Angermeyer M C, Daubmann A, Wegscheider K, Mnich E, Schomerus G, Knesebeck O V D
Center for Public Mental Health,Gösing am Wagram,Austria.
Department of Medical Biometry and Epidemiology,University Medical Center Hamburg-Eppendorf,Hamburg,Germany.
Epidemiol Psychiatr Sci. 2015 Aug;24(4):335-41. doi: 10.1017/S2045796014000262. Epub 2014 Apr 30.
Previous population-based studies did not support the view that biological and genetic causal models help increase social acceptance of people with mental illness. However, practically all these studies used un-labelled vignettes depicting symptoms of the disorders of interest. Thus, in these studies the public's reactions to pathological behaviour had been assessed rather than reactions to psychiatric disorders that had explicitly been labelled as such. The question arises as to whether results would have been similar if respondents had been confronted with vignettes with explicit mention of the respective diagnosis.
Analyses are based on data of a telephone survey in two German metropolises conducted in 2011. Case-vignettes with typical symptoms suggestive of depression or schizophrenia were presented to the respondents. After presentation of the vignette respondents were informed about the diagnosis.
We found a statistically significant association of the endorsement of brain disease as a cause with greater desire for social distance from persons with schizophrenia. In major depression, this relation was absent. With both disorders, there was no statistically significant association between the endorsement of hereditary factors as a cause and social distance.
Irrespective of whether unlabelled or labelled vignettes are employed, the ascription to biological or genetic causes seems not to be associated with a reduction of the public's desire for social distance from people with schizophrenia or depression. Our results corroborate the notion that promulgating biological and genetic causal models may not help decrease the stigma surrounding these illnesses.
以往基于人群的研究并不支持生物和遗传因果模型有助于提高社会对精神疾病患者接受度的观点。然而，实际上所有这些研究都使用了未标明诊断的案例 vignettes 来描述相关疾病的症状。因此，在这些研究中，评估的是公众对病理行为的反应，而非对明确标明为精神疾病的反应。问题在于，如果让受访者面对明确提及各自诊断的 vignettes，结果是否会相似。
分析基于2011年在德国两个大都市进行的电话调查数据。向受访者展示具有典型抑郁或精神分裂症症状的案例 vignettes。在展示 vignette 后，告知受访者诊断结果。
我们发现，将脑部疾病视为病因的认可度与希望与精神分裂症患者保持更大社交距离之间存在统计学上的显著关联。在重度抑郁症中，这种关系不存在。对于这两种疾病，将遗传因素视为病因的认可度与社交距离之间均不存在统计学上的显著关联。
无论使用未标明还是标明诊断的 vignettes，将病因归因于生物或遗传因素似乎都与公众希望与精神分裂症或抑郁症患者保持社交距离的意愿降低无关。我们的结果证实了这样一种观点，即宣扬生物和遗传因果模型可能无助于减少围绕这些疾病的污名化。
