Repairing negative side effects of believing depression is biologically-rooted
Tuesday, July 07, 2015
Posted by: Lorenzo Lorenzo-Luaces
Our understanding of the biological influences of mental disorders has grown so much in the last few decades that many individuals now understand that depression and other mental disorders have a strong genetic and neurobiological component. It was once believed that this would lead to lower stigma. While this is true, an unfortunate side effect of increasing awareness about the biology of mental disorders is that many individuals now believe that these conditions are unlikely to improve and are outside the control of the individual. Research led by Yale University graduate student Matthew S. Lebowitz suggests that these beliefs can be altered by educational information and that the effects of this intervention can be long-lasting. Lebowitz and Woo-kyoung Ahn (2015) conducted an online survey of adults in the United States. Half of the 454 individuals surveyed received an educational video that discusses research on the biology of mental disorders. Individuals were given information about how the brain and the genes involved in depression can be altered by somatic and non-somatic treatments like psychotherapy. The other half received no intervention. For participants who had weak beliefs about how biologically determined depression is to begin with, the intervention had no effect. However, after watching the video, participants who had strong beliefs about the biology of depression were more optimistic about their ability to handle negative moods and were more optimistic about the prognosis of depression. These findings were true even six weeks after participants had watched the short video. The findings from this study are noteworthy because individuals who have strong beliefs about the biology of depression are unlikely to think that psychotherapy can help them. Being more pessimistic about one’s prognosis has been related to poorer outcomes in treatment. Short interventions that teach patients about the effects of treatment on biology may make individuals more optimistic and willing to engage in treatment.
SPR member Michael Constantino commented on the study:
"Lebowitz and colleagues have conducted an important study that further underscores the psychological powers of expectancy and persuasion. Although the field has long acknowledged such influences, including in relation to psychopathology and psychotherapeutic change, the present study shows that helpers can engage in simple actions to change people’s beliefs about depression. Coupled with research, for example, that shows the value (in terms of changing people’s beliefs and expectancies) of providing a compelling treatment rationale (e.g., Ahmed & Westra, 2009; Ametrano, Constantino, Romano, & Nalven, 2014) and the ability to change people’s treatment duration expectations via a simple baseline educational script (Swift & Callahan, 2011), there is a growing number of evidence-based ways to persuade people to believe in the ability of psychotherapy to positively influence mood. Moreover, these short, but potent interventions might be particularly useful for certain people (in the present case, those who were most pessimistic about the impact that psychosocial intervention can have on biologically based depression). I am thrilled to see mounting work that translates research on patients’ expectations into actionable therapeutic practices. As we have noted elsewhere (Constantino, Ametrano, & Greenberg, 2012), “Through such continued investigations on the construct of expectations and how best to assess and address them, the field can continue to learn how to capitalize clinically on what appears to be a potent, and largely nondiagnostic, psychological variable” (p. 567)."