Based on the structure of stigmatisation one could explore six levels of intervention in anti-stigmatisation campaigns: the cognitive level - educational intervention; the affective level - psychological intervention; the discrimination level - legislative intervention; the denial level - linguistic intervention; the economic origin - political intervention; the evolutionary origin - intellectual and cultural intervention. As destigmatisation has to challenge fundamental human tendencies, anti-stigmatisation campaigns have to be continuous, non-stop, open-ended projects aiming at keeping alive thought processes that moderate and humanise the pursuit of self-interest and the urge to survive in a competitive world.

Stigmatization of schizophrenia is widespread and its genetic explanation may potentially increase the stigma. The present study investigated whether seeing schizophrenia as a genetic or environmental disorder might influence perceived beliefs towards people with schizophrenia and whether social stigmatizing attitudes were differently perceived the 202 subjects who were recruited. Perceived social stigmatizing attitudes were compared among participants who read two vignettes depicting a person with schizophrenia. Then, the Standardized Stigmatization Questionnaire (SSQ) was administered. A genetic explanation of schizophrenia was more frequently associated with stigmatizing attitudes. Also, there were higher levels of perceived stigmatization in medical students and medical doctors than in other groups based on their social experience or background. However, the sample size was small and this was a non-experimental design; also the SSQ would benefit from more cross-validation. About half of the participants perceived stigmatizing social attitudes. Finally, considering schizophrenia as a genetic disorder influenced participants perception of other people's beliefs about dangerousness and unpredictability and people's desire for social distance.

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Assessment of stigmatization and understanding of its roots are gaining more importance as its effect on the prognosis of mental health is recognized. A search with Medline showed that there are instruments assessing stigmatization, most containing misconceptions, and regrettably none with adequate reliability and validity. To develop a reliable and valid instrument for research into stigmatization, and to define the structure of stigmatization by factor analysis of the results, about two thousand items from patients' own explanatory models, user groups' ideas, relatives' and social workers' accounts were scrutinized by the author and an independent observer. The items were simplified and rephrased so that they each contained a single idea expressed in clear language. Items were excluded on the grounds of redundancy, culture-boundness or representing factual knowledge rather than attitude. The draft of the instrument was field-tested, and rigorous assessments proved its reliability and validity. Factor analysis derived three factors indicating social, psychological and evolutionary foundations of stigmatization. The result is the Standardized Stigmatization Questionnaire, version 1 (SSQ1) which is now being used in several research centres in Europe. The Unitary Theory of Stigmatization resulting from this study has contributed to a new understanding of the meaning of stigmatization. reporting to assess the stigmatization of mental illness. These included the Custodial Mental Illness Ideology (CMI) Scale by Gilbert and Levinson (1956), Cumming & Cumming's stigmatization scale (1957), Opinion about Mental Illness (OMI) by Cohen & Struening (1962), Community Mental Health Ideology (CMHI) by Baker & Schulberg (1967), Community Attitudes to Mental Illness (CAMI) scale by Taylor & Dear (1981), and intercultural stigmatization questionnaire by Littlewood (1998). Two main issues were identified in these instruments: first, the lack of a social desirability scale or at least a recommendation to use it, and second, misconceptualizations of stigmatization following factor analysis which delayed understanding of the meaning of stigmatization (see below).

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