Mainstream discourse about ‘mental illness’ often assumes that some ‘mental disorders’ are more ‘biologically caused’ than ‘psychologically caused.’ However, this common yet unsupported assumption might be steering many away from therapy. A new study from Yale University dives into this problematic belief, and the findings might change the way we approach mental health.
In the complex mental health landscape, the battle between biology and psychology is rife with misconceptions and misunderstandings. New research from Yale psychologists Annalise Perricone & Woo-kyoung Ahn explores why many people perceive psychotherapy to be less effective when mental disorders are assumed to be tied to biological factors. The results are as surprising as they are concerning.
“When mental disorders are attributed to biological factors, people appear to endorse psychotherapy’s effectiveness less strongly,” Perricone and Ahn explain. “Even mental health clinicians show this tendency. Given biological explanations for a hypothetical patient’s symptoms (e.g., genetic causes, brain abnormalities), clinicians judged psychotherapy to be less effective than when given psychosocial explanations for the same person’s symptoms (e.g., childhood trauma).”
The experiment conducted by Perricone & Ahn in the study sought to understand why people tend to perceive psychotherapy as less effective for mental disorders assumed to be more ‘biologically caused’ than ‘psychologically caused.’ The researchers focused on exploring three specific beliefs that might explain this perception:
- Neurodualism: The false idea that mental treatments can’t affect assumed ‘biologically caused’ disorders.
- Controllability: The incorrect notion that assumed ‘biologically caused’ processes are beyond control.
- Discount of Psychological Causes: The problematic tendency to ignore psychological factors once a disorder is labeled as ‘biologically caused.’
These misconceptions are not just erroneous; they’re influencing decisions about therapy.
A total of 278 U.S. adults participated in the experiment. Initially, participants’ endorsement of these three beliefs was measured. Participants were then asked to judge the effectiveness of psychotherapy for a hypothetical case of depression, and they were subsequently provided with information about the biological causes of the depression. After receiving this information, they were asked to rate the effectiveness of psychotherapy again.
The researchers looked at how participants’ endorsement of the three beliefs correlated with the change in the perceived effectiveness of psychotherapy after learning about the assumed ‘biological causes.’
What They Found
- Participants strongly endorsed all three misconceptions.
- This endorsement led to a shift in perception, undermining the value of psychotherapy for assumed ‘biologically caused’ depression.
- There was a clear link between holding these misconceptions and rejecting psychotherapy.
Simply put, the more one buys into these false beliefs, the less likely one is to consider therapy for mental disorders assumed to be ‘biologically caused.’
Participants strongly endorsed each of the proposed beliefs, with large effect sizes (Cohen’s d’s of 1.25, 1.68, and 0.53, respectively). There was also a significant decrease in the perceived effectiveness of psychotherapy for the assumed ‘biologically caused’ depression compared to the baseline ratings. The extent to which participants endorsed neurodualism, controllability, and discounting directly correlated with this decrease in perceived effectiveness.
The experiment not only identified the specific beliefs that lead to the diminished perceived effectiveness of psychotherapy for mental disorders assumed to be ‘biologically caused,’ but it also replicated previous findings, showing that participants judged psychotherapy to be less effective and medication more effective, after learning that the hypothetical depression was assumed to be ‘biologically caused.’
This research provided empirical evidence for the first time, shedding light on a widely held yet unsupported assumption that may hinder effective mental health treatment. It suggested possible interventions to counteract these beliefs and indicated areas for future research, including examining situations where medications might be perceived as less effective or where combined treatment is optimal.
“Changes in clinical practice may also reflect the trend, as biological explanations for mental disorders increasingly prevail,” the authors write. “For instance, among psychiatrists, the use of pharmacotherapy alone is increasing, while the use of psychotherapy is decreasing rapidly.”
“Furthermore, treatment perceptions can affect actual treatment outcomes… so viewing psychotherapy as less effective for mental disorders with presumed biological etiologies could be a barrier to recovery for those in need of psychotherapy.”
While enlightening, the study also points to limitations and a need for further exploration. The findings provide a basis for future studies to counter these misconceptions and explore other factors that might perpetuate this problematic view of mental disorders.
Understanding why therapy is overlooked for mental disorders assumed to be ‘biologically caused’ offers a chance to correct a pervasive and detrimental misunderstanding. This study could guide us toward more informed, compassionate, and effective treatment approaches by challenging assumptions and encouraging a more complex view of mental disorders. It’s a conversation that could redefine how we perceive and treat mental health, moving us closer to care that embraces the full complexity of the human mind.
Perricone, A., & Ahn, W. K. (2023). Reasons for the Belief that Psychotherapy is Less Effective for Biologically Attributed Mental Disorders. Cognitive Therapy and Research. Advance online publication. https://doi.org/10.1007/s10608-023-10392-7 (Link)