Effects of labeling and interpersonal contact upon attitudes towards schizophrenia: implications for reducing mental illness stigma in urban China

Abstract

Purpose As mental illness stigma contributes to poor outcomes for schizophrenia in China, locating strategies to reduce public stigma is imperative. It is currently unknown whether diagnostic labeling and contact with different help-seeking sources increase or decrease public stigma in China. Further, it remains unresolved whether prior personal contact acts to reduce stigma in this context. Advancing understanding of these processes may facilitate stigma-reduction strategies. Methods We administered an experimental vignette randomly assigning one of four labeling conditions to respondents to assess social distance towards a psychotic vignette individual in a sample of 160 Northern, urban Chinese community respondents. Results As expected, respondents given a “non-psychiatric, indigenous label” + “lay help-seeking” condition endorsed the least social distance. Unexpectedly, the labeling condition with a “psychiatric diagnostic label” + “lay help-seeking” condition elicited the greatest social distance. Unlike Western studies, personal contact did not independently decrease community stigma. However, prior contact reduced social distance to a greater extent in the labeling condition with a “non-psychiatric, indigenous label” + “lay help-seeking” condition when compared with all other labeling conditions. Conclusion The results indicate that cultural idioms do provide some protection from stigma, but only among respondents who are already familiar with what mental illness is. Our finding that the condition that depicted untreated psychosis elicited the greatest amount of stigma, while the “treated psychosis” condition was viewed relatively benignly in China, suggests that improved access to mental health services in urban China has the potential to decrease public stigma via labeling mechanisms.

Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India

“…That is, caregivers being more aware of the bio-medical illness model of schizophrenia did not protect them from experiencing stigma, and possibly had a negative effect on PLS’ experiences of discrimination (the nature and direction of the association remain unclear). These findings are supported by a growing body of research indicating that certain forms of knowledge, particularly information projecting a biomedical model of mental illness, may increase rather than decrease social distance from people with mental illness (Phelan et al., 2006, Schomerus et al., 2012, Yang et al., 2012). Overall, our findings suggest that ‘knowledge about schizophrenia’ interacts with the process of stigmatisation in complex ways.…”

Stigma related to labels and symptoms in individuals at clinical high-risk for psychosis

“…Future studies might also address culture-specific aspects of stigma (Yang et al, 2013; Yang et al, 2012) as this early identification is being adopted worldwide. Implementing procedures to avert stigma linked with the CHR status would ameliorate a major concern about its use to facilitate early identification worldwide.…”

Public Stigma Associated With Psychosis Risk Syndrome in a College Population: Implications for Peer Intervention

“…Dichotomized items belonging to a scale were summed and treated continuously (13). In no instance did this dichotomization affect the direction or significance of reported effects.…”