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Saturday
Oct292016

The Hormone Myth? Robyn Stein DeLuca Visits the NYC Skeptics

“Nothing seems to have the power of good and evil like women’s hormones,” said psychologist Robyn Stein DeLuca. While a less-than-optimal testosterone level might just turn a man into a “schlumpy, low-T guy,” any change in a woman’s hormone levels is often thought to cause legitimate physical or mental illnesses.

“There’s the ubiquitous PMS joke,” DeLuca told the packed house of New York City Skeptics at Baruch College on October 22. It’s usually about what the abbreviation actually stands for, whether that’s “Pardon My Sobbing” or “Pissy Mood Syndrome.” DeLuca’s personal favorite is the answer to a riddle – what do you get when you cross PMS with a GPS?

“A bitch who knows how to find you,” DeLuca said.

But despite the idea’s saturation in our culture, and after five decades of research, there is still no consensus on whether “premenstrual syndrome” even exists, DeLuca said. Proposed symptoms run the gamut from the familiar mood swings, depression, hostility and weight gain to either increases OR decreases in hunger and libido – over 150 possible symptoms in all. And researchers didn’t always agree on how soon before (or even after!) menstruation they have to occur to justify a diagnosis of PMS.

Depending on how you looked at it, then, anywhere from 3% to 97% of women may have suffered from PMS. The condition, now called premenstrual dysphoric disorder (PMDD), was finally codified more precisely in 1994’s fourth edition of the Diagnostic and Statistical Manual of Mental Disorders. To qualify, sufferers now must present one of four main symptoms (mood swings, irritability, depression or anxiety), plus four others, within the final week before menstruation. Under this new definition, less than 9% of American women can be diagnosed with PMDD.

“Your distress has to affect your functioning,” relationships or work, DeLuca put it more plainly. Just being grouchy isn’t enough.

And those afflicted will find some relief from PMS once menopause begins – unless that’s a disorder in need of treatment, too! The time of a woman’s life that officially starts after 12 months without menstruation wasn’t much talked about in medical journals until the 1950s, when doctors began to warn of women “getting annoyed with their husbands” and *gasp* “refusing to make dinner”! Conversely, most women who have undergone menopause rate it as not that big a deal. So why do some fear it?

DeLuca says much of the early blame can be placed on Robert Wilson and his 1966 book Forever Feminine, which she calls “a compendium of misogyny and chauvinism.” The book characterized menopause as a sort of living death that required hormonal replacement therapy. Good thing the drug company Wyeth, who helped Wilson write Forever Feminine, made a pill just for that.

“It’s like PMS all over again,” DeLuca said of the shift to treating menopause like a disorder. Many still believe that menopausal women are more likely to suffer from depression, something that statistics simply don’t bear out. And there’s a good, non-biological reason older women might get depressed. “When you get into your 50s and 60s, people start dying,” DeLuca said, “which is really depressing.”

The pharmaceutical industry’s motivation in medicating women’s hormones is clear – “You can [buy] some Midol to be a human being again,” DuLuca said – but women themselves can perpetuate the myths when using them as convenient excuses. It’s easy to blame momentary lapses and outbursts on hormones, and not just ordinary stress, when there’s familial pressure to keep the “good woman crown.”

But the hormone myth is more damaging than just a few pills and a Betty Crocker image. DeLuca thinks it has something to do with women’s continued underrepresentation at the top levels of business and in other occupations that are considered to be more “rational.” On a personal level, it’s hard to address any kind of issues when their origins are misattributed.

 “You kind of lose the opportunity to understand what’s going on with you and to do anything about it,” DeLuca said.

For more discussion on the hormone replacement drug Premarin, check out the Facebook Live video of DeLuca's lecture. Her book The Hormone Myth:  Junk Science, Gender Politics, and Lies About Women will be available in May.

Report by Russ Dobler, photos by Jonathan Nelson

Friday
Sep302016

The Raging Hormone Myth? What Science Has to Say about Women, Hormones, and Emotion

When: Saturday, October 22, 2016 @ 3:00 PM 
Where: Lawrence and Eris Field Building, Baruch College, 17 Lexington Ave., Room 306 (The "Skylight Room")

Are women at the whim of their hormones? PMS, and the extended idea that women’s mental health is threatened by any changes in reproductive hormones, continues to abound in American culture.  Despite decades of methodologically strong research establishing the limited to non-existent contribution of reproductive hormones to psychopathology in women, the concept of women as occasional hormonal lunatics persists. The hardiness of the hormone myth has benefited several parties, including the medical field, the pharmaceutical industry, psychologists, and anyone who sees an advantage in keeping women in traditional gender roles.

The hormone myth has produced billions in revenue for pharmaceutical companies who have convinced women they need to be on hormones to maintain health for decades of their lives, and for the physicians who prescribe them. A whole cottage industry of books, websites, and seminars for women thrives with the help of the hormone myth. Robyn Stein DeLuca says the myth has hurt women in a variety of ways: It contributes to the idea that women’s reproductive events are illnesses requiring treatment, exposing them to unnecessary and sometimes harmful interventions. It also reinforces gender stereotypes of women as biological, emotional and unreliable, and men as rational, logical, and steady. Finally, it keeps women from addressing the actual issues that cause them emotional upset, which are much more likely to be socially-based than hormonally-based.

Robyn Stein DeLuca has a Ph.D. in Health Psychology with a graduate certificate in Women’s Studies, and was a core faculty member in the Women’s and Gender Studies Program at Stony Brook University for 15 years. She taught a multitude of courses on the psychology of health, gender, and reproduction. Her research on postpartum depression and childbirth satisfaction has been published in journals like the Journal of Clinical and Consulting Psychology and Social Science and Medicine. She currently holds the title of Research Assistant Professor in the Stony Brook Psychology Dept.

 During her time at Stony Brook, Prof. DeLuca served for two years as the Executive Director of the Women in Science and Engineering (WISE) program at Stony Brook University, a program that provides mentoring, research opportunities, and scholarships to young women showing promise in science, technology, engineering, and math. 

In November 2014, Prof. DeLuca gave a Tedx talk titled “The Good News About PMS” which now has over one million views. Her book, The Hormone Myth will be published by New Harbinger Publications in May 2017.

NYC Skeptics tries to keep their lectures free and open to the public, but it does cost money to produce the events. Please consider donating to NYC Skeptics or becoming a member. Suggested donation for this talk is $10.

 Event Links

Monday
Sep262016

The Myth of War -- John Horgan Returns to NYC Skeptics

"I've been thinking about what to say here," journalist John Horgan told the New York City Skeptics at the beginning of his second invited talk for the group this year. "And there are a lot of different things I could say."

The things Horgan said on May 15 at the Northeast Conference on Science and Skepticism (NECSS) weren't received all that well, at least by the meeting's emcee, magician and skeptic Jamy Ian Swiss. After the former senior writer at Scientific American suggested skeptics focus less on "soft" targets, like homeopathy, and more on "hard" targets, like the nature of war, Swiss offered his own impromptu rebuttal, instead of leading the originally-planned question-and-answer session.

"It was one of the high points of my career, actually," the returning Horgan told the audience at Baruch College on September 24. During this second chance to make his case, Horgan decided to focus on the question of if war is inevitable, and what could be done to stop it.

"How many people think the end of war between nations could happen relatively soon?" Horgan asked the audience. Four of the approximately 30 people in attendance agreed war could be eradicated by the end of the century, about in line with the usual 10 per cent who agree when Horgan asks the question elsewhere. Most people tend to think war is part of human nature.

"It seems like common sense," Horgan said of the "Malthusian catastrophe" idea, that unchecked population growth will always lead to conflict over less abundant resources, despite evidence to the contrary. "It's simply not supported by the literature," Horgan said. He reminded the crowd of Steven Pinker's work that shows the worldwide decline of war, despite the continued, global rise in population. Horgan argued it's not war that's innate in humans, but the tendency toward conformity.

"Once war's invented in one place, it's extraordinarily infectious," Horgan said, likening the phenomenon to a psychological meme. More practically, if a country's neighbor becomes warlike, it may have to follow suit just to defend itself. Deliberate aggrandizement of conflict, like national holidays commemorating the fighting of wars, also help to maintain the trend, Horgan said.

Horgan opined that the United States could help by setting a better example to the rest of the world, through reductions in defense spending, closing of overseas military bases and the implementation of more imaginative methods of conflict resolution. That might not happen, though, when so many of our leaders are "fatalists," as Horgan said -- those who believe that war cannot be eradicated. Even the Nobel Peace Prize-winning President Obama has made efforts to bolster the United States' nuclear arsenal.

Some high-profile skeptics, like Pinker and Michael Shermer, also continue to accept the "deep roots" nature of war, which may be one reason Horgan believes the boundary between mainstream science and pseudoscience is now "very blurry." At NECSS and again during this lecture, Horgan said that several ideas in current physics, like string theory and the idea of a multiverse, were unscientific, and that many psychiatrists wrongly put too much confidence in medication for treatment of clinical depression.

After the lecture's conclusion, some audience members reminded Horgan that skeptics raise the same points, and that while plenty of people talk about war, homeopathy and other harmful practices often go unchallenged.

"Go ahead, do all that other stuff," Horgan said. But with such a destructive problem -- one that could be ended simply with a little convincing -- all hands are needed.

"I almost don't care about what you do as skeptics," Horgan said. "I'm appealing to you as human beings."

A Facebook Live video of John Horgan's September 24 NYC Skeptics lecture is available here. A higher-quality recording will be added at a later date.

Report by Russ Dobler, photos by Jonathan Nelson

Tuesday
Sep132016

Book Signing: "101 Bets You Will Always Win" by Richard Wiseman

When: Thursday, September 29, 2016 @ 7:00 PM 
Where: Paulaner, 265 Bowery, New York, NY 10002 (Map)

Richard Wiseman, globe trotting psychologist, magician, and keynote speaker at this year's Northeast Conference on Science and Skepticism, is back in NYC and looking to sign books and share drinks. Come join us at the Paulaner to celebrate the release of Richard's latest book, 101 Bets You Will Always Win. Copies will be available for sale!

Everyone loves a winner. Imagine being able to challenge anyone with seemingly impossible bets, safe in the knowledge that you will always win. Imagine no more. Richard Wiseman is a psychologist who has traveled the globe in search of the world's greatest bets and in 101 BETS YOU WILL ALWAYS WIN: Jaw-Dropping Illusions, Remarkable Riddles, Scintillating Science Stunts, and Cunning Conundrums That Will Astound and Amaze Everyone You Know (St. Martin’s Griffin; September 27, 2016) he shows you how to use science, logic and a  healthy dose of trickery always to be on the winning side of every bet you make

Richard Wiseman is based at the University of Hertfordshire in the United Kingdom and has gained an international reputation for research into offbeat areas of psychology, including deception, humor, and luck. He is the author of The Luck Factor, Quirkology, and numerous other books. A passionate advocate for science, Wiseman is well-known for his media appearances, high-profile talks, live demonstrations, and mass-participation studies. He has his own YouTube channel called Quirkology

Paulaner NYC is a Bavarian style restaurant and bar, featuring a wide variety of beers brewed onsite. The menu features everything from house-made sausages to vegetarian options. There's no reason to leave hungry or thirsty!

 Event Links

Saturday
Aug132016

John Horgan vs. Skeptics: Round Two

When: Saturday, September 24, 2016 @ 2:00 PM 
Where: Lawrence and Eris Field Building, Baruch College, 17 Lexington Ave., Room 306 (The "Skylight Room")

In a talk last spring at the Northeast Conference on Science and Skepticism (NECSS), science journalist John Horgan complained that skeptics dwell too much on "soft" targets, like Bigfoot and homeopathy, and not enough on "hard" targets, like Big Pharma and U.S. militarism. Skeptics accused Horgan of ignorance and arrogance. Because he is a glutton for punishment, Horgan has agreed to appear before New York City Skeptics to expand on his original arguments and rebut his critics.

John Horgan is a science journalist and Director of the Center for Science Writings at Stevens Institute of Technology, Hoboken, New Jersey. A former senior writer at Scientific American (1986-1997), he has also written for The New York Times, National Geographic, Time, Newsweek, The Washington Post, Slate and other publications around the world. He writes the "Cross-check" blog for Scientific American and contributes to "Science Faction" on Bloggingheads.tv. He tweets under the tag @​horganism.

NYC Skeptics tries to keep their lectures free and open to the public, but it does cost money to produce the events. Please consider donating to NYC Skeptics or becoming a member. Suggested donation for this talk is $10.

 Event Links

Sunday
Jul312016

Ben Goldacre on "Bad Trials" - Lecture Recap

Report by Russ Dobler on July 18, 2016 event.

Note:  An earlier version of this article misidentified Ben Goldacre's COMPare group as CONSORT, which is an unrelated set of recommendations for reporting randomized trials. The original article also incorrectly stated that no randomized trials had been conducted on the drug digoxin until recently.

It’s humbling to talk in America,” British academic and bestselling author Ben Goldacre told the New York City Skeptics, “because nobody knows who the fuck I am in America.” 

A packed house at Baruch College on this wet, hot, American summer evening argued otherwise. The physician and writer of the books Bad Science and Bad Pharma was on the continent and in town on July 18 to talk about a specific way in which medical science goes wrong, with bad drug trials.

Tens of thousands of randomized controlled trials (RCTs) are conducted every year, Goldacre said, to avoid the pitfalls of just using observational data to judge a treatment’s efficacy. The heart failure and atrial fibrillation drug digoxin, for example, was prescribed for years to lengthen the lives of cardiovascular patients, based largely on anecdotal reports that it worked. Later metanalyses of the existing research instead showed that digoxin, in reality, had no positive effect on mortality, although it may decrease the number of required hospitalizations.

But even the best intentions can yield bad results when trials are conducted improperly. Goldacre came armed with a laundry list of methods with which researchers can manipulate data, knowingly or unknowingly, to fool academia, the press or even themselves. 

About 30% of drugs approved by the U.S. Food and Drug Administration between the years 2000 and 2010 were tested with RCTs, but only against placebos, to see if the treatments worked better than no treatment at all. “That sounds superficially like the right thing to do,” Goldacre said, but the goal should actually be to find out if a treatment works better, and with fewer side effects, than existing drugs.

Of course, there’s room for deception when testing in direct comparison with other drugs, too. Some experimenters might use an unusually high dose of an existing treatment to accentuate its side effects, or a lower dose than needed of the subject drug, to mask its own. On the other side, pumping up the administered amount of a new drug might make it seem more effective than it actually is.

Choosing suitable participants for a trial is important, too, but not always for the reasons researchers think. “All too often, trials are conducted on ideal, perfect patients,” Goldacre said, when real life populations are “messy.” What good is it to bar marijuana-smokers from schizophrenia drug tests when many schizophrenics use it to help cope with symptoms? Some trials of clinical depression drugs don’t even accept people who drink alcohol.

And once a researcher has decided on selection criteria, that person needs to make sure someone else does the selecting. This kind of blinding can prevent experimenters from (consciously or unconsciously) tipping the scales by putting certain people in certain groups. The developer of a drug may want to put an especially sick person into the control group, so as to not make his own drug look bad if the patient doesn’t improve, for instance. Analyses have shown that drugs can seem to have up to 40% greater effects than they actually do if this allocation process is not done properly.

The whole thing becomes even murkier when you’re only testing what Goldacre called “surrogate” outcomes. "In the real world, the outcomes we’re concerned with are pain, suffering and death,” Goldacre said. Why is it then the things most-often tested are only related indicators, like cholesterol level and blood pressure?

“People take a long time to die,” Goldacre said of the practically of directly testing something like mortality. But using surrogate outcomes can leave you still wondering. While diabetes drugs are very good at lowering a patient’s blood sugar, not a single one has been shown to reduce the chances of amputations, heart attack or stroke.

That’s probably still better than switching what outcomes you’re testing for after the trial has begun. “You can give yourself so many opportunities to cherry pick your results,” Goldacre said, which can even lead to thinking that a treatment might be better for one group of people especially. A particularly famous (and poignant) instance was when British medical journal The Lancet insisted the ISIS-2 trial include a subgroup analysis, after the fact, to see if aspirin was more or less likely to prevent heart attacks in certain cohorts. Turns out it’s not very effective for Libras or Geminis.

This kind of "outcome switching" is the particular focus of the Centre for Evidence-Based Medicine's Outcome Monitoring Project (COMPare), of which Goldacre is a part. Between October 2015 and January 2016, the group collectively assessed the findings of every trial published in the world's most prestigious medical journals, to see if their findings were properly reported.

“We had three meetings a week; they were two hours long [each],” Goldacre said. “They were fucking miserable.” The results were perhaps even more painful, as just over half of all pre-specified outcomes were reported, and an average of five new outcomes were added to each study.

Things didn’t get much better when these observations were brought to the attention of those major medical journals. While the BMJ published corrections to the cited studies on their website, The Lancet waited six months to address the issue in print, with responses from the original trialists.

“This is no way to deal with the problem,” Goldacre said.

The Journal of the American Medical Association wanted nothing to do with COMPare at all, and didn’t respond when COMPare’s letters were corrected for being too “vague” and “repetitive.” The New England Journal of Medicine went the extra mile and noted all the mistakes COMPare itself had made. There was no response from the journal when Goldacre and company pointed out, with examples, how the accusation was factually incorrect.

More than half of the 58 total correction letters sent were rejected by journal editors.

In addition to working with COMPare, Goldacre helped found the AllTrials initiative in 2013, an effort to make sure that all clinical trials are reported, as currently only about half are ever published.

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