New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria).
Am J Psychiatry. 2021 Jul;178(7):635-642. doi: 10.1176/appi.ajp.2020.20091293. Epub 2021 Apr 26.
Public stigma is a barrier to care and increases the duration of untreated psychosis among individuals with first-episode psychosis. The authors recently demonstrated the efficacy of a 90-second social contact-based video intervention in reducing such stigma. That proof-of-concept study was the first to employ so brief an antistigma intervention in a sample of young adults. The authors now present a randomized controlled replication study with baseline, postintervention, and 30-day follow-up assessments. The authors aimed to replicate their previous findings and to show a persisting benefit for the video intervention.
Using a crowdsourcing platform (Amazon Mechanical Turk), the authors recruited and assigned 1,055 participants ages 18-30 years to a brief video-based intervention, to a written vignette intervention containing the same material, or to a nonintervention control condition. In the 90-second video, a 22-year-old African American woman with schizophrenia humanized the illness through her emotional description of living a meaningful and productive life.
A three-by-three group-by-time multivariate analysis of variance showed a significant group-by-time interaction for the total scores of all five stigma-related domains: social distance, stereotyping, separateness, social restriction, and perceived recovery. Post hoc pairwise tests showed greater reductions in the video group compared with the vignette and control groups at the postintervention and 30-day follow-up assessments, while the vignette group differed from the control group at the postintervention assessment but not at the 30-day assessment.
This randomized controlled study replicated and strengthened the authors' earlier findings, further showing month-long sustained stigma reduction in the social contact-based video intervention arm. A 90-second video sufficed to humanize schizophrenia and reduce stigma. Further research should examine longer-term sustainability, assess changes in behavior, and determine optimal effective video length.
公众污名是获得治疗的障碍，并会延长首发精神病患者的未治疗精神病期。作者最近证明了一种基于 90 秒社会接触的视频干预措施在减少这种污名方面的有效性。该概念验证研究首次在年轻成人样本中使用如此简短的反污名干预措施。作者现在提出了一项随机对照复制研究，包括基线、干预后和 30 天随访评估。作者旨在复制他们之前的发现，并表明视频干预具有持续的益处。
作者使用众包平台（亚马逊土耳其机器人）招募并分配了 1055 名年龄在 18 至 30 岁之间的参与者，他们被分配到一个简短的基于视频的干预组、一个包含相同材料的书面情景介绍干预组或一个非干预对照组。在 90 秒的视频中，一位 22 岁的非裔美国女性精神分裂症患者通过情感描述她过着有意义和富有成效的生活，使疾病人性化。
五个与污名相关的领域的总分的三因素三时间多元方差分析显示出显著的组间时间交互作用：社会距离、刻板印象、分离、社会限制和感知康复。事后两两比较显示，与情景介绍组和对照组相比，视频组在干预后和 30 天随访评估时的降幅更大，而情景介绍组在干预后评估时与对照组不同，但在 30 天评估时则不同。
这项随机对照研究复制并加强了作者早期的发现，进一步表明基于社会接触的视频干预在一个月内持续减少污名。一个 90 秒的视频足以使精神分裂症人性化并减少污名。进一步的研究应该检查长期的可持续性，评估行为的变化，并确定最佳的有效视频长度。
