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I generally enjoy reading David Perell's article but he generally frustrates me with his ad-hoc mix of science/research and his personal opinions. Example - he

I generally enjoy reading David Perell's article but he generally frustrates me with his ad-hoc mix of science/research and his personal opinions. Example - he references the 300% increase in college degrees amongst the population since 1970 and the pressure it places upon everyone else to "get a degree" and then turns around and bashes the idea of ADHD medications with ZERO evidence of its supposed dangers: "To their credit, my parents didn’t drug me. I had all the features of a kid who would have binged ADHD medications like shots at a New Year’s party. No matter how badly I acted, my parents never caved into the twisted logic that leads doctors to hand out prescription pills faster than candy on Halloween." Maybe if his parents HAD drugged him he wouldn't have been such a mess in middle school. I find him to generally be thought provoking but his immaturity (and youth) as a human shows through in a lot of his writing at times...

zepto 5y ago
He does say that there hasn’t been time for evidence of the long term dangers to become apparent.
- jtbayly 5y ago
  Like the vaccine?
  - zepto 5y ago
    If the vaccine altered behavior and was taken every day during a decade of rapid brain development, there would be a reasonable basis for comparison.
- wswope 5y ago
  He can say that, but the drugs have been around and extensively studied using every reasonable approach for many decades. Choosing to ignore evidence doesn’t make it not exist - he’s wrong according to a well-established scientific consensus.
  - zepto 5y ago
    The drugs have been around for decades. Using them daily with increasing numbers of children during a decade or so of brain development, has not.
    - wswope 5y ago
      Then why are there dozens of studies looking longitudinally at the effects of ADHD medications on children going (at least) back to the sixties all over Google Scholar? https://doi.org/10.1176/appi.ajp.2008.07091465 https://doi.org/10.1176/appi.ajp.2008.07091465 https://doi.org/10.1097/chi.0b013e318157cb3b https://doi.org/10.1097/chi.0b013e318157cb3b https://doi.org/10.1097/01.chi.0000128797.91601.1a https://doi.org/10.1097/01.chi.0000128797.91601.1a You done much reading on the subject to the contrary you can talk about? Any books on the topic you’ve read that you can name?
      - zepto 5y ago
        > You done much reading on the subject to the contrary you can talk about? Any books on the topic you’ve read that you can name? Have you? Or did you just find some papers that support your view with a quick search? Remember, most social science and medical research from this time period is now considered very weak. A few papers don’t make a ‘well established consensus’.
        wswope 5y ago
        I have a half dozen books on the subject on the bookshelf in my office, read quite a few more on top of those during undergrad and have easily read well over a hundred papers on the topic. I also have a pretty heavy background in stats, I’m well aware of the replication crisis, and I’m deeply skeptical by nature. My opinions are backed by an overwhelming preponderance of evidence, which you seem to feel qualified to criticize despite not having been aware of its existence until today, much less having actually read any of it. Did you try looking for more papers to confirm if it was really just a few? If so, what did you see?
- BirdieNZ 5y ago
  Ritalin's been used to treat ADHD for about 70 years. Also, we know that ADHD results in reduced life expectancy, so ADHD medication just has to improve that number for it to be pretty good. If your life expectancy due to taking ADHD meds improves by a couple years because you're less likely to crash your car or overdose on recreational drugs then ADHD meds are a far preferable option to not taking them.
  - zepto 5y ago
    > If your life expectancy due to taking ADHD meds improves by a couple years because you're less likely to crash your car or overdose on recreational drugs Do we know that accidents are the causes of excess mortality for people with unmedicated ADHD, or are they deaths of despair because of a lack of accommodation? Edit: Looks like there is evidence supporting the idea that it’s accidents. I would still be cautious about assuming this is true given how weak almost all social science and medical research is.
    - BirdieNZ 5y ago
      There are actually a lot of causes. Barkley (2018)[1] says: > The reduced ELE linked to ADHD was found to be a function of the first order variables of less education, less annual income, greater consumption of alcohol and tobacco, diminished sleep, and poorer overall health status relative to the control group. Moreover, ELE was also shown to be a function of the second order traits of deficient behavioral inhi- bition in daily life and, much less so, of low verbal IQ, greater interpersonal hostility, and deficient nonverbal fluency. and: > For instance, besides ADHD-C itself, this study showed that behavioral disinhibition (as assessed by EF ratings in daily life), verbal IQ, the comorbid psychopathology of hostility, and the EF of nonverbal fluency (and its associa- tion with nonverbal working memory) all uniquely contrib- uted, in descending order, to variation in life expectancy. The largest percentage, however, by far was contributed by behavioral disinhibition. Nigg (2013)[2] says: > ADHD is clearly associated with worse physical health outcomes across multiple domains. These include unhealthy behaviors and outcomes like smoking, illicit substance use disorders, accidental injuries, obesity, and even suicide attempts and completed suicides. ---- Basically, having ADHD means you have less self-control, engage in riskier behaviour (including riskier eating habits, substance abuse, driving, sex. It also means you struggle in life, resulting in suicidality, aggressiveness and anti-social behaviour. You sleep worse. You're more likely to smoke because nicotine is a stimulant which has a medicating effect on ADHD symptoms. [1]: Hyperactive Child Syndrome and Estimated Life Expectancy at Young Adult Follow-Up: The Role of ADHD Persistence and Other Potential Predictors, Barkley 2018 [2]: Attention-deficit/hyperactivity disorder and adverse health outcomes, Nigg 2013 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322430/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322430/)

zepto 5y ago

He does say that there hasn’t been time for evidence of the long term dangers to become apparent.

jtbayly 5y ago
Like the vaccine?
- zepto 5y ago
  If the vaccine altered behavior and was taken every day during a decade of rapid brain development, there would be a reasonable basis for comparison.
wswope 5y ago
He can say that, but the drugs have been around and extensively studied using every reasonable approach for many decades. Choosing to ignore evidence doesn’t make it not exist - he’s wrong according to a well-established scientific consensus.
- zepto 5y ago
  The drugs have been around for decades. Using them daily with increasing numbers of children during a decade or so of brain development, has not.
  - wswope 5y ago
    Then why are there dozens of studies looking longitudinally at the effects of ADHD medications on children going (at least) back to the sixties all over Google Scholar? https://doi.org/10.1176/appi.ajp.2008.07091465 https://doi.org/10.1176/appi.ajp.2008.07091465 https://doi.org/10.1097/chi.0b013e318157cb3b https://doi.org/10.1097/chi.0b013e318157cb3b https://doi.org/10.1097/01.chi.0000128797.91601.1a https://doi.org/10.1097/01.chi.0000128797.91601.1a You done much reading on the subject to the contrary you can talk about? Any books on the topic you’ve read that you can name?
    - zepto 5y ago
      > You done much reading on the subject to the contrary you can talk about? Any books on the topic you’ve read that you can name? Have you? Or did you just find some papers that support your view with a quick search? Remember, most social science and medical research from this time period is now considered very weak. A few papers don’t make a ‘well established consensus’.
      - wswope 5y ago
        I have a half dozen books on the subject on the bookshelf in my office, read quite a few more on top of those during undergrad and have easily read well over a hundred papers on the topic. I also have a pretty heavy background in stats, I’m well aware of the replication crisis, and I’m deeply skeptical by nature. My opinions are backed by an overwhelming preponderance of evidence, which you seem to feel qualified to criticize despite not having been aware of its existence until today, much less having actually read any of it. Did you try looking for more papers to confirm if it was really just a few? If so, what did you see?
BirdieNZ 5y ago
Ritalin's been used to treat ADHD for about 70 years. Also, we know that ADHD results in reduced life expectancy, so ADHD medication just has to improve that number for it to be pretty good. If your life expectancy due to taking ADHD meds improves by a couple years because you're less likely to crash your car or overdose on recreational drugs then ADHD meds are a far preferable option to not taking them.
- zepto 5y ago
  > If your life expectancy due to taking ADHD meds improves by a couple years because you're less likely to crash your car or overdose on recreational drugs Do we know that accidents are the causes of excess mortality for people with unmedicated ADHD, or are they deaths of despair because of a lack of accommodation? Edit: Looks like there is evidence supporting the idea that it’s accidents. I would still be cautious about assuming this is true given how weak almost all social science and medical research is.
  - BirdieNZ 5y ago
    There are actually a lot of causes. Barkley (2018)[1] says: > The reduced ELE linked to ADHD was found to be a function of the first order variables of less education, less annual income, greater consumption of alcohol and tobacco, diminished sleep, and poorer overall health status relative to the control group. Moreover, ELE was also shown to be a function of the second order traits of deficient behavioral inhi- bition in daily life and, much less so, of low verbal IQ, greater interpersonal hostility, and deficient nonverbal fluency. and: > For instance, besides ADHD-C itself, this study showed that behavioral disinhibition (as assessed by EF ratings in daily life), verbal IQ, the comorbid psychopathology of hostility, and the EF of nonverbal fluency (and its associa- tion with nonverbal working memory) all uniquely contrib- uted, in descending order, to variation in life expectancy. The largest percentage, however, by far was contributed by behavioral disinhibition. Nigg (2013)[2] says: > ADHD is clearly associated with worse physical health outcomes across multiple domains. These include unhealthy behaviors and outcomes like smoking, illicit substance use disorders, accidental injuries, obesity, and even suicide attempts and completed suicides. ---- Basically, having ADHD means you have less self-control, engage in riskier behaviour (including riskier eating habits, substance abuse, driving, sex. It also means you struggle in life, resulting in suicidality, aggressiveness and anti-social behaviour. You sleep worse. You're more likely to smoke because nicotine is a stimulant which has a medicating effect on ADHD symptoms. [1]: Hyperactive Child Syndrome and Estimated Life Expectancy at Young Adult Follow-Up: The Role of ADHD Persistence and Other Potential Predictors, Barkley 2018 [2]: Attention-deficit/hyperactivity disorder and adverse health outcomes, Nigg 2013 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322430/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4322430/)