New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, United States of America.
Department of Biostatistics, Columbia University Mailman School of Public Health, United States of America.
Schizophr Res. 2022 May;243:195-202. doi: 10.1016/j.schres.2022.03.011. Epub 2022 Apr 6.
Social contact-based interventions effectively reduce stigma toward psychosis. We recently demonstrated the efficacy of a 90-second video intervention in reducing stigma. The current randomized controlled study presents four briefer videos differing in presenter's gender/race, with baseline, postintervention, and 30-day follow-up assessments. The study replicates previous findings and examine whether concordance of presenter's and viewer's race/gender enhanced the anti-stigma effect.
Using a crowdsourcing platform, we recruited 1993 participants ages 18-35 years to one of four brief video-based interventions (Black/White female, Black/White male presenters) or a nonintervention control condition. In the videos, a young presenter with psychosis humanized their illness through an evocative description of living a meaningful and productive life.
Group-by-time ANOVA showed a significant group-by-time interaction for the total score of all five stigma domains: social distance, stereotyping, separateness, social restriction, and perceived recovery. One-way ANOVA showed greater reductions in video intervention groups than control at post-intervention and 30-day follow-up, but no differences between video groups. Matching race/gender did not further reduce stigma.
This randomized controlled study replicated and extended previous research findings, by showing stigma reduction across videos that differ in the presenter's gender and race, thus enhancing generalizability. The videos described the experience of psychosis and reduced stigma, suggesting their potential utility on social media platforms to increase the likelihood of seeking services and ultimately may improve access to care among young individuals with psychosis. Future research should address intersectional stigma experiences by focusing on race/gender and culturally tailoring the narrative.
基于社会接触的干预措施可有效减少对精神病的污名化。我们最近证明了 90 秒视频干预在减少污名方面的有效性。本随机对照研究提出了四个更简短的视频，其呈现者的性别/种族不同，同时进行基线、干预后和 30 天随访评估。该研究复制了先前的发现，并探讨了呈现者和观看者的种族/性别一致性是否增强了反污名效应。
我们使用众包平台招募了 1993 名年龄在 18-35 岁之间的参与者，他们被分配到四个基于视频的简短干预组之一（黑人/白人女性、黑人/白人男性呈现者）或非干预对照组。在视频中，一位患有精神病的年轻呈现者通过生动描述过有意义和富有成效的生活，使他们的疾病人性化。
组间时间方差分析显示，所有五个污名领域的总分存在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。单因素方差分析显示，与对照组相比，视频干预组在干预后和 30 天随访时的污名减少程度更大，但视频组之间没有差异。种族/性别匹配并没有进一步减少污名。
这项随机对照研究复制并扩展了先前的研究结果，表明通过呈现者的性别和种族不同的视频可以减少污名，从而提高了普遍性。这些视频描述了精神病的体验，并减少了污名，这表明它们在社交媒体平台上具有潜在的效用，可以增加寻求服务的可能性，并最终可能改善年轻精神病患者的获得护理的机会。未来的研究应通过关注种族/性别和文化调整叙事来解决交叉污名体验。
