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选择性支持治疗精神疾病的不同方法是否会影响人们对精神疾病病因和病程的看法?

Does selectively endorsing different approaches to treating mental illness affect lay beliefs about the cause and course of mental illness?

机构信息

School of Psychology, University College Dublin, Dublin, Ireland.

School of Psychology, University College Dublin, Dublin, Ireland.

出版信息

Psychiatry Res. 2021 Mar;297:113726. doi: 10.1016/j.psychres.2021.113726. Epub 2021 Jan 13.

DOI:10.1016/j.psychres.2021.113726
PMID:33486271
Abstract

The current paper reports three experimental studies that investigate how selectively emphasising different treatment approaches (biological, psychological or social) for mental health difficulties affects lay beliefs about those illnesses. Online experimental vignettes exposed participants to different treatment narratives for a clinical case of Major Depressive Disorder (Study 1; n=164), Generalized Anxiety Disorder (Study 2; n=173) and Schizophrenia (Study 3, n=170). Measures of causal attributions and illness perceptions assessed effects on beliefs about the causes and course of the illness. Emphasising psychological treatment of Major Depressive Disorder promoted more causal attributions to personal weakness, while endorsing biological treatment weakened confidence in individual control over the course of the illness. For Generalized Anxiety Disorder, stressing social treatment encouraged more causal attributions to personal weakness and lifestyle factors. Causal attributions for Schizophrenia did not shift according to treatment modality, but highlighting biological treatment made the symptoms appear more treatable, while emphasising psychological treatment made the illness seem more personally controllable. As lay understandings of the causes and course of mental illness have implications for help-seeking, treatment engagement and stigma, effects on illness beliefs may be an important consideration when endorsing a particular treatment approach in public discourse or clinical communication.

摘要

本研究报告了三项实验研究,旨在探讨有针对性地强调心理健康障碍的不同治疗方法(生物、心理或社会)如何影响人们对这些疾病的看法。在线实验案例使参与者接触到不同的治疗叙述,用于治疗一例重度抑郁症(研究 1;n=164)、广泛性焦虑症(研究 2;n=173)和精神分裂症(研究 3;n=170)的临床病例。归因和疾病认知的衡量标准评估了对疾病病因和病程的信念的影响。强调对重度抑郁症的心理治疗会导致更多的个人弱点归因,而支持生物治疗则会削弱对个人控制疾病进程的信心。对于广泛性焦虑症,强调社会治疗会鼓励更多的个人弱点和生活方式因素归因。精神分裂症的归因并未根据治疗模式发生转变,但强调生物治疗会使症状看起来更可治疗,而强调心理治疗会使疾病更具个人可控性。由于公众对精神疾病病因和病程的理解会影响到寻求帮助、治疗参与和污名化,因此在公共话语或临床沟通中支持特定治疗方法时,对疾病信念的影响可能是一个重要的考虑因素。

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