Summary: A study exploring the “creeping concept” shows that, with increased awareness of mental health in the aftermath of the COVID-19 pandemic, the concepts of “anxiety” and “depression” are becoming more widespread.
The study revealed that, contrary to expectations of less emotionally intense use, these terms have taken on more severe connotations over the past five decades. This shift was driven by the increasing association of these words with each other and with disease-related terms, such as “disorder” and “symptom”.
While raising awareness is critical, this study warns of the potential risk of overly pathological everyday mood states.
Key facts:
- A study of more than 800,000 psychology articles and colloquial American English shows that “anxiety” and “depression” are now associated with more severe emotions than they were decades ago.
- The words “anxiety” and “depression” are increasingly appearing together and alongside disease-related words, indicating a growing perception of them as clinical phenomena.
- While understanding and awareness of mental health issues has progressed, there is a risk of overuse of everyday mood conditions, leading to the potential for overdiagnosis and treatment.
Source: University of Melbourne
After COVID, mental health came front and center in public consciousness.
Traditional and social media are awash with stories about new treatments, alarming increases in the prevalence of mental health problems and deficiencies in the mental health system. Personal notes about living with mental health issues are being shared more than ever.
This increased attention is likely to have many positive effects.
Raising community awareness should help increase mental health literacy, reduce stigma and encourage people to seek appropriate help. Increasing the mental health profile should also galvanize efforts to improve health systems.
Despite these hopes, some commentators worry that greater attention to mental health may also have some downsides. Critics argue that ordinary human experience is further pathologicalized by psychiatric classifications, such as the DSM-5, leading to overdiagnosis and over-medication.
Some authors even suggest that raising awareness of poor mental health could backfire and inadvertently produce more mental health problems. Others claim that people’s concepts of mental health are changing in ways that may have damaging consequences.
Our research group explores changes like these as examples of “concept creep,” the historical tendency for hazard-related concepts to broaden their meaning.
For example, we have shown that while “trauma” has been popularized in recent years, its meaning has broadened to include less severe experiences. It used to refer only to life-threatening events, but in everyday language it increasingly refers to almost any adversity.
Could a similar creeping concept process be occurring for “anxiety” and “depression,” the two most common forms of distress associated with poor mental health?
Influential authors, American sociologist Professor Allan Horwitz and philosopher Professor Jerome Wakefield, propose that this has occurred in mainstream psychiatry, arguing that the DSM often misdiagnoses adaptive anxiety and everyday grief as mental disorders.
This paper is published in the journal PLOS ONE.
Creeping concept
To test whether “anxiety” and “depression” have creeped in or melted away in this way, our new study uses a natural language processing method we previously used to study trauma.
We looked at how the meanings of the two words had changed over the past half century in two large (“corporate”) datasets, hoping to find that they would become less emotionally intense.
One corpus contains abstracts of more than 800,000 psychology articles published from 1970 to 2018. The other corpus contains more than half a billion words drawn from a variety of everyday American English sources, such as TV shows, fiction, newspapers, and spoken language, during the same period.
The two corpora allow us to examine whether the meanings of “anxiety” and “depression” have changed in academic discourse and society in general.
We found every occurrence of “anxiety” and “depression” in each corpus and extracted all the words immediately before and after them. These joined words represent the semantic company that the concept holds.
These historical changes in collocations can help clarify how the meanings of “anxiety” and “depression” have evolved.
We evaluate the emotional severity of collocations using established norms for their emotional meaning. While we thought the severity would decline over the years, we found the opposite.
Across both corpus, words around “anxiety” and “depression” continue to become more emotionally severe, telling us that these words are now perceived as more distressing than they were decades ago.
A shift in the meaning of ‘anxiety’ and ‘depression’
Interested in understanding why the meanings of “anxiety” and “depression” are increasing rather than being diluted, as anticipated by our concept creep predictions, we explore which collocation words have changed over the decades.
Two trends emerge that help explain our findings.
First, “anxiety” and “depression” are increasingly appearing close together. For example, “depression” was not among the top ten collocations of “anxiety” in the general corpus in the 1970s or 1980s, but in the 2000s and 2010s, it became the most common.
Second, over the past five decades, these two concepts have appeared more and more frequently around disease-related words—such as “disorder” and “symptom.” This tells us that “depression” and “anxiety” are increasingly being understood as clinical phenomena.
Together, these two trends help explain why “anxiety” and “depression” have taken on more severe connotations in both academic psychology and in everyday language use.
“Anxiety” and “depression” have been seen as a pathological pair.
Pathology than normalized
Our findings, based on patterns of word use observed in large data sets over half a century, suggest that anxiety and depression are increasingly being viewed through a clinical lens.
Although anxiety and depression can be transient and functional, everyday mood conditions, they are increasingly being recognized as disorders.
They have been pathological rather than normalized.
Does this mean that “anxiety” and “depression” don’t suffer from concept creep? Not necessarily.
People are now able to use these words to refer to less severe phenomena than before and are increasingly adopting a clinical understanding of them when they do.
So the concepts of anxiety and depression may have been broad, intensive, and pathological simultaneously.
The implications of that possibility may be concerning.
People should seek help when they experience clinically significant anxiety or depression. But if they perceive ordinary anxiety or depression as pathological, it may mean they are seeking unnecessary treatment and self-diagnosing inappropriately.
About this depression and anxiety research news
Author: Nick Haslam
Source: University of Melbourne
Contact: Nick Haslam – University of Melbourne
Picture: The image is credited to Neuroscience News
Original Research: Open access.
“Have the concepts of ‘anxiety’ and ‘depression’ been normalized or pathologized? A corpus study of historical semantic change” by Yu Xiao et al. PLOS ONE
Abstract
Have the concepts of ‘anxiety’ and ‘depression’ been normalized or pathologicalized? A corpus study of historical semantic changes
Research on concept creep shows that the meaning of some psychological concepts has expanded in recent decades.
Some concepts related to mental health such as ‘trauma’, for example, have acquired a broader meaning and refer to a wider range of events and experiences.
‘Anxiety’ and ‘depression’ may have experienced similar semantic inflation, fueled by increased public attention and awareness. Critics argue that everyday emotional experiences are increasingly pathological, so that ‘depression’ and ‘anxiety’ have broadened to include sub-clinical experiences of sadness and worry.
The possibility that these concepts have been extended to include less severe phenomena (vertical concept creep) was tested by examining changes in the emotional intensity of surrounding words (collocations) using two large historical text collections, one academic and one general.
The academic corpus contains >133 million words of abstracts of psychology articles published 1970–2018, and the general corpus (>500 million words) comprises a variety of textual sources from the US for the same period.
We hypothesized that the ‘anxiety’ and ‘depression’ groups would decrease in mean emotional severity over the study period. Contrary to predictions, the mean collocation severity for both words increased in both groups, possibly due to the evolving clinical framework of the two concepts.
The study findings therefore do not support a historical reduction in the severity of ‘anxiety’ and ‘depression’ but provide evidence of an increase in their pathology.
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