get medication to people rapidly enough to make that difference in most trauma sitautions — rapes, car crashes, witnessing violent crimes, natural disasters, industrial accidents, etc. The one situation in which this is possible is with soldiers going into battle. There is much DoD-funded research interest in prophylactic measures with beta blockers and other therapeutic agents, which if successful will turn our forces even more into automatons insulated from any compunctions about or consequences of their actions.

As implausible as the promise of a ‘cure’ held out by the present study is, it does serve as an opportunity to underscore that a traumatic memory is not just a memory of a traumatic event. PTSD develops when certain — but not any — devastatingly disturbing experiences in some — but not any — individuals swamp the human organism’s coping strategies so thoroughly that it is put into a state of physiological arousal outside the bounds of what our machinery evolved to handle, beyond the evolutionary preparedness of the organism and its usual ‘flight or fight’ stress mechanisms. Even the proverbial scenario of the caveman confronted by the sabertooth tiger is within the bounds of expectable human experience.

This ‘outside the bounds’ factor used to be one of the diagnostic criteria for psychiatrists to classify a patient as having PTSD, but it has been dropped in subsequent iterations of the diagnostic criteria. The concept of PTSD has been broadened to the point where it is meaningless when applied by naive clinicians or patients interested in a convenient explanation for their distress or dysfunction. This has been particularly puissant in the sexual trauma arena. Trauma clinics and victim support groups are shared cheek-by-jowl by patients on the one hand who have undergone unendurable experiences of repeated brutal inhuman sexual violations, often under conditions of virtual captivity by people violating the basic trust of their parental or caretaker roles; and on the other hand those who once experienced a single inadvertent brush of the hand or suggestive glance from a babysitter or neighbor. PTSD has become synonymous with being ‘bummed out once in awhile by something negative that once may or may not have happened to me’. Of course, trauma is in the eye of the beholder, true PTSD sufferers have no choice about organizing their life around the terror, while many carrying the diagnosis, or their caregivers, have in effect opted in. This unwarranted expansion of the PTSD concept to the point where it is utterly meaningless is driven by ‘secondary gains’ for both clinicians and patients that have nothing to do with maximizing therapeutic efficacy.

Addendum (looking for feedback): do FmH readers like these extended pieces on mental health-related news? Longtime readers know I have a few pet peeves in the field I air over and over again, the bastardization and cooptation of the PTSD concept being one of them. You have heard them from me before, and I do tend to get pretty didactic and polemic. Not that there are many comments about any of my posts, but the silence is deafening after one of these psychiatric diatribes. They are of some use to me in blowing off steam, but do you get anything out of them? Among other things, I mean them as an insider’s cautionary tales for those of you who are consumers of mental health services. Of course, I may not get any feedback in response to this query because my readers may have not have gotten this far, having long since stopped reading this post far above…

Addendum II: Thanks to walker for reminding me about Warnock’s Dilemma, described thus by Wikipedia: “Warnock’s Dilemma, named for its progenitor Bryan Warnock, points out that a lack of response to a posting on a mailing list, Usenet newsgroup, or Web forum does not necessarily imply that no one is interested in the topic,” and goes on to posit six other possible explanations for reader nonresponse.

“As the civil rights leader’s widow struggles to recover from a stroke, their offspring fight over selling the King Center, which she founded…

As readers of FmH know, I have treated ADHD for a long time in my psychiatric practice but have been appalled by its burgeoning and unsystematic, laughably faddish overdiagnosis. It is now a wastebasket diagnosis comprising some children with a characteristic set of hardwired neurocognitive deficits in the regulation of attentional processes (who deserve the diagnosis); some with other psychiatric causes of inattention, distractibilityor impulsivity (warranting other psychiatric diagnoses), some children at the mercurial, impulsive or energetic end of the temperament spectrum; and some children whose difficulty paying sustained attention, avoiding distraction or maintaining decorum are shaped by sociocultural rather than internal influences. These latter two groups of ADHDers really do not warrant a psychiatric diagnosis at all.

While I have no affinity for diagnosis by aura, I think Carroll and Tober may be overcompensating for the overpathologizing with an equally silly lionization of the ‘ADHD child’. On the other hand, I do think that some children come to be seen as having attention deficit disorder in the classroom because the stultifying curriculum does not hold their interest and they are all over the map seeking stimulation. In my children’s school system, the townwide parent interest group for gifted and talented children is full of the parents of children with different, and often difficult, learning styles, and it is no accident.

Some of his readers have looked at the situation with packet sniffers and confirmed that if you turn off the mini-store function, iTunes does not upload any information, and Steve Jobs says that Apple discards any personal information the Ministore transmits to Apple.

Doctorow gives the credit for breaking this story to Marc at since1968.com, and makes note of this typology of silly apologists for Apple’s behavior:

• “It’s not spyware if Apple does it.”
• “Stop hyperventilating, iTMS is only collecting the songs you play. Where’s the harm?”
• “It’s your duty to monitor your outbound traffic..”
• “Corollary: You should expect that companies will take your information without asking, and it’s your duty to sniff and counter as desired.”
• “Privacy is dead, stop acting like companies are immoral for spying on you.”

I often get a version of some of these whenever I raise privacy concern about any sort of corporate behavior — either it is my responsibility to try to protect my privacy, or I should give it up and recognize that the battle is long since lost. I’ll be damned if I roll over and accept the latter; as to the former, I agree that it is my responsibility, when the data is collected transparently. For instance, to avoid their building a consumer database on me, I never sign up for the frequent buyers’ discount programs at large corporate chains at which I am forced to shop, since there are virtually no independent pharmacies, supermarkets, pet shops or stationery stores around anymore. (I am fortunate enough not to be faced with the same dilemma at Barnes and Noble or Borders, since I can frequent one of two wonderful independent bookstores and never shop the chains at all.) Likewise, as Marc’s discussion suggests, if I rip a CD into iTunes, it queries Gracenote for the tags on the tracks, but it tells me it is doing so.

This New York Times filmmaker portrait has an unfortunate headline. They do not mean that his debut film is ‘bombing’ or ‘tanking’, merely that it is about ‘virus bombs.’ Intentional or unintended ambiguity??

While panic-stricken coverage focuses on the dire pandemic awaiting us, there are suggestions that avian flu may not be as deadly as currently thought and that many mild cases may be going undetected. (New York Times )

More: Bird flu might be less deadly than feared: “Many mild or symptom-free H5N1 infections may have gone undetected in humans, meaning the real fatality rate is lower, a Vietnamese study suggests.” (New Scientist)

Dramatic contentions by the New York Times that the healthcare establishment has little incentive to control diabetes because treating the devastating consequences is so much more lucrative. “It’s almost as though the system encourages people to get sick and then people get paid to treat them,” one observer is quoted as saying starkly. However, I don’t think this is as nefarious as the sensationalistic spin suggests. It has been a perennial struggle to get the industry to fund wellness and preventive care, and there are complicated reasons why it does not happen, but they do not include powerful interests explicitly making sure that people do not get better because it is more profitable to treat them when they are sicker. Healthcare, of course, has long been dominated and defined by physicians who specialize in treating illness rather than maintaining health. Modern medicine has scored monumental success with intensive interventions in acute problems and in general flounders in approaching the more chronic insidious degenerative and lifestyle-related health problems that become more and more prominent on the healthcare landscape in the industrialized world. And the focus on the quick fix rather than the subtle holistic process is something endemic to the Western mindset. So I’m afraid the type of problem highlighted by this Times exposé will not be fixed by sensationalistic investigative reporting, legislative reforms or judicial proceedings as much as consciousness-raising and philosophical debate.

The New York Times posts intricate speculation that the writer who so starkly portrays prostitution, drug addiction and homelessness is a concoction both in public persona and authorship. But can it ever be said that an author is exactly who we think they are from reading them (and would we want that?).

Related: