A Comparison of Stigmatizing Attitudes Toward Persons with Schizophrenia in Four Stakeholder Groups: Perceived Likelihood of Violence and Desire for Social Distance

BackgroundIndividuals with mental illness often experience stigmatization and encounter stereotypes such as being dangerous or unpredictable. To further improve measures against psychiatric stigma, it is of importance to understand its components. In this study, we attend to the step of separation between “us” and “them” in the stigma process as conceptualized by Link and Phelan. In using the belief in continuity of mental illness symptoms as a proxy for separation, we explore its associations with stereotypes, emotional responses and desire for social distance in the stigma process.MethodsAnalyses are based on a representative survey in Germany. Vignettes with symptoms suggestive of schizophrenia (n = 1,338) or depression (n = 1,316) were presented to the respondents, followed by questions on continuum belief, stereotypes, emotional reactions and desire for social distance. To examine the relationship between these items, path models were computed.ResultsRespondents who endorsed the continuum belief tended to show greater prosocial reactions (schizophrenia: 0.07; p < 0.001, depression: 0.09; p < 0.001) and less desire for social distance (schizophrenia: −0.13; p < 0.001, depression: −0.14; p < 0.001) toward a person with mental illness. In both cases, agreement with the stereotypes of unpredictability and dangerousness was positively associated with feelings of anger and fear as well as desire for social distance. There were no statistically significant relations between stereotypes and continuum beliefs.DiscussionAssumptions regarding continuum beliefs in the stigma process were only partially confirmed. However, there were associations of continuum beliefs with less stigmatizing attitudes toward persons affected by either schizophrenia or depression. Including information on continuity of symptoms, and thus oppose perceived separation, could prove helpful in future anti-stigma campaigns.

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Attitudes toward mentally ill patients: a comparison between Romanian and International Medical Students

Medicine and Pharmacy Reports ◽

10.15386/cjmed-776 ◽

2017 ◽

Vol 90 (4) ◽

pp. 401-406

Author(s):

Codruta Alina Popescu ◽

Anca Dana Buzoianu ◽

Soimita Mihaela Suciu ◽

Sebastian Mihai Armean

Keyword(s):

Mental Illness ◽

Medical Students ◽

Social Distance ◽

Health Professionals ◽

Mentally Ill ◽

Negative Attitude ◽

Personal Contact ◽

Future Health ◽

People With Mental Illness ◽

Stigmatizing Attitudes

Background. Stigmatizing attitudes to mental illness, and especially schizophrenia, are not limited to the general population but are also common among health professionals. Health professionals are in a position to model health related attitudes both in the general public and patients. Medical students are an interesting group to focus upon, since they are future health professionals and correcting stigmatizing attitudes is still possible during their educational curriculum.Methods. This study investigated the attitude toward mental illness in medical students at the Iuliu Hatieganu University of Medicine and Pharmacy. We surveyed first year students, since they have not yet received specific classes or internships in psychiatry; 322 students from the Romanian and English sections participated, representing a response rate of 94.7%. The questionnaire consisted of the Romanian and English versions of Link's Social Distance Scale towards people with mental illness scale.Results. Overall, medical students had a relatively negative attitude towards people with mental illness, with moderate social distance and stereotypical attitudes. The level of personal contact with people with mental illness was correlated with positive attitudes. International students had scored lower then Romanian students on social distance toward mentally ill patients.Conclusions. Medical education can play an important role in the attitudes of students toward mental illness. Medical students have stigmatizing attitudes about mentally ill patients. Personal contact with people suffering from mental illness might contribute to a positive attitude from the medical students toward mentally ill patients.

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Factors determining social distance toward people with depression among community pharmacists

European Psychiatry ◽

10.1016/j.eurpsy.2010.12.009 ◽

2012 ◽

Vol 27 (7) ◽

pp. 528-535 ◽

Cited By ~ 25

Author(s):

S. Liekens ◽

T. Smits ◽

G. Laekeman ◽

V. Foulon

Keyword(s):

Social Distance ◽

Linear Regression Analysis ◽

Community Pharmacists ◽

Multiple Linear Regression Analysis ◽

Level Of Involvement ◽

Social Closeness ◽

The Social ◽

Proxy Measure ◽

Stigmatizing Attitudes ◽

Cognitive Attitude

AbstractObjectiveThe aim of the present study was to measure stigma among community pharmacists regarding patients with depression, using social distance as a proxy measure. Furthermore, factors influencing stigmatization were identified.MethodsA survey consisting of questions regarding social distance, cognitive attitude components, stereotypical beliefs and behavioural tendencies towards pharmaceutical care for patients with depression was carried out. The survey was completed by 149 community pharmacists with a response rate of 82%. Multiple linear regression analysis was applied to the results of the survey.ResultsMost pharmacists endorsed social distance towards patients with depression. The social distance further increased the more the situation described implied “social closeness”. Age, depression care attitude, the stereotypical belief “danger to others” and the level of involvement pharmacists showed towards patients with depression were found to predict social distance. The present model explains 32.3% of the variance in social distance.ConclusionThe results showed that community pharmacists have a stigmatizing attitude towards patients with depression. The determinants found to influence these stigmatizing attitudes might be addressed when trying to reduce stigmatization of patients with depression.

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The Long-Term Effectiveness of Interventions Addressing Mental Health Literacy and Stigma of Mental Illness in Children and Adolescents: Systematic Review and Meta-Analysis

International Journal of Public Health ◽

10.3389/ijph.2021.1604072 ◽

2021 ◽

Vol 66 ◽

Author(s):

Alexandra Maria Freţian ◽

Patricia Graf ◽

Sandra Kirchhoff ◽

Gloria Glinphratum ◽

Torsten M. Bollweg ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Mental Illness ◽

Health Literacy ◽

Social Distance ◽

Mental Health Literacy ◽

Meta Analysis ◽

Stigmatizing Attitudes

Objectives: This study aims to provide a systematic review and meta-analysis of the literature on the long-term effects of interventions addressing children’s and adolescents’ mental health literacy and/or stigmatizing attitudes.Methods: Articles in English or German published between January 1997 and May 2020 were retrieved from five databases, leading to a total of 4,375 original articles identified.Results: 25 studies were included after applying exclusion criteria, 13 of which were eligible for meta-analysis. The overall average of the follow-up period was about 5 months. Long-term improvements were sustained for mental health literacy, d = 0.48, 95% CI = (0.34, 0.62), as well as for stigmatizing attitudes, d = 0.30, 95% CI = (0.24, 0.36), and social distance, d = 0.16, 95% CI = (0.03, 0.29). The combination of educational and contact components within interventions led to worse results for mental health literacy, but not stigmatizing attitudes or social distance.Conclusion: Interventions targeting children and adolescents generally have a brief follow-up period of an average of 5 months. They show a stable improvement in mental health literacy, but are to a lesser degree able to destigmatize mental illness or improve social distance.

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Assessment of Four Stakeholder Groups’ Preferences Concerning Outpatient Commitment for Persons With Schizophrenia

American Journal of Psychiatry ◽

10.1176/appi.ajp.160.6.1139 ◽

2003 ◽

Vol 160 (6) ◽

pp. 1139-1146 ◽

Cited By ~ 55

Author(s):

Marvin S. Swartz ◽

Jeffrey W. Swanson ◽

H. Ryan Wagner ◽

Michael J. Hannon ◽

Barbara J. Burns ◽

...

Keyword(s):

Outpatient Commitment ◽

Stakeholder Groups ◽

Persons With Schizophrenia

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What is the Image of the “Typical Cancer Patient”? The View of Physicians

American Journal of Men s Health ◽

10.1177/1557988320988480 ◽

2021 ◽

Vol 15 (2) ◽

pp. 155798832098848

Author(s):

Angeliki Tsiouris ◽

Nadine Ungar ◽

Martina Gabrian ◽

Alexander Haussmann ◽

Karen Steindorf ◽

...

Keyword(s):

Cancer Patient ◽

Cancer Patients ◽

Social Distance ◽

Implicit Attitudes ◽

Professional Characteristics ◽

The Feminine ◽

Gender Neutral ◽

Stigmatizing Attitudes ◽

And Gender ◽

Study Participants

Former research has identified stigmatizing attitudes toward cancer patients in the general population. Little is known about (implicit) attitudes of physicians toward cancer patients. By using the prototype approach, the study investigated German physicians’ prototypical perceptions of cancer patients. Five hundred nineteen physicians (mean age: 46 years, 47% female) who regularly treat cancer patients participated in the questionnaire study. Participants were asked to state three prototype attributes that describe the “typical cancer patient.” Open format answers were coded on the dimensions favorability (coded with unfavorable, favorable, or neutral) and gender-stereotypicality (coded with masculine stereotypical, feminine stereotypical, or gender-neutral). Of all prototype attributes ( N = 1,589), 69.9% were coded as unfavorable and 14.3% as favorable, the remaining attributes were neutral (15.9%). Analysis of gender-stereotypicality revealed that nearly half of the attributes (49.5%) were compatible with the feminine, whereas only 6.5% were compatible with the masculine stereotype. The remaining attributes (44.0%) were gender-neutral. There were no significant associations between prototype favorability or gender-stereotypicality and demographic/professional characteristics of physicians. The prototype approach was successful to identify (implicit) attitudes toward cancer patients and might be more sensitive than social distance scales when investigating stigmatizing attitudes. Physicians described the “typical cancer patient” with predominantly unfavorable and feminine attributes, while favorable attributes were underrepresented and positive masculine attributes were barely mentioned. The finding that the “typical cancer patient” lacks (positive) masculine attributes should be followed up in further research.

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‘Love comes first, and it is ahead of any different political partisanism’: How political polarizations compare to other forms of discrimination in Buenos Aires (Argentina)

International Journal of Social Psychiatry ◽

10.1177/00207640211006736 ◽

2021 ◽

pp. 002076402110067

Author(s):

Martín Agrest ◽

Martín Nemirovsky ◽

Gabriella Dishy ◽

Daniel Abadi ◽

Eduardo Leiderman

Keyword(s):

Health Care ◽

Healthcare Provider ◽

Social Distance ◽

Political Party ◽

Buenos Aires ◽

Political Polarization ◽

Attitudes Toward Immigrants ◽

Political Partisanship ◽

Persons With Schizophrenia ◽

To Receive

Background: Affective polarization and stigma toward individuals with schizophrenia and toward immigrants in Argentina are not new despite its importance and dissemination. However, no research has been conducted taking into consideration political partisanship and attitudes toward these groups. Aims: Political polarization and attitudes toward socialization across party lines are studied in conjunction with attitudes toward immigrants and toward individuals with schizophrenia. Method: Individuals from Buenos Aires ( n = 712) were surveyed for their political partisanship and their attitudes toward Peruvian and Bolivian immigrants, people with schizophrenia and partisans from the opposing political party. A modified version of the Bogardus scale was used. Results: Social distance was from highest to lowest toward people with schizophrenia, political opponents, and immigrants. Individuals with schizophrenia were strongly discriminated against by most participants: 86% would definitely or probably not want them to take care of their children, 83% would not want them to be their healthcare provider, and 81% would not want to marry them. Immigrants were comparatively not discriminated against: 10% would not want them to take care of their children, 8% would not want to receive health care from them, and 28% would not want to marry them. Cristina Fernández de Kirchner partisans showed the lowest level of discrimination toward these two groups, compared to Mauricio Macri partisans and to independent voters. However, the former group had greater discriminatory attitudes toward Mauricio Macri partisans than the latter. Conclusions: As compared to other discriminatory attitudes, discrimination toward persons with schizophrenia is widespread and pervasive. Lower levels of discrimination toward people with schizophrenia and toward immigrants would not predict attitudes toward the opposing political partisans.

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The relationship between biogenetic attributions and desire for social distance from persons with schizophrenia and major depression revisited

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796014000262 ◽

2014 ◽

Vol 24 (4) ◽

pp. 335-341 ◽

Cited By ~ 22

Author(s):

M. C. Angermeyer ◽

A. Daubmann ◽

K. Wegscheider ◽

E. Mnich ◽

G. Schomerus ◽

...

Keyword(s):

Major Depression ◽

Social Distance ◽

Social Acceptance ◽

Population Based ◽

Causal Models ◽

People With Mental Illness ◽

Hereditary Factors ◽

Case Vignettes ◽

Explicit Mention ◽

Persons With Schizophrenia

Aims.Previous population-based studies did not support the view that biological and genetic causal models help increase social acceptance of people with mental illness. However, practically all these studies used un-labelled vignettes depicting symptoms of the disorders of interest. Thus, in these studies the public's reactions to pathological behaviour had been assessed rather than reactions to psychiatric disorders that had explicitly been labelled as such. The question arises as to whether results would have been similar if respondents had been confronted with vignettes with explicit mention of the respective diagnosis.Methods.Analyses are based on data of a telephone survey in two German metropolises conducted in 2011. Case-vignettes with typical symptoms suggestive of depression or schizophrenia were presented to the respondents. After presentation of the vignette respondents were informed about the diagnosis.Results.We found a statistically significant association of the endorsement of brain disease as a cause with greater desire for social distance from persons with schizophrenia. In major depression, this relation was absent. With both disorders, there was no statistically significant association between the endorsement of hereditary factors as a cause and social distance.Conclusions.Irrespective of whether unlabelled or labelled vignettes are employed, the ascription to biological or genetic causes seems not to be associated with a reduction of the public's desire for social distance from people with schizophrenia or depression. Our results corroborate the notion that promulgating biological and genetic causal models may not help decrease the stigma surrounding these illnesses.

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Comparison of the Effects of a Genetic, a Mild Encephalitis, and a Psychosocial Causal Explanation of Schizophrenia on Stigmatizing Attitudes – a Pilot Study With a Quasi-Experimental Design

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.745124 ◽

2021 ◽

Vol 12 ◽

Author(s):

Sonja Haouchet ◽

Carolin Harder ◽

Sabine Müller

Keyword(s):

Experimental Design ◽

Social Distance ◽

Causal Explanation ◽

Specific Effect ◽

Case Vignette ◽

Causal Explanations ◽

Quasi Experimental ◽

Stigmatizing Attitudes ◽

The Mean ◽

Gender Specific

Background: Previous research has shown that the endorsement of biogenetic causal explanations of schizophrenia is associated with stronger stigmatizing attitudes against people with schizophrenia than the endorsement of psychosocial explanations. However, little is known about whether different biogenetic causal explanation beliefs differentially affect stigmatizing attitudes. This is particularly valid for the endorsement of the mild encephalitis hypothesis of schizophrenia.Aim: To examine to what extent different causal explanations of schizophrenia influence the desire for social distance from persons with schizophrenia.Methods: A study with a prospective, quasi-experimental design was carried out with students in Germany (N = 333). A case vignette depicting a person with schizophrenia-typical symptoms was presented, and a social distance scale (SDS) was used to measure the stigmatizing attitude against the person described. Participants were randomly assigned to one of three groups receiving different causal explanations of schizophrenia (genetic, mild encephalitis hypothesis, or psychosocial) without treatment information.Results: A one-way ANOVA showed that the mean SDS was lowest in the group with the mild encephalitis hypothesis explanation, followed by the genetic explanation group, and highest in the psychosocial explanation group. However, the differences between the groups were small and not significant. A subanalysis revealed a significant interaction between gender and causal explanation. Women showed a significantly lower desire for social distance than men when receiving the mild encephalitis hypothesis. Neither the study discipline nor the number of semesters of study had significant effects on the mean SDS. The differences between the mean SDS scores for the different items were much bigger than the differences for the different causal explanations. Regardless of the causal explanation, the extent of the desired social distance depends strongly on social proximity.Conclusion: The present study fits into previous research, which has found that biogenetic beliefs were either associated with more social distance or did not yield a statistically significant association. Although we found a small gender-specific effect of the endorsement of the mild encephalitis hypothesis, we do not recommend gender-specific anti-stigmatization campaigns because they might rightly raise suspicions of dishonesty and manipulation. Rather we support recovery-oriented messages focusing on effective treatments.

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