There are a few questions I think are interesting and would like to know the answer to. Most of these questions I haven’t really bothered researching, or I’ve tried to start but got bored actually going through the research. Some of you guys are smart, so this post is just to throw out a few questions that I want to know the answer to, or at least hear some interesting takes on. Feel free to comment if you know of some interesting research on one of these questions, if you have a view that seems like I might not have thought of it, or if you have a question on something entirely different that I might be able to answer in a future post. I may actually write about some of these in future, let me know if any of them sound interesting to explore a bit further. Anyway, here we go!
Firstly, there are no clear distinct boundaries between one psychiatric disorder and another, with big grey areas of overlap. Psychiatric diagnoses are based on a clinician's interpretation of symptoms and the same symptoms can be present in different disorders (e.g. anxiety can be part of a depressive disorder or an anxiety disorder but can also be secondary to difficulties in communication/social interaction in the context of autism). So naturally different clinicians can interpret symptoms differently and consequently come to a different conclusion about the correct diagnosis.
There could be a few reasons behind this. The kinds of environmental risk factors that make a person more likely to develop depression, for example, may also put them at risk of developing a substance misuse disorder. Some disorders, like schizophrenia and bipolar disorder probably share some underlying mechanisms - https://pubmed.ncbi.nlm.nih.gov/29049482/
Furthermore, there is substantial shared genetic vulnerabilities between mental disorders - for an example, this paper looking at variation shared between ADHD and depression https://www.nature.com/articles/s41598-021-86802-1#Sec11
6)
I think it's worth saying that psychoanalysis never had the same hold over British psychiatry as it did in the states, where many head of psychiatry departments were analysts. This changed with the reemergence of biological psychiatry and massive swing towards psychopharmacology.
In terms of evidence-base, as a field psychoanalysis has historically not engaged with (or has actively resisted) trials of its effectiveness. My feeling is that psychoanalysis in general is not particularly interested in the scientific method or testing its theories. There are some notable exceptions to this rule, Peter Fonagy at UCL springs to my mind - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592654/
Additionally, compared with modalities like CBT or DBT, psychoanalytic psychotherapy is more difficult to evaluate. Therapy tends to be more open-ended, more long-term, less focussed on the reduction of symptoms, less able to be operationalised or standardised. It's also much more expensive for a person to be in therapy for years than to have say 12 sessions of CBT.
Despite not having a strong evidence base, I think most UK-based psychiatrists do see a role for psychoanalytic-based therapies, though the cost is more of a difficult one to argue in terms of the NHS, so it is reserved for a small number of patients.
6) "Therapeutic alliance" will be a useful bit of vocabulary in your search. My understanding is that most of the time therapeutic alliance matters more than the therapy modality. I don't think this is universally true (for example, CBT for insomnia).
4) I've had these thoughts too. I want electoral reform but I know that a different system would have tradeoffs and unintended consequences. It would be nice to know in advance what those might be.
3. Let's check the genomics studies first, and maybe find some "high level factor of mental health". My guess is that there are three dimensions of psychopathology, which relates to intelligence, plasticity, and stability, of the HEXACO personality. The trinity of Autism vs ADHD vs Bipolar are also of concern, having differences in academic achivement, sociability, and outside-of-the-box creativity. https://doi.org/10.1101/2020.05.01.072348https://pubmed.ncbi.nlm.nih.gov/27748619/
4. The idea is that there are at least three axes of political belief, and that in general, electoral reform consistently leads to likelihood of Republicans winning in a single-winner populist system (since they are cohesive), whilst Democrats will win in a representational multi-winner system (since they are diversely adaptive). "Leftist infighting" and "the Cathedral" (Democrat tendency to force cohesion and reject reform) is a good starting point.
5. It is highly possible that "pity porn" specifically targets the clueless gentry for donations, and that such organizations are relatively less effective at being charitable problem solvers. A better way to evaluate this is to see how rational they are vs how xenophilic they are.
I'm quite interested in what you uncover for #1. To clarify, do you mean "innovative" or "prolific"?
Example: Picasso, in his early years, was very innovative, as he pioneered (with Georges Braque) the techniques of cubism. In the last decade of his life, he produced dozens of studies of old master paintings which were recognizably his but which were (in my mind, at least) not very innovative. He was, however, prolific in making them.
When a person is described a being "creative", are we saying that they produce groundbreaking works which are ahead of their time or which stretch the possibilities of the medium? Or are we saying that they consistently produce a high volume of quality output in a style / genre which has already been well-established? Is seems to me that this is not a trivial distinction.
Let me have a go at 3) and 6).
3)
Firstly, there are no clear distinct boundaries between one psychiatric disorder and another, with big grey areas of overlap. Psychiatric diagnoses are based on a clinician's interpretation of symptoms and the same symptoms can be present in different disorders (e.g. anxiety can be part of a depressive disorder or an anxiety disorder but can also be secondary to difficulties in communication/social interaction in the context of autism). So naturally different clinicians can interpret symptoms differently and consequently come to a different conclusion about the correct diagnosis.
Secondly, being diagnosed with one psychiatric disorder makes a person much more likely to subsequently be diagnosed with a further psychiatric disorder (generally referred to as co-morbidity) - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2720421
There could be a few reasons behind this. The kinds of environmental risk factors that make a person more likely to develop depression, for example, may also put them at risk of developing a substance misuse disorder. Some disorders, like schizophrenia and bipolar disorder probably share some underlying mechanisms - https://pubmed.ncbi.nlm.nih.gov/29049482/
Furthermore, there is substantial shared genetic vulnerabilities between mental disorders - for an example, this paper looking at variation shared between ADHD and depression https://www.nature.com/articles/s41598-021-86802-1#Sec11
6)
I think it's worth saying that psychoanalysis never had the same hold over British psychiatry as it did in the states, where many head of psychiatry departments were analysts. This changed with the reemergence of biological psychiatry and massive swing towards psychopharmacology.
In terms of evidence-base, as a field psychoanalysis has historically not engaged with (or has actively resisted) trials of its effectiveness. My feeling is that psychoanalysis in general is not particularly interested in the scientific method or testing its theories. There are some notable exceptions to this rule, Peter Fonagy at UCL springs to my mind - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592654/
Additionally, compared with modalities like CBT or DBT, psychoanalytic psychotherapy is more difficult to evaluate. Therapy tends to be more open-ended, more long-term, less focussed on the reduction of symptoms, less able to be operationalised or standardised. It's also much more expensive for a person to be in therapy for years than to have say 12 sessions of CBT.
Despite not having a strong evidence base, I think most UK-based psychiatrists do see a role for psychoanalytic-based therapies, though the cost is more of a difficult one to argue in terms of the NHS, so it is reserved for a small number of patients.
7) Here's an old study that establishes the existence of lookism: https://www.researchgate.net/publication/223673076_Pretty_pleases_The_effects_of_physical_attractiveness_race_and_sex_on_receiving_help
6) "Therapeutic alliance" will be a useful bit of vocabulary in your search. My understanding is that most of the time therapeutic alliance matters more than the therapy modality. I don't think this is universally true (for example, CBT for insomnia).
4) I've had these thoughts too. I want electoral reform but I know that a different system would have tradeoffs and unintended consequences. It would be nice to know in advance what those might be.
This is gonna be a bad look, but I will try:
3. Let's check the genomics studies first, and maybe find some "high level factor of mental health". My guess is that there are three dimensions of psychopathology, which relates to intelligence, plasticity, and stability, of the HEXACO personality. The trinity of Autism vs ADHD vs Bipolar are also of concern, having differences in academic achivement, sociability, and outside-of-the-box creativity. https://doi.org/10.1101/2020.05.01.072348 https://pubmed.ncbi.nlm.nih.gov/27748619/
4. The idea is that there are at least three axes of political belief, and that in general, electoral reform consistently leads to likelihood of Republicans winning in a single-winner populist system (since they are cohesive), whilst Democrats will win in a representational multi-winner system (since they are diversely adaptive). "Leftist infighting" and "the Cathedral" (Democrat tendency to force cohesion and reject reform) is a good starting point.
5. It is highly possible that "pity porn" specifically targets the clueless gentry for donations, and that such organizations are relatively less effective at being charitable problem solvers. A better way to evaluate this is to see how rational they are vs how xenophilic they are.
6. CBT is practically emotional stoicism, and Psychoanalytics is problem solving (assuming it can be solved) https://hoarse.substack.com/p/cbt-is-dumb?s=r https://slatestarcodex.com/2018/08/29/bullst-jobs-part-1-of-%E2%88%9E/
7. This is some extreme "incel research" territory, but unfortunately yes, since facial structure correlates to both psychometrics and general health.
I'm quite interested in what you uncover for #1. To clarify, do you mean "innovative" or "prolific"?
Example: Picasso, in his early years, was very innovative, as he pioneered (with Georges Braque) the techniques of cubism. In the last decade of his life, he produced dozens of studies of old master paintings which were recognizably his but which were (in my mind, at least) not very innovative. He was, however, prolific in making them.
When a person is described a being "creative", are we saying that they produce groundbreaking works which are ahead of their time or which stretch the possibilities of the medium? Or are we saying that they consistently produce a high volume of quality output in a style / genre which has already been well-established? Is seems to me that this is not a trivial distinction.