“They Are Invasive in Different Ways.”: Stakeholders’ Perceptions of the Invasiveness of Psychiatric Electroceutical Interventions

Abstract

Medical interventions are usually categorized as “invasive” when they involve piercing the skin or inserting an object into the body. Beyond this standard definition, however, there is little discussion of the concept of invasiveness in the medical literature, despite evidence that the term is used in ways that do not reflect the standard definition of medical invasiveness. We interviewed psychiatrists, patients with depression, and members of the public without depression to better understand their views on the invasiveness of several psychiatric electroceutical interventions (treatments that involve electrical or magnetic stimulation of the brain) for the treatment of depression. Our study shows that people recognize several kinds of invasiveness: physical, emotional, and lifestyle. In addition, several characteristics of therapies influence how invasive they are perceived to be; these include the perceived capacity of an intervention to result in harm; how localized the effects of the intervention are; the amount of control retained by the person receiving the intervention; how permanent its effects are perceived as being; and how familiar it seemed to participants. Our findings contribute to a small literature on the concept of invasiveness, which emphasizes that categorizing an intervention as invasive, or as noninvasive, evokes a variety of other normative considerations, including the potential harm it poses and how it compares to other potential therapies. It may also draw attention away from other salient features of the intervention.

Keywords:

• Bioethics
• deep brain stimulation
• depression
• neuroethics

This article is referred to by:

Perceptions of Invasiveness and Fear of Stigmatization in Mental Health Care

Perceived Invasiveness and Therapeutic Acceptability of Transcranial Magnetic Stimulation

On Changes and Opportunities at AJOB Neuroscience

Perceptions of Invasiveness: A Moving Target for Neuromodulation

Invasiveness is Inevitable in Psychiatric Neurointerventions

From ‘What’ to ‘Why:’ Culture, History, Power and the Experiential Salience of Invasiveness in Psychiatric Treatment

Why Neuroethical Analyses of Invasiveness in Psychiatry Should Engage with Mental Health Service User Movement Knowledges and Considerations of Social In/Justice

The Normative Evaluation of Neurointerventions in Criminal Justice: From Invasiveness to Human Rights

ACKNOWLEDGEMENTS

We thank Emily Castillo and Megan Penzkofer for their assistance scheduling and conducting some of our interviews and Ms. Castillo for assisting with coding. We further thank our participants for their time and insightful responses.

Notes

1 We would like to thank an anonymous reviewer of this paper for raising this point.

Additional information

Funding

This study was supported by a BRAIN Initiative grant (#RF1MH117802) from the US National Institute of Mental Health to (PI: LC). The funding source had no influence on the study design; the collection, analysis, and interpretation of data; the writing of the report; or the decision to submit the manuscript for publication.