Further Thoughts on Objective(?) Data(?)

Once again exposing some bias or another1 in my thinking, I assumed everyone knew what the PHQ-9, GAD-7, and PCL-C were and how they worked. I may have even explained here at some point. or maybe I didn’t…

Anyway, the point is, I want to give a quick explanation of what they are and how they work.

All three of these are screening tools for various mental health diagnoses. The Patient Health Questionnaire-9 (nine questions) and Generalized Anxiety Disorder-7 (seven questions) especially were designed for primary care providers to use to screen all their patients for depression and anxiety. The PCL-C2 is the civilian version of the PTSD screening tool developed by the military to screen troops. They rely on the frequency of symptoms like anhedonia, feelings of isolation or disconnection from others, nightmares, etc. as reported by patients. They were designed to be used by health care professionals and their patients in the setting of a therapeutic assessment. They were never intended to be self-administered, and certainly not self-interpreted. I am, in short, using them wrong3 and the numbers may or may not mean anything.

They’ve been scientifically validated and are relied upon by experts in the field so I’m more or less obligated to accept them as valid. When used as intended. I tend to have fairly concrete thinking when it comes to health care so having any kind of number to look at makes things easier. Whether or not the numbers are actually useful is a different question.

  1. I’ve never been clear on which of my many neuroses causes this to happen but for whatever reason I commonly assume that if I know something, everyone else must know it too. It was something I was consciously trying to change when I was working on my education degree and have, clearly, fallen out of the habit. ↩︎
  2. I’ll be honest, I have no idea what this stands for and I’m not going to bother to look it up. ↩︎
  3. Considering the disdain I hold for people who use the internet to diagnose themselves with various things, this may come off a bit hypocritical. I thread that needle in my mind by asserting my (still valid) credentials as a health care professional and that these are being used in the setting of receiving treatment for the relevant disorders. Hopefully I can swing a bit more nuance than someone lacking the appropriate organs diagnosing themselves with uterine fibroids. ↩︎

5 thoughts on “Further Thoughts on Objective(?) Data(?)”

  1. I for one really, really appreciate the further contextualization, if for no other reason than, before you posted this, I assumed that the data you were presenting was the result of tests administered by your MHP. Knowing that these are home-rolled puts them in a new light. Not that it dismisses them out of hand, but I don’t have to tell you the truly yawning gap between your observations of yourself, observations made by your friends and family, and observations made by a qualified professional. All have their varying degrees of validity and efficacy, but the third category would be presumed to have the highest levels of same, if for no other reason than that they are the only set of observations over which an individual might possibly be sued. (^_-)

    1. Do you think I’m more prone to over-report my symptoms or under-report my symptoms?

      1. “Do you think I’m more prone to over-report my symptoms or under-report my symptoms?”

        I think you have a multi-decade history of under reporting your symptoms until a few years ago when your history of under-reporting meant that you had such a pile of them that they tipped over and crushed you!

        Right now you are neither under nor over reporting you are simply reporting.

        And the pile is getting smaller but it took a long time to build up and it’ll take a while to dig out. The fact that you are sharing your symptoms and your journey is good evidence that you’ve managed to switch from digging with a teaspoon to digging with something that resembles an actual shovel. Now we have to work on getting you up to the point where you can dig with an excavator.

        1. I’m leaving the question and the reply up for science. I realize, though, it isn’t exactly a fair question. Who is going to come right out and tell me I’m exaggerating my symptoms? No one.

          You make interesting and valid points but I don’t think I asked a question that can be answered in a meaningful way.

          1. I’m going to leave further opinion out of this as I feel I may have exhausted the utility of same, but will second Margaret’s take on things.

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