When do psychosocial explanations of psychiatric problems increase stigma? Self-report and implicit evidence

Abstract

Background and objectivesBiomedical explanations of psychiatric problems, compared to psychosocial explanations, may amplify psychiatric stigma. One limitation of existing research is the measurement of almost exclusively self-reported stigma. This study evaluated the stigma-related effects of biomedical versus psychosocial explanations of schizophrenia using conventional self-report and two other measurement approaches that may tap more deeply held attitudes. MethodsOne hundred three undergraduates listened to a vignette describing a man with (1) schizophrenia of biomedical origin, (2) schizophrenia of psychosocial origin, or (3) diabetes. They then completed an Implicit Association Test, conventional self-report stigma measures, and projected other measures that captured perceptions of most other people's likely impressions. Results: Participants were more likely to attribute stigmatizing views to others compared to themselves. The projected other measurement, but not the conventional self-report measurement, predicted implicit attitudes. We obtained no evidence that the psychosocial causal explanation of schizophrenia led to decreased stigma compared to the biomedical causal explanation. In fact, the psychosocial causal explanation increased stereotyped attitudes. LimitationsThe absence of a schizophrenia control group complicates interpretation of biomedical versus psychosocial group comparisons. ConclusionsFurther research is needed to evaluate discrepancies between the present findings and other published evidence pertaining to psychosocial causal explanations of psychiatric problems.