So here’s a recent New Scientist title: “Bad Boys Can Blame Their Behaviour on Hormones.”
All I can think is: New Scientist, Old School. Old, as in nature-nurture old and biological determinism old. Old as in moldy, rusted, failing ideas old.
But it’s not just New Scientist. Discover matches New Scientist with, “Teenage Hoodlums Can Blame Bad Behavior on Hormones.” And The Daily Mail delivers “Now Teenage Thugs Can Blame Their Hormones for Bad Behaviour.”
So what’s the problem? Well, it’s two-fold. First are journalists playing out a cultural script just like they subscribe to old-school cultural determinism. And second is some bad research that, not coincidentally, helps the journalists act like cultural automatons.
The cultural model goes like this: stereotypes, then blame, then biology. Take a stereotype we fear (“we” meaning journalists and readers alike). Bring in the politics and ideology of blame – hey, there’s a reason they are not like us, and why they threaten us. Invoke a cause, generally biological (though cultural causes come up too), outside of our particular realm of control. Hormones, nothing we can do about that, it means they were bad from the get-go. So we’re right to fear them and better make sure they don’t hurt us, whatever it takes.
Don’t believe me? Just look at the photos that accompany the articles. At the Daily Mail, a hooded guy point his hand like a gun at us the reader. Over at Discover, a crazed man with a clenched fist yells in our faces.
We all know journalists will play to stereotypes and will get research wrong and so forth. But in this case, like in most of the biologically-oriented research about complex human phenomena, the research only feeds into journalists typing out the normal crap.
The article in question is “Cortisol Diurnal Rhythm and Stress Reactivity in Male Adolescents with Early-Onset or Adolescence-Onset Conduct Disorder” (full access) by Graeme Fairchild, Stephanie van Goozen et al. and appears in the October 2008 issue of Biological Psychiatry. Neurocritic gives us the overview of the article if you don’t want to read the whole thing. (While I liked the Bad Boys music, I could have done with some more criticism in this particular Neurocritic post – but that’s okay, I’m going to play the bad boy this time.) Here’s the popular take from New Scientist on the article:
Out-of-control boys facing spells in detention or anti-social behaviour orders can now blame it all on their hormones. The “stress hormone” cortisol – or low levels of it – may be responsible for male aggressive antisocial behaviour, according to new research. The work suggests that the hormone may restrain aggression in stressful situations. Researchers found that levels of cortisol fell when delinquent boys played a stressful video game, the opposite of what was seen in control volunteers playing the same game.
The basic result of the study is that boys diagnosed with conduct disorder don’t have the same rise in cortisol in response to a stressful challenge, in this case a rigged game where the opponent taunts the player and it is impossible for the player to succeed. As the article says:
The competition began between 1 and 2 pm with a task involving confrontation, the Prisoner’s Dilemma Game (PDG), in which the opponent always failed to cooperate and sent antagonistic messages. Frustration was induced by having the participant perform a difficult, computer-based manual precision task (MPT) under time pressure while the video opponent and experimenter watched. By design, all participants failed to achieve their target score and received negative evaluations of their performance from the opponent.
So here is the fancy graph from Biological Psychiatry showing how the conduct disorder boys stayed close to controls who weren’t stressed while boys without conduct disorder has their cortisol go up in response to the challenge.
So what is so bad about this? Seems like a pretty clear case of a biological difference. End of story. The blame can start, since there’s obviously something wrong with those kids.
Just for the record, here’s the summary of the article:
BACKGROUND: Previous studies have reported lower basal cortisol levels and reduced cortisol responses to stress in children and adolescents with conduct disorder (CD). It is not known whether these findings are specific to early-onset CD. This study investigated basal and stress-induced cortisol secretion in male participants with early-onset and adolescence-onset forms of CD. METHODS: Forty-two participants with early-onset CD, 28 with adolescence-onset CD, and 95 control subjects participated in the study. They collected saliva across the day to assess their cortisol awakening response and diurnal rhythm. Subsequently, salivary cortisol was measured before, during, and after a psychosocial stress procedure designed to elicit frustration. Cardiovascular activity and subjective mood states were also assessed during stress exposure. RESULTS: There were no group differences in morning cortisol levels or the size of the cortisol awakening response. Basal cortisol levels in the evening and at 11 am during the laboratory visit were higher in both CD subgroups relative to control subjects. In contrast, cortisol and cardiovascular responses to psychosocial stress were reduced in both CD subgroups compared with control subjects. All groups reported similar increases in negative mood states during stress. CONCLUSIONS: Our findings suggest that group differences in cortisol secretion are most pronounced during stress exposure, when participants with CD show cortisol hyporeactivity compared with control subjects. There was no evidence for reduced basal cortisol secretion in participants with CD, but rather increased secretion at specific time points. The results do not support developmentally sensitive differences in cortisol secretion between CD subtypes.
So what’s wrong? Let’s start with the research design itself, before we move onto the overall approach and how that links into the supposed implications (promoted, of course) of this research.
Even just focused on the experimental methods, the study is suspect. The video game protocol was reported in a previous study, Salivary cortisol and cardiovascular activity during stress in oppositional-defiant disorder boys and normal controls, cited by the authors. The major conclusion of that work was: “Cortisol increase due to stress exposure was strongest in highly externalizing and highly anxious subjects.” Remember, this is the study to which they refer us to understand their main experimental protocol. It’s even done by the same main researcher, Stephanie van Goozen. But there is no direct measure of anxiety induced by the experimental protocol in this new paper.
Even worse, the protocol is designed to make them feel frustrated. No measurement of that. The researchers are proposing a link between low cortisol reactivity and aggression or conduct disorder. No measurement of aggressive impulses either.
It’s really breathtaking. They are working with individuals who have repeatedly been involved in aggressive situations and have dealt with their fair share of frustration in social situations where “conduct disorder” is a convenient label for being uppity (ah, did I mention that the conduct disorder kids came from a lower SES and had a greater percentage of minorities?). So, these kids are likely used to dealing with antagonistic opponents and negative evaluations. Why should that get a stress reaction out of them?
It’s absurd. And it could have been corrected by one small thing (well, besides measurements that actually get at the things that researchers are claiming). Say, a short interview after the experimental protocol to understand how the boys interpreted the test. But the researchers have absolutely no awareness of that need, and thus no sense of whether their measures capture anything realistic other than these kids have less cortisol reactions to situations that are likely similar to situations they have faced many times before.
The kicker is that Graeme Fairchild, the lead author, is aware of some of these problems and still did not address them in the research design. Here are some quotes from the press interviews: “It could be that they’re used to provocative situations and habituated to stress,” he says. Or: Researcher Dr Graeme Fairchild said: ‘The game was rigged to be impossible. The whole point is to make them feel angry and annoyed, and as if they were being socially evaluated.’
If the researchers want to make the claims that they do, then they should at least consider a more robust methodology. Besides actual measurements of the variables of interest, it would have been helpful to have at least two challenges in the study. An antagonistic, frustrating video game protocol could have been complemented with something, say a standard public speaking protocol, that would have provided some point of comparison.
Enough about the bad research design. Let us turn to the overall approach.
Describing something as “conduct disorder”, what a surprise, means it’s a mental illness, and thus should be treated as such. Did you realize that the researchers pulled that fast one right from the beginning?
Put differently, conduct disorder is simply something that psychiatrists have defined in the ways they see fit. In this case, it’s about behaviors like aggression and vandalism. The same thing happens with the other measures – subjective emotions, personality traits and the like. The only thing that really matters with these measurements is that they are reliable, that they give you the same scores more-or-less each time they are used. At times their connection to actual reality is quite tenuous.
So here we are dealing with a house of cards held together by statistics and the agreement of the research community – it’s their own cultural phenomenon, their own set of stereotypes and assumed causes and assigned blame. Think I sound absurd? Well, certainly I am pushing my analysis here, just the same as the researchers – this one cortisol drop in an experimental paradigm explains why these kids have problems.
Another thing that annoys me about this style of research is the lack of consistency, really of being thoughtful, by the majority of these types of researchers. They approach problems not as problems but as a chance to get data and get a publication. I already mentioned that they ignored one of the main results about anxiety from their previous research. But it’s worse than that. In a recent study, these same researchers showed that cortisol generally went up among antisocial/conduct disorder individuals: “reactive aggression was strongly correlated with elevated cortisol.” So one study it goes down, the other it goes up; one study it’s anxiety, the next study is that they have an emotional disconnect. That’s just being a bad scientist. I’d prefer someone who at least tries to think through problems alongside publishing research results and getting more funding.
The emphasis on biological causes also twists the accepted understanding of conduct disorder in the scientific literature, that it is a “biosocial” problem. A 2002 review by Adrain Raine, one of the major researchers in the field, states, “[W]hen biological and social factors are grouping variables and when antisocial behavior is the outcome, then the presence of both risk factors exponentially increases the rates of antisocial and violent behavior (pdf).”
These researchers’ own synthetic theoretical proposal goes “It is argued that serotonergic functioning and stress-regulating mechanisms are important in explaining individual differences in antisocial behavior. Moreover, low fear of punishment and physiological underactivity may predispose antisocial individuals to seek out stimulation or take risks and may help to explain poor conditioning and socialization.”
Serotonin and stress mechanisms are both sensitive to environmental influences; lower fear of punishment indicates an experience with punishment; socialization is a cause as well as a consequence. At least that’s how this neuroanthropologist sees it. They go back to nature vs. nurture, to a focus on “neurobiological deficits” not just as the mediators but often the assumed cause of antisocial behavior. It’s a safe bet, I am guessing, that these researchers rarely spend time outside their safe lab to see what life is really like in a rough neighborhood.
No, I am not saying it’s all social! That review by Raine, mentioned above, indicates that biological function can play an important role; for example, in well-to-do families, the link between neurobiological function and antisocial behavior are clearest, precisely since the social causes of antisocial behavior are not in the picture. But all this means is that the biology depends on context, a decidedly non-determinist view.
Conduct disorder and antisocial behavior are about behavior, types of social interactions, and violation of social norms. Here’s the American Academy of Child and Adolescent Psychiatry: “Children and adolescents with this disorder have great difficulty following rules and behaving in a socially acceptable way.” But these researchers went looking for biological differences, and gosh darn it, they found them. There is little sense that their research examined “why” in a holistic and integrative sense (biological and social) and in a way that takes into account the life experiences and perspectives of the individuals most affected by determinations of “antisocial disorder,” the boys themselves.
Rather, the researchers’ finding of biological difference then becomes the cause of behavior. Bad boys, whatcha gonna do?
That leads to the final and most scary part. Sure, journalists can get in wrong in selling a story. Researchers use bad methods and incomplete theoretical frameworks. It happens all the time. But in this case, the two add up to some frightening and completely wrong ideas about social policy and intervention.
Here’s the ending to the New Scientist piece:
The results also raise the possibility of finding biological markers in the blood of infants that identify those most likely to develop conduct disorders. Families and children could then be given help to manage and refocus their behaviour before it degenerates into the usual habits of lying, stealing, violence, malevolence and lack of concern for other people.
Alternatively, the research might lead to new drugs that have the same effect. It’s too soon to say whether extra cortisol would help. But Fairchild cites earlier experiments showing extreme violence in rats unable to make corticosterone, the rat equivalent of human cortisol. When the rats received extra corticosterone to compensate, it calmed them down.
Rather than people, we now have degenerate lab rats in need of injections and Big Brother re-training.
Or over at Discover, Graeme Fairchild is quoted as saying, “These findings basically indicate that antisocial behavior is probably more biologically based than many people recognize and is similar to conditions like depression and anxiety.” The Daily Mail actually opens with this point: “Teenage thugs could be suffering from a mental illness caused by a hormonal imbalance, scientists suggest today… Its findings point to the possibility of drugs being used in the future to control teenagers’ behaviour.”
So now antisocial behavior is a mental illness, rather than a social problem. Rather than tackling the social conditions that might bring about antisocial behavior, we are told that they have a mental imbalance and need to take drugs.
Indeed, the researchers aim to redefine the problem into biological terms and point to highly profitable ways for companies to extend their pharmaceutical reach and for governments to control their populations. It is a scary prospect, given the power of drug companies and the increasing reach of jails and other institutions for criminals and, now, “pre-criminals.”
Besides increasing those types of social control, disturbing questions arise, for example, if an “antisocial” child – determined by a blood test – is not given his drugs by the family, will that family lose the child? Will their taxes go up?
Biological determinism plays right into company profits and governmental oversight. If you like those things in your life, by all means, encourage one-dimensional research. But I for one think it would be quite nice if good research could help us get beyond letting other people determine my life.
Here’s a question along a very different line: If we think of antisocial disorder as related to neural processing, might it make more sense to think in terms of specific language deficits? Here early training programs and educational support can make a significant difference in making sure that specific deficits do not affect overall linguistic ability. Similarly, early interventions to help children interact in socially skilled ways could make a large difference for these kids. But no, it’s easier to say they have a biological problem, then drug them and walk away.
When Fairchild says, “A possible treatment for this disorder offers the chance to improve the lives of both the adolescents who are afflicted and the communities in which they live,” he has it backwards. How about improving the lives of those adolescents and the communities in which they live first?
Stereotypical reporting, bad research design, biological determinism, and social control – those are a very, very bad mix. Rather than helping us explore ways to work with these children, their families, their schools and their communities, this approach encourages us to stomp down, through harsh laws or harsh drugs, that which we don’t understand. In the end, it is much easier to blame their biology than to question ourselves.