Crankery under the microscope: Denialism as pathology

June 10, 2009

You can see it in this little-noted blog.  Someone drops by to tell me I’m in error, that Rachel Carson really did plot with Pol Pot to murder millions, and then they also show up in the creationism threads defending the view that dinosaurs never existed, or in a tangentially-related note on climate change, perhaps arguing that ocean levels rising are either not a problem, or the product of Atlantis’s rising from the depths (and therefore no problem, since the denizens of that city had better science than we do and will be able to fix things, never mind their being dead for 5,000 years).  [That last description is mostly fictional – mostly.]

What is it that makes one person deny reality on so many different fronts?

Mark Hoofnagle hit the research journals, listing results at denialism blog, demonstrating that crankery can be studied.  This raises in my mind the interesting little question of whether such crankery is a pathology, and perhaps treatable or curable.

Our recent discussions of HIV/AIDS denial and in particular Seth Kalichman’s book “Denying AIDS” has got me thinking more about the psychology of those who are susceptible to pseudoscientific belief. It’s an interesting topic, and Kalichman studies it briefly in his book mentioning the “suspicious minds”:

At its very core, denialism is deeply embedded in a sense of mistrust. Most obviously, we see suspicion in denialist conspiracy theories. Most conspiracy theories grow out of suspicions about corruptions in government, industry, science, and medicine, all working together in some grand sinister plot. Psychologically, suspicion is the central feature of paranoid personality, and it is not overreaching to say that some denialists demonstrate this extreme. Suspicious thinking can be understood as a filter through which the world is interpreted, where attention is driven towards those ideas and isolated anecdotes that confirm one’s preconceived notions of wrong doing. Suspicious thinkers are predisposed to see themselves as special or to hold some special knowledge. Psychotherapist David Shpairo in his classic book Neurotic Styles describes the suspicious thinker. Just as wee see in denialism, suspiciousness is not easily penetrated by facts or evidence that counter individuals’ preconceived worldview. Just as Shapiro describes in the suspicious personality, the denialist selectively attends to information that bolsters his or her own beliefs. Denialists exhibit suspicious thinking when they manipulate objective reality to fit within their beliefs. It is true that all people are prone to fit the world into their sense of reality, but the suspicious person distorts reality and does so with an uncommon rigidity. The parallel between the suspicious personality style and denialism is really quite compelling.

Go read it at denialism.

Denialism may be a little greater problem than is generally acknowledged, in my opinion.  When it infects policy makers it causes legislative and executive crackups, like Oklahoma’s Sen. Tom Coburn, who held up the naming of the Rachel Carson Post Office for a year under the bizarre misconception that she played a role in spreading malaria (ditto for Utah Rep. Rob Bishop, who shared the view but was unable to stop the bill in the House), or like the Bush administration officials at the U.S. Agency for International Development who kept refusing to authorize spending for pesticides in Africa, claiming environmental groups would oppose them while the environmental groups were lobbying the agency to spend the money on those pesticides.

Former South Africa President Thabo Mbeki denied that HIV causes AIDS.  Mbeki’s refusal to act on the best science available may have led to as many as 350,000 deaths, some accounts say.  Ashley Montagu told the story of Adolf Hitler’s odd views of heritage being spread by blood transfusions — to avoid any possibility of his soldiers’ being turned Jewish by a blood transfusion, Hitler forbade the use of blood banks.  Tens of thousands of German soldiers died unnecessarily from lack of blood for transfusing during World War II.  Partisans and scientists still debate whether  and how much Ronald Reagan’s belief that AIDS was a syndrome caused by sin rather than a virus early in the AIDS crisis created a cascade of actions that still frustrates the development of a vaccination or cure.

Denialism in high school students is interesting, but most often a classroom problem.  When kids take great issue with the course material the class can get derailed.  Even when a teacher is able to keep the class on track, the denialist student may feel marginalized.  A colleague reported a student had informed that historians now concur that George Washington was African-American.  She could not be dissuaded from the view.  I had a student who insisted well into the second semester than Adolf Hitler was a great leader, smart and humanitarian, framed for war crimes of the British and Americans.  Unfortunately, I could not put him in contact with the earlier student who believed Hitler had been framed by the Soviet Union, and that the Americans and British were victims of the cruel hoax.

As the nominal head of public relations in the old (Pleistocene?) office of Sen. Orrin Hatch, my crew and I got the brunt of denialists and crazies.  We had one woman in Salt Lake City, “Mrs. B,” who regularly called the Salt Lake office to complain about Hatch’s actions and what she assumed his beliefs must be.  For a while she complained that, as someone born outside of Utah, he could never appreciate the views of the Latter-day Saints in Utah.  When at last we persuaded her that he was also a Mormon, she began complaining that he ignored Utah’s non-Mormon population.  Her ability to switch sides in an argument so as always to remain on the opposite side of Sen. Hatch got noticed.

Near the end of a summer session just before the recess the Senate had a lot of late-night meetings.  The news of these sessions did not always make the morning papers.  On one issue of some Utah import, Hatch had suggested he would probably vote one way, because of some issue of agency direction that had him concerned.  In the end the agency agreed to amendments that assuaged all of Hatch’s concerns and he was happy to support the bill (I forget what it was — the issue is absolutely irrelevant to the story).

I had caught a late-night flight to Salt Lake, and arrived at the SLC office early enough to catch our Utah problem solver Jack Martin explaining to Mrs. B that Hatch did indeed care about Utah . . .   Jack and I could carry on a conversation with only his occasional remarks to Mrs. B keeping her going, a scene out of a Cary Grant comedy, perhaps.  “Yes, Mrs. B . . .  No, Mrs. B  . . . I think I see your point.”  What he said was unimportant.  I could hear her rant on the telephone, while I was on the other side of the room.  I finally asked Jack what her issue was, and he explained it was the bill that Hatch had reveresed his position on.  She was complaining at great length about his original position.  I explained to Jack that an accommodation had been reached and that Hatch changed his vote in the final tally.

Jack smiled broadly as he handed me the phone.  “You tell her!”  It took a long time to get her to stop talking so I could explain who I was and that I had new information.  Finally she fell silent and I explained that she should be happy because Hatch had come around to her position.  There was a silence of a few more seconds, and she started in again:  “Hatch is an idiot!  Only a fool would vote that way.”  And she was off again on a rant against Hatch, eviscerating the views that she herself had held less than a  minute earlier.

The issue wasn’t important to her.  Hatch was wrong, whatever he did, even when he supported her views.

That’s denialism in full force, a raw, unmitigated power of nature.

Hoofnagle concludes at denialism:

So what do these studies mean for our understanding of cranks? Well, in addition to providing explanations for crank magnetism, and cognitive deficits we see daily in our comments from cranks, it suggests the possibility that crankery and denialism may be preventable by better explanation of statistics. Much of what we’re dealing with is likely the development of shoddy intellectual shortcuts, and teaching people to avoid these shortcuts might go a long way towards the development and fixation on absurd conspiracy theories or paranormal beliefs.

Wouldn’t you love to see that study replicated on readers of Watt’s Up With That?, Texas Darlin’ , Junk Science, or one of the antivaxxer blogs?

You may also want to read:


Making a false case against Gardasil

May 2, 2009

Especially after working for so many years alongside the big drug companies working health legislation in the Senate, and after later policy work for private companies that made the point again that Big Pharma doesn’t always act scrupulously (remember Oraflex?), I’m no particular fan of the big companies.

But I am a big fan of getting the facts before making claims against them.  I also stand in awe of the accomplishments of medicine, including Big Pharma, in so many areas.  My oldest brother had polio as a kid, and it haunted him to his death.  Polio vaccine was a great advance.  I survived a bout of scarlet fever as an infant, but as a result I am particularly vulnerable to certain infections now; I stand in awe of a $10 prescription that literally saves my life.

Get the facts.  We’re talking saving lives here — be sure you’re accurate.

There is a nasty campaign against modern medicine claiming that vaccines and other injectable preventives do not work, or do much greater harm than is revealed.

One victim of this unholy smear campaign is the Merck Drug company, and its anti-cancer vaccine Gardasil.  This vaccine has been the topic of much controversy here in Texas.  I’ve written about it before.

So I was shocked once again browsing Neil Simpson’s blog (looking for a post that disappeared, it now seems), to discover this statement of concern from Mr. Simpson:

Gardasil Moms: If one of those 32 dead girls or women was your daughter. . . – I wouldn’t rush out and get the vaccine for your girls just yet.

32 dead girls from the vaccine?  Mr. Simpson fails to tell the whole story.  Here’s what CDC actually said:

As of December 31, 2008, there have been 32 U.S. reports of death among females who have received the vaccine. There was no common pattern to the deaths that would suggest that they were caused by the vaccine. [emphasis added]

This isn’t the first time opponents of Gardasil have failed to report accurately the deaths accounted for in the trials and use of the drug.  In previous outings, critics of the drug have done such bizarre things as counting deaths of people who never took the drug, as deaths perhaps caused by the drug.

For example, from the numbers available when I wrote about this in May 2007:

  • Of the 17 deaths reported in the clinical trials,  7 of them came from the placebo group.  That’s right:  Only 59% of the reported deaths were in the group that got Gardasil.  41% of the reported deaths came from people who had received no Gardasil vaccine.
  • 7 of the deaths were from auto accidents, 4 in the Gardasil group, 3 in the placebo group.
  • Most of the deaths were from causes generally thought to be unrelated to to Gardasil, including suicide and cancer.

Don’t you think that, in blaming deaths on a dosage of a vaccine, one should not count deaths to people who did not get the vaccine? So, can we trust numbers from a slander campaign that keeps repeating falsehoods for two years, though the data are freely available?

If you check the Gardasil site now, you’ll find more deaths have been added.  Merck follows up reports of problems, and they update the information when they can, as required by law.

There are now 24 deaths reported in Merck’s literature, 16 in the Gardasil group, and 9 in the control group; the Gardasil deaths have risen to 64% of total deaths; some new causes are added in.  But there is no glaring indictment of Gardasil, and it still seems to me to be rather unethical to claim, as Simpson’s source does, that deaths by auto accident can be attributable to Gardasil, especially when an almost equal number of auto accident deaths occurred in the control group.

Here is what the CDC says, unedited:

Reports to VAERS Following HPV Vaccination

As of December 31, 2008, more than 23 million doses of Gardasil were distributed in the United States.

As of December 31, 2008, there were 11,916 VAERS reports of adverse events following Gardasil vaccination in the United States. Of these reports, 94% were reports of events considered to be non-serious, and 6% were reports of events considered to be serious.

Based on all of the information we have today, CDC continues to recommend Gardasil vaccination for the prevention of 4 types of HPV. As with all approved vaccines, CDC and FDA will continue to closely monitor the safety of Gardasil.  Any problems detected with this vaccine will be reported to health officials, healthcare providers, and the public, and needed action will be taken to ensure the public’s health and safety.

23 million doses of the vaccine, high efficacy in preventing cancer and genital warts, only 6% serious events reported, no deaths that doctors can connect to the vaccine.

In the time Simpson writes about, several thousand women died of cervical cancer; he’s posing 32 deaths unrelated to the vaccine and saying it’s dangerous, when the facts show exactly the opposite.  Is that ethical?

It’s creationism syndrome:  Religionists decide on their conclusions, sometimes supported by scripture, but sometimes also supported by misreadings of scripture; then they set off in search of evidence to support their pre-conceived conclusion, and they step over real data and alter evidence to make sure their pre-conceived conclusions get the support.

In other words, they use doctored data.  Neil Simpson’s sources are using doctored data again.  Shame on them.  I’m sure he’ll correct it in his blog.

______________

Update, May 3: Simpson has not corrected his blog yet.  As an indicator of the issues at stake, you may want to look at CDC figures on cervical cancers, many of which are prevented completely by Gardasil.  Actually trends on the disease are encouraging:

Cervical cancer used to be the leading cause of cancer death for women in the United States. However, in the past 40 years, the number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly. This decline largely is the result of many women getting regular Pap tests, which can find cervical precancer before it turns into cancer.1

According to the U.S. Cancer Statistics: 2005 Incidence and Mortality Web site, 11,999 women in the U.S. were told that they had cervical cancer in 2005,* and 3,924 women died from the disease.2 It is estimated that more than $2 billion is spent on the treatment of cervical cancer per year in the U.S.3

Cervical cancer strikes disproportionately at minority women:

Even though these trends suggest that cervical cancer incidence and mortality continue to decrease significantly overall, and for women in some racial and ethnic populations, the rates are considerably higher among Hispanic and African-American women. Find more information about cervical cancer rates by race and ethnicity.

More information:


Voting for cancer, against prevention

May 31, 2007

Yeah, it was a bit tacky of Merck to create a campaign to get government officials to require inoculations against human papilloma viruses that cause cancer — but, people!, we’re talking about preventing cancer here.

The Texas legislature voted for cancer, overturning Gov. Rick Perry’s ill-considered good idea to require vaccinations for school kids in Texas. In a state with top-notch anti-cancer research at M. D. Anderson Cancer Center in Houston and UT’s Southwest Medical Center in Dallas, it was an odd, odd thing to witness.

The debates are skewed by a general distrust and dislike of big pharmaceutical companies, and by the religious right’s view that it’s better that a young mother die of cancer than she should get even the faintest idea that might in only the most perverse mind promote pre-marital sex. Still, we shouldn’t fall victim to voodoo science claims against vaccines.

Are my views, tempered by years of work promoting public health and fighting disease, clear enough for you?

Owlhaven wins popularity contests among mothers who read blogs, and it often is tender and touching — hey, I read it from time to time. But recently Mary, Owlhaven’s author, fell victim to a propaganda campaign from Judicial Watch, a far-right-wing bunch that campaigns against the U.S. justice system and generally makes a conservative-gratuitous-poke-in-the-butt out of itself. Judicial Watch claims to have some secrets from having filed a Freedom of Information Act Request with FDA to get Merck’s reports to FDA of adverse events known about Gardasil, Merck’s proprietary anti-cancer vaccine.

I responded, of course — but my response didn’t show on Owlhaven’s comments. Blackballed? Spam filtered due to the number or length of links? I can’t tell. Mary said she emptied the spam filter without checking. So, I repost my response, below the fold, for your benefit. Read the rest of this entry »