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David Epstein @davidnotdave.bsky.social · 3h

So, again, I really like the participatory approach taken here, but I don't agree that the results fail to map on to "the prevailing model of addiction." (4/4)

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David Epstein @davidnotdave.bsky.social · 3h

The framework also requires relapse, which CAN'T be a defining component of addiction: addiction has to be defined BEFORE you can specify whether someone has relapsed to addiction. Otherwise it's a Mobius strip. (3/4)

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David Epstein @davidnotdave.bsky.social · 3h

The conceptual framework used here (M. Griffiths, 2005, doi 10.1080/14659890500114359) is not a usable definition of addiction. For example, it REQUIRES both tolerance and withdrawal--which are neither necessary nor sufficient for addiction. (2/4)

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David Epstein @davidnotdave.bsky.social · 3h

Getting narrative accounts of lived experience was a great way to approach data collection. The accounts seemed to accord closely with the central construct of addiction (per ICD and DSM): ongoing use despite net detriment. (1/4)

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David Epstein @davidnotdave.bsky.social · 19/09/2026

And the link to a pdf is whitefonted in 2-point Dingbat typeface.

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David Epstein @davidnotdave.bsky.social · 16/09/2026

So if you’re going to argue that social-media use can’t be an addiction, you need a better foundation than “it’s just wanting to communicate and chat.” Online or offline, that “want” is an addiction if it pulls you inflexibly toward damaging behavior. (2/2)

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David Epstein @davidnotdave.bsky.social · 16/09/2026

...My point is, it's hogwash to say categorically: "You wanting to communicate and chat with your friends every day is not an addiction." We saw in 2020 that some instances of such "wanting" (based in meatspace, therefore viewed as expected) were 𝘧𝘢𝘵𝘢𝘭𝘭𝘺 insensitive to consequences. (1 /2)

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David Epstein @davidnotdave.bsky.social · 16/09/2026

Yes, I think addictions are best defined as behaviors that continue when they bring more harm than benefit. The relevant behaviors vary by context. I think we saw addiction to 𝘪𝘯-𝘱𝘦𝘳𝘴𝘰𝘯 (not online) socializing in 2020, when people did it avoidably and then died from it. Not being facetious.

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David Epstein @davidnotdave.bsky.social · 31/08/2026

As far as I know, no Bayesian procedure is resistant to evidence-based updating of beliefs the way a 1-sided frequentist test is. So I wouldn't compare a Bayesian posterior probability to a one-sided p. (5/5)

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David Epstein @davidnotdave.bsky.social · 31/08/2026

Also, the 1-sided frequentist test is problematic because, when you do one, you're not permitted to draw conclusions in the opposite of your hypothesized direction. If the treatment seems to reduce benefit (i.e., to do harm), your 1-sided test requires you to conclude only that it didn't help. (4/5)

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David Epstein @davidnotdave.bsky.social · 31/08/2026

The p values say nothing about the probability of benefit. They're the long-run frequency with which the observed results would occur over many trials in the absence of a real benefit. That's not a question anyone asked, and it's not very helpful for decisionmaking by clinicians or patients. (3/5)

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David Epstein @davidnotdave.bsky.social · 31/08/2026

That comparison doesn't hold up. The Bayes .92 means that, if the assumptions of the model (including the neutral prior) are correct, then, given the trial results, there’s a 92% probability that the treatment really had benefit. That's what clinicians/patients want to know. (2/5)

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David Epstein @davidnotdave.bsky.social · 31/08/2026

Hmm: "...a Bayesian posterior probability of treatment benefit of 0.92 in a large trial with a neutral prior corresponds approximately to a 1-sided frequentist P value of .08 or a 2-sided frequentist P value of .16, which would not meet conventional thresholds for statistical significance." (1/5)

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David Epstein @davidnotdave.bsky.social · 23/08/2026

Yep--I thought it was an aesthetically displeasing name (the "ep" component has a graceless "splat!" quality) even before it was definitively sullied.

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David Epstein @davidnotdave.bsky.social · 23/08/2026

We each of us bear the hunchback that is this surname. We have to stick together! :)

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David Epstein @davidnotdave.bsky.social · 23/08/2026

Clear it up, Cofnas signatories. Do you care about academic freedom, a fine ideal that includes empirical examinations of racism, misogyny, and gender nonbinaries? Or do you care only about an absence of consequences for racist tweets from your racist friends? Have the guts to say which.

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David Epstein @davidnotdave.bsky.social · 21/08/2026

Every week is Watts week when you like psychometric critiques of the DSM!

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David Epstein @davidnotdave.bsky.social · 14/08/2026

But isn't it time to recognize the autonomy with which Sharona was born?

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David Epstein @davidnotdave.bsky.social · 13/08/2026

Seems to me that one way to address this is to publish graphs of all the individual trajectories superimposed on each inferred latent trajectory. Readers can decide how well the estimates represent the observations (and know exactly how they don't).

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David Epstein @davidnotdave.bsky.social · 07/08/2026

Socks with sandals is logical and practical: socks for warmth; sandals for insulation from damp floors or uneven ground. The combination is often more comfortable than most kinds of shoes. If there's anything unsatisfactory about that, I've never seen it coherently explained.

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David Epstein @davidnotdave.bsky.social · 03/08/2026

You Thought They Weren't Giants. You Should Think Twice. Here's Why.

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David Epstein @davidnotdave.bsky.social · 01/08/2026

NIH does not have an institutional subscription to Nature Mental Health or Nature Reviews Psychology. They are offensively expensive publications, but that doesn’t stop NIH from subscribing to Nature Nanotechnology or Nature Plants or…

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David Epstein @davidnotdave.bsky.social · 31/07/2026

I second the recommendation (for Patti Smith's memoir 𝘑𝘶𝘴𝘵 𝘒𝘪𝘥𝘴). Also, if you know south NJ (Pitman/Deptford), the book is a reminder that the mid/late1960s happened there too.

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David Epstein @davidnotdave.bsky.social · 31/07/2026

My red text is on the right-hand side of the screencap. If you understand factor analysis and/or the circumplex model of affect, please explain it to me as if I were a toddler. And please don't be mean.

Screencap of "Independence and Bipolarity in the Structure of Current Affect" (1998), but Lisa Feldman Barrett and James Russell. My question is about how valence and arousal can be independent of each other while being represented as the circumference of a circle (whereby changes in one will restrict the range of the other). Shouldn't they be the full interior of a square?

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David Epstein @davidnotdave.bsky.social · 16/07/2026

More specifically, if your study is well underway, there's no point in submitting the protocol to a peer-reviewed journal. There's nothing for peers to review (because you can't change the protocol now), and you'll only introduce delays. If you wanna share it, just share it.

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David Epstein @davidnotdave.bsky.social · 16/07/2026

Here's a study protocol (no results, just protocol), newly published in a peer-reviewed journal. Looking at the dates, I don't know why. If you want your protocol publicly available, just put it on a preprint server.

To appear in:
Contemporary Clinical Trials Communications
Received Date: 2 June 2025
Revised Date: 5 June 2026
Accepted Date: 26 June 2026

Results
This study is ongoing and data collection is expected to be concluded in July 2025, with plans to publish the study results by November 2025.

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David Epstein @davidnotdave.bsky.social · 09/07/2026

Wow! This seems like the inferential-statistic cousin of the fallacy whereby people tout high accuracy for classification/prediction models using datasets with very low prevalence of cases. I suppose the math is different, but the mistake is similar.

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David Epstein @davidnotdave.bsky.social · 09/07/2026

I am so looking forward to reading this!

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David Epstein @davidnotdave.bsky.social · 27/06/2026

If we're peer-reviewing each other's cocktails now, I have no notes on this one. Accept! Great work!

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David Epstein @davidnotdave.bsky.social · 25/06/2026

This is great. And yes, I usually do better by honing my spoken phrasings and transitions before I sink time into making the visuals that should accompany them. PowerPoint-perfected and tongue-tied is no way to go through life.

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David Epstein @davidnotdave.bsky.social · 18/06/2026

Instances of, say, grief vs. shame are likely to be accurately classified by self-report. There will not be a field-deployable sensor that can obviate that, nor probably one that can augment it. At best, a sensor will tell you when to ask about it.

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David Epstein @davidnotdave.bsky.social · 18/06/2026

NIH intramural does not. We pay every cent from our small section budget.

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David Epstein @davidnotdave.bsky.social · 18/06/2026

Can you tell me how to get free Qualtrics data? The price we were quoted for the lowest-tier FedRamped Qualtrics license was $18,500 a year, and we can't afford that. Free sounds awesome.

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David Epstein @davidnotdave.bsky.social · 18/06/2026

Sure! You can validate your "indices of emotion" against, y'know, self-report. If they often come close to agreeing with it, you can use them to...move beyond it. Psychology! The science that aspires to understand people by not listening to them!

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David Epstein @davidnotdave.bsky.social · 22/05/2026

I’m not him. I’m an addiction researcher.

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David Epstein @davidnotdave.bsky.social · 17/05/2026

Even though "eructation" is the load-bearing wall of that post, every accompanying fillip and filigree is positioned and timed to max effect as well. No one asked me to analyze that. It's just a little service I come along and provide.

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David Epstein @davidnotdave.bsky.social · 15/05/2026

The main thing I do for fun is cross-mispronounce "Anthropic" and "biopic."

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David Epstein @davidnotdave.bsky.social · 07/05/2026

Not sure how this figures into the ol' h-index.

Screencap from John Oliver's May 4 "Last Week Tonight," showing a paper about tianeptine that was written by Kirsten Smith, Jeff Rogers, Justin Strickland, and me.

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David Epstein @davidnotdave.bsky.social · 03/04/2026

It looks like the actual precision was only .48 (range .37 to .56).

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David Epstein @davidnotdave.bsky.social · 29/03/2026

So, don't look for the Helpers, is what I hear you saying?

Screenshot of an 1970s SNL commercial parody called "Placenta Helper," which famously never aired.

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David Epstein @davidnotdave.bsky.social · 28/03/2026

Made my own sign for No Kings. No use of generative AI here. I did it the way the Amish would do it: Photoshop.

A graph of approval/disapproval ratings for 47 as their shape widens over time like a sideways letter V (disapproval up from 41% to 62%, approval down from 47% to 36%). They form a set of shark's teeth, inside the mouth of a shark in pursuit of him. Header, above the shark: "Help him 'tank.'"

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David Epstein @davidnotdave.bsky.social · 28/03/2026

Sure, there are countless hypotheses about specific neural causes and manifestations of addiction—hypotheses with varying degrees of specificity and support. But any or all could be refuted without causing proponents of the BDMA to stop saying “addiction is a brain disease.” (2/2)

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David Epstein @davidnotdave.bsky.social · 28/03/2026

The brain-disease model of addiction (BDMA) isn’t a model at all. As best I can tell, the BDMA is “addiction is a brain disease.” That’s best described as a slogan or a credo. It makes no falsifiable predictions. (1/2)

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David Epstein @davidnotdave.bsky.social · 16/02/2026

I propose “de-muliebriate” (to reduce in muliebrity).

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David Epstein @davidnotdave.bsky.social · 29/12/2025

I've long enjoyed your wit in short-form posts, and here I really valued your openness. Thank you for it.

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David Epstein @davidnotdave.bsky.social · 28/12/2025

Something I posted in 2010: "These days, when I see anti-Semitism, it’s like seeing a Swanson TV dinner with Salisbury steak, peas, and apple cobbler in a three-compartment foil tray. I’m like, ‘They still MAKE that stuff? It’s so boring.’” I said "anti-Semitism," but I could have said "racism."

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David Epstein @davidnotdave.bsky.social · 12/12/2025

Thank you for writing this paper.

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