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5 results

  • Promoting better mental health care for patients with psychosis by focusing on differences in causal beliefs between patients and clinicians

  • R. Rosenthal Oren, D. Roe, I. Hasson-Ohayon, Y. Zisman-Ilani
  • Journal:
    European Psychiatry / Volume 65 / Issue S1 / June 2022
    Published online by Cambridge University Press:
    01 September 2022, p. S778
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  • Introduction

    Nonadherence to antipsychotic medications and disengagement from psychiatric services are frequent among people with psychosis. Research indicates how the beliefs of people with psychosis about the etiology of their symptoms, or their causal beliefs, affect treatment choice and outcomes. Yet, there is less research on causal beliefs of clinicians or on the impact of patient–clinician disagreements on treatment and adherence.

    Objectives

    This review aimed to explore the scope of the literature focusing on clinicians’ causal beliefs and to map the degree of patient–clinician concordance in causal beliefs.

    Methods

    A systematic literature search of PubMed, Embase, Scopus, PsycInfo, and ASSIA and a grey literature search of PsyArXiv and MedNar yielded 11,821 eligible references.

    Results

    Forty-two articles indicated that whereas clinicians endorse mainly biogenetic beliefs (9/15 articles, 60%), patients endorse mainly psychosocial causal beliefs (16/31, 52%) and other non-biogenetic causal beliefs (8/31, 26%). Most studies did not compare causal beliefs of people with psychosis and their treating clinicians.

    Conclusions

    While clinicians and people with psychosis often hold complex causal models, a gap in causal beliefs between these groups appears to exist, which may affect the therapeutic relationship and pose barriers to treatment adherence. Future studies should address this gap by developing interventions that facilitate open communication about causal beliefs to promote treatment alliance and an agreed-on treatment plan.

    Disclosure

    No significant relationships.

  • ‘Treatable and Changeable’: The Effect of Treatment and Malleability Information on Stigma Towards Children with Behavioural Problems and Their Parents

  • Sarah Li, Lucy Tully, Mark R. Dadds
  • Journal:
    Behaviour Change / Volume 37 / Issue 4 / December 2020
    Published online by Cambridge University Press:
    02 December 2020, pp. 181-194

  • Improving knowledge about childhood mental health issues, reducing stigma, and encouraging appropriate treatment-seeking are important goals for public health. This study examined the effect of treatment and malleability information on stigmatisation towards children with Oppositional Defiant Disorder (ODD) and their parents, and on endorsements of causal beliefs. In an experimental study, university students (N = 234) were randomly allocated to receive/not receive treatment information (information on the existence and effectiveness of treatment for ODD) and to receive/not receive malleability information (information emphasising brain malleability and the potential to change). Participants then rated four measures of stigma towards a fictitious child with ODD and mother (blame, incompetence, dangerousness, and social distance), and rated their endorsements of causal explanations for ODD. Neither treatment nor malleability information had significant effects on stigmatisation towards either the child or mother. However, this information did impact upon causal beliefs about ODD as stemming from biological or mixed biological/environmental causes. Implications for the future development of public health initiatives and stigma research on childhood mental health are discussed.

  • The gap between parents’ knowledge and causal beliefs about etiology of autism: A key variable to understand parents’ anxiety

  • C. Derguy, M. Bouvard, G. Michel, K. M’Bailara
  • Journal:
    European Psychiatry / Volume 29 / Issue S3 / November 2014
    Published online by Cambridge University Press:
    17 April 2020, pp. 598-599
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  • Autism Spectrum Disorders (ASD) are associated with higher levels of anxiety for parents [1]. Provide medical information about autism etiology is the first step to help parents to understand the child disorder and to cope with it. The medical current community accepts that autism is a neurodevelopmental disorder in which genes play a role but that environmental factors likely contribute as well [2]. This conception can meet parent's beliefs constructed on their cultural values and personal experiences. In line with causal attribution theory [3], it is important to consider to parental beliefs because it can impact the treatment choices and the child developmental trajectory [4]. The Main purpose is to evaluate the consistency between parental knowledge and beliefs about ASD etiology. The second purpose is to explore the impact of consistency on parents’ anxiety. We interviewed through open-ended questions 89 parents of ASD children aged between 3 to 10 years about their knowledge and their beliefs about ASD etiology. A content analysis was performed using the Nvivo10 software. Anxiety is evaluated with the subscale of the Hospital Anxiety and Depression Scale (HADS). In agreement with previous work four categories of causes have been identified: biological (BIO), psychological (PSY), multifactorial etiology (BIO + PSY), others (OT). A percentage of 55.1% of parents is consistent between their knowledge and beliefs about ASD etiology while 43.8% are inconsistent. Parent anxiety is significantly higher (T (71.91) = 2.34; P < 0.05) when knowledge and beliefs are inconsistent than when they are consistent. This study demonstrates the deleterious impact of inconsistency between knowledge and beliefs about ASD etiology, on parental anxiety. In order to provide relevant support for parents, information delivered after diagnosis must consider pre-existing parental beliefs. A systematic assessment of parental beliefs would adjust the information provided after the diagnosis.

  • Individuals with currently untreated mental illness: causal beliefs and readiness to seek help

  • S. Stolzenburg, S. Freitag, S. Evans-Lacko, S. Speerforck, S. Schmidt, G. Schomerus
  • Journal:
    Epidemiology and Psychiatric Sciences / Volume 28 / Issue 4 / August 2019
    Published online by Cambridge University Press:
    16 January 2018, pp. 446-457
  • Aims.

    Many people with mental illness do not seek professional help. Beliefs about the causes of their current health problem seem relevant for initiating treatment. Our aim was to find out to what extent the perceived causes of current untreated mental health problems determine whether a person considers herself/himself as having a mental illness, perceives need for professional help and plans to seek help in the near future.

    Methods.

    In a cross-sectional study, we examined 207 untreated persons with a depressive syndrome, all fulfilling criteria for a current mental illness as confirmed with a structured diagnostic interview (Mini International Neuropsychiatric Interview). The sample was recruited in the community using adverts, flyers and social media. We elicited causal explanations for the present problem, depression literacy, self-identification as having a mental illness, perceived need for professional help, help-seeking intentions, severity of depressive symptoms (Patient Health Questionnaire – Depression), and whether respondents had previously sought mental healthcare.

    Results.

    Most participants fulfilled diagnostic criteria for a mood disorder (n = 181, 87.4%) and/or neurotic, stress-related and somatoform disorders (n = 120, 58.0%) according to the ICD-10. N = 94 (45.4%) participants had never received mental health treatment previously. Exploratory factor analysis of a list of 25 different causal explanations resulted in five factors: biomedical causes, person-related causes, childhood trauma, current stress and unhealthy behaviour. Attributing the present problem to biomedical causes, person-related causes, childhood trauma and stress were all associated with stronger self-identification as having a mental illness. In persons who had never received mental health treatment previously, attribution to biomedical causes was related to greater perceived need and stronger help-seeking intentions. In those with treatment experience, lower attribution to person-related causes and stress were related to greater perceived need for professional help.

    Conclusions.

    While several causal explanations are associated with self-identification as having a mental illness, only biomedical attributions seem to be related to increase perceived need and help-seeking intentions, especially in individuals with no treatment experiences. Longitudinal studies investigating causal beliefs and help-seeking are needed to find out how causal attributions guide help-seeking behaviour. From this study it seems possible that portraying professional mental health treatment as not being restricted to biomedical problems would contribute to closing the treatment gap for mental disorders.

  • The end of work or work without end? How people’s beliefs about labour markets shape retirement politics

  • Achim Kemmerling
  • Journal:
    Journal of Public Policy / Volume 36 / Issue 1 / March 2016
    Published online by Cambridge University Press:
    12 January 2015, pp. 109-138

  • This article argues that public opinion on retirement is related to people’s causal beliefs about how labour markets work. Whereas voters do not think that there is an employment trade-off between older and younger workers in some European countries, in others, this is a dominant paradigm. When they believe this trade-off exists, people are more hostile to reforms that lead to longer working lives. The article uses Eurobarometer data to investigate the determinants of this belief – for instance, more people being led to believe in such a trade-off under high levels of labour market regulation. The article then goes on to show that this belief is related to policy preferences about early retirement. Finally, the article illustrates the political consequences of this belief and shows that it affects many policy areas even beyond early retirement.