Trends in Neurosciences
Volume 25, Issue 8, 1 August 2002, Pages 430-431
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Genetic bases of mental illness – a cure for stigma?

https://doi.org/10.1016/S0166-2236(02)02209-9Get rights and content

Abstract

An increased emphasis on biological causes of mental illness has been viewed as having the potential to significantly reduce stigma. From this perspective, the current genetics revolution can be seen as a source of hope. However, some have argued that biological attributions could increase stigma, for example by making the ill person seem ‘defective’ or ‘physically distinct’ – ‘almost a different species’. In this paper, I use a multicomponent conceptualization of stigma as a guide in forming hypotheses about the likely impact of genetic attributions on the stigma of mental illness.

Section snippets

Mental illness and stigma

As recently emphasized by the US Surgeon General, people with mental illnesses suffer not only from their disorders, but also from the stigma and discrimination that accompany them [1]. Mental illness is associated in the public mind with an astoundingly broad range of negative attributes – for example, being dangerous, dirty, cold, worthless, bad, weak and ignorant [2]. The consequences of these stereotypes range from direct and obvious ones, such as discrimination in employment and housing,

How the genetics revolution could affect stigma – competing arguments

Enter the genetics revolution, bringing with it not only scientific information about genetic influences on specific human characteristics, but also a new cultural focus on genes and a new cultural lens through which we view ourselves as humans. The Human Genome Project will inevitably shape the way we understand the causes of human behavior, as well as the personal responsibility for – and the power of the social environment to shape – that behavior. It is also likely to influence the way we

Defining stigma and specifying hypotheses

Thus, the impact of genetic explanations for mental illnesses upon stigma can be complex. To explore these complexities, it is helpful to use the definition of stigma as a guide. Bruce Link and I have defined stigma as a process whereby a label sets the labeled person apart from others, links the person to undesirable characteristics and leads to rejection and discrimination [11]. How might a genetic label – when added to a label of mental illness – influence each of these components?

Family stigma

Finally, what about the question of the ‘courtesy’ or ‘associative stigma’ that spills over onto well family members [14]? As discussed above, genetic explanations should reduce the blame assigned to parents for contributing to mental illness in their offspring, for example, by poor parenting. However, associative stigma is likely to increase in other ways. A family member who is, and will always be, mentally healthy might nevertheless become tainted via a genetic connection to the ill

Implications

In summary, the lessening of blame that many have anticipated as a positive consequence of the biological framing of mental health problems might be accompanied by negative consequences. The foregoing predictions are only hypotheses at this point, and my colleagues and I are currently conducting research to test them. But why conduct such research? Certainly, we cannot alter the facts of what actually causes mental illnesses, and it would be neither ethical nor desirable to mislead the public

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    That perspective was evident in the 1999 U.S. Surgeon General's Report (U.S. Department of Health and Human Services (DHHS), 1999) and a 2003 report on mental health also published by the DHHS (U.S. New Freedom Commission on Mental Health, 2003). But, by the early 2000s, a few scholars began to speculate that a genetic or brain disease framework could actually magnify stigma by increasing perceptions of the illness as serious and persistent (Corrigan and Watson, 2004; Phelan, 2002) and began calling for evidence-based de-stigmatization campaigns (Read, 2002). Within a few years, researchers began to evaluate that idea and generally found, as expected, that a genetics explanation for mental illness magnified stigma by increasing perceptions of the illness as serious and persistent, and those perceptions often increased intentions to seek social distance from individuals diagnosed with or showing symptoms of a psychiatric illness, results evident in both correlational data (Pescosolido et al., 2010; Schnittker, 2008) and experimental data (Lincoln et al., 2008; Phelan, 2005; Walker and Read, 2002).

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    Clinically, individuals with eating disorders and their families and loved ones are deeply interested in the emerging genetic research. In a context in which historically, individuals and their families have been blamed (both overtly and covertly, intentionally and accidentally) for illness,66–77 genetic explanations for eating disorders hold the attraction of having the potential relieve the burden of blame associated with these conditions.78,79 Further, genetic findings help validate and legitimize experiences that are often dismissed as “all in the patient’s head.”

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