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 The study didn't involve real patients - only short descriptions of
fictional cases. Still, it found that psychiatrists, psychologists
and social workers expressed less empathy for patients with
conditions explained as biological rather than psychological.
The findings challenge the notion that biological explanations of
mental illness boost compassion for millions of Americans who suffer
from psychological conditions.
“Our study demonstrates an example of the downside of the trend
toward increasingly biological conceptualizations of mental health,”
lead author Matthew Lebowitz told Reuters Health.
“Overemphasizing this idea that people with mental disorders have
something fundamentally wrong with their brains can be
dehumanizing,” he said.
Lebowitz, a psychology graduate student at Yale University in New
Haven, Connecticut, and his colleagues asked 343 U.S. clinicians to
read fictional stories about mental health patients paired with
explanations based wholly or partly on either genetics and
neurobiology, or on childhood experiences and stressful life
circumstances.
The vignettes described people with social phobias, schizophrenia,
depression and obsessive-compulsive disorder.
In one, for example, the biological explanation for a college
student’s crippling shyness was that her mother and brother also
were shy, and an MRI technician found a part of her brain involved
with fear was more active than normal. The psychosocial explanation
instead offered details of the shy student’s history of childhood
bullying.
Overall, the clinicians responded with less empathy for stories with
symptoms based on biological factors and more empathy for stories
based on psychosocial factors, the researchers reported in the
Proceedings of the National Academy of Sciences.
All clinicians reacted with less empathy to biological explanations
and with more empathy to psychological explanations of symptoms. But
medical doctors reported significantly less empathy overall than
other clinicians, the study found. The authors could not explain
why.
The study authors called the results “alarming.”
“One of the benefits often touted for the biological explanations of
mental disorders is that they can reduce blame and personal
responsibility for their symptoms,” Lebowitz said. "But there are
some problems with that. Biological explanations can start to
dehumanize patients."
The authors note that the vignettes they presented were
oversimplified and failed to capture the complexity of the etiology
of mental disorders. The study cannot say whether clinicians facing
patients with real problems would react the same way.
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If true, however, they caution that the findings may lead clinicians
away from proven psychotherapy treatments. The study found
biological explanations were tied to clinicians believing less in
psychotherapy and more in medication.
James Tabery, a professor at the University of Utah School of
Medicine in Salt Lake City, said he found the study findings
“worrisome.” But he told Reuters Health he hoped the research would
be used as a training tool to teach aspiring clinicians about the
complex interplay between genetics, biology and environment in the
development of psychiatric conditions.
“The study does raise a troubling implication – the thought that the
patient-physician relationship is compromised by these biological
explanations. I would hope we could use this information to educate
aspiring clinicians so that they don’t (fall) victim to that trend,
to bring it to their attention so they can actively combat it,” he
said.
Tabery wrote a 2014 book titled Beyond Versus: The Struggle to
Understand the Interaction of Nature and Nurture. He was not
involved in the current study.
“There’s increasing effort among the scientific community to find
biological explanations for depression, social phobias," he said.
"The researchers have uncovered one potential cost of this
development."
Tabery and Lebowitz both see mental health conditions as resulting
from a combination of genetics, neurobiology and life experience.
“To reduce it all to one is to miss that complex story,” Tabery
said.
SOURCE: http://bit.ly/1tIAVVM Proceedings of the National Academy of
Sciences, online December 1, 2014.
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