Are you Crazy? NYU’s Online Sanity Test

Written by Jim Knipfel on . Posted in Breaking News, Posts.



That’s
why I was so surprised when, after honestly answering 10 simple multiple-choice
questions–questions like, “Do you feel that things always go or will
go wrong no matter how hard you try?” (Answer: “Most of the time”),
my computer-generated psychiatric evaluation came up screaming, “My
God, man! Get yourself locked up before you do any more damage
!!”


Well okay,
it didn’t exactly say that. But it did say, “Your answers show the
presence of prominent depressive symptoms. It is advised to seek a psychiatric
consultation,” followed by some links to various referral services.


NYU’s
Dept. of Psychiatry, it turns out, offers a whole slew of online screening tests
for various troubles–anxiety, sexual disorders, attention deficit disorder
and the like.


So just
out of curiosity after seeing those results from the depression test, I went
back and took the Online Anxiety Screening Test, which was listed just below
the depression test. Answered a few yes-or-no questions, hit a button and waited
for my evaluation to come up.


This time,
the machine listed my symptoms (“Avoidance of social situations” and
“Specific fears of certain objects,” among several others) before
telling me, “The above answer(s) are anxiety symptoms that might be part
of an Anxiety Disorder. It is advised to seek a psychiatric consultation.”


Things were
not going so well, but I seemed to be on some kind of a roll. So I went back
one last time and took the Online Personality Disorders Test. Fifteen years
ago, upon my release from a Minneapolis psych ward, the doctor in charge noted
in my file that I suffered from some kind of “mixed personality disorder,”
but gave no further details. Still, though, like I said, things seemed to be
well under control of late. I wasn’t too concerned.


Yet after
answering a few more yes/no questions and receiving another long list of apparently
ominous symptoms, I was diagnosed as schizoid.


Now that’s
no good at all. I’ve seen that Klaus Kinski movie, and being diagnosed
as schizoid bodes nothing but trouble. The machine might just as well have said,
“Pull down that stocking cap, throw on three extra coats and lose the shoes,
boyo–you’re on your own!”


Before things
got completely out of control, I stopped. I hadn’t yet taken the sexual
dysfunction test or the attention deficit test. No, I think starting the day
in a good mood and by 10 a.m. being labeled a depressive, anxiety-ridden schizoid
is plenty enough.


Now, granted,
all of these tests feature prominent disclaimers at the bottom stating that
the test results are no replacement for an evaluation by a real-live psychiatrist,
and that the results are only supposed to indicate whether or not you might
have reason to seek a shrink’s help. But still, to answer a few vague questions
with the click of a mouse, then have a machine tell you that you’re schizoid?
Well that just seems nuts. And potentially dangerous for someone sitting alone
in a darkened room, who perhaps didn’t care to step outside or shell out
the necessary cash to see a real shrink–someone who might later tell police,
“The computer told me I was crazy.”


Waguih William
IsHak, MD, is an Academic/Administrative Fellow at NYU’s Dept. of Psychiatry.
Among his myriad other duties, Dr. IsHak has been central in putting these screening
tests online, so I figured I’d ask him a few questions about what was behind
it all.


According
to Dr. IsHak, the tests were first posted on the Web in 1996. “Studies
of depressive disorders reveal that there is a high number of unrecognized and
untreated patients,” he told me. “According to the American Psychiatric
Association, the lifetime prevalence of Major Depressive Disorder is 10-25 percent
for women and 12 percent for men. Results of the Epidemiologic Catchment Area
study revealed that 46.1 percent of patients with unipolar major depression
were not treated in the last 12 months.”


The online
tests, he explained, were designed to help catch a few of the stragglers. It
seems to be doing the trick. “There were 96,000 visits per year to that
screening test. Online availability of this self-administered test allows users
in the privacy of their own locale, to self-evaluate symptoms of depression
and obtain a referral if needed. This can extend the outreach of psychiatric
services to individuals who are intimidated by conventional modes of referrals.”
It’s especially useful, he said, for shut-ins, the disabled and the elderly–people
who might have trouble getting to a regular clinic.


He also
noted that the online tests themselves were something new–you don’t
get asked the same questions you’d receive in person on National Depression
Screening Day. The NDSD questions are based on a test developed 30 years ago.
The new tests, he told me, were based on recent findings by the American Psychiatric
Association.


But isn’t
there a real danger in diagnosing psychiatric problems online?


“Again,”
he said, “it is important to emphasize the purpose of the tests. They aim
at providing a preliminary idea before having to go through the whole comprehensive
evaluation.” But he also admitted that “the impact of online information
about psychological problems remains understudied.”


Along those
lines, I wondered, does he have any indication as to how effective these online
tests have been so far?


“We
have not collected data on the use of the online screening tests,” he said,
“due to the fact that data collected online could be questioned for validity.”
As he explained it, “People might take the same test many times, they might
change their answers around to ‘test the test.'”


Along with
the psychological screenings for the general population, Dr. IsHak has also
posted some “test preparation” quizzes for medical students facing
their Board Certification Exams and, in the future, hopes to expand the site’s
educational uses by including interactive patient scenarios for students, as
well as professional psychiatrists.



You may test
your own sanity at: http://www.med.nyu.edu/Psych/public.html.


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