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Hello everyone! Thanks so much for all these questions. We'll leave it a couple more days before we start replying properly, but we'll try to answer all of them. And we'll discuss between us which ones we want to address in a future episode! Keep them coming. Thanks again!

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This may be too spicy for your show, but I’d love to see a conversation with Jesse Singal about his reporting on puberty blocker studies and research degrees of freedom (e.g., https://jessesingal.substack.com/p/on-scientific-transparency-researcher).

I also really enjoyed Stuart’s short book on intelligence, and a conversation about IQ (myths and facts) would be really cool

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The puberty blocker stuff is definitely a really interesting topic and I'd love to do it. MAAAAAYBE one to do behind the paywall for our beloved paid supporters? I feel like IQ and intelligence might be one we could put out for general consumption, although it does make people very cross. We'll put both on the list! Thank you

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I'm sure Jesse would come on for a guest episode - given the sheer amount of detail on his Substacks on this topic, I trust his knowledge of these studies way more than anyone else.

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I love both of these suggestions!

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Aug 21, 2023Liked by Tom Chivers

Related to something I saw Stuart post on twitter. What do studies show regarding the behavior/safety of different breeds of dogs? I've heard lots of people say that Pit Bulls are not dangerous or aggressive unless they are raised to be, but they don't seem impartial.

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author

Hi Mark! Sorry we've been so slow replying. We are just so, so [busy/lazy, delete as appropriate].

I'd be dead keen to do dog breeds. Something that Stuart pointed out in a piece he wrote on the topic recently (https://inews.co.uk/news/dog-breed-affects-behaviour-american-bully-xl-debate-2510306) is that EVEN IF dog breed didn't affect behaviour (which, to be clear, it probably does), then that's not the whole story: Say my sister's miniature schnauzer is just as likely to be aggressive as an American Bully XL, it doesn't matter as much, because if the schnauzer tries to bite my children I can just pick it up and drop-kick it over a fence. Whereas I would struggle to do that with a 65kg chunk of snarling muscle.

We'll put this on the list of possible topics!

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There seems to be an article in the UK news literally every day (sometimes multiple articles!) about the American Bully XL now. Including the "Daily Star Guide to fighting off an XL bully dog from gouged eyes to fingers up bum". What a headline. https://www.dailystar.co.uk/news/latest-news/daily-star-guide-fighting-xl-30823623

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Aug 22, 2023Liked by Stuart Ritchie

I think you guys are off to a strong start. Engaging content and your episodes are generally of Goldilocks length.

I would encourage you to have guests on occasion. It is good to spice things up, you two are good at asking questions (your day jobs), and then you don't have to be the total experts on every topic.

Please consider doing a round two on nicotine and vaping and invite Prof Ann McNeill of KCL's Nicotine Research Group. She has led the teams preparing the PHE/OHID evidence reviews and is highly regarded in the field. Measured, respectful, and just knows everything about these topics, including having contributed to a lot of the primary research.

Keep up the good work and thank you!

Joe

Disclosures: My employer, PinneyAssociates, Inc., provides consulting services on tobacco harm minimization for JUUL Labs, Inc., on an exclusive basis. I also own an interest in a novel nicotine gum that has not been developed nor commercialized.

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author

We are considering doing guests! Possibly as special paid-only content? All very much up for discussion at this point. Thanks for the kind words and the support!

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PS to answer another part of your question: yes, it would be wonderful to have guests on, particularly those who cite or carried out the relevant research, so they can also comment on drawbacks. One thing that I honestly would *love* to see is a forum for a long form discussion (not an Oxford style debate) between proponents of opposite views, so they can really hammer home what they each agree on and what they each disagree on. So for big topics, if there are two commentators citing opposite conclusions from "the studies", what I would really love to see is to have the disagreement discussed and hashed out in a constructive way. I'm not sure if that's possible!!

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I certainly like listening to podcasts where people disagree, rather than the usual thing where everyone just nods along and tells each other how clever they are. But it's easier said than done, because people on opposing sides of scientific debates so often hate each other!

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Ha I didn't know that, what a shame!!

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Hi there! I often find almost any big topic overwhelming to understand because there are so many claims over what research shows and I find myself in an endless loop of clicking on a study reported in an article or cited in a show and then discovering very quickly that that study didn't seem to show what is being claimed. So, thank you for your show! I'm really enjoying it.

Anyway, I have a few questions I have been pondering:

1. What do we actually know about the risk and impact of the hormonal combined contraceptive pill? There is so much out there about the risks of everything from blood clots to changes in female sexual desire, to estrogen killing all the frogs. What do the studies actually show on this question?

2. Carrying on with the theme of the impact of hormones: there was a question below on what we actually know about puberty blockers which I also have been thinking about. That would be a great one to cover too. Also, more broadly, what does the research actually show about the impact of the watchful waiting method Vs the immediate validation methods of treatment, and how strong is the evidence for things like rapid onset dysphoria or social contagions amongst some groups?

3. Do we have any good studies or data on reproductive technology, e.g IVF, surrogacy, etc? What do we know about the risks, benefits, harms, etc?

4. In conversations on marriage and divorce, people almost inevitably bring up statistics that everyone sort of knows but that I found hard to track down in any meaningful sense, like almost half of marriages end in divorce, and women are much more likely to initiate a divorce than men, that family courts are discriminatory towards fathers in favour of mothers, etc. People then draw conclusions from this that I can't see any justification for, for example, even if it is true that women initiate divorce more, does that tell us that they gave up on the marriage first, or just that they file more of the paperwork? If family courts favour mothers in more cases, is that because they're favouring women, or favouring whoever was the primary carer? In other words: What do we actually know about marriage, divorce, and - just to be spicy- adultery, rates of infidelity?

5. Linked to the above, there are lots of commentators now who emphasise the risks to children who grow up with unmarried versus married parents, and divorced parents versus those who are together, a lot of commentary on fatherless homes in particular, and a lot of commentary on the risks of growing up with a stepparent in the home (especially stepfathers). Again, it strikes me as difficult to tell whether some of the outcomes are due to the marital state of the parents themselves, or whether it is just that those parents who are able to stay married and create a stable home environment are also the sort of people who can parent a child towards better outcomes, or whether there is a genetic link there. What can we actually conclude from the research?

I appreciate those are all more sociological questions than the topics you usually cover, which are more amenable to bring studied in lab settings. But I focused on those ones because I already agree with pretty much every topic you've said you should do an episode on! Yes to them all!

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Sorry, one more question! What do we know about intermittent fasting? Just another diet fad, or are some claims about it's benefits for health and longevity borne out in "the studies"?

Thank you! :)

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author

Hey Zahira! There's a lot to respond to there.

One thing I'd *really* like to do is the divorce rates thing. Because it never really occurred to me until I wrote a thing about them that … obviously you can't just look! Most marriages are still ongoing! So you have to do some weird if-the-rate-of-divorces-carries-on-proportionally-to-earlier-marriages-over-the-course-of-the-marriage etc etc, if I recall correctly.

The pill is also something I'm super fascinated by. In fact all of these are, really! So, copy-and-paste into the Potential Episodes document. Thank you very much!

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Sorry, yes I know I had lots of questions! They've just been building in my head for many years and I'm so glad this show exists now for these sort of deep dives! Great, looking forward to potential future episodes :)

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Our list of ideas is a lot longer now - thanks for making sure we've a long way to go before we run out of topics to cover!

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Recently someone shared year over year standardized test scores for my kids' school. My gut tells me this is a terrible way to look at data, given theyre two different cohorts and one group could have started well behind another group, scored lower on the test, but actually achieved more learning during the year. Is this silly of me? Regardless of the small sample size problem, comparing cohorts from year to year on standardized tests to evaluate the school is going to be full of problems, right?

Also, it's all the rage these days to claim social media is harming children, but is this any different than the "video games are harming children" argument? (Or dance halls, or pinball, etc.) I've seen this argument with citations of studies showing an increase in mental health treatment for youth, but that's terrible analysis to then link it to social media, right?

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author

I tell you what we should do is get Daisy Christodoulou on the podcast some time, or speak to her as part of the prep for an episode. She's incredibly interesting on exams and testing. I'll drop her a line.

And re social media: It's 100% one we want to do in the future. Andy Przybylski, Amy Orben and Pete Etchells are three really interesting, thoughtful researchers who basically say the research is, as you say, really weak, and it's not good practice to do the "social media started around HERE and you can see THIS line go up HERE so IT MUST BE SOCIAL MEDIA" thing. (The other question of course is whether there's a real underlying change in mental health conditions or if there's greater awareness/greater propensity to report/etc. Could easily be both.)

Thanks for listening!

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author

The discussion keeps going on these studies - even the ones held up as the strongest evidence of negative effects of social media are vulnerable to quite strong criticisms. This is the newest critical discussion I've seen: https://statmodeling.stat.columbia.edu/2023/08/22/thefacebook-and-mental-health-trends-harvard-and-suffolk-community-college/

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You’ve already answered my first question - whether the podcast will focus solely on medical questions - with the latest episode.

In terms of topics, I’d definitely be interested in:

Meditation/mindfulness - I vaguely remember reading that a small percentage of people have negative side effects, but a sufficiently high number that if it were a drug you probably wouldn’t prescribe it

Intermittent fasting

Functional disorders - my prior (prejudice?) here is that they exist but are vastly over-diagnosed and the therapies offered have a very poor evidence base, particularly with regard to long-term efficacy.

Perhaps after you’ve done something less contentious, like youth gender medicine, a look at whether cycle helmets actually reduce risk.

Again, a nice non-contentious topic: do diversity trainings work?

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Sep 1, 2023Liked by Stuart Ritchie

I second the mindfulness and meditation one! It’s prescribed for everything from really serious mental illnesses to drug addiction, to chronic pain and childbirth. Yet the studies around it are suspiciously similar to those from the 1990s touting the benefits of prayer. The attitude is, “might as well, it can’t hurt” but then there is the old medical saying that any treatment that works should have side effects. So either mindfulness doesn’t work or it should have at least some risk. Would love to hear what’s going on with all that.

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I would bet there's a huuuuge "I want this to work" bias going on in that kind of research. Mainly that's because that bias exists in almost all kinds of research... but I bet it would be worse than usual here! Definitely worth a look.

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it's just occurred to me we forgot to give you a shoutout in the diversity training episode! We'll correct that in a Mea Culpa or something. Apologies and thank you!

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Oh god these are really good topics but we'll get so shouted at for them. Cycle helmets. Man. THAT is a can of worms. (I think meditation/mindfulness might, conceivably, be a good "I wouldn't necessarily expect this to work but there is some evidence for it" topic, although I haven't looked into it for years and maybe none of the studies that looked vaguely promising a decade ago have replicated.)

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I think you can avoid getting shouted at (maybe???) if you make clear that you're not arguing against diversity per se, but just against the specific trainings (unconscious bias, implicit association) that companies and governments and universities use to try and promote it. Or maybe I'm being a bit naïve.

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Here's another episode suggestion: Placebo effect. I recently came across this (someone posted it somewhere) https://www.nejm.org/doi/full/10.1056/nejm200105243442106. It compares studies that have placebo groups and no treatment groups and finds very little evidence of a placebo effect. I was listening to a podcast the other day and a host said confidently, "We know the placebo effect is real." I've even heard people suggest prescribing placebos to trigger the effect in lieu of actual treatment. This study is also over 20 years old. What is the current status of the placebo effect?

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Mark L: Thank you. May I suggest that you tune in tomorrow morning! I hope we do you justice. (And we do namecheck you at the end of the episode, having stupidly failed to remember your name when saying "it's from a listener" at the start of the episode.)

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Sep 4, 2023Liked by Stuart Ritchie

Cool. I'm looking forward to listening!

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One thing I haven’t heard discussed but is an important topic for me as a clinical psychologist is what to make of all the evidence-based psychotherapies in light of the replication crisis in psychology. Please cover this!

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Boosting this suggestion! Is the hype around CBT, DBT, EMDR, etc. real? If these are as effective as claimed, why aren’t we cured of everything? And how do you even measure the effectiveness of “traditional” therapy when some people say everyone should go forever and others treat it like a medicine to be used in discrete dosages (like insurers)?

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Hi Jane and Linotte! This does seem important. I've always assumed CBT is a real thing that works but I haven't looked into it in any great detail. Thank you!

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There was a review recently that claimed that CBT was just as good as any other kind of therapy (i.e. it wasn't the "gold standard" particularly). I have no idea whether that review was any good and would like an excuse to read it, so this would be a good episode to do!

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What's the optimal office temperature? Or more realistically, what is the optimal range of office temperatures. In other words as temperature drops, or rises, is there an inflection point in productivity, meaning we should design air-con systems to stay within a certain range and stop pandering to wimps, usually women and gayers ime who can't adjust their clothing by one layer. Or are we better insisting on a tight temperature range for the AC so no-one has to adjust their apparel and the energy and climate costs of that ('cos climate costs aren't in prices though they should be) can go swivel.

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I read something recently that a person's comfortable temperature range has dropped from a 10 degree swing each way to less than 5.

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I've definitely seen claims--no idea if accurate--about school classroom temperature and kids' academic performance. Definitely worth taking a look at the evidence and seeing if anyone's ever done an actual experiment on this.

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It would be helpful if you made brief asides (with editing?) to define terms of art from statistics or methodology. I know this is will be mildly repetitive but many common concepts aren't well defined (or understood) in the sciences. I think they're often critical to define to build to your larger points (eg Stu looks like a hedgehog, p < 0.00001).

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Hey Andy! We have noted your concern (see Mea Culpa episode): we're going to try to be better at this. Thanks for listening! Also, look elsewhere in the comments, but I think we're going to need your help on an episode about social media and mental health at some stage.

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What are your thoughts on technologies such as GeneSight (genetic testing for predicting best responses to psychotropic medications) and AlphaStim (cranial electro therapy stimulating)? Do any of these novel technologies for the treat of mental health symptoms look promising to you?

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Sep 4, 2023·edited Sep 4, 2023Author

I am afraid I know nothing at all about either of those topics. But I'll say the following things:

1) genetic testing really can offer some predictive power on various things. For instance, someone I know is about to start an immunotherapy drug for melanoma, and the doctors are very confident that the drug will work because the mutanome, the cancer's genome, contains a mutation that the drug attacks

2) it's much less effective at complex, polygenic things like height, intelligence, and, I would expect, response to psychogenic medicines. (Hopefully Stuart will swing by these comments soon: he's much more knowledgeable than me about this stuff.) But polygenic risk scores for height and intelligence definitely do better than nothing and I wouldn't be surprised if you could get some useful info on drug suitablility.

[edit: I've just looked it up and this meta-analysis basically found that the evidence is rubbish and we can't tell https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433545/]

3) Transcranial magnetic stimulation has amazingly spooky effects - you can make people move their arm by MAKING THEM FEEL LIKE THEY WANT TO. And electroconvulsive therapy is effective. So I'm not hugely sceptical of the basic idea of zapping the brain with electricity or magnetic fields to affect mental health. But I've just looked it up, and the first trial I found said that it was no more effective than a sham treatment: https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(23)00007-X/fulltext so I am at the moment happy to assume it doesn't do very much.

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I would love to hear what the studies show about EMDR therapy. When I was in graduate school in Clinical Psychology two decades ago, the consensus was that eye movement part of EMDR was all window dressing and it was the trauma exposure aspect that healed patients. However, I see now that both the WHO sand American Psychological Association list EMDR as an evidence based therapy.

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I have to admit I had never heard of EMDR until I read this comment and looking it up it sounds very woo-woo. Having now read deeply on a special trip to the British Library …

(OK, on Wikipedia)

…I find it very odd to note that NICE, the British regulator says the evidence of efficacy is "low to very low", the Institute of Medicine says there's all sorts of problems with the evidence, etc, but the WHO, APA and Australian regulators all recommend it. Extremely confused there. (Perhaps I'm being cruel but I think the fact that Prince Harry used it makes me trust it less.) Maybe it's a bit niche? I'll ask other listeners if they've come across it.

thank you!

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Another interesting topic for the show to explore would be the idea of "trauma". It seems like more and more problems are being labeled as trauma, and the source of that alleged trauma is often very unclear or unfalsifiable. For example, there is this very popular physician called Gabor Mate who attributes all kinds of health problems to hidden childhood trauma. This just seems like the "repressed memory" panic of the 1990's to me. The problem is that people like him get lots of uncritical media attention, and virtually nobody requests data and evidence for his claims. It would be nice to see you both dissect the evidence behind such claims.

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this is a really interesting idea - but probably one for the paid-only because I imagine it would annoy some people…

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Yes, it may be controversial to some listeners. Thanks for the reply.

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Hello! Have you considered doing an episode on attention spans and if they have shortened due to social media and similar?

It's something often assumed to be true but what does the actual research say?

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we like this! I'll put in on the list - thank you

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