New APPS: Art, Politics, Philosophy, Science

New Paper on Foucault and Parrhesia

By Gordon Hull

I'm happy to announce (shamelessly!) that my article, "The Banality of Cynicism: Foucault and Limits of Authentic Parrhesia" is now out in Foucault Studies (open access).

The abstract is:

Foucault’s discussion of parrhēsia – frank speech – in his last two Collège de France lecture courses has led many to wonder if Foucault is pursuing parrhēsia as a contemporary strategy for resistance.  This essay argues that ethical parrhēsia on either the Socratic or Cynical model would have little critical traction today because the current environment is plagued by problems analogous to those Plato thought plagued Athenian democracy. Specifically, authentication of parrhesiasts as a technique for authenticating their speech – the specific problem that the move to ethical parrhēsia in ancient Greece was designed to solve – becomes intractable in a social media environment, even with the added Cynical move to pure visibility. The problem is that contemporary society overproduces visibility as a condition for participation, which means that the context for authenticating parrhesiastic speech is one in which visibility is banalized and in which there is a surplus of speech which presents as parrhesiastic. The problem of authentication is thus a serious one, one which social media makes particularly intractable.

There's lots of papers in this issue, and I of course haven't read them yet - but they look good.

 

More on Facebook and Mental Health Privacy

By Gordon Hull

It’s not news that Facebook generates a lot of privacy concerns.  But it’s nonetheless worth keeping up a little, just to indicate how seriously we need to be concerned about the connection between Facebook and data analytics.  We’ve known for a while that automated analysis of Facebook likes can predict basic personality type.  A 2017 paper showed that targeting of advertising based on personality type was highly effective, as measured by clicks and purchases.  Facebook appears to be marketing predictive-advertising (so an advertiser can know to send you a nudge if FB software predicts you may be about to switch brands of something).

Now there’s this: an individual’s Facebook posts can apparently predict depression independently of subjective reporting (discussion here). From the study:

“Each year, 7–26% of the US population experiences depression, of whom only 13–49% receive minimally adequate treatment. By 2030, unipolar depressive disorders are predicted to be the leading cause of disability in high-income countries. The US Preventive Services Task Force recommends screening adults for depression in circumstances in which accurate diagnosis, treatment, and follow-up can be offered. These high rates of underdiagnosis and undertreatment suggest that existing procedures for screening and identifying depressed patients are inadequate. Novel methods are needed to identify and treat patients with depression.

By using Facebook language data from a sample of consenting patients who presented to a single emergency department, we built a method to predict the first documentation of a diagnosis of depression in the electronic medical record (EMR). Previous research has demonstrated the feasibility of using Twitter and Facebook language and activity data to predict depression, postpartum depression, suicidality, and posttraumatic stress disorder, relying on self-report of diagnoses on Twitter or the participants’ responses to screening surveys to establish participants’ mental health status. In contrast to this prior work relying on self-report, we established a depression diagnosis by using medical codes from an EMR.”

It seems to me that these paragraphs speak to why this technology can be so difficult to wrap one’s head around.  On the one hand, it is really important to take mental health seriously, and we live in a neoliberal society that both generates mental health problems and offers problematic band-aids to solve them, including moves by Pharma to drum up purchases of drugs with dubious clinical efficacy.  The study is classic big data: by looking at actual EMR records and correlated FB posts, the authors were able to train the algorithms with existing known cases of depression.  What it discovered was that certain words in posts predict a future diagnosis of depression pretty well, better as you get closer to the diagnosis.  And it doesn’t rely on self-reporting. Nor does it rely on a primary care physician spotting the problem, which the study suggests is part of why depression is so under-diagnosed.  As the authors put it, “the potential exists to develop burdenless indicators of mental illness that precede the medical documentation of depression (which may often be delayed) and which, as a result, could reduce the total extent of functional impairment experienced during the depressive episode.” There’s a chance here to do some real good for public health at a relatively low cost (though one should raise a digital divide worry: those who do not leave a sufficient social media trail – say, the homeless, who are at very high risk for mental health issues – will fall further through the cracks).

On the other hand, want to buy a list of depressed patients to sell those dubious remedies to?

Capitalism's Headache

By Gordon Hull

I mean the title of this post literally. A recent study that surveyed global neurological disease incidence concluded that neurological disorders now are the leading global cause of disability, and that their rates are rapidly rising.  A substantial portion of this is due to increasing rates of Parkinson’s Disease, Alzheimer’s and other dementias; as the study concludes, “the most striking change has been the more than doubling of people in the world who die or are disabled from Alzheimer's disease and other dementias over the past 25 years.”  The primary risk factor for these conditions is age, and the increase is clearly tied to increasing life expectancies.  It may also in part explain why women (who generally have higher life expectancies than men) have a 22% higher burden from these diseases than men.  Other results were similarly expected: the global rates of communicable neurological conditions like meningitis were declining due to vaccination programs; their burden was highest in low-income regions.  The study concludes:

“In conclusion, we have shown that neurological disorders are a large cause of disability and death worldwide. Globally, the burden of neurological disorders has increased substantially over the past 25 years because of population ageing, despite substantial decreases in mortality rates from stroke and communicable neurological disorders. Because low-income and middle-income countries still have a long way to go through the demographic transition of reductions in child mortality and population ageing, the number of patients who will need neurological care will continue to grow in the coming decades. It is important that policy makers and health-care providers are aware of these past trends to be able to provide adequate services for the growing numbers of patients with neurological disorders”

This sort of headline, especially about the staggering burden that Alzheimer’s is going to place on the U.S. healthcare  system as baby boomers enter old age, is relatively common.  Buried in the headline-grabbing statistics, though, is a somewhat alarming data point: the rise in headaches.  Between 1990 and 2015, the global prevalence of migraines shot up 49.6%, tension-type headaches 49.2%, and of medication-overdose headaches by 57.8% (table 1 in the linked article).  The highest rates of headaches were in high-income regions. There is also a fairly sharp drop in the rate of headaches at around age 65 in the table accompanying the graph.

One hesitates to interpret too much on a quick read (there is a lot of data; the article is open access, so those with better quantitative skills should dive in!), but it’s hard not to notice that the years from 1990 to 2015 are also the years that global capitalism took its victory lap over communism, and celebrated with a neoliberal intensification of staggering proportions.   It is also hard not to notice that 65 is retirement age.

Franco (“Bifo”) Berardi has  been saying for a long time that the rise in global mental health disorders needs to be read as a symptom of capitalism’s intensification, a point on which Will Davies concurs (I intend to do a post on this at some  point).  In Berardi’s case, though, the argument has the feel of speculation.  But here we have a data point that is difficult to explain otherwise: quite independently of how long one lives, life today, as Lenin once said of Hegel’s Logic, seems to be “a best means for getting a headache.”