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How NIMH policy effects research

The uncertainty of science: A policy change in how the National Institute of Mental Health (NIMH) awards grants during the Obama administration has had a profound influence on the research of mental-health in the United States.

An analysis by Nature suggests that the number of clinical trials funded by the NIMH dropped by 45% between 2009 and 2015. This coincides with the agency’s launch, in 2011, of the Research Domain Criteria (RDoC) — a framework for research on the mechanisms of mental illness. The NIMH’s roll-out of RDoC included asking researchers to focus more on the biological bases of behaviour — such as brain circuitry and genetics — than on the broader symptoms that clinicians typically use to define and classify mental illness.

The NIMH’s embrace of fundamental research has infuriated many clinical researchers, who see it as an attempt to invalidate their methods — and say that there is scant evidence to support the idea that using RDoC will lead to greater insight or better treatments for mental illness. Many of these researchers also note that NIMH funding for clinical trials has declined steadily over the past decade, adding to the perception that the agency now favours research that uses the RDoC framework.

Read the article. I have no idea if the change in NIMH policy is a good or bad thing. What disturbs me however is the federal government’s overall top-down control over mental-health research. Rather than obtain funding from many different sources — which would allow for the greatest flexibility and the most creativity — this research field appears to depend almost entirely on NIMH grants. Thus, the particular preferences of that agency dictates the nature of the research, whether or not its preferences are right.

Genesis cover

On Christmas Eve 1968 three Americans became the first humans to visit another world. What they did to celebrate was unexpected and profound, and will be remembered throughout all human history. Genesis: the Story of Apollo 8, Robert Zimmerman's classic history of humanity's first journey to another world, tells that story, and it is now available as both an ebook and an audiobook, both with a foreword by Valerie Anders and a new introduction by Robert Zimmerman.

 
The ebook is available everywhere for $5.99 (before discount) at amazon, or direct from my ebook publisher, ebookit. If you buy it from ebookit you don't support the big tech companies and the author gets a bigger cut much sooner.


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"Not simply about one mission, [Genesis] is also the history of America's quest for the moon... Zimmerman has done a masterful job of tying disparate events together into a solid account of one of America's greatest human triumphs."--San Antonio Express-News

13 comments

  • Dick Eagleson

    The government exercises such defacto top-down control over many fields of science. What started with the nuclear physicists under the exigent circumstances of WW2 has now metastasized into a near stranglehold on the majority of basic scientific research done in the U.S. The fact that the various scientific establishments have been eager participants in this federalization of science is no reason to approve of its often dysfunctional results. Sloppy and even fraudulent work has reached epidemic proportions across the board and certain entire fields, notably climate science, are now in the hands of what amount to organized criminals.

    The left has certainly not neglected the scientific establishment in its multi-decadal “march through the institutions.” The science establishment is in the process of being weaponized against the American people in the same way as the IRS, the DOJ, the EPA, the intelligence establishment and many other organs of the state have been. These trends need to be halted and thrown back.

  • wayne

    Yowza–
    this is a huge topic.

    humorous back-n-forth from The Big Bang Theory, that summarize one-dimension, in play:
    https://youtu.be/FitG_PLO9Rg
    (2:22)
    “rankest psychologism”

    That being said, personally I have a strong Behavioral bent and we have historically aligned ourselves with the neurobiology folks on the theoretical level.
    -At street-level, the rule of thumb is to utilize whatever works, within resource constraints.

    On a monetary funding level– you have basically two options for funding, government & pharmaceutical companies.

  • wayne

    Dick–
    Good stuff!

  • LocalFluff

    Mental health is the junction of almost all of the hardest nuts to crack in science and philosophy: Subjectivity, socializing, history, microbiology, “connectonics”. And some prominent scientists now suggest maybe even quantum mechanics. Still, no one can even cure a simple cold without some ancient household remedy (which actually work, I can recommend a couple of tricks!)

    I don’t know what to do about it, but taxing people in order to have more of the same that has been tried and failed, doesn’t seem optimal. At least Freud was paid by his clients/victims.

  • Garry

    Wayne, I’ve always had the impression that at the level where the mental health rubber hits the road, the therapist learns through, for lack of a better word, experimentation, and much of the art of the craft is trying to figure out which clients the individual can best help. I would think that this low-level experimentation would be much more influential than the more formal research results that come from on high.

    Am I out to lunch on this? In your career, how would you characterize the split (in terms of influence on your job performance) between (1) what you learned in school (2) what you learned on your own, before school or in the course of your practice (3) results of research from on high (4) whatever else I’m leaving out?

    On a (somewhat) related note, my mantra while I train new employees is “good judgment comes from experience, experience comes from bad judgment.” I point out that the bad judgment doesn’t always have to be one’s own, and we should all strive to learn from everybody’s bad judgment, past or present.

    LocalFluff, please do share your ancient household remedies; my remedy for a cold has been to suck it up and go to work anyway, and I’d love to find a better alternative.

  • LocalFluff

    Garry
    Eat a whole bunch of lemons and a garlic and put a hot towel on your head facing down over a bowl of hot water and inhale its fumes. (It works in my experience). You could put some herbs in it if you like as a matter of taste.

    Or, in my grandpa’s days, buy a coughing medicine at your pharmacy, like amphetamine, that tastes so horribly bad that the kids don’t dare cough or they’ll get punished by a spoon of it. (Nowadays they put sugar in it to make it taste good!!! Jesus H.)

  • LocalFluff

    Could very well be that these things are rituals that traditionally just make public fun of people having a cold. My wife had a laugh when she “cured” me. Get at’em while they’re weak, you know. But so called medical and psychological science hasn’t gotten any further anyway, so why not?

  • wayne

    Garry–
    big topic, excellent observations.
    Much like Physics– lots of Faith, Fashion, and Fantasy, in the mind-business.

    Depends on what you mean by therapy & what specific mental illness is in play, and if it’s private or Public mental health. (not to be flippant)

    (hopefully) You do learn to be eclectic rather quickly, or you wind up being mechanical and wasting everyone’s time.

    At times I’ve played the Artist, and at times, a highly skilled Technician. I did start at the “bottom,” and empathize highly with Technician’s everywhere.

    Off the top of the head– learned most everything I eventually needed to know about the “System,” and the people who interact with it, at the Staff & Case-Manager level. That does however, tend to force one into a certain path.
    My graduate degree says “Applied Behavior Analysis,” but my license says “Licensed Professional Counselor.” (4K hours of supervised on-the-job training.)

    I’ll have to ponder further.

  • Edward

    wayne,
    practical application, not theoretical research, is what cures patients. Here is a scene showing how the first session with a new psychologist can cure a patient.
    https://www.youtube.com/watch?v=Cu5F2Z9mKmo (3 minutes)

    On the other hand, she may not be as good at the profession as she thinks.

    Garry,
    It isn’t behavioral science, but in my profession:
    1) in school I learned largely how to think, but several “what to think” lessons from school would keep cropping up during my career (e.g. properties of materials rather than the modern lesson of letting the boys freely roam the girl’s locker room);
    2) before college, I learned some general space stuff that did not help my career much, but during my career I learned what to think and how to best research, design, and test new hardware (and failed to learn to not split infinitives twice in a single sentence);
    3) I didn’t really reference a lot of research papers, but I learned various lessons from colleagues regarding what works and what doesn’t; and
    4) I learned that a smart man learns from his mistakes (his poor judgement), but the wise man learns from other people’s mistakes — I learned to be as wise as possible.

    One of the most interesting differences and conundrums between my education and my career was my vibrations class. My professor did not believe in random vibration, but that is the type most widely used to physically test flight hardware. Thus, all I learned about random vibration in school was on one page of the textbook, in one sentence from the professor, and nowhere on the black board. By the time I was in that class, I already knew that random vibration was an emphasis in the career I was choosing, and I was disappointed that we were not going to study random vibration.

    Vibration tests record data largely by sending the vibration waveform (either random or sinusoidal) through a Fourier transform, which translates the output vibration into magnitude at various frequencies. This transform is how cell phones transmit voice, because it can be sent much more compactly than the regular waveform, and running it thought the Fourier transform again regains the waveform at the other end so that you can hear what the other person said. Thus, our tests turned random vibration into data that could (theoretically) repeat the test — as though it were not random at all but predetermined.

    Despite the technique of using random vibration tests, my professor had been somewhat correct, at the fundamental level, that even random vibration could be broken down as a series of vibrations at various frequencies. It took me a few years to figure that out, solving the conundrum between my professor’s lecture and my real world application. However, we still used power spectral density curves (G^2/Hz) in our analyses.

  • Garry

    Edward, your experience sounds similar to mine, in that in college I learned how to learn, and after that I learned from colleagues, reading, and experience (mistakes).

    Actually, I’ve never had a job where my primary activity was applying my mechanical engineering degree, but the logic and overall approach has helped me make sense of the jobs I’ve had. It’s been almost 30 years since I’ve done a job that I was formally educated or trained to do; I’ve had to learn on the fly, which is my preferred mode. I’ve learned a lot especially from subordinates, and at the same time I’ve shown them new ways of putting together what they know; I’ve come to call this process “mutual learning.”

    I’ve been able to apply knowledge / skills across fields, which has brought interesting results.

    My last formal education was in artillery fire direction, which is highly technical. I took my instructor’s words to heart when he told us “you’ve got to learn this stuff cold now, because once you get to apply it, you’ll be spending 90 percent of your time on other things, like dealing with broken vehicles, arranging emergency leave for your people, and a whole lot of other things, and in the 10 percent of the time that you’ll have a chance to apply what you learn here, there won’t be any time to study.”

    That certainly was accurate. Because of that, when I’ve had to learn new information and skills, I’ve made sure I had a solid grasp of the basics before I enter the arena, which has allowed me to improvise and adapt as the situation changes. I’ve always relied heavily on the basics, whether it be my various jobs in the military, my jobs as a teacher, my editing work, or my jobs as a manager in various fields.

    As a mechanical engineer, I took vibrations, and it was the one course I took that I was never able to put into context to the extent that I felt I had a basic grasp on it. To be fair, my thermodynamics courses also didn’t make sense, until something clicked in the 5th course and it all came together in my mind. Having taken only 1 vibrations course, I never had much of a chance to put it in perspective (and in the meantime I’ve forgotten most of what I’ve learned).

  • wayne

    Edward/Garry–
    Good stuff.

    -in particular:
    “…in college I learned how to learn, and after that I learned from colleagues, reading, and experience (mistakes).”
    I would echo that in large measure.

    My supervised internship was specifically designed to allow me to fail, without inflicting too much damage on real people. Out in the real world, without a net, I relied heavily on colleagues and a firm conviction in my theoretical underpinning’s. (And at the time, Behavorism was being repackaged as “kinder & gentler,” & we were increasingly open to utilizing more Cognitive approaches, which did involve keeping up with literature.)

    I’ve been trying to whip up a concise coherent paragraph, ref- Garry’s specific questions above, but have been too busy to think coherently.

  • Edward

    Garry wrote: “Actually, I’ve never had a job where my primary activity was applying my mechanical engineering degree, but the logic and overall approach has helped me make sense of the jobs I’ve had.

    My early career was in design, so I got to apply my mechanical engineering degree most days. I knew a young engineer who was disappointed that her first job out of college did not apply her degree, so she moved from surveying satellite assemblies (e.g. making sure everything pointed in the right direction) to designing ground support equipment used in the assembly and test of those satellites.

    I’ve had to learn on the fly, which is my preferred mode.

    I discovered that I was tossed into plenty of tasks without sufficient information or training. My last company took training seriously, because dropped satellites are terribly expensive, so we were trained on everything from how to do our jobs to how to work the fire extinguishers.

    I’ve learned a lot especially from subordinates, and at the same time I’ve shown them new ways of putting together what they know; I’ve come to call this process ‘mutual learning.’

    I once worked with a contractor whose philosophy was to learn more from each job than he taught. He was very knowledgeable.

    My last formal education was in artillery fire direction, which is highly technical.

    Yeah. I had a dynamics class that was either entirely that topic or else that is all I remember from that class (other than the professor mumbling the lecture to the chalkboard rather than speaking out to the class). In essence, we were supposed to come out of that class being able to calculate how far east to point the artillery when the target was 100 kilometers due south.

    in the 10 percent of the time that you’ll have a chance to apply what you learn here, there won’t be any time to study.

    It was important to know where to find the information or equation that was needed as well as how to use it, thus it was not so important to have memorized the equation. Work was similar to an exam, in that way; it was open book, but you didn’t have time to learn the subject.

    Another interesting thing that happened: when I first got out of school and into a job, I was using the latest computer equipment to make better looking presentations than the old fogies. A decade later, I discovered that the new guy, fresh out of school, was using the latest computer equipment to make better looking presentations than I was making. Yow! DO NOT fall behind with the technology. You may not have time to learn the latest technology, but find the time anyway.

    I’ve always relied heavily on the basics

    That is another good lesson: whenever you get into trouble, fall back to the fundamentals. If something gets complicated, remember that F=MA, and make sure that your analysis or design is not violating the fundamentals of physics or engineering. I keep watching for that on Star Trek, too, when in 60 minutes they use their computer to find a cure for an incurable disease that the advanced space alien race’s entire medical community couldn’t cure over the past century; if the computer model of the alien’s biology does not match the reality, the model is wrong.

    Also, watch out for those who believe anything that the computer says: “garbage in, gospel out” is a poor philosophy that was practiced by one of my bosses. If the computer said so, it must have been true.

    I took vibrations, and it was the one course I took that I was never able to put into context to the extent that I felt I had a basic grasp on it. To be fair, my thermodynamics courses also didn’t make sense, until something clicked in the 5th course and it all came together in my mind.

    Yeah, things can get pretty complicated. I decided to not even start the last of the 25 questions on my final exam, because it was just too complicated and I was going to get it wrong anyway, since I botched the setup of the homework version of the problem. I understood the vibration basics pretty well, but after a few years I couldn’t do many of the problems at the back of the chapters. Many of my other classes ended up that way, too, which makes it hard to go back to get a masters degree.

    Thermodynamics was fun, because one of my professors taught it as though we were designing typical power plants, and he would end his lectures with interesting, off-the-exam lessons, such as methods used to get rid of waste heat in cooling towers. He also taught my heat transfer class, where a table in the text had an order of magnitude difference in the coefficient for convection on a copper teapot than for a copper boiler — what’s up with that, and which coefficient do I use on the exam(!)?

    I have concluded that the job of thermal engineer is a tough one, because the real design works so differently than the model did. We would give the thermal engineer our design, his model would say that it was OK, then we couldn’t get the equipment to cool down as much as it should have. My conclusion: modelling reality is hard, which explains why so many designs break so easily. Apparently, models are often based upon assumptions that do not match the real world hardware. This also explains the failure of the current climate models.

  • wayne

    Edward–
    Great stuff!

    tangentially– I’ve had the distinct thrill of visiting the inner-workings of numerous pharmaceutical/chemical-plants, both pilot and full-scale industrial synthesis production- lines. Amazing engineering & design! (my daughter does Discovery & Screening, and my son-in-law is a Chemical-Engineer.)

    [oh, btw- highly recommend the “Kerbal Space” program. You would especially enjoy it.]

    humorous interlude…
    The Big Bang Theory –
    “Sheldon Trains Penny”
    https://youtu.be/qy_mIEnnlF4
    (2:44)

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