Ellison Nell, Mason Oliver, Scior Katrina
Clinical, Educational and Health Psychology Research Department, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
Clinical, Educational and Health Psychology Research Department, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
J Affect Disord. 2015 Apr 1;175:116-23. doi: 10.1016/j.jad.2014.12.047. Epub 2014 Dec 30.
Given the vast literature into public beliefs and attitudes towards schizophrenia and depression, there is paucity of research on attitudes towards bipolar disorder despite its similar prevalence to schizophrenia. This study explored public beliefs and attitudes towards bipolar disorder and examined the relationship between these different components of stigma.
Using an online questionnaire distributed via email, social networking sites and public institutions, 753 members of the UK population were presented with a vignette depicting someone who met DSM-IV criteria for bipolar disorder. Causal beliefs, beliefs about prognosis, emotional reactions, stereotypes, and social distance were assessed in response to the vignette. Preacher and Hayes procedure for estimating direct and indirect effects of multiple mediators was used to examine the relationship between these components of stigma.
Bipolar disorder was primarily associated with positive beliefs and attitudes and elicited a relatively low desire for social distance. Fear partially mediated the relationship between stereotypes and social distance. Biomedical causal beliefs reduced desire for social distance by increasing compassion, whereas fate causal beliefs increased it through eliciting fear. Psychosocial causal beliefs had mixed effects.
The measurement of stigma using vignettes and self-report questionnaires has implications for ecological validity and participants may have been reluctant to reveal the true extent of their negative attitudes.
Dissemination of these findings to people with bipolar disorder has implications for the reduction of internalised stigma in this population. Anti-stigma campaigns should attend to causal beliefs, stereotypes and emotional reactions as these all play a vital role in discriminatory behaviour towards people with bipolar disorder.
尽管双相情感障碍的患病率与精神分裂症相似，但针对公众对双相情感障碍的信念和态度的研究却很少，尽管已有大量关于公众对精神分裂症和抑郁症的信念和态度的文献。本研究探讨了公众对双相情感障碍的信念和态度，并检验了这些不同耻辱感成分之间的关系。
通过电子邮件、社交网站和公共机构分发在线问卷，向753名英国民众展示了一个描述符合双相情感障碍DSM-IV标准的人的 vignette（小插曲、案例描述）。针对该 vignette 评估了因果信念、预后信念、情绪反应、刻板印象和社会距离。使用Preacher和Hayes程序来估计多个中介变量的直接和间接效应，以检验这些耻辱感成分之间的关系。
双相情感障碍主要与积极的信念和态度相关，并且引发的社会距离意愿相对较低。恐惧部分介导了刻板印象与社会距离之间的关系。生物医学因果信念通过增加同情心降低了社会距离意愿，而命运因果信念通过引发恐惧增加了社会距离意愿。心理社会因果信念则有混合效应。
使用 vignettes 和自我报告问卷来测量耻辱感对生态效度有影响，并且参与者可能不愿意透露其负面态度的真实程度。
将这些研究结果传播给双相情感障碍患者对于减少该人群的内化耻辱感具有意义。反耻辱运动应关注因果信念、刻板印象和情绪反应，因为这些在对双相情感障碍患者的歧视行为中都起着至关重要的作用。
