Jessecae K. Marsh

Beliefs About Essences and the Reality of Mental Disorders

Do people believe mental disorders are real and possess underlying essences? The current study found that both novices and practicing clinicians held weaker essentialist beliefs about mental disorders than about medical disorders. They were also unwilling to endorse the idea that mental disorders are real and natural. Fur-thermore, compared with novices, mental health clinicians were less likely to endorse the view that there is a shared cause underlying a mental disorder and that one needs to remove the cause to get rid of the mental disorder. Clinicians were polarized on their views about whether mental disorders are categorical or dimensional. These findings reflect current controversies about mental disorders in the field at large.

Effect of theory-based feature correlations on typicality judgments.

In the present study, we examine what types of feature correlations are salient in our conceptual representations. It was hypothesized that of all possible feature pairs, those that are explicitly recognized as correlated (i.e., explicit pairs) and affect typicality judgments are the ones that are more likely theory based than are those that are not explicitly recognized (i.e., implicit pairs). Real-world categories and their properties, taken from Malt and Smith (1984), were examined. We found that explicit pairs had a greater number of asymmetric dependency relations (i.e., one feature depends on the other feature, but not vice versa) and stronger dependency relations than did implicit pairs, which were statistically correlated in the environment but were not recognized as such. In addition, people more often provided specific relation labels for explicit pairs than for implicit pairs; these labels were most often causal relations. Finally, typicality judgments were more affected when explicit correlations were broken than when implicit correlations were broken. It is concluded that in natural categories, feature correlations that are explicitly represented and affect typicality judgments are the ones about which people have theories.

Order effects in contingency learning: The role of task complexity

Dennis and Ahn (2001) found that during contingency learning, initial evidence influences causal judgments more than does later evidence (a primacy effect), whereas López, Shanks, Almaraz, and Fernández (1998) found the opposite (a recency effect). We propose that in contingency learning, people use initial evidence to develop an anchoring hypothesis that tends to be underadjusted by later evidence, resulting in a primacy effect. Thus, factors interfering with initial hypothesis development, such as simultaneously learning too many contingencies, as in López et al., would reduce the primacy effect. Experiment 1 showed a primacy effect with learning contingencies involving only one outcome but no primacy effect with two outcomes. Experiment 2 demonstrated that the magnitude of the primacy effect correlated with participants’ verbal working memory capacity. It is concluded that a critical moderator for exhibition of the primacy effect is task complexity, presumably because it interferes with initial hypothesis development.

Spontaneous Assimilation of Continuous Values and Temporal Information in Causal Induction

Existing models of causal induction primarily rely on the contingency between the presence and the absence of a causal candidate and an effect. Yet, classification of observations into these four types of covariation data may not be straightforward because (a) most causal candidates, in real life, are continuous with ambiguous, intermediate values and because (b) effects may unfold after some temporal lag, providing ambiguous contingency information. Although past studies suggested various reasons why ambiguous information may not be used during causal induction, the authors examined whether learners spontaneously use ambiguous information through a process called causal assimilation. In particular, the authors examined whether learners willingly place ambiguous observations into one of the categories relevant to the causal hypothesis, in accordance with their current causal beliefs. In Experiment 1, peoples frequency estimates of contingency data reflected that information ambiguous along a continuous quantity dimension was spontaneously categorized and assimilated in a causal induction task. This assimilation process was moderated by the strength of the upheld causal hypothesis (Experiment 2), could alter the overall perception of a causal relationship (Experiment 3), and could occur over temporal sequences (Experiment 4).

Causal essentialism in kinds

The current study examines causal essentialism, derived from psychological essentialism of concepts. We examine whether people believe that members of a category share some underlying essence that is both necessary and sufficient for category membership and that also causes surface features. The main claim is that causal essentialism is restricted to categories that correspond to our intuitive notions of existing kinds and hence is more attenuated for categories that are based on arbitrary criteria. Experiments 1 and 3 found that people overtly endorse causal essences in nonarbitrary kinds but are less likely to do so for arbitrary categories. Experiments 2 and 4 found that people were more willing to generalize a members known causal relations (or lack thereof) when dealing with a kind than when dealing with an arbitrary category. These differences between kinds and arbitrary categories were found across various domains—not only for categories of living things, but also for artefacts. These findings have certain real-world implications, including how people make sense of mental disorders that are treated as real kinds.

The influence of expertise on essence beliefs for mental and medical disorder categories

Research suggests that expertise in a specific category domain influences categorization. Work related to beliefs about mental disorders finds that laypeople treat mental disorders as if they do have causal essences, while clinicians do not-differences that may be attributable to expertise (Ahn, Flanagan, Marsh, & Sanislow, 2006). To test whether reduced beliefs in essences are indicative of an overall influence of expertise or a demonstration of a phenomenon specific to expertise in the mental health domain we compared beliefs about mental and medical disorders held by practicing physicians (n = 43; 19 primary care and 24 non-psychiatry specialists) and laypeople (n = 40). We found differences between these groups in beliefs held concerning the necessity of removing shared category features to effectively cure disorders. While laypeople endorsed the idea that the cause needed to be removed to cure both mental and medical disorders, this endorsement decreased with expertise. Primary care providers were less willing to endorse this for mental disorders than for medical disorders. Our results support the notion that the reduction of beliefs concerning the existence of essences is a unique effect of expertise in the mental health domain, and does not extend to other areas of expertise. In physicians, this reduction of essentialist beliefs was most evident in questions regarding treatment. Similarities and differences to the results from Ahn et al. (2006) are discussed.

Thinking you can catch mental illness: How beliefs about membership attainment and category structure influence interactions with mental health category members

We explored beliefs about mental disorder categories that influence potential interactions with category members. Specifically, we investigated beliefs related to how membership in a mental disorder category is obtained (communicability and causal origin) as well as beliefs related to the underlying reality of disorder categories (essentialism and controllability). In Experiment 1, participants’ interaction-willingness decisions were predicted by their beliefs that a mental disorder category was (1) communicable, (2) psychologically caused, (3) environmentally caused, and (4) possessed all-or-none membership. With fictitious mental disorders, people were less willing to interact with people described as having a communicable mental disorder than with those described as possessing any of the other factors of interest, highlighting the independent influence of these contagion beliefs (Experiment 2). We further explored beliefs about the communicability of mental disorders in Experiment 3 by asking participants to generate descriptions of how mental disorders are transferred between people. Our findings suggest the importance of understanding contagion beliefs in discovering why people distance themselves from people diagnosed with mental disorders. More generally, our findings help in understanding how our basic category knowledge is used to guide interactions with category members, illustrating how knowledge is translated into action.

Lay Judgments of Mental Health Treatment Options The Mind Versus Body Problem

Background: Past research shows that people believe psychologically caused mental disorders are helped by different treatments than biologically caused mental disorders. However, it is unknown how people think about treatment when limited information is known to identify the disorder. Objective: Our objective was to explore how laypeople judged the helpfulness of treatments when a limited set of mental health symptoms is presented. Method: Across four experiments, Mechanical Turk and college undergraduate participants (N = 331) read descriptions displaying sets of three mental health symptoms and rated how helpful pharmaceuticals, counseling, or alternative medicine would be on a 0 (not at all helpful) to 100 (completely helpful) scale. We measured judgments for perceived mental and medical symptoms (Experiment 1) and how judgments were influenced by symptom severity (Experiment 2), duration (Experiment 3), and if alternative medicine and conventional treatments were used in conjunction (Experiment 4). Results: Perceived mental symptoms were rated as helped by counseling, while perceived medical symptoms were rated as helped by medication. Alternative medicine was never rated as extremely helpful. For example, in Experiment 1, counseling (mean [M] = 80.1) was rated more helpful than pharmaceuticals (M = 50.5; P < 0.001) or alternative medicine (M = 45.1; P < 0.001) for mental symptoms, and pharmaceuticals (M = 62.6) was rated more helpful than counseling (M = 36.1; P < 0.001) or alternative medicine (M = 47.5; P < 0.001) for medical symptoms. This pattern held regardless of severity, duration, or the adjunct use of alternative medicine. Limitations: We employed a general population sample and measured hypothetical treatment judgments. Conclusions: Mental health symptoms viewed as problems of the mind are thought to need different treatment than mental health symptoms seen as problems of the body.

Leveraging the Multiple Lenses of Psychological Science to Inform Clinical Decision Making: Introduction to the Special Section:

Understanding how clinicians and laypeople make critical decisions related to the assessment, diagnosis, and treatment of mental health is an important step toward improving mental healthcare. This Special Section features new research that, collectively, leverages interdisciplinary approaches from basic psychological science to enhance our understanding of clinical decision making. In this “Introduction to the Special Section,” we illustrate how three tasks integral to clinical decision making (assessment, diagnosis, and treatment selection) can be reframed as specific examples of more basic cognitive processes. We conclude by highlighting challenges to conducting interdisciplinary research on clinical decision making, by providing an overview of the contributions in this Special Section, and by presenting a list of essential readings on clinical decision making.

Explaining Away Disorder: The Influence of Context on Impressions of Mental Health Symptoms:

Clinical assessments involve understanding displays of mental disorder symptoms in the contexts in which they display. Contextual information plays a large role in externalizing disorder assessments. Yet we know little about contextual information’s impact within internalizing disorder assessments. Panic disorder symptoms develop outside environmental effects, but over time symptoms become conditioned responses to one’s environment, making this disorder an interesting test case. In two experiments (N = 269), lay participants read vignettes about children displaying a single symptom of panic disorder embedded in contextual information that either conformed or did not conform to the presence of panic disorder. Contextual information changed interpretations of panic disorder symptoms and reduced judgments of the likelihood of panic disorder. This effect held when participants made judgments about panic disorder only (Experiment 1) and when alongside externalizing disorder symptoms (Experiment 2). These findings have important implications for understanding interpretive judgments about symptoms within diagnostic assessments of mental health.