The Mathematics of Narcissism
The common statistical thread between psychiatric diagnosis and grad school rankings.
By Jordan EllenbergPosted Wednesday, Jan. 5, 2011, at 6:32 AM ET
http://www.slate.com/id/2279932/Another long-gestating project—the National Research Council's ranking of U.S. graduate programs in 59 subject areas—wrapped up in 2010 as well. The ranking came in five years overdue, and its results, like the new DSM, roused widespread dissatisfaction. Stephen Stigler, a professor of statistics at the University of Chicago, described the methodological problems as so severe that the project was "
doomed from the start."The particulars of the two scientific disputes are too gnarled to detail here. In a mathematical sense, though, the controversies are much alike. They both rest on the tension between two fundamentally different strategies of data analysis, clustering and dimension reduction.
Suppose you've got a large collection of objects—say, graduate programs in mathematics, or psychiatric patients. For each object you have a large collection of measurements. For the graduate programs, you can assess the average time to degree or median publications per faculty member. For the patients, the measurements could be responses to diagnostic questionnaires or assessments by clinicians on various scales.
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But when someone wants to know "what's wrong with my patient?" or "which graduate school should I go to?" a list of two dozen numbers isn't so helpful. You need a human-readable description of the object in question.
One way to do this is clustering—you look for divisions along which the objects of study cleave naturally into groups bearing common features. This is the DSM-IV approach to clinical diagnosis: Narcissists resemble other narcissists more than they resemble paranoids, or
borderlines, or people without any personality disorder at all. Humans are born clusterers—we almost can't help doing it. Entities neither fish nor fowl discomfit us: Politicians are liberal or conservative, animals break up into phyla, pop songs are black metal or death metal or math rock or shoegaze or grime.Then there's dimension reduction—here, we try to boil down the many measurements to a few numbers that really matter. This is what we do when we boil down all the aspects of a baseball player's performance to his batting average (or, nowadays, OPS and
Wins Above Replacement). It's what the NRC was charged with doing—given all the data about graduate programs, put them in order from best to worst. And it's the way the DSM, in its latest edition, now proposes to reclassify personality disorders. Instead of partitioning patients into groups, they are now measured on six personality axes: negative emotionality, introversion, antagonism, disinhibition, compulsivity, and schizotypy. The patient previously known as "the narcissist" will now be a high scorer on four facets of "antagonism": callousness, manipulativeness, narcissism, and histrionism. In the new paradigm, there's no breakpoint where one personality disorder stops and another begins—there's such a thing as narcissism, but no such thing as a narcissist.The tough part of dimension reduction is figuring out which few numbers to use. Getting to consensus on the six personality axes took years. And if that sounds hard, consider the charge given to the NRC, which had to capture the essential features of a graduate program with a single number. That's a tall order—imagine if the DSM group had to devise a linear scale to rank patients from sanest to most crazy!
In the end, the NRC group couldn't agree on a uniform ranking. Instead, they offered a range of possible metrics and an
interactive tool where users can rank departments via various dimensions endorsed by the NRC or using their own homebrewed measures. This compromise, statistically principled though it may have been, satisfied nobody. After waiting 10 years for the rankings to come out, people wanted their department's standing to be more definitive than "between 6th and 16th, depending on which metric you choose." (And the complaints about the NRC rankings weren't purely methodological—many departments complained the dataset itself was hopelessly shot through with error.)So, what's the right way to tame your data? It depends on the objects. The researchers driving the changes in DSM take the view,
which has some empirical support, that people really do vary continuously from normal to disordered. On that account, carving out various precincts of psychopathology is like divvying up people into "beanpoles," "fatties," and "pipsqueaks" instead of reporting their height and weight. Dimension reduction is the way to go.The NRC, on the other hand, might have done better to toss the idea of rankings entirely, and just clustered the departments into natural groupings. The statistician
Leland Wilkinson ran a quick and dirty clustering on the NRC data for math departments. He found that the departments broke up into five clusters: 10 elite departments, a big group of 59 upper-tier departments, 47 lower-tier departments, and two smaller clusters whose meaning, if any, isn't clear to me. This is much coarser information than a full ranking—but it has the advantage of not depending on politically contentious choices as to which criteria matter most.In the end, dimension reduction and clustering are going to have to coexist. We rely on continuous metrics to describe baseball players, but at the same time we form mental clusters around prototypes like the plodding slugger and the crafty slap hitter. We cluster our music collections into genres and our politicians into parties, but it can be just as illustrative to map
bands and senators in two dimensions using continuous coordinates. So narcissists, and the therapists who treat them, can breathe easy—the notion of the narcissist was alive before the diagnosis broke into the DSM in 1980, and it will persist after the diagnosis is gone.The Divorce So Bad it Made the Family Judge Flip Out
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Belinda Luscombe Wednesday, January 5, 2011 | 16 comments « Previous PostYou May Be Less Bald Than You Think Next Post »4 Ways Americans Are Healthier Alreadyhttp://healthland.time.com/2011/01/05/the-family-judge-who-flipped-out/
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Ontario Superior Court Judge Joseph Quinn's 31-page December decision—which made the local papers and is still doing the rounds of legal circles on the internet—is filled with the kind of black humor and derision one would imagine is usually kept for close berobed colleagues only. He chided the couple for "marinating in a mutual hatred so intense as to surely amount to a personality disorder," and said the chances of amicable resolution were "laughable." The wife had poisoned their daughter "irreparably" against the father who, the judge admitted, had "a near-empty parenting tool box." (More on TIME.com: 5 New Reasons to Get or Stay Married This Year)
Quinn mocked the couple's habit of sending abusive, vulgarity-laced texts to each other and their inability to be civil at their children's sporting events. On one occasion apparently, Catherine, the wife, had tried to run Larry over with her car — "always a telltale sign that a husband and wife are drifting apart," the judge noted.
Catherine's relatives, several of whom are Hell's Angels, made death threats against her ex , which the judge mentioned, adding that "on Oct. 18, 2007, a nautical theme was added. According to Larry, 'Catherine's sister-in-law yelled out her window that I was going to be floating in the canal dead.' " That Catherine told her children they'd go to jail if they even called their dad did not help matters.
Larry, meanwhile, was given to flipping the bird every time he drove past his ex-wife's house, leading the justice to observe that "a finger is worth a thousand words and therefore, is particularly useful should one have a vocabulary of less than a thousand words." (More on TIME.com: Why Married Men Are Less Antisocial)
Quinn knew his tone was harsh but defended it saying since the parties were "immune to reason" he had used ridicule as a last resort. Is there a standup circuit for the legal set?
Nursing School Says No Way to Placentas on Facebook
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Bonnie Rochman Wednesday, January 5, 2011 | 21 comments « Previous PostNew Way to Investigate Crime: A DNA Test for Hair Color Next Post »The Daddy Bonus: Which Fathers Get Paid More at Work?
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Disrespecting the placenta in cyberspace was not a savvy move, for the women were kicked out of Johnson County Community College. Now one of the students, Doyle Byrnes, has headed to court to try to compel the school to re-admit her before classes resume Jan. 19. Prior to her placenta problems, Byrnes was on track to graduate in May. (More on Time.com: A Baby is Born, His Mother Dies; Read About It on Facebook)
What were the nurses-in-training doing getting up close and personal with a third-party placenta anyway? The students were part of a group attending an off-site course at a hospital to see what a real, live placenta looks like when one of the students asked the instructor, Amber Delphia, if it would be alright to immortalize the placenta on Facebook, according to The Kansas City Star.
Delphia, according to the lawsuit, merely said, "Oh, you girls," and did not tell them not to do it or that it could result in discipline.
Four students had themselves photographed with the organ, which had no identification linking it to a particular woman. Byrnes' photo showed her smiling broadly, wearing a lab coat and surgical gloves and leaning over the placenta in a tray.
Far from amused, Jeanne Walsh, director of nursing at the college, chastised Byrnes in a letter included with the lawsuit:
"Your demeanor and lack of professional behavior surrounding this event was considered a disruption to the learning environment and did not exemplify the professional behavior that we expect in the nursing program." (More on Time.com:
Can an iPhone App Save Your Marriage?)Byrnes responded to Walsh in writing:
"In my excitement to be able to share with my loved ones the phenomenal learning experience in which I had been blessed enough to take part, I did not consider that others might view this photograph as unprofessional, offensive to the school I was representing and more importantly the sanctity of human life," she wrote. "For my actions I am truly sorry."
Ah, the perils of social networking. (More on Time.com:
Facebook Says You'll Break Up Before Spring Break)In any case, Byrnes' attorney points out, the school's code of conduct addresses neither photographs nor social media. It's unknown whether the code addresses bad judgement, which Byrnes and her buddies displayed in no short supply.
No Pain, Little Brain: Anesthesia Is More Like Coma Than Sleep
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Maia Szalavitz Tuesday, January 4, 2011 | 83 comments « Previous PostTreating Depression: How Bright Light Can Help Next Post »Mind Reading: The Art of Comforting
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By exploring the brain regions that are active — or not — when patients are under anesthesia, researchers found more similarities between the brain states of patients in comas and those under general anesthesia than between anesthetized patients and those who were slumbering.
Although doctors like to use the term "going to sleep" when putting patients under anesthesia, the new study finds that the two states are very different, with only the deepest states of sleep resembling the very lightest stages of anesthesia.
In a phone interview with Reuters, study co-author Dr. Nicholas Schiff of Weill Cornell Medical College in New York described the brain under anesthesia:
"The brain is becoming very, very quiet. The activity of the neurons is being dampened dramatically...That is also true in coma."
Schiff, an expert in coma recovery, said while no two brain injuries are alike, studying the way people come out of anesthesia could be used as a model for predicting the stages of emerging from a coma.
"Although recovery from anesthesia is much faster, there are hints that some of the circuit mechanisms have some overlap," he said.
The research explains how the return of brain activity after anesthesia follows a predictable pattern as specific brain regions come back online. First, respiration is restored, marking the return of the back of the brain stem. Activity then moves forward in the brain, with salivation, tearing, gagging and grimacing appearing as autonomic functions are restored nerve by nerve, followed ultimately by awareness. The same pattern of awakening may occur more slowly during coma recovery, the authors say. (More on TIME.com:
Some Scientific Evidence for Beauty Sleep)Incidentally, the study also offers some insight into why Michael Jackson might have been so fond of the anesthetic drug propofol — apparently, just before the drug obliterates consciousness, it produces a "state of paradoxical excitation" that may include "euphoria."
A better understanding of the how anesthesia works may not only help ensure that patients are kept safe and pain-free throughout surgery, but it could also ultimately help improve treatment of coma, and may lead to better solutions for the problems many elderly patients endure during post-surgical recovery.
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