Clinicians' Judgments of the Need for Psychological Treatment

临床医生对心理治疗必要性的判断

• 批准号: 7846778
• 负责人: NANCY S. KIM
• 金额: $ 7.8万
• 依托单位: NORTHEASTERN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-06-01 至 2012-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7846778
• 关键词: Address; Affect; Attenuated; Awareness; Basic Science; Behavior; Caring; Client; Clinical; Control Locus; Decision Making; Distress; Educational Intervention; Event; Foundations; Future; Goals; Head; Health; Health Professional; Healthcare; Individual; Intervention; Judgment; Knowledge; Lead; Legal; Life; Medical; Mental Health; Mental disorders; Modeling; Nature; Outcome; Perception; Persons; Physicians; Positioning Attribute; Primary Care Physician; Process; Psychiatrist; Psychologist; Research; Solid; Source; Specific qualifier value; Symptoms; Testing; Translating; Translational Research; United States National Institutes of Health; Veins; Work; abstracting; care delivery; clinical practice; coping; follow-up; improved; innovation; knowledge base; psychologic; psychological distress; public health relevance; research study

DESCRIPTION (provided by applicant): Expert and novice mental health clinicians have previously been shown to demonstrate an understanding-normality effect (Meehl, 1973), wherein having a plausible explanation for a client's bizarre behaviors results in perceiving those behaviors as being more "normal" or acceptable (Ahn, Novick, & Kim, 2003). We propose to test whether this understanding-normality effect influences clinicians' judgments of clients' need for mental health treatment, and if so, what types of explanations trigger the effect. (1) First, we propose to test whether knowing an explanation for a client's behaviors leads clinicians to see clients as being less in need of psychological treatment. A hypothesis consistent with the understanding-normality effect is that clinical psychologists and psychiatrists will perceive hypothetical clients as being less in need of treatment when provided with a plausible explanation for their behaviors. If true, such findings would challenge the standard clinical assumption that understanding a client's problems is necessarily beneficial for the client or, at the very least, cannot harm the client. (2) Second, we will examine what types of explanations for behaviors are most likely to trigger the effect in treatment decisions. In particular, we will test the degree to which activation of the effect depends on whether clients are seen as having been in control of the precipitating events that lead to their current behaviors. (3) Third, we will also ask primary care physicians to judge the likelihood that they would refer the same clients to a mental health professional. By examining the differential impacts of explanations reasonably likely to be generated by clinicians, we can better identify the potential scope of the effect and specify its systematic triggers. We will actively seek to publicize our results to raise clinicians' awareness of the possibility that more understanding could lead to less treatment. PUBLIC HEALTH RELEVANCE: People suffering from mental disorders are in distress regardless of what explanations a clinician is able to mentally generate and bestow upon their behaviors and other symptoms. This proposal describes translational research testing the hypothesis that clinicians will perceive a client as being less in need of professional psychological treatment when the client's symptoms can be plausibly explained. After we document the effect and its triggers in the proposed research, we will have a solid foundation for a larger NIH proposal, in which we will examine the same process in clients and its effect on treatment seeking, study the influence of the effect on decisions to terminate treatment, and develop an intervention to increase clinicians' and clients' awareness of the effect.

描述（由申请人提供）：专家和新手心理健康临床医生先前已显示出理解正常性效应（Meehl，1973），其中对客户的怪异行为有合理的解释，导致感知这些行为更“正常”或可接受（Ahn，Novick和Kim，2003）。我们建议测试这种理解正常性效应是否会影响临床医生对客户心理健康治疗需求的判断，如果是这样，什么类型的解释会触发这种效应。(1)首先，我们建议测试是否知道一个客户端的行为解释导致临床医生看到客户作为需要较少的心理治疗。与理解正常效应一致的一个假设是，临床心理学家和精神病学家会认为假设的客户在为他们的行为提供合理的解释时不太需要治疗。如果是真的，这样的发现将挑战标准的临床假设，即理解客户的问题必然有利于客户，或者至少不会伤害客户。(2)其次，我们将研究什么类型的行为解释最有可能触发治疗决策的影响。特别是，我们将测试这种效应的激活程度取决于来访者是否被视为控制了导致他们当前行为的突发事件。(3)第三，我们还将要求初级保健医生判断他们将同一客户转介给心理健康专业人员的可能性。通过检查临床医生合理可能产生的解释的差异影响，我们可以更好地确定影响的潜在范围，并指定其系统触发因素。我们将积极寻求宣传我们的结果，以提高临床医生对更多理解可能导致更少治疗的可能性的认识。公共卫生关系：患有精神障碍的人处于痛苦之中，无论临床医生能够在精神上产生什么解释，并赋予他们的行为和其他症状。该提案描述了翻译研究测试的假设，即临床医生将认为客户端作为不太需要专业的心理治疗时，客户端的症状可以合理地解释。在我们在拟议的研究中记录效果及其触发因素之后，我们将为更大的NIH提案奠定坚实的基础，在该提案中，我们将检查客户的相同过程及其对寻求治疗的影响，研究效果对终止治疗决定的影响，并制定干预措施以提高临床医生和客户对效果的认识。

项目成果

Proportionate responses to life events influence clinicians' judgments of psychological abnormality.

对生活事件的相应反应影响临床医生对心理异常的判断。

• DOI: 10.1037/a0026416
• 发表时间: 2012
• 期刊: Psychological assessment
• 影响因子: 3.6
• 作者: Kim,NancyS;Paulus,DanielJ;Gonzalez,JeffreyS;Khalife,Danielle
• 通讯作者: Khalife,Danielle

Hindsight bias and causal reasoning: a minimalist approach.

事后偏见和因果推理：极简主义方法。

• DOI: 10.1007/s10339-011-0414-z
• 发表时间: 2012
• 期刊: Cognitive processing
• 影响因子: 1.7
• 作者: Yopchick,JennelleE;Kim,NancyS
• 通讯作者: Kim,NancyS

Do clinical psychologists extend the bereavement exclusion for major depression to other stressful life events?

临床心理学家是否会将重度抑郁症的丧亲之痛排除范围扩大到其他压力性生活事件？

• DOI: 10.1177/0272989x12443417
• 发表时间: 2012
• 期刊: Medical decision making : an international journal of the Society for Medical Decision Making
• 作者: Kim,NancyS;Paulus,DanielJ;Nguyen,ThaoP;Gonzalez,JeffreyS
• 通讯作者: Gonzalez,JeffreyS

Understanding Lay Assessments of Alcohol Use Disorder: Need for Treatment and Associated Stigma.

了解酒精使用障碍的非专业评估：治疗需求和相关耻辱。

• DOI: 10.1093/alcalc/agv069
• 发表时间: 2016
• 期刊: Alcohol and alcoholism (Oxford, Oxfordshire)
• 作者: Weine,ErienneR;Kim,NancyS;Lincoln,AlisaK
• 通讯作者: Lincoln,AlisaK