UNDERSTANDING IMPLICATIONS OF GENETIC ATTRIBUTIONS FOR ADDICTION

成瘾性疾病越来越多地被概念化为具有遗传根源的生物医学疾病。而 传统观点认为，将成瘾归因于遗传应该有很多好处， 有理由怀疑它可能会产生一些意想不到的负面后果。特别是，遗传 对成瘾性疾病的解释可能会导致人们认为成瘾者缺乏代理权， 自我效能，以克服他们的症状，并相信非生物医学治疗，如 心理治疗，不太可能有效。如果这些影响发生在成瘾者和 治疗他们的临床医生，有意义的负面临床后果-具有潜在的重大伦理， 社会和政策的影响，可能会导致。这个K99/R 00提案是一个为期五年的研究序列， 培训和职业发展活动的重点是研究基因解释的影响， 成瘾和准备候选人过渡到职业生涯作为一个独立的ELSI研究员。这些 活动将在纽约州立精神病研究所进行，这是研究的主要地点 为哥伦比亚大学精神病学系举办的教育活动。的具体目标 建议的研究是：（1）调查遗传归因对人群成瘾的影响 物质成瘾（酒精使用障碍）和行为成瘾（赌博障碍）的人， 通过定量分析他们对遗传学解释的认可与他们的行为之间的关系， 成瘾和他们的自责水平，对治疗有效性的期望，以及对他们的信念。 自我能动性和自我效能感;（2）检查遗传归因对临床医生成瘾的影响 通过实验测试成瘾的基因解释如何影响他们的归因， 对病人的指责，他们对治疗效果的期望，以及他们对病人的代理的信念， 和（3）探索遗传归因对成瘾的进一步深入的影响，使用定性 对成瘾者和治疗成瘾的临床医生进行采访。候选人的职业目标是 进行严格的跨学科研究，有助于全面了解 对行为、身份和健康结果的遗传学和其他生物学解释会影响社会和 临床后果的信念和态度，以及伦理，社会和政策的影响，这样的 方面的影响.拟议的定性方法、基因组科学、生物伦理学和公共政策培训将使 他进行研究，通知临床实践，公共教育活动和社会政策，并 有助于推动该领域的理解如何最好地促进准确理解基因组- 及其在健康方面的作用，包括在患者、临床医生和公众中的精神健康， 而不产生或加剧消极或有害的信念和态度。

Addictive disorders are increasingly conceptualized as biomedical diseases with genetic roots. While conventional wisdom has suggested that attributing addictions to genetics should have many benefits, there is reason to suspect that it could have some unintended, negative consequences. In particular, genetic explanations for addictive disorders could lead to the perception that people with addictions lack agency or self-efficacy to overcome their symptoms and to the belief that non-biomedical treatments, such as psychotherapy, are unlikely to be effective. If these effects were to occur among people with addictions and the clinicians who treat them, meaningful negative clinical consequences—with potentially significant ethical, social, and policy implications—could result. This K99/R00 proposal is for a five-year sequence of research, training, and career development activities focused on studying the implications of genetic explanations for addiction and preparing the candidate to transition into a career as an independent ELSI researcher. These activities will take place at the New York State Psychiatric Institute, which is the primary location of research and educational activities for Columbia University’s Department of Psychiatry. The specific aims of the proposed research are: (1) to investigate the implications of genetic attributions for addiction among people with a substance addiction (alcohol use disorder) and people with a behavioral addiction (gambling disorder), by quantitatively analyzing the relationships between their endorsement of genetic explanations for their addictions and their levels of self-blame, expectancies about treatment effectiveness, and beliefs about their own agency and self-efficacy; (2) to examine the effects of genetic attributions for addiction among clinicians who treat addiction, by experimentally testing how a genetic explanation for addiction affects their ascriptions of blame to patients, their expectancies about treatment effectiveness, and their beliefs about patients’ agency, and (3) to explore the implications of genetic attributions for addiction in further depth, using qualitative interviews among people with addictions and clinicians who treat addictions. The candidate’s career goal is to conduct rigorous interdisciplinary research that contributes to a comprehensive understanding of the ways in which genetic and other biological explanations for behavior, identity, and health outcomes affect socially and clinically consequential beliefs and attitudes, as well as the ethical, societal, and policy implications of such effects. The proposed training in qualitative methods, genomic sciences, bioethics, and public policy will allow him to conduct research that informs clinical practice, public education campaigns, and social policy, and to help move the field toward an understanding of how best to facilitate accurate understandings of the genome— and its role in health, including mental health—among patients, clinicians, and members of the general public, without engendering or exacerbating negative or harmful beliefs and attitudes.