An investigation into the effect of causal beliefs about depression on attitudes and clinical judgements

Biological explanations of depression have been found to increase professional perceptions of the effectiveness of medical treatments and reduce the perceptions of the effectiveness of psychological therapy. Studies in lay populations have shown that biological explanations reduce perceptions of self-efficacy and control over depression symptoms. There is a lack of research examining the impact of causal models on clinicians’ attitudes. The current study aimed to explore whether clinicians’ causal models of a client’s depression can be biased by aetiological labelling and, in turn, whether clinicians’ causal models impact clinical judgements and attitudes. An experimental design was utilised, with one independent variable (labelling of the client’s depression) with three levels (biological, psychosocial and neutral). Outcomes measured causal beliefs, treatment effectiveness, control, clinical attitudes and perceived stigma in relation to a client vignette. Observational data were analysed to explore the effects of clinicians’ primary causal models on the outcome variables. Over 200 trainee clinical psychologists, across England, Scotland and Wales, took part in an online survey, presented using surveymonkey®. Where appropriate data were analysed using ANOVA. There was a small effect of the manipulation; labelling the depression as biological increased biological causal attributions and increased perceptions of the effectiveness of medical treatments. The exploratory analysis demonstrated substantial effects of strongly endorsing biological causal beliefs on judgements of medical treatments and client engagement. The results suggest that clinicians’ causal models of a client’s depression may bias clinical judgements. These findings are preliminary and further research is needed