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Why Are Computers So Accurate At Predicting Schizophrenia?

This article is more than 8 years old.

Last month, a group of researchers published the results of a study in which computers were able to predict with 100% accuracy which interview subjects would develop schizophrenia. The collaboration between Columbia University, the New York State Psychiatric Institute, and IBM’s T.J. Watson Research Center surveyed 34 subjects between 14 and 27 years-old, evaluating 45-minute interviews for syntactical and semantic coherence. After two and a half years, it turned out the computer program had predicted with 100% accuracy which subjects would become schizophrenic, outperforming clinicians, EEG recordings, and biomarker readings.

The group acknowledged the experiment’s limitations due to its small sample size, with only five of 34 subjects developing schizophrenia. But even with caveats, the suggestion that a computer is capable of perfect performance in identifying something as conceptually and clinically imprecise as schizophrenia is profound. The National Institute of Mental Health estimates schizophrenia occurs in 1% of the American population, or around 3 million people, yet the condition has never had an especially clear definition since it was first formulated in the late 19th Century.

The current way of evaluating patients for schizophrenia is uncannily similar to how computers work, parsing code first character by character and then building more complex semantic operations out of patterns found in it. Similarly, researchers measure for potential schizophrenia by evaluating speech for length of sentences and relative coherence between them. The shorter a person’s sentences, and the more disconnected from one another they seem, the higher the correlation with schizophrenia. Other symptoms include audio and visual hallucinations, delusional behavior, extreme disorganization, and occasionally prolonged catatonic dazes.

Like many psychiatric conditions schizophrenia is defined by what University of Washington neuropsychiatrist Assen Jablensky described as the “inherent weakness” of its diagnostic concept. “Research has identified a number of putative biological markers associated with the disorder, including neurocognitive dysfunction, brain dysmorphology, and neurochemical abnormalities,” he writes in a history of the condition. “Yet none of these variables has to date been definitively proven to possess the sensitivity and specificity expected of a diagnostic test.”

The Mayo Clinic says a major part of schizophrenia diagnosis depends on eliminating other potential causes for the generalized behavior, including substance abuse, side-effects from medication, or complications from other psychological conditions. This comparative uncertainty as to both cause and mechanism have given cover to a variety of social stigmas about schizophrenia. Studies have linked schizophrenia to marijuana use while others have suggested that ethnicity plays a part in determining what sorts of symptoms schizophrenics experience. 

Categorizing health conditions inevitably leads to cataloging people, something that’s most dangerous and least purposeful when organized around perceived negatives. Schizophrenia is particularly connected to, and worsened by, an awareness of other people’s capacity to criticize and castigate. In an essay on the phenomenon of hearing voices, the most common hallucinatory symptom of schizophrenia according the Mayo Clinic, Shruti Ravindran cites Barry Smith, director of the Institute of Philosophy at the School of Advanced Study, arguing many of the qualities we often attribute to schizophrenia may be connected to anticipatory anxieties over how a person’s being perceived.

People narrativize the social and physical phenomenon they experience, attempting to make them seem rational and inevitable. “If you’re subliminally aware of your heartbeat, your breathing, of how heavy your limbs are, you make predictions about continuing to feel that,” he told Ravindran, “and when you get sensory information that matches what you’re feeling, the brain says: ‘Ah, that must be me. And these are my thoughts, my limbs, my memories.’”

The split brain phenomenon of schizophrenia—the semantic incoherence, the interjectionary thought patterns, the hallucinatory voices—may be intimately connected to an awareness of the evaluative structures that pronounce people mentally ill. Believing there are negative health consequences associated with something can have a worse effect than the thing itself. A recently published study from Case Western’s Joshua Grubbs found that people who believed they were addicted to porn had a heightened propensity for depression, anxiety, anger, and stress. Porn use itself seemed to have no influence on these negative emotions, but the subjects taught to categorize themselves with a prejudicial label were much more likely to suffer. 

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Alongside improving mental health diagnoses, computers have revealed the self-replicating thoughtlessness behind much of what passes for normalcy. The herd thinking that produces an overwhelmingly interchangeable sameness is an essential element of how computers formulate values, not around ethical or moral distinctions but by measuring baselines and deviations.

Computers act as a guarantee that, even as times change, we can still rely on our standard deviations remaining proportionally the same. And as one form replaces another, one popular institution or pastime surpasses another, our culture creates a need for a typologized population of outsiders who become proprietary problems because of their atypical status. The atypical must be tamed again by being placed back inside a type.

In his lecture notes collection, How to Live Together, Roland Barthes argued the “fantasmatic” conception of an ideal community depends not on “who we chose; but who we exclude.” This conception of an excluded figure, a pariah, remains included in the communal whole, but its inclusion depends on it retaining the status of outsider or reject. 

“All societies jealously guard their rejects, prevent them from leaving,” he wrote. “So what would be needed as part of a globalized sociology is a theory of the incorporated reject, of the retained reject (simply: the different forms of hypocrisy, of ideological justification with regard to the pariah, who no longer tends to be recognized as such).”

Instead of thinking about ways to make our social habits, labor structures, and systems of exchange more accommodating to a wider group of behavioral types, our communal labor is bent toward articulating the maladies of those outside the normal and creating regiments that attempt to normalize them for profit. If you’re incapable of participating in our common theater of manners, finance, and fatalistic monogamy, there is no choice but to categorize you as unwell in mind and morals.

As a type, schizophrenia is the collision of individual mental and behavioral tendencies with immovable concepts like jobs, politesse, and money. These abstract systems can’t account for the existence of schizophrenic behavior in any way other than as patients, and they cannot tolerate anyone called a patient having the agency to exist separate from the consensus normalcy. And even as technologies like the computer or the computer phone arrive with vague promises of social transformation, they always end up reproducing the same prejudices along new lines. Someone has to be kept outside, what’s necessary is not contesting that fact but creating a convincing enough story about why their exclusion was inevitable. They didn’t take the right meds, kept getting kicked out of school, couldn’t hold down a job, made you feel unsafe.

One of my brother’s best high school friends slowly developed schizophrenic behavior patterns in his late teen years. The smart, athletic, charming boy everyone seemed to love started behaving in unusual ways. First it was chain smoking and binge drinking, a gradual loss of interest in hygiene, trading daily showers and hair gel for a baggy army surplus coat and ratty gym pants. Talking to him felt like riding a bucking bronco. In the middle of a perfectly lucid conversation about why guitars were more expressive instruments than violins he'd shift to  minutes of yowling unintelligible syllables or else repeating incoherent slogans formed from his high school Spanish, “Pig vato! E jole, pig vato! Peeeeeeeeeg! Peeeeeeeg vaaaaato!” 

He grew more violent, showing off his martial arts training at uncomfortably close range, and sometimes picked fights at parties. He began calling at all times of day and night, wanting attention for hours at a time,. When my brother finally began ignoring him, he’d leave incoherent minutes-long messages on our answering machine in the middle of the night. He stole random things from our house, smashed in our front windows while we were on vacation, tore up our front lawn with his car in the middle of the night. 

He grew paranoid and resentful, left two colleges after a semester each, was fired from one job after a few months and then another. After five years he seemed physically transformed, avoidant of eye contact, his car filled with trash, nowhere to live but his widowed mother’s home. No one wanted to see him anymore. People had gotten jobs, started relationships, bought property, grown afraid. His instability made him phantom-like. 

But he always seemed to retain an anxious self-awareness of this abandonment, a dog sense for some long glacial shift in the order of things that was transforming his rabble of adolescent friends into weirdly distant adults who couldn’t accept him for what he was or what he was changing into. In a way, he was already living in a community of proto-computers formed in the rigid thought patterns of everyone he took for a friend, a nascent code of values that would eventually pull them all toward a standard of normalcy that couldn’t accommodate him. 

While society has some difficulty accomodating people categorized as schizophrenic, computers seem too ready to accommodate modes of schizophrenic thinking. In 2011, researchers at the University of Texas Austin programmed a computer to simulate schizophrenic speech rather than analyze it for symptoms. The project was built around the hyperlearning theory of schizophrenia, through which the condition emerges as a result of excess levels of dopamine making it difficult for the brain to distinguish the saliency of information and begins to treat all things as equally relevant. 

In humans this is a psychopathology, but in computers it’s a defining function, from the nonsensical informational collisions of social media and news aggregators to the functional intrusion of bugs and often nonsensical mysteries differing software or OS interfaces. Computers invert the obvious in human communication through a frail but incontestable hyper-linearity. They make the world seem both more radically synchronous and dangerously out of joint, a place that makes you feel crazy for not wanting to connect with the systems accelerating its unhinging.

Driving this system is an equally unhinged utopianism, paradoxically obsessed with reclaiming the schizophrenic as a perfected endstate. Earlier this month, Mark Zuckerberg suggested that social networking would eventually lead to a future of computer-mediated telekinesis. “You'll just be able to think of something and your friends will immediately be able to experience it too if you'd like,” he said. “This would be the ultimate communication technology.” 

This fantastical goal seems unambiguously schizophrenic, a world in which other people’s voices, interject into your own flow of thought at irregular intervals, driven by powers only superficially under your control. It’s less schizophrenic behavior that people seem to fear than a flattening of the power that separates people into increasingly prejudicial categories. One generation's malady becomes another's idyllic fantasy, and around we go.