I respect physicians and yes, even most surgeons. They do great work and are the primary caregivers for most of the population seeking treatment for common mental health concerns like depression and anxiety. But sometimes they don’t know what they’re talking about. It concerns me because so many people see doctors as authoritative — no matter what their specialty. Many people’s ears perk up when a doctor speaks.
On Thursday, David Volpi, M.D. decided to share with Huffington Post readers the results of a bunch of survey data — released back in March — about the use of technology and mental health symptoms.
But unlike the researchers, Dr. Volpi doesn’t carefully distinguish between cause and effect and appears to jump to the conclusion that heavy technology use is causing these symptoms (rather than the other way around — that people who are more prone to such problems, or that have them already, simply turn to technology to use to feel more emotionally connected with others and relieve some of those symptoms).
That’s one reason that I believe docs like Dr. Volpi should stick to surgery rather than disseminating psychological research results to the public. But wait, there’s more…
I enjoy when physicians and others share their opinions and insights with ordinary folks about the medical literature, research, and more. I enjoy it a little less when they do so outside their field of expertise, or disseminate findings without any kind of context.
The Multiple Problems with This Research
Nowhere in Dr. Volpi’s 947 word essay does he mention, for instance, that the research he’s quoting is from a student’s thesis. A thesis, while potentially important work, is not the equivalent of peer-reviewed research that appears in a medical or psychology journal. Anyone can write a thesis; not everyone can get a study published.
Dr. Volpi doesn’t mention that survey research is the weakest sort of psychological research there is. Because it’s so weak, it’s generally used just for exploratory purposes — to explore a certain possible link between many variables, for instance. Survey research can only provide you data about what you’re specifically measuring — and nothing about what you failed to measure. What this means is that if you haven’t identified all the possible confounds or alternative variables that might account for the data relationship, you may be only looking at a small (and potentially inconsequential) part of the bigger picture.
He also fails to mention this survey was conducted exclusively on people from Sweden. Now, I love people from Sweden — they are some of the nicest people on Earth. However, they are not representative of people around the world, nor my home country, the United States.
But what about the study itself? Was it any good?
It certainly appeared good — detailed and extensive in its scope and data analysis. But something is off about its primary components (Study III and Study IV). We can see the problem starting right here:
Only about one quarter of the women and 41% percent of the men (in both cohorts) were categorized as reporting neither stress, sleep disturbances, nor symptoms of depression, at baseline.
Put another way, 60 percent of men and 75 percent of women in these studies — at the baseline measurement — reported either serious stress, sleep disturbances, or symptoms of depression. These are numbers that are significantly larger than we would expect to see. It’s a red flag about the researcher’s choices of measurements, or the population selected (or both).
Looking at the questionnaires administered, we find one potential answer. The researchers didn’t use existing measures to study depression, sleep and stress. They adopted existing measures into their own unique measure, and defined arbitrary cutoffs for what determined “depression.”
Here’s an example of the problem. Other researchers typically use a 20- or 21-item assessment to measure depression. ((In case you were wondering, you can probably use a measure of no less than 10 items to accurately assess depression, according to other research.)) How many items did the present research use? Just one (but divided into two items).
You can imagine such a reduction is going to increase the number of people who have “depression” in the study because it isn’t going to have very good specificity. ((The researchers even knew this was a problem going into the study, but argued by using 2 items instead of just one, it’ll help the problem; no mention was made of the fact that this would not be standard procedure in most research examining depression.))
Confirmatory Bias in Action
This is what happens when you read a news release about a study that only confirms your own beliefs and biases. This is what psychologists call, not surprisingly, confirmatory bias (or myside bias), and is a rampant problem among professionals and researchers of all stripes.
Which Dr. Volpi then nicely demonstrates in his essay, suggesting this is just one more solid data-point that we can add to this “growing and serious public health hazard:”
I tend to think that the relationship between technology and stress, sleep disorders and depression has more to do with the overuse of technology in our society, especially among young people. If you’re a parent like I am, than you know firsthand how difficult it can be to get children to turn off the computer or put down their phone and stop texting so you can, just maybe, have a real conversation.
This is a growing and serious public health hazard that should be acknowledged and addressed by both the medical community and technology industry.
Uh, okay… But no, I don’t think it needs to be either acknowledged or addressed. Because the research hasn’t demonstrated causal links between technology and these concerns the way some docs and some researchers believe it has.
This particular area of psychology research is littered with weak, correlational studies. When physicians like Dr. Volpi do a quick read and then write an essay about it on HuffPo, it only reinforces this kind of research. And makes the message all the more confusing to readers trying to figure out how much we actually know on this subject.
So Dr. Volpi, I’ll make you a deal. I won’t write about the world of ears, noses and throats (what an otolaryngology surgeon specializes in) if you keep out of the world of psychological research. Thanks!
Read the full article: Heavy Technology Use Linked to Fatigue, Stress and Depression in Young Adults.
2 comments
I should like very much to know which technology is to blame in 1967 when I was 9 and had my first major depression and suicidal thoughts? TV was Black and White and my older sister picked all the shows as we are completely different personalities I would read rather than watch what she picked. TV also went off the air at midnight back then. I was hauled off to the mayo clinic for many rounds of test, as they never talked to ME. I was not dx. They told my parents I had migraines(true) & unlcers(true) but neither were the real problem. My next depression w/ sicidal thoughts and this time I tried to act on them took place in 77 as a freashman at UW. A policeman drove me by to the dorm and at my one trip to the campus counslor I was told with a hyper smile all I had to do was change my thoughts and Voila my feelings would change. At that time we had a computer it took up an entire building of its own and my dorm was the only one w/ a monitor(in the basement-a huge thing with no pictures, just a key board and a countous run of paper-it took a minium of 20min to get a reply)
My question; Is there really more mental illness or is it simply better(not always accurate) dx? Are we less willing to just accept that there are illnesses and wanting to point the finger of blame at something–anything rather than accept that there is suffering in the world.
THANK. YOU.
finally someone has the audacity to challenge these “hard facts” put before us. i work with hundreds of people with depression, anxiety, bipolarity, etc. it is NOT caused by the use of technology. this is the entire “which came first, the chicken or the egg” argument all over again. from what Ive seen, depressed people tend to use technology more than neurotypical people. why? because when you are down, pessimistic and loathing of everything, you want to watch funny things. read happy stories. listen to idiots laughing and playing games. or maybe you want to know that there are others out there like you, that you are not entirely alone in your pain. you want a sad song, or people telling you it will be okay. more often than not, the internet is more a safe haven that a tormentor, providing depressed/anxious people with a place to hide from the true horrors of the world. and i also agree with the comment by Anne, when she states that technology has not been around for all of the time that people have been depressed and/or suicidal. i remember being diagnosed with depression after people had told me that everything would be better if i didn’t exist. a human said this, to my face. not a computer. my parents told me i was just another problem, and that i was only making things worse. my best friend started self harming at age 9, when she and her mother fled from her abusive father. depression is not caused by technology, it is soothed by it. the original article reminds my of a crack article done by the comedy website LosBanosDaily, which states “A recent study has shown that people with medical insurance are ten times more likely to discover some kind of ailment or illness when they visit the doctor, opposed to those without.”
Again, thank you for writing this. this is perfection.