Public stigma is an important barrier to the recovery of patients with psychosis. This study aimed to explore public stigma associated with a newly adopted Chinese name for psychosis ‘si-jue-shi-tiao’ in a representative Chinese population in Hong Kong, focusing on factors contributing to public stigma. Exposure to mass media and its relationship with the stigma were explored in detail.
Methods:
Random telephone survey of general population in Hong Kong was conducted. Information including basic demographics, psychosis literacy, recent news recall about psychosis and stigma, measured with the revised Link’s Perceived Discrimination-Devaluation Scale (LPDDS) were obtained. Univariate analysis of LPDDS score and demographic variables, news exposure, previous contacts with people with psychosis and knowledge about psychosis were conducted. Further hierarchical regression analysis was performed.
Results:
A total of 1,016 subjects were interviewed. The sample was comparable with the whole Hong Kong population aged 18 years and above. Those of female gender, with higher educational level and better knowledge about symptoms and treatment of psychosis had higher score of LPDDS. The model significantly explained 8.3% of variance of LPDDS score (F(7, 895) = 12.606, p < .0001, p < .0001). The negative news recall had trend significance in the model.
Conclusion:
The finding suggested that discrimination among the general public against people with psychosis was still common. Specific strategies will need to be established in targeting media news reporting about psychosis, knowledge disseminating and needs of specific population. Further researches should be conducted to understand the mechanisms of the stigma development in relation to these factors so that more focused and effective strategies could be developed.
AngermeyerM. C.DietrichS.PottD.MatschingerH. (2005). Media consumption and desire for social distance towards people with schizophrenia. European Psychiatry: The Journal of the Association of European Psychiatrists, 20, 246–250.
2.
AngermeyerM. C.SchulzeB. (2001). Reinforcing stereotypes: How the focus on forensic cases in news reporting may influence public attitudes towards the mentally ill. International Journal of Law and Psychiatry, 24, 469–486.
3.
CallaghanP.ShanC. S.YuL. S.ChingL. W.KwanT. L. (1997). Attitudes towards mental illness: Testing the contact hypothesis among Chinese student nurses in Hong Kong. Journal of Advanced Nursing, 26, 33–40.
4.
ChanK. W. S.WongM. H. M.HuiC. L. M.LeeE. H. M.ChangW. C.ChenE. Y. H. (2015). Perceived risk of relapse and role of medication: Comparison between patients with psychosis and their caregivers. Social Psychiatry and Psychiatric Epidemiology, 50, 307–315.
5.
ChenE. (2004). Developing an early intervention service in Hong Kong: Best Care in Early Psychosis Intervention. London, England: Taylor & Francis.
6.
ChiuC. P.-Y.LamM. M.-L.ChanS. K.-W.ChungD. W.-S.HungS.-F.TangJ. Y.-M.… ChenE. Y.-H. (2010). Naming psychosis: The Hong Kong experience. Early Intervention in Psychiatry, 4, 270–274.
7.
ChungK. F.ChanJ. H. (2004). Can a less pejorative Chinese translation for schizophrenia reduce stigma? A study of adolescents’ attitudes toward people with schizophrenia. Psychiatry and Clinical Neurosciences, 58, 507–515.
8.
ChungK. F.ChenE. Y.LiuC. S. (2001). University students’ attitudes towards mental patients and psychiatric treatment. The International Journal of Social Psychiatry, 47, 63–72.
9.
ComptonM. T.QuinteroL.EsterbergM. L. (2007). Assessing knowledge of schizophrenia: Development and psychometric properties of a brief, multiple-choice knowledge test for use across various samples. Psychiatry Research, 151, 87–95.
10.
DietrichS.HeiderD.MatschingerH.AngermeyerM. C. (2006). Influence of newspaper reporting on adolescents’ attitudes toward people with mental illness. Social Psychiatry and Psychiatric Epidemiology, 41, 318–322.
11.
Evans-LackoS.HendersonC.ThornicroftG. (2013). Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009–2012. The British Journal of Psychiatry, 55(Suppl.), s51–s57.
12.
GoffmanE. (1963). Stigma notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall.
13.
GranelloD. H.PauleyP. S. (2000). Television viewing habits and their relationship to tolerance toward people with mental illness. Journal of Mental Health Counseling, 22, 162–175.
14.
JonesE. E.ScottR. A.MarkusH. (1984). Social stigma: The psychology of marked relationships. New York, NY: W.H. Freeman.
15.
KlinA.LemishD. (2008). Mental disorders stigma in the media: Review of studies on production, content, and influences. Journal of Health Communication, 13, 434–449.
16.
KniftonL.GervaisM.NewbiggingK.MirzaN.QuinnN.WilsonN.Hunkins-HutchisonE. (2010). Community conversation: Addressing mental health stigma with ethnic minority communities. Social Psychiatry and Psychiatric Epidemiology, 45, 497–504.
17.
KvaaleE. P.HaslamN.GottdienerW. H. (2013). The ‘side effects’ of medicalization: A meta-analytic review of how biogenetic explanations affect stigma. Clinical Psychology Review, 33, 782–794.
18.
LauberC.NordtC.FalcatoL.RösslerW. (2004). Factors influencing social distance toward people with mental illness. Community Mental Health Journal, 40, 265–274.
19.
LeeA. A.LaurentS. M.WykesT. L.Kitchen AndrenK. A.BourassaK. A.McKibbinC. L. (2014). Genetic attributions and mental illness diagnosis: Effects on perceptions of danger, social distance, and real helping decisions. Social Psychiatry and Psychiatric Epidemiology, 49, 781–789.
20.
LeeS.ChiuM. Y. L.TsangA.ChuiH.KleinmanA. (2006). Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Social Science & Medicine, 62, 1685–1696.
21.
LinkB. G.PhelanJ. C. (2001). Conceptualizing stigma. Annual Review of Sociology, 27, 363–385.
22.
LinkB. G.StrueningE. L.Neese-toddS.AsmussenS.PhelanJ. C. (2002). On describing and seeking to change the experience of stigma. Psychiatric Rehabilitation Skills, 6, 201–231.
23.
MorganA. J.JormA. F. (2009). Recall of news stories about mental illness by Australian youth: Associations with help-seeking attitudes and stigma. Australian and New Zealand Journal of Psychiatry, 43, 866–872.
24.
NgP.ChanK. F. (2000). Sex differences in opinion towards mental illness of secondary school students in Hong Kong. The International Journal of Social Psychiatry, 46, 79–88.
25.
PescosolidoB. A.MartinJ. K.LongJ. S.MedinaT. R.PhelanJ. C.LinkB. G. (2010). ‘A Disease Like Any Other’? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. American Journal of Psychiatry, 167, 1321–1330.
26.
PhelanJ. C.LinkB. G. (2004). Fear of people with mental illnesses: The role of personal and impersonal contact and exposure to threat or harm. Journal of Health and Social Behavior, 45, 68–80.
27.
SartoriusN. (1998). Stigma: What can psychiatrists do about it?The Lancet, 352, 1058–1059.
28.
SchlierB.SchmickS.LincolnT. M. (2014). No matter of etiology: Biogenetic, psychosocial and vulnerability-stress causal explanations fail to improve attitudes towards schizophrenia. Psychiatry Research, 215, 753–759.
29.
SchomerusG.SchwahnC.HolzingerA.CorriganP. W.GrabeH. J.CartaM. G.AngermeyerM. C. (2012). Evolution of public attitudes about mental illness: A systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 125, 440–452.
30.
ShannonC.DavidP. (2003). Interpersonal contact and the stigma of mental illness: A review of the literature. Journal of Mental Health, 12, 291–305.
31.
Shokoohi-YektaM.RetishP. M. (1991). Attitudes of Chinese and American male students towards mental illness. The International Journal of Social Psychiatry, 37, 192–200.
32.
SibitzI.AmeringM.UngerA.SeyringerM. E.BachmannA.SchrankB.… WoppmannA. (2011). The impact of the social network, stigma and empowerment on the quality of life in patients with schizophrenia. European Psychiatry: The Journal of the Association of European Psychiatrists, 26, 28–33.
33.
StoutP. A.VillegasJ.JenningsN. A. (2004). Images of mental illness in the media: Identifying gaps in the research. Schizophrenia Bulletin, 30, 543–561.
34.
StuartH.Arboleda-FlórezJ. (2001). Community attitudes toward people with schizophrenia. Canadian Journal of Psychiatry, 46, 245–252.
35.
TangJ. Y. M.WongG. H. Y.HuiC. L. M.LamM. M. L.ChiuC. P. Y.ChanS. K. W.… ChenE. Y. H. (2010). Early intervention for psychosis in Hong Kong: The EASY programme. Early Intervention in Psychiatry, 4, 214–219.
36.
ThorntonJ. A.WahlO. F. (1996). Impact of a newspaper article on attitudes toward mental illness. Journal of Community Psychology, 24, 17–25.
37.
TsangH. W. H.TamP. K. C.ChanF.CheungW. M. (2003). Stigmatizing attitudes towards individuals with mental illness in Hong Kong: Implications for their recovery. Journal of Community Psychology, 31, 383–396.
38.
WahlO. F. (2012). Stigma as a barrier to recovery from mental illness. Trends in Cognitive Sciences, 16, 9–10.
39.
WahlO. F.LefkowitsJ. Y. (1989). Impact of a television film on attitudes toward mental illness. American Journal of Community Psychology, 17, 521–528.
40.
WahlO. F.LefkowitsJ. Y. (2004). Stop the presses: Journalistic treatment of mental illness. In FriedmanL. D. (Ed.), Cultural sutures: Medicine and media (pp. 55–69). Durham, NC: Duke University Press.
41.
YangL. H.LoG.WonPat-BorjaA. J.SinglaD. R.LinkB. G.PhillipsM. R. (2012). Effects of labeling and interpersonal contact upon attitudes towards schizophrenia: Implications for reducing mental illness stigma in urban China. Social Psychiatry and Psychiatric Epidemiology, 47, 1459–1473.
42.
YangL. H.Purdie-VaughnsV.KotabeH.LinkB. G.SawA.WongG.PhelanJ. C. (2013). Culture, threat, and mental illness stigma: Identifying culture-specific threat among Chinese-American groups. Social Science & Medicine, 88, 56–67.
43.
YangL. H.Wonpat-BorjaA. J.OplerM. G.CorcoranC. M. (2010). Potential stigma associated with inclusion of the psychosis risk syndrome in the DSM-V: An empirical question. Schizophrenia Research, 120, 42–48.
