Friday, March 8, 2013

Cannabis, IQ and socio-economic status in the Dunedin data - an update

I’ll start with a short recap: Researchers published article august 2012 arguing that adolescent-onset cannabis smoking harms adolescent brains and causes IQ to decline. I responded with an article available here arguing that their methods were insufficient to establish a causal link, and that non-cognitive traits (ambition, self-control, personality, interests etc) would influence risks of adolescent-onset cannabis use while also potentially altering IQs by influencing your education, occupation, choice of peers etc. For various reasons, I argued that this could show up in their data as IQ-trends that differed by socioeconomic status (SES), and suggested a number of analyses that would help clarify whether their effect was biased due to confounding and selection-effects. In a reply this week (gated, I think), the researchers show that there is no systematic IQ-trend difference across three SES groups they’ve constructed. However, as I note in my reply (available here), they still fail to tell us how different the groups of cannabis users (never users, adolescent-onset users with long history of dependence etc) were on other dimensions, and they still fail to control for non-cognitive factors and early childhood experiences in any of the ways I proposed. In fact, none of the data or analyses that my article asked for have been provided, and the researchers conclude with a puzzling claim that randomized clinical trials only show “potential” effects while observational studies are needed to show “whether cannabis actually is impairing cognition in the real world and how much.” 

In light of the response, it seems I have made a very poor job of communicating my point. The researchers reduce my entire argument to a temporary effect of schooling on low-SES children, so let me try one last (?) time:

Are you strongly confident that cannabis is the only thing that systematically affects IQ after the age of 13? If so, the original research design may seem OK: Look at IQ trends for those who used a lot of cannabis and compare to IQ trends of those who used little. If nothing else systematically affects IQ, there is no need to know how similar or different these groups are in other ways. It is irrelevant, just as we don’t need to know the color of falling ball to calculate its speed.

However, if you think other things may or are likely to affect IQ after the age of 13, such as education, genes, early childhood experiences, then we need to know more about the people who used a lot and the people who used only a little cannabis or none at all. In my original article I gave several references supporting the claim that IQ-trends are affected by environment. I also noted that past research has found the heritability of IQ to increase with age. A common interpretation of this is that our genes influence our non-cognitive traits. As long as we are young, we usually have to live with our parents and attend the neighborhood school. As we age, our non-cognitive traits have an increasingly strong effect on where we end up - what environment we are in, what friends we have, what activities we participate in etc. Our genes thus influence our future environment, and the cognitive challenges from our environment influence our IQ.

In light of this, it seems (to me) reasonable to ask for information on other differences between their groups. What we know, we have to glean from other research based on the same data. Some of this was referenced in my original article, but to give two simple examples: One of the researchers once described the cannabis-dependent 21-year olds in their data as having

had a long history of anti-social behavior, going right back to when they were three years old. They were being naughty, beating up other kids in the sandpit, being disruptive, then they went to stealing milk money, then they went to beating up bigger kids in the schoolground, then they converted a car … It goes on and on and on [...] When stuff doesn’t work out right they just resort to violence.
More recently, the Dunedin data were used in research that found women with more sexual partners far more likely to become dependent on alcohol or cannabis. Women reporting 2.5 or more partners per year when 18-20 years old, were almost 10 times more likely to be dependent on alcohol or cannabis at 21. My point is that this indicates that the early-onset cannabis users who go on to dependence do differ systematically from those who start later or never use, and that these differences may be related to underlying “non-cognitive traits” that would also affect their lives, environments and thus IQ independently of their cannabis use. 

The Dunedin group apparently see such traits as irrelevant to their argument. At times, they even underplay the numbers they presented in their own article on the subject: In their response to my article, they write that “Many young cannabis users opted out of education, but that did not account for their IQ drop.” However, their original numbers indicated that education substantially affected the size of the cannabis-use effect: The differences between non-users and adolescent-onset cannabis users with long-term dependence was markedly different for people with different educational levels. This lead the authors to write that “among the subset with a high-school education or less, persistent cannabis users experienced greater decline.” As I noted in my article, the magnitude of the “effect” (IQ change of highest-exposure group minus IQ change of no-exposure group) was twice as large for those with high-school or less compared to the same effect for those with more education.
How important you think these selection issues are will of course differ with your prior beliefs about the importance of various IQ-determinants. As long as the Dunedin data remains difficult to access for other researchers, there is little I can do to examine these things myself. I suggested a number of analyses and robustness checks, but the researchers were not interested in pursuing these and reduced my argument to “school temporarily raises low-SES IQ”. 

This misinterpretation of my article’s argument is to some (a large?) extent my own fault: While my article does discuss non-cognitive traits, rising heritability of IQ, and proposes a number of analyses to cope with the complications these raise - I too often use the shorthand “SES” rather than “non-cognitive traits correlated with SES.” It would have been clearer and better if I had first discussed the importance of non-cognitive traits in general, and then introduced the hypothesis that this would show up as differing IQ-trajectories across SES groups. That would have made my alternative causal model (non-cognitive traits have increasing influence over environments as people age, and the environment you end up in influences you IQ) clearer. My bad. I tried to remedy this by running the new 500-word reply in PNAS by a number of colleagues and friends before publishing, rewriting extensively to try and make my causal model clearer while also a) explaining why I thought (wrongly, it now seems) that this would show up as differing IQ-trends for different SES groups, and b) clarifying my more general methodological points and the extent to which they still remain relevant.
While some of the cause for misinterpretation is likely due to my own communicative skills, there is also a difference in methodological attitudes at work: In empirical labor economics, researchers are very concerned with selection effects, and you need to have credible, “plausibly exogenous” variation in causal variables for your effects to be accepted as causal. In contrast, the Dunedin researchers write that randomized clinical trials only show “potential” effects while observational studies are needed to show “whether cannabis actually is impairing cognition in the real world and how much.”

To me, this sounds very odd:. We have several instances of randomized clinical trials contradicting effects identified in a large number of observational studies. Three of the most famous ones are described here (possibly gated): Hormone replacement therapy was thought to reduce female coronary heart disease risk but may actually increase it, beta-carotene seemed to reduce cancer risk in observational studies but actually increased it, and vitamin C had no effect on heart disease risk while observational studies indicated it was protective. Closer to the subject matter at hand, a 2007 meta-review of observational studies in the Lancet indicated a strong causal effect of cannabis use on schizophrenia risk. Some researchers pointed out that since increasing shares of young people had been using cannabis, this implied that the number of UK schizophrenia cases should rise strongly , but this didn’t happen and the importance of the link is now again in doubt.

What all these cases have in common is that there seemed to be convincing evidence from observational studies that there was an effect, but it turned out that the effect was largely due to subtle forms of confounding. The examples certainly do not show that, e.g., beta-carotene has a “potential” negative effect that is “actually” positive in everyday life - though that is what the argument from the Dunedin researchers seems to state. Instead, these cases show that causal inference from observational data is difficult. This is the perspective from which my argument comes. I don’t claim that the correlation observed in the Dunedin data is actually fully accounted for by non-cognitive traits. I argue that they have yet to tell us how groups defined by cannabis use patterns differ on other dimensions, and that they have yet to show us how robust their effect estimates are to “controls for causal back channels unrelated to neurotoxicity, simultaneous inclusion of multiple potential confounders, and changes to their statistical model.”