Explaining How Psychotherapy Affects the Brain Can Increase the Perceived Effectiveness of Psychotherapy: A Randomized Controlled Trial.

Past studies repeatedly found that biological explanations of mental disorders cause laypeople and clinicians to doubt the effectiveness of psychotherapy. This could be clinically detrimental, as combined pharmacotherapy and psychotherapy is often optimal. The distrust of psychotherapy is theorized to stem from dualistic reasoning that psychotherapy, perceived as occurring in the mind, does not necessarily affect the brain. The current study aims to mitigate this belief in a randomized controlled trial. Participants (individuals with symptoms of depression (n = 262), the general public (n = 374), and mental health clinicians (n = 607)) rated the efficacy of psychotherapy for a depression case before and after learning that the case was biologically caused. Participants also received either an intervention passage describing how psychotherapy results in brain-level changes, an active control passage emphasizing the effectiveness of psychotherapy without explaining the underlying biological mechanisms, or no intervention. Unlike the active control and no-intervention control conditions, the intervention caused participants to judge psychotherapy as significantly more effective than at baseline even though they learned that depression was biologically caused. An intervention counteracting dualism can mitigate the belief that psychotherapy is less effective for biologically caused depression. Future research should examine the durability of this intervention in clinical settings.

The effect of neuroscientific evidence on sentencing depends on how one conceives of reasons for incarceration.

Neuroscientific evidence is increasingly utilized in criminal legal proceedings, prompting discussions about how such evidence might influence legal decisions. The effect of neuroscientific testimony on legal decisions remains uncertain, with some studies finding no effect, others reporting that neuroscience has a mitigating impact, and some indicating neuroscience evidence has an aggravating effect. The present study attempts to explain these divergent findings by showing that the effect of neuroscience evidence on sentencing interacts with beliefs about the goals of the criminal legal system. Using a between-subjects design, participants (N = 784) were asked to assume different rationales for imprisonment, before receiving neuroscientific evidence about antisocial behavior and its potential relation to the defendant. Participants recommended a sentence for the defendant prior to and after reading the neuroscientific evidence. Participants who were given the rationale of retribution as the primary goal of imprisonment significantly decreased their sentencing recommendations. When the goal of imprisonment was to protect the public from dangerous people, participants provided longer post-testimony sentences. Lastly, when the goal was to rehabilitate wrongdoers, participants also increased sentences from pre to post. Thus, the impact of neuroscientific evidence is not monolithic, but can lead to either mitigated or aggravated sentences by interacting with penal philosophy.

It's Time to be disgusting about COVID-19: Effect of disgust priming on COVID-19 public health compliance among liberals and conservatives.

The COVID-19 pandemic is far from over, in part due to poor adoption of public health mitigation measures in the U.S. and the continued spread of the Delta and Omicron variants. Current public health messaging used in the U.S. could be improved to better combat mistrust about COVID-19 and its mitigation measures, especially vaccines. We propose that a disgust-inducing public health campaign will be more effective than current approaches, primarily among conservatives, who are both sensitive to moralized disgust and are less compliant with U.S. public health guidelines. Using a convenience sample across two studies (n = 1610), we found that presenting disgusting images related to the COVID-19 pandemic increased public health compliance more among conservatives than among liberals. Among unvaccinated conservative participants, disgusting images significantly increased willingness to be vaccinated compared to less disgusting images of COVID-19 or perks offered for COVID-19 vaccines. Using disgusting images for public health messaging has the potential to improve compliance among conservatives and accelerate the end of the COVID-19 pandemic in the U.S.

The symptom discounting effect: what to do when negative genetic test results become risk factors for alcohol use disorder.

Most consumers of genetic testing for health conditions test negative, yet the psychological perils of this are hardly known. In three experiments (N = 2103) participants discounted repercussions of alcohol use disorder (AUD), after learning or imagining that they were not genetically predisposed to AUD. Such discounting can lead people to avoid treatment and to feel safe to continue or even increase their drinking, ironically turning the negative genetic feedback into a risk factor for AUD. Concerningly, the debriefing currently used by a direct-to-consumer genetic testing company failed to counteract this discounting among those already engaging in problematic drinking in all three studies. It was hypothesized that this discounting derives from not understanding the Causal Markov condition; once AUD symptoms are present, their ramifications remain the same regardless of whether genes or environmental factors caused the symptoms. Educating participants about this principle successfully mitigated the irrational discounting of threats of AUD.

Neurodualism: People Assume that the Brain Affects the Mind more than the Mind Affects the Brain.

People commonly think of the mind and the brain as distinct entities that interact, a view known as dualism. At the same time, the public widely acknowledges that science attributes all mental phenomena to the workings of a material brain, a view at odds with dualism. How do people reconcile these conflicting perspectives? We propose that people distort claims about the brain from the wider culture to fit their dualist belief that minds and brains are distinct, interacting entities: Exposure to cultural discourse about the brain as the physical basis for the mind prompts people to posit that mind-brain interactions are asymmetric, such that the brain is able to affect the mind more than vice versa. We term this hybrid intuitive theory neurodualism. Five studies involving both thought experiments and naturalistic scenarios provided evidence of neurodualism among laypeople and, to some extent, even practicing psychotherapists. For example, lay participants reported that "a change in a person's brain" is accompanied by "a change in the person's mind" more often than vice versa. Similarly, when asked to imagine that "future scientists were able to alter exactly 25% of a person's brain," participants reported larger corresponding changes in the person's mind than in the opposite direction. Participants also showed a similarly asymmetric pattern favoring the brain over the mind in naturalistic scenarios. By uncovering people's intuitive theories of the mind-brain relation, the results provide insights into societal phenomena such as the allure of neuroscience and common misperceptions of mental health treatments.

Effects of genetic information on memory for severity of depressive symptoms.

The general public is increasingly aware of the role of genes in causing depression. Recent studies have begun uncovering unintended negative consequences of learning about a person's genetic susceptibility to disorders. Because people tend to believe that genes determine one's identity, having genes related to a disorder can be misinterpreted as equivalent to having the disorder. Consequently, learning that a person is genetically predisposed to depression can make people misremember mild depression as more severe. Participants across three experiments read a target vignette about a character displaying mild depressive symptoms, while descriptions of the character's genetic susceptibility to depression were experimentally manipulated. Participants then read a foil vignette describing a character with more severe depressive symptoms. Afterwards, participants who had learned that the target character was genetically predisposed to depression were comparatively more likely to misremember the target symptoms as being severe, when in fact they were mild. This pattern of results was obtained among both laypeople (Experiments 1 and 2) and practicing master's-level, but not doctoral-level, mental health clinicians (Experiment 3). Given that depression is diagnosed primarily based on a person's memory of depressive symptoms, the current findings suggest that genetic information about depression may lead to over-diagnosis of depression.

Perceptions of the competent but depressed.

Accurately recognizing and remembering the depressive symptoms of other people can be crucial in helping those suffering from depression. Yet, lay theories about depression might interfere with accurate perception or recollection of depression in others. The current study examined whether laypersons would misremember depressive symptoms in highly competent people as being less severe than they actually are. Participants first read a target vignette about a character displaying depressive symptoms, whereas the level of competency of the target character varied across different conditions. Then, participants read a foil vignette describing a character with similar depressive symptoms, which was intended to elicit memory errors for the target vignette. When the foil vignette described that the depressive symptoms were eventually overcome, participants were more likely to false-alarm the recovery as the competent character's than as the less competent character's (Experiment 1a). Conversely, when the foil vignette's depressive symptoms were described to be highly severe, participants were less likely to false-alarm them as the competent character's symptoms than as the less competent character's symptoms (Experiment 2a). This phenomenon appears to be unique to laypeople's perception of depression, as the same pattern of results was not obtained when the participants were mental health clinicians (Experiments 1b and 2b) or when laypeople participants read about symptoms of physical disorders or other mental disorders (Experiment 3). Taken together, the current study presents novel findings suggesting that competent people's depression is underdetected by laypeople. The implications and the limitations of the study are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Blue Genes? Understanding and Mitigating Negative Consequences of Personalized Information about Genetic Risk for Depression.

Personalized genetic testing for vulnerability to mental disorders is expected to become increasingly common. It is therefore important to understand whether learning about one's genetic risk for a mental disorder has negative clinical implications, and if so, how these might be counteracted. Among participants with depressive symptoms, we administered a sham biochemical test purportedly revealing participants' level of genetic risk for major depression. Participants told that they carried a genetic predisposition to depression expressed significantly lower confidence in their ability to cope with depressive symptoms than participants told they did not carry this predisposition. A short intervention providing education about the non-deterministic nature of genes' effects on depression fully mitigated this negative effect, however. Given the clinical importance of patient expectancies in depression, the notion that pessimism about one's ability to overcome symptoms could be exacerbated by genetic information-which will likely become ever more widely available-represents cause for concern. Education and counseling about the malleability of genetic effects may be an important tool for counteracting clinically deleterious beliefs that can be evoked by genetic test results. Genetic counselors may be able to help patients avoid becoming demoralized by learning they have a genetic predisposition to depression by providing education about the non-deterministic role of biology in depression, and a brief audiovisual intervention appears to be an effective approach to delivering such education.

An experiment assessing effects of personalized feedback about genetic susceptibility to obesity on attitudes towards diet and exercise.

As increasing attention is paid to possible genetic influences on susceptibility to obesity, recent studies have examined how genetic attributions can impact laypeople's weight-related attitudes and eating behavior. Little consideration, however, has been devoted to understanding the potential effects of learning that one does not have a genetic predisposition to obesity. The present study investigated the possibility that such feedback might bring about negative consequences by making people feel invulnerable to weight gain, which is termed a genetic invincibility effect. After conducting a saliva test disguised as genetic screening, participants were randomly assigned to be told that there was either a very high or very low chance that they carried genes known to increase one's risk of developing obesity. Participants who were told that they were not genetically predisposed to obesity judged the efficacy of healthy diet and exercise habits to be significantly lower than did those who were told that they were genetically predisposed and those who did not receive any genetic feedback. When prompted to select a meal from a menu of options, participants who were told that they were not genetically predisposed to obesity were also more likely than others to select unhealthy foods. These findings demonstrate the existence of a genetic invincibility effect, suggesting that personalized feedback indicating the absence of a genetic liability could have negative psychological consequences with substantial health-related implications.

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

OBJECTIVE: Depression, like other mental disorders and health conditions generally, is increasingly construed as genetically based. This research sought to determine whether merely telling people that they have a genetic predisposition to depression can cause them to retroactively remember having experienced it. METHOD: U.S. adults (men and women) were recruited online to participate (Experiment 1: N = 288; Experiment 2: N = 599). After conducting a test disguised as genetic screening, we randomly assigned some participants to be told that they carried elevated genetic susceptibility to depression, whereas others were told that they did not carry this genetic liability or were told that they carried elevated susceptibility to a different disorder. Participants then rated their experience of depressive symptoms over the prior 2 weeks on a modified version of the Beck Depression Inventory-II. RESULTS: Participants who were told that their genes predisposed them to depression generally reported higher levels of depressive symptomatology over the previous 2 weeks, compared to those who did not receive this feedback. CONCLUSIONS: Given the central role of self-report in psychiatric diagnosis, these findings highlight potentially harmful consequences of personalized genetic testing in mental health. (PsycINFO Database Record

The effect of abstract versus concrete framing on judgments of biological and psychological bases of behavior.

Human behavior is frequently described both in abstract, general terms and in concrete, specific terms. We asked whether these two ways of framing equivalent behaviors shift the inferences people make about the biological and psychological bases of those behaviors. In five experiments, we manipulated whether behaviors are presented concretely (i.e. with reference to a specific person, instantiated in the particular context of that person's life) or abstractly (i.e. with reference to a category of people or behaviors across generalized contexts). People judged concretely framed behaviors to be less biologically based and, on some dimensions, more psychologically based than the same behaviors framed in the abstract. These findings held true for both mental disorders (Experiments 1 and 2) and everyday behaviors (Experiments 4 and 5), and yielded downstream consequences for the perceived efficacy of disorder treatments (Experiment 3). Implications for science educators, students of science, and members of the lay public are discussed.

Using Personification and Agency Reorientation to Reduce Mental-Health Clinicians' Stigmatizing Attitudes Toward Patients.

People with mental disorders are strongly stigmatized. Among mental-health professionals, stigmatizing attitudes often manifest as desire for social distance from people with mental disorders. Currently ascendant biomedical conceptualizations of psychopathology could exacerbate this problem by engendering dehumanization, which is linked to prejudice. Given the clinical implications of such an occurrence, the present research tested a possible mitigation strategy. In an online study of 216 U.S. mental-health clinicians, two strategies for mitigating dehumanization in healthcare were tested-personification, highlighting personal traits of people with mental disorders rather than presenting them as malfunctioning brains, and agency reorientation, underscoring people's ability to make choices and decisions. This approach yielded significantly less desire for social distance, among clinicians, from a person with depression whose symptoms were explained biologically. These findings may suggest an avenue for decreasing stigma in clinical practice.

The influence of framing on clinicians' judgments of the biological basis of behaviors.

Practicing clinicians frequently think about behaviors both abstractly (i.e., in terms of symptoms, as in the Diagnostic and Statistical Manual of Mental Disorders, 5th ed., DSM-5; American Psychiatric Association, 2013) and concretely (i.e., in terms of individual clients, as in DSM-5 Clinical Cases; Barnhill, 2013). Does abstract/concrete framing influence clinical judgments about behaviors? Practicing mental health clinicians (N = 74) were presented with hallmark symptoms of 6 disorders framed abstractly versus concretely, and provided ratings of their biological and psychological bases (Experiment 1) and the likely effectiveness of medication and psychotherapy in alleviating them (Experiment 2). Clinicians perceived behavioral symptoms in the abstract to be more biologically and less psychologically based than when concretely described, and medication was viewed as more effective for abstractly than concretely described symptoms. These findings suggest a possible basis for miscommunication and misalignment of views between primarily research-oriented and primarily practice-oriented clinicians; furthermore, clinicians may accept new neuroscience research more strongly in the abstract than for individual clients.

Effects of Biological Versus Psychosocial Explanations on Stigmatization of Children With ADHD.

OBJECTIVE: Previous studies have found biological conceptualizations of psychopathology to be associated with stigmatizing attitudes and prognostic pessimism. This research investigated how biological and psychosocial explanations for a child's ADHD symptoms differ in affecting laypeople's stigmatizing attitudes and prognostic beliefs. METHOD: Three experiments were conducted online with U.S. adults, using vignettes that described a child with ADHD and attributed his symptoms to either biological or psychosocial causes. Dependent measures gauged social distance and expectations about the child's prognosis. RESULTS: Across all three studies, the biological explanation yielded more doubt about treatability but less social distance-a result that diverges from previous research with other disorders. Differences in the amount of blame ascribed to the child mediated the social distance effect. CONCLUSION: The effects of biological explanations on laypeople's views of ADHD seem to be a "double-edged sword," reducing social rejection but exacerbating perceptions of the disorder as relatively untreatable.

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

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.

Sometimes more competent, but always less warm: Perceptions of biologically oriented mental-health clinicians.

BACKGROUND AND AIMS: Biological conceptualizations of psychopathology are ascendant, including among mental-health clinicians. However, it is unknown how this might affect people's perceptions of clinicians, which in turn could have considerable public-health implications. The present studies sought to address this issue. METHODS: In the present research, participants imagined that they or their loved ones were suffering from a mental disorder and then rated their perceptions of one clinician espousing the view that 'mental disorders are brain diseases' and another describing them as 'disorders of thoughts and emotions'. RESULTS: Biologically oriented clinicians were perceived as more competent and effective only when the disorder in question was judged to be biologically caused. Otherwise, there was no significant difference in perceived competence, and biologically oriented clinicians were rated less effective. Regardless, all participants perceived the biologically oriented clinician as significantly less warm on average than the psychosocially oriented clinician. CONCLUSION: These findings may have important clinical implications for the crucial therapeutic alliance between therapists and patients.

Causal Networks or Causal Islands? The Representation of Mechanisms and the Transitivity of Causal Judgment.

Knowledge of mechanisms is critical for causal reasoning. We contrasted two possible organizations of causal knowledge­an interconnected causal network, where events are causally connected without any boundaries delineating discrete mechanisms; or a set of disparate mechanisms­causal islands­such that events in different mechanisms are not thought to be related even when they belong to the same causal chain. To distinguish these possibilities, we tested whether people make transitive judgments about causal chains by inferring, given A causes B and B causes C, that A causes C. Specifically, causal chains schematized as one chunk or mechanism in semantic memory (e.g., exercising, becoming thirsty, drinking water) led to transitive causal judgments. On the other hand, chains schematized as multiple chunks (e.g., having sex, becoming pregnant, becoming nauseous) led to intransitive judgments despite strong intermediate links ((Experiments 1-3). Normative accounts of causal intransitivity could not explain these intransitive judgments (Experiments 4 and 5).

Effects of biological explanations for mental disorders on clinicians' empathy.

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.

Biological explanations of generalized anxiety disorder: effects on beliefs about prognosis and responsibility.

OBJECTIVE: Biological explanations of psychopathology can reduce the extent to which people with mental disorders are blamed for their symptoms but can also yield prognostic pessimism--the belief that psychiatric conditions are relatively immutable. However, few studies have examined whether these effects occur among persons who actually have psychiatric symptoms. This study sought to address this question. METHODS: Adults living in the United States (N=351) were recruited online in January and February 2012 and assessed for symptoms of generalized anxiety disorder. The participants were randomly assigned to two groups: a biological condition, in which participants (N=176) were provided a description of generalized anxiety disorder and a biological explanation of the etiology of the disorder, and a control condition, in which participants (N=175) were provided the same description without any explanation of etiology. Dependent measures of treatability, duration of symptoms, and responsibility for symptoms were used to gauge beliefs regarding the prognosis and personal responsibility of a typical person with generalized anxiety disorder. RESULTS: Among participants with and without symptoms of generalized anxiety disorder, the biological condition was associated with decreased ascriptions of personal responsibility for anxiety (p=.02) and expectations of increased duration of symptoms of generalized anxiety disorder (p=.01). CONCLUSIONS: This finding has important social and clinical implications, especially because biological conceptualizations of psychopathology are increasingly prevalent. By causing prognostic pessimism about generalized anxiety disorder, including among those with symptoms of the disorder, biological explanations could negatively affect treatment seeking and outcomes. Efforts to dispel the link between biological explanations and prognostic pessimism are needed.

Fixable or fate? Perceptions of the biology of depression.

OBJECTIVE: Previous research has shown that biological (e.g., genetic, biochemical) accounts of depression--currently in ascendancy--are linked to the general public's pessimism about the syndrome's prognosis. This research examined for the first time whether people with depressive symptoms would associate biological accounts of depression with pessimism about their own prognoses and whether a psychoeducation intervention portraying the biology of depression as malleable could decrease prognostic pessimism among symptomatic individuals. METHOD: In 3 studies, participants were recruited online and assessed for depression symptoms. Those with significant depressive symptomatology (a Beck Depression Inventory-II score of at least 16) rated their endorsement of biochemical and genetic causal attributions for their symptoms and indicated expected length of symptom duration. An audiovisual intervention emphasizing the malleability of gene effects and neurochemistry was developed, and its effects on symptomatic individuals' prognostic pessimism, feelings of agency, guilt, and general hopelessness were measured. RESULTS: Biochemical and genetic causal attributions for depression were significantly associated with prognostic pessimism among symptomatic individuals. The malleability intervention significantly reduced prognostic pessimism, increased feelings of agency, and decreased general hopelessness. CONCLUSIONS: Biochemical and genetic attributions for depression are related to prognostic pessimism among individuals with depressive symptoms, and not just among the general public. However, emphasizing the malleability of gene effects and brain chemistry in depression can foster more optimism about depression-related beliefs.