Etiological Beliefs, Treatments, Stigmatizing Attitudes toward Schizophrenia. What Do Italians and Israelis Think?

Abstract

Background: Although scientific research on the etiology of mental disorders has improved the knowledge of biogenetic and psychosocial aspects related to the onset of mental illness, stigmatizing attitudes and behaviors are still very prevalent and pose a significant social problem.Aim: The aim of this study was to deepen the knowledge of how attitudes toward people with mental illness are affected by specific personal beliefs and characteristics, such as culture and religion of the perceiver. More precisely, the main purpose is the definition of a structure of variables, namely perceived dangerousness, social closeness, and avoidance of the ill person, together with the beliefs about the best treatment to be undertaken and the sick person’ gender, capable of describing the complexity of the stigma construct in particular as far as schizophrenia is concerned.Method: The study involved 305 university students, 183 from the University of Padua, Italy, and 122 from the University of Haifa, Israel. For the analyses, a latent class analysis (LCA) approach was chosen to identify a latent categorical structure accounting for the covariance between the observed variables. Such a latent structure was expected to be moderated by cultural background (Italy versus Israel) and religious beliefs, whereas causal beliefs, recommended treatment, dangerousness, social closeness, and public avoidance were the manifest variables, namely the observed indicators of the latent variable.Results: Two sets of results were obtained. First, the relevance of the manifest variables as indicators of the hypothesized latent variable was highlighted. Second, a two-latent-class categorical dimension represented by prejudicial attitudes, causal beliefs, and treatments concerning schizophrenia was found. Specifically, the differential effects of the two cultures and the religious beliefs on the latent structure and their relations highlighted the relevance of the observed variables as indicators of the expected latent variable.Conclusion: The present study contributes to the improvement of the understanding of how attitudes toward people with mental illness are affected by specific personal beliefs and characteristics of the perceiver. The definition of a structure of variables capable of describing the complexity of the stigma construct in particular as far as schizophrenia is concerned was achieved from a cross-cultural perspective.

How do education and experience with mental illness interact with causal beliefs, eligible treatments and stigmatising attitudes towards schizophrenia? A comparison between mental health professionals, psychology students, relatives and patients

“…In order to overcome such a limitation, in this study, a vignette approach was used to examine the validity of the expected latent structure characterised by schizophrenia indicators, namely, social distance, dangerousness and avoidance as perceived by four different groups of people, together with causal beliefs and recommended treatments [46]. In line with the large amount of previous scientific literature using the vignette approach [4,11,20,47,48] in this research, vignettes cognitively tested in the Italian environment in the studies by Mannarini, Boffo, Rossi and Balottin (2018) and Mannarini and Boffo (2015) were applied. In order to make sure that each vignette was properly understood, the participants of the patients group in particular were individually assisted during the vignette administration.…”

“…In order to make sure that each vignette was properly understood, the participants of the patients group in particular were individually assisted during the vignette administration. A vignette is a story and/or a brief sketch about a person presenting the most common problems and symptoms typical of schizophrenia, which was developed according to DSM-5 diagnostic criteria [49], and the mental health disorder was not mentioned in any part of the text [4,11]. Moreover, the gender of the vignette protagonist was counterbalanced across participants.…”

“…As a consequence, the possibility of developing treatment interventions is based either on medical approaches or psychological ones, or on an integrated perspective. Studies on people's perception of schizophrenia, direct experience of manifestations and stigmatisation of such an illness, are frequently found in past and recent literature [3][4][5][6][7][8][9][10][11]. Stigmatising thinking concerning schizophrenia, such as prejudice, feeling in danger, public avoidance and various forms of discrimination, are still very frequent and represent a significant social problem [12][13][14][15].…”

“…Therefore, it is expected for the patient to stay passive and be obedient to mental health experts, who assumedly know more about the person's situation than he/she does [22]. Researches as regards the effects of causal beliefs on stigmatisation, in particular, in reference to schizophrenia, have been carried out in different countries [4,6,11,17,20,[24][25][26][27][28][29][30]. Different groups of people that are involved with schizophrenia from different perspectives also have been studied and their views and preferences compared.…”

“…Hypotheses were also made concerning relations between schizophrenia origins and possible treatments and of relations with a desire for social distance, perception of danger and general public avoidance of schizophrenic patients [3,[38][39][40]. Furthermore, a hypothesis was formulated that a latent structure, combining schizophrenia causal beliefs, social distance, perceived dangerousness and avoidance, should exist, also including possible schizophrenia treatments [4,11]. Moreover, such a structure should take into account the thinking and preferences concerning schizophrenia of different groups of people; in other words, different profiles should emerge representing the beliefs and thinking of mental health professionals, relatives, patients and students.…”