Department of Psychiatry, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians & Surgeons, New York, NY.
Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY.
Schizophr Bull. 2021 Jan 23;47(1):7-14. doi: 10.1093/schbul/sbaa114.
Stigma decreases healthcare seeking and treatment adherence and increases the duration of untreated psychosis among people with first-episode psychosis (FEP). This study evaluated the efficacy of a brief video-based intervention in reducing stigma among youth toward individuals with FEP and schizophrenia. We hypothesized that the social-contact-based video intervention group would reduce stigma more than written vignette and control groups, and the vignette more than the control group.
Using Amazon Mechanical Turk, we recruited and assigned 1203 individuals aged 18-30 to either (a) video intervention, (b) written description of the same content ("vignette"), or (c) nonintervention control arm. In the 90-second video intervention, an empowered young woman with schizophrenia described her FEP and the aspects of successful coping with her everyday life difficulties, exposing the viewer to schizophrenia in the context of her personal narrative. Web-based self-report questionnaires assessed stigma domains, including social distance, stereotyping, separateness, social restriction, and perceived recovery.
A MANOVA showed a significant between-group effects for all 5 stigma-related subscales (P < .001). Post hoc pairwise tests showed significant differences between video and vignette vs control for all 5 stigma domains. Video and vignette groups differed significantly on social distance, stereotyping, and social restriction. Secondary analyses revealed gender differences across stigma domains in the video group only, with women reporting lower stigma.
A very brief social contact-based video intervention efficaciously reduced stigma toward individuals with FEP. This is the first study to demonstrate such an effect. Further research should examine its long-term sustainability.
污名化会降低首发精神病患者（FEP）寻求医疗和坚持治疗的意愿，并延长未治疗的精神病期。本研究评估了一种基于简短视频的干预措施在减少青年人群对 FEP 和精神分裂症患者的污名化方面的效果。我们假设基于社会接触的视频干预组将比书面描述和对照组更能减少污名化，而书面描述将比对照组更能减少污名化。
我们使用亚马逊 Mechanical Turk 招募并分配了 1203 名年龄在 18-30 岁的个体，将他们分为（a）视频干预组、（b）相同内容的书面描述（“描述”）组或（c）非干预对照组。在 90 秒的视频干预中，一位患有精神分裂症的有能力的年轻女性描述了她的 FEP 和成功应对日常生活困难的方面，使观众在她的个人叙述中接触到精神分裂症。基于网络的自我报告问卷评估了污名化领域，包括社会距离、刻板印象、分离感、社会限制和感知康复。
MANOVA 显示所有 5 个与污名相关的子量表都存在显著的组间效应（P<0.001）。事后两两比较显示，视频组和描述组与对照组在所有 5 个污名领域都有显著差异。视频组和描述组在社会距离、刻板印象和社会限制方面存在显著差异。二次分析显示，仅在视频组中，女性在各个污名领域的性别差异显著，女性的污名化程度较低。
一种非常简短的基于社会接触的视频干预有效地减少了对 FEP 患者的污名化。这是第一项证明这种效果的研究。进一步的研究应该检验其长期的可持续性。
