Thanks for revisiting your earlier depression stuff. A whole episode dedicated to conceptualizing depression is a wonderful idea! Really excited for you to cover some of Eiko’s amazing work. If you get more into behavior activation, I think it’s worth contrasting a behaviorist conceptualization of depression with the popular understanding of depression that is so steeped in the biomedical model. Behaviorists tend to analyze an individual’s relationship with their environment rather than just the stuff going on inside a person. It’s a more process-oriented approach to mental health where you tackle things like a client’s experiential avoidance, you look for genetic vulnerabilities to learn dysfunctional behaviors, you combine drug therapies with behavioral goals, etc. Good stuff IMO.
Speaking of which, I think you’re still kind of backing yourselves into a corner with an overly nomothetic, psychiatric way of looking at this exercise question. It’s not a matter of exercise boosting some people’s moods but not others. It’s how exercise, like any other behavior, functions for a person in a given context. If you change that function, you change how exercise affects them. Some depressed men exercise (often to injury) in order to escape unwanted feelings. The exercise feels good (& escaping unwanted feelings is negatively reinforced), but the excessive avoidance behavior functions to worsen their depression. If you help them address the avoidance behaviors, exercise will have different implications for their mental state. Other people dislike exercise, but working through the discomfort to pursue a health goal can increase their self-efficacy and alleviate their depression, even though it feels bad. So overall I just don’t think a weak main effect of exercise on BDI scores is telling as much as you do.
I went back to look at the Twenge paper for other reasons & found this:
> (Note: we are not arguing that social media is as dangerous as binge drinking or drug use for a single user at a single time. We are just pointing out that in this dataset, knowing the number of hours that a girl uses social media each week gives you about as much ability to predict her level of mental health problems as does knowing how often she binge drinks or uses certain drugs.)
Hello and sorry to harp on the two topics that seem to have brought you the most grief, but I have follow-up comments about literacy and depression:
1) Re: literacy, I have some professional experience with the "reading wars", and I think it's both true that phonics is the best we have in a lot of cases AND that the evidence still may not be particularly statistically robust. I would actually compare the state of literacy instruction to other topics covered in your show recently, including therapy and exercise: one of the primary benefits of phonics-based instruction is not that it works perfectly, but that we can measure whether it works at all. With a structured phonics program, you can in a 1:1 session clearly isolate and identify specific problems in kids' reading habits (e.g., whether a child is struggling because they are confusing one letter for another, simply doesn't know a letter because they were absent that day, should be screened for an issue like dyslexia, etc.). Teaching phonics will not automatically make kids love and understand books, or comprehend themes and metaphors, or solve any of the other problems associated with reading and comprehension. But it's absolutely crucial for moving reading science out of the dark ages where nothing is measurable and problems are therefore unfixable. Maybe kids with great parents, without dyslexia, and with great teachers don't need a highly structured phonics program; unfortunately, most kids don't have a truly great teacher, in the same way that many people don't have brilliant therapists, so standardized protocols like phonics and CBT at least mitigate the harms of the worst case scenario, which is people spending loads of time and money putting their trust in professionals that have absolutely no idea what they are doing and have no way of being held accountable. I have come across parents who were told by the school system that their children were permanently illiterate and unteachable; only after spending a small fortune on specialists, these families discovered that their children were just a little dyslexic and needed some extra evidence-based literacy tutoring, which should have been provided free by the school as part of their child's right to education.
That being said, the data for phonics being effective is--like most education data--a mess. I once tried to do a research review on the effectiveness of a particular phonics program. In my follow-up interviews with research participants, I could not find a single school site or instructor who had actually used the program as designed! Therefore, all the data about the program's effectiveness was deeply flawed. Now I've learned the hard way what many teachers know: never trust data on the effectiveness of particular education methods unless I have observed the implementation with my own eyes. I wouldn't call phonics the "gold standard" (just as I wouldn't call CBT the gold standard) but rather a "pre-requisite" to evidence-based teaching. It's the first step, not a goal, and I'm sorry people gave you a hard time about that.
2) Re: depression: Perhaps you could do an entire (paid) episode on suicide and the various issues with the related data. I disagree with the common practice of using suicide as a proxy for mental illness. If that is so, how is it that women seem to suffer higher rates of anxiety and depression and yet men commit the vast majority of suicides? Why are so many of the risk factors for suicide as recorded by the CDC not related to individual disease at all (https://www.cdc.gov/suicide/factors/index.html#factors-contribute)? If decreasing access to the logistical means of suicide (like poison and guns) is so effective, then how can the suicide rate be a measure of individual disease pathology?
I would even be skeptical about using the murder rate to measure the incidence of crime. The criminal justice system seems designed to document violent crimes perpetrated by men (i.e., typically crimes of aggression committed with conventional weapons). Recently I have been listening to the podcast "Nobody Should Believe Me" by Andrea Dunlop, which looks at the some of the emerging data around murders and violent crimes committed by women through the medical system. Because medical abuse is the most lethal form of child abuse, and is almost never documented and prosecuted, Dunlop's investigations have revealed a potentially significant data gap in crime data. Perhaps you could do a future episode on the issues with determining "cause of death" and how that data ends up impacting so many fields, from epidemiology to nutrition to forensics.
Thanks for revisiting your earlier depression stuff. A whole episode dedicated to conceptualizing depression is a wonderful idea! Really excited for you to cover some of Eiko’s amazing work. If you get more into behavior activation, I think it’s worth contrasting a behaviorist conceptualization of depression with the popular understanding of depression that is so steeped in the biomedical model. Behaviorists tend to analyze an individual’s relationship with their environment rather than just the stuff going on inside a person. It’s a more process-oriented approach to mental health where you tackle things like a client’s experiential avoidance, you look for genetic vulnerabilities to learn dysfunctional behaviors, you combine drug therapies with behavioral goals, etc. Good stuff IMO.
Speaking of which, I think you’re still kind of backing yourselves into a corner with an overly nomothetic, psychiatric way of looking at this exercise question. It’s not a matter of exercise boosting some people’s moods but not others. It’s how exercise, like any other behavior, functions for a person in a given context. If you change that function, you change how exercise affects them. Some depressed men exercise (often to injury) in order to escape unwanted feelings. The exercise feels good (& escaping unwanted feelings is negatively reinforced), but the excessive avoidance behavior functions to worsen their depression. If you help them address the avoidance behaviors, exercise will have different implications for their mental state. Other people dislike exercise, but working through the discomfort to pursue a health goal can increase their self-efficacy and alleviate their depression, even though it feels bad. So overall I just don’t think a weak main effect of exercise on BDI scores is telling as much as you do.
I think the heroin vs phones comparison in ep 25 may be based on a statistical misunderstanding... see my comment at
https://www.thestudiesshowpod.com/p/episode-25-is-it-the-phones/comment/48726723
I went back to look at the Twenge paper for other reasons & found this:
> (Note: we are not arguing that social media is as dangerous as binge drinking or drug use for a single user at a single time. We are just pointing out that in this dataset, knowing the number of hours that a girl uses social media each week gives you about as much ability to predict her level of mental health problems as does knowing how often she binge drinks or uses certain drugs.)
Hello and sorry to harp on the two topics that seem to have brought you the most grief, but I have follow-up comments about literacy and depression:
1) Re: literacy, I have some professional experience with the "reading wars", and I think it's both true that phonics is the best we have in a lot of cases AND that the evidence still may not be particularly statistically robust. I would actually compare the state of literacy instruction to other topics covered in your show recently, including therapy and exercise: one of the primary benefits of phonics-based instruction is not that it works perfectly, but that we can measure whether it works at all. With a structured phonics program, you can in a 1:1 session clearly isolate and identify specific problems in kids' reading habits (e.g., whether a child is struggling because they are confusing one letter for another, simply doesn't know a letter because they were absent that day, should be screened for an issue like dyslexia, etc.). Teaching phonics will not automatically make kids love and understand books, or comprehend themes and metaphors, or solve any of the other problems associated with reading and comprehension. But it's absolutely crucial for moving reading science out of the dark ages where nothing is measurable and problems are therefore unfixable. Maybe kids with great parents, without dyslexia, and with great teachers don't need a highly structured phonics program; unfortunately, most kids don't have a truly great teacher, in the same way that many people don't have brilliant therapists, so standardized protocols like phonics and CBT at least mitigate the harms of the worst case scenario, which is people spending loads of time and money putting their trust in professionals that have absolutely no idea what they are doing and have no way of being held accountable. I have come across parents who were told by the school system that their children were permanently illiterate and unteachable; only after spending a small fortune on specialists, these families discovered that their children were just a little dyslexic and needed some extra evidence-based literacy tutoring, which should have been provided free by the school as part of their child's right to education.
That being said, the data for phonics being effective is--like most education data--a mess. I once tried to do a research review on the effectiveness of a particular phonics program. In my follow-up interviews with research participants, I could not find a single school site or instructor who had actually used the program as designed! Therefore, all the data about the program's effectiveness was deeply flawed. Now I've learned the hard way what many teachers know: never trust data on the effectiveness of particular education methods unless I have observed the implementation with my own eyes. I wouldn't call phonics the "gold standard" (just as I wouldn't call CBT the gold standard) but rather a "pre-requisite" to evidence-based teaching. It's the first step, not a goal, and I'm sorry people gave you a hard time about that.
2) Re: depression: Perhaps you could do an entire (paid) episode on suicide and the various issues with the related data. I disagree with the common practice of using suicide as a proxy for mental illness. If that is so, how is it that women seem to suffer higher rates of anxiety and depression and yet men commit the vast majority of suicides? Why are so many of the risk factors for suicide as recorded by the CDC not related to individual disease at all (https://www.cdc.gov/suicide/factors/index.html#factors-contribute)? If decreasing access to the logistical means of suicide (like poison and guns) is so effective, then how can the suicide rate be a measure of individual disease pathology?
I would even be skeptical about using the murder rate to measure the incidence of crime. The criminal justice system seems designed to document violent crimes perpetrated by men (i.e., typically crimes of aggression committed with conventional weapons). Recently I have been listening to the podcast "Nobody Should Believe Me" by Andrea Dunlop, which looks at the some of the emerging data around murders and violent crimes committed by women through the medical system. Because medical abuse is the most lethal form of child abuse, and is almost never documented and prosecuted, Dunlop's investigations have revealed a potentially significant data gap in crime data. Perhaps you could do a future episode on the issues with determining "cause of death" and how that data ends up impacting so many fields, from epidemiology to nutrition to forensics.