Impact of causal explanations for social anxiety disorder on stigma and treatment perceptions

Abstract

Background and aims: There is evidence to suggest that biogenetic explanations for symptoms of mental disorders have become increasingly popular. Research suggests that such explanations provokes mixed blessings: biological explanations may reduce blame but also encourage prognostic pessimism and promote perceptions of pharmacological treatment over psychotherapy. The goal of this study was to evaluate the impact of different causal explanations on social anxiety disorder.

Method: About 205 adults completed an experiment where they read a vignette describing an individual with social anxiety disorder and were randomly assigned to a symptom explanation that was: (1) biological, (2) biopsychosocial, (3) psychosocial, or (4) no explanation.

Results: The psychosocial condition yielded the highest perceived credibility and lowest attributions of blame. The biological condition promoted positive expectations for medication effectiveness compared to other conditions. Conditions did not differ on prognostic expectations.

Conclusions: Calls attention to the risk of generalizing from previous research to mental disorders as a whole.

Keywords:

• Social anxiety disorder
• biological framing
• blame
• stigma
• treatment

Declaration of interest

The authors have no conflicts of interest to disclose.

This study was funded through the first author’s startup package.

Notes

1 For the biopsychosocial (BPS) condition, participants read vignettes that either presented the biological component of the explanation first followed by the psychosocial component (n = 41) or the psychosocial component of the explanation first followed by the biological (n = 41) in order to balance the order of presentation to reduce potential bias. These two conditions yielded very few differences across study dependent variables [exceptions include: (1) credibility—the BPS biological first condition only yielded a trend toward lower credibility ratings compared to the psychosocial condition (p = 0.07), whereas BPS psychosocial first did show a significant difference (p = 0.02); and (2) responsibility—BPS biological first yield higher attributions of responsibility (p = 0.009) than the psychosocial condition whereas the BPS psychosocial first did not (p = 0.21)]. Thus, the data from these two conditions were collapsed to simplify interpretation of study results.