Westernized Treatment for Depression vs Rwanda

Found this little gem on my newsfeed today.

A person in Rwanda, talking to a western writer, Andrew Solomon, about his experience with western mental health and depression, had this to say:

“We had a lot of trouble with western mental health workers who came here immediately after the genocide and we had to ask some of them to leave.

They came and their practice did not involve being outside in the sun where you begin to feel better. There was no music or drumming to get your blood flowing again. There was no sense that everyone had taken the day off so that the entire community could come together to try to lift you up and bring you back to joy. There was no acknowledgement of the depression as something invasive and external that could actually be cast out again.

Instead they would take people one at a time into these dingy little rooms and have them sit around for an hour or so and talk about bad things that had happened to them. We had to ask them to leave.”

The second paragraph, especially the last line, was slightly mind-blowing, for me.

The full podcast is here.

50% People “remember” false stories that never happened if they support their preconceived ideas

Remembering is believing, right?

Not really.

We have always known that people remember things that they agree with, and forget things that are inconvenient for them. However, here is some research that proves that people can “remember” completely made up events.

Here is the scary abstract of the research paper:

In the largest false memory study to date, 5,269 participants were asked about their memories for three true and one of five fabricated political events. Each fabricated event was accompanied by a photographic image purportedly depicting that event. Approximately half the participants falsely remembered that the false event happened, with 27% remembering that they saw the events happen on the news. Political orientation appeared to influence the formation of false memories, with conservatives more likely to falsely remember seeing Barack Obama shaking hands with the president of Iran, and liberals more likely to remember George W. Bush vacationing with a baseball celebrity during the Hurricane Katrina disaster. A follow-up study supported the explanation that events are more easily implanted in memory when they are congruent with a person’s preexisting attitudes and evaluations, in part because attitude-congruent false events promote feelings of recognition and familiarity, which in turn interfere with source attributions.

Let me repeat the most important points for effect:

  • The study involved 5000+ participants, so there is little chance of it being a few weirdos. This probably applies to “most of us”
  • Half the people “remembered” an even that had never taken place
  • 27% of the people remembered “seeing” the event on the news – an event that never took place
  • People were more likely to “remember” false events that agreed with their preconceived notions / political leanings

With the rise of social media putting an increasingly harsh spotlight on every action by every political leader, can we feel happier that the truth is more likely to come out? I would argue that social media just makes it easier to manipulate people…

Check out the original paper if you’re interested, and the related reddit discussion.

More information and openness is not always a good thing – via @TimHarford

Tim Harford has an interesting article on the murkier side of transparency – i.e. how more information is not always better.

For example, he talks about how Toronto installed countdown timers at various traffic signals, giving pedestrians an idea of how many seconds they have to cross the road. Since they installed these signals on only some intersections and not others, some researchers used this opportunity to study the impact of the timers on the accident rate.

Their findings:

You might well anticipate that the countdowns would make junctions less dangerous, by telling pedestrians whether or not they have time to cross in safety. Toronto’s traffic planners certainly seemed to believe that would be the case. They were wrong. The new signals caused more accidents.

How is this possible? Here is the suggested explanation:

If a signal is about to turn red for pedestrians crossing at a junction, then drivers who are trying to get across the junction in the same direction are also about to get a red light. Since there was more speeding and more rear-end collisions after the countdown signals were installed, Kapoor and Magesan reckon the natural explanation is that some drivers were accelerating into the junction to avoid being delayed, just as other drivers were slowing down.

This idea, that more information can actually hurt, shows up in other places too. Here is an example of a study conducted on hospitals which insisted that success rates of individual doctors/surgeons be published.

Ten years ago, David Dranove, Daniel Kessler, Mark McClellan and Mark Satterthwaite looked at the impact of mandatory “report cards” in New York and Pennsylvania, which published data on the performance of individual doctors, hospitals or both.

One might imagine that this information would, at the very least, be convenient. At best it should spur physicians to improve their skills because patients would seek out the very best. But the researchers looked at the impact on cardiac surgery, and found a tragic side effect: once doctors and hospitals knew that their success rates would be published, they had a strong incentive to operate on the healthiest patients. The best hospitals had their pick of the sick and selected easy cases. Meanwhile patients with more complicated conditions were more likely to have surgery postponed. The net result: more money was spent, yet more people died of heart attacks.

In other words, sometimes it pays to make information available only selectively:

Publishing clear information is often a way to make the world a better place – but not always. Sometimes it pays to be selective. Doctors could benefit from report cards, provided their patients never find out what they said. And Toronto’s countdown signals would work perfectly if only they could be hidden from drivers.

Read the full article