Novel Intervention to Reduce Social
Stigma of Psychotic Disorders
Mason Drusano, B.S., & Gili Freedman, Ph.D.
Department of Psychology, St. Mary’s College of Maryland
Mental disorders are often associated with social stigma, which contributes to social rejection (Mannarini & Boffo, 2015).
Social rejection can lead to negative quality of life outcomes and increase severity of symptoms related to mental illness (Fulford & Mueser, 2020; Boysen et al., 2018; Capriola-Hall et al., 2018).
Disorders with psychotic symptoms are highly stigmatized compared to other symptoms like anxiety and depression (Thibodeau & Principino, 2019).
Some continuum interventions exist to help reduce stigmatized beliefs by promoting continuum beliefs. These interventions are written vignettes and are effective at increasing continuum beliefs for depression and anxiety. However, these interventions struggle to be consistently effective about changing beliefs for mental illnesses with psychotic symptoms such as schizophrenia (Thibodeau, 2020).
Introduction
A novel video intervention will increase continuum beliefs about psychotic symptoms, as well as decrease likelihood of social rejection towards people who experience psychotic symptoms. Additionally, the video intervention will be more effective than the written vignette at increasing continuum beliefs.
Hypotheses
Method
Participants & Procedure
82 undergraduate students (Mage = 20.5, SD = 3.0) completed an online study and were placed into 1 of 3 conditions: vignette, video, or control vignette. Participants were given a pretest that measured their continuum beliefs about psychotic symptoms of mental illness. After being exposed to either the video, vignette, or control vignette, participants took the continuum beliefs questionnaire again to measure changes between before and after the intervention. Additionally, participants took a social rejection questionnaire about their likelihood to reject a fictional individual with psychotic symptoms.
Measures
- Continuum Beliefs Questionnaire (Schomerus et al., 2016)
- Social Rejection Questionnaire (Hales et al., 2016)
A one-way between-subjects ANOVA was run to investigate whether the video intervention would be more effective at decreasing the likelihood of rejecting those with mental illness that have psychotic symptoms. Contrary to the hypothesis, there were no significant differences between the vignette condition (M = 1.86, SD = 0.74), video condition (M = 1.85, SD = .71), and the control condition (M = 1.94, SD = .52) on social rejection likelihood: F(2, 80) = 0.16, p = .845, ηp2 = .004.
A 2 (time: pre-test, post-test) x 3 (condition: vignette, video, control) mixed ANOVA was run to investigate whether the video condition will be more effective at increasing continuum beliefs about psychotic symptoms. There was a main effect of time, F(1, 80) = 21.1, p < .001, ηp2 = .209, such that participants at time 2 had higher continuum belief scores (M = 3.5x5, SD = 0.66) than participants at time 1 (M = 3.27, SD = 0.57; mean diff = 0.28, SE = 0.06, p < .001).
See Figure 1.
Results did not suggest that the novel video intervention was more effective than the written vignette at increasing continuum beliefs. However, the video intervention was still successful at increasing continuum beliefs between time 1 and time 2. This result shows that the video is an effective format at increasing continuum beliefs- just not more effective than a written vignette at this stage.
Despite continuum beliefs significantly increasing for both the vignette and video conditions, there was not a significant difference between any of the three conditions in rejection likelihood. Across all three conditions, participants were unlikely to reject the fictional character who presents with psychotic symptoms. A potential explanation could be a social desirability bias prompting participants to not reject the fictional individual despite this not being their true feelings.
The success of the novel video format points to a promising direction in the reduction of social stigma surrounding mental disorders with psychotic symptoms.
Future research could alter the video intervention to make it more appealing and engaging. The video used in this study was still very rudimentary and a more pronounced effect could have been seen if the video was more deeply engaging and held the attention of the participant.
One major limitation to this study was that stigmatized beliefs about mental illness were never directly measured. So, we cannot assume that the interventions reduced beliefs.
Note. There was a significant difference in continuum beliefs between time 1 and time 2 for both the video (p < .05) and vignette conditions (p = .004), but no significant differences in continuum beliefs between time 1 and time 2 in the control condition (p = .696).
Results
Boysen, G. A., Morton, J., & Nieves, T. (2019). Mental illness as a relationship dealbreaker. Stigma and Health, 4(4), 421–428. https://doi.org/10.1037/sah0000157
Capriola-Hall, N. N., Wieckowski, A. T., Ollendick, T. H., & White, S. W. (2018). The influence of social communication impairments on gaze in adolescents with social anxiety disorder. Child Psychiatry and Human Development, 49(4), 672–679. https://doi.org/10.1007/s10578-018-0782-z
Fulford, D., & Mueser, K. T. (2020). The importance of understanding and addressing loneliness in psychotic disorders. Clinical Psychology: Science and Practice, 27(4). https://doi.org/10.1111/cpsp.12383
Schomerus, G., Angermeyer, M. C., Baumeister, S. E., Stolzenburg, S., Link, B. G., & Phelan, J. C. (2016). An online intervention using information on the mental health-mental illness continuum to reduce stigma. European Psychiatry, 32, 21-27. https://dx.doi.org/j.eurpsy.2015.11.006
Thibodeau, R. (2020). Continuum belief, categorical belief, and depression stigma: Correlational evidence and outcomes of an online intervention. Stigma and Health, 5(4), 404–412. https://doi.org/10.1037/sah0000211
Thibodeau, R., & Principino, H. M. (2019). Keep your distance: People sit farther away from a man with schizophrenia versus diabetes. Stigma and Health, 4(4), 429–432. https://dx.doi.org/10.1037/sah0000156
Conclusions
References
Acknowledgment
A tremendous “thank you” to Dr. Freedman for her outstanding mentorship during this entire study. Her support and guidance was essential in this project and I am grateful for such a fantastic experience working with her.