The Prejudice towards People with Mental Illness (PPMI) scale: structure and validity

Associations of continuum beliefs with personality disorder stigma: correlational and experimental evidence

PURPOSE

A pervasive and deeply entrenched stigma of personality disorders exists. For other mental disorders, a large body of research suggests that continuum beliefs (i.e., the endorsement of continuum perspectives on mental health and psychopathology) stimulate more favorable attitudes toward affected persons. Additionally, mental disorder classification systems increasingly incorporate continuous personality disorder models. Yet, it is unclear how continuum beliefs are related to personality disorder stigma. This study evaluated the link of continuum beliefs with personality disorder stigma based on correlational and experimental data.

METHODS

A large general population sample (N = 848) completed self-report measures of continuum beliefs regarding personality disorders, desired social distance, and prejudice toward persons with personality disorders. Additionally, participants were randomly presented with information supporting a continuous or a dichotomous view of personality disorders.

RESULTS

Continuum beliefs were associated with lower desired social distance (r = - 0.19) and prejudice (r = - 0.22). Additionally, the brief continuum intervention was associated with increased continuum beliefs (d = 0.99) and decreased desired social distance (d = - 0.14) and prejudice (d = - 0.17). Finally, the intervention effects on desired social distance and prejudice were mediated by continuum beliefs.

CONCLUSION

This study suggests that highlighting continuum views on personality disorders in public communication and interventions might reduce personality disorder stigma.

Decreasing Prejudicial Attitudes of Fear and Avoidance Toward Those Who Live with a Mental Illness-A Quasi-Experimental Controlled Study

The undergraduate mental health nursing course is an optimal time to address stigma and prejudice, while developing positive student attitudes toward those who live with mental health conditions. A quasi-experimental, pretest-posttest, nonequivalent-group study with a sample of undergraduate nursing students in New York City (N = 126) was conducted to determine the impact of an undergraduate mental health nursing course on attitudes toward people living with a general mental illness, depression, or schizophrenia. The intervention resulted in a significant reduction in total prejudice scores toward those with a general mental illness when compared to the control (p = 0.033, partial η2 = 0.062). The intervention had no significant impact on total prejudice scores regarding those with depression, or schizophrenia. Subscale analysis revealed the intervention significantly reduced attitudes of fear/avoidance regarding general mental illness (p = 0.040, partial η2 = 0.058) and schizophrenia (p < 0.001, partial η2 = 0.164). There was no impact on authoritarian or malevolent attitudes. Though some attitudes were not amenable to change, this study provides evidence that positive attitudes can be cultivated through undergraduate nursing education. Curricular reform is needed to reduce all facets of prejudice and best prepare future nurses to care for those with mental health conditions.

A Systematic Review of the Effect of Stigmatization on Psychiatric Illness Outcomes

A significant proportion of individuals with psychiatric disorders face dual challenges such as managing the symptoms and disabilities of their conditions and enduring stigma arising from misconceptions about mental illness. This stigma denies them quality-of-life opportunities, such as access to satisfactory healthcare services, better employment, safer housing, and social affiliations. This systematic review aims to evaluate the effect of stigmatization on psychiatric illness outcomes, particularly its influence on treatment adherence, treatment-seeking behavior, and care outcomes. We conducted a systematic review of 39 studies published between 2010 and 2024, focusing on the effects of stigmatization on psychiatric illness outcomes. The review utilized robust methodology following Cochrane guidance and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, including studies from 2010 to 2024 obtained from databases such as PubMed, Embase, Google Scholar, Web of Science, and SCOPUS. The quality of the included studies was assessed using the Appraisal Tool for Cross-Sectional Studies, with most studies rated as moderate to high quality. The findings indicate that stigma in psychiatric illness is closely associated with several factors, including illness duration (mean effect size = 0.42, p < 0.05), frequency of clinic visits (mean reduction = 2.3 visits/year), and diagnosis of psychotic disorders (OR = 1.78, 95% CI: 1.20-2.65). Stigma manifests through misinformation, prejudice, and discrimination, leading to significant barriers to accessing and adhering to psychiatric treatment, thereby worsening health outcomes. It leads to delays in accessing healthcare, poor adherence to medication and follow-up, and negative psychiatric health outcomes, including disempowerment, reduced self-efficacy, increased psychiatric symptoms, and decreased quality of life. Also, stigma extends to caregivers and healthcare professionals, complicating care delivery. This review highlights the need for effective interventions and strategies to address stigma, emphasizing the importance of educational interventions to mitigate the adverse effects of public stigma. Understanding the multifaceted nature of stigma is crucial for developing targeted approaches to improve psychiatric care outcomes and ensure better mental health services for individuals with mental illnesses.

Trial by YouTube: effects of expert psychiatric witness testimony on viewers' opinions of Amber Heard and Johnny Depp

AIMS AND METHOD

We aimed to assess whether viewing expert witness evidence regarding the mental health of Johnny Depp and Amber Heard in the 2022 court case in the USA would affect viewers' attitudes towards the mental health of the two protagonists and towards mental illness in general. After viewing excerpts of the cross-examination evidence, 38 trial-naive undergraduate students completed the Prejudice towards People with a Mental Illness (PPMI) scale.

RESULTS

Following viewing, participants held more stigmatising views of the protagonists than they held about mental disorders in general.

CLINICAL IMPLICATIONS

It is plausible that mass media trial coverage further stigmatises mental illness.

A Missed Opportunity to Cultivate Positive Attitudes about Mental Health Recovery among Undergraduate Nursing Students - A Quasi-Experimental Controlled Study

INTRODUCTION

Mental health recovery is a critical concept that needs to be thoroughly understood and supported by nurses. Undergraduate nurse educators have the opportunity to clarify misconceptions and cultivate positive recovery attitudes.

AIM

To assess the impact of an undergraduate nursing course on attitudes toward mental health recovery and the relationship between recovery attitudes and prejudice toward those who experience a mental illness.

METHODS

A quasi-experimental pretest-posttest, nonequivalent-control group study was conducted using a sample of undergraduate nursing students in New York City (N = 126). The intervention group was assigned to an undergraduate mental health nursing course and the control group to a pediatric/maternal health nursing course. Attitudes toward mental health recovery and prejudice were measured at the beginning and end of the semester. Two-way mixed analyses of variance were used to determine the differences in students' attitudes. Pearson product-moment correlation analyses were used to assess the relationship between prejudice toward people who experience a mental illness and attitudes toward recovery.

RESULTS

The mental health nursing course had no measurable impact on students' recovery attitudes. However, there was a moderate-to-strong inverse relationship between recovery attitudes and prejudice toward those who experience a general mental illness (r = -0.54), depression (r = -0.60), or schizophrenia (r = -0.43).

CONCLUSIONS

Curriculum reform is needed to optimize the impact of undergraduate education on students' attitudes. Possible changes include a more holistic approach to mental health that does not over accentuate the biomedical model, the use of nontraditional clinical sites that provide students an opportunity to interact with those further along in their recovery, and the inclusion of those in recovery in curriculum development. As there was a moderate-to-strong inverse relationship between recovery attitudes and prejudice, educational interventions that positively impact one may also impact the other. Further research is needed to investigate if the relationship is causal.

Acknowledging Stigma: Levels of Prejudice among Undergraduate Nursing Students toward People Living with a Mental Illness-A Quasi-Experimental Single-Group Study

INTRODUCTION

The undergraduate mental health nursing course may be an optimal time to cultivate students' positive attitudes toward people living with a mental illness.

AIM

To determine the impact of an undergraduate mental health nursing course on students' attitudes toward people living with a mental illness, depression, and schizophrenia.

METHOD

A quasi-experimental single-group pretest posttest study was conducted using a sample of undergraduate nursing students in New York City (N = 44). Self-reported measures of prejudice toward those living with a mental illness were collected at the beginning of a mental health nursing course and again at its conclusion.

RESULTS

A statistically significant decrease in prejudice scores was found concerning mental illness (p = .03, d = 0.23), depression (p = .01, d = 0.31), and schizophrenia (p = .013, d = 0.34). Subscale analysis revealed significant decreases in the fear/avoidance and unpredictability subscales. Yet no significant change was found in the subscales of authoritarianism and malevolence for any of the three conditions.

DISCUSSION

A mental health course led to a modest decrease in prejudice. However, certain facets of prejudice remain unchanged.

IMPLICATIONS FOR PRACTICE

Major curricular reform is needed to optimize the impact of undergraduate nursing education.

Prejudice toward people with borderline personality disorder: Application of the prejudice toward people with mental illness framework

BACKGROUND

People living with borderline personality disorder (BPD) face high levels of prejudice and discrimination from both the community and medical professionals, but no measure of prejudice toward people living with BPD exists.

AIMS

The current study aimed to adapt an existing Prejudice toward People with Mental Illness (PPMI) scale and investigate the structure and nomological network of prejudice toward people with BPD.

METHODS

The original 28-item PPMI scale was adapted to create the Prejudice toward People with Borderline Personality Disorder (PPBPD) scale. The scale and related measures were completed by three samples: 217 medical or clinical psychology students, 303 psychology undergraduate students, and 314 adults from the general population.

RESULTS

The original four-factor structure of the PPMI was supported in the PPBPD scale. Reported prejudice toward people with BPD was more negative than prejudice toward people with mental illness in general. The association of the PPBPD scale with antecedents and consequences was assessed, including social dominance orientation, right-wing authoritarianism, ethnocentrism, personality traits, empathy, prior contact, and feelings toward other stigmatized groups and mental illnesses.

CONCLUSIONS

This study provided evidence for the validity and psychometric properties of the PPBPD scale across three samples and investigated anticipated relationships with theoretically related antecedents and consequences. This research will help improve understanding of the expressions underlying prejudice toward people with BPD.

How to measure mental illness stigma at work: development and validation of the workplace mental illness stigma scale

Introduction

The study objective was to design a new theoretically driven multidimensional scale for the use in the empirical measurement of stigmatizing attitudes towards persons with mental illness within the return-to-work process as this integral part of vocational reintegration has been widely neglected by scholars so far.

Methods

Therefore, we developed and validated a 21-item instrument to comprehensively measure the three-factorial structure of stigmatizing attitudes (affect, cognition, behavior) across two studies (overall N = 251).

Results

In both studies the new scale proved to be highly internally consistent, and its proposed three-factor structure was equally supported across the two studies. Convergent and discriminant validity were demonstrated by moderate and high correlations or zero correlations with pertinent measures. Furthermore, construct validity of the new scale was supported by significant positive associations with relevant personality characteristics within stigma research.

Discussion

The WMISS is the first instrument to measure mental health stigma specifically within the return-to-work-process and demonstrates strong psychometric properties. Inclusion of this scale in future research can help facilitate understanding of mental illness stigma within the occupational sector and assist with targeted intervention development.

Dimensionality and risk factors of the personal stigma of depression in adults aged 50 years and older at risk of depression

Objectives: Knowledge about the mechanism of the personal stigma of depression may inform strategies to reduce stigma and promote help-seeking. We examined the dimensionality and risk factors of the personal stigma of depression in older adults at risk of depression.Methods: Seven-hundred and one Hong Kong adults aged 50 years and older at risk of depression completed the personal stigma subscale of the depression Stigma Scale (DSS-personal) at two-time points. We used exploratory factor analysis (EFA) to explore the factor structure of DSS personal and confirmatory factor analysis to examine the model fit of the EFA-informed factor structure and structures proposed in previous studies. Regression analyses examined the relationships between risk factors and personal stigma dimensions.Results: Factor analyses identified a 3-factor structure of DSS-personal resembling the social-cognitive model consistent over time and included stereotype, prejudice, and discrimination (CFI = 0.95, TLI = 0.92, RMSEA = 0.05). Regression analyses indicated all stigma dimensions were associated with older age, less education, and no personal history of depression (B = -0.44 to 0.06); discrimination was also associated with more depressive symptoms (B = 0.10 to 0.12).Conclusion: Findings illustrated the potential theoretical underpinning of DSS-personal. Stigma reduction interventions could target and tailor to older adults with risk factors to enhance effectiveness and promote help-seeking.

Depression literacy and misconceptions scale (DepSter): a new two-factorial tool for measuring beliefs about depression

BACKGROUND

Depression literacy has received extensive attention within mental health research. It has been studied by different social groups and professions in Western and non-Western cultures. The importance of this topic stems from the fact that depression literacy is strongly related to attitudes toward people who are diagnosed with depression, the tendency to stigmatize this mental disorder, and to the propensity to undertake help-seeking behaviors. Therefore, understanding and promoting depression literacy is crucial in contemporary mental health prevention and promotion. We propose a new two-factorial tool measuring beliefs about depression. This 14-item self-report measure captures how people vary across two dimensions of beliefs about depression-depression literacy and misconceptions about depression.

METHODS

In ten studies with a total sample of over 4,600 participants from three countries, we demonstrated the two-factorial structure of the Depression Literacy and Misconceptions Scale (DepSter) in Polish (Studies 1 and 2), American (Study 4), and British (Study 5) samples. We showed measurement equivalence for the Polish and English versions of the scale (Study 3). Furthermore, we tested the discriminant meaning of the two dimensions of beliefs about depression analyzing its association with health literacy, mental health literacy, and prejudice toward people with mental illness (Study 4), depression literacy and depression stigma (Study 5), empathetic concerns (Study 7), social dominance orientation (Study 8), and the Big Five personality traits (Study 9). We also investigated whether individuals with formal education in psychology and direct or indirect experience with depression demonstrate a higher level of depression literacy and a lower level of misconceptions about depression (Study 6). Our measure showed high stability for two dimensions of beliefs about depression (Study 10), in both its Polish and English versions, with the measurement conducted after three weeks and three months.

DISCUSSION

We conclude that the proposed approach to beliefs about depression capturing both depression literacy and misconceptions about depression measured with the DepSter scale can easily be applied in clinical and social settings, especially in studies concerning the perception of those diagnosed with depression.

Comparing Social Stigma of Dissociative Identity Disorder, Schizophrenia, and Depressive Disorders

The aim of the current study was to explore how the social stigmatization of dissociative identity disorder (DID) compared to that of schizophrenia and depressive disorders. Using a between-subjects experimental design, a total of 139 participants (126 usable data [39 men, 84 women, 3 other]) from the general population were randomly assigned to either a DID, schizophrenia, or depressive disorders experimental condition and responded to an adapted version of the Prejudice Toward People With Mental Illness (PPMI) Scale. Results suggested that, overall, depressive disorders were stigmatized against the least, schizophrenia was stigmatized against the most, and DID was intermediate, with its PPMI score being closer to schizophrenia than that of depressive disorders. We also found the same pattern for most of the subscales of the PPMI. At least relative to other well-known disorders, there is negative stigma associated with having DID.

The Impact of Linguistic Form of Labels on Desire for Social Distance in Mental Health

The American Psychological Association, among other influential bodies, make recommendations on language for describing people with mental health conditions. The present studies test the impact of the recommended language on stigma. In Study 1, participants (n = 294) were asked to complete measures of desire for social distance from individuals given a diagnostic label in either person-first possessive, identity-first noun, or identity-first adjective forms. Familiarity with the diagnoses was considered as a potential influence on the outcome. The 3*2 (linguistic form * experience) factorial design was repeated for three diagnoses - schizophrenia, anorexia and alcoholism. In Study 2, the research was replicated with a sample recruited from the UK population via social media (n = 230). Factorial ANOVA was used for analysis. In contrast with previous literature, the studies found neither an effect of linguistic form (hypothesis 1) nor an interaction effect with familiarity (hypothesis 2). Research on this topic is in an early stage and, above all, it remains important to use language, which shows respect when talking to or about others.

Prejudice towards people with mental illness, schizophrenia, and depression among mental health professionals and the general population

The aim of the study was to measure and compare prejudice towards people with specific mental illnesses between mental health professionals and the general population, and examine personality, ideological, and attitudinal antecedents of prejudice. To do so, we also aimed to validate three shortened scales of prejudice. A sample of mental health professionals (N = 299) and a sample from the general population (N = 427) completed shortened versions of the Prejudice towards People with Mental Illness, Prejudice towards People with Schizophrenia, and Prejudice towards People with Depression scales. They also completed measures of validity criteria and demographics. The scales demonstrated construct validity in both samples. Although prejudice was highest towards people with schizophrenia and lowest towards people with depression, mental health professionals demonstrated significantly less prejudice overall than the general population. Prejudice was associated with higher social dominance orientation, right wing authoritarianism, ethnocentrism, conservatism, and generalized prejudice, and lower agreeableness, openness to experience, and contact. These antecedents of prejudice were better predictors than any demographic or profession-related variables examined. This study contributes increased knowledge of the structure and correlates of prejudice towards people with mental disorders. This knowledge should inform more nuanced and effective interventions, therapy, and training.

Why So Serious? An Attempt to Mitigate the Short-Term Harmful Effects of the Film Joker on Prejudice toward People with Mental Illness

The media perpetuates many harmful stereotypes about people with mental illness. In two studies, we demonstrate the impact of negative media portrayals of mental illness on prejudice and attempt to mitigate these negative effects. Specifically, in Study 1, participants watched the movie Joker, a recent film which associates mental illness with violent behavior, or a control film (Terminator). Participants completed the Prejudice towards People with Mental Illness (PPMI) scale before and after viewing their respective films. The PPMI consists of four dimensions: fear/avoidance (i.e., wanting to avoid people with mental illness), malevolence (i.e., viewing people with mental illness as inferior), authoritarianism (i.e., preference for control over people with mental illness), and unpredictability (i.e., the behavior of people with mental illness is unreliable). We hypothesized that participants who watched the film Joker would display an increase in their fear/avoidance of people with mental illness and their support for authoritarian approaches to their treatment. Consistent with these hypotheses, participants who viewed Joker displayed a significant increase in the fear/avoidance and authoritarian subscales of the PPMI, relative to participants that watched Terminator. In Study 2, in an attempt to mitigate the impact of Joker on prejudice towards people with mental illness, directly after the film we displayed educational and counter-stereotypical statements on-screen that challenged the view that people with mental illness are violent. A control group viewed Joker without these statements. Identical to Study 1, all participants completed the PPMI scale before and after viewing the film. We hypothesized that participants who viewed Joker with the statements would display lower prejudice relative to the control condition. Unfortunately, participants in the experimental and control conditions displayed a comparable increase in prejudice. Together, these studies confirm the negative effect of media portrayals of mental illness (as depicted in Joker) and demonstrate that these effects are not easily mitigated.

Parasocial relationships on YouTube reduce prejudice towards mental health issues

Intergroup contact has long been established as a way to reduce prejudice among society, but in-person interventions can be resource intensive and limited in reach. Parasocial relationships (PSRs) might navigate these problems by reaching large audiences with minimal resources and have been shown to help reduce prejudice in an extended version of contact theory. However, previous studies have shown inconsistent success. We assessed whether parasocial interventions reduce prejudice towards people with mental health issues by first creating a new PSR with a YouTube creator disclosing their experiences with borderline personality disorder. Our intervention successfully reduced explicit prejudice and intergroup anxiety. We corroborated these effects through causal analyses, where lower prejudice levels were mediated by the strength of parasocial bond. Preliminary findings suggest that this lower prejudice is sustained over time. Our results support the parasocial contact hypothesis and provide an organic method to passively reduce prejudice on a large scale.

Public attitudes towards protecting the human rights of people with mental illness: a scoping review and data from a population trend study in Germany

The human rights of people with mental illness are constantly threatened. We conduct a scoping review showing how public attitudes towards protecting human rights have so far been examined and providing an overview of our present knowledge of these attitudes, and present novel findings from a trend study in Germany over nine years, reporting attitudes elicited in 2020 and examining whether these attitudes have changed since 2011. Few studies address attitudes towards human rights explicitly, but several studies contain single items on either first generation human rights, mainly concerning involuntary admission, or civil liberties like the right to vote, or second generation human rights, mainly with regard to funding for healthcare, but also for example regarding career choice. Recent data from Germany showed little improvement in attitudes towards protecting human rights over the last decade and particularly high support for restricting job opportunities for people with mental illness. Although generally, most restrictions were supported by a minority of respondents only, both our data and our scoping review indicate substantial support for several restrictions in several countries, showing that public attitudes pose a challenge to the human rights of persons with mental illness. We discuss possible lines of future research.

Validation of UK Biobank data for mental health outcomes: A pilot study using secondary care electronic health records

UK Biobank (UKB) is widely employed to investigate mental health disorders and related exposures; however, its applicability and relevance in a clinical setting and the assumptions required have not been sufficiently and systematically investigated. Here, we present the first validation study using secondary care mental health data with linkage to UKB from Oxford - Clinical Record Interactive Search (CRIS) focusing on comparison of demographic information, diagnostic outcome, medication record and cognitive test results, with missing data and the implied bias from both resources depicted. We applied a natural language processing model to extract information embedded in unstructured text from clinical notes and attachments. Using a contingency table we compared the demographic information recorded in UKB and CRIS. We calculated the positive predictive value (PPV, proportion of true positives cases detected) for mental health diagnosis and relevant medication. Amongst the cohort of 854 subjects, PPVs for any mental health diagnosis for dementia, depression, bipolar disorder and schizophrenia were 41.6%, and were 59.5%, 12.5%, 50.0% and 52.6%, respectively. Self-reported medication records in UKB had general PPV of 47.0%, with the prevalence of frequently prescribed medicines to each typical mental health disorder considerably different from the information provided by CRIS. UKB is highly multimodal, but with limited follow-up records, whereas CRIS offers a longitudinal high-resolution clinical picture with more than ten years of observations. The linkage of both datasets will reduce the self-report bias and synergistically augment diverse modalities into a unified resource to facilitate more robust research in mental health.

Prejudice Toward People With Mental Illness, Schizophrenia, and Depression: Measurement, Structure, and Antecedents

Objectives

Many existing measures of prejudiced attitudes toward people with mental illness have conceptual, theoretical, and psychometric problems. The recently created Prejudice toward People with Mental Illness (PPMI) scale has addressed many of these limitations, but prejudice toward people with different mental disorders may be unique and require further exploration. This study aimed to facilitate this exploration by adapting the PPMI to focus on schizophrenia and depression, and investigate the structure, distinctiveness, and the nomological network of prejudice toward people with these mental disorders.

Study Design

We adapted the original 28-item PPMI scale to create the Prejudice toward People with Schizophrenia (PPS) and Prejudice toward People with Depression (PPD) scales. There were 406 participants from the general population, who completed these scales and related measures.

Study Results

The original 4-factor structure (fear/avoidance, unpredictability, authoritarianism, and malevolence) was supported for each scale. Participants expressed the highest levels of prejudice toward people with schizophrenia, followed by prejudice toward people with mental illness, and lastly by prejudice toward people with depression. Analyses supported the proposed nomological network of prejudice, which involves theoretical antecedents of social dominance orientation, right-wing authoritarianism, empathy, personality traits, disgust sensitivity, and prior contact.

Conclusions

This research provides evidence for the validity and psychometric properties of the PPMI, PPS, and PPD scales, expanding our understanding of antecedents to prejudice toward people with different mental disorders. This research also shows that we gain more insight into prejudice when we use measures targeting specific disorders rather than mental illness in general.

Development and validity of the Value-based Stigma Inventory (VASI): a value-sensitive questionnaire for the assessment of mental health stigma

BACKGROUND

It has been hypothesized that mental illness stigma differs according to what matters most to people, and that this results in value-based differences in stigma within societies. However, there is a lack of stigma measures that account for a broad range of values, including modern and liberal values.

METHODS

For the development of the Value-based Stigma Inventory (VASI) a preliminary item-pool of 68 VASI-items was assembled by mental health and stigma experts. For psychometric evaluation, we tested the VASI in an online sample of the general population (n = 4983).

RESULTS

Based on item-characteristics as well as explorative and confirmatory factor analyses, a final version of the VASI was developed, comprising 15 items and 5 subscales. The VASI shows good psychometric properties (item difficulty = 0.34 to 0.67; mean inter-item correlation r = 0.326; Cronbach's α = 0.879). Medium to high correlations with established stigma scales (SDS, SSMI), medium associations with instruments assessing personal values (PVQ, KSA-3) and small to no associations with a social desirability scale (KSE-G) attest to good convergent and discriminatory validity of the new instrument. Normative values for the VASI subscales are presented.

CONCLUSIONS

The developed VASI can be used to assess public stigma of mental illness including personal stigma-relevant value orientations.

[Psychometric Evaluation of a Long and Short German Version of the Prejudice Towards People with Mental Illness Scale (PPMI-D)]

OBJECTIVE

We present a German version of the Prejudice towards People with Mental Illness Scale in long (PPMI-D_L) and short form (PPMI-D_K) and provide a psychometric evaluation in a German population sample.

METHODS

After German translation (including back-translation), an online survey (N = 1004) was conducted.

RESULTS

Item difficulty and selectivity are in the desirable medium range. Internal consistencies are high to excellent (PPMI-D_L: α = 0.919; PPMI-D_K: α = 0.872) in the overall scale. Confirmatory factor analyses confirm the 4 subscales of the original scale. Medium correlations are found with authoritarian attitudes (KSA-3) and low negative correlations with social desirability (KSE-G). Norm values for the PPMI subscales are reported.

CONCLUSION

The PPMI-D can be used in German-speaking countries to survey prejudice towards people with mental illness.

Self-Stigma Is Associated with Depression and Anxiety in a Collectivistic Context: The Adaptive Cultural Function of Self-Criticism

Literature on the cultural psychological aspect of mental health suggests that antecedents of mental health in individualistic cultures, or societies that prioritize independence, autonomy, and personal uniqueness do not always apply in collectivistic cultures, or societies that prioritize interdependence, social connection, interpersonal harmony, and norms. The aim of the present study was to determine the mechanisms underlying the impact of self-stigma on depression and anxiety in a collectivistic culture such as the Philippines. Specifically, this study sought to examine: (1) the mediating role of self-criticism on the impact of self-stigma on depression and anxiety, and (2) the moderating role of interdependent self-construal on the impact of self-criticism on depression and anxiety in Filipinos. Surveys measuring self-stigma, self-criticism, interdependent self-construal, depression, and anxiety symptoms were administered to 312 adolescents in rural communities in the Philippines. Using structural equation modeling, findings revealed indirect effects of self-stigma on both depression and anxiety via self-criticism. Findings confirmed that interdependent self-construal attenuate the detrimental impact of self-criticism on depression and anxiety in collectivistic contexts. This study offers novel insights about the underlying mechanisms that operate in the impact of self-stigma on depression and anxiety symptoms among individuals in collectivist contexts. We highlight that self-criticism may have both adaptive and maladaptive functions in collectivist cultures. The study provides implications on the importance of culturally sensitive clinical interventions in preventing depression and anxiety by combating self-stigma and the negative aspect of self-criticism in collectivist cultures. Limitations and future directions are discussed.

Psychometric Properties of the Chinese Version of Short-Form Community Attitudes Toward Mentally Illness Scale in Medical Students and Primary Healthcare Workers

OBJECTIVE

To assess the psychometric properties of the short form Community Attitudes toward Mentally Illness (SF-CAMI) scale among medical students and primary healthcare workers in China.

METHODS

Original English version CAMI was translated following a standard procedure. and then short-form CAMI developed through the multistage procedure. The psychometric properties were tested among two separate samples which contained 1,092 primary healthcare workers and 1,228 medical students. Reliability was assessed by internal consistency reliability and test-retest reliability. Exploratory factor and confirmatory factor analyses were performed to determine the structure and to assess the validity of the scale.

RESULTS

The Chinese version of SF-CAMI consists of 20 items and with three subscales: Benevolence, Fear and Exclusion, and Support and Tolerance. The confirmatory factor analysis indicated good fitting models for medical students and primary healthcare workers. The Cronbach α of total scale for both samples was good (0.82 for medical students and 0.85 for primary healthcare workers), and acceptable test-retest reliability was found (intraclass correlation coefficient is 0.62 for medical students and 0.60 for primary healthcare workers).

CONCLUSION

The Chinese version of SF-CAMI performed good reliability and validity among both primary healthcare workers and medical students, provide more feasible and available tools for assessing the effect of mental health service programs in China.

Association of Viewing the Films Joker or Terminator: Dark Fate With Prejudice Toward Individuals With Mental Illness

This survey study assesses the association of viewing the film Joker with level of prejudice toward individuals with mental illness.

There Is a Limit to Your Openness: Mental Illness Stigma Mediates Effects of Individual Traits on Preference for Psychiatry Specialty

Objective: The widening gap between the need for mental health professionals and the low percentages of medical students pursuing a psychiatric career urges an examination of how individual traits, stigma attitudes, and related intended behaviors interact to better explain the variance in preferences for psychiatry as a specialty choice. Methods: Participants were second-year, preclinical medical students at Bologna University, Italy. The study consisted in completion of an online questionnaire evaluating preferences for the psychiatry specialty (one single item and a scenario-based response), personality traits (the Big Five Questionnaire), attitudes (Mental Illness for Clinicians' Attitude scale), behaviors (Reported and Intended Behavior Scale), and fears toward mental illness (questionnaire created ad hoc). Sociodemographic data were also collected. Results: A total of 284 medical students [58.8% female, mean (SD) age 20.47 ± 1.90] completed the questionnaire. Preference for the psychiatry specialty was significantly and positively associated with openness to experience and negatively related with Mental Illness for Clinicians' Attitude scale and Reported and Intended Behavior Scale. The full-mediation model provided good indices explaining 18% of the variance. Mental illness stigma was strongly and negatively associated with both openness to experience and preference for psychiatry, and the mediation results evidenced a positive and significant effect. Conclusions: Mental illness stigma influences medical students' choice of psychiatry as a specialty, accounting for the effects of the openness to experience trait. Stigma awareness and reduction programs should be introduced as early as possible in medical education.

Translating experimental paradigms into individual-differences research: Contributions, challenges, and practical recommendations

Psychological science has long been cleaved by a fundamental divide between researchers who experimentally manipulate variables and those who measure existing individual-differences. Increasingly, however, researchers are appreciating the value of integrating these approaches. Here, we used visual attention research as a case-in-point for how this gap can be bridged. Traditionally, researchers have predominately adopted experimental approaches to investigating visual attention. Increasingly, however, researchers are integrating individual-differences approaches with experimental approaches to answer novel and innovative research questions. However, individual differences research challenges some of the core assumptions and practices of experimental research. The purpose of this review, therefore, is to provide a timely summary and discussion of the key issues. While these are contextualised in the field of visual attention, the discussion of these issues has implications for psychological research more broadly. In doing so, we provide eight practical recommendations for proposed solutions and novel avenues for research moving forward.