Change Your Category, Change Your Mind: The Mutability of Folk Models of Mental Health Disorders

摘要

One of the basic tenets of mental health counseling is that assisting a client to change the way he thinks about aspects of the world results in a changed view of the world. When this is examined in therapy, typically the issue at hand is measured (a client may complete the Beck Depression Scale), an intervention with associated techniques is used for some amount of time (Cognitive-Behavioral Therapy), and then outcome is measured using the original scale. Of course, if the concern is alleviation of signs and symptoms then a decrease in measured distress is an indicator of a successful intervention. However, despite this success, a number of cognitive questions remain. Due to the fact that it does not necessarily follow that an alleviation of signs and symptoms means that worldview has changed (i.e., a client may have learned additional coping mechanisms), the first question is whether there has there been a change in world view. A second question is what, if anything, about the intervention, resulted in a changed worldview.;Kim and Ahn (1992, 1996) developed a methodology for their research which permitted an examination of the impact of manipulations of narratives through the lens of mental health disorders. I investigated how supporting or challenging primary or peripheral features of four mental health disorders impacted the conceptualization of those disorders. Results for the Conceptual Centrality task, a ratings task that focused on supporting or challenging the symptom of interest, revealed that participants used a theory-based approach (compared to a prototype-based approach) for this task. This indicated that people consider the nature of causal chains when rating the centrality or primary and peripheral symptoms. Results for the more complex Causal Centrality Task, in which participants constructed multiple iterations of mental health disorders by identifying symptoms from a list and indicating causal relationships, indicated that constructing individual models, focused on a specific manifestation of a mental health disorder, later influenced general models, focused on the same disorder in general. The addition of a discursive partner revealed that although both partners influenced the later model of the other, they did so differentially. In general, the partner who was more anxious constructed a later model that was smaller (i.e., used fewer unique symptoms) whereas their partner utilized more unique symptoms (in line with construction of a general model). The patterns observed in this research indicate that manipulating mental health narratives does influence conceptualizations of their respective disorders. This research has ramifications for research involving categorization as well as mental health issues.