Beliefs About Essences and the Reality of Mental Disorders

Abstract

Do people believe mental disorders are real and possess underlying essences? The current study found that both novices and practicing clinicians held weaker essentialist beliefs about mental disorders than about medical disorders. They were also unwilling to endorse the idea that mental disorders are real and natural. Furthermore, compared with novices, mental health clinicians were less likely to endorse the view that there is a shared cause underlying a mental disorder and that one needs to remove the cause to get rid of the mental disorder. Clinicians were polarized on their views about whether mental disorders are categorical or dimensional. These findings reflect current controversies about mental disorders in the field at large.Prior to the understanding of sex chromosomes, gender was distinguished on the basis of cooccurrence of surface features (e.g., voice, height; Rosch & Mervis, 1975). Even so, gender categories were almost certainly treated as real and natural: People most likely believed that an underlying, hidden essence made a man a man or a woman a woman, although they did not know what that essence was (Medin & Ortony, 1989). The current understanding of mental disorders presents an analogous situation. That is, knowledge about the etiology of most mental disorders in the current taxonomy is incomplete (e.g., American Psychiatric Association, APA, 2000). Do people nevertheless believe that mental disorders are real, exist naturally, and possess hidden essences?There are reasons to predict that people believe mental disorders are real and possess essences (e.g., Kendell, 1986). For instance, past research suggests that laypeople have a tendency to essentialize many forms of human groupings, such as racial and ethnic categories (e.g., Hirschfeld, 1995). Furthermore, proponents of the disease (or medical) models for mental disorders maintain that each disorder is universal and has a biologically based etiology with discrete boundaries (see Haslam, 2000, andKiesler, 1999, for reviews). If people hold disease models for mental disorders, they would view disorders as real and as having essences.Clinicians, in particular, may have such a view because of their experience with and knowledge about the domain. For instance, the symptom-level descriptions adopted in the contemporary versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM; APA, 1980APA, , 1987APA, , 1994 are often deemed (e.g., Kihlstrom, 2002;Kupfer, First, & Regier, 2002) to have been built on the Kraepelinian assumption: "Cases of mental disease originating in the same causes must also present the same symptoms, and the same pathological findings" (Kraepelin & Diefendorf, 1904/1907 However, mental disorders instead might be seen as nominal and constructed by culture (e.g., Cohen, 1981;Sedgwick, 1982). The relatively well-known fact that the etiologies of most mental disorders are unknown might make both experts and novices hesitant to endorse even the possibility of essences or reality for these disorders. Fur...

Classification as diagnostic reasoning

“…Consistent with this interpretation, Rehder and Kim (2009) found a stronger causal status effect when observable features were given an explicit underlying cause (also see Rehder, 2003b). And, Ahn and her colleagues found that expert clinicians both view mental disorders as less essentialized than laypersons (Ahn, Flanagan, Marsh, & Sanislow, 2006) and exhibit only a weak causal status effect (Ahn, Levin, & Marsh, 2005), consistent with the idea that the causal status effect depends on diagnostic reasoning from observable features to underlying properties that are strongly associated with category membership.…”

The influence of expertise on essence beliefs for mental and medical disorder categories

“…In physicians, this reduction of essentialist beliefs was most evident in questions regarding treatment. Similarities and differences to the results from Ahn et al (2006) are discussed.…”

“…Work related to beliefs about mental disorders finds that laypeople treat mental disorders as if they do have causal essences, while clinicians do not-differences that may be attributable to expertise (Ahn, Flanagan, Marsh, & Sanislow, 2006). To test whether reduced beliefs in essences are indicative of an overall influence of expertise or a demonstration of a phenomenon specific to expertise in the mental health domain we compared beliefs about mental and medical disorders held by practicing physicians (n = 43; 19 primary care and 24 non-psychiatry specialists) and laypeople (n = 40).…”

Determinants of Gender Essentialism in College Students

“…Although essentialism is often criticized as biologically inaccurate (Bohan 1993;Mayr 1991;Sober 1994;Wilson 1999), it nonetheless persists in everyday reasoning. Essentialist reasoning has been found in the USA among both children (Gelman 2003;Giles 2003;Heyman and Gelman 2000;Hirschfeld 1996;Taylor 1996) and adults (Ahn et al 2006;Atran 1998;Haslam 1998;Haslam and Ernst 2002;Haslam et al 2000;Rehder 2007), and in other cultural contexts as well (Astuti et al 2004;Diesendruck 2001;Diesendruck and Gelman 1999;Gil-White 2001;Mahalingam 1998). The purpose of the present studies is to examine some of the factors that encourage gender essentialism in the USA, by asking which gender concepts are essentialized and who essentializes gender.…”