Continuum beliefs and schizophrenia stigma: Correlational and experimental evidence.

Abstract

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.

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

“…The continuum group desired significantly less social distance from Allen than the categorical group and marginally less social distance from Allen than the control group; both effects were in the medium range according to effect size conventions (Cohen, 1988). These results largely corroborate and valuably extend the small body of published research on continuum belief intervention (Corrigan et al, 2016;Schomerus et al, 2016;Thibodeau, 2016;Wiesjahn et al, 2016). Notably, these effects emerged in spite of factors that could conspire to undermine them.…”

“…To evaluate the effects of the experimental manipulation, we administered a four-item scale that measured participants' endorsement of continuum (e.g., "Anybody could develop schizophrenia under the right circumstances") and categorical (e.g., "Symptoms of schizophrenia represent clear departures from the way normal people function") views of schizophrenia (see Thibodeau, 2016). Responses were recorded on four-point scales (1 = strongly disagree, 4 = strongly agree).…”

“…In this view, individuals with psychiatric problems are not categorically different from others; rather, continuum beliefs emphasize similarities between psychopathology and the ordinary distress to which everybody is vulnerable. There is a small but growing correlational literature that indicates that continuum beliefs are related to more positive and less negative emotional reactions, less desire for social distance, and weaker endorsement of damaging stereotypes (Angermeyer, Millier, Rémuzat, Refaï, Schomerus, & Toumi, 2014;Makowski, Mnich, Angermeyer, & von dem Knesebeck, 2016;Schlier, Scheunemann, & Lincoln, 2016;Schomerus, Matschinger, & Angermeyer, 2013;Thibodeau, 2016;Wiesjahn, Brabban, Jung, Gebauer, & Lincoln, 2014;Wiesjahn, Jung, Kremser, Rief, & Lincoln, 2016).…”

“…In a third study (Thibodeau, 2016), online volunteers read a detailed description of a young man with schizophrenia and were then randomized to read either a summary of research attesting to a continuum view of schizophrenia, a summary of research attesting to a categorical view of schizophrenia, or no additional material. There was no evidence that the experimental manipulation affected self-reported stigma of the young man with schizophrenia.…”

“…That is, belief in the "otherness" of individuals with psychiatric problems may be useful insofar as it affords safe psychological distance from mental illness, a plight that is universally dreaded. Continuum intervention, which explicitly aims to weaken perceptions of "otherness," could be met with an increase in perceived vulnerability and, ultimately, defensive rejection (Thibodeau, 2016). Second, continuum intervention may strip psychiatric problems of medical legitimacy, in which case people's struggles could be appraised as arising from moral weaknesses or defects of character (Gergel, 2014).…”