Good Science, Bad History, in the British Journal of Psychiatry

The latest February 2012 issue of the British Journal of Psychiatry features a paper about the association between child abuse and later mental health problems. I haven't read it yet, but it looks pretty good.

However, it also includes an editorial from John Read and Richard Bentall which argues that:

Just 20 years ago, however, it would have been difficult to get the paper published. Mental health professions have been slow, even resistant, to recognise the role of childhood adversities in psychiatric disorder... Until very recently the hypothesis that abuse in childhood has a causal role in psychosis was regarded by many biologically oriented psychiatrists as heresy...

Really? I checked the BJP from exactly 20 years ago. The February 1992 issue contained:

• A paper about child sexual abuse in female psychiatric patients.
• A letter praising a different article, on the same topic.
• A review of 11 studies on psychosocial family interventions as treatments for schizophrenia.
• A paper looking at the effect of the social environment on symptoms of schizophrenia.

Four strikes and they're out. It's not true that this kind of thing wasn't being discussed 20 years ago.

Such grandstanding is bad for science. Few would deny that psychiatry in recent years has undervalued psychosocial factors and overvalued genetics and neuroscience, but it's actually quite a complicated story, not a Punch and Judy show with bad guys on one side and good guys on the other.

Rhetorical flourishes like this editorial certainly get attention but in the long run, down that road lies madness.

Read, J., and Bentall, R. (2012). Negative childhood experiences and mental health: theoretical, clinical and primary prevention implications The British Journal of Psychiatry, 200 (2), 89-91 DOI: 10.1192/bjp.bp.111.096727