Research for Whom?

The fourth hit really says "Do We Need Theory to Study Disease?"

Upfront Disclaimer: This post is probably unforgivably biased by the current reading.

When I first thought to offer this up as a discussion topic, I convinced myself that it’s a potentially esoteric-to-the-point-of-absurd topic, as is arguably the case with most of academia.

Then I reconsidered: Most people do not read scholarly, peer-reviewed publications. I, for one, do not read them regularly, and when I do my reading has nothing to do with mental illness. That being said, most people read or watch the popular news, and every time another study saying something anyone might find interesting is published in an academic journal, some popular news outlet does a little piece on it.

A few days ago, forum member Meredith pointed me toward this such news piece. If you don’t feel like reading it, I’ll summarize by saying its title is “BD II patients exhibit distinct cognitive deficits.” I read the article and had about a thousand unanswered questions, so I accessed the actual study and read that. Perhaps needless to say, the summary provided by the more accessible article was just a tad overly generalizing. And that title is just silly.

This post is not about the specifics of this one piece, but about MI-related research more generally. My obsessive nature leads me to read all the citations in a stupid, inconsequential article found on the Internet. And when that means I end up reading mental-illness studies, I generally get pissed. Who are these people? What are these tests? Who invented (and who vetted) these tests? Who’s measuring that they, in fact, measure what they say they’re measuring? How generalizable are they claiming their findings are? What’s the readership of this journal? Whose clinical practice is about to be affected by this nonsense, and how many patients do they have? What sources are these writers citing and how old is that research? … And down the obsessive rabbit hole I go.

I have a tenuous, at best, relationship with mental illness research, and I’ve identified two reasons for this. First, I think the research questions are almost always the wrong questions and the research methods are almost always the wrong ways to answer them. Granted, I’m not a psychological researcher, so it’s likely that I don’t know what I’m talking about. Still, “Are BD II patients cognitively impaired?” seems like a less than productive question. Couldn’t we focus research resources on how to raise the cognitive functioning of those who think they need it? Isn’t whether someone “feels impaired” all we really need to gauge? Most research questions of this sort lead to some variation of “So, Johnny, now that we’ve diagnosed you as mentally ill, we’re going to have to diagnose you as stupid. If you don’t feel stupid now, don’t worry – You will.” (And by now we all know how much I dislike methods that use “objective” metrics for completely subjective variables. But that’s just me.)

The other reason for my distaste lies really in the popular (“accessible”) news media that cover these publications. The title of the example article is a definitive statement not truly concluded in the study being covered. And the studies asking unproductive questions (with maybe inappropriate methods) are each being reported on by a culture that promotes a terrible stigma. Ugh.

So, Questions: Am I alone in this frustration? Even if all you know about the academic research going on is what’s reported by news outlets, how do you feel about it? Maybe more importantly, do you feel as though the bulk of research being done is for the benefit of the MI community? Because I don’t.

  1. Meredith said:

    1. I voted and accidentally hit the 4th star (I am BD II, remember) so please change it if you can to 5 stars because it is an excellent piece of writing with EXCELLENT questions.
    2. You are not alone, obviously, because, as you pointed out, I brought your attention to the article that I was unable to read myself.
    3. The interesting thing about the researchers, specifically the summarizers, is that they aren’t necessarily specialists in MH. Take, Whitaker for example. He was/is a journalist. WOW that says a lot. Clearly he’s a more scholarly journalist than most, but a journalist nonetheless. Why does everyone need to put their hands into MH? A good question, I think, which deserves research. But, for the lack of it at the moment, I will answer. Everyone wants to fix MI people because we are broken. We do not fit society’s desired image, much like homeless people (who may or may not be MI). If MI people just wouldn’t do this or talk like that, we would all be so much better off because we wouldn’t have to see so much imperfection (defined by their own brains defining mental perfection).
    4. Asking “are bp II people cognitively lacking?” (I’m playing devil’s advocate here) could actually be a useful question if they are looking at brain patterns (ok I just skim-read the article and WHOA! idiot alert)…change in topic a minute. Yes that study was done summarizing the findings of 55 studies using memory tests, IQ tests (which we know are biased), the WAIS, and other psycho tests. So right there, seeing that, I’m up in arms. That’s fucking ridiculous. The whole point of doing research on MI SHOULD be to find the cause, the actual parts of the brain involved in these diseases. So back to the brain patterns. They can see activity in the brain using electrodes and stuff and people could walk around with remote electrodes on and get triggered. See what the brain says, then. Not when it has to act with the help of the eyes and the mouth. Also, I have questions about their control groups.
    5. In short (since I am so NOT), I am skeptical about this research, was before, and am even more so now since I’ve been reading Whitaker. As I’ve said before, ∃, we should do our own study. Too bad we have no backers.

    • said:

      1. I cannot change the rating. Now that I think about it, there would be serious ethical implications to me being able to change it. Sadly, you might just need to vote again and settle for a net 4.5 stars. And thank you!
      2. True. That might’ve been a dumb question. (For the record, the actual study was happy to report that on many tests of cognitive functioning, BD I patients are a lot more deficient.)
      3. Well, I do believe that those researchers conducting scholarly, peer-reviewed studies are indeed academics with MH specialties. But, yet, the summarizers are very much not specialists.
      3b. I don’t know that everyone wants to fix us. Surely, lots and lots of people believe that we’re broken or, worse, dangerous. But, have you ever gotten the feeling that the HFMI are exoticized (especially the historical mentally ill people of the world)? I sometimes get the feeling that MH research is more about understanding, for the sake of understanding, the spectrum of the human (mental) condition. And while I’m generally all for knowledge generation for its own sake, I get really thrown by resources wasted on understanding what won’t help in the long run.
      4. Oh…you mean the “Healthy Control” group, as the study in this example calls them? Earlier today I was thinking about my psychotic tendencies after reading your comment on my phone, and I wondered who wouldn’t put me in a Healthy Control group if they met me on a good day. And between #3 and #4 I thought the following: Does psychosis interfere with the way I want to live MY life? Yes. Is it bad? In any moral sense, No. I am not in treatment right now because anyone told me to. I left that version of treatment. I am in treatment because it makes my experience of my life better. That’s the only fucking metric I need.
      5. If I ever decide that I can use my name in this context, we can get backers. I’m sure you’ll be among the first to know if I make that decision.

  2. Meredith said:

    Thank you for the suggestion. I got the 4.5! or rather you did. As for #5…I forgot. Maybe if you got your phd in a different topic you could keep pretending á la high functioning. :)
    3b. you’re right . Not everyone wants to fix us. I think that includes the MH docs, many of them, are just happy (tummy-pattingly so) to make us feel better. Since the meds are working so WELL for such a high percentage of MIs, why work harder? The pharms are making loads and we all know the docs get kickbacks for their research. Cynical? Nahhh. I gave that up for straight on pessimism.

  3. Jess said:

    1. So I’m a little biased because I am a psychological researcher. That being said, I agree wholeheartedly that the BP II have cognitive deficits is not a productive research question. What should be asked is how to treat clients to either reduce the deficits or allow coping skills and CBT to HELP those clients. Or, if it is the research question, frame it in a way that the answers to the question can help develop treatments or reduce the deficits.
    2. I agree with Meredith, it really, really FRUSTRATES me that the general population will read articles like this and believe it at face value because they aren’t scholarly works, written by doctors, MH prof, or researchers. But most people don’t want to read the scholarly articles that have been peer-reviewed and vetted by top journals. Granted, I don’t know what journals the citations were published in, but I’d like to think they were quality journals. I hate how people take out the “sexy” parts of an article or the most controversial parts of an article and use that to create a nice article online for the general population to read.

    • Thanks for your unique perspective, Jess! I do think, though that they have to identify the problem before they can think about fixing it. However, as we see with mi, they don’t really do that. Just stick a drug in them and shut them up. ok. I’m in a mean mood. sorry. The drugs have helped me a lot so I’m not knocking that. But yeah, treating symptoms is nutty in itself. And I don’t think determining who has more cognitive defects is as helpful as mapping where those might be coming from, which didn’t seem like the purpose of that study. ok. have a better day than I’m having *and it’s only 7:20 am* argh.

      • Jess said:

        Meredith, and there in lies the rub regarding treatment orientations. Personally, I’m more of a Cognitive Behavioral person, as I think we not only need to address the symptoms (behavior, so strict behaviorists believe this), but also the emotions and cognitions. My medicines have also helped me tremendously in decreasing my depression (I’ve only had two manic episodes, so the hardest part for me is the depression).

        I hope your day improves! I’m sorry you’re not feeling well. Check out JT’s blog if you’d like; he makes me laugh (a lot!)

        Take care,

        • I do therapy as well. couldn’t grow without it. I just couldn’t have gone any further without the meds. I visit jt often. that’s how i knew about you! Thanks, my day is already better. Talked to a friend. :)

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