Notable Links & Announcements - April 23, 2023
1. I’m presenting at the upcoming annual meeting of the American Psychiatric Association in San Francisco, CA in May 2023. I’ll be talking at the following 3 sessions. If you are attending the meeting, you are very welcome to drop by! The presentation on Conceptual Competence builds on my previous work with G. Scott Waterman (pdf).
Saturday, May 20, 2023. 1:30 PM - 3:00 PM PDT
Conceptual Competence in Psychiatric Training: Building a Culture of Conceptual Inquiry
Chair: G. Scott Waterman, M.D. Presenter: Awais Aftab, M.D. Presenter: John Zell Sadler, M.D. Presenter: Brent Michael Kious, M.D., Ph.D.
Sunday, May 21, 2023. 10:30 AM - 12:00 PM PDT
Advancing Psychiatry Using Insights From Philosophy of Science
Chair: Awais Aftab, M.D. Presenter: Jonathan Fuller, M.D., Ph.D. Presenter: Awais Aftab, M.D. Presenter: Serife Tekin, Ph.D.
Monday, May 22, 2023. 1:30 PM - 3:00 PM PDT
Free Will in Psychiatry: A Clinical Introduction
Chair: James Alexander Scott Presenter: Lawrence Belcher, M.D. Presenter: Awais Aftab, M.D.
2. The 2023 Annual Meeting of the Association for the Advancement of Philosophy and Psychiatry (AAPP) will take place concurrently with the APA meeting on May 20-21, 2023, San Francisco, CA at the San Francisco Hilton Union Square. See here for program schedule. I'm on the executive council of AAPP and their meetings offer a rich interdisciplinary dialogue around philosophical issues in psychiatry. (See here for an overview of the 2022 meeting)
3. Sarah An Myers at Psychology Today asked me about how our understanding of delusions and hallucinations in psychiatry has changed over the past century. You can read the post here. Some excerpts:
“For the fathers of the concept of schizophrenia—Emil Kraepelin and Eugen Bleuler—delusions and hallucinations were of secondary importance diagnostically, and they gave greater importance to features such as a deteriorating course of illness, cognitive impairment, peculiarities of thought process, and flattened affect.
Finally, for Bleuler, delusions and hallucinations represented adaptive responses of the mind. Bleuler understood schizophrenia as breakdown in the mind’s ability to make stable associations, and thought this was ultimately caused by a metabolic or genetic defect. However, his understanding of psychosis went beyond this.”
“This idea that delusions and hallucinations might be cognitive and psychological functional responses to other dysfunctions was forgotten, or at the very least was neglected, with the rise of symptom-based diagnostic manuals, and the symptoms themselves came to be seen as dysfunctional. It is only recently—especially through predictive processing approaches to psychosis—that we have begun to find our way back to Bleuler’s hypothesis.”
“We have to understand that what we consider to be states of psychosis are richer in meaning and significance than is currently conceivable within the medical framework, and we have to look to our colleagues in fields such as anthropology, religious studies, and Mad studies for collaboration and guidance. When is psychosis a pathology? When is it a reflection of human neurocognitive variation? When does it represent our relationship to the divine? Our culture needs to create spaces to explore these questions in a meaningful way.”
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4. Repurposing a failed class of schizophrenia drugs to treat menopausal symptoms: The science and serendipity behind neurokinin-3 receptor antagonists. Rational Psychiatry
5. “Genes are one of the rare viable causal threads that can link biology to psychiatry. Which means that they are also one of the rare causal threads to rule out a link between a specific biological process and psychiatry.” Michel Nivard
6. Sensitivity of Schizophrenia Endophenotype Biomarkers to Anticholinergic Medication Burden. Joshi, et al. in American Journal of Psychiatry —
“Our results show for the first time that the total anticholinergic medication burden aggregated from all medications is associated with diminished MMN [mismatch negativity] and P3a response in schizophrenia and suggests that ACB>6 may uniquely attenuate EAIP [early auditory information processing] biomarker relationships in schizophrenia, a degree of ACB seen in at least 25% of schizophrenia patients.”
“results support the idea that in patient-oriented studies, accounting for ACB may help optimize bench to bedside translational pipelines and add important information to “go or no-go” decision making, particularly those using EAIP biomarkers to test central nervous system target engagement of novel pro-cognitive therapeutic molecules or other treatment approaches”
7. “While we ascribe this capacity to explain to “models,” it is actually the narratives within which theory is born that provide models with their explanatory power, not the equations themselves.” — Sarah P. Otto and Alirio Rosales
8. Subjective signal strength distinguishes reality from imagination — Nadine Dijkstra & Stephen M. Fleming in Nature Communications
9. The Corrections Dilemma: Media Retractions Increase Belief Accuracy But Decrease Trust
10. xkcd: They finally did a meta-analysis of all of science…
11. “We have created a science of bureaucrats, of meaningless repetitive tasks, of obsession with a quantitative metrics of productivity that no longer bear any relation to desirable output.” Mel Andrews, Philosophy in the Trenches and Laboratory Benches of Science, for The Philosopher
12. Is Exercise Better Than Medicine For Depression? Why the evidence doesn’t hold up very well when it comes to exercise and depression — Gideon M-K
13. At every point on the income distribution, Americans live shorter lives than the English.
14. My Primal Scream of Rage: The Big Alcohol Study That Didn't Happen — Dynomight for Asterisk magazine. “Five years ago, the National Institutes of Health cancelled the largest study on alcohol ever planned. Here’s why — and why you should be mad too.”
15. “Pulling futilely at a Norman Door is more than annoying: it is a grim indication that we live in a world where good ideas lose.” Experimental History
PS. Some inquired if the post “Messy, Bloody, and of the Past” was intended to signal my negative assessment of socialism. Not at all! The only thing it was intended to signal was that our best ideas about system redesign are always implemented in the real world under suboptimal conditions, and if the viability of a proposal depends on it being implemented in an ideal world, it’s not really a good proposal.
Would love to attend those sessions at the APA conference, but am not going this year. Somewhat strangely, I signed up for the MAPS conference in June instead due to scheduling conflicts. Super happy to see them being part of what attendee's to the APA will be seeing!
Will be introducing the psychiatry residents to the Conceptual Competence paper (plus Rosa Ritunnano’s Hermeneutical Injustice paper) for the first time in May (including it in the psychodynamic series to start).