The Skeptical Psychologist

The Rorschach-Wikipedia Kerfuffle Continues

Scott Lilienfeld — Mon, 03 Aug 2009 16:05:25 +0000

As regular readers of the New York Times and other major newspapers are aware, Wikipedia recently triggered a scandal in the psychological community by posting the much cherished Rorschach inkblots - first published by Hermann Rorschach in 1921 - online. In fact, this was not the first public "outing" of the blots (or at least the outlines of the blots), but the New York Times' decision to accord Wikipedia's unveiling of the blots front page coverage on July 29th generated a major internecine battle between proponents and opponents of the test. Not surprisingly, most devotees of the test were appalled. One visitor to a Website wrote: "It's disgraceful! Wikimedia should pull down or obscure those images!...Publishing these Rorshach (sic) images can have the same devastating (sic) effect to a potential patient, a sick individual who needs help, and could be harmed because he got access to the test material via Wikipedia." In contrast, most critics of the test were blasé, to put it mildly. One yawned that he hoped the Rorschach would eventually be found along horoscopes in daily newspapers; another remarked wryly that the Rorschach should long ago have been burned along with witches. To a substantial extent, responses to the Wikipedia entry paralleled people's initial attitudes toward the test, rendering the public and scientific reaction to the posting something of a Rorschach in and of itself. By the way, if you're curious, you can find the now infamous Wikipedia entry, along with thumbnails of the actual blots, here. http://en.wikipedia.org/wiki/Rorschach_test

Was making the inkblots public a good idea? I'm torn. On the one hand, most research on the Rorschach indicates that with the exception of a handful of clinical purposes, like detecting thought disorder (as in schizophrenia and bipolar disorder), measuring interpersonal dependency, and perhaps predicting the prognosis of psychotherapy, the Rorschach isn't particularly valid or useful as a clinical instrument. Even most of its advocates acknowledge that it's not especially helpful as a diagnostic test, and most studies show that it correlates weakly with personality traits of interest to clinicians, like aggressiveness, depression-proneness, or impulsivity. Moreover, the major rap against the Rorschach, namely that it lacks what Lee Sechrest and Paul Meehl termed "incremental validity" in the early 1960s, has never been satisfactorily addressed. Incremental validity is the extent to which a test affords information above and beyond information that's already been collected. Sure, we can use the Rorschach to detect thinking disturbances in severely psychotic individuals, but do we really need the Rorschach to do that? If a client looks at Card 1 and sees two giraffes with boxing gloves - and gives similarly bizarre responses to other cards - there's a decent chance he or she isn't thinking straight. No matter how you look at it, Card 1 doesn't look like two giraffes with boxing gloves (well, then again...). Even those studies that have found incremental validity for Rorschach scores above and beyond other information, like self-report, suggests that this incremental validity is modest at best. So as I wrote in a letter published in today's New York Times, I'm not at all sure that making the inkblots public will harm the validity of the Rorschach very much, as I'm doubtful that many of its 100 plus scores possess all that much validity to begin with, and probably even less incremental validity above and beyond already available information.

But I'm torn because making the blots public could set a dangerous precedent. Some academic psychologists disagree with me, arguing that "science is not about secrets." They argue that science thrives on openness to critical scrutiny, and they're right. But science is also about reducing error, and making all psychological tests public will almost surely increase error by making responses easier to fake or otherwise distort, and rendering normative comparisons with other respondents well-nigh useless. The advocates of the "there should no secrets in science" view miss the crucial point that psychological tests of necessity draw on a small sample of items from a huge universe of potential items. But in using tests, psychologists attempt to draw inferences to this broader universe. So permitting respondents to see actual test items will probably compromise the ability of psychologists to draw the kinds of inferences essential to scientifically based assessment. Surely, we would not argue that the Educational and Testing Service (ETS) should make the SAT or GRE questions public before each round of test administration, or that prospective American citizens should know in advance precisely which questions they will be asked before taking their citizenship tests (similarly, although it would be a quick and easy way to boost my teacher evaluation ratings, I don't share my test questions with the students in my undergraduate psychology classes prior to their exams). Doing so confuses the sample of test items with the wider domain of test items from which it's drawn.

So to the bottom line, will the Wikipedia decision damage the field of psychological assessment? If it remains limited to the Rorschach inkblots, probably not. If it extends to a host of other psychological tests, it might.

The Polygraph Test Strikes – and Strikes Out – Again

Scott Lilienfeld — Tue, 21 Jul 2009 20:41:18 +0000

About two weeks ago, I received word that a close friend of mine from elementary school (I'll be altering a few details to protect this friend's identity) - let's call her Ellen - failed a required polygraph test she had taken as part of her application for a high-level government position. I can say without qualification that Ellen, a former social worker, is among the two or three most honest people I've ever known. She is a person of exceptional integrity, and is truthful almost to a fault. In fact, she is in possession of what Freudians would call an "overdeveloped superego" - meaning, in common parlance, that she is highly guilt-prone.

My suspicion is that Ellen is a prime example of what some polygraph examiners informally term a "guilt grabber" - an innocent person who flunks the polygraph test not because he or she is actually guilty of having done anything wrong, but because he or she feels guilty at the mere thought of having done something wrong. I've often fantasized about stealing a cheesecake (not merely a slice, but the whole shebang) from one of my favorite New York City delicatessens, but I don't feel guilty because I've never actually done so and never would. In contrast, a guilt grabber might feel pangs of conscience at the mere thought of having imagined walking off with a cheesecake. Indeed, in Ellen's case, the polygraph examiners left fairly convinced that she had committed a major crime in her youth - which in fact Ellen had not.

The polygraph or so-called "lie detector" test is, as most scientists acknowledge, badly misnamed. It's a detector of autonomic arousal, not of lies. As a consequence, people who become highly aroused in response to the relevant (or "Did you do it?") questions, but not in response to the other questions, will tend to fail the test. In some cases, this arousal almost surely reflects actual guilt stemming from commission of a crime - and for this reason there's general consensus that the polygraph test probably does somewhat better than chance at detecting lies. But in many cases, this arousal just as surely reflects emotions other than guilt stemming from malfeasance, such as understandable anxiety at the prospect of failing the test, indignation at being accused of a crime one didn't commit, and - perhaps in the case of my friend Ellen - guilt at the mere thought of having once fantasized about having committed a crime. My late Ph.D. mentor, David Lykken, who was the world's foremost critic of the polygraph test, put the overall accuracy of the test at about 70%, but not surprisingly, fervent proponents of the test place it higher.

In any case, there is no disagreement among reasonable scholars that, Meet the Parents and other Hollywood portrayals aside, the polygraph is not an infallible detector of lies. Yet survey data suggest that many people believe otherwise; the results of one study revealed that 45% of undergraduates enrolled in introductory psychology courses believed that the polygraph "can accurately identify attempts to deceive."

Many scientists contend that a true lie detector is not possible, at least given the present state of psychophysiological technology. That's because no-one has yet found a "Pinocchio response" - a physiological or behavioral reaction that's specific to lying. Like Pinocchio's protruding nose, this response would be emitted only during lying and never at other times. Some scientists doubt that such a response will ever be found; I remain skeptical myself given the enormous diversity of motivations underlying lies. There are white lies, lies intended to protect oneself, lies intended to protect others, malicious lies, lies told for the mere fun of fooling others (that is, lies told for what psychologist Paul Ekman calls "duping delight"), and many others; the prospect of finding any deep-seated biological or psychological commonalities underpinning of all of them seems doubtful. But perhaps my skepticism will one day prove unwarranted.

Ironically, the developer of the polygraph test, William Moulton Marston, was also the developer of the comic book character Wonder Woman, who lured criminals into telling the truth by encircling their waists with a magical lasso. For Marston, the polygraph was the real-world equivalent of Wonder Woman's lasso: An infallible truth detector.

Given that it's really an arousal detector, the polygraph test suffers from a high rate of what psychologists call "false positives" - innocent people whom the test deems guilty. Ironically, some of these false positives, like Ellen, may be among the guilt-prone and honest among us, although this disturbing possibility has received surprisingly little attention from researchers.

There's at least one other great irony in all of this. In 1988, the federal government passed the Employee Polygraph Protection Act, which banned most uses of the polygraph in the private sector - for example, for pre-employment screening or for trying to ferret out pilferers in the workplace. Yet the government refused to ban the test for screening its own potential employees. In essence, the government told private employees, "We won't let you use this test, as it doesn't work very well, but we'll keep on using it ourselves." More than two decades later, my friend Ellen and hundreds of others are continuing to feel the unfortunate effects of this paradoxical policy.

Michael Jackson, Truth Serum, and False Memories

Scott Lilienfeld — Tue, 07 Jul 2009 20:22:29 +0000

In the wake of the recent death and funeral of pop superstar Michael Jackson, many public comments have naturally turned to his, well - rather unusual - life and lifestyle. Some of these comments have been thoughtful, others considerably less so. And a few have been irresponsible. A number of prominent figures, among them New York Congressional Representative Peter King, have recently asserted without qualification that Michael Jackson was a child molester. Over the July 4th weekend, King referred to Jackson as a "pervert," "child molester," and "pedophile." In evaluating these comments, it's crucial to note that Michael Jackson was never found guilty of child molestation, although he settled such charges out of court for millions of dollars.

I do not know whether Michael Jackson ever molested a child. I suspect we will never know for sure (although if I were a betting man, I would bet against it). Clearly, Jackson was guilty of eccentricity, naïveté, and exceedingly poor judgment - such as allowing children into his bed - on multiple occasions. But eccentricity, naïveté, and poor judgment are not against the law.

I do know, however, that recent press coverage of the sexual abuse charges against Jackson has typically omitted one crucial fact. One of the two charges that received the most press coverage surfaced in 1993, when Evan Chandler filed a lawsuit against Jackson for sexually abusing his 13 year old son, Jordan. At the time, the news media reported widely that Jordan Chandler accused Jackson of performing oral sex on him, and that Chandler provided law enforcement authorities with a description of Jackson's genitalia. Eventually, Jackson settled this case out of court for $22 million; some have argued that this settlement is prima facie evidence of his guilt, whereas others have argued that Jackson understandably wanted to avoid a prolonged and emotionally grueling civil trial. I do not know which side is right, so I will withhold judgment on that issue here.

So what crucial fact has most of the press coverage omitted? It's that Jordan Chandler apparently never made any accusations against Jackson until his father, a registered dentist, gave him sodium amytal during a tooth extraction. Only then did Jackson's purported sexual abuse emerge; Jordan Chandler's reports became more elaborated and embellished during a later session with a psychiatrist.

Sodium amytal is a barbiturate and one of the most commonly used variants of what is popularly known as "truth serum," which is a spectacular misnomer. There's no scientific evidence that Sodium amytal or other supposed truth serums increase the accuracy of memories. To the contrary, as psychiatrist August Piper has observed, there's good reason to believe that truth serums merely lower the threshold for reporting virtually all information, both true and false. As a consequence, like other suggestive therapeutic procedures, such as guided imagery, repeated prompting, hypnosis, and journaling, truth serums can actually increase the risk of false memories - memories of events that never occurred, but are held with great conviction. http://www.fmsfonline.org/APiper.html#AP1

In fact, because the physiological actions of barbiturates are similar in many ways to that of alcohol, the effects of ingesting Sodium amytal are probably similar to those of imbibing a few stiff drinks. When we're rip-roaring drunk, we're more likely than when sober to say lots of things, only some of them accurate. Moreover, as Piper notes, there's overwhelming evidence that people can distort the truth or lie while under the influence of truth serum.

None of this proves, of course, that Jordan Chandler wasn't sexually abused. But the fact that his reports of abuse apparently surfaced only after the administration of Sodium amytal means that we should view these reports with more than a dose of healthy skepticism.

As always, in evaluating claims of sexual abuse, we need to walk a fine line. We need to be careful not to dismiss any such claims cavalierly, as we know all too well that some of them are true. At the same time, we need to be careful not to jump the gun against the accused, as we also know all too well that some of these claims are false. And of particular relevance to the Jackson case, scientific evidence reminds us to be especially dubious of claims that emerge only after the administration of suggestive memory procedures.

Recent Negative Findings for Gene-Environment Interaction in Depression Impart Useful Lessons

Scott Lilienfeld — Mon, 29 Jun 2009 14:48:47 +0000

Replication.

It's one of those arcane words that psychological and psychiatric researchers use regularly, but precious few people in the general public have heard of, let alone understand. Yet if I had to compile a list of 10 terms that every educated layperson interested in psychology should know, "replication" would be high on that list. It refers to the ability of researchers, ideally independent researchers, to duplicate earlier findings. Independent replication is especially crucial, because one investigative team can keep repeating its mistakes, resulting in the erroneous appearance of a trustworthy finding.

Replications in psychology are extremely important, especially because scores of interesting findings are flukes. Remember the famous 1968 Rosenthal and Jacobson "bloomer" study showing that artificially inducting positive expectations in schoolteachers can produce higher in IQs in their students? Lots of people, including many educated laypeople, have heard about this finding, but few know that a slew of later researchers found these results difficult to replicate. The original Rosenthal and Jacobson finding either isn't robust or (more likely) it's small in magnitude, especially in the real world where teachers have the opportunity to interact extensively with their pupils - which swamps the effects of teacher expectations. The same replicability problem applies to medicine; in a 2005 article, John Ioannides found that about a third of findings in clinical trials don't hold up in later studies.

But there's a problem with replications: They aren't sexy. To many, replications seem like "old news." So the news media - which, after all, report on what's "new" - often ignore them. Take the extrasensory perception (ESP) literature, in which the media routinely report with great fanfare any hint of a positive research finding or even a supportive anecdote, but barely mention the over 150 years of hundreds of failed replications of purported psychic phenomena.

Replications aren't sexy to journal editors either. Early in my career, when I was still a graduate student, I submitted (along with a co-author) an article to a major psychological journal that was essentially a replication and minor extension of earlier findings on the symptomatic differences between two overlapping childhood conditions, attention-deficit/hyperactivity disorder and oppositional defiant disorder. The reviews we received were quite positive, but the editor initially declined to publish the paper on the grounds that our study was "only" a replication of a previous finding (to give the editor his due, he was willing to be persuaded, and ended up publishing our article following a substantial revision). But in most cases, replications are probably even more important than the original finding, because so many initial findings don't hold up in later research.

That's why an article that appeared on the front page of the New York Times on June 17th put a smile on my face. It did so not because I have any particular intellectual or personal investment in the finding - I don't - but because it marked one of the first times I can recall in which a failure to replicate a finding received almost as much media coverage as the original finding. This article, written by the able New York Times psychology reporter Ben Carey, reported that a widely ballyhooed finding - first reported by Avshalom Caspi and his colleagues in 2003 article in the prestigious journal Science - didn't hold up when 14 other studies were combined in what psychologists call a meta-analysis, which is a fancy statistical technique that allows investigators to combine multiple studies and treat them as though they were one big study. Specifically, in 2003, Caspi and his collaborators had found that a specific gene variant relevant to the neurotransmitter serotonin "interacted" with life stress in boosting risk for depression. That is, people with both the gene variant and life stress were especially depression-prone, so that the "effects" of genetic and environmental influences were multiplicative, not additive.

To many observers, the Caspi finding was especially appealing because it dovetailed with popular - and arguably politically correct - notions of "gene-environment interaction." It became one of the most widely discussed and cited findings in modern psychology; as of this writing (June 28th, 2009), it's been cited a staggering 1996 times in the scientific literature (by way of comparison, the modal number of citations for journal articles in psychology is 0 - yes, zero), and was widely hailed as among the significant scientific findings of the decade. Yet the new meta-analysis, led by geneticist Neil Risch and published in the Journal of the American Medical Association (JAMA), showed that when the data from other studies were combined along with the original Caspi findings, the interaction effect vanished. http://jama.ama-assn.org/cgi/content/full/301/23/2462

Of course, it's possible that this negative verdict may itself change over time with the emergence of new findings, and that Caspi and colleagues will ultimately be vindicated. The beauty of science is that it's self-correcting in the long term, even if it's often messy in the short term. Eventually, the truth regarding serotonin genes, stressful life events, and depression will out. But with the appearance of the JAMA article, the ball is now in the court of Caspi and colleagues, not in the court of their critics, to show that their interaction effect wasn't a mirage.

What lessons can we draw from this episode? We shouldn't put too much trust in any psychology finding unless and until a different investigative team has replicated it. We should also remember that the news media rarely appreciate the importance of replication, so they're liable to hype surprising findings before others have duplicated them. And investigators themselves should strive to contain their excitement about most findings until others have found them to be dependable. In the interests of full disclosure, I should note that I may be guilty of having violated this precept. On two occasions, I have published findings of interactions in the domains of personality and psychopathology, and to my knowledge nobody has tried to replicate them. In retrospect, I wish I had been more circumspect in reporting them, in part because (for a host of statistical reasons I won't bore readers with) interactions may be especially unlikely to replicate, and in part because I've since come to recognize how easy it is to fall in love with one's results - especially when they dovetail with one's hypotheses.

Finally, as consumers of the psychological literature, we should remember a nugget of wisdom that my wise Ph.D. mentor, the late David Lykken, was fond of dispensing: In general, the more intriguing a psychological finding, the less likely it is to replicate. With a few exceptions, David was probably right, because the more a finding contradicts accumulated knowledge from carefully conducted research, the more likely it is to be wrong. Of course, surprising findings will occasionally turn out to be true, so in interpreting such findings we need to walk a fine line between excessive skepticism and excessive open-mindedness. But if Lykken is correct, the amount of media coverage a finding receives - which usually reflects its counterintuitiveness - may actually be inversely related to its trustworthiness. Caveat emptor.

Is Positive Psychology For Everyone? New Research Raises Doubts

Scott Lilienfeld — Fri, 19 Jun 2009 14:02:37 +0000

As even a casual observer of the psychology scene is surely aware, the field of psychology has long had its share of fads. A handful of these fads mature into developed scientific disciplines, many die out entirely, and still others become full-fledged pseudosciences.

Over the past decade or so, one of psychology's foremost fads has undeniably been "positive psychology," an intriguing, sprawling, but at times inchoate movement that seeks to restore "positive" features of human nature, such as happiness, virtues, personal strengths, and altruism, to their rightful place within the field of psychology. Many advocates of positive psychology believe that the field of psychology has been too focused on mental illness, and insufficiently focused on mental health. Although the term positive psychology was actually coined by humanistic psychologist Abraham Maslow in 1964, the term - and the intellectual approach surrounding it - didn't really gain momentum until the American Psychological Association (APA) presidency of University of Pennsylvania psychologist Martin Seligman in 1998. Seligman made positive psychology the centerpiece of his APA presidency, and the field took off soon after. Some popular authors, like former New York Times writer Daniel Goleman, have since played a major role in fueling positive psychology's widespread appeal.

It remains to seen whether positive psychology will mature into a legitimate scientific discipline. Without question, some positive psychology research has proven valuable, and some scholars in this domain, like Ed Diener, Daniel Gilbert, Jonathan Haidt, and Barbara Frederickson, have conducted rigorous, creative, and important work on the correlates and causes of happiness and related emotions. In addition, positive psychology has helped to highlight a crucial point that popular psychology had neglected for far too long - namely, that most of us are far more resilient than traditional psychologists give us credit for. In 1973, the brilliant University of Minnesota clinical psychologist Paul Meehl poked fun at what he called the "spun glass theory" of the mind - the notion that most of us are delicate, fragile, and easily shattered creatures who need to be treated with kid gloves. Since then, thoughtful researchers like Norman Garmezy, Ann Masten (both also at Minnesota), Camille Wortman of Stony Brook University, and George Bonanno of Columbia University, have shown that most people are surprisingly resilient even in the face of extreme trauma. For example, even when confronted with horrifically frightening events, like wartime combat, earthquakes, or floods, the majority of trauma-exposed people (probably 70% or 75%) do not develop posttraumatic stress disorder. I suspect that a better understanding of resilience and the factors that buffer people from developing psychopathology in the face of stressors will prove to be among positive psychology's more enduring - and valuable - contributions.

All that said, I still worry about positive psychology. I worry especially about the all too frequent implication (which, in all fairness, a few of the more thoughtful exponents of positive psychology have not endorsed) that positive psychology is for everyone. Psychology must respect individual differences, and one-size-fits-all interventions are rarely helpful. In some cases, such as crisis debriefing for trauma-exposed victims, they can probably do harm (more on that in upcoming posts).

One potent strike against the "positive psychology is for everyone" assumption derives from the clever work of Wellesley psychologist Julie Norem on defensive pessimism, summarized nicely in her book, The Positive Power of Negative Thinking. If you knew someone in school who drove everyone nuts worrying about how he/she would do on exams and who ended up getting A pluses on all of her his/her exams, you probably knew a defensive pessimist. For defensive pessimists, worrying about upcoming challenges is a way of life. But it's also a healthy coping strategy that helps them prepare for adversity. Norem has shown that when defensive pessimists are deprived of their pessimism by being forced to look on the bright side of life, their performance on tasks plummets. For defensive pessimists, positive psychology has a decidedly negative side.

Last week, another article on positive psychology - now in press at the prestigious journal Psychological Science - caught my eye and gave me further reason to worry (perhaps an indication of my own defensive pessimism?) about the uncritical "accentuate the positive" approach to life propounded by some positive psychology enthusiasts. In an elegant three-part study, Joanne Wood of the University of Waterloo and two colleagues decided to have a systematic look at the effects of positive self-statements. Such affirmations are the bread-and-butter of much of the popular self-help movement, as anyone who recalls the hilarious parodies of Al Franken as Stuart Smalley ("I'm good enough, I'm smart enough, and doggonit, people like me!") on Saturday Night Live surely knows. A quick peek at Amazon.com reveals a host of books and products devoted to daily affirmations, like "Affirmations - Your Passport to Happiness," "Positive Affirmations for Mind & Body Healing," "Unleash the Power of your Subconscious with Positive Affirmation," "Change Almost Anything in 21 Days: Recharge Your Life with the Power of over 500 Affirmations," and my favorite, a "Handcrafted Tiger-eye Gemstone Inspirational Believe Affirmation Message Bead Bookmark" (no, that's not a typo).

So, Wood and her colleagues wanted to know, do positive affirmations work?

The answer, it turns out, isn't so simple, and it again raises troubling questions about the mantra that positive psychology is for everyone. For participants with high self-esteem, repeating a positive self-statement ("I'm a lovable person") made them feel a bit better, but not all that much. But of course, people with high-esteem rarely need to repeat positive self-statements, as they already like themselves. What about participants with low self-esteem, from whom positive affirmations are typically intended? Here Wood and colleagues found that repeating a positive self-statement actually made them feel worse, probably because doing so underscored the discrepancy between how they feel about themselves and how they want to feel about themselves. In all likelihood, it just reminded them of how unlovable they really feel.

So although positive psychology surely has a useful role to play for some of us, it just as surely has its limits. And for some people, a purely positive approach to everyday life appears to backfire. As we psychologists have yet again learned the hard way, any cookie-cutter approach to human nature that cavalierly neglects individual differences is bound to fail. So if your defensively pessimistic friend wants to spend the weekend worrying about that Monday morning job interview, let him have at it - just so long as he doesn't overdo it.

The Autism Fad Parade Continues

Scott Lilienfeld — Sun, 31 May 2009 21:02:33 +0000

At long, long last, I have decided to take the plunge and launch the long-delayed Psychology Today blog, “The Skeptical Psychologist.” As is almost always the case, the blame for the inexcusable delay rests entirely with yours truly. I was massively overcommitted with work during the Spring semester, but now that classes are over, my best excuses are over too.

Today and in the weeks to come, The Skeptical Psychologist will examine a broad array of claims on the fringes – and sometimes outside the fringes – of scientific psychology. We’ll do so with an open mind, but with an eye toward insisting on convincing evidence. Our overarching motto will be the Missouri principle, also espoused by Carnegie Mellon University psychologist Robyn Dawes – “Show me.” We’re willing to be persuaded by novel and even unconventional psychological claims, but will first demand clear and compelling data.

My inaugural post concerns a news story that caught my eye this week while out of town at the Association for Psychological Science (APS) meeting in San Francisco. The headline in the LA Times read “Testosterone-related treatment for autism stirs controversy.” The story focuses on the well known father-son team of Mark and David Geier, who claim that the medication Lupron (generic name leuprolide) is a “miracle” (their words) treatment for autism. Lupron is a prostate cancer and endometriosis drug that is sometimes used to “chemically castrate” dangerous sex offenders. According to the Geiers, Lupron ostensibly treats (cures?) the core symptoms of autism because autism ostensibly is associated with precocious puberty and excessive levels of testosterone. This excessive testosterone in turn ostensibly - my use of “ostensibly” on three occasions is intentional - results in a hypermasculinized brain, which British psychologist Simon Baron-Cohen (cousin of comedian Sasha Baron-Cohen of “Borat” fame) believes to be responsible for many or most of the problematic features of autism. Baron-Cohen, however, vehemently disapproves of Lupron treatment for autism, telling the LA Times that the idea of disseminating Lupron treatment “without a careful trial…fills me with horror.”

As I read this new story and another similar story, I experienced an odd and not entirely reassuring sense of déjà vu. After all, as those of us old enough to have gone around the block a few times surely recall, claims regarding new “miracle cures” for autism are almost too numerous to count. As Paul Offit observes in his recent and superb book, “Autism’s False Prophets: Bad Science, Risky Medicine, and the Search for a Cure,” the autism field has witnessed a seemingly never-ending parade of fad treatments – sensory-motor integration treatment, Son-Rise, facilitated communication, chelation, hyperbaric oxygen treatments, secretin, herbal remedies, and on and on (see also Tristam Smith’s excellent, if depressing, review of these and other treatments in a recent issue of the Scientific Review of Mental Health Practice). Although the jury is still out on a handful of these treatments, like sensory-motor integration, the scientific verdict on many others, like facilitated communication and secretin, is clear – and resoundingly negative. And several of these fad autism treatments, like chelation, are potentially dangerous. All of these treatments, including Lupron, share at least one cardinal characteristic – they have been marketed and promoted far and wide in the wholesale absence of replicated controlled studies.

Although I worked with a number of autistic children in the 1980s as a clinical psychology graduate student and have several close friends (at least two of them academic clinical psychologists) with autistic children, I frankly cannot imagine what it would be like to have an autistic child. So I blame no place whatsoever on the parents of autistic children for embracing such treatments; I suspect that if I were in their shoes, I might well be willing to try any treatment that has even a remote chance of working –so long as the apparent risk was minimal (which is not all clear in the case of Lupron, incidentally). But I do place blame squarely on the Geiers and others who advance wildly enthusiastic claims about autism treatments before they’ve been adequately tested. Giving the parents and relatives of autistic individuals hope is wonderful, but only if this hope is justified. In the long run, nothing is crueler than false hope.

All of us should remain open to the possibility that Lupron alleviates at least some the symptoms of autism; let’s all hope that it does. But we should also insist that researchers and practitioners don’t advance claims that outstrip evidence. As Indiana University Dick McFall reminds us, humility should be our guiding principle as clinical scientists.

Why are so many smart people utterly convinced that dubious or even useless treatments for autism – and for most other psychological conditions, for that matter – are effective? Stay tuned for some potential answers in forthcoming columns – as a little teaser, Google the phrase “naïve realism” for starters.