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)
A staff dialogue on a socially distanced patient: psychosocial issues faced by patients, their families, and caregivers.
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Shortly before his death in 1995, Kenneth B. Schwartz, a cancer patient at Massachusetts General Hospital (MGH), founded The Kenneth B. Schwartz Center at MGH. The Schwartz Center is a non-profit organization dedicated to supporting and advancing compassionate health care delivery, which provides hope to the patient, support to caregivers, and encourages the healing process. The center sponsors the Schwartz Center Rounds, a monthly multidisciplinary forum where caregivers reflect on important psychosocial issues faced by patients, their families, and their caregivers, and gain insight and support from fellow staff members. The following case of an HIV-positive woman who was diagnosed with cervical cancer during a twin pregnancy was discussed at the May, 1999 Schwartz Center Rounds. The patient was in drug rehabilitation having been dependent on crack cocaine, with a past history of syphilis and gonorrhea. She was single and her other children were in foster care. Initially she was suspicious and non-compliant. A plan was negotiated to biopsy the cervical lesion after cesarean section and with confirmation of malignancy she underwent radical surgery and subsequently radiotherapy. Despite the almost insurmountable social and educational distance between her and her caregivers, they managed to bond and facilitate care. Although there were compromises with which staff were uncomfortable, the relationship was maintained and continues. (+info)
Politically correct labels and schizophrenia: a rose by any other name?
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This study investigated the role of politically correct labels in emotional reactions, attributions regarding illness, behavioral intentions, and knowledge of schizophrenia symptoms. Two samples, undergraduate students and community members, were asked to rate a target individual on various scales using one of four labels varying in "political correctness": consumer of mental health services, person with severe mental illness, person with schizophrenia, and schizophrenic. Results showed that the label "consumer of mental health services" was associated with less negative reactions and was considered to be reflective of a condition more likely to change relative to the other, less politically correct labels. However, this label did not result in greater behavioral intention to interact with persons with a psychiatric disorder. Furthermore, participants receiving this label identified fewer symptoms associated with DSM-IV criteria of schizophrenia and were more likely to attribute responsibility for the condition to the target person, relative to the other labels. (+info)
Prejudice, social distance, and familiarity with mental illness.
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In this study, the paths between two prejudicial attitudes (authoritarianism and benevolence) and a proxy measure of behavioral discrimination (social distance) were examined in a sample drawn from the general public. Moreover, the effects of two person variables (familiarity with mental illness and ethnicity) on prejudice were examined in the path analysis. One hundred fifty-one research participants completed measures of prejudice toward, social distance from, and familiarity with mental illness. Goodness-of-fit indexes from path analyses supported our hypotheses. Social distance is influenced by both kinds of prejudice: authoritarianism (the belief that persons with mental illness cannot care for themselves, so a paternalistic health system must do so) and benevolence (the belief that persons with mental illness are innocent and childlike). These forms of prejudice, in turn, are influenced by the believers' familiarity with mental illness and their ethnicity. We also discuss how these findings might contribute to a fuller understanding of mental illness stigma. (+info)
Interpersonal control and expressed emotion in families of persons with schizophrenia: change over time.
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This study examined communication patterns in 62 families of persons with schizophrenia, comparing families with relatives who were low expressed emotion (EE) at the beginning and end of a 2-year study, those who were high EE at the beginning and end, and those whose EE status changed. Interaction was coded with the Relational Control Coding System and analyzed as a Markov process. Dialogues in the stable low-EE and stable high-EE families were rather similar initially, and both groups showed increasing flexibility at year 1. However, at year 2, low-EE dyads showed increasingly complex structure and flexibility in control, but high-EE dyads showed simpler structure and rigidly controlling patterns. When EE status changed, so did the structure of the dialogues and the patterning of control. Although earlier research found more "tightly joined" systems in families of high-EE relatives, it may be that over time, these family members distance from each other and so are less connected. It is also possible that relatives who remain high EE despite intervention are a subset of high-EE relatives who need more support or different therapeutic approaches to maintain change. (+info)
Identity and search in social networks.
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Social networks have the surprising property of being "searchable": Ordinary people are capable of directing messages through their network of acquaintances to reach a specific but distant target person in only a few steps. We present a model that offers an explanation of social network searchability in terms of recognizable personal identities: sets of characteristics measured along a number of social dimensions. Our model defines a class of searchable networks and a method for searching them that may be applicable to many network search problems, including the location of data files in peer-to-peer networks, pages on the World Wide Web, and information in distributed databases. (+info)
Nutrition, infant behavior, and maternal characteristics: a pilot study in West Bengal, India.
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Free activities and mother-child interaction in a standard setting were observed among undernourished and well-nourished children between the ages of 7 and 18 months in West Bengal. The undernourished boys showed less vigor in play activity, less attachment behavior toward the mother, especially in interaction across a distance, and maintained close physical contact with her more frequently than did the well-nourished boys. The mothers of the undernourished boys had lower scores in four of six measures of maternal behavior. Correlations between child and maternal scores revealed a high reciprocity in mother-child interaction for the well-nourished boys, but a lack of reciprocity for the undernourished boys. The developmental quotient and activity scores of the well- and undernourished boys were not different. However, the correlations between these and the maternal scores showed a divergent pattern of relationships for the two nutritional groups. (+info)
Reducing psychiatric stigma and discrimination: evaluation of educational interventions in UK secondary schools.
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BACKGROUND: The persistent and disabling nature of psychiatric stigma has led to the establishment of global programmes to challenge the negative stereotypes and discriminatory responses that generate social disability, but these initiatives are rarely evaluated. AIMS: To assess the effectiveness of an intervention with young people aimed at increasing mental health literacy and challenging negative stereotypes associated with severe mental illness. METHOD: A total of 472 secondary school students attended two mental health awareness workshops and completed pre- and post-questionnaires detailing knowledge, attitudes and behavioural intentions. RESULTS: Young people use an extensive vocabulary of 270 different words and phrases to describe people with mental health problems: most were derogatory terms. Mean positive attitude scores rose significantly from 1.2 at baseline to 2.8 at 1-week follow-up and 2.3 at a 6-month follow-up. Changes were most marked for female students and those reporting personal contact with people with mental illness. CONCLUSIONS: Short educational workshops can produce positive changes in participants' reported attitudes towards people with mental health problems. (+info)