Continuum belief, categorical belief, and depression stigma: Correlational evidence and outcomes of an online intervention.

Abstract

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.

Continuum beliefs and mental illness stigma: a systematic review and meta-analysis of correlation and intervention studies

“…Other factors to improve identification could involve the gender of the vignette character (Angermeyer et al, 2015), as well as cultural, ethnic, and national characteristics (Corrigan, 2004). Certainly, face-to-face contact would improve the respondent's personal involvement (Thibodeau, 2019), however, our results indicate that text-or video-based interventions are also capable of promoting a continuum of mental health and illness which includes the respondents and encourages them to view people with mental illness as in-group. In line with that, studies should focus on further developing even more identifiable and involving interventions.…”

“…Regarding studies about persons with mental illness, Thibodeau ( 2019 ) investigated attitudes of people with self-reported depression and found no significant intervention effects on depression stigma. Beyond stigmatising attitudes, Morris et al ( 2020 ) found a continuum intervention on alcohol use disorder to improve problem recognition of the respondents' own heavy drinking.…”

“…Manipulations of intervention studies are prominently text-based, which is of high internal validity and can easily be implemented into online surveys. Undergoing efforts to further improve continuum interventions, by designing audio-visual vignettes (Corrigan et al, 2015 , 2017 ; Dolphin & Hennessy, 2017 ; Morris et al, 2020 ), or extending the intervention to more time points (Corrigan et al, 2015 ; Thibodeau, 2019 ; Thibodeau et al, 2018 ) are likely to improve personal involvement of the respondent as well. Personal contact and the inclusion of lived experiences had positive effects (Hansson, Stjernswärd, & Svensson, 2016 ).…”

“…In the separate analyses (see online Supplementary Appendix 5), sensitivity analyses based on type of disorder and operationalisation were conducted. To assess publication bias, we conducted Funnel plots, Egger's regression, Trim and Fill procedure, and Fisher's Fail-Safe-N. Two subgroups of studies emerged based on common measures of continuum beliefs and analytic strategies [subgroup 1: one-item measure of continuum beliefs by Schomerus, Matschinger, and Angermeyer ( 2013 ) using regression analyses; subgroup 2: items of Thibodeau ( 2017 , 2018 , 2019 ) or Wiesjahn, Brabban, Jung, Gebauer, and Lincoln ( 2014 ), Wiesjahn, Jung, Kremser, Rief, and Lincoln, ( 2016 ) using correlation analyses], prompting us to do additional analyses referring to these subgroups.…”

A Call to Action. A Critical Review of Mental Health Related Anti-stigma Campaigns

“…Recently, to limit these unintended effects, there has been some consideration of whether non-categorical messages are effective in challenging stigmatizing beliefs which divide between “us” and “them.” Whilst, there is reasonable correlational evidence to associate continuum-based messages with lower degrees of public and self-stigma ( 71 , 97 , 98 ), the evidence from experimental research is mixed ( 99 ). Specifically, whilst those participants exposed to continuum beliefs did see someone with experiences of schizophrenia as more similar to themselves and did increase their belief in possible recovery, the type of message did not significantly impact measures of explicit prejudice and discrimination ( 99 ).…”