Brilliant analysis as always. At what point do we classify leftism as a mental disorder? All of the correlations are plain to see in your charts.
From a young age, girls are indoctrinated with anti-human dogma. Hate men because they are full of toxic masculinity, don't have children because the world is ending from climate change, abortion is a holy empowering right - not building a family with a husband and children you love. They cope with digital opium like TikTok, physical opium like anti-depressants and drugs, and self-mutilation like trans surgeries, cutting, and anorexia.
Parents need to push back against this demoralization. If they don't, their girls will grow up as bitter, depressed, childless women - the rates of which continue to set new records every year. The new NPR CEO and E Jean Carroll are two of many examples of childless "girlbosses" who are spiritually empty and bankrupting our society: https://yuribezmenov.substack.com/p/commissar-npr-ceo-katherine-maher-she-her
Liberalism, not leftism. Liberal freedom gave us the isolating suburbs where kids are not able to play freely lest they get smushed by a large suv on the street. People in western economies wanted the ability to live in their own free domain rather than share experiences with others. It's why the dream is a single house with a manicured lawn in the suburbs with a numb 3 row SUV parked in the driveway for the two kids.
The happier Catholic and Orthodox countries have a lot more community because they put less priority on Liberal individualism. Many people in these countries tend to understand they live in a community. They will live in a small townhouse or apartment, they drive in small cars, or walk or take transit. they make friends with the local baker instead of shopping at the local super-Mart. They have public squares. Places where friends can meet up. The small houses mean that kids will have to go outside to play as well. Here in the west, children have to be organized play-dates at some other kids house to have a structured playtime. The things that help increase the sense of community are classically Conservative, but they are also leftist since they involve co-operation.
Wow! What an incredibly thorough analysis. I must re-read and then re-read again. The youth mental health crisis and its intersection with youth substance use and nicotine is my current vocation and passion point. Understanding the challenges with data collection by chance you have explored correlation with adverse childhood experiences?
I wish there was more research on individualism and collectivism as a guiding principle for raising healthy children. There is so much truth to this and as a parent in the US, it is something I think about often.
Excellent post, much appreciated. Perhaps we can think of religion and culture as community-building and sense-making institutions, which kind of get in the way when everything is going well, but are there for you when things aren't. For example, as a kid, I only looked forward to going to church when I was really suffering and needed some solace. When things were normal, it was just a missed opportunity to sleep in :)
I think your usage of GINI index is wrong. You should be using perception of inequality for each country instead of GINI which is actually calculated from objective data.
Most people don't know GINI or any other index value for their country and they don't know where their country is relative to other countries. But they do have a perception of various things (inequality, corruption, etc.) and then they behave in line with that.
So it could be, for example, that the poorest countries have a large perception of inequality, but if you actually calculate GINI you find out that they are among those with the lowest inequality based on objective income data.
But the people are poor (objectively) and a lot of them think it's because those rich people stole everything from them. That could skew perception of inequality.
Great point. I do think GINI has value in itself, but definitely oes not tell the whole story. You are right that subjective social/economic status would be important to look at. I also imagine that social media has altered our perception of our relative social status as well.
Thank you for this data-packed post! I always appreciate your in-depth analysis. The next important step is to find concrete ways to help youth regain ground in reality and face-to-face relationships.
To that end, my husband and I are currently working on a book (The Making of Unmachine Minds) and hope to encourage parents to model, guide, and support their children and teens toward a healthier relationship with tech. Thanks again for your crucial work!
It seems that the advent of the internet has perhaps hyperextended individualism far beyond the confines of its utility. That is, while freedom is wonderful, people are better off who willingly place restraints on themselves which tether them to a value-set and to others. But as many have withdrawn from communities which do this as a function of their nature (religious communities) and retreated further into the landscape of social media (which offers no limitations, and no real constraints on one’s behavior) it is understandable that young people especially would begin to feel the isolating impact. Furthermore, the online world is a 24/7 competition for social capital. Whereas prior, young girls especially would presumably go home and have a reprieve from the battle for social capital, it has now become ubiquitous. There is no break.
The religiosity factor (and differentiation among religious traditions) is a fascinating one! Is it possible to do an analysis of the effects of wealth, individualism, and religiosity separate from one another? I’m curious if, for example, the individualism factor would fade quite a bit when controlled for religion - or possibly the opposite.
The fact that religious and non-religious American teens have such different outcomes suggests to me that the loss of religious belief could potentially be a third pillar of the mental health deterioration you’ve documented and an explaining factor for the difference between individualist and collectivist societies. It may be that something like “loss of a play- and faith-based childhood, replaced by a phone-based childhood full of mostly secular concerns” is the right way to describe the problem.
The question of what factor is driving what is tough and this is going to take us quite some time to disentangle individualism, religiosity, etc. because they are so highly related to eachother.
To follow up on this, I’ll add that the authors of this article do well to note the social shielding that religion provides, but I would suggest religion also has many other explanatory factors: For example:
- belief in life after death reduces the anxiety of this-life problems
- belief in a good God reduces fear of worst-case scenarios (both personal scenarios like sickness and worldwide scenarios like climate change)
- religious rituals such as prayer, singing worship songs, and reading Scripture are mentally healthy practices in and of themselves (consider how secular alternatives like meditation, music therapy, and reading physical books are suggested therapies for the anxious)
- participating in a religion with a deep history of ancient beliefs and practices provides strong defense against anomie even in individualistic contexts, because sense-making comes partially from unchanging historical figures, not just nearby peers
I can see why teens from more religious / collectivist / conservative cultures do better. I don't think that individualism is a problem unto itself, but an individualist attitude often leads to less community and religious involvement.
At my college, most of my friends were from Orange County, CA (though I'm not from there). Orange County (the coast, at least), is quite conservative and much more religious / traditionalist than SoCal as a whole. Again, this is anecdotal, but many of my OC friends grew up being pretty religiously involved. They also tended to be pretty mild-mannered and not neurotic. This is in sharp contrast to the people I knew from the bay area, (and the San Diego area, to a lesser extent), which is much less religious and much more liberal. People in San Francisco would be embarrassed to admit to being religious. The tech-centered culture there is also much stronger, and families in the Bay Area seem to think that lots of screen time is inevitable, and therefore do not seem to limit it as much as more conservative families. At my high school (in San Diego, CA), the culture was still somewhat laid back, but you'd have lots of kids who were terrified of climate change killing them and thought that the Trump Presidency would usher in the end of the universe. Definitely more catastrophizing than my friends in college. Also, more students from OC play sports in high school (at least compared to the bay area), which strengthens community ties and leads to better mental and physical health outcomes.
A play-based childhood implies that children had free time in which to play. At school they had free time in the playground, then after school in the street, in the park or when hanging out with friends. Free time was therefore by definition social and play-based, not individual or solitary.
The arrival of the iPhone completely upended this this way of life by capturing children’s free time, and they went from living in the present to living in their phones. Social interaction with others gave way to solitary interaction with a smartphone – which started the upward trends we see in the charts.
What I haven't seen in these 4 posts, and I easily may have missed it, is what has happened with the suicide rates in *adults* in the same countries/areas. Is it absolutely clear that this increase only hits teens, or are adults also feeling the pain. The answer to this conundrum might significantly change any proposed remedies. Along with some other things, the smartphones of the Digital Revolution have, as every Industrial Revolution does, further atomized many societies, particularly those best positioned to use the tools of the Digital Revolution. If the same effect is being seen in adults, we might need more than, or an addition to, the "control you child's use of smartphones and let them play" prescription.
There is a rise across the board in the U.S., but those rises often begin earlier. The story in the other anglo countries vary a bit more, as you'll see.
Great analysis. I had an instinctive revulsion to the concept of social media when I first heard about Facebook in the noughties....... having previously been very positive about the marvel of the internet search engine. Ironically both negative and positive reactions reflected, I guess, my own individualistic and (perhaps slightly) asocial tendencies. The search engine was a boon for the intellectually curious individualist whereas social media was a turbocharger of man's groupthink tendencies. But I was late middle aged when all this came along so I never foresaw just how poisonous it would prove to be for the young.
I take issue somewhat with the use of the term “individualistic” and “collectivistic.” For instance, Russia is listed as “collectivistic” and yet it less religious than the most secular city in the United States (the most individualistic country). During the Cold War, the term collectivist did not mean communitarian. It meant a society in which the individual was nothing more than a pawn to be used for the greater good of the whole society, and whose self-interest (hopes, desires, dreams, loves, fears, etc.) was to be viewed with suspicion. Individualistic societies were more capitalist and more classically-liberal (founded on the belief that the individual is the fundamental unit of society, a person in possession of natural rights).
CDC 2021 survey result................Teens online <1 hour/day.....Teens online 5+ hours per day....Odds ratio
Mental health poor.................................................24%.......................................................37%...................................1.82
Considered suicide..................................................16%.......................................................24%...................................1.75
Mental health poor, attempted suicide..........33%........................................................21%..................................0.54
Sad, attempted suicide..........................................34%.........................................................20%.................................0.48
Hospitalized for suicide attempt..........................5%...........................................................2%..................................0.45
Note the top four lines. Compared to teens who rarely or never go online (less than 1 hour a day), teens who are online a lot (5+ hours per day) are much more depressed, sadder, and likely to consider and plan suicide (OR > 1.0). That’s in line with the conventional view.
Now, look at the next four lines. They show a complete reversal. Compared to teens who rarely/never go online, teens who go online a lot are LESS likely to actually ATTEMPT suicide and to suffer a serious (injurious) suicide attempt requiring hospitalization (OR < 1.0).
That is, among the teens who consider or plan suicide, nearly all who spend little time online go on to attempt suicide, compared to just one-third of the teens who spend many hours online.
How can the same 7,000 teens report on the same survey that being online a lot is associated with substantially MORE depression, sadness, suicide ideation, and suicide planning – and also with substantially LESS actual suicidal behavior and injury? How can teens with poor mental health and/or sadness (the ones we think are most vulnerable) report that being online a lot is associated with substantially fewer suicide attempts? What major factor intervenes to prevent suicide attempts, especially serious ones, among teens who are online a lot that doesn’t deter teens who are not online? This pattern, which is obvious for those who download and analyze the full CDC survey, applies across several measures to all ages and both sexes of teens with only small variations.
Strongly appreciate your thorough analysis of this issue! That said, a bit of friendly critical pushback:
1) The whole "there is a youth mental health crisis... in girls... in this specific age group... in protestant/individualistic communities... except the ones with free and high-quality healthcare systems..." does begin to feel like (unintentional, I'm sure) p-hacking: if you post-hoc refine your hypothesis often enough to fit patterns in your observed data, you will literally always find a (very specific sub-)group that conforms with your initial hypothesis. Do you do any kind of multiple hypothesis test correction, external validation etc. to address this issue?
2) "Underlying these regional changes is a story about how adolescents from wealthy, individualistic, and secular nations were less tightly bound into strong communities and **therefore more vulnerable to the harms of the new phone-based childhood that emerged in the early 2010s**" where exactly is the evidence for this causation / the second clause? This post almost exclusively describes evidence for the first clause; the link to tech use and especially the direction of causation seems like pure conjecture? (The causal directionality could also be, e.g., individualism (rising for some external reason) --> mental health decline --> tech use, no? And many other settings could be imagined.)
Eike, thank you for your constructive thoughts, it is really helpful to get these kinds of questions.
This won't do your questions full justice but a quick response from my end.
1) The whole "there is a youth mental health crisis... in girls... in this specific age group... in protestant/individualistic communities... except the ones with free and high-quality healthcare systems..." does begin to feel like (unintentional, I'm sure) p-hacking: if you post-hoc refine your hypothesis often enough to fit patterns in your observed data, you will literally always find a (very specific sub-)group that conforms with your initial hypothesis. Do you do any kind of multiple hypothesis test correction, external validation etc. to address this issue?
I see your point, but this is actually the hypothesis that we have had for a very long time. The larger problem we have been facing is that others have not been considering many of these factors in their analyses. For example, many merge boys and girls together; look at all adults, not teens; and looking at every country they can find and merge them together.
Our hypothesis has been clear: it specifically teenage girls who will be most strongly effected by smartphones and social media. But you are right that this post adds on more complexity with moderated cultural factors of individualism and religiosity (but all social science questions will be driven by a multitude of moderating forces). -- and I have long been interested in these factors, especially the role of individualism.
I also think when in comes to suicide, the factors that drive those trends (especially among groups of people who do not commit suicide a high levels, e.g., teen girls) will be heavily influenced by the culture they are in. Access to means of lethal suicide is incredibly important and often can explain rises and falls in suicides within different countries. It is simply much easier (low effort) to die by suicide in the United States than it is in Denmark (both due to the availability to prescription drugs for self-poising and guns, and the kind of preventative care that they have in place). And thIs is part of the reason why I think it is crucial that we look at suicide AND other mental health trends. Reports of poor mental health among teens (especially girls) are showing up all across the Nordic countries. I was recently in Denmark, and spoke to a number of health officials who are extremely concerned about the mental health teen girls in Denmark.
These Substack posts are designed to put out big ideas so that we ultimately can refine our hypotheses. My posts are definitely, in no way, definitive statements on the causal chain. It is a plausable theory based on the evidence that I have seen.
2) "Underlying these regional changes is a story about how adolescents from wealthy, individualistic, and secular nations were less tightly bound into strong communities and **therefore more vulnerable to the harms of the new phone-based childhood that emerged in the early 2010s**" where exactly is the evidence for this causation / the second clause? This post almost exclusively describes evidence for the first clause; the link to tech use and especially the direction of causation seems like pure conjecture? (The causal directionality could also be, e.g., individualism (rising for some external reason) --> mental health decline --> tech use, no? And many other settings could be imagined.)
You are right. There are different potential causal pathways here and there is a lot more work needed to be done. This is the broader hypothesis that I am exploring and I appreciate you pointing this out.
I also want to note for clarity that a number of the Eastern European countries were also showing post 2010 rises high psych distress. My point is more around softening the effects, not that they will be necessarily non-existent.
Thank you for the very thorough response! I personally believe that your hypothesis is very plausible and that you have already accumulated quite a lot of evidence; my snarky remarks came more from a nit-picky journal reviewer's perspective. ;-) But of course you cannot go into all the gory technical details in a blog post. I do think it's awesome that you invest the effort to make these investigations accessible to "normal" people, and also that you're seeking out this kind of critical interaction and feedback! Very much looking forward to future posts.
Brilliant analysis as always. At what point do we classify leftism as a mental disorder? All of the correlations are plain to see in your charts.
From a young age, girls are indoctrinated with anti-human dogma. Hate men because they are full of toxic masculinity, don't have children because the world is ending from climate change, abortion is a holy empowering right - not building a family with a husband and children you love. They cope with digital opium like TikTok, physical opium like anti-depressants and drugs, and self-mutilation like trans surgeries, cutting, and anorexia.
Parents need to push back against this demoralization. If they don't, their girls will grow up as bitter, depressed, childless women - the rates of which continue to set new records every year. The new NPR CEO and E Jean Carroll are two of many examples of childless "girlbosses" who are spiritually empty and bankrupting our society: https://yuribezmenov.substack.com/p/commissar-npr-ceo-katherine-maher-she-her
It is clearly a mental disorder. These mentally deranged women are the authoritarians running the Biden Crime syndicate.
🎯
Liberalism, not leftism. Liberal freedom gave us the isolating suburbs where kids are not able to play freely lest they get smushed by a large suv on the street. People in western economies wanted the ability to live in their own free domain rather than share experiences with others. It's why the dream is a single house with a manicured lawn in the suburbs with a numb 3 row SUV parked in the driveway for the two kids.
The happier Catholic and Orthodox countries have a lot more community because they put less priority on Liberal individualism. Many people in these countries tend to understand they live in a community. They will live in a small townhouse or apartment, they drive in small cars, or walk or take transit. they make friends with the local baker instead of shopping at the local super-Mart. They have public squares. Places where friends can meet up. The small houses mean that kids will have to go outside to play as well. Here in the west, children have to be organized play-dates at some other kids house to have a structured playtime. The things that help increase the sense of community are classically Conservative, but they are also leftist since they involve co-operation.
^^^this
Wow! What an incredibly thorough analysis. I must re-read and then re-read again. The youth mental health crisis and its intersection with youth substance use and nicotine is my current vocation and passion point. Understanding the challenges with data collection by chance you have explored correlation with adverse childhood experiences?
I wish there was more research on individualism and collectivism as a guiding principle for raising healthy children. There is so much truth to this and as a parent in the US, it is something I think about often.
Excellent post, much appreciated. Perhaps we can think of religion and culture as community-building and sense-making institutions, which kind of get in the way when everything is going well, but are there for you when things aren't. For example, as a kid, I only looked forward to going to church when I was really suffering and needed some solace. When things were normal, it was just a missed opportunity to sleep in :)
Thanks for all the hard work.
I think your usage of GINI index is wrong. You should be using perception of inequality for each country instead of GINI which is actually calculated from objective data.
Most people don't know GINI or any other index value for their country and they don't know where their country is relative to other countries. But they do have a perception of various things (inequality, corruption, etc.) and then they behave in line with that.
So it could be, for example, that the poorest countries have a large perception of inequality, but if you actually calculate GINI you find out that they are among those with the lowest inequality based on objective income data.
But the people are poor (objectively) and a lot of them think it's because those rich people stole everything from them. That could skew perception of inequality.
Great point. I do think GINI has value in itself, but definitely oes not tell the whole story. You are right that subjective social/economic status would be important to look at. I also imagine that social media has altered our perception of our relative social status as well.
Thank you for this data-packed post! I always appreciate your in-depth analysis. The next important step is to find concrete ways to help youth regain ground in reality and face-to-face relationships.
To that end, my husband and I are currently working on a book (The Making of Unmachine Minds) and hope to encourage parents to model, guide, and support their children and teens toward a healthier relationship with tech. Thanks again for your crucial work!
It seems that the advent of the internet has perhaps hyperextended individualism far beyond the confines of its utility. That is, while freedom is wonderful, people are better off who willingly place restraints on themselves which tether them to a value-set and to others. But as many have withdrawn from communities which do this as a function of their nature (religious communities) and retreated further into the landscape of social media (which offers no limitations, and no real constraints on one’s behavior) it is understandable that young people especially would begin to feel the isolating impact. Furthermore, the online world is a 24/7 competition for social capital. Whereas prior, young girls especially would presumably go home and have a reprieve from the battle for social capital, it has now become ubiquitous. There is no break.
Perfect summary right here.
Way too long!
The religiosity factor (and differentiation among religious traditions) is a fascinating one! Is it possible to do an analysis of the effects of wealth, individualism, and religiosity separate from one another? I’m curious if, for example, the individualism factor would fade quite a bit when controlled for religion - or possibly the opposite.
The fact that religious and non-religious American teens have such different outcomes suggests to me that the loss of religious belief could potentially be a third pillar of the mental health deterioration you’ve documented and an explaining factor for the difference between individualist and collectivist societies. It may be that something like “loss of a play- and faith-based childhood, replaced by a phone-based childhood full of mostly secular concerns” is the right way to describe the problem.
I little clunky... but I love it!
The question of what factor is driving what is tough and this is going to take us quite some time to disentangle individualism, religiosity, etc. because they are so highly related to eachother.
To follow up on this, I’ll add that the authors of this article do well to note the social shielding that religion provides, but I would suggest religion also has many other explanatory factors: For example:
- belief in life after death reduces the anxiety of this-life problems
- belief in a good God reduces fear of worst-case scenarios (both personal scenarios like sickness and worldwide scenarios like climate change)
- religious rituals such as prayer, singing worship songs, and reading Scripture are mentally healthy practices in and of themselves (consider how secular alternatives like meditation, music therapy, and reading physical books are suggested therapies for the anxious)
- participating in a religion with a deep history of ancient beliefs and practices provides strong defense against anomie even in individualistic contexts, because sense-making comes partially from unchanging historical figures, not just nearby peers
Etc. etc.
Thank you for this important work!
I can see why teens from more religious / collectivist / conservative cultures do better. I don't think that individualism is a problem unto itself, but an individualist attitude often leads to less community and religious involvement.
At my college, most of my friends were from Orange County, CA (though I'm not from there). Orange County (the coast, at least), is quite conservative and much more religious / traditionalist than SoCal as a whole. Again, this is anecdotal, but many of my OC friends grew up being pretty religiously involved. They also tended to be pretty mild-mannered and not neurotic. This is in sharp contrast to the people I knew from the bay area, (and the San Diego area, to a lesser extent), which is much less religious and much more liberal. People in San Francisco would be embarrassed to admit to being religious. The tech-centered culture there is also much stronger, and families in the Bay Area seem to think that lots of screen time is inevitable, and therefore do not seem to limit it as much as more conservative families. At my high school (in San Diego, CA), the culture was still somewhat laid back, but you'd have lots of kids who were terrified of climate change killing them and thought that the Trump Presidency would usher in the end of the universe. Definitely more catastrophizing than my friends in college. Also, more students from OC play sports in high school (at least compared to the bay area), which strengthens community ties and leads to better mental and physical health outcomes.
A play-based childhood implies that children had free time in which to play. At school they had free time in the playground, then after school in the street, in the park or when hanging out with friends. Free time was therefore by definition social and play-based, not individual or solitary.
The arrival of the iPhone completely upended this this way of life by capturing children’s free time, and they went from living in the present to living in their phones. Social interaction with others gave way to solitary interaction with a smartphone – which started the upward trends we see in the charts.
I explain how this happened in my latest post, "How the iPhone stole our free time", https://michaelgentle.substack.com/p/how-the-iphone-stole-our-free-time
What I haven't seen in these 4 posts, and I easily may have missed it, is what has happened with the suicide rates in *adults* in the same countries/areas. Is it absolutely clear that this increase only hits teens, or are adults also feeling the pain. The answer to this conundrum might significantly change any proposed remedies. Along with some other things, the smartphones of the Digital Revolution have, as every Industrial Revolution does, further atomized many societies, particularly those best positioned to use the tools of the Digital Revolution. If the same effect is being seen in adults, we might need more than, or an addition to, the "control you child's use of smartphones and let them play" prescription.
This is a really important/good question. I have not focused much on adults, and this is an area where I plan to spend more time on.
But I do cover suicide variation by age in my post on Anglo suicide: https://www.afterbabel.com/p/anglo-teen-suicide
There is a rise across the board in the U.S., but those rises often begin earlier. The story in the other anglo countries vary a bit more, as you'll see.
Thanks! SORRY I must have missed the 10.30.23 post. "Atomization hits everyone, some worse than others."
Great analysis. I had an instinctive revulsion to the concept of social media when I first heard about Facebook in the noughties....... having previously been very positive about the marvel of the internet search engine. Ironically both negative and positive reactions reflected, I guess, my own individualistic and (perhaps slightly) asocial tendencies. The search engine was a boon for the intellectually curious individualist whereas social media was a turbocharger of man's groupthink tendencies. But I was late middle aged when all this came along so I never foresaw just how poisonous it would prove to be for the young.
I take issue somewhat with the use of the term “individualistic” and “collectivistic.” For instance, Russia is listed as “collectivistic” and yet it less religious than the most secular city in the United States (the most individualistic country). During the Cold War, the term collectivist did not mean communitarian. It meant a society in which the individual was nothing more than a pawn to be used for the greater good of the whole society, and whose self-interest (hopes, desires, dreams, loves, fears, etc.) was to be viewed with suspicion. Individualistic societies were more capitalist and more classically-liberal (founded on the belief that the individual is the fundamental unit of society, a person in possession of natural rights).
With regard to posts about the relationship of social media use to teen suicide, can anyone help explain a major mystery in the CDC’s 2021 Adolescent Behavior and Experiences Survey (I apologize if formatting is a problem; see formatted table at: https://mikemales.substack.com/publish/posts/detail/142303583?referrer=%2Fpublish%2Fhome ):
CDC 2021 survey result................Teens online <1 hour/day.....Teens online 5+ hours per day....Odds ratio
Mental health poor.................................................24%.......................................................37%...................................1.82
Persistent sadness....................................................37%.......................................................51%...................................1.81
Considered suicide..................................................16%.......................................................24%...................................1.75
Suicide plan.................................................................17%.......................................................24%...................................1.53
Attempted suicide...................................................15%........................................................11%...................................0.67
Mental health poor, attempted suicide..........33%........................................................21%..................................0.54
Sad, attempted suicide..........................................34%.........................................................20%.................................0.48
Hospitalized for suicide attempt..........................5%...........................................................2%..................................0.45
Note the top four lines. Compared to teens who rarely or never go online (less than 1 hour a day), teens who are online a lot (5+ hours per day) are much more depressed, sadder, and likely to consider and plan suicide (OR > 1.0). That’s in line with the conventional view.
Now, look at the next four lines. They show a complete reversal. Compared to teens who rarely/never go online, teens who go online a lot are LESS likely to actually ATTEMPT suicide and to suffer a serious (injurious) suicide attempt requiring hospitalization (OR < 1.0).
That is, among the teens who consider or plan suicide, nearly all who spend little time online go on to attempt suicide, compared to just one-third of the teens who spend many hours online.
How can the same 7,000 teens report on the same survey that being online a lot is associated with substantially MORE depression, sadness, suicide ideation, and suicide planning – and also with substantially LESS actual suicidal behavior and injury? How can teens with poor mental health and/or sadness (the ones we think are most vulnerable) report that being online a lot is associated with substantially fewer suicide attempts? What major factor intervenes to prevent suicide attempts, especially serious ones, among teens who are online a lot that doesn’t deter teens who are not online? This pattern, which is obvious for those who download and analyze the full CDC survey, applies across several measures to all ages and both sexes of teens with only small variations.
Strongly appreciate your thorough analysis of this issue! That said, a bit of friendly critical pushback:
1) The whole "there is a youth mental health crisis... in girls... in this specific age group... in protestant/individualistic communities... except the ones with free and high-quality healthcare systems..." does begin to feel like (unintentional, I'm sure) p-hacking: if you post-hoc refine your hypothesis often enough to fit patterns in your observed data, you will literally always find a (very specific sub-)group that conforms with your initial hypothesis. Do you do any kind of multiple hypothesis test correction, external validation etc. to address this issue?
2) "Underlying these regional changes is a story about how adolescents from wealthy, individualistic, and secular nations were less tightly bound into strong communities and **therefore more vulnerable to the harms of the new phone-based childhood that emerged in the early 2010s**" where exactly is the evidence for this causation / the second clause? This post almost exclusively describes evidence for the first clause; the link to tech use and especially the direction of causation seems like pure conjecture? (The causal directionality could also be, e.g., individualism (rising for some external reason) --> mental health decline --> tech use, no? And many other settings could be imagined.)
Eike, thank you for your constructive thoughts, it is really helpful to get these kinds of questions.
This won't do your questions full justice but a quick response from my end.
1) The whole "there is a youth mental health crisis... in girls... in this specific age group... in protestant/individualistic communities... except the ones with free and high-quality healthcare systems..." does begin to feel like (unintentional, I'm sure) p-hacking: if you post-hoc refine your hypothesis often enough to fit patterns in your observed data, you will literally always find a (very specific sub-)group that conforms with your initial hypothesis. Do you do any kind of multiple hypothesis test correction, external validation etc. to address this issue?
I see your point, but this is actually the hypothesis that we have had for a very long time. The larger problem we have been facing is that others have not been considering many of these factors in their analyses. For example, many merge boys and girls together; look at all adults, not teens; and looking at every country they can find and merge them together.
Our hypothesis has been clear: it specifically teenage girls who will be most strongly effected by smartphones and social media. But you are right that this post adds on more complexity with moderated cultural factors of individualism and religiosity (but all social science questions will be driven by a multitude of moderating forces). -- and I have long been interested in these factors, especially the role of individualism.
I also think when in comes to suicide, the factors that drive those trends (especially among groups of people who do not commit suicide a high levels, e.g., teen girls) will be heavily influenced by the culture they are in. Access to means of lethal suicide is incredibly important and often can explain rises and falls in suicides within different countries. It is simply much easier (low effort) to die by suicide in the United States than it is in Denmark (both due to the availability to prescription drugs for self-poising and guns, and the kind of preventative care that they have in place). And thIs is part of the reason why I think it is crucial that we look at suicide AND other mental health trends. Reports of poor mental health among teens (especially girls) are showing up all across the Nordic countries. I was recently in Denmark, and spoke to a number of health officials who are extremely concerned about the mental health teen girls in Denmark.
These Substack posts are designed to put out big ideas so that we ultimately can refine our hypotheses. My posts are definitely, in no way, definitive statements on the causal chain. It is a plausable theory based on the evidence that I have seen.
2) "Underlying these regional changes is a story about how adolescents from wealthy, individualistic, and secular nations were less tightly bound into strong communities and **therefore more vulnerable to the harms of the new phone-based childhood that emerged in the early 2010s**" where exactly is the evidence for this causation / the second clause? This post almost exclusively describes evidence for the first clause; the link to tech use and especially the direction of causation seems like pure conjecture? (The causal directionality could also be, e.g., individualism (rising for some external reason) --> mental health decline --> tech use, no? And many other settings could be imagined.)
You are right. There are different potential causal pathways here and there is a lot more work needed to be done. This is the broader hypothesis that I am exploring and I appreciate you pointing this out.
I also want to note for clarity that a number of the Eastern European countries were also showing post 2010 rises high psych distress. My point is more around softening the effects, not that they will be necessarily non-existent.
Thank you for the very thorough response! I personally believe that your hypothesis is very plausible and that you have already accumulated quite a lot of evidence; my snarky remarks came more from a nit-picky journal reviewer's perspective. ;-) But of course you cannot go into all the gory technical details in a blog post. I do think it's awesome that you invest the effort to make these investigations accessible to "normal" people, and also that you're seeking out this kind of critical interaction and feedback! Very much looking forward to future posts.