Public conceptions of mental illness: labels, causes, dangerousness, and social distance.
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OBJECTIVES: The authors used nationwide survey data to characterize current public conceptions related to recognition of mental illness and perceived causes, dangerousness, and desired social distance. METHODS: Data were derived from a vignette experiment included in the 1996 General Social Survey. Respondents (n = 1444) were randomly assigned to 1 of 5 vignette conditions. Four vignettes described psychiatric disorders meeting diagnostic criteria, and the fifth depicted a "troubled person" with subclinical problems and worries. RESULTS: Results indicate that the majority of the public identifies schizophrenia (88%) and major depression (69%) as mental illnesses and that most report multicausal explanations combining stressful circumstances with biologic and genetic factors. Results also show, however, that smaller proportions associate alcohol (49%) or drug (44%) abuse with mental illness and that symptoms of mental illness remain strongly connected with public fears about potential violence and with a desire for limited social interaction. CONCLUSIONS: While there is reason for optimism in the public's recognition of mental illness and causal attributions, a strong stereotype of dangerousness and desire for social distance persist. These latter conceptions are likely to negatively affect people with mental illness. (+info)
The public's view of the competence, dangerousness, and need for legal coercion of persons with mental health problems.
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OBJECTIVES: The authors examined Americans' opinions about financial and treatment competence of people with mental health problems, potential for harm to self or others, and the use of legal means to force treatment. METHODS: The 1996 General Social Survey provided interview data with a nationally representative sample (n = 1444). Respondents were given a vignette based on diagnostic criteria for schizophrenia, major depression, alcohol dependence, or drug dependence, or a "control" case. RESULTS: The specific nature of the problem was the most important factor shaping public reaction. Respondents viewed those with "troubles," alcohol dependence, or depression as able to make treatment decisions. Most reported that persons with alcohol or drug problems or schizophrenia cannot manage money and are likely to be violent toward others. Respondents indicated a willingness to coerce individuals into treatment. Respondent and other case characteristics rarely affected opinions. CONCLUSIONS: Americans report greater concern with individuals who have drug or alcohol problems than with persons who have other mental health problems. Evaluations of dangerousness and coercion indicate a continuing need for public education. (+info)
Difficult behaviour in drug-misusing and non-drug-misusing patients in general practice--a comparison.
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Some GPs may be unwilling to take on the management of drug misusers because of the risk of difficult behaviour. However, this study found that in a practice running a drug misuse treatment programme there was a relatively small difference in the rates of difficult behaviour from drug misusers and general patients. (+info)
Preventive detention must be resisted by the medical profession.
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A policy of "preventive detention" has recently been debated in the British Parliament. Alarmed by the high-profile criminal activities of people suspected of having dangerous severe personality disorder (DSPD), the government have made clear their intention to "indeterminately but reviewably detain" people with DSPD, after diagnosis by forensic psychiatrists, even if the individuals are yet to commit an offence. Such a policy may improve the safety of the public, but has obvious implications for civil liberties. This essay criticises the morality of the government's intention and rejects the notion that the medical profession could ethically collude with such a policy. (+info)
Actions, causes, and psychiatry: a reply to Szasz.
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In a recent paper, it was argued forcefully by Thomas Szasz that it is crucial to the scientific credibility of psychiatry that it abandon talk of the behaviour of the mentally "ill" in terms of causes: such behaviour is not caused by their condition--it simply has reasons, which are discounted by the medical model. It is argued in this paper that Szasz's theory is incomplete for two reasons: first, in assuming that reasons are radically different from causes, it cannot account for the possibility that "sane" behaviour might be just as much caused as "insane"; and second, it tacitly assumes that the origin of behaviour always lies with the agent--a view that arguably is an accident of grammar. Hence while there is no mental illness, this is because there is nothing that could be ill--and this means that there is no such thing as mental "health" either. (+info)
The social-environmental context of violent behavior in persons treated for severe mental illness.
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OBJECTIVES: This study examined the prevalence and correlates of violent behavior by individuals with severe mental illness. METHODS: Participants (N = 802) were adults with psychotic or major mood disorders receiving inpatient or outpatient services in public mental health systems in 4 states. RESULTS: The 1-year prevalence of serious assaultive behavior was 13%. Three variables-past violent victimization, violence in the surrounding environment, and substance abuse-showed a cumulative association with risk of violent behavior. CONCLUSIONS: Violence among individuals with severe mental illness is related to multiple variables with compounded effects over the life span. Interventions to reduce the risk of violence need to be targeted to specific subgroups with different clusters of problems related to violent behavior. (+info)
Challenging two mental illness stigmas: personal responsibility and dangerousness.
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Two stigmatizing attitudes related to dangerousness and personal responsibility may undermine the opportunities of persons with serious mental illness. This study set out to examine path models that explain how these attitudes lead to discriminatory behavior and to assess the impact of antistigma programs on components of personal responsibility and dangerousness models. Two hundred thirteen persons were randomly assigned to one of five antistigma conditions: education on personal responsibility, education on dangerousness, contact with a person with serious mental illness where personal responsibility is discussed, contact where dangerousness is discussed, or no change. Persons completed an attribution questionnaire (AQ) representing personal responsibility and dangerousness path models at pretest, posttest, and 1-week followup. They also completed tasks that represented helping behavior. Goodness of fit indexes from linear structural modeling were mixed for both models but suggested that fear of dangerousness was a key attitude leading to discriminatory behavior. Results also showed that subjects who had contact with persons with serious mental illness experienced greater changes than subjects in the education or control groups did on measures of attribution and helping behavior. (+info)
Individual differences in behavioral compliance to warnings representing varying degrees of threat.
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Research regarding warning compliance has often emphasized the physical aspects of the warning itself. Here, we examine the role of the perceiver in sensation seeking and health orientation as individual difference variables that affect behavioral compliance to a health warning. The experiment used a laboratory-based simulation of a chemistry demonstration that has been used in previous warnings research. In addition, however, individual difference effects of sensation seeking and health orientation were investigated. Among the significant findings were a significant interaction between condition assignment and sensation seeking on compliance outcome and a significant interaction between condition and health orientation. These results indicate that individual difference variables represent significant influences on the degree to which persons comply with warnings. (+info)