A Monthly Summary of News and Events
Vol. 3 No. 11 - November 2000
This newsletter is sponsored by EEG Spectrum International Intl, Inc.,
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Past issues are available at www.eegspectrum.com/newsletter/
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The opinions related in this newsletter reflect those of the author only.
Copyright (C) 2000 by EEG Spectrum International Intl, Inc. All rights reserved.
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The Ritalin Controversy
by Siegfried Othmer, Ph.D.
The Los Angeles Times editorialized recently on the lawsuits against the Ritalin industry. Titled "Detour for Ritalin Issue" (October 27, 2000), the editors said:
Now when it comes to research, it appears that cigarette companies significantly under-represented the health hazards of cigarettes over the years. The same can be said for the Ritalin industry. How is it that after more than forty years of Ritalin use no large-scale study as ever been performed to monitor the long-term effects? How is it that the recently completed "Multi-Site Study" did not meet the gold standard for research design in such studies? For example, there were no "no-treatment" controls, and there was no random assignment. Children who had already been on medication successfully for some time were introduced into the medication phase of that program. They were preselected! In the world of science, this is a scandal. Of course this biased the outcome of the study in favor of medications. The U.S. Government sponsored this study. Hence the NIH was a co-conspirator in this flawed design. In any research that could threaten Ritalin supremacy, these same researchers would insist on the gold standard being met
This points up the difficulty in simply asking for more research on Ritalin. The drug companies control the whole process, even down to their acolytes within the NIMH. There is the same commercial interest in the case of the Ritalin industry as there is in the case of the tobacco industry. If flawed research and the misrepresentation of legitimate research helped make the case for taking tobacco companies to court, then the same argument can be made against the Ritalin industry.
The primary complaint about cigarettes of course relates to its negative health consequences and associated death rates. Now we also have reports of deaths on Ritalin, and on combinations of Ritalin with other drugs. These are children dropping dead from heart failure. One autopsy showed what is commonly known as a cocaine addict's heart. These children cannot have been on the drugs for very long. There is every reason to believe that there could be long-term negative consequences that should be investigated. But the drug companies and the FDA are in denial. A couple of years ago, a prominent child psychiatrist at UCLA, Professor Dennis Cantwell, lamented this state of affairs. He said, "ADHD may be a terrible thing, but you don't die from it, and you shouldn't die from the remedy." He was driven to look for an alternative. He was about to launch upon a major study of neurofeedback, a very promising non-medication approach to ADHD, when he succumbed to a heart attack. Without his involvement, the study never got underway. The drug mentality still rules. Research under that mentality will likely only confirm what is already believed.
One difference between tobacco and Ritalin is that the former induces dependency in its users, whereas the latter primarily induces dependency in its providers. In fact, most commercially successful drugs promote such dependency. Therefore one cannot depend on the drug industry to police itself. Even the FDA is ultimately the servant of the drug industry. Certainly the NIMH is captive. For a breath of fresh air, there must be outside intervention into this incestuous state of affairs. Hence, in the grand American tradition, a law suit.
It is likely that good law will make for bad science, here as elsewhere. Science does not flourish in the adversarial climate of the courtroom. However, the courtroom is not a bad venue for shedding light on what may be a very rotten situation.
According to the Los Angeles Times editorial, "[the plaintiffs] depict as conspiratorial common practices like drug company funding of a disease advocacy group." The reference is to CHADD. The editors agree that this is "somewhat troubling." It is no surprise that an organization like CHADD supports stimulant medication as a treatment for ADHD. And it is not blameworthy for doing so. After all, Ritalin does work for many children, and is a Godsend for some. Where the organization stepped over the line, it seems to me, is with the overtly hostile attitude it adopted to any alternatives to Ritalin, such as neurofeedback training of the brain. After all, there was no research evidence for such a position. All the existing research was favorable in its implications. The only valid criticism of the existing body of research is that it was not all that might have been wanted for such "large" claims.
Here is where a case can be made that a conspiracy to suppress alternatives exists. The vigorous, even strident opposition to neurofeedback has the smell of intellectual dishonesty about it, not merely of self-interest. Here is where scientists stopped acting as scientists should, and were using the scientific method not to elicit the truth but to club emerging ideas into oblivion. CHADD was in thrall to its own scientific advisers, and turned out to be a willing pawn in the larger campaign to turn more and more of our children into lifelong dependency on the pharmacology enterprise.
See comments in paper at www.latimes.com/news/comment/20001107/t000106656.html
Dreaming Souls: Sleep, Dreams, and the Evolution of Mind
ADHD in Children and Adults
Chronic Fatigue Syndrome: An Integrative Approach to Evaluation and Treatment
Ethical Conflicts in Psychology
Pathological Gambling: The Making of a Medical Problem
Asperger Syndrome and Difficult Moments: Practical Solutions for Tantrums, Rage, and Meltdowns
Storming Heaven: LSD and the American Dream
A Neurodevelopmental Approach to Specific Learning Disorders
Care of the Psyche: A History of Psychological Healing
Electroshock: Restoring the Mind
Is asperger syndrome/high-functioning autism necessarily a disability? : Does Asperger syndrome (AS) or high-functioning autism (HFA) lead to a disability or merely a "difference"? Two models summarize how these individuals are "different": the central coherence model, and the folk psychology-folk physics model.
Neuroimaging in bipolar disorder: what have we learned? : Besides possible structural abnormalities associated with bipolar disorder, decreased activity of the prefrontal cortex is found for bipolar patients during depression, though it is not clear if these changes are reversed with mania.
Global processing in high-functioning autism and Asperger's disorder. : Using a global-local identification task (e.g., a letter outline consists of smaller letters, same or different) the autism group made more global errors than controls (indicative of right-hemisphere dysfunction) whereas the Asperger's group did not.
Effect of somatic comorbidity on alleviation of depressive symptoms. : Moderate somatic comorbidity has only a minor effect on recovery from depression.
Structural and functional brain development and its relation to cognitive development. : Recent pediatric neuroimaging studies suggest that increasing cognitive capacity during childhood coincides with a gradual loss rather than formation of new synapses and presumably a strengthening of remaining synaptic connections.
History, evolution, and diagnosis of premenstrual dysphoric disorder. : Premenstrual problems with mood and behavior have been widely known forever, but has been formally recognized since 1987. Its history and how it differs from other conditions are reviewed.
Early maternal depression on infant-mother attachment : Infants of depressed mothers often lack secure attachment and occasionally exhibit avoidant and disorganised attachment.
Effects of nicotine and caffeine on EEG topography : Nicotine increases EEG power in some higher frequency bands in some conditions whereas caffeine decreases EEG power across almost all conditions.
Neuropsychological consequences of abstinence among older alcoholics : Memory and executive skills only slowly recover, if at all, with abstinence.
Evidence of an amygdala hypothesis of autism. : A developmental malformation of the amygdala may underlie high-functioning autism. These individuals often show enlarged amygdalas and characteristics assoc. with amygdala damage (impaired recognition of fear expressions, perception of eye-gaze).
Discussion of developmental plasticity: factors affecting cognitive outcome after pediatric traumatic brain injury. : Discusses current research in the context of a model of the numerous factors influencing recovery after brain injury in children including brain plasticity.
Neurologic evaluation of violent juveniles. : Argues for a systematic, meticulous neurologic evaluation of any juvenile who has acts violently. This evaluation should include tests of cerebral-cortical function and waking and sleep EEGs, and other neuroimaging investigations.
Polysomnographic and spectral sleep EEG in primary alcoholis : Ethnicity interacts with alcohol dependency in prolonged sleep latency, loss of delta sleep, and short rapid eye movement (REM) latency. African-American alcoholic patients show more severe sleep abnormalities than Euro-American alcoholics.
Interhemispheric asymmetry of motor cortical excitability in major depression : Major depressive disorder patients show interhemispheric differences in motor threshold due to lower excitability on the left hemisphere. Controls do not.
Upcoming CoursesComprehensive
4-Day Beta/SMR - Los Angeles area
2-day Alpha/Theta - Los Angeles area
Sue Othmer's 2-day Advanced Practicum
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Conferences for Neurofeedback Clinicians & Researchers | ||
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| CONFERENCE | LOCATION | DATES |
| Winter Brain 2001 | Miami, FL | Feb 2-6 |
The 9th Annual Winter Brain 2001 Neurofeedback and Brain Sciences Meeting, Feb 2-6, 2001 Miami FL
Lectures on Peak Performance, QEEG, ADDHD, Transpersonal experience, and more. Selected speakers include Karl Pribram, Thom Hartmann, Jay Gunkelman, Robert Gurnee,
Joel & Judith Lubar, Sig and Sue Othmer, & Barry Sterman.
Includes 30+ workshops and an exhibit hall.
Reflections on a Retraction
by Siegfried Othmer
A recent issue of Science Magazine (Volume 289,18 August, 2000, p1137) reflects on yet another report of research fraud. The editorial observes "So far, the incidents have been concentrated in the life sciences, particularly basic biomedical research." Why should this be so? Perhaps it is because of the proximity of the life sciences to the end product, which is not so much scientific knowledge as it is medical practice. And medical practice tends to lean on science much the way the priesthood relies on sacred text. In medicine, science is more about truth rather than process. For example, it has been said that "It is no longer true that neurons don't regenerate." Of course if it is not true now, then it was never true. The only way the statement makes sense is that in medicine we are dealing with a provisional truth, arrived at by concensus, that has a certain declarative validity quite independent of any true "scientific" basis.
So, in biomedical research, there may be an undue primacy given to the collective body of declared "truth," and experimental science is simply marshaled in the service of this truth. If one can be more efficient in helping nature along in revealing its secrets, what's the harm, since we know what the answer is anyhow? The culpable scientist was surely not trying to rewrite the laws of nature. He was just being a good acolyte in helping the natural progression of research along its most efficient path.
It is only on this basis that we can understand the visceral opposition to the claims of neurofeedback within the anointed (or self-anointed) scientific priesthood. It is not yet within the scope of what can be believed. The workhorse that is drafted in support of such thinking is, of course, the long-suffering placebo effect. In thinking further about the placebo effect, I realize that it serves the same function in biomedical research as the stork does in childhood. That is, it deflects the discussion from what is really being asked. The stork theory does not really answer the question of where babies come from. And the placebo model does not really provide an answer to the question of what might be going on. Both answers instead close the door on the intended inquiry. Just to bring this analogy closer, I think we should in future simply stipulate that all vaunted placebo effects are probably valid, and brought to us by that famous Spanish tenor, Placebo Degringo. Then we can get back to the real issue of what is going on. (A debt of thanks to Mark Steinberg.)
It is time, I think to hold our critics up to ridicule for their position. In the late sixties, Richard Feynman gave his BBC lectures at Cornell, and the auditorium was filled with people from the Physics Department. After the end of one of the lecture, with the mikes presumably turned off, Feynman carried on. He said, "Physics is sex; and mathematics is masturbation." This brought down the house. Experimental science engages with the real world. To a man, our critics have distanced themselves from any experimental verification or contradiction of our claims, even though this could be trivially done. In this regard, then, they should be classified with the mathematicians.