Neurobiological narratives: experiences of mood disorder through the lens of neuroimaging

Abstract

Many scientists, healthcare providers, policy makers, and patients highly anticipate the application of biomedical technologies such as functional neuroimaging to the prediction, diagnosis, and treatment of mental disorders. The potential efficacy of such applications is controversial, and functional neuroimaging is not yet routinely used in psychiatric clinics. However, commercial ventures and enthusiastic reporting indicate a pressing need to engage with the social and ethical issues raised by clinical translation. There has been little investigation of how individuals living with mental illness view functional neuroimaging, or of the potential psychological impacts of its clinical use. We conducted 12 semi-structured interviews with adults diagnosed with major depression or bipolar disorder, probing their experiences with mental healthcare and perspectives on the prospect of receiving neuroimaging for prediction, diagnosis, and treatment planning. Participants discussed the potential role of neuroimages in 1) mitigating stigma; 2) supporting morally-loaded explanations of mental illness due to an imbalance of brain chemistry; 3) legitimizing psychiatric symptoms through objective representations of disorder; and 4) reifying disorder categories and links to identity. We discuss these anticipated outcomes in the context of participant lived experience and attitudes to biologisation of mental illness, and argue for bringing these voices into upstream ethics discussion.

Scepticism and hope in a complex predicament: People with addictions deliberate about neuroscience

“…This finding is similar to the optimism expressed by individuals with mood disorders about the positive impacts of neuroimaging on their views about the treatment of depression (Buchman, Borgelt, Whiteley, & Illes, 2013).…”

“…Some found it useful to 'biologise' the processes of addiction as a way of externalising it by gaining a perspective on their addiction (cf. Buchman, et al, 2013). Appreciating these different frames, may be helpful for practitioners interested in providing neuroscience ideas to healthcare consumers at the right time, and in ways that improve self-efficacy and treatment seeking, and lessen selfblame.…”

Public Understandings of Addiction: Where do Neurobiological Explanations Fit?

“…While our findings support those of Bröer and Heerings' [24] study of individuals living with ADHD, they differ from other studies of individuals diagnosed with mental illness that have shown a greater appropriation of neuroscientific understandings (e.g. [18,20]). A fertile site for future inquiry would be investigating similarities and differences in the causal attributions made when individuals reflect upon their own condition, as opposed to when one is asked to reflect on another's condition.…”

“…Empirical philosophy, sociological and anthropological investigations of individuals living with mental illness [18][19][20][21] and Angermeyer and colleagues' [22] systematic review of literature on public beliefs about biogenetic causes of mental illness lend support to this view. Angermeyer and colleagues [22] found indicators of increased acceptance of biogenetic models of mental illness (including neuroscientifically based models) across a number of OECD countries but they also found that this had not resulted in any greater social tolerance of people who are mentally ill. Other studies have found that, while stigma has not been reduced, increased acceptance of neurobiological explanations can increase support for treatment [23].…”

(Low) Expectations, Legitimization, and the Contingent Uses of Scientific Knowledge: Engagements with Neuroscience in Scottish Social Policy and Services

“…Second, our analysis will augment literatures concerned with the ways in which different actors draw on (neuro)science for policy and service design and delivery (Broer and Pickersgill 2015;Edwards, Gillies, and Horsley 2015;Lowe, Lee, and Macvarish 2015a;Lowe, Lee, and Macvarish 2015b) especially through underscoring the ambiguities and uncertainties present in their accounts. Third, this paper enhances empirical specificity concerning the impacts and translation of neuroscientific knowledge in contemporary society (Bröer and Heerings 2013;Buchman et al 2013;Pickersgill 2013;Pickersgill et al 2015;Rose 2007;Rose and Abi-Rached 2013;Singh 2013;Vidal 2009;Vrecko 2010).…”