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I have been diagnosed with OCD. One of the things you learn through medical treatment by qualified physicians is the general belief that a disorder like OCD has

I have been diagnosed with OCD. One of the things you learn through medical treatment by qualified physicians is the general belief that a disorder like OCD has genetic factors. These can be latent and untriggered but in the case of OCD in particular, it can get triggered by stress during life events like graduating from college - or this is just literally want happened to me. I'm not citing dozens of resources here but I feel really safe in saying that most medical literature on various mental disorders have a large faction of researchers (academic, medical, non-quack, quack) that will say that these mental disorders have a huge genetic as well as environmental compoenent. Please tell me and show me otherwise. Sorry but this is exactly the sort of speculative leap that you proceed to deride in the rest of the paragraph. Yes, you're right, but it is also informed by the academic literature on conspiracy theories which is readily available and everyone has access to. Here's a literature review: Understanding Conspiracy Theories - Douglas - 2019 https://onlinelibrary.wiley.com/doi/pdf/10.1111/pops.12568 https://onlinelibrary.wiley.com/doi/pdf/10.1111/pops.12568

maybelsyrup 5y ago
> I have been diagnosed with OCD Sorry to hear it; OCD sucks. > One of the things you learn through medical treatment by qualified physicians is the general belief that a disorder like OCD has genetic factors. To say that a human phenomenon "has genetic factors", or that something has "huge genetic as well as environmental component[s]" is nearly meaningless, as there's little about our species' functioning that wouldn't have anything to do, somewhere in the causal chain, with some genetic code being expressed or/and some environmental thing being tripped too. Not to mention that for about 50 years, nearly everything human beings do or say or fart out has been called "genetic" at some point. One needs to say more than that. Or at least, here's a stranger on the internet trying to ask you to do so. The issue, with OCD and with every other mental disorder, is that we can't really say that much more. Hence my "what?". There are many reasons for this, beginning with the fact that after a lot of money and effort and time, we're nowhere close to being able to define any of these conditions beyond groupings of behaviors that, in someone's eyes, sometimes appear together. In other words, we have no known underlying pathophysiology to refer to, no "lesion" or disease entity we can verify outside of the perception of the sufferer or the observer (friend, coworker, physician). Note that this is not to say that the phenomena aren't real -- they're very real, and people suffer horribly -- it's just to say that the way we talk about constructs like OCD or depression is, in a way, overly confident, whether we're saying they're environmental or asserting their genetic basis on some web forum. We talk about these things as if we know as much about them as we know about the flu, or cancer, or Covid-19, and we simply don't. Here's a good summation of the state of things from 2013 (it hasn't changed since). And before you shout "quack", know that this comes from the highest levels of "official", mainstream medicine - the kind your doctor listens to. Here's Tom Insel, former head of the NIMH: > "Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, [mental disorder] diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever." [At the time he said that, around 2013, Insel began scaring a lot of the bigwigs in his field because he started mouthing off about this and other skeletons in the mental health closet. Here's another one: > “I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs—I think $20 billion—I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness.”] There's a bigger reason we can't say much, however: the entire project of "genes for mental disorders / mental health / psychiatry" has been a monumental failure. I'd cite a bunch on the matter, but I've written enough to bore everyone here to tears, so I'll just give you what I think is the seminal gloss on this [x], which I highly recommend. So with mental disorders and genetics, the absence of proof is in the absence of pudding, as it were. This is how I know that you weren't given a blood test, or a genetic test, or a brain scan to confirm your physician's OCD diagnosis - because one doesn't exist. I'm a mental health professional (non-physician), in clinical practice for a decade, and I can't order such a test! (And brother I'm fuckin' dying to!) There isn't any test because we don't know what the thing is beyond "the nature of chest pain", in Insel's words. We have things like this [y], but they don't say that much (see [x] for why), and in that paper's case the authors couldn't even find any good twin studies on OCD to include, leading them to say find only "mixed support for the familial aggregation of OCD" (1573). What I'm belaboring the point to try and say is (sorry for that) that if we don't know what the thing is - if, in mental health, we're using constructs with extremely little scientific validity - it's very, very hard to say anything concrete about genetic factors, or latent cases, or triggering. Not in the case of OCD, and much, much less so in the case of a very vague "inability to understand", as you put it earlier. > most medical literature on various mental disorders have a large faction of researchers We're appealing to "most" and to "general belief" here as a measure of truth? On HN? Come onnnnn > Yes, you're right, but it is also informed by the academic literature on conspiracy theories which is readily available and everyone has access to. Here's a literature review: Sorry to say this, but "informed by the academic literature" creates the impression that something very specific has been shown or said on some matter, when in fact what you've shown is pretty vague. They're weasel words. First, how is what you've said informed by the source you cite? The source you cite sorta says everything and nothing: it's a review, right?, so the authors aren't coming out and making a claim -- they're just telling the reader their view of the state of field w/r/t conspiracy theories, psychology, and politics. And the field seems to say ... well, a bit of everything, if you read the review. All the way from ... > "Goertzel proposed that conspiracy beliefs comprise part of a monological belief system where these beliefs comprise a self-sealing and expanding network of ideas that mutually support each other" to ... > "It is important for scholars to define what they mean by “conspiracy theorist” and “conspiracy theory” because—by signalling irrationality—these terms can neutralize valid concerns and delegitimize people." In fact, the authors devote a great deal to points of view like this latter quote, making me wonder if the review is making the point you think it's making. Second, sure, what you've cited is indeed a "review", but no one in political science, psychology, or elsewhere puts much stock in reviews as a category as reliable evidence of anything, at least not sight-unseen. They're a great format, and they're even better for the author (because you learn a shit ton), but they're basically book reports. There are some highly impactful ones in every field, but they're diamonds in the rough. There's a way to do reviews highly rigorously [z], but this isn't doing that. Also, not that impact factors are the be-all and end-all, but this journal isn't at the top of its niche. In fact, this niche ("political psychology") isn't exactly overflowing with Nobel laureates, and it's hard to tell what it's contributed in terms of major, lasting, replicated findings. And that's to say nothing of the major evidentiary crisis in psychology and psychological research in the last ten years concerning replication and scientific rigor -- and that's only research psychology, not even "mental health" or "psychiatry", which are in much worse shape, as I outlined earlier. [x] Joseph and Ratner, "The Fruitless Search for Genes in Psychiatry and Psychology: Time to Reexamine a Paradigm" in "Genetic Explanations: Sense and Nonsense", Harvard University Press, 2013. The book is here - https://www.amazon.com/Genetic-Explanations-Nonsense-Sheldon-Krimsky/dp/0674064461 https://www.amazon.com/Genetic-Explanations-Nonsense-Sheldon... - and you can find it for, uh, cheaper, in your favorite, uh, website. For books. You know the ones I mean. [y] https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.158.10.1568 https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.1... [z] http://prisma-statement.org/ http://prisma-statement.org/
- hluska 5y ago
  This is one of the most tasteless replies I have ever read to someone who self identifies with a mental illness. I’m rarely shocked by humans but in this case, I’m genuinely shocked a human wrote this.
  - z0r 5y ago
    If you read the poster's comment history, they claim expertise in the field (see the comment immediately preceding this one). And they did reply to a comment containing "Please tell me and show me otherwise." The post might or might not be a load of nonsense, but I think you can leave gustavo-fring to be offended on his own behalf.
    - deleted 5y ago
      [deleted]
  - kelnos 5y ago
    I don't really see where you're coming from, here. It seemed well-thought-out and informative to me, and from someone who claims to be a mental health professional. Perhaps apply the principle of charity and avoid attributing a negative/dismissive/argumentative tone when maybe there wasn't one?
  - stordoff 5y ago
    I'm not sure where you're coming from here. I also have OCD (though I'm not overly sure that's relevant), and found the reply to be perfectly reasonable (particularly given the "Please tell me and show me otherwise" part of the parent comment).
    - gustavo-fring 5y ago
      It's just very, very smug. It's not wrong but it's very pedantic and not considerijng that the reason I didn't spell it all out and cite a bunch of sources is because the entire subthread is besides my main point. That shit is exhausting. Not to make an argument from authority but having dealt with OCD and a lot of caregivers over a decade and having been in graduate level academia for a decade I know a little more about scientific research and how it ideally works than the poster gives any credit for. It's just very rude and not half as smart as it thinks it is. Yes, I know what a literature review is. I mean, in their words, come onnn.

maybelsyrup 5y ago

> I have been diagnosed with OCD Sorry to hear it; OCD sucks. > One of the things you learn through medical treatment by qualified physicians is the general belief that a disorder like OCD has genetic factors. To say that a human phenomenon "has genetic factors", or that something has "huge genetic as well as environmental component[s]" is nearly meaningless, as there's little about our species' functioning that wouldn't have anything to do, somewhere in the causal chain, with some genetic code being expressed or/and some environmental thing being tripped too. Not to mention that for about 50 years, nearly everything human beings do or say or fart out has been called "genetic" at some point. One needs to say more than that. Or at least, here's a stranger on the internet trying to ask you to do so. The issue, with OCD and with every other mental disorder, is that we can't really say that much more. Hence my "what?". There are many reasons for this, beginning with the fact that after a lot of money and effort and time, we're nowhere close to being able to define any of these conditions beyond groupings of behaviors that, in someone's eyes, sometimes appear together. In other words, we have no known underlying pathophysiology to refer to, no "lesion" or disease entity we can verify outside of the perception of the sufferer or the observer (friend, coworker, physician). Note that this is not to say that the phenomena aren't real -- they're very real, and people suffer horribly -- it's just to say that the way we talk about constructs like OCD or depression is, in a way, overly confident, whether we're saying they're environmental or asserting their genetic basis on some web forum. We talk about these things as if we know as much about them as we know about the flu, or cancer, or Covid-19, and we simply don't. Here's a good summation of the state of things from 2013 (it hasn't changed since). And before you shout "quack", know that this comes from the highest levels of "official", mainstream medicine - the kind your doctor listens to. Here's Tom Insel, former head of the NIMH: > "Unlike our definitions of ischemic heart disease, lymphoma, or AIDS, [mental disorder] diagnoses are based on a consensus about clusters of clinical symptoms, not any objective laboratory measure. In the rest of medicine, this would be equivalent to creating diagnostic systems based on the nature of chest pain or the quality of fever." [At the time he said that, around 2013, Insel began scaring a lot of the bigwigs in his field because he started mouthing off about this and other skeletons in the mental health closet. Here's another one: > “I spent 13 years at NIMH really pushing on the neuroscience and genetics of mental disorders, and when I look back on that I realize that while I think I succeeded at getting lots of really cool papers published by cool scientists at fairly large costs—I think $20 billion—I don’t think we moved the needle in reducing suicide, reducing hospitalizations, improving recovery for the tens of millions of people who have mental illness.”] There's a bigger reason we can't say much, however: the entire project of "genes for mental disorders / mental health / psychiatry" has been a monumental failure. I'd cite a bunch on the matter, but I've written enough to bore everyone here to tears, so I'll just give you what I think is the seminal gloss on this [x], which I highly recommend. So with mental disorders and genetics, the absence of proof is in the absence of pudding, as it were. This is how I know that you weren't given a blood test, or a genetic test, or a brain scan to confirm your physician's OCD diagnosis - because one doesn't exist. I'm a mental health professional (non-physician), in clinical practice for a decade, and I can't order such a test! (And brother I'm fuckin' dying to!) There isn't any test because we don't know what the thing is beyond "the nature of chest pain", in Insel's words. We have things like this [y], but they don't say that much (see [x] for why), and in that paper's case the authors couldn't even find any good twin studies on OCD to include, leading them to say find only "mixed support for the familial aggregation of OCD" (1573). What I'm belaboring the point to try and say is (sorry for that) that if we don't know what the thing is - if, in mental health, we're using constructs with extremely little scientific validity - it's very, very hard to say anything concrete about genetic factors, or latent cases, or triggering. Not in the case of OCD, and much, much less so in the case of a very vague "inability to understand", as you put it earlier. > most medical literature on various mental disorders have a large faction of researchers We're appealing to "most" and to "general belief" here as a measure of truth? On HN? Come onnnnn > Yes, you're right, but it is also informed by the academic literature on conspiracy theories which is readily available and everyone has access to. Here's a literature review: Sorry to say this, but "informed by the academic literature" creates the impression that something very specific has been shown or said on some matter, when in fact what you've shown is pretty vague. They're weasel words. First, how is what you've said informed by the source you cite? The source you cite sorta says everything and nothing: it's a review, right?, so the authors aren't coming out and making a claim -- they're just telling the reader their view of the state of field w/r/t conspiracy theories, psychology, and politics. And the field seems to say ... well, a bit of everything, if you read the review. All the way from ... > "Goertzel proposed that conspiracy beliefs comprise part of a monological belief system where these beliefs comprise a self-sealing and expanding network of ideas that mutually support each other" to ... > "It is important for scholars to define what they mean by “conspiracy theorist” and “conspiracy theory” because—by signalling irrationality—these terms can neutralize valid concerns and delegitimize people." In fact, the authors devote a great deal to points of view like this latter quote, making me wonder if the review is making the point you think it's making. Second, sure, what you've cited is indeed a "review", but no one in political science, psychology, or elsewhere puts much stock in reviews as a category as reliable evidence of anything, at least not sight-unseen. They're a great format, and they're even better for the author (because you learn a shit ton), but they're basically book reports. There are some highly impactful ones in every field, but they're diamonds in the rough. There's a way to do reviews highly rigorously [z], but this isn't doing that. Also, not that impact factors are the be-all and end-all, but this journal isn't at the top of its niche. In fact, this niche ("political psychology") isn't exactly overflowing with Nobel laureates, and it's hard to tell what it's contributed in terms of major, lasting, replicated findings. And that's to say nothing of the major evidentiary crisis in psychology and psychological research in the last ten years concerning replication and scientific rigor -- and that's only research psychology, not even "mental health" or "psychiatry", which are in much worse shape, as I outlined earlier. [x] Joseph and Ratner, "The Fruitless Search for Genes in Psychiatry and Psychology: Time to Reexamine a Paradigm" in "Genetic Explanations: Sense and Nonsense", Harvard University Press, 2013. The book is here - https://www.amazon.com/Genetic-Explanations-Nonsense-Sheldon-Krimsky/dp/0674064461 https://www.amazon.com/Genetic-Explanations-Nonsense-Sheldon... - and you can find it for, uh, cheaper, in your favorite, uh, website. For books. You know the ones I mean. [y] https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.158.10.1568 https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.1... [z] http://prisma-statement.org/ http://prisma-statement.org/

hluska 5y ago
This is one of the most tasteless replies I have ever read to someone who self identifies with a mental illness. I’m rarely shocked by humans but in this case, I’m genuinely shocked a human wrote this.
- z0r 5y ago
  If you read the poster's comment history, they claim expertise in the field (see the comment immediately preceding this one). And they did reply to a comment containing "Please tell me and show me otherwise." The post might or might not be a load of nonsense, but I think you can leave gustavo-fring to be offended on his own behalf.
  - deleted 5y ago
    [deleted]
- kelnos 5y ago
  I don't really see where you're coming from, here. It seemed well-thought-out and informative to me, and from someone who claims to be a mental health professional. Perhaps apply the principle of charity and avoid attributing a negative/dismissive/argumentative tone when maybe there wasn't one?
- stordoff 5y ago
  I'm not sure where you're coming from here. I also have OCD (though I'm not overly sure that's relevant), and found the reply to be perfectly reasonable (particularly given the "Please tell me and show me otherwise" part of the parent comment).
  - gustavo-fring 5y ago
    It's just very, very smug. It's not wrong but it's very pedantic and not considerijng that the reason I didn't spell it all out and cite a bunch of sources is because the entire subthread is besides my main point. That shit is exhausting. Not to make an argument from authority but having dealt with OCD and a lot of caregivers over a decade and having been in graduate level academia for a decade I know a little more about scientific research and how it ideally works than the poster gives any credit for. It's just very rude and not half as smart as it thinks it is. Yes, I know what a literature review is. I mean, in their words, come onnn.