Lebowitz Matthew S, Pyun John J, Ahn Woo-kyoung
Psychiatr Serv. 2014 Apr 1;65(4):498-503. doi: 10.1176/appi.ps.201300011.
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.
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.
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).
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.
精神病理学的生物学解释能够减少人们对精神障碍患者症状的指责，但也可能导致预后悲观主义，即认为精神疾病相对难以改变。然而，很少有研究探讨这些影响是否会在实际有精神症状的人群中出现。本研究旨在解决这一问题。
2012年1月和2月在美国在线招募了成年居民（N = 351），并对其广泛性焦虑症症状进行评估。参与者被随机分为两组：生物学组，该组参与者（N = 176）收到了一份关于广泛性焦虑症的描述以及该疾病病因的生物学解释；对照组，该组参与者（N = 175）收到了相同的描述，但没有任何病因解释。使用关于可治疗性、症状持续时间和症状责任的相关测量来评估对典型广泛性焦虑症患者预后和个人责任的看法。
在有和没有广泛性焦虑症症状的参与者中，生物学组与焦虑个人责任归因减少（p = 0.02）以及广泛性焦虑症症状持续时间增加的预期（p = 0.01）相关。
这一发现具有重要的社会和临床意义，尤其是鉴于精神病理学的生物学概念日益普遍。通过引发对广泛性焦虑症的预后悲观主义，包括在有该疾病症状的人群中，生物学解释可能会对寻求治疗和治疗结果产生负面影响。需要努力消除生物学解释与预后悲观主义之间的联系。
