Continuum Beliefs Research Articles

Continuum beliefs and attitudes towards people with mental illness: Results from a national survey in France.

Whether mental disorders should be considered as categorical or dimensional has found increasing attention among mental health professionals. Only little is known about what the public thinks about this issue. First, to assess how prevalent the belief in a continuum of symptoms from mental health to mental illness is among the general public. Second, to examine how continuum beliefs are associated with attitudes towards people with mental disorder. In 2012, an on-line survey was conducted in France (N = 1,600). After the presentation of a case-vignette depicting a person with either schizophrenia or depression, belief in a continuum of symptoms, emotional reactions and desire for social distance related to the person in the vignette were assessed. While 58.2% of respondents agreed in a symptom continuum for depression, this percentage was only 28.5% for schizophrenia. In both disorders, continuum beliefs were associated with more pro-social reactions and less desire for social distance. Only in schizophrenia, there was an inverse relationship with the expression of anger. There is increasing evidence of an association between continuum beliefs and positive attitudes towards people with mental illness. Information on the continuous nature of psychopathological phenomena may usefully be included in anti-stigma messages.

Continuum beliefs and stigmatizing attitudes towards persons with schizophrenia, depression and alcohol dependence

Separation is a central step in the process of stigmatizing persons with mental disorders. We examine whether belief in a continuum of symptoms from mental health to mental illness is associated with less stigmatizing attitudes. In a representative population survey in Germany (n=3642), using case-vignettes of persons suffering from schizophrenia, depression or alcohol dependence, we measured belief in a continuity of symptoms, emotional reactions and desire for social distance related to the person described in the vignette. While 42% of respondents agreed in symptom continuity for depression, this percentage was 26% for schizophrenia and 27% for alcohol dependence. Continuum beliefs were associated in general with more positive emotional reactions and less desire for social distance. This relationship was strongest for schizophrenia, followed by alcohol dependence. Continuum beliefs thus seem to be associated with less stigmatizing attitudes, particularly regarding schizophrenia and alcohol dependence. Educational information on the continuous nature of most psychopathological phenomena could usefully be integrated in anti-stigma messages.

Are continuum beliefs about psychotic symptoms associated with stereotypes about schizophrenia?

Contact with people diagnosed with schizophrenia, and causal beliefs about the disorder, have both been shown to correlate with stigmatization. However, the associations are complex and heterogeneous. The effects of antistigma campaigns that have implemented personal contact have been limited and interventions promoting biological causal explanations have been found to increase stigmatization in some cases. Possibly a more suitable strategy for antistigma interventions could be to incorporate continuum beliefs, which propose that symptoms of schizophrenia lie on a continuum with normal experiences. The present study considers the potential for interventions focused on continuum beliefs by investigating the association between continuum beliefs and stigmatization. Within a sample of 120 participants of an online study, higher levels of continuum beliefs (assessed with the Continuum Beliefs Questionnaire, CBQ) were significantly correlated with lower stereotype scores. This association remained significant after controlling for known correlates of stereotypes (contact, causal beliefs, and educational level). We did not find an association between continuum beliefs and social distance. It is concluded that the promotion of continuum beliefs should be considered in the development of new antistigma campaigns.