Thursday, July 30, 2009

Tell me, what do you see?

So Adam Man Tium sent me a most interesting article yesterday.  The New York Times has posted that a bit of a stink has been thrown up about the publication of common answers to Rorschach tests. It is a really good article, filled with all sorts of juicy little morsels for our brains to feast upon.

First, there is the issue of the release jeopardising the validity of a famous psychological test. While I can see why the clinical psychs are a bit cranky, I don't particularly see any objection to such a move. I mean, other fields that deal with people encounter this all the time. Hell, psychologists have to deal with the fact that people learn. That they can learn faster now just means that new scales will have to be designed. The fact that there are apparently tens of thousands of papers written trying to link behaviours and results on the tests doesn't seem to matter. I mean, for research psychs - shouldn't you guys be happy? You now have more work. Get over it. As to the wringing of hands about posterity, that's a touch weak as far as I'm concerned. if the cryptographers cried every time someone on the internet cracked a code, the world would be awash with their tears and broken dreams.  My experiences with people who are in the business of fooling psychs is that if someone wants to fool a psych, faking a Rorschach isn't going to be the only trick up their sleeves.

What is more interesting is the concern that leaking psychological diagnostic tests may lead amateurs to wrongly diagnose people they know.  More importantly, this is seen (it seems) as a violation of the psychological professional code of conduct.  Now, my own internal jury is still out on whether this in the Rorschach case has sufficient empirical grunt to follow through, but I actually think this kind of argument is quite a pressing one.  There is already a growing worry about self-diagnosis and subsequent prescription of medical treatments.  Of course, it hasn't stopped a whole swag of individuals jumping on the home-medicine bandwagon, and considering the US health problems of the day maybe this is justified.  Nonetheless, there is a reason that people train as long as they do in health-related disciplines.  The harms potentially caused by misdiagnosis and malpractice (as liability premiums for medical practitioners show) can be quite catastrophic.  Again, if you are only doing it for yourself, maybe that's okay.  But anecdotally, if someone thinks they know how to cure your particular brand of sniffles, they are going to go around telling everyone they can.  Noone just keeps their home-medicine to themselves.  That's how medicine evolved.  Unfortunately, in our society, the risks are that much greater, and there are weighty ethical concerns that accompany the trial-and-error way of the home doctor.

What is startling about this article is that the above concerns about harms and professional responsibility is actually shown nicely by the very person who is the staunchest defender of the postings, Dr. James Heilman. Before I do that, I'm going to take the chance to e-ridicule him:

Heilman, the man who originally posted the material, compared removing the plates to the Chinese government’s attempt to control information about the Tiananmen massacre. That is, it is mainly a dispute about control, he said.
IDIOT. You think this is in anyway like the cover up of Tienanmen, because of control? So by your logic, the protection of patient details, or the identity of rape victims, or any other form of control of information based on the risk of considerable harm caused is like Communist repression. I mean, come on people! The mere attempt to exert control over something doesn't make you any [insert favourite political scapegoat of the day]. Heilman obviously hasn't been engaging with the arguments on any substantive level, because otherwise he'd be focusing on actual argument, rather than meaningless hyperbole.

To cap it off, we have his own personal coup de gras:
To illustrate his point, Dr. Heilman used the Snellen eye chart, which begins with a big letter E and is readily available on the Wikipedia site. 
“If someone had previous knowledge of the eye chart,” he said, “you can go to the car people, and you could recount the chart from memory. You could get into an accident. Should we take it down from Wikipedia?” 

And, Dr. Heilman added, “My dad fooled the doctor that way.”

So doc, what you are saying is that you let your dad endanger the lives of other people by faking a really quite justified intervention into people's right to drive their cars around (i.e. whether or not they can see), and this is somehow meant to act as a rebuttal to those psychologists who are worried about harms caused by misuse of their diagnostic materials?  Yeah, that's totally coherent.  In fact, I would be tempted to say YES.  Yes we should.  Not only have you shown that leaving the loaded gun on the kitchen table risks kids shooting each other with it, but you've got video footage of little Jimmy running off with it to play cops and robbers with his friends.  You've proved their point!  Hell, all they need now is a little push in the empirical direction to show its not only you and your dad who are menaces to everyone around them, and there's a case for regulation right there!  I mean, right to freedom of expression is one thing.  Right to cheat on your driving eye-test is quite another.

I mean, there is a better solution to the eye thing - just randomise the letters.  But I'm not in the biz, so I don't know if that is feasible or jeopardises the reliability of the test.  It probably does. Still, an interesting article all in all, filled with equal amounts of the good, the bad, and the stupid.

1 comment:

Adam Man Tium said...

I was just reading the abstract of an article* on the above named Rorschach tests.

This long term meta-analysis of the Rorschach tests has come up with the following statement:
Despite a few positive findings, the Rorschach has demonstrated little validity as a diagnostic tool...Otherwise the Rorschach has not shown a well-demonstrated relationship to these disorders or to Major Depressive Disorder, posttraumatic Stress Disorder (PTSD), anxiety disorders other than PTSD, Dissociative Identity Disorder, Dependent, Narcissistic, or Antisocial Personality Disorders, Conduct Disorder, or Psychopathy.

Looks like these clowns have very little to moan about. (And by 'these clowns', I mean the psycho-babblers crying about the emperor and his lack of style. Looks time L. Ron Hubbard was right eh?)

* From James M. Wood, Scott O. Lilienfeld, Howard N. Garb, M. Teresa Nezworski, "The Rorschach test in clinical diagnosis: A critical review, with a backward look at Garfield (1947)", Journal Of Clinical Psychology, 2000, 56 (3), pp. 395 - 430.