An empirical examination of the biogenetic approach in schizophrenia stigma reduction through an attribution lens

Interventions to decrease health students' stigma toward schizophrenia: A scoping review

BACKGROUND

Schizophrenia is heavily stigmatized among health professionals. Given that health professional students are future members of the workforce and will provide care for people with schizophrenia, it is essential to implement interventions aimed at reducing stigma among this group.

OBJECTIVE

This scoping review aimed to identify and synthesize existing literature on interventions to decrease schizophrenia stigma among health professional students, and to determine the possible gaps in the literature.

DESIGN

Nine electronic databases and gray literature were searched, including PubMed, Embase, the Cumulative Index to Nursing and Allied Health Literature, PsycINFO, MEDLINE, Web of Science, Scopus, China National Knowledge Infrastructure, WanFang, and Google on 5 May 2023. Two researchers independently conducted data screening, data extraction, and assessed study risks. A most updated search was also done on 22 May 2024. The Cochrane risk of bias tool version 2 for randomized trials and Risk of Bias in Non-randomized Studies were used to assess the studies' risk of bias. Data synthesis and analysis were conducted by two reviewers using a narrative approach. Reporting adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews.

RESULTS

This review included twenty-one studies with 2520 health professional students. The majority of included studies were non-randomized controlled trials (38 %) and pre-post studies (52 %). Most of the included studies were conducted in the United States (24 %). The participants in ten (48 %) studies were medical students. The number of intervention sessions ranged from one to 13, with an average of three. Seven (33 %) studies had an intervention duration of less than four weeks and 16 (76 %) studies had no follow-up. Various scales were used to assess the outcomes of schizophrenia stigma. Only two studies (10 %) indicated the intervention's ineffectiveness, with the majority of interventions led by psychiatry department faculty and individuals with schizophrenia.

CONCLUSIONS

Most studies (90 %) utilized various approaches, including face-to-face or online education, direct contact with individuals with schizophrenia, or a combination thereof, to diminish stigma among health professional students. However, none addressed cultural and empathy factors in their intervention designs, and the included studies lacked theoretical guidance. The review only comprised English quantitative studies with significant heterogeneity, with 17 studies (81 %) displaying serious or high risk of bias, limiting comprehensive discussions. These findings offer valuable insights for future systematic review. Tweetable abstract Studies on reducing health professional students' schizophrenia stigma need to address cultural and empathy factors.

Weiner's Attribution-Emotion-Action Model: Uncovering the Mediating Role of Self-Blame and the Moderating Effect of the Helper's Responsibility for the Help Recipient's Behavior

Seven preregistered experimental studies investigated a potential mediator (self-blame) and moderator (the perceived responsibility of the helper for the help recipient's behavior) of Weiner's attribution-emotion-action model. When participants considered a nonchild close other experiencing depression, higher perceived controllability was related to lower sympathy, which correlated with less willingness to provide support; however, among parents considering their child experiencing depression, perceived controllability was either positively associated with sympathy (study 1) or did not influence sympathy (study 2). Offering an explanation, studies 3a/3b indicated a significantly weaker relationship between controllability and responsibility attributions when the target of help was the participant's child. Study 4 investigated the underlying mechanism. Parents experienced self-blame when the cause was controllable, which lowered the association between controllability and responsibility attributions. Studies 5 and 6 revealed this pattern was not specific to the parent-child relationship but occurred whenever the potential helper felt responsible for the help recipient's behavior.

Stereotype-driven emotional responses and their impact on discriminatory intentions towards suicidal individuals

BACKGROUND

This research delves into the role of stereotypes and emotional prejudice in behavioral intentions, particularly towards individuals with suicidal tendencies. The study extends the cognitive-affective-behavioral process model, identifying pathways that negative stereotypes use to impact emotional responses and behavioral intentions.

METHODS

A cross-sectional online survey was conducted in South Korea, utilizing the largest Korean online panel (1,623,938 users) to recruit 552 eligible participants (49.1% male, 50.9% female) aged 20 and above with online access and no history of suicide attempts. The survey assessed negative stereotypes, prejudices, and behavioral intentions related to suicidal thoughts, employing specific measurements.

RESULTS

The findings established the correlation between negative stereotypes and both stigmatized emotional responses and discriminatory intentions. The study uniquely demonstrated that emotional responses act as a bridge between negative stereotypes and behavioral intentions towards suicidal individuals. These findings carry profound implications for health psychology, emphasizing the necessity of modifying attitudes to reduce suicide stigma. It was observed that stereotypical perceptions fuel negative emotions, which in turn provoke various behavioral intentions.

CONCLUSIONS

The study enhances our understanding of the influential role emotional reactions can have in shaping attitudes. It points towards the potential that addressing emotions holds in the stigma process, enabling people to shift their attitudes about stigmatized individuals, thus establishing intervention opportunities for stigma reduction in health psychology.