Perceived Dangerousness as Related to Psychiatric Symptoms and Psychiatric Service Use \u2013 a Vignette Based Representative Population Survey

Julia F. Sowislo,Undine E. Lang,Franca Gonet-Wirz,Christian G. Huber,Stefan Borgwardt

doi:10.1038/srep45716

Julia F. Sowislo, Undine E. Lang + Show 3 more

Open Access

https://doi.org/10.1038/srep45716

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Abstract

Perceptions of dangerousness are an influential component of mental health stigma and can be driven by the display of psychiatric symptoms and the use of psychiatric service institutions. Yet, no previous study compared symptoms and service use associated perceptions of dangerousness. Therefore, we conducted a representative survey (N = 2,207) in the canton of Basel-Stadt, Switzerland. Participants were asked to answer the perceived dangerousness scale with respect to a vignette that either depicted psychiatric symptoms of a fictitious character or a psychiatric service institution the fictitious character had been admitted to. Between the vignettes, type of symptoms, type of psychiatric service, dangerousness, and gender were systematically varied. Perceived dangerousness was significantly lower as related to psychiatric service use than related to psychiatric symptoms. Overall, symptoms of alcohol dependency, behavior endangering others, and male gender of the fictitious character tend to increase perceived dangerousness. Furthermore, being hospitalized in a psychiatric unit at a general hospital or the rater being familiar with psychiatric services tends to decrease perceived dangerousness. Effective anti-stigma initiatives should integrate education about dangerousness as well as methods to increase familiarity with psychiatry. Additionally, an integration of modern psychiatry in somato-medical care institutions might decrease stigmatization.

Highlights

Individuals with mental illness are exposed to extreme stigmatization and devaluation[1]
There is one previous study showing that hospitalizations in a psychiatric unit at a general hospital evoke less desire for social distance[14]
Concerning type of psychiatric symptoms, symptoms of alcohol dependency tended to elicit significantly more perceived dangerousness than symptoms of borderline personality disorder (BPD), whereas there was no corresponding difference between symptoms of alcohol dependency and symptoms of psychotic disorder

Summary

Introduction

Individuals with mental illness are exposed to extreme stigmatization and devaluation[1]. Individuals with mental illness are commonly perceived as being relatively dangerous, as multiple representative studies have shown[4] This finding is mirrored in everyday life, for instance by stereotyped media portrays that highlight a high risk for violence in mental illness[3]. The only existent studies suggest that mental health professionals[11,12] perceive individuals with borderline personality disorder (BPD) as more dangerous than individuals with alcoholism. This effect might be specific to professionals, as individuals with BPD tend to evoke a intense disorder-specific countertransference in treatment[13]. By often being geographically dislocated, psychiatric hospitals might evoke associations of confinement and foster perceptions of dangerousness[15]

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