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Madrid-Valero JJ, Rubio-Aparicio M, Gregory AM, Sánchez-Meca J, Ordoñana JR. The heritability of insomnia: Systematic review and meta-analysis of twin studies. Sleep Med Rev 2021; 58:101437. [PMID: 33556853 DOI: 10.1016/j.smrv.2021.101437] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/07/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
Twin studies have consistently found that genetic factors explain a substantial proportion of the variance for insomnia. However, studies vary widely in their heritability estimates. Therefore, this meta-analysis aimed to: 1) Estimate the mean heritability of insomnia; 2) Assess heterogeneity among twin studies of insomnia; and 3) Search and analyse characteristics of the studies (moderator variables) that may explain heterogeneity among estimates. For this purpose, separate meta-analyses were carried out for MZ and DZ correlations and for heritability estimates by assuming random-effects models. Thirteen independent samples were included in this meta-analysis. The heterogeneity index for heritability estimates was significant in both best fitting models (I2 = 98.77, P < .0001) and full models (I2 = 97.80, P < .0001). MZ correlations were higher (0.37; 95%CI: 0.31,.43) than DZ correlations (0.15; 95%CI: 0.12,.18). A mean heritability of 0.39 (95%CI: 0.32,.44) was found for insomnia. These results highlight the role of genetic factors in explaining differences among the population on insomnia and Emphasize heterogeneity among studies. Further research is needed to identify variables that could explain this heterogeneity.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Spain.
| | - María Rubio-Aparicio
- Department of Health Psychology, Faculty of Health Science, University of Alicante, Spain
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, United Kingdom
| | - Julio Sánchez-Meca
- Department of Basic Psychology and Methodology, University of Murcia, Spain
| | - Juan R Ordoñana
- Department of Human Anatomy and Psychobiology, University of Murcia, Spain; Murcia Institute of Biomedical Research, IMIB-Arrixaca, Spain
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Dar-Nimrod I, Kuntzman R, MacNevin G, Lynch K, Woods M, Morandini J. Genetic essentialism: The mediating role of essentialist biases on the relationship between genetic knowledge and the interpretations of genetic information. Eur J Med Genet 2020; 64:104119. [PMID: 33285312 DOI: 10.1016/j.ejmg.2020.104119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 10/15/2020] [Accepted: 11/26/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE Genetic research, via the mainstream media, presents the public with novel, profound findings almost on a daily basis. However, it is not clear how much laypeople understand these presentations and how they integrate such new findings into their knowledge base. Genetic knowledge (GK), existing causal beliefs, and genetic essentialist tendencies (GET) have been implicated in such processes; the current study assesses the relationships between these elements and how brief presentations of media releases of scientific findings about genetics are consumed and affect the readers. METHODS An Australian national survey of GK, GET, and existing causal beliefs about health phenomena (heart disease and obesity) was conducted. Participants were also exposed to news headlines that offered genetic and non-genetic partial explanations of the same health phenomena and reported their evaluations of these headlines, as well as the effects of the headlines on their personal understanding of the health phenomena. RESULTS GK was negatively-associated with GET. Whereas GK did not directly predict the evaluation and effects of the genetic headlines, GET did. GK predicted the effects of the headlines indirectly via GET and via GET and existing causal beliefs. CONCLUSION GET seem to predict unwarranted effects of exposure to news headlines about genetic science, whereas GK seems to indirectly mitigate the same unwarranted effects.
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Affiliation(s)
- Ilan Dar-Nimrod
- School of Psychology, University of Sydney, Australia; The Charles Perkins Centre, University of Sydney, Australia.
| | - Ruth Kuntzman
- School of Psychology, University of Sydney, Australia
| | | | - Kate Lynch
- The Charles Perkins Centre, University of Sydney, Australia; Department of Philosophy, University of Sydney, Australia
| | - Marlon Woods
- School of Psychology, University of Sydney, Australia
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Magliano L, Citarelli G, Read J. The beliefs of non-psychiatric doctors about the causes, treatments, and prognosis of schizophrenia. Psychol Psychother 2020; 93:674-689. [PMID: 31502403 DOI: 10.1111/papt.12252] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 07/23/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES To examine the causal beliefs about schizophrenia of non-psychiatric doctors and whether differential belief in biogenetic vs. psychosocial causes influences doctors' views about treatments and prognosis. DESIGN AND METHODS Three hundred and five non-psychiatric doctors working in outpatient community centres completed the 'Opinions on mental disorders Questionnaire' after reading a clinical description of people with schizophrenia. RESULTS The factors most frequently reported as causes of schizophrenia were heredity (65.2%) and use of street drugs (54.1%). Seventy-five per cent of participants endorsed both one or more biological causal factors and one or more psychosocial causal factors. Of the 264 participants who expressed their opinion about the most important cause of schizophrenia, 53.8% indicated a biogenetic cause. Fifty-two per cent of respondents thought it 'completely true' that drugs are useful in schizophrenia, and 33.9% thought it 'completely true' that people with schizophrenia must take drugs all their life. Participants stating that the most important cause was biogenetic more frequently recommended a psychiatrist and less frequently a psychologist. Compared to doctors who indicated a psychosocial cause as the most important one, those who indicated a biogenetic cause were more sceptical about recovery, more confident in the usefulness of drugs, and more convinced of the need of lifelong pharmacological treatments in schizophrenia. CONCLUSIONS These findings suggest the need to provide some doctors with training on the multiple, interacting causes of schizophrenia and the efficacy of the broad range of available treatments. The education of health professionals regarding stigma and its effects on clinical practice is also needed. PRACTITIONER POINTS Viewing schizophrenia as mainly due to a biological cause is associated with greater confidence in the usefulness of drugs, higher belief in the need for lifelong pharmacological treatments, and greater prognostic pessimism. Belief in a biologically oriented model of schizophrenia may lead doctors to underestimate the value of psychologists. Prognostic pessimism among doctors may negatively influence clinical decisions, the information doctors provide to their clients, and clients' own beliefs about their chances of recovery. Belief in the need for lifelong pharmacological treatments in schizophrenia may lead doctors to resist drug withdrawal in case of severe side effects.
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Affiliation(s)
- Lorenza Magliano
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - Giulia Citarelli
- Department of Psychology, University of Campania 'Luigi Vanvitelli', Caserta, Italy
| | - John Read
- School of Psychology, University of East London, UK
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Ahn WK, Bitran A, Lebowitz M. Effects of genetic information on memory for severity of depressive symptoms. PLoS One 2020; 15:e0239714. [PMID: 33052909 PMCID: PMC7556482 DOI: 10.1371/journal.pone.0239714] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/14/2020] [Indexed: 11/23/2022] Open
Abstract
The general public is increasingly aware of the role of genes in causing depression. Recent studies have begun uncovering unintended negative consequences of learning about a person’s genetic susceptibility to disorders. Because people tend to believe that genes determine one’s identity, having genes related to a disorder can be misinterpreted as equivalent to having the disorder. Consequently, learning that a person is genetically predisposed to depression can make people misremember mild depression as more severe. Participants across three experiments read a target vignette about a character displaying mild depressive symptoms, while descriptions of the character’s genetic susceptibility to depression were experimentally manipulated. Participants then read a foil vignette describing a character with more severe depressive symptoms. Afterwards, participants who had learned that the target character was genetically predisposed to depression were comparatively more likely to misremember the target symptoms as being severe, when in fact they were mild. This pattern of results was obtained among both laypeople (Experiments 1 and 2) and practicing master’s-level, but not doctoral-level, mental health clinicians (Experiment 3). Given that depression is diagnosed primarily based on a person’s memory of depressive symptoms, the current findings suggest that genetic information about depression may lead to over-diagnosis of depression.
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Affiliation(s)
- Woo-kyoung Ahn
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
- * E-mail:
| | - Alma Bitran
- Department of Psychology, Yale University, New Haven, Connecticut, United States of America
| | - Matthew Lebowitz
- Department of Psychiatry, Columbia University, New York, New York, United States of America
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McGrath MJ, Haslam N. Development and validation of the Harm Concept Breadth Scale: Assessing individual differences in harm inflation. PLoS One 2020; 15:e0237732. [PMID: 32810186 PMCID: PMC7437461 DOI: 10.1371/journal.pone.0237732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 07/31/2020] [Indexed: 11/19/2022] Open
Abstract
Three studies (Ns = 350, 301 & 341) examined the reliability, validity, and correlates of a new measure of harm inflation, the individual differences counterpart of 'concept creep'. The Harm Concept Breadth Scale (HCBS) assesses variability in the expansiveness of concepts of harm (i.e., bullying, mental disorder, prejudice, trauma), such that these concepts refer to a wider range of phenomena among people scoring high on the scale. Study 1 developed 66 vignettes representing potential instances of the four concepts, selected optimal subsets of 10 vignettes for each concept, and demonstrated satisfactory internal consistency of the subscales. Study 2 demonstrated that the HCBS had excellent internal consistency, and established construct validity through associations with measures of moral foundations, justice sensitivity, general category inclusiveness, and political orientation. Study 3 employed participants from a different national background and further clarified the correlates of the HCBS via measures of empathy, moral expansiveness, and the Big Five personality traits. The findings indicate that concept breadth is a reliably measurable individual difference variable with weak to moderate associations with harm-based morality, prosocial concern, political liberalism, female gender, and negative emotionality. The HCBS is a valid psychometric instrument for examining the causes and implications of harm inflation.
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Affiliation(s)
- Melanie J. McGrath
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
| | - Nick Haslam
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia
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Valery KM, Prouteau A. Schizophrenia stigma in mental health professionals and associated factors: A systematic review. Psychiatry Res 2020; 290:113068. [PMID: 32474069 DOI: 10.1016/j.psychres.2020.113068] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/29/2020] [Accepted: 05/02/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND The consequences of schizophrenia stigma are numerous and highly damaging to individuals, their families, the health care system and society. Mental health professionals (MHP) are considered to be one of the main sources of stigmatization. OBJECTIVES To identify the characteristics of MHP stigma in schizophrenia in comparison with other psychiatric disorders, the specificities of MHP compared with other social groups, and associated factors. METHODS Following PRISMA guidelines, we systematically searched multiple electronic databases for articles: (i) reporting original data published in English in peer-reviewed journals, (ii) reporting quantitative data with statistical analysis, (iii) assessing stigma in a broad sense, and (iv) including samples composed only of MHP. RESULTS A total of 38 articles published from 1999 to 2019 and involving 10,926 MHP fulfilled our inclusion criteria. Studies showed that schizophrenia is the most stigmatized mental illnesses in MHP, despite recent results suggesting that borderline personality disorder and substance abuse may be more stigmatized. In comparison with other social groups, MHP reported less dangerousness beliefs and more positive beliefs regarding pharmacological treatment. Nevertheless, results were less consistent regarding prognosis and desire for social distance. Age, education level, type of mental health profession, or length of practice were associated factors that showed inconsistent relations with stigma. Work setting and biological causal beliefs were more clearly associated with MHP stigma. CONCLUSION These findings provide strong support for the need to conduct specific research on schizophrenia stigma in MHP and the importance of controlling for several variables to identify predictors of stigma.
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Affiliation(s)
- Kevin-Marc Valery
- Laboratory of Psychology EA 4139, University of Bordeaux, 3 ter place de la Victoire, 33000 Bordeaux, France; Department of Adult Psychiatry, Jonzac Hospital, Jonzac, France; EDEA Association, Bordeaux, France.
| | - Antoinette Prouteau
- Laboratory of Psychology EA 4139, University of Bordeaux, 3 ter place de la Victoire, 33000 Bordeaux, France; Department of Adult Psychiatry, Jonzac Hospital, Jonzac, France
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Read J, Harper DJ. The Power Threat Meaning Framework: Addressing Adversity, Challenging Prejudice and Stigma, and Transforming Services. JOURNAL OF CONSTRUCTIVIST PSYCHOLOGY 2020. [DOI: 10.1080/10720537.2020.1773356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- John Read
- School of Psychology, University of East London, London, UK
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58
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Morris J, Albery IP, Heather N, Moss AC. Continuum beliefs are associated with higher problem recognition than binary beliefs among harmful drinkers without addiction experience. Addict Behav 2020; 105:106292. [PMID: 32007833 DOI: 10.1016/j.addbeh.2020.106292] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 01/03/2020] [Accepted: 01/05/2020] [Indexed: 11/18/2022]
Abstract
Low problem recognition may be an important barrier to opportunities for self-change or help-seeking in harmful drinkers. Little is known about how the beliefs harmful drinkers hold about the nature and causes of alcohol problems affect problem recognition and subsequent behaviour change processes. Participants (n = 597) recruited online were randomised to one of two conditions designed to promote beliefs according to (a) a continuum model of alcohol problems or (b) a binary disease model, or (c) a control condition. Participants completed measures of alcohol problem beliefs, problem recognition and other indices including the Alcohol Use Disorder Identification Test (AUDIT), addiction beliefs, addiction experience and demographics. Results showed that harmful drinkers without addiction experience exposed to the continuum condition had significantly higher problem recognition than those in binary disease model or control conditions. Continuum beliefs appear to offer self-evaluative benefits for harmful drinkers with low alcohol problem recognition, thus potentially facilitating help-seeking or self-change regarding alcohol use. Further research to understand the mechanisms by which continuum beliefs may promote more accurate drinking self-evaluation and its potential for behaviour change is warranted. The role of continuum beliefs may have important consequences for alcohol-related messaging and interventions seeking to promote self-change or help-seeking.
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Affiliation(s)
- J Morris
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom.
| | - I P Albery
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
| | - N Heather
- Faculty of Health & Life Sciences, Northumbria University, United Kingdom
| | - A C Moss
- Centre for Addictive Behaviours Research, School of Applied Sciences, London South Bank University, United Kingdom
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59
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Devendorf A, Bender A, Rottenberg J. Depression presentations, stigma, and mental health literacy: A critical review and YouTube content analysis. Clin Psychol Rev 2020; 78:101843. [DOI: 10.1016/j.cpr.2020.101843] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 02/21/2020] [Accepted: 03/03/2020] [Indexed: 12/24/2022]
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60
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Larkings JS, Brown PM, Scholz B. Addressing causal beliefs in treatment: insights from mental health practitioners in Australia. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2019. [DOI: 10.1080/03069885.2019.1690631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | - Patricia M. Brown
- Discipline of Psychology, University of Canberra, Bruce, ACT, Australia
| | - Brett Scholz
- ANU Medical School, The Australian National University, Acton, ACT, Australia
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61
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Glas G. Conceptual issues in neuroscientific research on empathy. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 65:101358. [PMID: 29903402 DOI: 10.1016/j.ijlp.2018.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 05/22/2018] [Indexed: 06/08/2023]
Abstract
This paper gives an analysis of some conceptual issues in the neuroscientific study of empathy. The focus will almost exclusively be on a seminal paper by Decety and Jackson (2004) on the functional architecture of empathy. The authors withstand reductionistic tendencies in the exposition of what their findings might mean for the psychology of social cognition. They are aware of the thorny conceptual issues that arise when attempting to bridge intuitive folk psychological conceptions of empathy with explanations offered by social psychology, developmental science, and, most of all, neuroscience. They defend a conception which puts emphasis on the developmental, interactional and human aspects of empathy. In the second part of the paper we will see that this overt contention is at some points at odds with the conceptual framework that underlies the presentation of scientific findings. It will appear that the method of decomposition, i.e., breaking empathy down into (mutually interacting) 'pieces', is difficult to reconcile with the idea that empathy should primarily be defined as an interactional phenomenon. The method of decomposition puts empathy back within the brain, whereas recent philosophical work argues that empathy needs a definition which includes both processes in the empathizing subject and in the person with whom the subject empathizes. In the final part of the paper it is asked whether, how and to what extent it does matter that professionals know about the social neuroscience of empathy and, especially, its underlying conceptual framework. It is argued that conceptual innovations that currently are emerging in social neuroscience do matter for clinical and legal practices. In spite of the limitations mentioned earlier, Decety & Jackson's developmental and interactional approach helps to overcome reductionistic and mentalistic interpretations of human empathy.
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Affiliation(s)
- Gerrit Glas
- Vrije Universiteit, Department of Philosophy, Faculty of Humanities, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands.
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62
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Ganesan A, Kashima Y, Kiat JE, Dar-Nimrod I. Transmission of disorder and etiological information: Effects on health knowledge recollection and health-related cognition. PLoS One 2019; 14:e0218703. [PMID: 31226156 PMCID: PMC6588244 DOI: 10.1371/journal.pone.0218703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 06/07/2019] [Indexed: 11/25/2022] Open
Abstract
Biased transmission of health knowledge has far-reaching effects on information reproduction and health-related cognitions. We examined whether transmissions of different types of disorder and etiological information influence recollections of health knowledge and evaluations of patients, by simulating the digital transmission of information. Transmission chains of four non-interacting persons (i.e., four generations) were formed. The first generation read three vignettes describing fictitious patients with one of three disorders (physiological, psychological, culture-bound) uniquely paired with one of three etiologies (genetic, environmental, unknown etiology). Next, they evaluated patients’ well-being, rated desired social distance, and recalled the vignettes. These written recollections replaced the original vignettes for a second-generation of participants, whose recollections were used for the third generation and so on. The framing of disorders affected recollections of etiology, in which culture-bound framings resulted in the poorest recall of etiologies. Participants also perceived the culture-bound disorder as the least serious but desired the most social distance from patients diagnosed with it, when compared to other disorders. The study showed that health information is selectively attended to and reproduced, possibly affected by perceived self-relevance. Faulty recollections and framing of disorders affect health cognitions, potentially instigating biased transmission of disorder- and patient-related narratives.
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Affiliation(s)
- Asha Ganesan
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia
| | - Yoshihisa Kashima
- School of Psychological Sciences, Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - John Emmanuel Kiat
- Center for Mind and Brain, University of California, Davis, California, United States of America
| | - Ilan Dar-Nimrod
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, New South Wales, Australia.,The Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia
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63
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Self-rated amygdala activity: an auto-biological index of affective distress. PERSONALITY NEUROSCIENCE 2019; 2:e1. [PMID: 32435736 PMCID: PMC7219683 DOI: 10.1017/pen.2019.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/28/2019] [Accepted: 04/13/2019] [Indexed: 02/07/2023]
Abstract
Auto-biological beliefs—beliefs about one’s own biology—are an understudied component of personal identity. Research participants who are led to believe they are biologically vulnerable to affective disorders report more symptoms and less ability to control their mood; however, little is known about the impact of self-originating beliefs about risk for psychopathology, and whether such beliefs correspond to empirically derived estimates of actual vulnerability. Participants in a neuroimaging study (n = 1256) completed self-report measures of affective symptoms, perceived stress, and neuroticism, and an emotional face processing task in the scanner designed to elicit threat responses from the amygdala. A subsample (n = 63) additionally rated their own perceived neural response to threat (i.e., amygdala activity) compared to peers. Self-ratings of neural threat response were uncorrelated with actual threat-related amygdala activity measured via BOLD fMRI. However, self-ratings predicted subjective distress across a variety of self-report measures. In contrast, in the full sample, threat-related amygdala activity was uncorrelated with self-report measures of affective distress. These findings suggest that beliefs about one’s own biological threat response—while unrelated to measured neural activation—may be informative indicators of psychological functioning.
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Doubting the Diagnosis but Seeking a Talking Cure: An Experimental Investigation of Causal Explanations for Depression and Willingness to Accept Treatment. COGNITIVE THERAPY AND RESEARCH 2019. [DOI: 10.1007/s10608-019-10027-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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65
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Palk AC, Dalvie S, de Vries J, Martin AR, Stein DJ. Potential use of clinical polygenic risk scores in psychiatry - ethical implications and communicating high polygenic risk. Philos Ethics Humanit Med 2019; 14:4. [PMID: 30813945 PMCID: PMC6391805 DOI: 10.1186/s13010-019-0073-8] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/14/2019] [Indexed: 06/09/2023] Open
Abstract
Psychiatric disorders present distinct clinical challenges which are partly attributable to their multifactorial aetiology and the absence of laboratory tests that can be used to confirm diagnosis or predict risk. Psychiatric disorders are highly heritable, but also polygenic, with genetic risk conferred by interactions between thousands of variants of small effect that can be summarized in a polygenic risk score. We discuss four areas in which the use of polygenic risk scores in psychiatric research and clinical contexts could have ethical implications. First, there is concern that clinical use of polygenic risk scores may exacerbate existing health inequities. Second, research findings regarding polygenic risk could be misinterpreted in stigmatising or discriminatory ways. Third, there are concerns associated with testing minors as well as eugenics concerns elicited by prenatal polygenic risk testing. Fourth, potential challenges that could arise with the feedback and interpretation of high polygenic risk for a psychiatric disorder would require consideration. While there would be extensive overlap with the challenges of feeding back genetic findings in general, the potential clinical use of polygenic risk scoring warrants discussion in its own right, given the recency of this possibility. To this end, we discuss how lay interpretations of risk and genetic information could intersect. Consideration of these factors would be necessary for ensuring effective and constructive communication and interpretation of polygenic risk information which, in turn, could have implications for the uptake of any therapeutic recommendations. Recent advances in polygenic risk scoring have major implications for its clinical potential, however, care should be taken to ensure that communication of polygenic risk does not feed into problematic assumptions regarding mental disorders or support reductive interpretations.
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Affiliation(s)
- A. C. Palk
- Department of Psychiatry, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
| | - S. Dalvie
- Department of Psychiatry and SA MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
| | - J. de Vries
- Department of Medicine, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
| | - A. R. Martin
- Analytic & Translational Genetics Unit, Massachusetts General Hospital, Boston, MA USA
- Stanley Center for Psychiatric Research & Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - D. J. Stein
- Department of Psychiatry and SA MRC Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Groote Schuur Hospital, Observatory, Cape Town, 7925 South Africa
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66
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Schofield CA, Abdul-Chani M, Gaudiano BA. Impact of causal explanations for social anxiety disorder on stigma and treatment perceptions. J Ment Health 2019; 29:84-91. [PMID: 30741047 DOI: 10.1080/09638237.2018.1487543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background and aims: There is evidence to suggest that biogenetic explanations for symptoms of mental disorders have become increasingly popular. Research suggests that such explanations provokes mixed blessings: biological explanations may reduce blame but also encourage prognostic pessimism and promote perceptions of pharmacological treatment over psychotherapy. The goal of this study was to evaluate the impact of different causal explanations on social anxiety disorder.Method: About 205 adults completed an experiment where they read a vignette describing an individual with social anxiety disorder and were randomly assigned to a symptom explanation that was: (1) biological, (2) biopsychosocial, (3) psychosocial, or (4) no explanation.Results: The psychosocial condition yielded the highest perceived credibility and lowest attributions of blame. The biological condition promoted positive expectations for medication effectiveness compared to other conditions. Conditions did not differ on prognostic expectations.Conclusions: Calls attention to the risk of generalizing from previous research to mental disorders as a whole.
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Affiliation(s)
- Casey A Schofield
- Psychology Department, Skidmore College, Saratoga Springs, NY, USA and
| | | | - Brandon A Gaudiano
- Butler Hospital/Brown University Warren Alpert School of Medicine, Providence, RI, USA
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67
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A Neuroethics Framework for the Australian Brain Initiative. Neuron 2019; 101:365-369. [PMID: 30731059 DOI: 10.1016/j.neuron.2019.01.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 12/19/2018] [Accepted: 12/29/2018] [Indexed: 11/30/2022]
Abstract
Neuroethics is central to the Australian Brain Initiative's aim to sustain a thriving and responsible neurotechnology industry. Diverse and inclusive community and stakeholder engagement and a trans-disciplinary approach to neuroethics will be key to the success of the Australian Brain Initiative.
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68
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Fontesse S, Demoulin S, Stinglhamber F, Maurage P. Dehumanization of psychiatric patients: Experimental and clinical implications in severe alcohol-use disorders. Addict Behav 2019; 89:216-223. [PMID: 30326462 DOI: 10.1016/j.addbeh.2018.08.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/23/2018] [Accepted: 08/31/2018] [Indexed: 01/04/2023]
Abstract
Dehumanization, defined as the denial of one's membership to humanity, is a process repeatedly reported in extreme contexts (e.g., genocides) but also in everyday life interactions. Some antecedents of dehumanizing experiences (e.g., social exclusion, negative stereotypes) have been reported among patients presenting psychiatric disorders, but dehumanization's experience remains completely unexplored in addictive disorders. We propose a theoretical model and research agenda to overcome this limitation and to improve our understanding of dehumanization's experience in psychiatry, with a special focus on alcohol-related disorders. We also propose much-needed clinical avenues to reduce dehumanization in clinical contexts, centrally by (1) improving dehumanization awareness among medical workers; (2) reducing the need for healthcare workers to use dehumanization to alleviate professional exhaustion; and (3) optimizing medical training to increase empathy toward patients. Finally, some additional improvements are proposed to promote patient's choices, comfort, dignity, and ultimately humanity in hospitals.
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Affiliation(s)
- Sullivan Fontesse
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Place C. Mercier 10, B-1348 Louvain-la-Neuve, Belgium
| | - Stéphanie Demoulin
- Center for the Study of Social Behavior, Psychological Sciences Research Institute, Université catholique de Louvain, Place C. Mercier 10, B-1348 Louvain-la-Neuve, Belgium
| | - Florence Stinglhamber
- Work and Organizational Psychology Lab, Psychological Sciences Research Institute, Université catholique de Louvain, Place C. Mercier 10, B-1348 Louvain-la-Neuve, Belgium
| | - Pierre Maurage
- Laboratory for Experimental Psychopathology, Psychological Sciences Research Institute, Université catholique de Louvain, Place C. Mercier 10, B-1348 Louvain-la-Neuve, Belgium.
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69
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Mirza A, Birtel MD, Pyle M, Morrison AP. Cultural Differences in Psychosis: The Role of Causal Beliefs and Stigma in White British and South Asians. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2019. [DOI: 10.1177/0022022118820168] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
While previous research has demonstrated the negative impact of stigma in individuals with mental health problems, little is known about cross-cultural differences in experiences and explanations of mental health, in particular in young people, despite the first episode of psychosis often occurring in adolescence. Aim of this study was to examine cultural differences in causal beliefs and stigma toward mental health, in particular psychosis. White British and South Asian young people ( N = 128) from two schools and colleges in the United Kingdom, aged 16 to 20 years, completed a cross-sectional survey. Results revealed significant associations between ethnic group and our dependent measures. White British reported more previous contact with a mental health service as well as with people with mental health problems than South Asians. They also reported lower stigma in form of a greater intentions to engage in contact with people with mental health problems. Furthermore, South Asians reported higher beliefs in supernatural causes of psychosis than White British. Psychotic experiences moderated the effect of ethnic group on supernatural beliefs, with South Asians reporting higher supernatural beliefs than White British when their own psychotic experiences were low to moderate. We discuss the implications of the findings, arguing that a greater culture-sensitive understanding of mental health is important to reach ethnic minorities with psychosis, and to challenge stigma toward psychosis from an early age on.
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Affiliation(s)
| | | | - Melissa Pyle
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, UK
| | - Anthony P. Morrison
- University of Manchester, UK
- Psychosis Research Unit, Greater Manchester West Mental Health NHS Foundation Trust, UK
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70
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Lebowitz MS, Appelbaum PS. Biomedical Explanations of Psychopathology and Their Implications for Attitudes and Beliefs About Mental Disorders. Annu Rev Clin Psychol 2018; 15:555-577. [PMID: 30444641 DOI: 10.1146/annurev-clinpsy-050718-095416] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Mental disorders are increasingly conceptualized as biomedical diseases, explained as manifestations of genetic and neurobiological abnormalities. Here, we discuss changes in the dominant explanatory accounts of psychopathology that have occurred over time and the driving forces behind these shifts, lay out some real-world evidence for the increasing ascendancy of biomedical explanations, and provide an overview of the types of attitudes and beliefs that may be affected by them. We examine theoretical and conceptual models that are relevant to understanding how biomedical conceptualizations might affect attitudes and beliefs about mental disorders, and we review some empirical evidence that bears on this question. Finally, we examine possible strategies for combatting potential negative effects of biomedical explanations and discuss important conclusions and directions for future research.
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Affiliation(s)
- Matthew S Lebowitz
- Center for Research on Ethical, Legal, and Social Implications of Psychiatric, Neurologic, and Behavioral Genetics; Department of Psychiatry; Columbia University Medical Center; New York, NY 10032, USA;
| | - Paul S Appelbaum
- Center for Research on Ethical, Legal, and Social Implications of Psychiatric, Neurologic, and Behavioral Genetics; Department of Psychiatry; Columbia University Medical Center; New York, NY 10032, USA;
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71
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Loughman A, Haslam N. Neuroscientific explanations and the stigma of mental disorder: a meta-analytic study. COGNITIVE RESEARCH-PRINCIPLES AND IMPLICATIONS 2018; 3:43. [PMID: 30426319 PMCID: PMC6234201 DOI: 10.1186/s41235-018-0136-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 08/09/2018] [Indexed: 12/31/2022]
Abstract
Genetic and other biological explanations appear to have mixed blessings for the stigma of mental disorder. Meta-analytic evidence shows that these “biogenetic” explanations reduce the blame attached to sufferers, but they also increase aversion, perceptions of dangerousness, and pessimism about recovery. These relationships may arise because biogenetic explanations recruit essentialist intuitions, which have known associations with prejudice and the endorsement of stereotypes. However, the adverse implications of biogenetic explanations as a set may not hold true for the subset of those explanations that invoke neurobiological causes. Neurobiological explanations might have less adverse implications for stigma than genetic explanations, for example, because they are arguably less essentialist. Although this possibility is important for evaluating the social implications of neuroscientific explanations of mental health problems, it has yet to be tested meta-analytically. We present meta-analyses of links between neurobiological explanations and multiple dimensions of stigma in 26 correlational and experimental studies. In correlational studies, neurobiological explanations were marginally associated with greater desire for social distance from people with mental health problems. In experimental studies, these explanations were associated with greater desire for social distance, greater perceived dangerousness, and greater prognostic pessimism. Neurobiological explanations were not linked to reduced blame in either set of studies. By implication, neurobiological explanations have the same adverse links to stigma as other forms of biogenetic explanation. These findings raise troubling implications about the public impact of psychiatric neuroscience research findings. Although such findings are not intrinsically stigmatizing, they may become so when viewed through the lens of neuroessentialism.
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Affiliation(s)
- Amy Loughman
- Food & Mood Centre, Deakin University, Geelong, VIC, 3220, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Nick Haslam
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia.
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72
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Huggett C, Birtel MD, Awenat YF, Fleming P, Wilkes S, Williams S, Haddock G. A qualitative study: experiences of stigma by people with mental health problems. Psychol Psychother 2018; 91:380-397. [PMID: 29345416 DOI: 10.1111/papt.12167] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 12/01/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Prior research has examined various components involved in the impact of public and internalized stigma on people with mental health problems. However, studies have not previously investigated the subjective experiences of mental health stigma by those affected in a non-statutory treatment-seeking population. DESIGN An in-depth qualitative study was conducted using thematic analysis to investigate the experiences of stigma in people with mental health problems. METHODS Eligible participants were recruited through a local mental health charity in the North West of England. The topic of stigma was examined using two focus groups of thirteen people with experience of mental health problems and stigma. RESULTS Two main themes and five subthemes were identified. Participants believed that (1) the 'hierarchy of labels' has a profound cyclical impact on several levels of society: people who experience mental health problems, their friends and family, and institutional stigma. Furthermore, participants suggested (2) ways in which they have developed psychological resilience towards mental health stigma. CONCLUSIONS It is essential to utilize the views and experiences gained in this study to aid understanding and, therefore, develop ways to reduce the negative impact of public and internal stigma. PRACTITIONER POINTS People referred to their mental health diagnosis as a label and associated that label with stigmatizing views. Promote awareness and develop improved strategies (e.g., training) to tackle the cyclical impact of the 'hierarchy of labels' on people with mental health problems, their friends and family, and institutional stigma. Ensure the implementation of clinical guidelines in providing peer support to help people to combat feeling stigmatized. Talking about mental health in psychological therapy or health care professional training helped people to take control and develop psychological resilience.
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Affiliation(s)
- Charlotte Huggett
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK.,Stockport and District Mind, UK
| | - Michèle D Birtel
- Department of Psychology, Social Work and Counselling, University of Greenwich, London, UK
| | - Yvonne F Awenat
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK.,Stockport and District Mind, UK
| | - Paul Fleming
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | - Sophie Wilkes
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
| | | | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, UK
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73
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Choudhry FR, Khan TM, Park MSA, Golden KJ. Mental Health Conceptualization and Resilience Factors in the Kalasha Youth: An Indigenous Ethnic and Religious Minority Community in Pakistan. Front Public Health 2018; 6:187. [PMID: 30065918 PMCID: PMC6056674 DOI: 10.3389/fpubh.2018.00187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 06/13/2018] [Indexed: 11/13/2022] Open
Abstract
The Kalasha are a religious, ethnic, and linguistic minority community in Pakistan. They are indigenous people living in remote valleys of the Hindu Kush Mountains in northern Pakistan, neighboring Afghanistan. The Kalasha are pastoral, as well as agricultural people to some extent, although they are increasingly facing pressures from globalization and social change, which may be influencing youth and community development. Their traditional world view dichotomizes and emphasizes on the division of the pure (Onjeshta) and the impure (Pragata). There remains a scarcity of literature on mental health and resilience of indigenous communities in South Asia and Pakistan generally, and the polytheistic Kalasha community specifically. Thus, the current study was conducted with the aim to explore the cultural protective factors (resilience) of the Kalasha youth (adolescents and emerging adults) and to explore their perceived etiological understandings and preferred interventions for mental health support systems. The theoretical framework of Bronfenbrenner's (1, 2) ecological systems model was used. Interpretative Phenomenological Analysis (IPA) was conducted, considering the advantage of its idiographic approach and the “double hermeneutic” analytic process. This methodology was consistent with the aim to understand and make sense of mental health and resilience from the Kalasha indigenous perspective. A total of 12 in-depth interviews were conducted with adolescents and emerging adults (5 males, 7 females), along with ethnographic observations. The analysis revealed 3 superordinate themes of mental health perceptions and interventions, each with more specific emergent themes: (1) Psychological Resilience/Cultural Protective Factors Buffering Against Mental Health Problems (Intra-Communal Bonding & Sharing; Kalasha Festivals & Traditions; Purity Concept; Behavioral Practice of Happiness and Cognitive Patterns); (2) Perceived Causes of Mental Health Issues (Biological & Psychosocial; Supernatural & Spiritual; Environmental); and (3) Preferred Interventions [Shamanic Treatment; Ta'awiz (Amulets); Communal Sharing & Problem Solving; Medical Treatment; Herbal Methods]. The overall findings point to the need for developing culturally-sensitive and indigenous measures and therapeutic interventions. The findings highlighted the Kalasha cultural practices which may promote resilience. The findings also call for indigenous sources of knowledge to be considered when collaboratively designing public health programs.
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Affiliation(s)
- Fahad R Choudhry
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia.,National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan
| | - Tahir M Khan
- Institute of Pharmaceutical Science, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Miriam Sang-Ah Park
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia.,School of Social and Health Sciences, Leeds Trinity University, Leeds, United Kingdom
| | - Karen J Golden
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Bandar Sunway, Malaysia
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74
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Vess M, Brooker RJ, Stichter M, Neiderhiser JM. Genes and Virtue: Exploring How Heritability Beliefs Shape Conceptions of Virtue and Its Development. Behav Genet 2018; 49:168-174. [DOI: 10.1007/s10519-018-9908-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 06/11/2018] [Indexed: 11/24/2022]
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75
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Lynch KE, Morandini JS, Dar-Nimrod I, Griffiths PE. Causal Reasoning About Human Behavior Genetics: Synthesis and Future Directions. Behav Genet 2018; 49:221-234. [DOI: 10.1007/s10519-018-9909-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 06/11/2018] [Indexed: 11/29/2022]
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76
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Larkings JS, Brown PM. Do biogenetic causal beliefs reduce mental illness stigma in people with mental illness and in mental health professionals? A systematic review. Int J Ment Health Nurs 2018; 27:928-941. [PMID: 28942615 DOI: 10.1111/inm.12390] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/13/2017] [Indexed: 01/16/2023]
Abstract
Viewing mental illness as an 'illness like any other' and promoting biogenetic causes have been explored as a stigma-reduction strategy. The relationship between causal beliefs and mental illness stigma has been researched extensively in the general public, but has gained less attention in more clinically-relevant populations (i.e. people with mental illness and mental health professionals). A systematic review examining whether endorsing biogenetic causes decreases mental illness stigma in people with mental illness and mental health professionals was undertaken using the preferred reporting items for systematic reviews and meta-analyses guidelines. Multiple databases were searched, and studies that explored the relationship between biogenetic causal beliefs and mental illness stigma in people with mental illness or mental health professionals were considered. Studies were included if they focussed on depression, schizophrenia, or mental illness in general, were in English, and had adult participants. The search identified 11 journal articles reporting on 15 studies, which were included in this review. Of these, only two provided evidence that endorsing biogenetic causes was associated with less mental illness stigma in people with mental illness or mental health professionals. The majority of studies in the present review (n = 10) found that biogenetic causal beliefs were associated with increased stigma or negative attitudes towards mental illness. The present review highlights the lack of research exploring the impacts of endorsing biogenetic causes in people with mental illness and mental health professionals. Clinical implications associated with these results are discussed, and suggestions are made for further research that examines the relationship between causal beliefs and treatment variables.
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Affiliation(s)
- Josephine S Larkings
- Department of Health, Psychology, University of Canberra, Canberra, ACT, Australia
| | - Patricia M Brown
- Department of Health, Psychology, University of Canberra, Canberra, ACT, Australia
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77
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Thibodeau PH, Uri R, Thompson B, Flusberg SJ. Narratives for Obesity: Effects of Weight Loss and Attribution on Empathy and Policy Support. HEALTH EDUCATION & BEHAVIOR 2018; 44:638-647. [PMID: 28718352 DOI: 10.1177/1090198116684794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Despite an urgent need to address the issue of obesity, little research has examined the psychological factors that influence support for obesity-related policy initiatives, which represent an important tool for addressing this complex health issue. In the present study, we measured the degree to which people supported obesity-related policy interventions and empathized with a person struggling with obesity after reading a personal account of his or her situation. The narrative described an obese individual who was portrayed as either successfully losing weight or not, and as attributing his or her weight-loss outcome to personal or environmental factors. We found that protagonists who successfully lost weight and/or took personal responsibility for their situation elicited more empathy from participants, which was associated with support for societal policy interventions for obesity. These findings suggest that specific features of personal narratives influence support for obesity-related policies and highlight empathy as a mechanism through which such narratives affect obesity-related attitudes.
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78
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Vaghee S, Kashani Lotfabadi M, Salarhaji A, Vaghei N, Hashemi BM. Comparing the Effects of Contact-Based Education and Acceptance and Commitment-Based Training on Empathy toward Mental Illnesses among Nursing Students. IRANIAN JOURNAL OF PSYCHIATRY 2018; 13:119-127. [PMID: 29997657 PMCID: PMC6037580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 03/17/2018] [Accepted: 03/24/2018] [Indexed: 11/10/2022]
Abstract
Objective: Empathy is an important and valuable tool in therapeutic communication. Improvement barriers of empathy in psychiatric nursing education are associated with challenges, such as stress due to negative attitudes toward psychiatric disorders. The current study aimed at comparing the effects of contact-based education and commitment and acceptance-based training on empathy toward mental illnesses among nursing students. Method: In this clinical trial, 111 nursing students were selected using cluster and quota sampling methods in Mashhad, Iran. They were divided into 3 groups: (1) contact-based education (interpersonal contact among individuals with improved mental illnesses), (2) acceptance and commitment-based training, and (3) control group. The study tool was Jefferson Nurses Empathy Questionnaire, which was completed in 3 stages of pretest, posttest, and follow- up. Data were analyzed by repeated- measures ANOVA. Results: There was no significant difference between contact-based education and acceptance and commitment-based training groups in increasing the average score of total empathy during pretest, posttest, and 1-month follow- up (p = 0/92). However, a significant difference was found between contact-based education and control group (p = 0/004) and between acceptance and commitment-based training and control group (p = 0/02). Conclusion: Both methods of contact-based education and acceptance and commitment-based therapy were effective in increasing the level of empathy into mental illnesses in nursing students.
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Affiliation(s)
- Saeed Vaghee
- Psychiatry Faculty, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Azam Salarhaji
- Research Center for Cognitive and Behavioral Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Nastaran Vaghei
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Bibi Maryam Hashemi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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79
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Sabatello M. A Genomically Informed Education System? Challenges for Behavioral Genetics. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2018; 46:130-144. [PMID: 29805246 PMCID: PMC5967657 DOI: 10.1177/1073110518766027] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The exponential growth of genetic knowledge and precision medicine research raises hopes for improved prevention, diagnosis, and treatment options for children with behavioral and psychiatric conditions. Although well-intended, this prospect also raise the possibility-and concern-that behavioral, including psychiatric genetic data would be increasingly used-or misused-outside the clinical context, such as educational settings. Indeed, there are ongoing calls to endorse a "personalized education" model that would tailor educational interventions to children's behavioral and psychiatric genetic makeup. This article explores the justifications for, and prospects and pitfalls of such endeavors. It considers the scientific challenges and highlights the ethical, legal, and social issues that will likely arise should behavioral genetic data become available (or be perceived as such) and are routinely incorporated in student education records. These include: when to disclose students' behavioral and psychiatric genetic profile; whose genomic privacy is protected and by whom; and how students' genetic data may affect education-related decisions. I argue that the introduction of behavioral genetics in schools may overshadow the need to address underlying structural and environmental factors that increase the risk for psychiatric conditions of all students, and that the unregulated use of student behavioral genetic profiles may lead to unintended consequences that are detrimental for individuals, families and communities. Relevant stakeholders-from parents and students to health professionals, educators, and policy-makers-ought to consider these issues before we forge ahead with a genomically informed education system.
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Affiliation(s)
- Maya Sabatello
- Assistant Professor of Clinical Bioethics and Co-Director, Precision Medicine: Ethics, Politics, and Culture Project, Department of Psychiatry, Columbia University
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80
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Associations between causal attributions and personal stigmatizing attitudes in untreated persons with current mental health problems. Psychiatry Res 2018; 260:24-29. [PMID: 29156297 DOI: 10.1016/j.psychres.2017.11.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/27/2017] [Accepted: 11/03/2017] [Indexed: 11/22/2022]
Abstract
Past research has shown that among the general public, certain causal explanations like biomedical causes are associated with stronger desire for social distance from persons with mental illness. Aim of this study was to find out how different causal attributions of persons with untreated mental health problems regarding their own complaints are associated with stigmatizing attitudes, anticipated self-stigma when seeking help and perceived stigma-stress. Altogether, 207 untreated persons with a current depressive syndrome were interviewed. Biomedical causes, but also belief in childhood trauma or unhealthy behavior as a cause of the problem, were associated with stronger personal stigma and with more stigma-stress. Similarities and differences to findings among the general population and implications for future research are discussed.
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81
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Abstract
BACKGROUND Addictions are highly stigmatized and increasingly construed as biomedical diseases caused by genes, partly to reduce stigma by deflecting blame. However, genetic explanations may have negative effects, which have been understudied in the context of addiction. How the effects of genetic explanations might differ for substance addictions versus behavioral addictions is also unknown. AIMS This study examined the impact of genetic explanations for addiction on measures of treatment expectancies, blame, and perceived agency and self-control, as well as whether these varied depending on whether the addiction was to a substance or a behavior. METHODS Participants read about a person ('Charlie') with either alcohol use disorder or gambling disorder, receiving either a genetic or nongenetic explanation of Charlie's problem. They rated how much they blamed Charlie for his disorder, his likelihood of benefitting from medication or psychotherapy, and how much agency and self-control they ascribed to him. RESULTS Compared to the nongenetic explanation, the genetic explanation reduced blame and increased confidence in the effectiveness of pharmacotherapy. However, it also decreased the expected effectiveness of psychotherapy and reduced ascriptions of agency and self-control. CONCLUSION Genetic explanations for addiction appear to be a 'double-edged sword', with beneficial effects that come at a cost.
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Affiliation(s)
- Matthew S Lebowitz
- Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics, New York, NY, USA Psychiatric Institute and Department of Psychiatry, Columbia University, New York, NY, USA
| | - Paul S Appelbaum
- Center for Research on Ethical, Legal and Social Implications of Psychiatric, Neurologic and Behavioral Genetics, New York, NY, USA Psychiatric Institute and Department of Psychiatry, Columbia University, New York, NY, USA
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82
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Santamaría-García H, Baez S, García AM, Flichtentrei D, Prats M, Mastandueno R, Sigman M, Matallana D, Cetkovich M, Ibáñez A. Empathy for others' suffering and its mediators in mental health professionals. Sci Rep 2017; 7:6391. [PMID: 28743987 PMCID: PMC5527046 DOI: 10.1038/s41598-017-06775-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/16/2017] [Indexed: 12/30/2022] Open
Abstract
Empathy is a complex cognitive and affective process that allows humans to experience concern for others, comprehend their emotions, and eventually help them. In addition to studies with healthy subjects and various neuropsychiatric populations, a few reports have examined this domain focusing on mental health workers, whose daily work requires the development of a saliently empathic character. Building on this research line, the present population-based study aimed to (a) assess different dimensions of empathy for pain in mental health workers relative to general-physicians and non-medical workers; and (b) evaluate their relationship with relevant factors, such as moral profile, age, gender, years of experience, and workplace type. Relative to both control groups, mental health workers exhibited higher empathic concern and discomfort for others' suffering, and they favored harsher punishment to harmful actions. Furthermore, this was the only group in which empathy variability was explained by moral judgments, years of experience, and workplace type. Taken together, these results indicate that empathy is continuously at stake in mental health care scenarios, as it can be affected by contextual factors and social contingencies. More generally, they highlight the importance of studying this domain in populations characterized by extreme empathic demands.
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Affiliation(s)
- Hernando Santamaría-García
- Centro de Memoria y Cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
- Pontificia Universidad Javeriana, Psychiatry and Physiology Department, Bogotá, Colombia
- Grupo de Investigación Cerebro y Cognición Social, Bogotá, Colombia
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Sandra Baez
- Grupo de Investigación Cerebro y Cognición Social, Bogotá, Colombia
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Departamento de Psicología, Universidad de los Andes, Bogotá, Colombia
| | - Adolfo M García
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Faculty of Education, National University of Cuyo (UNCuyo), Mendoza, Argentina
| | | | - María Prats
- IntramedPortal www.intramed.net, Buenos Aires, CABA, Argentina
| | | | - Mariano Sigman
- Universidad Torcuato di Tella, Laboratorio de Neurociencias, Buenos, Aires, Argentina
| | - Diana Matallana
- Centro de Memoria y Cognición Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia
- Pontificia Universidad Javeriana, Aging Institute Bogotá, Bogotá, Colombia
| | - Marcelo Cetkovich
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive and Translational Neuroscience (INCyT), INECO Foundation, Favaloro University, Buenos Aires, Argentina.
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
- Universidad Autónoma del Caribe, Barranquilla, Colombia.
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile.
- Australian Research Council Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
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83
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Abstract
The United States' ambitious Precision Medicine Initiative proposes to accelerate exponentially the adoption of precision medicine, an approach to health care that tailors disease diagnosis, treatment, and prevention to individual variability in genes, environment, and lifestyle. It aims to achieve this by creating a cohort of volunteers for precision medicine research, accelerating biomedical research innovation, and adopting policies geared toward patients' empowerment. As strategies to implement the PMI are formulated, critical consideration of the initiative's ethical and sociopolitical dimensions is needed. Drawing on scholarship of nationalism and democracy, we discuss the PMI's construction of what we term "genomic citizenship"; the possible normative obligations arising therefrom; and the ethical, legal, and social challenges that will ensue. Although the PMI is a work in progress, discussion of the existing and emerging issues can facilitate the development of policies, structures, and procedures that can maximize the initiative's ability to produce equitable and socially sensitive outcomes. Our analysis can also be applied to other population-based, precision medicine research programs.
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Abstract
PURPOSE OF REVIEW Genetic testing for mental illness is likely to become increasingly prevalent as the science behind it is refined. This article identifies anticipated ethical challenges for patients, psychiatrists, and genetic counselors and makes recommendations for addressing them. RECENT FINDINGS Many of the ethical challenges of psychiatric genetic testing are likely to stem from failures to comprehend the nature and implications of test results. Recent studies have identified gaps in the knowledge base of psychiatrists and genetic counselors, which limit their abilities to provide patients with appropriate education. A small number of studies have demonstrated the value of counseling in empowering patients to deal with relevant genetic information. Psychiatrists and other health professionals must be able to assist patients and families in making informed decisions about genetic testing and interpreting test results. Filling their knowledge gaps on these issues will be a critical step towards meeting these responsibilities.
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85
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Speerforck S, Schomerus G, Matschinger H, Angermeyer MC. Treatment recommendations for schizophrenia, major depression and alcohol dependence and stigmatizing attitudes of the public: results from a German population survey. Eur Arch Psychiatry Clin Neurosci 2017; 267:341-350. [PMID: 28032255 DOI: 10.1007/s00406-016-0755-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 12/13/2016] [Indexed: 10/20/2022]
Abstract
In addition to mental health literacy, several potentially conflicting emotions and attitudes among the public are hypothesized to guide their recommendations for specific mental health treatments. It is unclear whether evidence-based treatment strategies are guided by pro-social or stigmatizing attitudes and emotions. In a representative population survey in Germany (n = 3642), we asked respondents to what extent they would recommend psychotropic medication, psychotherapy and relaxation techniques for a person with mental illness described in an unlabelled vignette. For each treatment recommendation, we used multinomial logistic regression analyses to obtain predicted probabilities. Predictors comprised illness recognition, vignette condition, causal beliefs (current stress, childhood adversities, biogenetic), emotions (fear, anger, pro-social reactions), social distance, age, gender and education. Fear predicted greater probability for recommending psychotropic drugs in all investigated illnesses (p < 0.001), whereas associations of fear with recommending psychotherapy were generally lower and no associations with the recommendation for relaxation techniques were found. Anger was related to fewer recommendations for psychotherapy in all illnesses (p < 0.01). Pro-social reactions were predominantly related to the recommendation of relaxation techniques for a person with schizophrenia or major depression (p < 0.001). Higher desire for social distance predicted fewer recommendations for relaxation techniques in all three vignette conditions (p < 0.05). Our study corroborates findings that treatment recommendations are not necessarily linked to pro-social reactions or mental health literacy. The recommendation for a treatment modality like psychotropic medication or psychotherapy can be linked to underlying fear, possibly reflecting a public desire for protection against people with mental illness.
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Affiliation(s)
- Sven Speerforck
- Department of Psychiatry and Psychotherapy, University Medicine, Greifswald University, Ellernholzstraße 1-2, 17475, Greifswald, Germany.
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University Medicine, Greifswald University, Ellernholzstraße 1-2, 17475, Greifswald, Germany
| | - Herbert Matschinger
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.,Institute of Medical Sociology and Health Economics, University of Hamburg, Hamburg, Germany
| | - Matthias C Angermeyer
- Department of Public Health, Clinical and Molecular Psychiatry, University of Cagliari, Cagliari, Italy.,Center for Public Mental Health, Gösing Am Wagram, Austria
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86
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Howell AJ. Believing in Change: Reviewing the Role of Implicit Theories in Psychological Dysfunction. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2017. [DOI: 10.1521/jscp.2017.36.6.437] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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87
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Yücel M, Carter A, Allen AR, Balleine B, Clark L, Dowling NA, Gainsbury SM, Goudriaan AE, Grant J, Hayes A, Hodgins D, van Holst R, Lattimore R, Livingstone C, Lorenzetti V, Lubman D, Murawski C, Parkes L, Petry N, Room R, Singh B, Thomas A, Townshend P, Youssef G, Hall W. Neuroscience in gambling policy and treatment: an interdisciplinary perspective. Lancet Psychiatry 2017; 4:501-506. [PMID: 28219609 DOI: 10.1016/s2215-0366(16)30369-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 10/28/2016] [Accepted: 10/28/2016] [Indexed: 01/05/2023]
Abstract
Neuroscientific explanations of gambling disorder can help people make sense of their experiences and guide the development of psychosocial interventions. However, the societal perceptions and implications of these explanations are not always clear or helpful. Two workshops in 2013 and 2014 brought together multidisciplinary researchers aiming to improve the clinical and policy-related effects of neuroscience research on gambling. The workshops revealed that neuroscience can be used to improve identification of the dangers of products used in gambling. Additionally, there was optimism associated with the diagnostic and prognostic uses of neuroscience in problem gambling and the provision of novel tools (eg, virtual reality) to assess the effectiveness of new policy interventions before their implementation. Other messages from these workshops were that neuroscientific models of decision making could provide a strong rationale for precommitment strategies and that interdisciplinary collaborations are needed to reduce the harms of gambling.
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Affiliation(s)
- Murat Yücel
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
| | - Adrian Carter
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia; UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia
| | - Amy R Allen
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Bernard Balleine
- Behavioural Neuroscience Laboratory, Brain and Mind Research Institute, University of Sydney, Camperdown, NSW, Australia
| | - Luke Clark
- Centre for Gambling Research, University of British Columbia, Vancouver, BC, Canada
| | - Nicki A Dowling
- Faculty of Health, School of Psychology, Deakin University, Burwood, VIC, Australia; Melbourne Graduate School of Education, University of Melbourne, Parkville, VIC, Australia; Centre for Gambling Research, Australian National University, Canberra, ACT, Australia
| | - Sally M Gainsbury
- School of Psychology, University of Sydney, Camperdown, NSW, Australia
| | - Anna E Goudriaan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands; Arkin Mental Health Care, Amsterdam, Netherlands
| | - Jon Grant
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Alan Hayes
- Family Action Centre, University of Newcastle, Callaghan, NSW, Australia
| | - David Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Ruth van Holst
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, Netherlands; Donders Institute for Cognition, Brain and Behaviour, Radboud University, Netherlands
| | - Ralph Lattimore
- Productivity Commission, Australian Government, Canberra, ACT, Australia
| | - Charles Livingstone
- School of Public Health and Preventive Medicine, Monash University, Clayton, VIC, Australia
| | - Valentina Lorenzetti
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia; Department of Psychological Sciences, Institute of Psychology Health and Society, University of Liverpool, Liverpool, UK
| | - Dan Lubman
- Eastern Health Clinical School, Monash University, Clayton, VIC, Australia; Turning Point, Eastern Health, Fitzroy, VIC, Australia
| | - Carsten Murawski
- Decision Neuroscience Laboratory, Department of Finance, University of Melbourne, Parkville, VIC, Australia
| | - Linden Parkes
- Brain and Mental Health Laboratory, Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Nancy Petry
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, VIC, Australia
| | - Bruce Singh
- Victorian Responsible Gambling Foundation, North Melbourne, VIC, Australia
| | - Anna Thomas
- Australian Gambling Research Centre, Australian Institute of Family Studies, Melbourne, VIC, Australia
| | - Phil Townshend
- Victorian Responsible Gambling Foundation, North Melbourne, VIC, Australia
| | - George Youssef
- Faculty of Health, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Wayne Hall
- UQ Centre for Clinical Research, University of Queensland, Brisbane, QLD, Australia; Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, QLD, Australia
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88
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Heather N. Q: Is Addiction a Brain Disease or a Moral Failing? A: Neither. NEUROETHICS-NETH 2017; 10:115-124. [PMID: 28725283 PMCID: PMC5486515 DOI: 10.1007/s12152-016-9289-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Accepted: 11/02/2016] [Indexed: 11/05/2022]
Abstract
This article uses Marc Lewis' work as a springboard to discuss the socio-political context of the brain disease model of addiction (BDMA). The claim that promotion of the BDMA is the only way the general public can be persuaded to withhold blame and punishment from addicts is critically examined. After a discussion of public understandings of the disease concept of addiction, it is pointed out that it is possible to develop a scientific account of addiction which is neither a disease nor a moral model but which the public could understand. Evidence is reviewed to suggest that public acceptance of the disease concept is largely lip-service and that the claim the BDMA removes stigma among the public and professionals is unsupported by evidence. Further, there is good evidence that biogenetic explanations of mental/behavioural disorders in general have been counterproductive in the attempt to ally stigma. A model of addiction as a disorder of choice may attract special problems in public-facing communications and risks being misunderstood. However, ways of presenting this model to the public are suggested that may avoid such risks. Lastly, the claim that the BDMA is the only way of ensuring access to treatment and of maintaining research funding for addiction is disputed and a way in which these benefits can be retained under a disorder-of-choice model proposed. The article concludes by enthusiastically endorsing Lewis' call for a third stage in the governing image of addiction.
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Affiliation(s)
- Nick Heather
- Department of Psychology, Northumbria University, 8 Roseworth Terrace, Newcastle on Tyne, NE3 1LU UK
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89
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Pavon G, Vaes J. Bio-genetic vs. psycho-environmental conceptions of schizophrenia and their role in perceiving patients in human terms. PSYCHOSIS 2017. [DOI: 10.1080/17522439.2017.1311359] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Giulia Pavon
- School of Social Science, Nottingham Trent University, Nottingham, UK
| | - Jeroen Vaes
- Department of Psychology and Cognitive Sciences, University of Trento, Trento, Italy
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90
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Kim NS, Johnson SGB, Ahn WK, Knobe J. The effect of abstract versus concrete framing on judgments of biological and psychological bases of behavior. COGNITIVE RESEARCH-PRINCIPLES AND IMPLICATIONS 2017; 2:17. [PMID: 28367497 PMCID: PMC5357666 DOI: 10.1186/s41235-017-0056-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/03/2017] [Indexed: 12/22/2022]
Abstract
Human behavior is frequently described both in abstract, general terms and in concrete, specific terms. We asked whether these two ways of framing equivalent behaviors shift the inferences people make about the biological and psychological bases of those behaviors. In five experiments, we manipulated whether behaviors are presented concretely (i.e. with reference to a specific person, instantiated in the particular context of that person's life) or abstractly (i.e. with reference to a category of people or behaviors across generalized contexts). People judged concretely framed behaviors to be less biologically based and, on some dimensions, more psychologically based than the same behaviors framed in the abstract. These findings held true for both mental disorders (Experiments 1 and 2) and everyday behaviors (Experiments 4 and 5), and yielded downstream consequences for the perceived efficacy of disorder treatments (Experiment 3). Implications for science educators, students of science, and members of the lay public are discussed.
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Affiliation(s)
- Nancy S Kim
- Department of Psychology, Northeastern University, 125 Nightingale Hall, 360 Huntington Avenue, Boston, MA 02115 USA
| | - Samuel G B Johnson
- Department of Psychology, Yale University, Box 208205, New Haven, CT 06520-8205 USA
| | - Woo-Kyoung Ahn
- Department of Psychology, Yale University, Box 208205, New Haven, CT 06520-8205 USA
| | - Joshua Knobe
- Department of Philosophy, Yale University, 344 College Street, New Haven, CT 06511 USA
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91
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Kong C, Dunn M, Parker M. Psychiatric Genomics and Mental Health Treatment: Setting the Ethical Agenda. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2017; 17:3-12. [PMID: 28328372 DOI: 10.1080/15265161.2017.1284915] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Realizing the benefits of translating psychiatric genomics research into mental health care is not straightforward. The translation process gives rise to ethical challenges that are distinctive from challenges posed within psychiatric genomics research itself, or that form part of the delivery of clinical psychiatric genetics services. This article outlines and considers three distinct ethical concerns posed by the process of translating genomic research into frontline psychiatric practice and policy making. First, the genetic essentialism that is commonly associated with the genomics revolution in health care might inadvertently exacerbate stigma towards people with mental disorders. Secondly, the promises of genomic medicine advance a narrative of individual empowerment. This narrative could promote a fatalism towards patients' biology in ways that function in practice to undermine patients' agency and autonomy, or, alternatively, a heightened sense of subjective genetic responsibility could become embedded within mental health services that leads to psychosocial therapeutic approaches and the clinician-patient therapeutic alliance being undermined. Finally, adopting a genomics-focused approach to public mental health risks shifting attention away from the complex causal relationships between inequitable socio-economic, political, and cultural structures and negative mental health outcomes. The article concludes by outlining a number of potential pathways for future ethics research that emphasizes the importance of examining appropriate translation mechanisms, the complementarity between genetic and psychosocial models of mental disorder, the implications of genomic information for the clinician-patient relationship, and funding priorities and resource allocation decision making in mental health.
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92
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93
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MacDuffie KE, Strauman TJ. Understanding Our Own Biology: The Relevance of Auto-Biological Attributions for Mental Health. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2017. [DOI: 10.1111/cpsp.12188] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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94
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Doley JR, Hart LM, Stukas AA, Petrovic K, Bouguettaya A, Paxton SJ. Interventions to reduce the stigma of eating disorders: A systematic review and meta-analysis. Int J Eat Disord 2017; 50:210-230. [PMID: 28230911 DOI: 10.1002/eat.22691] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 01/13/2017] [Accepted: 01/16/2017] [Indexed: 12/27/2022]
Abstract
Stigma is a problem for individuals with eating disorders (EDs), forming a barrier to disclosure and help-seeking. Interventions to reduce ED stigma may help remove these barriers; however, it is not known which strategies (e.g., explaining etiology to reduce blame, contact with a person with an ED, or educating about ED) are effective in reducing stigma and related outcomes. This review described effectiveness of intervention strategies, and identified gaps in the literature. A search of four databases was performed using the terms (eating disorder* OR bulimi* OR anorexi* OR binge-eating disorder) AND (stigma* OR stereotyp* OR beliefs OR negative attitudes) AND (program OR experiment OR intervention OR education), with additional texts sought through LISTSERVs. Two raters screened papers, extracted data, and assessed quality. Stigma reduction strategies and study characteristics were examined in critical narrative synthesis. Exploratory meta-analysis compared the effects of biological and sociocultural explanations of EDs on attitudinal stigma. Eighteen papers were eligible for narrative synthesis, with four also eligible for inclusion in a meta-analysis. Biological explanations reduced stigma relative to other explanations, including sociocultural explanations in meta-analysis (g = .47, p < .001). Combined education and contact interventions improved stigma relative to control groups or over time. Most studies examined Anorexia Nervosa (AN) stigma and had mostly female, undergraduate participants. Despite apparent effectiveness, research should verify that biological explanations do not cause unintentional harm. Future research should evaluate in vivo contact, directly compare education and contact strategies, and aim to generalize findings across community populations.
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Affiliation(s)
- Joanna R Doley
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | - Laura M Hart
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia.,Melbourne School of Global and Population Health, University of Melbourne, Parkville, VIC, Australia
| | - Arthur A Stukas
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | - Katja Petrovic
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
| | | | - Susan J Paxton
- Department of Psychology and Counselling, La Trobe University, Melbourne, VIC, Australia
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95
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Cronan SB, Key KD, Vaughn AA. Beyond the Dichotomy: Modernizing Stigma Categorization. STIGMA AND HEALTH 2017; 1:225-243. [PMID: 28083562 DOI: 10.1037/sah0000031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Even though our knowledge of the cause of disease and disability has grown, stigma still exists. Weiner, Perry, and Magnusson's seminal study on attributions of stigma has been cited over 500 times since its publication in 1988. The current research sought to replicate and expand this literature in two studies. We used the 10 stigmas from the original study and we added six more (representing common psychological and physical stigmas). In the first study, we examined the classification of stigmas using cluster analysis. We found that instead of dichotomizing stigmas into either psychological or physical, attributions of controllability and stability together resulted in four distinct clusters. Although these were mostly consistent with past literature, the fourth cluster included both psychological and physical stigmas and was rated as moderately controllable and moderately stable. In the second study, we examined how information about responsibility shifts causal attributions, emotional responses, and helping behaviors. Information that an individual was responsible for their stigma led to greater attributions of controllability, less positive emotions, and less help compared to information that an individual was not responsible. More interestingly, the no-information control condition was similar to the responsibility information condition for stigmas that fell into the controllable clusters whereas the control condition was similar to the not responsible information condition for stigmas that fell into the uncontrollable clusters. While parsimony is valued, the psychological/physical dichotomy is not nuanced enough to fully capture the variation in stigmas, which in turn has implications for future research on stigma reduction.
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96
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Heine S, Dar-Nimrod I, Cheung B, Proulx T. Essentially Biased. ADVANCES IN EXPERIMENTAL SOCIAL PSYCHOLOGY 2017. [DOI: 10.1016/bs.aesp.2016.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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97
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Faucher L, Goyer S. [The Research Domain Criteria (Rdoc), reductionism and clinical psychiatry]. REVUE DE SYNTHESE 2016; 137:117-149. [PMID: 27550461 DOI: 10.1007/s11873-016-0292-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The focus of the advocates of the Research Domain Critria (RDoC) on faulty brain circuits has led some to suspect it of being a reductionist enterprise. And because RDoC will eventually impact clinical psychiatry, some have feared that it will transform clinical psychiatry in a mindless and applied neurobehavioral science. We argue that if RDoC is officially endorsing a kind of reductionism, the particular kind of reductionism it endorses is not suffering from the shortcomings of more classical forms of reductionism. Because of that, at least in principle, RDoC could enrich rather than impoverish clinical psychiatry. This paper raises few potential problems of the RDoC for clinical psychiatry caused by its implicit epistemological reductionism.
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Affiliation(s)
- Luc Faucher
- Département de philosophie, Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, Québec, Canada, H3C 3P8.
| | - Simon Goyer
- Département de philosophie, Université du Québec à Montréal, C.P. 8888, Succ. Centre-Ville, Montréal, Québec, Canada, H3C 3P8
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98
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Affiliation(s)
- Johannes Fuss
- Correspondence to: J. Fuss, Institute for Sex Research and Forensic Psychiatry, Martinistr. 52, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
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99
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Sabatello M, Appelbaum S. Psychiatric Genetics in Child Custody Proceedings: Ethical, Legal, and Social Issues. CURRENT GENETIC MEDICINE REPORTS 2016; 4:98-106. [PMID: 27695660 DOI: 10.1007/s40142-016-0093-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This paper considers the ethical, legal, and social issues raised by the prospect of increasing use of psychiatric genetic data in child custody litigation. Although genetic tests cannot currently confirm a parent or child's psychiatric diagnosis, it is likely that as relevant findings emerge, they will be introduced in family courts to challenge parental capacity. Here, we draw on three projected, but plausible, scenarios for obtaining psychiatric data about parents -- imposed genetic testing, access to medical records, and genetic theft -- then consider the use of psychiatric genetic data of children, to highlight the issues that judges, child custody evaluators, and clinicians who may provide treatment for parents or children with mental health issues will need to consider. These include: genetic privacy, stigma, genetic surveillance, and judicial and health professionals' bias. We argue that the unchecked introduction of psychiatric genetic data may have a detrimental effect on the administration of justice. In particular, the article highlights the risk that the (mis)use of psychiatric genetic data in custody disputes would 1) exacerbate stigma and treatment-avoidance among parents and incentivize privacy violations to pressure parents to relinquish parental rights; 2) disproportionately affect poor parents and single mothers of color involved with Child Protective Services; and 3) detract attention from social and environmental factors impacting mental health to the detriment of the families involved. Awareness of these issues and an understanding of the meaning of genomic data by judges and custody evaluators will be pivotal in ensuring that justice is served.
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Affiliation(s)
- Maya Sabatello
- Assistant Professor of Clinical Bioethics in the Division of Law, Ethics, and Psychiatry, Department of Psychiatry, Columbia University College of Physicians and Surgeons
| | - S Appelbaum
- Elizabeth K. Dollard Professor of Psychiatry, Medicine, and Law, and Director, Center for Research on Ethical, Legal & Social Implications of Psychiatric, Neurologic & Behavioral Genetics, Department of Psychiatry, Columbia University College of Physicians and Surgeons
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100
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Abstract
One major approach to weight stigma reduction consists of decreasing beliefs about the personal controllability of-and responsibility for-obesity by educating about its biogenetic causes. Evidence on the efficacy of this approach is mixed, and it remains unclear whether this would create a deterministic view, potentially leading to detrimental side-effects. Two independent studies from Germany using randomized designs with delayed-intervention control groups served to (1) develop and pilot a brief, interactive stigma reduction intervention to educate N = 128 university students on gene × environment interactions in the etiology of obesity; and to (2) evaluate this intervention in the general population (N = 128) and determine mechanisms of change. The results showed (1) decreased weight stigma and controllability beliefs two weeks post-intervention in a student sample; and (2) decreased internal attributions and increased genetic attributions, knowledge, and deterministic beliefs four weeks post-intervention in a population sample. Lower weight stigma was longitudinally predicted by a decrease in controllability beliefs and an increase in the belief in genetic determinism, especially in women. The results underline the usefulness of a brief, interactive intervention promoting an interactionist view of obesity to reduce weight stigma, at least in the short term, lending support to the mechanisms of change derived from attribution theory. The increase in genetic determinism that occurred despite the intervention's gene × environment focus had no detrimental side-effect on weight stigma, but instead contributed to its reduction. Further research is warranted on the effects of how biogenetic causal information influences weight management behavior of individuals with obesity.
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Affiliation(s)
- Anja Hilbert
- Integrated Research and Treatment Center Adiposity Diseases, Department of Medical Psychology and Medical Sociology, University of Leipzig Medical Center, Leipzig, Germany
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