Analyzing the presentation and the stigma of schizophrenia in French newspapers

The depiction of people with schizophrenia in news media: A cross-national analysis

BACKGROUND

Though people with schizophrenia have been habitually stigmatized in the media, the past two decades have seen a substantial rise in public awareness and anti-stigma intervention plans.

AIMS

In this comprehensive cross-national study, we examine the portrayal of people with schizophrenia in the news media across four countries: the U.S., the U.K., Russia, and Israel.

METHODS

We employed thematic content analysis to analyze 80 articles from four prominent middle-market and tabloid news media outlets.

RESULTS

Findings suggest people with schizophrenia were routinely depicted in the news media as violent and dangerous perpetrators who were typically young adult white males.

CONCLUSIONS

Though some differences existed between venues in different countries, this study suggests that despite the rise in public awareness and anti-stigma intervention plans, the media overall - regardless of country origin - mostly failed to deliver the desired anti-stigma results.

Comparing stigma between French people experiencing schizophrenia versus bipolar disorders

BACKGROUND

Among the multiple challenges that people experiencing mental illness in general, and schizophrenia or bipolar disorders in particular, have to face, stigma appears to be one of the most difficult to tackle. In France, the body of research about stigma regarding people experiencing schizophrenia or bipolar disorders is growing, but not as much as in other western countries.

AIMS

In this context, our study aims to explore and compare stigma in French people experiencing schizophrenia or bipolar disorders, along with their respective mental healthcare system experience, in order to better address them within public health policies.

METHODS

20 French mental health service users experiencing schizophrenia and 20 experiencing bipolar disorders answered the Stigma Scale, which assesses three dimensions of stigma (discrimination, difficulties of divulgation and lack of positive aspects). A semi-structured interview was used to collect information about the experience of the mental healthcare system (level of information, access to diagnosis, treatment, access to psychoeducation, etc.).

RESULTS

People experiencing schizophrenia and people experiencing bipolar disorders are different populations in terms of social impairment. However, they share a comparable negative experience of the mental healthcare system and a comparable level of information about their illness, to the exception of diagnosis divulgation, as people experiencing bipolar disorders have a better access to their diagnosis. People experiencing schizophrenia perceive a higher actual discrimination than people experiencing bipolar disorders.

CONCLUSIONS

Public health policies should take into account the strong perception of actual discrimination of people experiencing schizophrenia, with capitalizing on what seems beneficial for people experiencing bipolar disorders.

Evidence for the Effectiveness of Psychological Interventions for Internalized Stigma among Adults with Schizophrenia Spectrum Disorders: A Systematic Review and Meta-Analyses

In recent years, psychological interventions have been used to alleviate internalized stigma in people with schizophrenia spectrum disorders, but outcomes have been inconsistent. The aim of this review was to examine the existing evidence regarding this matter. Four electronic databases (EMBASE, MEDLINE, PsycINFO, and the Cochrane Central Register of Controlled Trials) were searched from inception until 8 September 2022, using appropriate strategies. The eligibility, quality, and strength of evidence of each study were all evaluated against the predetermined standards. Further quantitative analyses were performed using the RevMan software. A total of 27 studies were included in the systematic review. Eighteen studies with extractable data for meta-analysis yielded a statistically significant overall effect (Z = 3.00; p = 0.003; 95% CI: -0.69 [-1.15, -0.24]; n = 1633), although there was considerable heterogeneity (Tau2 = 0.89; Chi2 = 303.62, df = 17; p < 0.00001; I2 = 94%). Subgroup analyses for Narrative Enhancement and Cognitive Therapy (NECT) produced a statistically significant and highly homogenous effect (Z = 3.40; p = 0.0007; 95% CI: -0.44 [-0.70, -0.19]; n = 241; Tau2 = 0.00; Chi2 = 0.14, df = 2 (p = 0.93); I2 = 0%). In conclusion, the majority of the psychological interventions are successful in lowering levels of internalized stigma, especially NECT, and interventions that integrate multiple therapies may be more beneficial.

A 20-year review comparing the use of 'schizophrenia' and 'psychosis' in UK newspapers from 2000 to 2019: Implications for stigma reduction

BACKGROUND

There have been increasing calls for schizophrenia to be renamed to reduce negative associations with the diagnosis. 'Psychosis' is one proposed alternative, yet some research suggests this has greater negative connotations. This study compared the use of both terms within UK newspapers longitudinally to assess which is more negatively portrayed in the media.

STUDY DESIGN

Using LexisLibrary News, six UK newspaper archives were searched for the terms 'schizophrenia' and 'psychosis' in articles published between 2000 and 2019; the included article total was n = 9802. Articles were analysed using Linguistic Inquiry and Word Count software.

STUDY RESULTS

A two-level multilevel model was created of newspaper articles nested within newspapers. Adding predictors revealed that diagnostic term was a significant predictor of the emotional tone of articles (β = -2.30, SE = 0.51, p < .001, 95 % CI -3.30 to -1.30), with 'psychosis' having a more negative tone than 'schizophrenia.' Tabloids were shown to have a significantly more negative tone than broadsheets (β = -9.32, SE = 1.04, p < .001, 95 % CI -11.36 to -7.28), and emotional tone of writing had become more negative over time (β = -0.26, SE = 0.04, p < .001, 95 % CI -0.34 to -0.18).

CONCLUSIONS

These findings suggest 'psychosis' is associated with greater negativity than 'schizophrenia' within UK newspapers, and may be a poor substitute term to reduce stigma. As article tone worsened for both diagnoses over time, increased stigma reduction campaigns are required to target negativity within the media.

The effect of cognitive behavioral therapy-based psychoeducation on internalized stigma and functional remission in individuals diagnosed with schizophrenia

PURPOSE

The aim of this study is to determine the effect of cognitive behavioral therapy-based psychoeducation provided to individuals diagnosed with schizophrenia on internalized stigma and functional remission.

DESIGN AND METHODS

The study was conducted based on the quasi-experimental design with pretest-posttest control group with 100 individuals, who were diagnosed with schizophrenia, in a Community Mental Health Center between September 2020 and June 2021.

FINDINGS

It was determined that after the cognitive behavioral therapy-based psychoeducation, the internalized stigma level decreased and the functional remission level increased in the experimental group compared with the control group.

PRACTICE IMPLICATIONS

In the study, it was determined that the experimental and control groups had low levels of functional remission and high levels of internalized stigma before the cognitive behavioral therapy-based psychoeducation, and the functional remission levels increased and the internalized stigma levels decreased in the experimental group compared with the control group after the cognitive behavioral therapy-based psychoeducation.

Schizophrenia on Turkish Twitter: an exploratory study investigating misuse, stigmatization and trivialization

PURPOSE

This study aims to investigate use and misuse of the word 'schizophrenia' and its derivatives to assess the prevalence of stigmatizing and trivializing attitudes and the meanings attributed to the condition on Turkish Twitter.

METHODS

Using R programming language, we collected Turkish Twitter posts containing the terms used for schizophrenia in Turkish through Twitter's Search API over a 47-day period between July and June 2019. After removing retweets, we randomly sampled 3000 tweets and manually categorized them in three dimensions: use type (metaphorical/non-metaphorical), topic and attitude. Qualitative analysis on representative tweets were performed and word frequencies were calculated.

RESULTS

In total 44,266 tweets were collected and after removing retweets, 24,529 tweets were obtained. Overwhelming majority of the tweets (91.7%) used the terms metaphorically and the majority displayed stigmatizing (68.3%) and trivializing (23%) attitudes. Politics was the most common topic (58.2%) followed by everyday/social chatter (28.5%). Only a small number of tweets were part of awareness campaigns (0.2%) or displayed a supportive attitude (0.8%). Terms were often used metaphorically in a stigmatizing manner as personal or political insults, while in everyday/social contexts, they were used in a trivializing manner to label eccentricity, oddness, overthinking and suspiciousness. Popularity and reach metrics show that these tweets were extensively retweeted, liked and reached millions of users.

CONCLUSION

This is the first study investigating attitudes towards schizophrenia on Turkish Twitter. Significantly higher rates of stigmatizing attitudes demonstrate the urgent need for public health and social awareness campaigns targeting stigma surrounding schizophrenia in Turkey.

Stigma towards individuals with schizophrenia: Examining the effects of negative symptoms and diagnosis awareness on preference for social distance

Social exclusion towards individuals with schizophrenia can occur as a result of stigmatizing attitudes towards the diagnosis or as a response to observing atypical behaviours resulting from symptoms. The present study examined social exclusion towards schizophrenia as a function of diagnosis awareness and presence of negative symptoms. 64 healthy participants watched four different videos of confederates who were either labelled / not labelled with schizophrenia and displayed / did not display negative symptoms. Participants ranked their preference for social interaction with individuals in ten different activities and were told that they would complete the activities based on their rankings. A significant interaction between label and symptoms was found as knowledge of diagnosis increased desire for social distance if symptoms were absent and decreased desire for social distance if symptoms were present. A main effect of symptom presence was also found as participants displayed greater desire to complete activities with individuals not displaying symptoms than participants displaying symptoms but there was no effect of diagnostic label. Social exclusion appears to be dependent on both presence of negative symptoms and knowledge of diagnosis. It may be useful to focus on increasing public acceptance of specific symptom presentations in public mental health campaigns.

Public beliefs and attitudes toward schizophrenia and depression in Taiwan: A nationwide survey

Beliefs about and attitudes toward mental illness may be influenced by cultural- or country-specific contexts. Through a national survey, the current study investigated beliefs and attitudes toward people with schizophrenia and depression among the general public in Taiwan. A random-digit-dialing telephone-based cross-sectional survey was administered to Taiwanese adults aged 20-64 years (n = 1600). The data were analyzed through binary logistic regressions to test for differences between these disorders in causal beliefs, stereotypes, emotional reactions, desire for social distance, and help-seeking behavior. The results revealed that respondents were more concerned with biogenetic causal explanations for people with schizophrenia than for those with depression. Significantly more respondents perceived people with schizophrenia as more likely to be unpredictable and violent toward others. A similar trend was observed for the desire for social distance. For both disorders, respondents were significantly more likely to express compassion than to express anger toward the person described in the vignette. Respondents also expressed more desire for social distance from someone like the vignette who have received psychiatric treatment. These findings provide useful directions for the implementation of optimal psychoeducation among such communities. .

Exploring the link between stigma and social representations among people with and without schizophrenia in the French context

We explored the representations that individuals associate with schizophrenia in the French context, as well as the relationships between their own representations and the representations they attribute to other French people. Data were collected from individuals in the general population (N = 98) and those with schizophrenia (N = 59). Using a verbal association technique, participants produced words spontaneously based on the inductor word "schizophrenia". The instruction invited them to respond on their own behalf, but also "as the French would in general". Prototypical and similarity analyses were carried out. Results indicated that the representations of participants from the general population were associated with a vocabulary relative to schizophrenia as an illness and with stigmatizing stereotypes, such as madness, dangerousness and split personality when they expressed themselves on their own behalf, as well as psychopathy and confinement when they imagined how French people express themselves regarding schizophrenia. Participants with schizophrenia who had a clear view of the general population's stereotypes mostly referred to negative experiences and emotions such as loneliness, suffering and fear. These findings underline the value of considering the representations associated with schizophrenia in designing awareness campaigns, but also in clinical care for people with schizophrenia.

Social Dominance Orientation and Discrimination against People with Schizophrenia: Evidence of Medicalization and Dangerousness Beliefs as Legitimizing Myths

Medicalizing beliefs about schizophrenia (biogenetic causes and psychiatric labels) are connected to the belief that people with schizophrenia are dangerous and to discriminating intentions towards them. In this research, we draw on the Social Dominance theory and we examine these beliefs as legitimizing myths that are connected to the individuals' social dominance orientation (SDO) and that legitimize discrimination. In total, 238 Humanities students participated in the current research (Mage = 20.4; SD = 3.03; 107 male and 131 female). A vignette presenting a person with schizophrenia symptoms that offered no labels or explanations about the depicted person's condition was presented to research participants. A structural equation modeling analysis was carried out, in order to confirm our hypotheses in accordance with social dominance theory. Participants' social dominance orientation (SDO) was associated with higher endorsement of medicalizing (β = .16, p < .01) and dangerousness beliefs (β = .22, p < .001). In turn, medicalizing beliefs were connected to dangerousness (β = .21, p < .001) and higher discriminating intentions, both for desired social distance (β = .15, p < .05) and for deprivation of sociopolitical rights (β = .14, p < .05). Dangerousness was highly associated with both these measures (β = .28, p < .001 and β = 43, p < .001 respectively) while SDO was not significantly associated with discriminating intentions. Our model showed good fit to the data. This study confirms the role of SDO in schizophrenia stigma and the fact that ideological and power factors underpin the stigma of schizophrenia.

Evidence for the Influence of Social Dominance Orientation and Intergroup Relations on the Stigma of Schizophrenia

Abstract. The stigma of schizophrenia is an intergroup phenomenon associated with issues of social power. We consider that the concept of stigma power should be extended to include intergroup relations that go beyond the aspect of the relation between “schizophrenic” and “normal.” With the present study, we intend to demonstrate that perceivers hold more stigmatizing attitudes toward a person with schizophrenia belonging to the outgroup and that especially when the perceiver has a higher Social Dominance Orientation (SDO). One hundred and sixty-one participants from the general population participated in our study (50.3% male, Mage = 39.14, SD = 16.36), which was based on a 2 (Sex of Target: male vs. female) × 2 (Sex of Participant: male vs. female) × SDO between-subjects design. The participants read a standardized vignette used in previous research, depicting a person presenting the symptoms of schizophrenia, and were then asked to complete questionnaires about SDO and intention to discriminate against the depicted individual. Our analysis showed the main effect of SDO on discriminating intentions. Simple slope analysis revealed that SDO predicts male participants’ discriminating intentions when the target is a woman, while this relation is not significant when the target is a man. The exact reverse pattern was observed among female participants. Our results suggest intergroup relations and ideological motivations underpin the stigma of schizophrenia. We conclude that different group belongings of individuals with schizophrenia as well as the public’s ideological motivations should be further considered by future research and anti-stigma efforts.