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Neurobiological narratives: Experiences of mood disorder through the lens of neuroimaging

机译：神经生物学叙事：从神经影像学的角度看情绪障碍的经历

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Many scientists, healthcare providers, policymakers and patients are awaiting in anticipation the application of biomedical technologies such as functional neuroimaging for the prediction, diagnosis and treatment of mental disorders. The potential efficacy of such applications is controversial, and functional neuroimaging is not yet routinely used in psychiatric clinics. However, commercial ventures and enthusiastic reporting indicate a pressing need to engage with the social and ethical issues raised by clinical translation. There has been little investigation of how individuals living with mental illness view functional neuroimaging, or of the potential psychological impacts of its clinical use. We conducted 12 semi-structured interviews with adults diagnosed with major depression or bipolar disorder, probing their experiences with mental health care and their perspectives on the prospect of receiving neuroimaging for prediction, diagnosis and planning treatment. The participants discussed the potential role of neuroimages in (i) mitigating stigma; (ii) supporting morally loaded explanations of mental illness due to an imbalance of brain chemistry; (iii) legitimising psychiatric symptoms, which may have previously been de-legitimised since they lacked objective representation, through objective representations of disorder; and (iv) reifying DSM-IV-TR disorder categories and links to identity. We discuss these anticipated outcomes in the context of participant lived experience and attitudes to biologisation of mental illness, and argue for bringing these voices into upstream ethics discussion.
机译：许多科学家，医疗保健提供者，政策制定者和患者都在等待生物医学技术（例如功能性神经成像）在精神疾病的预测，诊断和治疗中的应用。此类应用的潜在疗效尚存争议，精神病诊所尚未常规使用功能性神经成像。但是，商业投资和热情的报道表明，迫切需要解决由临床翻译引起的社会和道德问题。很少有关于患有精神疾病的个体如何看待功能性神经影像学或其临床使用的潜在心理影响的调查。我们对被诊断患有严重抑郁症或双相情感障碍的成年人进行了12次半结构化访谈，探讨了他们在精神保健方面的经验以及他们对接受神经成像以进行预测，诊断和计划治疗的前景的看法。参与者讨论了神经图像在（i）减轻耻辱感方面的潜在作用; （ii）支持由于脑部化学反应失衡而导致精神疾病的道德解释; （iii）使精神病症状合法化，这些症状以前可能由于缺乏客观的表征而被取消了合法性，这是通过对疾病的客观表征来实现的; （iv）调整DSM-IV-TR疾病类别和与身份的联系。我们在参与者对精神疾病进行生物识别的实践经验和态度的背景下讨论这些预期的结果，并主张将这些声音纳入上游道德讨论中。

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