Diagnostic labels can enhance our empathy for those in need. But there are downsides

The language of indigent mental health is inescapable. Diagnostic terms like depression and post-traumatic stress disorder (PTSD) permeate popular culture and the online world. They are the currency of countless news and awareness campaigns.

Growth diagnostic labels could be celebrated. This suggests that public awareness of mental health is increasing, and the stigma associated with mental illness is decreasing. As the shame associated with it decreases, mental illness is coming out of the shadows.

But the rise of diagnostic language may have its drawbacks. Some critics say it reflects medicalization of suffering and maybe contribute to excessive medication intakeAnd just as naming conditions can reduce stigma, it can enhance it. Labels can be sticky, having a lasting impact on how others judge people with mental illness and how they see themselves.

IN new studyMy colleagues and I looked at how labeling a person’s relatively bland or marginal mental health problems affects how others perceive them.

We found that the presence of labels increased empathy and concern for those affected, but also pessimism about their ability to recover. In general, diagnostic labels seem to be a mixed blessing when applied at the less severe end of the spectrum of suffering.

Spread of the concept

When we talk about the growth of diagnostic labels, a particular concern is that the concepts of mental illness have been expanding in recent years. They now encompass a wider range of experiences than before. The so-calledcreep concept“means that people can operate diagnostic terms to refer to relatively bland or marginal phenomena.

British psychologist Lucy Foulkes says people may increasingly over identification mental illness. This means that they apply diagnostic labels to experiences that do not meet the diagnostic threshold.

The latest research (including those from my research group) support this possibility. These studies have shown that people who hold broad conceptions of mental illness are more likely to self-diagnose than those with narrower conceptions.

The consequences of using diagnostic terms loosely are unclear. Using them to label relatively bland suffering can have positive effects, such as encouraging people to take their suffering seriously and seek professional aid.

But it can have equally negative effects, stigmatizing the person being labeled or leading to the person being defined and constrained by the disease. It can even lead to people misdiagnosing themselves.

Our research

We sought to understand the impact of these expanded conceptions of mental illness by examining how diagnostic labeling affects the perceptions of people experiencing relatively bland problems.

In two experiments, we presented nearly 1,000 American adults with brief descriptions of a hypothetical person experiencing a marginal, nonsevere mental health problem. Each description was carefully tested to be near the diagnostic threshold.

Participants were randomly assigned to read identical descriptions, with or without a diagnostic label (major depressive disorder, generalized anxiety disorder, and bipolar disorder in experiment one, and PTSD, obsessive-compulsive disorder, and binge eating disorder in experiment two).

After reading each description, we asked participants to rate how much they felt sorry for the person, how much they would deserve to be treated professionally, and how much they should receive accommodations at school or work, such as extra time on assignments or special leave.

We also asked how likely it was that the person would make a full recovery (both experiments) and how much control they had over their problems (experiment two). We then compared these judgments between the labeled and unlabeled conditions.

Labels had an impact

Participants who read descriptions preceded by a diagnostic label tended to report more empathy for the person and more support for efforts to adjust to their problems. They also viewed the person as more suitable for treatment than those who read the same descriptions without the label.

At the same time, the presence of labeling made participants perceive the person’s problems as more indefinite and perceive their recovery as a process less dependent on them.

Many of these judgments varied across disorders. There was some evidence that labeling effects were strongest for lesser-known disorders such as binge eating and bipolar disorder.

Mixed Blessings

When diagnostic labels are applied to marginal cases of mental illness, the implications seem to be mixed. On the one hand, labels legitimize help-seeking, promote responsive support, and enhance empathy. These positives contradict suggestions that labeling promotes stigmatization.

However, diagnostic labels also seem to encourage the view that mental health problems are indefinite and that people have constrained options for overcoming them. In other words, diagnostic labels can lead people to see mental illness as a indefinite identity rather than a transient state. Such a perception can undermine expectations of recovery in those experiencing problems and undermine efforts to achieve it.

Even the apparent benefits of labeling can have a downside in the context of relatively bland anxiety. It can encourage unnecessary and ineffective treatment or perpetuate a “infirmed” role by offering special amenities to people with minor disabilities.

Our findings shed lithe on the possible consequences of the ongoing expansion of diagnostic concepts. As these concepts spread to less severe forms of suffering and impairment, and diagnostic labels are used more loosely, we must be alert to the likely costs as well as benefits.