Effects of biological explanations for mental disorders on clinicians’ empathy

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.

Child sexual abuse: Raising awareness and empathy is essential to promote new public health responses

“…Empathy is also known to enable clinical professionals to make prosocial responses. 42 We posit that efforts to develop empathy in this context offer multiple opportunities for health policy and for practical gains. At the individual level, heightened empathy may contribute to a potential offender resisting the impulse to abuse a child; to a parent sensitively dealing with a child's disclosure instead of dismissing it; to a professional who does not suppress his or her knowledge or suspicion of a child's experience and instead reports it.…”

Stigma of mental illness and multicultural counseling self-efficacy : investigating the implications of the multicultural training environment, mental health literacy, and empathy.

“…Although a direct link between empathy and mental illness stigma remains less empirically supported, there is evidence that empathy is related to indicators of stigmatizing attitudes. In their study of mental health clinicians (medically and nonmedically trained), Lebowitz and Ahn (2014) found that biological explanations for symptoms of mental illness significantly decreased clinician's empathy for clients. The authors suggested that the biological explanations of mental illnesses may categorize symptomatic individuals as "systems of interacting mechanisms" (Lebowitz & Ahn, 2014, p. 17788), effectively reducing an individual to a dehumanized state similar to that described by Goffman (1963) as stigma.…”

“…The underlying theoretical assumption is that a biological or biogenetic explanation tends to be associated with less blame on the part of the client, compared to a psychosocial explanation, which often include lifestyle choices made by the client (Deacon, 2013;Kvaale, Haslam, & Gottdiener, 2013). In a series of three studies investigating the effect of this information on the attitudes of mental health providers, Lebowitz and Ahn (2014) provided a series of vignettes to a national sample of mental health clinicians practicing in the United States (n = 132 in study 1; n = 105 in study 2; n = 106 in study 3), which included both medically trained mental health care providers (psychiatrists) and nonmedically trained mental health care providers (psychologists and social workers). Participants were presented with vignettes describing fictional clients with diagnoses of schizophrenia, social phobia, major depression, and obsessive-compulsive disorder.…”

“…Although this seems counterintuitive, given the emotion control associated with higher levels of perspective taking (Pulos, 2004), an explanation may lie in participants' underlying views regarding explanations for mental illnesses, which were not directly elicited in the current study. Lebowitz and Ahn (2014) suggested in their study of clinicians' responses to biogenic explanations for causality of mental illness that, while these explanations may increase empathic response by limiting the blame placed on an individual for their own mental illness, a corresponding reduction in mental illness stigma was not found. Despite the reduction in blame, the categorical otherness created by biogenic explanations for mental illnesses ultimately resulted in an essentialism that led to increases in mental illness stigma (Deacon, 2013).…”

“…That which does exist has indicated that, among mental health care providers, the stigma associated with mental illness and the people who have those illnesses centers on very specific and clinically-based stigmatizing attitudes or beliefs. These may include attitudes centered on recovery and outcome expectations, estimation of dangerousness, and beliefs that may be grounded in the essentialism of biogenic causes of mental illnesses (Deacon, 2013;Lebowitz & Ahn, 2014). Future study that disaggregates these clinically-based stigmatizing beliefs and addresses them in the context of the clinical environment may serve to more precisely define the sources of counselors' endorsement of stigmatizing beliefs.…”