Examining differences in the stigma of depression and schizophrenia

Abstract

Background: Although there is evidence of greater stigmatization of schizophrenia in comparison to depression, there has been little investigation of the reasons for this difference.

Aims: To examine the role of beliefs about depression and schizophrenia in mediating the difference in preferred social distance towards individuals with these two disorders.

Methods: In Study I, 200 undergraduates completed questionnaires concerning beliefs about depression or schizophrenia and willingness to interact with an individual who has one of the two disorders. In Study II, 103 members of a community service club completed similar measures.

Results: For both samples, beliefs about likely appropriateness of social behaviour showed evidence of mediating differences in preferred level of social distance. In addition, differences in perceived danger may have been a mediator for the undergraduate sample and perceived prognosis for the service club respondents.

Conclusions: Beliefs about social appropriateness, danger and prognosis, which have implications for likely costs and benefits of interaction, are more likely to mediate differences in social distance towards the disorders than beliefs concerning causation or continuity with normal experience.

Keywords

schizophrenia depression stigmatization diagnosis stereotypes social distance

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References

Angermeyer

M.C.

Beck

Matschinger

(2003) Determinants of the Public’s Preference for Social Distance from People with Schizophrenia. Canadian Journal of Psychiatry 48, 663–668.

Angermeyer

M.C.

Matschinger

(1996) The Effect of Personal Experience with Mental Illness on the Attitude Towards Individuals Suffering from Mental Disorders. Social Psychiatry and Psychiatric Epidemiology 31, 321–326.

Angermeyer

M.C.

Matschinger

(2003) Public Beliefs about Schizophrenia and Depression: Similarities and Differences. Social Psychiatry and Psychiatric Epidemiology 38, 526–534.

Angermeyer

M.C.

Matschinger

(2004) The Stereotype of Schizophrenia and its Impact on Discrimination against People with Schizophrenia: Results from a Representative Survey in Germany. Schizophrenia Bulletin 30, 1049–1061.

Angermeyer

M.C.

Matschinger

(2005a) Causal Beliefs and Attitudes to People with Schizophrenia. Trend Analysis Based on Data from Two Population Surveys in Germany. British Journal of Psychiatry 186, 331–334.

Angermeyer

M.C.

Matschinger

(2005b) Labelling – Stereotype – Discrimination. An Investigation of the Stigma Process. Social Psychiatry and Psychiatric Epidemiology 40, 391–395.

Angermeyer

M.C.

Matschinger

Corrigan

P.W.

(2004) Familiarity with Mental Illness and Social Distance from People with Schizophrenia and Major Depression: Testing a Model Using Data from a Representative Population Survey. Schizophrenia Research 69, 175–182.

Angermeyer

M.C.

Schulze

(2001) Reducing the Stigma of Schizophrenia: Understanding the Process and Options for Interventions. Epidemiologia e Psichiatria Sociale 10, 1–5.

Austin

J.C.

Honer

W.G.

(2007) The Genomic Era and Serious Mental Illness: A Potential Application for Psychiatric Genetic Counselling. Psychiatric Services 58, 254–261.

10.

Baron

R.M.

Kenny

D.A.

(1986) The Moderator-Mediator Variable Distinction in Social Psychological Research: Conceptual, Strategic and Statistical Considerations. Journal of Personality and Social Psychology 51, 1173–1182.

11.

Baumann

A.E.

(2007) Stigmatization, Social Distance and Exclusion because of Mental Illness: The Individual with Mental Illness as a ‘Stranger’. International Review of Psychiatry 19, 131–135.

12.

Bogardus

E.S.

(1925) Social Distance and its Origins. Journal of Applied Sociology 9, 216–226.

13.

Corrigan

P.W.

(2000) Mental Health Stigma as Social Attribution: Implications for Research Methods and Attitude Change. Clinical Psychology: Science and Practice 7, 48–67.

14.

Corrigan

P.W.

(2002) Testing Social Cognitive Models of Mental Illness Stigma: The Prairie State Stigma Studies. Psychiatric Rehabilitation Skills 6, 232–254.

15.

Corrigan

P.W.

(2004) How Stigma Interferes with Mental Health Care. American Psychologist 59, 614–625.

16.

Corrigan

P.W.

(2005) On the Stigma of Mental Illness: Practical Strategies for Research and Social Change. Washington, DC: American Psychological Association.

17.

Corrigan

P.W.

Green

Lundin

Kubiak

M.A.

Penn

D.L.

(2001) Familiarity with and Social Distance from People who have Serious Mental Illness. Psychiatric Services 52, 953–958.

18.

Corrigan

P.W.

Rowan

Green

Lundin

River

Uphoff-Wasowski

White

Kubiak

M.A.

(2002) Challenging Two Mental Illness Stigmas: Personal Responsibility and Dangerousness. Schizophrenia Bulletin 28, 293–309.

19.

Crisp

A.H.

Gelder

M.G.

Rix

Meltzer

H.I.

Rowlands

O.J.

(2000) Stigmatisation of People with Mental Illnesses. British Journal of Psychiatry 177, 4–7.

20.

Crowne

D.P.

Marlowe

(1960) A New Scale of Social Desirability Independent of Psychopathology. Journal of Consulting Psychology 24, 349–354.

21.

Dain

(1994) Reflections on Antipsychiatry and Stigma in the History of American Psychiatry. Hospital and Community Psychiatry 45, 1010–1014.

22.

Dietrich

Beck

Bujantugs

Kenzine

Matschinger

Angermeyer

M.C.

(2004) The Relationship Between Public Causal Beliefs and Social Distance Toward Mentally Ill People. Australian and New Zealand Journal of Psychiatry 38, 348–354.

23.

Dietrich

Matschinger

Angermeyer

M.C.

(2006) The Relationship Between Biogenetic Causal Explanations and Social Distance Toward People with Mental Disorders: Results from a Population Survey in Germany. International Journal of Social Psychiatry 52, 166–174.

24.

Feldman

D.B.

Crandall

C.S.

(2007) Dimensions of Mental Illness Stigma: What About Mental Illness Causes Social Rejection? Journal of Social & Clinical Psychology 26, 137–154.

25.

Fleiss

J.L.

(1986) Reliability of Measurements. In Fleiss

J.L.

(ed.) The Design and Analysis of Clinical Experiments. New York, NY: John Wiley & Sons.

26.

Goerg

Fischer

Zbinden

Guimon

(2004) Differentiation in the Public Representations of Mental Disorders and Psychiatric Treatments. European Journal of Psychiatry 18, 225–234.

27.

Green

D.E.

McCormick

I.A.

Walkey

F.H.

Taylor

A.J.

(1987) Community Attitudes to Mental Illness in New Zealand Twenty Two Years On. Social Science & Medicine 24, 417–422.

28.

Griffiths

K.M.

Nakane

Christensen

Yoshioka

Jorm

A.F.

Nakane

(2006) Stigma in Response to Mental Disorders: A Comparison of Australia and Japan. BMC Psychiatry 6, 21. doi:10.1186/1471-244X-6-2110.1186/1471-244X-6-21.

29.

Haghighat

(2001) A Unitary Theory of Stigmatization: Pursuit of Self-Interest and Routes to Destigmatization. British Journal of Psychiatry 178, 207–215.

30.

Haghighat

(2005) The Development of an Instrument to Measure Stigmatization: Factor Analysis and Origin of Stigmatization. European Journal of Psychiatry 19, 144-154.

31.

Han

D.Y.

Chen

S.H.

Hwang

K.K.

Wei

H.L.

(2006) Effects of Psychoeducation for Depression on Help-Seeking Willingness: Biological Attribution versus Destigmatization. Psychiatry & Clinical Neurosciences 60, 662–668.

32.

Haslam

Ernst

(2002) Essentialist Beliefs about Mental Disorders. Journal of Social & Clinical Psychology 21, 628–644.

33.

Hayward

Bright

J.A.

(1997) Stigma and Mental Illness: A Review and Critique. Journal of Mental Health 6, 345–354.

34.

Hinshaw

S.P.

(2007) The Mark of Shame: Stigma of Mental Illness and an Agenda for Change. New York, NY: Oxford University Press.

35.

Hinshaw

S.P.

Stier

(2008) Stigma as Related to Mental Disorders. Annual Review of Clinical Psychology 4, 367–393.

36.

Hugo

C.J.

Boshoff

D.E.

Traut

Zungu-Dirwayi

Stein

D.J.

(2003) Community Attitudes Toward and Knowledge of Mental Illness in South Africa. Social Psychiatry and Psychiatric Epidemiology 38, 715–719.

37.

Jones

E.E.

Farina

Hastorf

A.H.

Markus

Miller

D.T.

Scott

R.A.

(1984) Social Stigma: The Psychology of Marked Relationships. New York, NY: Freeman.

38.

Jorm

A.F.

Christensen

Griffiths

K.M.

(2005) Public Beliefs about Causes and Risk Factors for Mental Disorders: Changes in Australia over Eight Years. Social Psychiatry and Psychiatric Epidemiology 40, 764–767.

39.

Jorm

A.F.

Korten

A.E.

Jacomb

P.A.

Christensen

Rodgers

Pollitt

(1997) Public Beliefs about Causes and Risk Factors for Depression and Schizophrenia. Social Psychiatry and Psychiatric Epidemiology 32, 143–148.

40.

Kingdon

(2009) What is Normal? In Turkington

Kingdon

Rathod

Wilkock

S.K.J.

Brabban

Cromarty

Dudley

Gray

Pelton

Siddle

Weiden

(eds.) Back to Life, Back to Normality: Cognitive Therapy, Recovery and Psychosis. New York, NY: Cambridge University Press.

41.

Kuppin

Carpiano

R.M.

(2006) Public Conceptions of Serious Mental Illness and Substance Abuse, their Causes and Treatments: Findings from the 1996 General Social Survey. American Journal of Public Health 96, 1766–1771.

42.

Kurzban

Leary

M.R.

(2001) Evolutionary Origins of Stigmatization: The Functions of Social Exclusion. Psychological Bulletin 127, 187–208.

43.

Lauber

Nordt

Falcato

Rossler

(2004) Factors Influencing Social Distance toward People with Mental Illness. Community Mental Health Journal 40, 265–274.

44.

Levey

Howells

(1995) Dangerousness, Unpredictability and the Fear of People with Schizophrenia. Journal of Forensic Psychiatry 6, 19–39.

45.

Levin

(2006) Schizophrenia Should be Renamed to Help Educate Patients and the Public. International Journal of Social Psychiatry 52, 324–331.

46.

Link

B.G.

Cullen

F.T.

(1986) Contact with the Mentally Ill and Perceptions of How Dangerous They Are. Journal of Health and Social Behavior 27, 289–302.

47.

Link

B.G.

Phelan

J.C.

(2001) Conceptualizing Stigma. Annual Review of Sociology 27, 363–385.

48.

Link

B.G.

Yang

L.H.

Phelan

J.C.

Collins

P.Y.

(2004) Measuring Mental Illness Stigma. Schizophrenia Bulletin 30, 511–541.

49.

MacKinnon

D.P.

Lockwood

C.M.

Hoffman

J.M.

West

S.G.

Sheets

(2002) A Comparison of Methods to Test Mediation and Other Intervening Variable Effects. Psychol Methods 7, 83–104.

50.

Mann

C.E.

Himelein

M.J.

(2004) Factors Associated with Stigmatization of Persons with Mental Illness. Psychiatric Services 55, 185–187.

51.

Marie

Miles

(2008) Social Distance and Perceived Dangerousness across Four Diagnostic Categories of Mental Disorder. Australian and New Zealand Journal of Psychiatry 42, 126–133.

52.

Mehta

Farina

(1997) Is Being ‘Sick’ Really Better? Effect of the Disease View of Mental Disorder on Stigma. Journal of Social & Clinical Psychology 16, 405–419.

53.

Neuberg

S.L.

Cottrell

C.A.

(2006) Evolutionary Basis of Prejudices. In Schaller

Simpson

J.A.

Kenrick

D.T.

(eds.) Evolution and Social Psychology. New York, NY: Psychology Press.

54.

Norman

R.M.

Sorrentino

R.M.

Windell

Manchanda

(2008a) The Role of Perceived Norms in the Stigmatization of Mental Illness. Social Psychiatry and Psychiatric Epidemiology 43, 851–859.

55.

Norman

R.M.

Sorrentino

R.M.

Windell

Manchanda

(2008b) Are Personal Values of Importance in the Stigmatization of the Mentally Ill? Canadian Journal of Psychiatry 53, 75–83.

56.

Perry

B.L.

Pescosolido

B.A.

Martin

J.K.

McLeod

J.D.

Jensen

P.S.

(2007) Comparison of Public Attributions, Attitudes and Stigma in Regard to Depression among Children and Adults. Psychiatric Services 58, 632–635.

57.

Pescosolido

B.A.

Monahan

Link

B.G.

Stueve

Kikuzawa

(1999) The Public’s View of the Competence, Dangerousness, and Need for Legal Coercion of Persons with Mental Health Problems. American Journal of Public Health 89, 1339–1345.

58.

Phelan

J.C.

Cruz-Rojas

Reiff

(2002) Genes and Stigma: The Connection between Perceived Genetic Etiology and Attitudes and Beliefs about Mental Illness. Psychiatric Rehabilitation Skills 6, 159–185.

59.

Phelan

J.C.

Link

B.G.

Stueve

Pescosolido

B.A.

(2000) Public Conceptions of Mental Illness in 1950 and 1996: What is Mental Illness and Is It to Be Feared? Journal of Health & Social Behavior 41, 188–208.

60.

Read

Law

(1999) The Relationship of Causal Beliefs and Contact with Users of Mental Health Services to Attitudes to the ‘Mentally Ill’. International Journal of Social Psychiatry 45, 216–229.

61.

Schomerus

Matschinger

Angermeyer

M.C.

(2006) Public Beliefs about the Causes of Mental Disorders Revisited. Psychiatry Research 144, 233–236.

62.

Thompson

A.H.

Stuart

Bland

R.C.

Arboleda-Florez

Warner

Dickson

R.A.

(2002) Attitudes about Schizophrenia from the Pilot Site of the WPA Worldwide Campaign Against the Stigma of Schizophrenia. Social Psychiatry and Psychiatric Epidemiology 37, 475–482.

63.

Thornicroft

(2006) Shunned: Discrimination Against People with Mental Illness. Oxford: Oxford University Press.

64.

US Public Health Service, Office of the Surgeon General, Center for Mental Health Services (US) and National Institute of Mental Health (US) (1999) Mental Health: A Report of the Surgeon General. Rockville, MD: Department of Health and Human Services.

65.

van’t Veer

J.T.

Kraan

H.F.

Drosseart

S.H.

Modde

J.M

. (2006) Determinants that Shape Public Attitudes towards the Mentally Ill: A Dutch Public Study. Social Psychiatry and Psychiatric Epidemiology 41, 310–317.

66.

Watson

A.C.

Corrigan

P.W.

(2005) Challenging Public Stigma: A Targeted Approach. In Corrigan

P.W.

(ed.) On the Stigma of Mental Illness: Practical Strategies for Research and Social Change. Washington, DC: American Psychological Association.

67.

Watson

A.C.

Miller

F.E.

Lyons

J.S.

(2005) Adolescent Attitudes toward Serious Mental Illness. Journal of Nervous and Mental Disease 193, 769–772.