Department of Sociology (Elliott) and the Interdisciplinary Social Psychology Ph.D. Program (Ragsdale, LaMotte), University of Nevada, Reno.
Psychiatr Serv. 2024 Feb 1;75(2):131-138. doi: 10.1176/appi.ps.20230169. Epub 2023 Aug 9.
The purpose of this study was to test the effects of causal explanations, information about treatability, and type of psychiatric diagnosis on how the public reacts to an individual described as having a specific mental illness versus subclinical distress.
A 5 (mental health condition) × 2 (treatability) × 4 (causal explanation) vignette experiment was embedded in an online survey, followed by assessments of prognostic optimism and desire to maintain social distance from the vignette character. Data were collected, in late 2022, from a probability sample (N=1,607) representative of the U.S. adult population. Ordinary least-squares regression was used to estimate the effects of the experimental conditions, covariates, and interactions on respondents' desire for social distance and their prognostic optimism.
Attribution of mental illness to a genetic predisposition (vs. no attribution) significantly (p<0.001) predicted unwillingness to socially interact with the vignette character, regardless of the character's psychiatric diagnosis. Describing the illness as treatable with medication or psychotherapy (vs. no treatability information) also reduced willingness to socially interact, yet it also increased optimism for recovery. Desire for social distance and prognostic pessimism were greater for alcohol use disorder, opioid use disorder, or schizophrenia compared with major depression or subclinical distress.
Attributing mental illness solely to genetics predicts social rejection of people diagnosed as having psychiatric disorders. Efforts to reduce stigma, increase social acceptance, and protect the mental health of individuals diagnosed as having a mental illness should include not framing mental illness exclusively in genetic terms.
本研究旨在测试因果解释、可治疗性信息以及精神科诊断类型对公众对被描述为患有特定精神疾病与亚临床困扰的个体的反应的影响。
一项 5（心理健康状况）×2（可治疗性）×4（因果解释）的情景实验嵌入在线调查中，随后评估预后乐观和与情景角色保持社会距离的意愿。数据于 2022 年末从具有代表性的美国成年人群概率样本（N=1,607）中收集。使用普通最小二乘法回归估计实验条件、协变量和交互作用对受访者保持社会距离的意愿和预后乐观的影响。
将精神疾病归因于遗传易感性（与无归因相比）显著（p<0.001）预测了不愿意与情景角色进行社交互动，无论该角色的精神科诊断如何。将疾病描述为可用药物或心理疗法治疗（与无治疗信息相比）也会降低社交互动的意愿，但也会增加康复的乐观程度。与重度抑郁症或亚临床困扰相比，酒精使用障碍、阿片类药物使用障碍或精神分裂症更倾向于保持社会距离和预后悲观。
将精神疾病仅归因于遗传会预测对被诊断为患有精神障碍的人的社会排斥。减少污名化、增加社会接受度和保护被诊断为患有精神疾病的个体的心理健康的努力应包括不将精神疾病完全归因于遗传因素。
