Biological accounts of mental illness may dent patients’ hope and increase stigma

“Mental illnesses are biologically based brain disorders” - that's the bold proclamation made by The National Alliance on Mental Illness and many other campaign groups. No doubt, one intention of such proclamations is to reduce the stigma associated with mental illness – to show that mental illnesses are not “all in the mind”, but are as real as any physical illness. However, Danny Lam and Paul Salkovskis report that such arguments may in fact do more harm than good, increasing stigma, and causing patients to feel pessimistic about their chances of recovery.

Forty-nine participants suffering from depression or anxiety were played a ten minute assessment video featuring a woman who suffers from panic attacks and agoraphobia. Crucially, before watching the video, some participants read an information sheet that explained panic attacks are caused by psychological processes, whereas others read a version that said panic is a biological condition caused by a chemical imbalance. A control group read that the causes of panic disorder are unknown.

After watching the video, the participants rated the woman’s chances for the future. Those who’d read that panic was a biological condition predicted the woman’s treatment would take longer than the other participants did, and regarded her as having a higher risk of harming herself and others. By contrast, the participants who read that panic is a psychological condition rated the woman’s chances of recovery as significantly better than the other participants did.

Together with prior research, the researchers said these findings suggested “biological explanations of mental health problems may increase public, professional and patient perception of harm (self-harm and harming others) and result in more negative predictions regarding prognosis, whilst psychological accounts may have the opposite (destigmatising) effect.”
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Lam, D.C.K. & Salkovskis, P.M. (2006). An experimental investigation of the impact of biological and psychological causal explanations on anxious and depressed patients’ perception of a person with panic disorder. Behaviour Research and Therapy, 45, 405-411.

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