As a psychologist, especially one who was a researcher for many years, I know a lot about probability. The efficacy of our treatments are assessed using probabilities. For example, in a study assessing the efficacy of a treatment for depression, the question for the treatment group would be, “How probable is it that improvements in the group that got the depression treatment were due to chance rather than from the treatment itself?” If the probability is low, less than 5%, it is taken as positive support for the treatment. I am oversimplifying here so that you don’t pass out with boredom before I get to my point.
In my clinical work, I work to select strategies that maximize the probability that a child will be helped. There are no absolutes. We can’t control other people, we can just look for the avenues where we have the best chance of influence and focus our efforts there. I also can make predictions about long-term outcomes for kids with particular issues but I can’t tell parents absolutely what the future reality will be. For example, I can tell a parent if he/she has ADHD, there’s nearly a 50% chance that any child he/she will have will also have ADHD. I can also tell them that if a child has ADHD, there’s about a 66% chance that he/she will have some other diagnosable condition. I can tell a parent of a child whom I’ve diagnosed with ADHD what the best practices are for treatment, for example that stimulant medication has an 80% efficacy rate. (I know that ADHD meds make a lot of people uncomfortable but if you wouldn’t mind, please don’t use my blog as a forum for expressing your views on this subject.) I can give a list of possibilities and sometimes I can even make pretty good predictions based on information I already have about the child but I can’t know for sure. In talking to parents about these numbers, I have to balance a tight rope of providing them with enough information so that they can make informed decisions, convey the information in a way that will encourage relatively quick action, but not scare them silly. This is a different balance for each parent, which can make it difficult if I am talking to two parents who have very different coping styles. It also depends on the child’s particular situation. Some situations are more dire and urgent than others. Oops, I’m blathering on and on again. Back to the main point.
So I know a lot about numbers, predicting, identifying risk and protective factors, treatment effects, etc. I also know that the numbers can be extremely useful but there is a balance between keeping myself knowledgeable and borrowing trouble. I will be getting my genetics testing results back in a couple of weeks. I know that my chances of having any of the genes is low based on probabilities for the general population as well as those based on my family history. I know the probability is low but I can’t tell you the exact number. And I’m not going to look it up in my notes from the genetics counselor. I have learned the hard way in my life that worrying about something I can’t do anything about is a recipe for crazy. When the time is right to get lots of information, you know I’m going to get lots and make the best decision I can based on the information that is available. So until I know what the findings of the test are and can develop a plan for dealing with it, I’m going to fight the urge to spin my wheels on the Internet or keep myself up at night worrying. Obviously, this will be harder as I get closer to the two week mark, but I’m going to do my best.
Wish me luck in keeping this balance between information-collection and sanity preservation.