What the explanation does, and what nobody has measured
Biological explanations reduce blame and increase pessimism about recovery - both at once, in the same studies. What nobody has measured is what happens when the explanation is taken away.
We have not finished checking this source. No judgement either way. how we score evidence
Caveat on this rating: This literature does not point one way, and the row would be dishonest if it implied otherwise. A randomised study from the same research group as the bogus-test experiment found self-blame and perceived helplessness GREATER after a cognitive-behavioural explanation than a biological one (Lee et al. 2016, J Soc Clin Psychol 35(7):571-588), and a pre-registered sham-genetic-test experiment found no effect on beliefs about depression at all (Lamontagne et al. 2023, PMID 36869258). Both are named here and neither is quoted, because their full texts were not obtained. The Kvaale effect sizes are small to moderate, the dangerousness result may reflect publication bias by the authors' own account, and the samples across this field are dominated by undergraduates and online panels rather than people in treatment. The absence of any study of debunking, or of any behavioural outcome, is stated as an absence found by search - it is not proof that no such work exists anywhere.
There is a real literature on what a chemical-imbalance explanation does to the person receiving it. It does two things at once, and the second is part of why this trail exists.
Significant findings
A meta-analysis of 28 experiments in Clinical Psychology Review pooled the effects of biogenetic explanations of psychological problems. They reduce blame (Hedges' g = -0.324) and they induce pessimism about recovery (g = 0.263). They also increased endorsement of the stereotype that people with psychological problems are dangerous (g = 0.198), a result its authors say "could reflect publication bias", and they did not typically change how much distance people wanted to keep. The authors' own summary: "promoting biogenetic explanations to alleviate blame may induce pessimism and set the stage for self-fulfilling prophecies that could hamper recovery."
The most direct experiment gave people who had had a depressive episode the result of a bogus but credible biological test, telling them their symptoms were, or were not, caused by a chemical imbalance. The chemical-imbalance feedback "failed to reduce self-blame, elicited worse prognostic pessimism and negative mood regulation expectancies, and led participants to view pharmacotherapy as more credible and effective than psychotherapy" (doi:10.1016/j.brat.2014.02.009).
The effect is not fixed, and that is the most useful finding in this stop. Among 165 people with depressive symptoms, those told a sham test showed a genetic predisposition to depression reported less confidence in handling low mood than those told it did not (d = 0.41, 95% CI 0.03 to 0.79). A short segment explaining that genes are not deterministic did not merely remove that effect - the group who saw it ended up more confident than either other group (d = 0.90, 0.50 to 1.31; doi:10.1007/s10897-017-0140-5). What appears to do harm is not biology. It is biology described as fixed.
Then there is what nobody knows. There is no study of what happens to people when the chemical-imbalance explanation is taken away - not for the public, and not for people currently taking these medications. None appears anywhere in the literature citing the 2022 umbrella review. Nor does any study in this field measure behaviour: not one of these experiments records whether a person started, stopped or kept taking anything. They measure beliefs and expectations, mostly among students and online panels.
Worth asking
That gap is why this trail will not tell you what to conclude. If reading it has changed how you think about something you take, the useful next move is not a decision but a conversation: this is what I now understand about why I was prescribed this - is that right, and what are we actually going by?
Source
The 'side effects' of medicalization: a meta-analytic review of how biogenetic explanations affect stigma — Kvaale EP, Haslam N, Gottdiener WH (2013)
Read the source: https://doi.org/10.1016/j.cpr.2013.06.002
DOI: 10.1016/j.cpr.2013.06.002
How this was scored
- Study design
- not recorded
- Funding
- not recorded
- Published in
- not recorded
- Sample size
- not recorded
- Preregistered
- not recorded
- Conflicts disclosed
- not recorded
- Independent of proponent
- not recorded
- Retracted
- No
We have not finished checking this source, so there is no scoring to show yet. “We have not checked this yet” and “this is disputed” are different statements, so no scored band is shown rather than a low one.
Read the full scoring rubric, including what it can't tell you.
Published September 10, 2026.
Questions
How strong is the evidence behind this?
veisund rates this source "not yet assessed". We have not finished checking this source. No judgement either way. One caveat travels with that badge: This literature does not point one way, and the row would be dishonest if it implied otherwise. A randomised study from the same research group as the bogus-test experiment found self-blame and perceived helplessness GREATER after a cognitive-behavioural explanation than a biological one (Lee et al. 2016, J Soc Clin Psychol 35(7):571-588), and a pre-registered sham-genetic-test experiment found no effect on beliefs about depression at all (Lamontagne et al. 2023, PMID 36869258). Both are named here and neither is quoted, because their full texts were not obtained. The Kvaale effect sizes are small to moderate, the dangerousness result may reflect publication bias by the authors' own account, and the samples across this field are dominated by undergraduates and online panels rather than people in treatment. The absence of any study of debunking, or of any behavioural outcome, is stated as an absence found by search - it is not proof that no such work exists anywhere. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
The 'side effects' of medicalization: a meta-analytic review of how biogenetic explanations affect stigma — Kvaale EP, Haslam N, Gottdiener WH (2013). DOI: 10.1016/j.cpr.2013.06.002. The full source is linked on this page so you can read it yourself.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.