Zeng Xiangming
Department of Public Management, Law School, Wenzhou University, China.
Heliyon. 2024 Jun 18;10(12):e32985. doi: 10.1016/j.heliyon.2024.e32985. eCollection 2024 Jun 30.
Mental illness in China has traditionally been attributed to physical factors and somatization tendencies, which seldom result in stigma. How has this perception changed after decades of social change?
Based on the Chinese General Social Survey database in 2011, this study constructed a structural equation model to analyze the effects of causal attribution and emotional responses on social distance. The causal attributions include dangerousness, controllability, and responsibility. And the emotional responses encompass negative affect, traditional prejudice, treatment carryover, and exclusionary sentiments. In addition, higher scores indicating greater social distance, whereas a low score reflected stronger emotional responses or a greater degree of internal attribution.
The results reported a high level of social distance towards people with mental illness. These findings indicated that emotional responses have a direct impact on social distance. Specifically, when negative affect, traditional prejudice, and exclusionary sentiments increase by one standard deviation, the social distance decreases by 0.497, 0.178, and 0.073 standard deviation, respectively. Conversely, as the level of treatment carryover rises, social distance increases by 0.087. Meanwhile, the causal attribution only exerts a significant indirect effect on social distance by the function of emotional causal responses.
The results indicated that the public attributes mental illnesses like depression primarily to psychological issues rather than somatic ones. It suggested widespread stereotypes and public stigma towards people with mental illness in China, as well as an arduous task in anti-stigma. In addition, a targeted way to address public stigma lies in changing the stereotype of people with mental illness.
在中国，精神疾病传统上一直被归因于身体因素和躯体化倾向，这种情况很少导致污名化。经过几十年的社会变革，这种观念发生了怎样的变化？
基于2011年中国综合社会调查数据库，本研究构建了一个结构方程模型，以分析因果归因和情绪反应对社会距离的影响。因果归因包括危险性、可控性和责任性。情绪反应包括负面影响、传统偏见、治疗延续效应和排斥情绪。此外，得分越高表明社会距离越大，而得分越低则反映出更强的情绪反应或更高程度的内部归因。
结果显示对患有精神疾病的人存在高度的社会距离。这些发现表明情绪反应对社会距离有直接影响。具体而言，当负面影响、传统偏见和排斥情绪增加一个标准差时，社会距离分别减少0.497、0.178和0.073个标准差。相反，随着治疗延续效应水平的上升，社会距离增加0.087。同时，因果归因仅通过情绪因果反应的作用对社会距离产生显著的间接影响。
结果表明，公众将抑郁症等精神疾病主要归因于心理问题而非躯体问题。这表明在中国，对患有精神疾病的人存在普遍的刻板印象和公众污名，以及反污名化的艰巨任务。此外，解决公众污名的一个有针对性的方法在于改变对患有精神疾病的人的刻板印象。
