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Thursday, June 15, 2006

 

Genetics and stigmatization

From the Journal of Health and Social Behavior (Dec., 2005), pp. 307-22 comes this interesting abstract:

Title: Geneticization of deviant behavior and consequences for stigma: the case of mental illness.
Author: Phelan JC. of the Mailman School of Public Health, Columbia University, Department of Sociomedical Sciences, 722 W. 168th Street, New York, NY 10032, USA. jcp13@columbia.edu

Abstract: One likely consequence of the genetics revolution is an increased tendency to understand human behavior in genetic terms. How might this "geneticization" affect stigma? Attribution theory predicts a reduction in stigma via reduced blame, anger, and punishment and increased sympathy and help. According to "genetic essentialist" thinking, genes are the basis of human identity and strongly deterministic of behavior. If such ideas are commonly accepted, geneticization should exacerbate stigma by increasing perceptions of differentness, persistence, seriousness, and transmissibility, which in turn should increase social distance and reproductive restrictiveness. I test these predictions using the case of mental illness and a vignette experiment embedded in a nationally representative survey. There was little support for attribution theory predictions. Consistent with genetic essentialism, genetic attributions increased the perceived seriousness and persistence of the mental illness and the belief that siblings and children would develop the same problem. Genetic attribution did not affect reproductive restrictiveness or social distance from the ill person but did increase social distance from the person's sibling, particularly regarding intimate forms of contact involving dating, marriage, and having children.

Polling data about homosexuality supplied by Wayne Besen on his website seems to be counter to the impact on mental illness. I wonder if the fact that most people do not see homosexuality as a mental illness could contribute to the difference. Not going anywhere particularly, just thought the study was interesting. I am interested in this because I am concerned that the advances in genetics will erode perceptions of free will and have impact on how clients perceive a variety of clinical issues. The whole chemical imbalance thing makes it difficult to establish talk therapy with clients who want to "wait until the meds kick in."

Comments:
Seems like genetic attribution can easily lead to a sense of "we all have it and *I* don't show it in this way so others shouldn't either". (Ie depression was a lot different before prozac made it not a rare condition).
 
Wrongly applied as it often is, alcoholism does have some useful parallels for discussion.

There does appear to be a genetic component. But it is triggered by introducing a chemical into your system. Every alcoholic starts with the first drink. It later becomes a chemical dependency.

But, of course, most people who drink are not alcoholics.

And here the parallel of sexuality with alcoholism ends.

While some may abstain completely (of either) for religious reasons, it does appear many are unable ... when it comes to homosexuality ... to distinguish the difference between someone who enjoys a glass of wine with dinner and someone who opens a new bottle of bourbon at 8am.

And remind me again of all the social and criminal ills that Prohibition caused...
 
Seems to me the analogy only works in a moral context for those who intoxication and homosexual behavior as sins. Being tempted to drink to excess (have gay sex) is ok, but the indulgence is problem. The analogy is not precise and requires a moral assessment of things that separates the impulse to do something considered wrong from the doing of it.
 
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