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Serial indirect effects of psychosocial causal beliefs and stigma on help-seeking preferences for depression. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02683-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Mwamba RN, Sao SS, Knettel BA, Minja LM, Osaki H, Mmbaga BT, Watt MH. The Disclosure Dilemma: Willingness to Disclose a Positive HIV Status Among Individuals Preparing for HIV Testing During Antenatal Care in Tanzania. AIDS Behav 2021; 25:908-916. [PMID: 33011883 PMCID: PMC7886955 DOI: 10.1007/s10461-020-03058-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 11/25/2022]
Abstract
HIV status disclosure can reduce transmission risks and improve care engagement. Individuals may have strong feelings about HIV disclosure even prior to diagnosis. We assessed willingness to disclose a positive HIV status among pregnant women and their male partners awaiting routine HIV testing during antenatal care in Tanzania (n = 939). Logistic regression models were used to examine factors associated with willingness to disclose to one's inner circle (partner/family member) and outer circle (friend/neighbor) in the event of an HIV diagnosis. Almost all (93%) were willing to disclose to at least one person; participants were more willing to disclose to their inner circle (91%) vs outer circle (52%). Individuals with some form of employment, more stigmatizing attitudes of social distancing of PLWH, greater anticipated HIV stigma, more perceived social support, and prior contact with someone living with HIV were more likely to disclose to their inner circles. Individuals who were older, male, and who had higher levels of perceived social support were more willing to disclose to their outer circle. These findings increase the understanding of the intra- and interpersonal factors that influence HIV disclosure decisions. Tailored pre- and post- HIV test counseling are needed to facilitate social support and overcome barriers to disclosure if they test positive for HIV.
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Affiliation(s)
- Rimel N Mwamba
- Duke Global Health Institute, Duke University, 310 Trent Drive, Box 90519, Durham, NC, 27710, USA.
| | - Saumya S Sao
- Duke Global Health Institute, Duke University, 310 Trent Drive, Box 90519, Durham, NC, 27710, USA
| | - Brandon A Knettel
- Duke Global Health Institute, Duke University, 310 Trent Drive, Box 90519, Durham, NC, 27710, USA
| | - Linda M Minja
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Haika Osaki
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - Blandina T Mmbaga
- Duke Global Health Institute, Duke University, 310 Trent Drive, Box 90519, Durham, NC, 27710, USA
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Melissa H Watt
- Duke Global Health Institute, Duke University, 310 Trent Drive, Box 90519, Durham, NC, 27710, USA
- University of Utah, Salt Lake City, UT, USA
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Abayneh S, Lempp H, Hanlon C. Participatory action research to pilot a model of mental health service user involvement in an Ethiopian rural primary healthcare setting: study protocol. RESEARCH INVOLVEMENT AND ENGAGEMENT 2020; 6:2. [PMID: 31934350 PMCID: PMC6951014 DOI: 10.1186/s40900-019-0175-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Involvement of service-users at all levels of the mental health system is a policy imperative in many countries internationally. However, putting policy into practice seems complex; little is known about how best to involve service users and efforts are often criticized for being tokenistic. In low-and-middle income countries, less attention has been given to the roles of service users within mental health systems. The proposed study is part of a larger project intended to develop service-user involvement in mental health system strengthening in Ethiopia. A Theory of Change (ToC) model has already been developed through a participatory approach. This study protocol aims to describe the theoretical background and methods to pilot this model using participatory action research (PAR) and explore participants' experience of involvement. METHODS The proposed study will apply a PAR approach situated in critical social theory and conduct a phenomenological case study to find out participants' experience of involvement. This will be conducted in three stages. The focus of Stage 1 will be to(i) establish a Research Advisory Group (RAG), and Research Participant Group (RPG) at district and primary healthcare facility levels, respectively, and (ii) identify and prioritize potential areas of concern for involvement in the domains of advocacy, service planning and development, monitoring and improving service quality. In Stage 2, we will work with the RPG to develop a plan of action for the selected area. Stage 3 will aim to assist the RPG to implement and evaluate the plan of action. Process indicators and observation will be combined with in-depth interviews with participants to elicit their experiences of involvement. Thematic content analysis will be used. DISCUSSION The participatory approach to mental health service user involvement in health system strengthening employed by this study will support the implementation of solutions through locally relevant and contextualized actions. Findings from this study will contribute to the body of knowledge towards understanding the complexity of implementation of service user involvement and refine the ToC model for transferability to similar settings.
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Affiliation(s)
- Sisay Abayneh
- College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, Ethiopia
| | - Heidi Lempp
- King’s College London, Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, Weston Education Centre, 10, Cutcombe Rd, London, SE5 9RJ UK
| | - Charlotte Hanlon
- College of Health Sciences, School of Medicine, Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, Addis Ababa University, Addis Ababa, Ethiopia
- King’s College London, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF UK
- Centre for Innovative Drug Development and Therapeutic Trials for Africa (CDT-Africa), College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Abi Doumit C, Haddad C, Sacre H, Salameh P, Akel M, Obeid S, Akiki M, Mattar E, Hilal N, Hallit S, Soufia M. Knowledge, attitude and behaviors towards patients with mental illness: Results from a national Lebanese study. PLoS One 2019; 14:e0222172. [PMID: 31525219 PMCID: PMC6746362 DOI: 10.1371/journal.pone.0222172] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/22/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES Patients with mental health disorders often have to endure the burdens of the condition itself and the stigma that follows. Since no study has been conducted in Lebanon on this topic, our objective was to assess the knowledge, attitude and behaviors towards public stigma of mental health diseases, among a sample of the Lebanese population. METHODS A cross-sectional study, conducted between November 2017 and May 2018, enrolled 2289 participants. The Mental Health Knowledge Schedule (MAKS), the Community Attitudes toward Mental Illness (CAMI) and the Reported and Intended Behavior Scale (RIBS) were used to assess knowledge, attitude and behaviors toward mental illness respectively. The 25th, 50th and 75th percentile of the MAKS, CAMI and RIBS scales scores were considered as cutoff points for low, medium and high scores respectively. RESULTS A high knowledge score was found in 33.0% of the participants, whereas a high attitude score and a higher behavior score were found in 32.2% and 26.9% of the participants respectively. Living in North Lebanon (Beta = 1.331) and being familiar with a non-close person with mental illness (Beta = 0.811) were associated with higher knowledge of mental illness (higher MAKS score), whereas living in Bekaa (Beta = -8.693) and being 70 years old and above (Beta = -5.060) were associated with lower knowledge toward mental illness (lower MAKS score). Higher knowledge of mental illness (higher MAKS score) (Beta = 0.670), having a high level of education (university (Beta = 8.785), secondary (Beta = 6.084) and technical (Beta = 5.677)) were associated with less stigmatizing attitudes (higher CAMI scale). Being familiar with close people with mental illness (Beta = 0.577), less stigmatizing attitudes (higher CAMI scale) (Beta = 0.077) and higher knowledge of mental illness (higher MAKS score) (Beta = 0.115) were associated with higher favorable behaviors (higher RIBS score), whereas knowing a non-close person who have a mental illness (Beta = -0.720) was associated with lower favorable behaviors (lower RIBS score). CONCLUSION A mass media awareness campaigns that could transmit health messages to a wide public audience in the country to fight stigma toward mental illness, seems warranted.
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Affiliation(s)
- Carla Abi Doumit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Chadia Haddad
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Hala Sacre
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Pascale Salameh
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sahar Obeid
- Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Philosophy and Human Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Faculty of Pedagogy, Lebanese University, Beirut, Lebanon
| | - Maria Akiki
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Elie Mattar
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Najla Hilal
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Beirut, Lebanon
| | - Michel Soufia
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Lowder EM, Ray BR, Gruenewald JA. Criminal Justice Professionals' Attitudes Toward Mental Illness and Substance Use. Community Ment Health J 2019; 55:428-439. [PMID: 30706306 DOI: 10.1007/s10597-019-00370-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/23/2019] [Indexed: 11/29/2022]
Abstract
Despite the high prevalence of behavioral health disorders in justice settings and prior research on the importance of attitudes in successful treatment outcomes for behavioral health populations, few studies have examined criminal justice professionals' attitudes toward mental illness and substance use. We conducted a state-wide survey of 610 criminal justice professionals using items adapted from the Drug and Drug Problems Perceptions Questionnaire (Albery et al. 2003) to examine attitudes toward mental illness and substance use as a function of criminal justice position and personal contact. For attitudes toward both mental illness and substance use, defense attorneys and community corrections officers reported more positive attitudes relative to jail correctional staff and prosecutors. For attitudes toward substance use, personal contact moderated the effect of position on attitudes. Findings underscore the importance of targeted training and other contact-based interventions to improve criminal justice professionals' attitudes toward behavioral health populations.
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Affiliation(s)
- Evan M Lowder
- School of Public and Environmental Affairs, Indiana University Purdue University Indianapolis, 801 W. Michigan Street, BS 3025, Indianapolis, IN, 46202, USA.
| | - Bradley R Ray
- School of Public and Environmental Affairs, Indiana University Purdue University Indianapolis, 801 W. Michigan Street, BS 3025, Indianapolis, IN, 46202, USA
| | - Jeffrey A Gruenewald
- School of Public and Environmental Affairs, Indiana University Purdue University Indianapolis, 801 W. Michigan Street, BS 3025, Indianapolis, IN, 46202, USA
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Aljedaani SM. Adults' Knowledge, Attitudes, and Willingness to Interact With Patients Suffering From Mental Illness in Jeddah City. J Am Psychiatr Nurses Assoc 2019; 25:360-375. [PMID: 30132711 DOI: 10.1177/1078390318792610] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND: Mental illness is a serious health problem. Understanding the views of different communities toward patients with mental illness is important in understanding how communities deal with these patients. AIM: To investigate Saudi adults' knowledge, attitudes, and willingness to interact with patients with mental illness. METHOD: The study followed a quantitative approach, a descriptive correlation design. RESULTS: The study results indicate that while participants had knowledge and positive attitudes toward certain aspects, they had negative knowledge and attitudes regarding other aspects. Most participants (61.1%) mentioned that the cause of mental illness is biological, 61.9% stated that medication is a useful way to treat patients with mental illness, and 90% believed that patients with mental illness deserve respect. Furthermore, 35.8% of participants believed that patients with mental illness had a tendency toward dangerous and aggressive behavior, whereas 33.2% believed that the community is safer if patients with mental illness are kept in hospitals. There was a positive correlation between knowledge and attitudes toward patients with mental illness (r = .305, p < .01). On the other hand, the study found that there is a statistically significant and negative correlation among adults' attitudes and their readiness to interact with patients. CONCLUSIONS: The study will ideally encourage stakeholders to design and initiate an educational strategic program at the community level in order to improve community members' awareness and attitudes and enhance their readiness to interact with patients with mental illness.
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Affiliation(s)
- Shafeah M Aljedaani
- 1 Shafeah M. Aljedaani, MN, BN, PMHN, Falculty of Nursing, Fakeeh College of Medical Sciences, Jeddah, Kingdom of Saudi Arabia
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Norman RMG, Li Y, Sorrentino R, Hampson E, Ye Y. The differential effects of a focus on symptoms versus recovery in reducing stigma of schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2017; 52:1385-1394. [PMID: 28821903 DOI: 10.1007/s00127-017-1429-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/06/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE We extend investigations of the impact of the content of video contact with an individual with schizophrenia on stigma reduction. We examine whether differential impacts persist over a 2-week period and the extent to which they are mediated by perceived similarity and feelings of empathy and/or sympathy. METHOD We used a randomized control trial wherein participants were exposed to a video in which an individual described his recovery from schizophrenia, or the same person described acute symptoms of schizophrenia, or a no-video control condition. Outcomes included impressions of and preferred social distance to the person in the video and people in general with schizophrenia and well as perceptions of similarity and feelings of sympathy and empathy. We also measured an overt behaviour, seating distance, at 2-week follow-up. RESULTS The recovery-focused material was generally more effective in improving impressions and reducing preferred level of social distance. Although the symptom-focused video resulted in great sympathy for the person, this did not translate into positive impressions or reduced social distance. Mediational analyses yielded findings consistent with the benefits of the recovery video being mediated by increased perceptions of similarity and lower feelings of sympathy. Exposure to the recovery-focused video resulted in less anxiety in anticipation of meeting the person in the video relative to the control condition. CONCLUSIONS Video contact emphasizing potential for recovery from schizophrenia was more effective in reducing stigmatizing responses than contact highlighting acute symptoms. Increased sympathy does not necessarily translate into reductions in stigma.
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Affiliation(s)
- Ross M G Norman
- Department of Psychiatry, Western University, A2-648, 800 Commissioners Road, East London, ON, Canada, N6A 5W9. .,Department of Epidemiology and Biostatistics, Western University, London, ON, Canada.
| | - Yixian Li
- Department of Psychology, Western University, London, ON, Canada
| | | | - Elizabeth Hampson
- Department of Psychiatry, Western University, A2-648, 800 Commissioners Road, East London, ON, Canada, N6A 5W9.,Department of Psychology, Western University, London, ON, Canada
| | - Yang Ye
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Beliefs and Prejudices Versus Knowledge and Awareness: How to Cope Stigma Against Mental Illness. A College Staff E-survey. Community Ment Health J 2017; 53:589-597. [PMID: 28188389 DOI: 10.1007/s10597-017-0116-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 01/31/2017] [Indexed: 10/20/2022]
Abstract
The aims of this study were to collect information about attitudes toward mental illness from the staff of Brescia University, and to detect predictors of issues regarding mental disorders and evaluate their relationship with public stigma. The study involved 1079 people and each participant received a letter explaining the purpose of the e-research. Four hundred and eighty-six people completed the questionnaires. The results showed that those who had a higher level of education, a personal life experience with mental disorders and a higher professional role were more likely to develop behaviours of acceptance toward the mentally ill. Factor analysis of the CAMI showed three main factors: Social distance and isolation, Social integration, Social responsibility and tolerance. Through the structural equation model it was found that the latent construct stigma was mainly defined by the first factor. From this study it emerged that education and personal contact were protective factors against public stigma.
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Villani M, Kovess - Masfety V. Could a short training intervention modify opinions about mental illness? A case study on French health professionals. BMC Psychiatry 2017; 17:133. [PMID: 28390399 PMCID: PMC5385095 DOI: 10.1186/s12888-017-1296-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 03/31/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In France, negative views on schizophrenia are pervasive, even among health professionals. Prior research suggests that the level of prejudice is lower when the illness is described with the example of a specific individual. This finding highlights the importance of designing local, targeted destigmatization campaigns. The present study aims to evaluate the benefits of a short intervention offering contact with psychiatric services users on reducing the stigma about mentally ill people, among a sample of Health Administrators and Students. METHODS Data were collected before (Time 0) and after (Time 1) a short training intervention program proposed to a sample of 121 Health Services Administrators and Students. This four-day workshop explained the multiple causes of mental illness, the clinical implications of psychosis and various mental disorders, the subjective experience of mental illness and the legal evolutions of users' rights. The intervention was strongly based on live testimonies from users. Using a French version of the Attitudes to Mental Illness scale, we compared attitudes before and after the training intervention among 58 trainees having answered our questionnaire at Time 0 and Time 1. RESULTS After the training, a significantly lower endorsement of stigmatizing statements compared to baseline was found in one third (9 out of 27) of the items. These results plead for further research about the potential benefits of initiatives like this short intervention program on significantly reducing stigmatizing attitudes towards mentally ill people among Health Administrators and Students. CONCLUSIONS The present study highlights the importance of further studying the effect of targeted interventions that offer first hand contact with persons with mental illness.
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Affiliation(s)
- Murielle Villani
- Fondation Pierre Deniker, 36 avenue Raymond Poincaré, Paris, France. .,Laboratoire de Psychopathologie et Processus de Santé, Paris Descartes University, Paris, EA4057, France.
| | - Viviane Kovess - Masfety
- Fondation Pierre Deniker, 36 avenue Raymond Poincaré, Paris, France ,grid.10992.33Laboratoire de Psychopathologie et Processus de Santé, Paris Descartes University, Paris, EA4057 France ,grid.414412.6Ecole des Hautes Etudes en Santé Publique, Paris, France
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Angermeyer MC, van der Auwera S, Carta MG, Schomerus G. Public attitudes towards psychiatry and psychiatric treatment at the beginning of the 21st century: a systematic review and meta-analysis of population surveys. World Psychiatry 2017; 16:50-61. [PMID: 28127931 PMCID: PMC5269489 DOI: 10.1002/wps.20383] [Citation(s) in RCA: 134] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Public attitudes towards psychiatry are crucial determinants of help-seeking for mental illness. It has been argued that psychiatry as a discipline enjoys low esteem among the public, and a "crisis" of psychiatry has been noted. We conducted a systematic review and meta-analysis of population studies examining public attitudes towards various aspects of psychiatric care. Our search in PubMed, Web of Science, PsychINFO and bibliographies yielded 162 papers based on population surveys conducted since 2000 and published no later than 2015. We found that professional help for mental disorders generally enjoys high esteem. While general practitioners are the preferred source of help for depression, mental health professionals are the most trusted helpers for schizophrenia. If respondents have to rank sources of help, they tend to favor mental health professionals, while open questions yield results more favorable to general practitioners. Psychiatrists and psychologists/psychotherapists are equally recommended for the treatment of schizophrenia, while for depression psychologists/psychotherapists are more recommended, at least in Europe and America. Psychotherapy is consistently preferred over medication. Attitudes towards seeking help from psychiatrists or psychologists/psychotherapists as well as towards medication and psychotherapy have markedly improved over the last twenty-five years. Biological concepts of mental illness are associated with stronger approval of psychiatric help, particularly medication. Self-stigma and negative attitudes towards persons with mental illness decrease the likelihood of personally considering psychiatric help. In conclusion, the public readily recommends psychiatric help for the treatment of mental disorders. Psychotherapy is the most popular method of psychiatric treatment. A useful strategy to further improve the public image of psychiatry could be to stress that listening and understanding are at the core of psychiatric care.
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Affiliation(s)
- Matthias C Angermeyer
- Center for Public Mental Health, Gösing am Wagram, Austria
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Sandra van der Auwera
- Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Mauro G Carta
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany
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Schomerus G, Matschinger H, Angermeyer MC. Causal beliefs of the public and social acceptance of persons with mental illness: a comparative analysis of schizophrenia, depression and alcohol dependence. Psychol Med 2014; 44:303-314. [PMID: 23574735 DOI: 10.1017/s003329171300072x] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND There is an ongoing debate whether biological illness explanations improve tolerance towards persons with mental illness or not. Several theoretical models have been proposed to predict the relationship between causal beliefs and social acceptance. This study uses path models to compare different theoretical predictions regarding attitudes towards persons with schizophrenia, depression and alcohol dependence. METHOD In a representative population survey in Germany (n = 3642), we elicited agreement with belief in biogenetic causes, current stress and childhood adversities as causes of either disorder as described in an unlabelled case vignette. We further elicited potentially mediating attitudes related to different theories about the consequences of biogenetic causal beliefs (attribution theory: onset responsibility, offset responsibility; genetic essentialism: differentness, dangerousness; genetic optimism: treatability) and social acceptance. For each vignette condition, we calculated a multiple mediator path model containing all variables. RESULTS Biogenetic beliefs were associated with lower social acceptance in schizophrenia and depression, and with higher acceptance in alcohol dependence. In schizophrenia and depression, perceived differentness and dangerousness mediated the largest indirect effects, the consequences of biogenetic causal explanations thus being in accordance with the predictions of genetic essentialism. Psychosocial causal beliefs had differential effects: belief in current stress as a cause was associated with higher acceptance in schizophrenia, while belief in childhood adversities resulted in lower acceptance of a person with depression. CONCLUSIONS Biological causal explanations seem beneficial in alcohol dependence, but harmful in schizophrenia and depression. The negative correlates of believing in childhood adversities as a cause of depression merit further exploration.
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Affiliation(s)
- G Schomerus
- Department of Psychiatry, Greifswald University, Germany
| | - H Matschinger
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany
| | - M C Angermeyer
- Department of Public Health, University of Cagliari, Italy
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