The Implications of Genetic and Other Biological Explanations for Thinking about Mental Disorders

Abstract

Given the rise of genetic etiological beliefs regarding psychiatric disorders, a growing body of research has focused on trying to elucidate the effects that such explanatory frameworks might be having on how mental disorders are perceived by patients, clinicians, and the general public. Genetic and other biomedical explanations of mental disorders have long been seen as a potential tool in the efforts to destigmatize mental disorders, given the harshness of the widespread negative attitudes about them and the important negative clinical and social impacts of this stigma. The conventional wisdom has appeared to be that because the effects of genes are seen as falling outside individual control, conceiving of mental disorders as caused by genes casts patients as blameless, thereby reducing stigmatization. Indeed, the results of experimental and correlational research have now robustly linked genetic and other biomedical explanations for mental disorders with reductions in the extent to which people are blamed for their psychiatric symptoms. However, research examining the impact of genetic and other biomedical explanations of mental disorders has also suggested that they can have significant downsides. The most consistently observed negative effect of these kinds of explanations is that they can apparently lead to the assumption that mental disorders are unlikely to improve or abate. Genetic and other biomedical explanations of mental disorders can also increase people’s confidence in the effectiveness of biomedical treatments (such as pharmacotherapy) but decrease their confidence in the effectiveness of “nonbiomedical” treatments (such as psychotherapy).

Laypeople Are Strategic Essentialists, Not Genetic Essentialists

“…Scholars are already giving serious consideration to the difference that interests make in the response to genetic accounts. As Matthew Lebowitz notes in this special report, “[T]he picture is decidedly not straightforward”—a statement that reprises the elegant research summary by Heine et al Continuing to build those interests deliberately and systematically into our research designs is now requisite. Yet shifting our view of humans from genetic essentialists (or snookered simpletons) to strategic essentializers also demands that we broaden our interpretations of those experiments to how our scenarios may be shifting interests.…”

“…Scholars are already giving serious consideration to the difference that interests make in the response to genetic ac-counts. As Matthew Lebowitz notes in this special report, "[T]he picture is decidedly not straightforward" 19 Eye color s demands that we broaden our interpretations of those experiments to how our scenarios may be shifting interests.…”

On What We Have Learned and Still Need to Learn about the Psychosocial Impacts of Genetic Testing

“…According to Lebowitz, there is some reassuring news in this context: genetic information can attenuate the tendency to blame patients for their mental illnesses. But the less reassuring news is that such information can also promote “prognostic pessimism” in people with mental illness 18. As he explains in his essay, he and his colleagues showed that when people are told that their depression is genetically caused, they are more likely to report experiencing depressive symptoms and to be pessimistic about their chances for recovery.…”

“…In fact, as we prepared this set of essays for publication, evidence emerged (for the first time, so far as we know) that learning one’s genetic risk for diseases such as Alzheimer’s, cancer, and obesity can change one’s physiology—independent of the actual genetic risk 19. An important conclusion from these findings appears to be that, in Lebowitz’s words, “pronouncements about the supposed failure to find negative psychosocial effects of personalized genetic health information seem premature.”20…”

“…But the less reassuring news is that such information can also promote "prognostic pessimism" in people with mental illness. 18 As he explains in his essay, he and his colleagues showed that when people are told that their depression is genetically caused, they are more likely to report experiencing depressive symptoms and to be pessimistic about their chances for recovery. Genetics can mean less blame, Lebowitz observes, but also less sense of agency.…”