What is a Risk Factor? Difference Between a Risk Factor and a Cause
We have on this website a section called Causes of Premature Ejaculation. This section list all the premature ejaculation risk factors, but not the causes. Although it can look misleading, it’s because nobody really knows the root causes of premature ejaculation. In scientific vocabulary, the term cause involves a level of certainty more important than in common language. In our everyday life, we can say something like “eating junk food is a cause of obesity”. Most people will agree because there are enough scientific studies that show the link between high-calorie diet and obesity. However, this sentence isn’t correct if we consider the scientific concept of causality. A high-calorie diet is a risk factor for obesity, not a cause.
What is a Cause?
Let’s take an example. We have three hypothetical guys named Bob, Steve, and Sam. Bob has a bad diet and he’s overweight. Steve has a bad diet and he isn’t overweight. Sam has a healthy diet and he’s also overweight. Because of his active life and his metabolic rate, Steve compensates for his bad diet and still has a healthy weight. For Sam, his weight problem isn’t caused by his diet but by his genetics.
As you can see, a bad diet isn’t always synonym of a weight problem. Also, it’s possible to be overweight even with a healthy diet. Still, the bad diet is responsible for Bob’s weight problem. So, does a bad diet is a cause of obesity?
It depends on your definition of cause. Kenneth Rothman, a famous American epidemiologist, define a cause as “an event, condition, or characteristic without which the disease would not have occurred.” As you can see, to be considered a cause, we have to be sure that the condition wouldn’t have happened without this specific factor. So, in a specific example, like Bob’s case, we can say that his bad diet causes his obesity. If Bob were eating less calorific food, he wouldn’t be overweight.
However, when we’re talking about the general condition, it isn’t so clear. Of course, if you have a bad diet, you increase your chance of suffering from obesity. In common language, it’s accepted that a bad diet is a “cause” of obesity since it’s the cause of a lot of individual weight problem. However, since a bad diet doesn’t necessarily cause obesity, scientific texts will use the word risk factor instead of “cause.”
So what is a risk factor? A risk factor is anything that increases your chance of having a condition. A risk factor is based on a correlation.
The best way to explain what is a correlation is to use an example. Let’s say we take a group of person and we measure their weight and the “healthiness” of their diet. We draw a graph with the x-axis representing their weight and the y-axis representing their diet. For each person, we put a dot on the graph where the person stands in term of weight/diet ratio. Then, we draw a line in the middle of all the dots. If this line is up and straight, we have a correlation.
In simple terms, a correlation happens when a factor (like a bad diet) can help us predict the occurrence of a condition (like obesity). However, you may have already heard that correlation doesn’t imply causation. It’s not because a factor correlates with the condition that it causes it. There are several ways a risk factor could be linked to a condition.
Some risk factor could worsen an already present condition. For example, as you can read on the premature ejaculation and anxiety page, some studies show a correlation between some anxiety disorders and premature ejaculation. However, it’s not clear that an anxiety disorder alone could cause the premature ejaculation problem. It’s possible that it aggravates the condition without causing it. If this is the case, treating the anxiety disorder would help the PE problem, although it wouldn’t address it completely.
Vicious/Virtuous Cycle (cyclic causation)
Sometimes, the aggravating factor could also be aggravated by the condition. It’s what we often call a vicious cycle. For example, the anxiety could contribute to the PE, but the PE can also contribute to the anxiety.
Consequence of a Similar Cause
Another possible explanation for the correlation is that anxiety and premature ejaculation share a common cause. For example, if premature ejaculation is caused by an imbalance in the nervous system, like a diminished level of serotonin, and at a certain level, that imbalance also causes some anxiety disorders, you will have a correlation. However, the big difference, in this case, is that treating the anxiety won’t help the ejaculation problem if the anxiety treatment doesn’t resolve the nervous system imbalance.
Consequence (reverse causation)
Another explanation for the anxiety/premature ejaculation correlation would be that early ejaculation causes anxiety disorders. In this case, treating the PE would cure the anxiety problem, but addressing the anxiety won’t help the PE problem.
Root cause (direct causation)
The last explanation for the anxiety/premature ejaculation correlation would be that anxiety itself cause the PE problem. In this case, treating the anxiety would help the PE, but not the other way around.
When it comes to premature ejaculation, the link between each risk factors and the condition is never clear. For most risk factors listed on the premature ejaculation causes, we can’t explain why the correlation happens. However, we know that most PE risk factors have multiple and complicated links. There doesn’t seem to have simple direct causation, but a web of indirect causation, aggravating factors and cyclic causation all linked together.