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A third of Americans now show signs of clinical anxiety or depression

washingtonpost.com

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Re: A third of Americans now show signs of clinical anxiety or depression

#431

Post by tjs8rj »

sometw wrote: post #185
sdwa wrote: post #173

Earlier quoted context omitted.

I agree about the toxicity of social media, it's why I don't have an Instagram and, well, Facebook is dead among my generation anyway so it's not an issue. >Attractive, fit, intelligent men get a completely outsized proportion of the interest on apps like Bumble and Tinder, while even median men are mostly ignored. Is this a real problem though? I've heard about how women rate most men as below average, yada yada, bu…

You're missing a few pieces that contribute to the decay of society: - No they don't build harems, but they are more likely to wait before settling down with a long term partner. Also, perhaps it's the circles I've run in, but monogomy is far less dominant than it was in the past, and serial dating is far more common, especially when you start looking at some folks interpretations of 'empowerment'. I'm using airquote…

Definitely agree with this.

I have a roommate that serial dates and she's gradually gone from "im getting over my breakup" after dating a man for 3 years to "ug can we just get rid of men" and telling my girlfriend to dump me when I'm standing in the room. She's gotten very bitter, and self-destructive to her original intention (finding a soulmate) breaking things off with new guys when they don't pick her up random things or run odd errands.

While this is just one example of the few I've seen, and of course this is just my experience, but I would hypothesize that serial dating combined with a culture of "empowerment" + unlimited options is detrimental.

Re: A third of Americans now show signs of clinical anxiety or depression

#432

Post by tjs8rj »

pengaru wrote: post #166
Exmoor wrote: post #3

>“What’s worrying is the effect this situation is clearly having on young adults.” I wonder if this is a perverse side effect of normalcy bias [0]? For me, a person in middle age, I can look back at my life and see a lifetime of fairly stable history with only a few traumatic events (9/11, 2008 crash). If you're 22, the current circumstances make up a much larger portion of your life. >The toll has also hit the poor…

> This seems completely, and sadly, reasonable. You probably couldn't design a situation in a lab that would screw over the poor more than COVID-19. I'm in a very low-income rural community. With most the folks living off food stamps already, their lives were relatively unaffected by COVID-19, it's not like they were working much anyways. If you wanted to maximally screw over the poor, you'd first get them all sittin…

As someone also from a low-income rural community, I'd say that entire scenario you presented has problems deeper than removal of social systems. If you were to rank worlds from best to worst, I'd say it looks like this: 1. The poor are net positive on the tax/social system. 2. The poor are neutral on the tax/social system. 3. The poor are negative but not dependent on the tax/social system. 4. The poor are negative and dependent on the tax/social system. 5. The poor are negative and have no social system.

In your scenario, the poor start at 4. In your view, the current admin trying to move towards 5. In your view, how does one get to 3? I imagine the move to 3 would require scaling back the social system as to prevent abuse and dependency on it.

We probably agree that the poor shouldn't remain a negative impact on the tax payer and dependent on the social system (I'm a conservative, you seem to lean more left of center on this). Where we likely disagree is how to get to 3, and I think scaling back social systems is some cold water in the face to help catalyze that change.

Re: A third of Americans now show signs of clinical anxiety or depression

#434

Post by anbende »

skissane wrote: post #397
anbende wrote: post #358

Earlier quoted context omitted.

I'm a PhD in clinical psychology, currently working with clients, whose research has focused on the psychometric evaluation of questionnaire measures. I have no idea what you're talking about. The diagnostic criteria are not "very broad because they are necessary as tools". The diagnostic criteria are meant to be sufficient criteria for diagnosing a disorder. Questionnaire-based measures act as a scientifically valid…

> Over-diagnosis is only an issue in cases where prevalence is below the false positive rate (technical term is "sensitivity") of the test. That is not the case here. The term "overdiagnosis" is actually ambiguous. As [1] points out, the word is used in two different ways: (a) to argue that the diagnostic criteria (such as in the DSM-5) are overly broad, and are labelling people as having a "disorder" who shouldn't b…

This is a fair point. I read the op's comment as using the former definition. The latter definition wouldn't really apply as this is being determined by standardized testing. Unless one thinks that the standardized tests are overly liberal (their criteria are based on correlations with in-person diagnoses, so it's possible).

Re: A third of Americans now show signs of clinical anxiety or depression

#435

Post by anbende »

imgabe wrote: post #372
anbende wrote: post #358

Earlier quoted context omitted.

I'm a PhD in clinical psychology, currently working with clients, whose research has focused on the psychometric evaluation of questionnaire measures. I have no idea what you're talking about. The diagnostic criteria are not "very broad because they are necessary as tools". The diagnostic criteria are meant to be sufficient criteria for diagnosing a disorder. Questionnaire-based measures act as a scientifically valid…

Is feeling anxious in a potentially dangerous situation or depressed in a depressing situation really a disorder that needs to be treated? It seems like a normal response and what needs to change is the situation, not people's reaction to it.

Anxiety and sadness can both be adaptive, yes. How we cope with those emotions can also be adaptive or maladaptive.

Both anxiety and depression, even in circumstances where they are reasonable responses, can benefit from supportive counseling, acceptance, self-compassion, etc. It's important to note that a therapist can "treat a problem" and "support and facilitate". In the second sense, all suffering can be "treated", even if it is not considered pathological.

Re: A third of Americans now show signs of clinical anxiety or depression

#436

Post by anbende »

Jon_Lowtek wrote: post #403
anbende wrote: post #358

Earlier quoted context omitted.

I'm a PhD in clinical psychology, currently working with clients, whose research has focused on the psychometric evaluation of questionnaire measures. I have no idea what you're talking about. The diagnostic criteria are not "very broad because they are necessary as tools". The diagnostic criteria are meant to be sufficient criteria for diagnosing a disorder. Questionnaire-based measures act as a scientifically valid…

20% false positives is not "just fine". That is a huge error.

These are screening tools. They are not meant to make definitive diagnoses for the most part. They are used for epidemiology and flagging clients for further assessment.

There's always a balance to be made between sensitivity (picking up on real positives) and specificity (not producing false positives). The balance for these instruments is at about 80-85%. If a person is depressed, there's an 80-85% chance they will be correctly classified. If a person is not depressed, there is an 80-85% chance they will be correct classified.

Raise the threshold and you'll be more specific but less sensitive. Lower the threshold and you'll be less specific but more sensitive. It's just how the game works and why questionnaires are only first-pass tools.

Re: A third of Americans now show signs of clinical anxiety or depression

#437

Post by anbende »

rhema wrote: post #418
anbende wrote: post #358

Earlier quoted context omitted.

I'm a PhD in clinical psychology, currently working with clients, whose research has focused on the psychometric evaluation of questionnaire measures. I have no idea what you're talking about. The diagnostic criteria are not "very broad because they are necessary as tools". The diagnostic criteria are meant to be sufficient criteria for diagnosing a disorder. Questionnaire-based measures act as a scientifically valid…

>"very broad because they are necessary as tools" >"diagnostic criteria are meant to be sufficient criteria for diagnosing a disorder" Aren't these equivalent ideas? I don't think the parent comment was meant to be critical so much as it was to make an assessment. An overall rate of 80% accurate for a questionnaire instrument seems like a fine tool.

I read the comment as implying that they were overly broad and so should not be applied to the larger population outside of a professionals supervision.

My counter-argument was that they were properly narrow and could indeed be applied to the general population, though this would not provide definitive diagnoses only prevalence information.

I read the OP as saying that these statistics were not representative of the actual underlying mental health phenomena. I believe and asserted that they are.

Re: A third of Americans now show signs of clinical anxiety or depression

#438

Post by ryanwaggoner »

thelean12 wrote: post #355
ryanwaggoner wrote: post #235

Earlier quoted context omitted.

What a perfect encapsulation of the individualism that drives the special American breed of blame-the-victim mentality. It allows society to erode the well-being of huge swaths of the population while simultaneously making them feel ashamed of their inability to triumph over the ruthless machine grinding them into the dirt. Yes, we need personal responsibility, but maybe we could also stop making it harder for people…

While the person you're responding to has a horrible tone, I've sort of grown to agree with the general sentiment. Most of the problems I've seen people face can be solved on their own, or could have been prevented on their own. Pandemic made you lose your job? Absolutely not your fault. Massive injury or illness wipe out your savings and leave you in debt? Absolutely not your fault. These are things we can and shoul…

But it's really hard for me to feel bad about people who end up with a massive amount of school loans. There are plenty of state school options available. Work moderately hard in high school and you'll get a massive discount on college, too. Would it be great if it were free? Absolutely. But it isn't. And that shouldn't be an excuse for ending up with a massive loan afterwards.

I hear you, and you're absolutely right. So many people with massive student loans would be better off had they made better decisions. But why didn't they? Why has student loan debt massively exploded to $1.6 trillion? To me it seems obvious that there are systemic incentives and disincentives at play that are actively making it more difficult for people to make good decisions in these areas, not a sudden rash of people being born or raised with inferior character or intellect to the generations that came before.

Re: A third of Americans now show signs of clinical anxiety or depression

#439

Post by anbende »

cshimmin wrote: post #414
anbende wrote: post #358

Earlier quoted context omitted.

I'm a PhD in clinical psychology, currently working with clients, whose research has focused on the psychometric evaluation of questionnaire measures. I have no idea what you're talking about. The diagnostic criteria are not "very broad because they are necessary as tools". The diagnostic criteria are meant to be sufficient criteria for diagnosing a disorder. Questionnaire-based measures act as a scientifically valid…

Hold on, do I understand correctly your comment about the 20% false positive rate? So even if exactly ZERO Americans were experiencing depression, a random sampling would indicate 20% of Americans are showing signs of depression? And if it's 20% for both tests, that would would correspond to a 36% false positive rate for at least one condition [0]. So the headline that a third of Americans are showing signs of anxiet…

The situation is a little more complicated as these tests ALSO have a false negative rate. And that false negative rate is also about 20%. As well, the false positive rate is for scores at threshold, which is 3 out of 5. If they score a 4 or a 5, the false positive rate drops dramatically.

As well, this isn't an antibody test. Diagnosis is not dichotomous but dimensional. A false positive on depression inventory does not mean the person actually has zero symptoms. It means that their symptoms might actually be mild rather than moderate because of the way they interpreted one or more of the questionnaire items.

In general, the way to look at this is that of the people who took the test, 80% of those who scored at threshold would likely receive a diagnosis from a clinician.

Re: A third of Americans now show signs of clinical anxiety or depression

#440

Post by skissane »

anbende wrote: post #434
skissane wrote: post #397

Earlier quoted context omitted.

> Over-diagnosis is only an issue in cases where prevalence is below the false positive rate (technical term is "sensitivity") of the test. That is not the case here. The term "overdiagnosis" is actually ambiguous. As [1] points out, the word is used in two different ways: (a) to argue that the diagnostic criteria (such as in the DSM-5) are overly broad, and are labelling people as having a "disorder" who shouldn't b…

This is a fair point. I read the op's comment as using the former definition. The latter definition wouldn't really apply as this is being determined by standardized testing. Unless one thinks that the standardized tests are overly liberal (their criteria are based on correlations with in-person diagnoses, so it's possible).

Well, it is a legitimate question of how well the standardised tests actually fit the diagnostic criteria for various disorders. [1] argues that the fit between the commonly used standardised tests for ASD and the DSM-5 diagnostic criteria is less than ideal. (And I doubt this finding is unique to ASD, I think it likely if you repeated the authors' exercise for other diagnoses you would get similar results.)

[1] https://link.springer.com/article/10.1007%2Fs00787-020-01481...

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