Biogenetic explanations and public acceptance of mental illness: systematic review of population studies.

Centre for Public Mental Health, Gösing am Wagram, Austria.
The British journal of psychiatry: the journal of mental science (Impact Factor: 6.62). 11/2011; 199(5):367-72. DOI: 10.1192/bjp.bp.110.085563
Source: PubMed

ABSTRACT Biological or genetic models of mental illness are commonly expected to increase tolerance towards people with mental illness, by reducing notions of responsibility and blame.
To investigate whether biogenetic causal attributions of mental illness among the general public are associated with more tolerant attitudes, whether such attributions are related to lower perceptions of guilt and responsibility, to what extent notions of responsibility are associated with rejection of people who are mentally ill, and how prevalent notions of responsibility are among the general public with regard to different mental disorders.
A systematic review was conducted of representative population studies examining attitudes towards people with mental illness and beliefs about such disorders.
We identified 33 studies relevant to this review. Generally, biogenetic causal attributions were not associated with more tolerant attitudes; they were related to stronger rejection in most studies examining schizophrenia. No published study reported on associations of biogenetic causal attributions and perceived responsibility. The stereotype of self-responsibility was unrelated to rejection in most studies. Public images of mental disorder are generally dominated by the stereotypes of unpredictability and dangerousness, whereas responsibility is less relevant.
Biogenetic causal models are an inappropriate means of reducing rejection of people with mental illness.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Mental disorders are increasingly understood in terms of biological mechanisms. We examined how such biological explanations of patients' symptoms would affect mental health clinicians' empathy-a crucial component of the relationship between treatment-providers and patients-as well as their clinical judgments and recommendations. In a series of studies, US clinicians read descriptions of potential patients whose symptoms were explained using either biological or psychosocial information. Biological explanations have been thought to make patients appear less accountable for their disorders, which could increase clinicians' empathy. To the contrary, biological explanations evoked significantly less empathy. These results are consistent with other research and theory that has suggested that biological accounts of psychopathology can exacerbate perceptions of patients as abnormal, distinct from the rest of the population, meriting social exclusion, and even less than fully human. Although the ongoing shift toward biomedical conceptualizations has many benefits, our results reveal unintended negative consequences.
    Proceedings of the National Academy of Sciences 12/2014; · 9.81 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The purpose of this review is to clarify and demystify a set of ideas and assumptions, which pervade the field of psychiatry and cause confusion and unfortunate consequences for the practice and teaching of psychiatry. These crystalize in the so-called mind/body problem or mind/body dualism. Mind/Body dualism has adverse consequences for psychiatry, such as stigmatization of mental illness, restricted funding for research and patient care, discrimination against patients with psychiatric or addictive disease in the insurance market place and leads to cognitive distortions affecting the training and practice of psychiatry. This paper attempts to deconstruct a set of ideas, which tend to under girth our intuitive mind/body dualism and proposes that neuroscience is increasingly capable of describing human cognition, emotion and psychopathology as the manifestations of brain activity. Psychiatry operates in a border region of the neurobiology of the brain and mind. Mind is the overarching concept incorporating notions of consciousness, phenomenological experience, free will and the idea of the soul. Psychiatric practice involves modifying brain functions by the use of medications and other means, as well as interventions broadly described as psychotherapy. Psychiatry as a medical discipline has an ambivalent and uneasy relationship with the idea of mind/brain. In this paper, we attempt to trace this tension to the pervasive, intuitive mind/body dualism that lay people as well as scientists tend to adopt. A rapidly growing empirical literature is eroding the idea of mind/ brain dualism. We will review claims that consciousness, first person phenomenological experience or " qualia, " and free will are ontologically beyond the grasp of empirical study. A growing number of neuroscientific research results are placing increasing constraints on these claims. We suggest an alternative view based on the philosophy of pragmatism, which we believe would recommend a critical reappraisal of our intuitive beliefs, by means of an empirically responsible stance. The literature on these topics is extensive. We restrict our review to very recent results from neurobiology.
    J Psychiatry 2015, 18:1. 01/2015; 18:1.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Challenges to psychiatric stigma fall between a rock and a hard place. Decreasing one prejudice may inadvertently increase another. Emphasising similarities between mental illness and 'ordinary' experience to escape the fear-related prejudices associated with the imagined 'otherness' of persons with mental illness risks conclusions that mental illness indicates moral weakness and the loss of any benefits of a medical model. An emphasis on illness and difference from normal experience risks a response of fear of the alien. Thus, a 'likeness-based' and 'unlikeness-based' conception of psychiatric stigma can lead to prejudices stemming from paradoxically opposing assumptions about mental illness. This may create a troubling impasse for anti-stigma campaigns.
    The psychiatric bulletin (2014). 08/2014; 38(4):148-51.


Available from
May 22, 2014