Emphasizing Malleability in the biology of depression: Durable effects on perceived agency and prognostic pessimism

Abstract

Biological attributions for depression, which are currently ascendant, can lead to prognostic pessimism—the perception that symptoms are relatively immutable and unlikely to abate (Kvaale, Haslam, & Gottdiener, 2013; Lebowitz, Ahn, & Nolen-Hoeksema, 2013). Among symptomatic individuals, this may have important clinical ramifications, as reduced confidence in one’s own ability to overcome depression carries the risk of becoming a self-fulfilling prophecy. Previous research (Lebowitz, Ahn, et al., 2013) has demonstrated that educational interventions teaching symptomatic individuals about how the effects of genetic and neurobiological factors involved in depression are malleable and can be modified by experiences and environmental factors can reduce prognostic pessimism. While previous research demonstrated such effects only in the immediate term, the present research extends these findings by testing whether such benefits persist six weeks after the intervention. Indeed, among individuals who initially considered biological factors to play a major role in influencing their levels of depression, exposure to malleability-focused psychoeducation reduced levels of depression-related prognostic pessimism and stronger belief in their ability to regulate their moods. Critically, this benefit persisted six weeks after the intervention. Clinical implications of the findings are discussed.

Testing positive for a genetic predisposition to depression magnifies retrospective memory for depressive symptoms.

“…Moreover, in the present work, an approach that has been shown to mitigate genetic attributions’ detrimental effects on people’s feelings of agency in confronting their symptoms(Lebowitz & Ahn, 2015; Lebowitz et al, 2013) failed to counteract the effects of genetic feedback on symptom recall. This may reflect the fact that overall, the widespread bias toward assuming that genes affect health deterministically is difficult to counteract; indeed, much of the existing work that has effectively weakened such assumptions has done so by disproportionately emphasizing the role of non-genetic factors, which may be viewed as more controllable (Heine et al, 2017).…”

“…In work by Lebowitz and Ahn (2015), this brief video successfully restored feelings of agency over depression, even among people who strongly attributed depression to biological causes (see also Lebowitz et al, 2013 for similar findings). Thus, if genetic determinism were to cause increased recall of depressive symptoms, this video intervention could have counteracted such an effect.…”

“…It discussed the notion that genes alone are not sufficient to cause depression, provided information about gene-by-environment interactions and epigenetics, and discussed actions that people can take to combat or decrease their risk of depression even if they are genetically predisposed (Lebowitz & Ahn, 2015). The video is available at https://www.youtube-nocookie.com/embed/hupQ_kkJXrg.…”

“…The video is available at https://www.youtube-nocookie.com/embed/hupQ_kkJXrg. After watching the video, participants were asked to “write a few sentences about the information you learned from the video you just watched…and give at least a few examples of how you (or somebody else) might use the information you learned to prevent or overcome depression.” Instructing participants to compose these reflections took advantage of the so-called “saying is believing” effect, in which people come to internalize a viewpoint more strongly after they have advocated for it themselves (Higgins, 1999; Lebowitz & Ahn, 2015; Lebowitz et al, 2013; Walton & Cohen, 2011). As detailed in the Appendix, analyses of the written reflections showed that 93.6% of participants demonstrated full comprehension of the video.…”

The desire to belong: Social identification as a predictor of treatment outcome in social anxiety disorder

“…A more tolerant, less dichotomous and rigid, separation of ill and healthy could be associated with an improved sense of perceived personal control (e.g., Lebowitz & Ahn, 2015), In a recent series of studies using unselected community samples, Greenaway et al (2015) found robust positive associations between group identification and perceived personal control. They theorized an upward spiral of well-being, whereby feelings of control increase as individuals identify with groups, which in turn allows individuals to increase the quantity and quality of their social connections.…”