Recently, I have been examining the possible role of confirmation bias in the attributions of reparative therapists.  In this post, I look at a classic study of how theoretical persuasion associates with clinical judgment.

Ellen Langer’s and Robert Abelson’s 1974 study* on clinical judgment is an important caution to clinicians about the role of preconceived ideas on diagnosis and attributions about patients. The abstract for the study is presented here:

The effect of labels on clinicians’ judgments was assessed in a 2 X 2 factorial design. Clinicians representing two different schools of thought, behavioral and analytic, viewed a single videotaped interview between a man who had recently applied for a new job and one of the authors. Half of each group was told that the interviewee was a “job applicant,” while the remaining half was told that he was a “patient.” At the end of the videotape, all clinicians were asked to complete a questionnaire evaluating the interviewee. The interviewee was described as fairly well adjusted by the behavioral therapists regardless of the label supplied. This was not the case, however, for the more traditional therapists. When the interviewee was labeled “patient,” he was described as significantly more disturbed than he was when he was labeled ”job applicant.”

In addition to ratings of pathology, the authors recorded some of the descriptions of the interview by therapists who were told the interviewee was a job applicant and those who were told he was a patient. The differences are striking. Behavior therapists did not differ much but the psychoanalytic therapists described the job applicants as well adjusted but the same interviewee, when labeled as a patient, was labeled as disturbed. Note these differences from Langer and Abelson’s discussion of their study.

In the study just described, all of the subjects saw the same videotaped interview. Yet when asked to describe the interviewee, the behavior therapists said he was “realistic”; ”unassertive”; “fairly sincere, enthusiastic, attractive appearance”; “pleasant, easy manner of speaking”; “relatively bright, but unable to assert himself”; “appeared responsible in interview.” The analytic therapists who saw a job applicant called him “attractive and conventional looking”; “candid and innovative”; “ordinary, straightforward”; ”upstanding, middle-class-citizen type, but more like a hard hat”; “probably of lower or blue-collar class origins”; “middle-class protestant ethic orientation; fairly open-— somewhat ingenious.” The analytic therapists that saw a patient described him as a “tight, defensive person . . . conflict over homosexuality”; ”dependent, passive-aggressive”; ”frightened of his own aggressive impulses”; ”fairly bright, but tries to seem brighter than he is … impulsivity shows through his rigidity”; “passive, dependent type”; “considerable hostility, repressed or channeled.”

Note the dramatic differences in descriptions. The same person who was described as well adjusted by analysts who thought they were watching a person applying for a job was described in pathological terms when they thought they were watching a patient being interviewed. Note that an attribution of homosexuality was made by at least one of the analytic therapists.

When reparative therapists say they are not biased when examining the histories of their same-sex attracted patients, I am highly skeptical.

Langer and Abelson describe the potential problem with making attributions based on patient labeling:

In practical terms, the labeling bias may have unfortunate consequences whatever the specific details of its operation. Once an individual enters a therapist’s office for consultation, he has labeled himself “patient.” From the very start of the session, the orientation of the conversation may be quite negative. The patient discusses all the negative things he said, did, thought, and felt. The therapist then discusses or thinks about what is wrong with the patient’s behavior, cognitions and feelings. The therapist’s negative expectations in turn may affect the patient’s view of his own difficulties, thereby possibly locking the interaction into a self-fulfilling gloomy prophecy.

It is not hard to see how a client presenting with “unwanted same-sex attraction” could end up in the kind of self-fulfilling prophecy described by Langer and Abelson. Since reparative therapists believe homosexuality is invariably caused by “gender wounds” early in life, no small amount of effort will be spent to find evidence of them, whether or not they exist.

*Langer, E.J.; & Abelson, R.P. (1974).A patient by any other name . . . : Clinician group difference in labeling bias.Journal of Consulting and Clinical Psychology.42(1), 4-9.

Related:

• Reparative therapy and confirmation bias: An illustration
• The evangelical blackout of research on sexual orientation
• NARTH rewards what it does
• Psychoanalyst disavows study of lesbians; questions the Bieber study
• What if NARTH was a scientific organization?
• Marketing the Bieber Study: Cornelia Wilbur’s Other Scandal
• Bieber Study Co-Author, Cornelia Wilbur, Accused of Fabricating Case of Sybil

One of the biggest problems I have with reparative therapy is the self-fulfilling nature of the approach. Reparative therapists assume that the existence of same-sex attraction means a person has suffered gender based trauma during a specific period of childhood.

Reparative therapist David Pickup has commented on another post that straight men may have wounds but, from his point of view, they are not as deep as those which haunt gay men. In other words, if a straight man says he was traumatized in the same way, the reparative therapist’s answer is that the trauma wasn’t deep enough to trigger the reparative drive leading to same-sex attraction. If the gay man says he does not recall any such trauma, then the reparative drive theory posits that the gay man has repressed it and needs to uncover it. It seems to me the powerful effects of confirmation bias are at work.

The assumptions necessary to work as a reparative therapist remind me of the assumptions often associated with the repressed memory movement. Especially during the decade of the 1990s, many therapists assumed that negative moods such as depression or relational problems were due to childhood abuse of some kind that had been forgotten via the defense mechanism of repression. Some therapists harbored a belief that clients who could not remember trauma from the past were in a state of denial. This belief  led some therapists to repeatedly ask about recollections of trauma and hold out the possibility to their clients that they were simply unable to remember.

By questioning the mechanism of repression, I am not questioning the reality of gender based trauma. I am not questioning that some gay people had very impoverished childhoods. Of course that is true. But so did many straight people. In his recent comment, Mr. Pickup proposed that gay people have experienced deeper trauma than straight people experienced. This seems circular to me. How can you tell which experiences are worse? As far as I can tell, the way reparative therapists answer this question iss by knowing the sexual orientation of the client. Straight people have deep wounds; gay people, by definition according to the reparative approach, have deeper wounds.

As an illustration of how clients can adapt themselves to the theories of their therapists, I offer the experience of Carol Diament. Ms. Diament initially thought she would not need to detach from her family, as the other clients at Genesis Associates did. However, after awhile, “memories of abuse came up” and she detached from her parents (over three years), husband and even small children (at least 8 months and maybe longer).

Eventually Carol got away from Genesis, sought another therapist and came to realize that her memories were reconstructed with the help of her therapists at Genesis. By then, the damage was done. She had lost years of her life and had even lost her immediate family.

The clip is just over nine minutes long, but I hope you will watch it all the way through. Then, I hope you will discuss this and let me know what you think. Am I seeing a parallel with reparative theory that is valid or not?

Over the years, I have worked with many clients, gay and straight, who have experience significant trauma with parents. However, I have not been able to differentiate them based on the severity of their experiences. Furthermore, I know and have worked with many gay men and women who recall no deep trauma relating to their parents or peers. I also know gay men who experienced trauma after they came out to their parents because of the tension surrounding homosexuality. However, prior to the disclosure, the relationship was on par with any comparable straight person’s home life.

I also want to be clear that I am not closed to the possibility that certain childhood experiences could influence some people to question sexuality and engage in same-sex behaviors. In addition, some experiences of abuse are associated with risky sexual behavior of all kinds. Therapy, even reparative therapy, might help such people. However, I think these scenarios represent only a portion (probably very small) of the total gay and bisexual population.

For the sake of time, I am going to react to parts of NARTH’s new statement on sexual orientation change. First, I want to say a few things about this paragraph:

Finally, it also needs to be observed that reports on the potential for sexual orientation change may be unduly pessimistic based on the confounding factor of type of intervention. Most of the recent research on homosexual sexual orientation change has focused on religiously mediated outcomes which may differ significantly from outcomes derived through professional psychological care. It is not unreasonable to anticipate that the probability of change would be greater with informed psychotherapeutic care, although definitive answers to this question await further research. NARTH remains highly interested in conducting such research, pursuant only to the acquisition of sufficient funding.

I am surprised that NARTH complains about religiously mediated change when they highlight such change on the organization website. In any event, it is good that the writer of this statement acknowledges that religious mediation is different than therapy. Now, if only they would stop offering Jones and Yarhouse as evidence that therapy works.

On the subject of research, I am highly skeptical that NARTH really wants to do the type of study that would really address questions about change related to therapy. I say this because NARTH has been in existence since 1992 and they have had ample opportunities to do research. I believe one study has been funded by NARTH (please correct me if I am wrong NARTH readers).

Regarding funding, I believe the religious conservative world could spare funds for such research if there was a willingness to do it. I recognize NARTH is not a rich organization but there are ways to do research without large sums of money. For instance, Mark Yarhouse has been prolifically doing research on sexual identity and the sexual identity framework without much funding. I have done some research on my own out of my own pocket (although far less than Yarhouse). Surely, some Christian right organizations could go together and get NARTH the funds necessary to really test their claims.

Over the past several years, I have asked various social conservative sources for funding in order to test those who say they have changed in Michael Bailey’s lab at Northwestern. We need somewhere between $60-100K to do it. Bailey has identified profiles of straights, gays and bisexuals. I think we could also identify the spousosexual profile with some creativity but neither one of us has had success in getting funds.

An intellectually more honest position would be to say that NARTH does not know for sure about change since adequately designed research has not been conducted. Until then, NARTH’s leaders who go out to religious right groups saying with confidence that change from gay to straight happens will be violating their own statement.

Apparently in response to Alan Chambers’ candor about sexual orientation change, the National Association for the Research and Therapy of Homosexuality issued a clarification of what that organization means by change.

Issued January 27, the statement reads in full:

Current discussions of homosexual sexual orientation change are unavoidably occurring within a sociopolitical climate that makes nonpartisan scientific inquiry of this subject very difficult.  In light of this reality, a few considerations are crucial for accurately understanding the sometimes contradictory opinions regarding the possibility of sexual orientation change.   First and foremost, it is important to recognize that how change is conceptualized has vast implications for our thinking about change.  Some of the more ardent proponents and opponents of homosexual sexual orientation change may view change in strictly categorical terms, where change is an all-or-nothing experience.  Proponents and opponents with this view differ only in the direction of their desired outcome.  Proponents of change understood in categorical terms may view a homosexual sexual orientation as a lifestyle choice that merely needs to be renounced. Opponents who take this viewpoint, on the other hand, may conceive of sexual orientation as essentially hard wired and simply not modifiable.  NARTH does not support either of these perspectives.

NARTH believes that much of the expressed pessimism regarding sexual orientation change is a consequence of individuals intentionally or inadvertently adopting a categorical conceptualization of change. When change is viewed in absolute terms, then any future experience of same-sex attraction (or any other challenge), however fleeting or diminished, is considered a refutation of change. Such assertions likely reflect an underlying categorical view of change, probably grounded in an essentialist view of homosexual sexual orientation that assumes same-sex attractions are the natural and immutable essence of a person.  What needs to be remembered is that the de-legitimizing of change solely on the basis of a categorical view of change is virtually unparalleled for any challenge in the psychiatric literature.  For example, applying a categorical standard for change would mean that any subsequent reappearance of depressive mood following treatment for depression should be viewed as an invalidation of significant and genuine change, no matter how infrequently depressive symptoms reoccur or how diminished in intensity they are if subsequently re-experienced.  Similar arguments could be made for any number of conditions, including grief, alcoholism, or marital distress.  The point is not to equate these conditions with homosexuality, but rather to highlight the inconsistency of applying the categorical standard only to reported changes in unwanted same-sex attractions.

Rather than pigeonholing homosexual sexual orientation change into categorical terms, NARTH believes that it is far more helpful and accurate to conceptualize such change as occurring on a continuum.  This is in fact how sexual orientation is defined in most modern research, starting with the well known Kinsey scales, even as subsequent findings pertinent to change are often described in categorical terms. NARTH affirms that some individuals who seek care for unwanted same-sex attractions do report categorical change of sexual orientation.  Moreover, NARTH acknowledges that others have reported no change. However, the experience of NARTH clinicians suggests that the majority of individuals who report unwanted same-sex attractions and pursue psychological care will be best served by conceptualizing change as occurring on a continuum, with many being able to achieve sustained shifts in the direction and intensity of their sexual attractions, fantasy, and arousal that they consider to be satisfying and meaningful. NARTH believes that a profound disservice is done to those with unwanted same-sex attractions by characterizing such shifts in sexual attractions as a denial of their authentic (and gay) personhood or a change in identity labeling alone.  Attempts to invalidate all reports of such shifts by presuming they are not grounded in actual experience insults the integrity of these individuals and posits wishful thinking on an untenably massive scale.

Finally, it also needs to be observed that reports on the potential for sexual orientation change may be unduly pessimistic based on the confounding factor of type of intervention.  Most of the recent research on homosexual sexual orientation change has focused on religiously mediated outcomes which may differ significantly from outcomes derived through professional psychological care.  It is not unreasonable to anticipate that the probability of change would be greater with informed psychotherapeutic care, although definitive answers to this question await further research.  NARTH remains highly interested in conducting such research, pursuant only to the acquisition of sufficient funding.

To summarize, then, those who are  highly pessimistic regarding change in sexual orientation appear to have assumed a categorical view of change, which is neither in keeping with how sexual orientation has been defined in the literature nor with how change is conceptualized for nearly all other psychological challenges.  NARTH believes that viewing change as occurring on a continuum is a preferable therapeutic approach and more likely to create realistic expectancies among consumers of change-oriented intervention.  With this in mind, NARTH remains committed to protecting the rights of clients with unwanted same-sex attractions to pursue change as well as the rights of clinicians to provide such psychological care.

I hope to post something on this Monday or Tuesday; but for now here is NARTH’s official word on the subject of orientation change. Discuss…

As noted Friday, President of Exodus International, Alan Chambers, spoke that evening as a part of a panel discussion at the annual conference of the Gay Christian Network.  Audio of the panel is now up at GCN (Part 1, part 2). During part 2, about 5:30 into the file, Alan Chambers is asked, I think by GCN Executive Director Justin Lee,  about the way Exodus and member ministries describe the work they do. Specifically, Lee asked about the slogan “change is possible.” Chambers responds by discussing his views of sexual orientation change, saying

The majority of people that I have met, and I would say the majority meaning 99.9% of them have not experienced a change in their orientation or have gotten to a place where they could say that they could  never be tempted or are not tempted in some way or experience some level of same-sex attraction. I think there is a gender issue there, there are some women who have challenged me and said that my orientation or my attractions have changed completely. Those have been few and far between. The vast majority of people that I know will experience some level of same-sex attraction.

There was also some discussion of change meaning a change of viewpoint and behavior but the consensus was that Chambers was giving an honest appraisal of the aspect of sexuality that involves essential attractions. As one who once defended sexual reorientation change efforts, I have to agree with Chambers’ assessment. Credible reports of change are rare and do come more often from women than men.

Now, I wonder. Will this news be reported by Christian media, or become part of the evangelical blackout?

Another researcher has issued a statement accusing a member of the National Association for the Research and Therapy of Homosexuality (NARTH) of misrepresenting research. In a statement first issued to blogger Rob Tisinai yesterday, Theodora Sirota, a professor of Nursing at Seton Hall University, said, NARTH advisory board member Rick Fitzgibbons “mis-reported and misrepresented the results of my 2009 research.” At issue is a 2009 Archives of Psychiatric Nursing article* authored by Sirota about attachment in daughters of gay or bisexual fathers. In November, Fitzgibbons used Sirota’s research in an article on  Catholic website, MercatorNet, to make the claim that “children raised by same sex couples fare less well than children raised in stable homes with a mother and a father.”

Dr. Sirota told me today by phone that her study could not be used to make a generalization about same-sex couples because the participants in her study did not grow up in same-sex homes. Instead, they grew up in what she called, “heterosexually-organized families where fathers were gay or bisexual.” In other words, the parents were in a mixed orientation marriage, where the mother was straight and the father was gay or bisexual.

In his MercatorNet article, Fitzgibbons refers to Sirota’s article in a section titled, “The children do suffer” and claims that “There are strong indications that children raised by same sex couples fare less well than children raised in stable homes with a mother and a father.” As Sirota points out, her research does not support Fitzgibbon’s claim. He compares apples and oranges.

The women surveyed by Sirota were in families with a mother and father, not same-sex couples as implied by Fitzgibbons. Fitzgibbons improperly generalizes from mixed orientation marriages to same-sex couples. Sirota pointed this out to Fitzgibbons in the comment section of his article, but he declined to retract his incorrect use of her study.

Another factor pertinent to the findings of attachment problems in women is the frequency of divorce in mixed orientation marriages found by Sirota. Parental divorce was reported more frequently by women who grew up in mixed orientation homes than by the women with two straight parents. Sirota describes these differences in her dissertation (the 2009 study was based on her PhD dissertation research conducted in 1996). On page 81, Sirota wrote,

Daughters of gay or bisexual fathers reported significantly higher rates of divorce among their parents than daughters of heterosexual fathers (x²( 3, N = 112) = 22.53 p .001).  These data are presented in Table 18.  Mean age at parents’ separation or divorce was 12.8 years for daughters of gay or bisexual fathers (n = 39) and 9.4 years for daughters of heterosexual fathers (n = 16).

Note that 57.4% of the group with gay fathers reported divorce or separation compared to only 25% of the group with straight parents. Divorce is known to be a relevant factor in attachment formation and the group with gay or bisexual fathers reported significantly more of it. One cannot say that the orientation of the men was the factor which led to the poorer attachment reported by the participants in Sirota’s study. In fact, it makes more sense, especially given the average age of the daughters when the divorce took place (12.8 vs. 9.4), to propose that divorce and related instability is more the culprit for the poorer attachment results than the sexual orientation of the fathers. In any event, without controlling for divorce, one cannot reasonably isolate the father’s sexual orientation as the sole factor relating to differences in attachment, if it is a factor at all.

Having discussed divorce as a confounding variable, the main objection of Dr. Sirota remains. Her study cannot be generalized to say anything about same-sex couples and attachment dynamics in their children. Dr. Fitzgibbons makes an improper generalization in his article and adds insult to injury by defending his treatment of the study when the misuse was pointed out.

There are other studies in the MercatorNet article which are stretched too far (e.g., Sarantakos) and I may come back to the topic in a future post.

*Sirota, T, (2009) Adult attachment style dimensions in women with gay or bisexual fathers. Archives of Psychiatric Nursing, 23, 289-297.

In other news…

Leaders of the National Association for the Research and Therapy of Homosexuality (NARTH) like to say that the group is a scientific organization. Past president and current board member, Dean Byrd, told me that NARTH would not take a position on the criminalization of homosexuality because it is a scientific organization.

However, NARTH will promote the Torah, or at least the understanding of the Torah that requires reparative therapy. On the NARTH website, a link to the Torah Declaration is provided. This statement, by what appear to be a collection of Orthodox rabbis, and mental health professionals, relates to their view of the Torah requires of a person who is attracted to the same-sex:

The only viable course of action that is consistent with the Torah is therapy and teshuvah. The therapy consists of reinforcing the natural gender-identity of the individual by helping him or her understand and repair the emotional wounds that led to its disorientation and weakening, thus enabling the resumption and completion of the individual’s emotional development. Teshuvah is a Torah-mandated, self-motivated process of turning away from any transgression or sin and returning to G-d and one’s spiritual essence. This includes refining and reintegrating the personality and allowing it to grow in a healthy and wholesome manner.

These processes are typically facilitated and coordinated with the help of a specially trained counselor or therapist working in conjunction with a qualified spiritual teacher or guide. There is no other practical, Torah-sanctioned solution for this issue.

According to this group, NARTH is doing God’s work. Even more specifically, therapy must  repair gender wounds which are assumed to cause the attractions.

The declaration takes the position that same-sex attraction can’t be anything other than what the declaration says it is because that is what the Torah says. No science is offered, no research.

As one might imagine, NARTH is represented in this group with Arthur Goldberg, and Norman Goldwasser listed as signers. MassResistance’s Brian Camenker is also a signer.

To be clear, I have no problem with the Rabbis teaching their congregations what they believe the Torah teaches. I post this because this is one more indication that NARTH is not a science group. Rather, they hold a religious view about homosexuality and bend research to promote that belief.

To reflect on 2011, I have listed here the ten most popular posts in terms of visits this year. Two of the posts were written in prior years but were visited frequently this year. In addition to being popular, I think they are representative of the stories and issues which I wrote about this year.

1. The Trail of Tears remembered

2. Uganda update: Anti-Homosexuality Bill on tomorrow’s agenda

3. Committee chair says Uganda’s Anti-Homosexuality Bill may not be considered

4. What would dominionists do with gays?

5. A major study of child abuse and homosexuality revisited (2009)

6. NARTH is not primarily composed of mental health professionals

7. Only the gay die young: Examining the claims of shorter life expectancy for homosexuals (2007)

8. The evangelical blackout of research on sexual orientation

9. William Penn founded the Quakers and other tall tales from David Barton

10. Was the Jefferson Bible an evangelism tool?

In one of the better studies of the effects of lesbians as parents of sons and daughters, researchers reported that 17-year old boys raised by lesbians were no more likely to be gay than those raised in straight homes. Gartrell, Bos and Goldberg found that 5.6% of boys raised in lesbian households reported sex with other boys whereas 6.6% of boys from a representative national survey reported ever engaging in sex with other boys. The difference was not large enough to be considered a statistically significant finding.

Reparative theorists claim that boys who are raised without a strong, salient father often become homosexual. In this study, the boys of lesbian parents had not been raised with any father figure and yet they were no more likely to report a gay identification than boys surveyed in a national sample with predominantly straight parents. If the absence of strong male role model generates same-sex attraction, the effect should show up in this sample.

I need to add that the group of lesbian parents represent a convenience sample and may not be representative of all lesbian parenting. Even so, the fact that boys raised in these homes displayed no behavioral indication of the effect predicted by reparative therapists is worth noting.

I assume these researchers will continue to follow these families and the results may shift more in line with reparative expectations. However, at present, this study is a challenge to the classic reparative theory.

Gartell, N. K., Bos, H. M. W., & Goldberg, N. G. (2011). Adolescents of the U.S. national longitudinal lesbian family study: Sexual orientation, sexual behavior, and sexual risk exposure. Archives of Sexual Behavior, 40, 1199-1209.

For more on this study, see this post. I should also make clear that this post is not intended to be a comprehensive review of this study. I am here highlighting one aspect of it. There are many findings of interest, including the results with girls which indicates  that girls are more likely to engage in same-sex sexual behavior.

Last week, I commented on what I see as an evangelical blackout of sexual orientation research by Christian media and organizations. While I stand by that viewpoint, the situation is actually worse than a blackout. The blackout is selective; some new research is reported. However, the studies reported and the way they are reported seem designed to create a slanted picture.

A case in point. Currently, on the NARTH (National Association for the Research and Therapy of Homosexuality) website, scientific advisory board member, Chris Rosik, reviews a new report from Gartrell, Bos and Goldeberg about lesbian parenting recently published in the Archives of Sexual Behavior. The headline for the review is

New Study: Daughters of Lesbian Parents More Likely to Engage in Same-Sex Behavior and Identify as Bisexual

This is definitely a new study. The blackout is not total, but as I will demonstrate, it is selective. NARTH ignores the hard science involved in the brain scan studies but finds one aspect of a small longitudinal study of lesbian parenting to report. Now that you read the headline, read what Rosik says about how the study can be used.

While this small study is valuable as a starting point for longitudinal research into same-sex parenting, professionals and policy makers should be very wary of making any meaningful conclusions from its findings.  Serious methodological limitations also argue against making sweeping generalizations.  As is the case for the vast majority of studies in this area, the sample size is quite small, constituting only 78 adolescents.  The sample of lesbian parents is self-selected and appears to be different from the general population on important demographics such as socioeconomic status and educational attainment.  Demand characteristics (i.e., external influences such as political goals that might motivate study participants to respond in a particular manner) are not considered or assessed by the study’s authors with respect to the lesbian mothers or their adolescent children.

And then…

Certainly the Gatrell, et al. (2011) study provides some intriguing though entirely non-generalizable findings that are consistent with the hypothesis that non-heterosexual experiences and identities are more common among daughters of lesbian families than those raised in heterosexual families.

First, Rosik reports, via headline, the finding that would be of concern to religious conservatives but then in the article says one cannot make such generalizations. If one cannot generalize beyond the sample, then why report the finding as if one could?

The study also found that no children were abused in lesbian homes. This finding is in contrast to heterosexual families where abuse is reported (26% of teens report physical abuse by a parent or caregiver according to national surveys). Since NARTH is commonly represented in cases against same-sex parenting, and such information is relevant to their membership, why was that fact not a part of the headline?

Another interesting finding in the study was that boys were less likely to have been sexual involved with girls in lesbian families than in straight families. Isn’t that what abstinence educators want to promote?

My point here is that NARTH leaders do keep an eye out for new research, however, their reporting of them is selective. And then when they choose to review a study, their review is selective.

I have established that NARTH is a key source of information for Christian right organizations. When some relevant studies are ignored, and others are selectively reported, it seems clear to me evangelicals are poorly served by the organizations they count on for information.