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

Peter, Lina-Jolien; Schindler, S.D.; Sander, Christian; Schmidt, Silke; Muehlan, Holger; McLaren, Thomas; Tomczyk, Samuel; Speerforck, Sven; Schomerus, Georg

doi:10.1017/s0033291721000854

Cited by 87 publications

(90 citation statements)

References 77 publications

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“…Even though the categorical perspective decreased perceptions of personal responsibility, this was not accompanied by an increased intention to help the targets. Our study also adds to the research that did not find an effect of continuum beliefs on prosocial behavior intentions (Peter et al, 2021). From the perspective of attribution theory, the absence of a negative effect in the continuum condition is compatible with responsibility perceptions not being affected negatively by continuum beliefs.…”

Section: Discussionsupporting

confidence: 71%

“…The categorical perspective is perceived limited for imposing “artificial categories onto a multidimensional space” (Dalgleish et al, 2020, p. 179) of clinical information, for excluding individuals from treatment who do not meet the criteria for a particular condition yet experience psychological distress that warrants care (Dalgleish et al, 2020), and for not providing a system for the identification of transdiagnostic risk factors which, if treated early, could prevent the development of full-threshold symptoms (Waszczuk et al, 2017). In the light of this paradigm shift and the sobering results with regard to reducing stigmatizing attitudes via a categorical concept of mental illness, stigma researchers have turned their attention to the benefits that a dimensional perspective on mental illness might have for improving stigmatizing attitudes (see Peter et al, 2021, for a review and meta-analysis). The dimensional perspective is usually induced by describing the severity or duration of mental illness symptoms in terms of a continuum 1 .…”

Section: Categorical and Dimensional Perspectives On Mental Illness A...mentioning

confidence: 99%

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Effects of continuum and categorical beliefs on attitudes related to eating disorder stigma.

Thörel¹,

Thörel²,

Tuschen‐Caffier³

2023

Stigma and Health

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The present research examined the benefits and caveats of a categorical and continuum perspective on mental illness on attitudes related to two contradictory forms of eating disorder (ED) stigma: Volitional stigma refers to the perception that ED-related behaviors are choices, whereas mental illness stigma emphasizes that, due to the severity of their condition, individuals with mental illness are very different from other people. We hypothesized that categorical beliefs improve attitudes related to volitional stigma (perceptions of responsibility for an ED, prosocial behavior intentions), but worsen attitudes related to mental illness stigma (distrust, social distance preferences, recovery expectations). Conversely, we expected continuum beliefs to be beneficial with regard to mental illness stigma but worsen attitudes related to volitional stigma. In an online experiment, 725 participants (68.28% female; mean age = 32.03 years) were assigned to receive information on a mental health continuum, a dichotomy of mental health and illness, or information related to neither perspective (control condition). Then they read a vignette about a target with anorexia nervosa (AN), bulimia nervosa (BN), or binge eating disorder (BED) before completing measures on ED stigma. Compared to the control condition, distrust and social distance preferences were lower in the continuum condition, whereas responsibility perceptions were lower in the categorical condition. There was also a reduction in distrust and social distance preferences in the categorical condition, albeit only the former was significant. Prosocial behavior intentions and recovery expectations were unaffected by perspective, and we did not find any perspective to have negative effects on stigma-related attitudes.

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Section: Discussionsupporting

confidence: 71%

Section: Categorical and Dimensional Perspectives On Mental Illness A...mentioning

confidence: 99%

Effects of continuum and categorical beliefs on attitudes related to eating disorder stigma.

Thörel¹,

Thörel²,

Tuschen‐Caffier³

2023

Stigma and Health

View full text Add to dashboard Cite

show abstract

“…To the extent that these dimensions extend to some degree into many people’s lives, it may be possible to use this dimensionality to reduce stigma by allowing people to see some similarity between themselves and the stigmatized other. Indeed, there is good evidence from the field of mental health stigma that dimensional beliefs about mental illness are linked to reduced stigma (Peter et al, 2021) and so it could be applied beyond this domain to other areas of stigmatization.…”

Section: Discussionmentioning

confidence: 99%

The Factorial Structure of Stigma and Its Targets

et al. 2022

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Abstract. We aimed to determine (1) the attributes of multiple stigmatized populations, (2) whether Kurzban and Leary’s (2001) functional typology of stigma emerges and identifies the dimensions upon which each stigma type differs, and (3) the emotional responses toward emergent stigma types. Participants ( N = 2,674) were assigned to 1/52 stigma target conditions and their attitudes surveyed. Data were analyzed by multilevel factor analysis with stigma targets at Level 2. There were five within-factors at Level 1 (social competence, interpersonal access, social inclusion, immorality, perceived permanence) and three between-factors at Level 2 (interpersonal stigmatization, morality-based stigmatization, chronic stigmatization). Interpersonal stigmatization was predicted by disgust and pity, and morality-based stigmatization was predicted by disgust and [-]happiness, with no predictors for chronic stigmatization. These results support a functional typology of stigma.

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“…a focus on headless bodies, comparable to “mugshots” and images of drug overdose or extreme intoxication in relation to substance use) warrant further investigation. Other work in the alcohol and mental health fields suggests that presentation of conditions on a continuum, which suggests that people all experience relevant symptoms at some point in their life, rather than as a binary, where experiences are presented as different from normative human experiences, is associated with reduced stigma (Peter et al , 2021). This type of framing may increase perceived similarities between groups, thus reducing inter-group boundaries.…”

Section: Discussionmentioning

confidence: 99%

Less than human: dehumanisation of people who use heroin

Sumnall

Atkinson

Gage

et al. 2021

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PurposeStigma reduction is an important public health challenge because of the large morbidity and mortality associated with some forms of substance use. Extreme stigma can lead to dehumanisation of target groups, who are ascribed with lesser humanity. The authors examined whether there was blatant and subtle dehumanisation of people who use heroin, and if these were associated with levels of support for non-discriminatory drug policy.Design/methodology/approachA cross-sectional online study using a UK convenience sample (n = 307 [75.2% female, mean age 28.6 ± 12.2 years]) was conducted. Participants completed assessments of blatant (Ascent of Humans [AoH] scale) and subtle (an emotion attribution task) dehumanisation and a bespoke measure assessing support for non-discriminatory drug policies. Other measures controlled for stigma towards people who use drugs (PWUD) and moral disgust.FindingsThere was greater blatant dehumanisation of people who used heroin compared to the general population and other potentially stigmatised reference groups, including people who use cannabis. The authors also found evidence of subtle dehumanisation, and people who used heroin were rated as being less likely to feel uniquely human emotions, less likely to feel positive emotions and more likely to feel negative emotions. Blatant dehumanisation was associated with significantly lower probability of support for non-discriminatory drug policy.Social implicationsDehumanisation may present significant challenges for stigma reduction initiatives and in fostering public support for drug policy and treatment. Denial of the humanity of this group could be used to justify discriminatory policies or relative deprioritisation of support services in funding decisions. Activities that seek to “rehumanise” PWUD, including social inclusion, and encouraging compassionate media representations that portray the lived experiences of substance use may be useful areas of future work.Originality/valueThis is the first study to investigate blatant and subtle dehumanisation of people who use heroin, and how this relates to public support for drug policy.

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

Cited by 87 publications

References 77 publications

Effects of continuum and categorical beliefs on attitudes related to eating disorder stigma.

Effects of continuum and categorical beliefs on attitudes related to eating disorder stigma.

The Factorial Structure of Stigma and Its Targets

Less than human: dehumanisation of people who use heroin

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