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Thursday, December 25, 2014

Effects of biological explanations for mental disorders on clinicians’ empathy

By Matthew S. Lebowitz and Woo-kyoung Ahn
Effects of biological explanations for mental disorders on clinicians’ empathy
PNAS 2014 : 1414058111v1-201414058

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.

Significance

Mental disorders are increasingly understood biologically. We tested the effects of biological explanations among mental health clinicians, specifically examining their empathy toward patients. Conventional wisdom suggests that biological explanations reduce perceived blameworthiness against those with mental disorders, which could increase empathy. Yet, conceptualizing mental disorders biologically can cast patients as physiologically different from “normal” people and as governed by genetic or neurochemical abnormalities instead of their own human agency, which can engender negative social attitudes and dehumanization. This suggests that biological explanations might actually decrease empathy. Indeed, we find that biological explanations significantly reduce clinicians’ empathy. This is alarming because clinicians’ empathy is important for the therapeutic alliance between mental health providers and patients and significantly predicts positive clinical outcomes.

The entire article is here.