Saturday, January 19, 2013

A Response to Ned Kalin

A few months ago a local reporter contacted Ned Kalin and asked about his resurrection of maternal deprivation of infant rhesus monkeys at the University of Wisconsin, Madison. He received a letter from Kalin in response and asked me to comment, which I did, at length. Unfortunately, the reporter left the paper and did not report on the matter. The rest of Madison’s media have been loath to report on the controversies surrounding the use of animals at the university. Madison is a company town.

Readers of this blog and those somewhat familiar with the history of primate vivisection know that Harry Harlow was a professor at the university and that he and his students’ work was the catalyst for the hundreds of horrific projects around the country that subjected animals, particularly monkeys, to a seeming infinite variety of social, emotional, and environmental deprivation experiments, none of which yielded an iota of benefit to anyone but the scientists suckling at the public teat.

The definitive compilation of this dark period in science is Maternal Deprivation Experiments in Psychology: A Critique of Animal Models. Martin L. Stephens, American Anti-Vivisection Society, National Anti-Vivisection Society (U.S.), New England Anti-Vivisection Society, American Anti-Vivisection Society, 1986.

It’s been two decades since anyone at the UW-Madison has isolated baby monkeys to cause them psychological trauma.

The university’s spin on their resumption of this particular bit of cruelty is the assertion that the baby monkeys Kalin is isolating aren’t really isolated because someone comes by to feed them and clean up their incubators. They claim that because Kalin’s method isn’t as extreme as some of Harlow’s methods, that they aren’t extreme at all.

But the spin doctors haven’t done their homework. In fact, baby rhesus monkeys are harmed by even brief separations from their mothers. Rhesus monkeys are normally in constant contact with their mothers early in life. Permanent separations coupled with an absence of other loving care is widely recognized to cause lasting detriment. Infant rhesus monkeys taken from their mothers and kept alone can begin to bite themselves - self-mutilate - as early as 32 days of age. [The effects of four nursery rearing strategies on infant behavioral development in rhesus macaques (Macaca mulatta). Rommeck I, Gottlieb DH, Strand SC, McCowan B. J Am Assoc Lab Anim Sci. 2009.]
The importance of maternal contact is well known:
Rhesus monkey infants spend most of their first days of life on their mothers’ nipple, and a large part of the first 2-3 months in body contact or close proximity to them. [First steps in the macaque world: do rhesus mothers encourage their infants' independent locomotion? D Maestripieri - Animal Behaviour, 1995.]
Rhesus monkey infants begin life completely dependent on their mother for survival, receiving from her all nourishment, physical warmth and other basic biological support, and psychological comfort derived from tactile contact... Infants spend virtually all of their first month of life in physical contact with or within arm’s reach of their mother, and mothers typically limit any other social contact of their infants to female members of their immediate family. During this time a strong and enduring social bond inevitably develops between mother and infant, recognized by Bowlby... to be basically homologous with the mother-infant attachment relationship universally seen in all human cultures. [Mother-infant attachment, peer relationships, and the development of social networks in rhesus monkeys SJ Suomi. Human Development. 2005.]
I am less than sanguine about responding to Kalin’s letter in a point/counter-point format. Some research suggests it isn’t an effective method and can result in a mixed-up recollection of the facts later on by some readers. [The intricacies of setting people straight. N Schwarz , LJ Sanna, I Skurnik, C Yoon. Adv Exp Soc Psych. 2007.] It does though, feel like an honest way to debate in print. I could simply paraphrase Kalin, but readers might then wonder whether what I was claiming was a fair retelling.

In any case, jumping in and doing exactly what the research cited above suggests isn't wise, this is my response to Kalin’s apology pretty much line-by-line. I suspect that most readers are more interested and informed than the average person on the street who might quickly skim a flier.

Kalin: Mental illness accounts for tremendous suffering.

Response: Tremendous suffering is associated with many different maladies and circumstances. Suffering in and of itself does not justify causing more suffering.

Kalin: Children, adolescents and adults are commonly afflicted with serious depression, bipolar disorder, anxiety, substance abuse, attentional disorders and schizophrenia.

Response: Children, adolescents, and adults are not commonly afflicted with serious depression, bipolar disorder, anxiety, substance abuse, attentional disorders, and schizophrenia.

Anxiety is a normal emotion experienced by normal people. Children, adolescents, and adults are occasionally afflicted by severe anxiety disorders, serious depression, bipolar disorder, substance abuse, attentional disorders, and schizophrenia.

Kalin: In addition to creating immeasurable suffering and dysfunction, the worst outcome, suicide, is increasing and is among the leading causes of death in adolescents.

Response: Immeasurable suffering implies that statistics are unavailable to judge the incidence and impact of one disease compared to another. This is not correct.

U.S. government agencies have been collecting mortality data, cause of death by age, age group, and cause for well over a century. Among all age groups, suicide is not a leading cause of death. According to the U.S. Census Bureau, Statistical Abstract of the United States: 2012, for all age groups, the ten leading causes of death, in order of magnitude, are:

Diseases of heart
Malignant neoplasms
Cerebrovascular diseases
Chronic lower respiratory diseases
Accidents (unintentional injuries)
Alzheimer’s disease
Diabetes mellitu
Influenza and pneumonia
Nephritis, nephrotic syndrome and nephrosis
Septicemia

In children age 5 to 14 years, the ten leading causes of death, in order of magnitude are:

Accidents
Malignant neoplasms
Assault (homicide)
Congenital malformations, deformations and chromosomal abnormalities Diseases of heart
Intentional self-harm (suicide)
Chronic lower respiratory diseases
In situ neoplasms, benign neoplasms and neoplasms of uncertain or unknown behavior
Cerebrovascular diseases
Septicemia

And in teens and young adults (15 to 24 years of age) the leading causes are:

Accidents (unintentional injuries)
Assault (homicide)
Intentional self-harm (suicide)
Malignant neoplasms
Diseases of heart
Congenital malformations, deformations and chromosomal abnormalities
Cerebrovascular diseases
Human immunodeficiency virus (HIV) disease
Influenza and pneumonia
Pregnancy, childbirth and the puerperium
Diabetes mellitus
Septicemia

Subjectively, many forms of suffering are immeasurable, but others are not. Doctors commonly ask patients to rate their suffering on a scale.


In support of Kalin’s claim that suicide among adolescents is increasing, he sites two sources:
http://www.cdc.gov/violenceprevention/suicide/statistics/index.html
http://www.cdc.gov/nchs/data/databriefs/db37.pdf

This graph comes from one of the many data sets included in his first citation:

According to the graph, suicide among adolescents has increased slightly since 2007, but only slightly. Suicide is a leading cause of death in adolescents, but is responsible for only 11% of the deaths. Accidents account for 48% of all deaths in adolescents, and automobile accidents account for the majority of those according to data referenced by Kalin in the second citation, where this graph is found:

But these statistics must be considered in context, this graph suggests that the age group in question has a very low death rate to begin with:


These data sets suggest that the problem Kalin claims to be trying to address is not particularly serious when considered against the total number of deaths and causes of death.

If a malady’s rank among the causes of death is being used to justify the methods one uses to combat it, and justifies one’s decision to work to reduce it’s effect on society, then Dr. Kalin ought to be spending his time combating heart disease – the number one killer in the U.S. If he feels a particular compunction to aid children, then he would save many more lives by reducing the incidence of automobile accidents, which is related to drunk driving, particularly in Wisconsin, and advocating for better enforcement of the seat belt laws.

Kalin: While some of our current treatments are effective, many patients do not get better and face life-long suffering.

Response: According to the National Alliance on Mental Illness, the realty is not nearly so bleak:
The best treatments for serious mental illnesses today are highly effective; between 70 and 90 percent of individuals have significant reduction of symptoms and improved quality of life with a combination of pharmacological and psychosocial treatments and supports.

With appropriate effective medication and a wide range of services tailored to their needs, most people who live with serious mental illnesses can significantly reduce the impact of their illness and find a satisfying measure of achievement and independence. A key concept is to develop expertise in developing strategies to manage the illness process.

Early identification and treatment is of vital importance; By ensuring access to the treatment and recovery supports that are proven effective, recovery is accelerated and the further harm related to the course of illness is minimized.

Kalin: We are a long way from curing these complex diseases.

Response: The problems Kalin uses to justify his use of maternal deprivation and repeated use of frightening experiences have complex causes, which he admits in his approved protocol.

Kalin is attempting to medicalize a suite of social problems. He envisions a pill to treat adolescents who have lived through physical abuse, sexual abuse, chronic neglect, inadequate nutrition, exposure to violence, and various other insults in proportions and at times during development that combine to create highly complex etiologies and symptoms.

Active intervention by caring authorities in the lives of children in living situations involving these insults is the best way to help.

Kalin: It is necessary to understand the root cause of psychiatric illnesses in order to develop treatments that will be more effective and allow millions of people to live without disabling psychiatric problems.

Response: In fact, the neurobiological details of action of psychiatric drugs are poorly understood and remain largely speculative due to our limited understanding of the neurobiology of consciousness.

What is very well known is that victimized children need love and need to feel protected and safe. The root causes of mental illnesses associated with abuse and neglect are well known: abuse and neglect. Longitudinal studies of chronically neglected children indicate that loving supportive environments are the most beneficial means of achieving recovery. See The Bucharest Early Intervention Project.

Kalin: As a practicing clinical psychiatrist and the chair of the department of psychiatry I observe, on a daily basis, the devastation that these illnesses bring to afflicted patients and their families. I am driven, and have dedicated my life's work, to eliminating the suffering of these patients. In my opinion it would be immoral to not engage in research that has the real potential to improve the lives of our patients and their families.

Response: Potentials must be weighed. Looking for obscure experimentally induced chemical variations in abused and neglected baby monkeys’ brains is much less likely to have as great an impact on the lives of abused and neglected human children as direct family interventions. It is immoral to ignore known ways to help children grow up healthy and to spend limited tax dollars on speculative and cruel methods when other more straightforward ways of helping are available and effective.

Kalin: Because these disorders involve complicated interacting alterations in emotion, motivation, behavior, and thinking, they cannot be performed in test tubes.

Response: Emotion, motivation, and thinking are subjectively measured in animals, while human subjects can report firsthand experiences. Direct intervention in abusive/neglectful situations is the moral course of action.

Kalin: The studies must be performed in more complex living animals.

Response: These studies are cruel and a gross waste of limited taxpayer resources.

Kalin: While we are performing studies in children and adults with psychiatric disorders, human studies cannot examine the basic brain mechanisms that cause the problem.

Response: Brain mechanisms do not cause the problem; disrupted mechanisms are a symptom of abuse and neglect. Additionally, basic brain mechanisms can be studied in humans. See for instance: Abnormal brain connectivity in children after early severe socioemotional deprivation: a diffusion tensor imaging study. Eluvathingal TJ, et al. Pediatrics. 2006.

Kalin: The value of human studies is that they allow us to gauge the effects of illness and treatments on the brain and body. Without a clear understanding of the cause, the most effective treatments cannot be developed.

Response: This particular claim rewrites history. Thorazine, the first widely-used antipsychotic, was synthesized in 1950, before any “clear understanding of the cause” of psychotic behavior was postulated. In fact, the causes of mental illness remain somewhat controversial and speculative.

Kalin: While some medical research studies can be performed in rodents, many studies in rodents have been shown to not be directly applicable to humans.

Response: It is unethical to believe that studies in rodents have been shown to not be directly applicable to humans and remain silent on the issue while researchers in the UW Department of Psychiatry, the department Kalin chairs, report regularly on their experiments on mice and rats.

Kalin: The primate brain, unlike the rodent brain, has a fully developed prefrontal cortex, which is one of the critical sites malfunctioning in psychiatric illness. Using primate models allows us to be certain that the knowledge we acquire is directly relevant to understanding the causes of human suffering. This knowledge provides the best chance to identify new and more effective ways to treat psychiatric disorders.

Response: Kalin means to say that the rhesus monkey prefrontal cortex is more similar to the human prefrontal cortex than the rat prefrontal cortex. The term “fully developed” is fraught with misunderstanding about the nature of evolution and projects an unwarranted claim about the human brain. Rodents are the most commonly used non-human species in psychiatric research.

More importantly, animal models of human biology are notoriously poor. The dismal success of translating data derived from experiments on animals into treatments for human maladies has been the subject of many reports and critiques. The idea that knowledge gained from experiments on monkeys is certain to be directly relevant to understanding the causes of human suffering is controversial at best, and is an outrageous dismissal of a body of analysis that demonstrates the exact opposite likelihood.

See for instance:

Translation of research evidence from animals to humans. Hackam DG, Redelmeier DA. JAMA. 2006.
Translating animal research into clinical benefit. Hackam DG. BMJ. 2007.
Comparison of treatment effects between animal experiments and clinical trials: systematic review. Perel P, et. al. BMJ. 2007.
Where is the evidence that animal research benefits humans? Pound P, et.al. Reviewing Animal Trials Systematically (RATS) Group. BMJ. 2004.

Kalin: This is particularly important in relation to mental illness that involves complex interactions between emotional and social behavior.

Response: The baby monkeys being used in Kalin’s protocol will have no normal social experiences. The meaning of the complex emotional results will be speculative and subjective.

Kalin: This knowledge provides the best chance to identify new and more effective ways to treat psychiatric disorders.

Response: In cases of severe neglect and abuse in early childhood, it is unlikely that drugs will “cure” people suffering from the consequences. The best course is early intervention and placement of children in warm, loving, safe homes.

Kalin: It is now widely accepted that early stressful environments that include parental stress, physical, sexual and emotional abuse, neglect and inadequate parenting are the most relevant risk factors for the later development of psychiatric illness.

Response: The distressful environments children can experience are highly variable. It is unlikely that wide-ranging insults experienced in wide-ranging circumstances will have a simple common result remedied by a pharmaceutical intervention. But this appears to be Kalin’s fundamental claim.

Kalin: Unfortunately, this type of adversity during childhood is endemic in our society.

Response: Endemic is a word with multiple meanings. It can refer to native species and naturally occurring phenomena. It is true that child abuse is endemic in this sense of the word in American and other societies. In medical terminology, endemic is usually means that something occurs frequently and at a predictable rate. Given the rest of Kalin’s letter, this must be his use of the word here.

In support of his assertion, Kalin provides a link to a page on the U.S. Children’s Bureau website: http://www.acf.hhs.gov/programs/cb/stats_research/index.htm#can. Included there is a report to Congress titled Child Maltreatment 2010.

According to Child Maltreatment 2010, maltreatment of children varies by the age of the child – the youngest children accounted for the largest percentage of victims, and by the type of maltreatment – with neglect being the overwhelmingly largest category. Overall, the incidence of maltreatment was 9.2 per 1000 children. Not all of these children will suffer mental illness as a result.

Moreover, the more extreme forms of abuse that Kalin cites – physical, sexual and emotional abuse – are relatively rare. Combined, these three forms of abuse account for less than 20% of the 9.2 cases of abuse per 1000 children.

Kalin: These early adverse circumstances can change the trajectory of a developing brain such that it becomes wired in a way that leads less fortunate individuals down a path of anxiety, depression and other forms of psychopathology.

Response: It is likely that the frequency, severity, and circumstances surrounding each of the abuses enumerated by Kalin will have variable effects on a child depending on a complex array of non-uniform factors such as nutrition, genetics, family structure, economics, culture, the timing and quality of interventions, and a host of other highly variable factors. Looking for differences in the brains of abused and less abused baby monkeys is unlikely to shed much light on the variety of potential neurochemical responses child victims will have from some or all of the potential types of maltreatment they may endure.

Kalin: Discovering new interventions aimed at preventing the long term consequences of early adversity in children is critical and requires a basic understanding of the influences of suboptimal rearing on the primate brain.

Response: Kalin seems to imagine a magic pill that will cure the effects of a litany of possible abuses. But actual work with neglected and abused children demonstrates clearly that no understanding of brain biology is necessary to help these children. Children need love and hugs. What is needed are sensitive, nurturing caregivers and a safe environment, not experimental drugs.

Kalin: Recent advances in neuroscience and molecular neurobiology allow us, for the first time, to identify promising new molecular pathways that have the potential to counter the effects of early adversity on childhood development.

Response: Kalin seems to imagine a vaccination of sorts. If we vaccinate children at birth, maybe we won’t have to be concerned about children being abused because they won’t suffer any lasting consequences.

Kalin: Let me be clear, the welfare of the animals we use in our research is of utmost importance to me and my entire staff. We go to great lengths to ensure that we minimize any pain and discomfort experienced by our research subjects, and follow government-mandated guidelines to the letter of the law.

Response: These claims belong in the Theater of the Absurd. Throughout Kalin’s long career he has been publishing papers explaining the ways he harms animals. His papers have detailed the many ways he has caused distress and fear; his methods have included the use of acid and electrocautery to burn away parts of young monkeys’ brains.

Male rhesus monkeys, the same kind of monkeys Kalin is using in the experiments he defends here, have a high rate of mental illness when they are individually confined to cages, as they are in labs throughout the U.S. and around the world. But Kalin has never sought to find a way to alleviate this widespread suffering. Instead, he claims he needs to artificially induce mental illness in more monkeys. His claim of concern for animals is hollow and readily disproved by his extensive publishing history.

Kalin: My decision to use animal models to understand human psychiatric disorders is not made lightly, as the extent of human suffering is so great, I believe the use of animals in this research is not only warranted but morally imperative.

Response: It is morally imperative to try to help those who are suffering. But this imperative is not license to hurt others in the process of trying to do so.

Not once in Kalin’s defense of his maternal deprivation and fear-inducing terminal experiments does he try to explain why it would be moral to harm and kill animals he believes experience fear and anxiety much like our own. His long history of harming and killing is testimony to his intransigence. When he began publishing the details of his cruel experiments on monkeys in 1983, the profound similarity of human and nonhuman primate cognition and emotion was less well known. The idea that other primates have cultures, a sense of self, use tools, can add and learn the meaning of abstract symbols, can reason, and are like us is so many other ways – that idea was dismissed as preposterous.

It is worth noting that Ned Kalin's experiments on monkeys have been continuously supported by the National Institutes of Health since 1990. His grant, R01MH046729, DEVELOPMENT AND REGULATION OF EMOTION IN PRIMATES, has cost taxpayers over $5 million since 2000, without yielding discernible benefit to human patients.

For much more detail on his new project and a brief history of maternal deprivation experiments on monkeys at the University of Wisconsin, Madison, visit UW Not In Our Name.

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