Continuum Beliefs and Schizophrenia Stigma: Correlational and Experimental Evidence

Recent correlational research has indicated that belief in a continuum of psychiatric problems is related to decreased psychiatric stigma. These findings have generated enthusiasm to conceive antistigma programming centered on encouraging embrace of continuum beliefs. However, the extant correlational literature does little to support the prospects of manipulation of continuum beliefs. Moreover, several factors converge to suggest that an experimental manipulation of continuum beliefs cannot easily be achieved. Volunteers in an online study read a detailed description of a young man with schizophrenia and were then randomized to read either (a) a summary of research attesting to a continuum view of schizophrenia, (b) a summary of research attesting to a categorical view of schizophrenia, or (c) no additional material. Respondents also completed self-report measures of the strength of their endorsement of continuum and categorical views of schizophrenia. Consistent with published correlational findings, greater endorsement of the continuum view was related to less desire for social distance, lesser endorsement of the unpredictability stereotype, and marginally less fear. On the other hand, there was no evidence that experimental manipulation of continuum beliefs affected stigma. The current findings are discussed in the context of other recent continuum-based antistigma interventions. Additional work is needed to more fully evaluate the prospects of such an approach

Continuum Belief, Categorical Belief, and Depression Stigma: Correlational Evidence and Outcomes of an Online Intervention

Continuum belief interventions that erode boundaries between “normal” individuals and individuals with psychiatric problems may help to reduce psychiatric stigma, but a number of questions persist. The magnitude of belief change attributable to the intervention is unclear. Moreover, most studies have executed continuum interventions to reduce stigma of schizophrenia, and all studies have examined intervention effects on only public stigma. This study utilized a large sample (n = 654) to examine effects of a continuum intervention on depression stigma—public stigma in the full sample and self-stigma among participants with a self-reported history of depression. Participants were randomly assigned to one of three intervention groups: (a) the control group, which read material that merely described depression, (b) the continuum group, which read material that attested to a continuum view of depression, or (c) the categorical group, which read material that attested to a categorical view of depression. Correlational analyses demonstrated that preintervention categorical belief positively predicted, and preintervention continuum belief negatively predicted, depression stigma. Moreover, preintervention categorical belief positively predicted, and preintervention continuum belief negatively predicted, self-stigma among participants with a self-reported history of depression. There was scant evidence that the intervention affected public stigma among participants without a history of depression and no evidence that it affected self-stigma among participants with a history of depression. These findings illuminate a number of key priorities for future research on continuum belief intervention and its prospects for stigma reduction

Keep your distance: People sit farther away from a man with schizophrenia versus diabetes

Although concrete behavior—such as avoidance, discrimination, rejection—is foundational to most definitions of stigma, knowledge of psychiatric stigma has been constructed mostly on the basis of measurement of self-reported attitudes, beliefs, and feelings. To help fill this gap, the current study examined avoidance behavior in psychiatric stigma. That is, we predicted that people would seek more physical distance from a man with a psychiatric problem than a man with a medical problem. One hundred fourteen undergraduates expected to meet a man with either Type II diabetes or schizophrenia. After completing several measures of self-reported stigma, participants eventually moved to an adjacent room and sat in one of several seats that systematically varied in their proximity to a seat ostensibly occupied by the target man. Results indicated that the expectation of meeting a man with schizophrenia, compared with diabetes, led to greater desired social distance, greater self-reported fear, and higher appraisals of the man’s dangerousness and unpredictability. More importantly, participants elected to sit farther away from the ostensible man with schizophrenia. This pattern of findings offers behavioral evidence of the psychiatric stigma phenomenon that has mostly been documented via measurement of self-reported attitudes and impressions. We hope that these results stimulate renewed interest in measuring stigma-relevant behavior in the laboratory setting. (PsycINFO Database Record (c) 2018 APA, all rights reserved

On continuum beliefs and psychiatric stigma: Similarity to a person with schizophrenia can feel too close for comfort

Continuum belief interventions that blur boundaries between “normal” individuals and individuals with psychiatric problems have shown promise in reducing psychiatric stigma. Interventions to date have afforded participants considerable psychological distance from individuals with mental illness. An intervention that compels psychological closeness to individuals with mental illness may lead to increased anxiety/threat and an attenuated intervention effect on stigma. In a randomized experiment, one hundred thirty-five participants listened to a bogus interview involving an ostensible person with schizophrenia who shared numerous characteristics in common with participants. In the interview, the target person (1) did not verbally broach issues of similarity to “normal” people, (2) endorsed a continuum view, or (3) endorsed a categorical view. Participants then read a bogus research article on schizophrenia that (1) was agnostic with respect to the continuum/categorical distinction, (2) attested to a continuum view, or (3) attested to a categorical view. Correlational analyses demonstrated that greater endorsement of continuum beliefs predicted less stigma. Experimental analyses demonstrated that the continuum intervention had no effect on stigma. The continuum intervention increased participants’ feelings of anxiety/threat, measured via self-report and a lexical decision task. These findings might usefully inform the design of stigma reduction programming centered on continuum beliefs

Does the Approach/Avoidance Task Correlate with Other Measures of Approach/Avoidance Processes?

The Approach/Avoidance Task (AAT; Rinck & Becker, 2007) assesses approach and avoidance motivational processes by requiring participants to respond to pictures by either pulling a joystick handle toward them or pushing it away. The amount of time required to execute these actions is the dependent variable. The rationale is that appetitive images should facilitate pull (i.e., approach) responses, whereas unpleasant images should facilitate push (e.g., avoid) responses. A small research literature attests to the AAT’s validity in measuring approach/avoidance motivational processes (e.g., Wiers et al., 2010, 2011). Nevertheless, we deemed it important to empirically explore the extent to which the AAT is related to other implicit and explicit measures of responses to emotionally evocative, motivationally relevant stimuli. In this study, undergraduates completed an (a) AAT designed to measure approach/avoidance biases in relation to pictures of snakes or spiders, (b) an Implicit Association Test (IAT) designed to measure automatic evaluations of snakes or spiders, and (c) several self-report items designed to tap the cognitive, affective, and motivational elements of snake or spider fear. We expected that links between the AAT and these other measures would be modest, a pattern that would imply that the AAT taps affective/motivational processes that are separable from the psychological processes that lie at the heart of these other assessment tools. METHOD Forty-two undergraduates participated in the study for $10. The AAT presented participants with 30 pictures in each of four categories (images of food or babies, general threat-related scenes, neutral objects, and snakes or spiders). Half the pictures in each category were presented in landscape orientation; the other half were presented in portrait orientation. Upon picture onset, half of the participants were instructed to pull the joystick handle toward them in response to pictures presented in landscape and push the joystick handle away from them in response to pictures presented in portrait. The other half of the participants were given the opposite instruction. We followed standard procedures for the analysis of AAT data (Rinck & Becker, 2007). Our IAT measured the strength of associative links between snakes/spiders or butterflies and the concepts “approach” or “avoid.” We followed standard procedures for the analysis of IAT data (Greenwald et al., 2003). Self-report items (7-point scale) were as follows: “If you encountered a snake/spider on the way home...” How would you feel? (affective) How long would it be before you could think about or focus on anything else? (cognitive) How strongly would you try to avoid it? (motivational). RESULTS AND DISCUSSION Correlational analyses demonstrated, as predicted, that the AAT showed modest or near-zero links with the other explicit and implicit measures utilized here (IAT, r = -.02; affective self-report, r = -.06; cognitive self-report, r = .29, p = .07; motivational self-report, r = .13, p = .43). These results suggest that the AAT, compared to the other measures used here, taps separable approach/avoidance motivational processes. Additional research might more rigorously evaluate this possibility by determining the unique contributions of these measures to the prediction of motivationally relevant behavior

Does Celebrity “Case Material” Worsen Attitudes Surrounding Mental Illness?

Case study in college courses that bear on psychopathology boasts numerous merits. However, one approach to case study—diagnose a celebrity—may worsen attitudes surrounding mental illness. Celebrity case material may incline students to think that psychological problems are trivial or amusing, to believe that mental health professionals are not sober practitioners in serious fields of study, or to desire greater social distance from individuals with psychological problems. In this study, I evaluated the effect of consumption of celebrity case material on attitudes surrounding mental illness. Two-hundred sixty participants were randomly assigned to 1 of 3 groups in an online experiment: (a) the control group, which did not read any case material; (b) the celebrity group, which read an article from an Internet gossip website about the psychological struggles of a young actress; or (c) the standard case group, which read a bogus psychological evaluation that mirrored the celebrity gossip article but that stripped all entertainment-related elements. Self-report scales capturing attitudes surrounding mental illness were administered. Results did not support the prediction that celebrity case material would worsen attitudes surrounding mental illness. Unexpectedly, the standard case material led to significantly greater desired social distance from people with psychological problems. Insofar as the standard case material compelled participants to see the young woman depicted in the case through a psychiatric lens, these findings could be attributable to the pervasive tendency to devalue individuals who possess psychiatric labels. These results suggest that stigma-related concerns should be featured more prominently in psychopathology coursework

Do continuum beliefs reduce schizophrenia stigma? Effects of a laboratory intervention on behavioral and self-reported stigma

Background and objectives Correlational research shows that belief in a continuum of psychiatric problems predicts decreased public stigma. However, the correlational findings fail to inform the stigma reduction prospects of manipulating continuum beliefs. All extant experimental work has been executed online. This study examined effects of a laboratory-based continuum intervention on behavioral and self-report measures of psychiatric stigma. Methods Sixty-nine undergraduates believed that they would meet a man with schizophrenia. They then read a bogus scientific article that attested to a categorical view of schizophrenia, a continuum view, or that merely described schizophrenia. Some participants then completed a task that required reflection on their differences from (categorical group) or similarities to (continuum group) the man with schizophrenia. Participants eventually moved to an adjacent room and sat in one of several seats that varied in their proximity to a seat ostensibly occupied by the man with schizophrenia. Results The continuum intervention decreased self-reported social distance and the categorical intervention increased endorsement of damaging stereotypes. Seat selection was unaffected by our manipulation, but we obtained evidence of significant links to validated stigma measures. Limitations Our sample was small, and our behavioral stigma measure could be modified to maximize variability in participants\u27 seat selection. Conclusions The study offers modest support of the stigma reduction effect of continuum belief intervention. It offers new evidence of the pernicious consequences of interventions that inflate perceptions of the “otherness” of individuals with psychiatric problems. Finally, it shines new light on stigma-related behavior measurable in the laboratory

Individual Differences in Need for Affect and Reactivity

People are different with respect to their emotional propensities, including emotional abilities/skills and emotional style. Regarding emotional abilities/skills, alexithymia (i.e., difficulties identifying and describing emotions; Bagby et al., 1994) and emotional intelligence (Mayer et al., 1999) have been among the more widely studied constructs. Regarding emotional style, research has examined the intensity of emotion (Larsen et al., 1986) and individual differences in general positive/negative affectivity (Watson et al., 1988) or specific emotions (e.g., anxiety; Spielberger, 1985). Notably, very little work has examined people’s motivation to pursue experiences that should give rise to strong emotion. To fill this gap, Maio and Esses (2001) constructed the Need for Affect (NFA) scale, which captures individual differences in the tendency to embrace emotion. Maio and Esses (2001) demonstrated that NFA is empirically related to, but distinct from, other emotion-related individual differences. Their results also showed that individual differences in NFA predict important emotion-related outcomes. These advances notwithstanding, additional work is needed to more fully illuminate the causes, correlates, and implications of NFA. For example, is a greater need for affect accompanied by stronger reactivity to emotional challenge? The purpose of the present research was to interrogate this question using a variety of emotional reactivity measures. METHOD 56 undergraduates participated in the study. After completing the NFA scale, participants viewed a series of 64 emotion-laden pictures obtained from the International Affective Picture System (Lang et al., 2005). Pictures were grouped into three categories: pleasant (e.g., babies), neutral (e.g., household objects), and unpleasant (e.g., attack). Pictures were shown for 6 s, followed by an intertrial interval that varied between 7 and 10 s. During picture viewing, the size of participants’ eyeblinks in response to startling noises was evaluated using electromyographic recording. Eyeblink startle is a widely used psychophysiological technique for evaluating responses to emotion-laden stimuli (see Blumenthal et al., 2005). After the first round of picture viewing, during which eyeblink startle data were collected, participants viewed the same pictures a second time. Three additional measures were administered during this phase: (1) the amount of time spent viewing each picture during a free viewing period, (2) self-reported pleasantness, and (3) self-reported arousal. RESULTS AND DISCUSSION For eyeblink startle, free viewing time, and self-reported arousal, NFA did not interact with Picture Type, Fs \u3c 1.31, ps \u3e .27. Thus, patterns of reactivity to the three categories of pictures were similar regardless of NFA scores. For self-reported valence, there was a significant NFA by Picture Type interaction (F[2,102] = 9.98, p \u3c .001). High NFA participants reported greater pleasantness while viewing pleasant pictures (t = -3.35, p \u3c .01), and greater unpleasantness while viewing unpleasant pictures (t = 2.33, p \u3c .03), compared to low NFA participants. The self-reported valence results, together with the nonsignificant findings for eyeblink startle, are especially revealing. Although NFA appears to predict self-reports of the pleasantness of emotion-laden stimuli, it does not appear to predict emotional reactivity at the level of the underlying physiological systems responsible for marshaling responses to pleasant and unpleasant stimuli

On Associative Stigma: Implicit and Explicit Evaluations of a Mother of a Child with Autism

Individuals with psychiatric problems are subjected to highly damaging stigma. Some research suggests this stigma may extend to associates (e.g., family, friends), who themselves report being devalued, avoided, and rejected. The research literature on associative stigma is largely qualitative, and extant quantitative research has utilized only explicit measures which are notably weakened by self-presentational motives. In the current study, 95 undergraduates were randomized to hear one of two audio recorded vignettes pertaining to a fictional mother of a child with either autism spectrum disorder (ASD) or severe asthma. Participants then completed an Implicit Association Test capturing implicit evaluations of the fictional mother and two separate measures of explicit stigma. No group differences for either explicit measure emerged. However, the predicted group difference in implicit stigma emerged, such that the mother of the child with ASD was evaluated less positively than the mother of the child with severe asthma. Implicit-explicit correlations were not statistically significant but in the small to medium range according to effect size conventions. This study appears to offer the first evidence of implicit associative stigma in the psychiatric domain. It also points to a variety of interesting avenues for further illumination of this potentially important phenomenon

When do psychosocial explanations of psychiatric problems increase stigma? Self-report and implicit evidence

Background and objectives Biomedical explanations of psychiatric problems, compared to psychosocial explanations, may amplify psychiatric stigma. One limitation of existing research is the measurement of almost exclusively self-reported stigma. This study evaluated the stigma-related effects of biomedical versus psychosocial explanations of schizophrenia using conventional self-report and two other measurement approaches that may tap more deeply held attitudes. Methods One hundred three undergraduates listened to a vignette describing a man with (1) schizophrenia of biomedical origin, (2) schizophrenia of psychosocial origin, or (3) diabetes. They then completed an Implicit Association Test, conventional self-report stigma measures, and projected other measures that captured perceptions of most other people\u27s likely impressions. Results: Participants were more likely to attribute stigmatizing views to others compared to themselves. The projected other measurement, but not the conventional self-report measurement, predicted implicit attitudes. We obtained no evidence that the psychosocial causal explanation of schizophrenia led to decreased stigma compared to the biomedical causal explanation. In fact, the psychosocial causal explanation increased stereotyped attitudes. Limitations The absence of a schizophrenia control group complicates interpretation of biomedical versus psychosocial group comparisons. Conclusions Further research is needed to evaluate discrepancies between the present findings and other published evidence pertaining to psychosocial causal explanations of psychiatric problems