emotional reactions to people with mental illness: results from population studies matthias c....
Post on 28-Mar-2015
213 Views
Preview:
TRANSCRIPT
Emotional Reactions to People with Mental Illness:
Results from Population Studies
Matthias C. AngermeyerCenter for Public Mental Health
Gösing am WagramAustria
“…Social psychologists have focused upon thoughts (cognition) rather than feelings (affect). … However, the reactions of a host majority acting with prejudice in rejecting a minority group usually involve not just negative thoughts but also emotionally laden attitudes involving anxiety, anger, resentment, hostility, distaste or disgust…In fact, prejudice may more strongly predict discrimination than do stereotypes…Interestingly,…there is almost nothing published about emotional reactions to people with mental illness apart from that which describes a fear of violence …”
(Thornicroft & Kassam 2008, 189ff)
Systematic Review of Population Studies on Public Beliefs About Mental Disorders and Attitudes Towards the Mentally Ill
• Inclusion criteria: - Population studies using random sampling - All languages
• Time period covered: 1948 – 2008
• Countries included: 62
• Number of publications: 369
• Number of studies: 261 (137 national, 124 local/regional)
0
10
20
30
40
50
60
70
80
90
100
110
46-48
49-51
52-54
55-57
58-60
61-63
64-66
67-69
70-72
73-75
76-78
79-81
82-84
85-87
88-90
91-93
94-96
97-99
00-02
03-05
06-08
N P
ublic
atio
nsPublications on Population Studies on Public Beliefs About Mental Disorder and Attitudes Towards People With Mental
Illness (N=369)
Years
Studies on Public Beliefs about Mental Disorders and AttitudesTowards the Mentally Ill (n=261)
1-9
10+
Publications on Population Studies Including Measures of Emotional Reactions
N % of all studies (n=261)
Perspective of the Stigmatizer
● Positive feelings 15 5.7
● Anxiety 19 7.3
● Anger 15 5.7
Perspective of the Stigmatized
● Shame 7 2.7
● Embarrassment 18 6.9
Total 45 17.2
Components of Modern Conceptualizations of Stigma
Link & Phelan 2004 Corrigan & Watson 2002 Thornicroft 2006
Labelling
Stereotyping
Separating
Status loss + Discrimination
Dependence of Stigma on Power
Stereotype
Discrimination
Ignorance
Discrimination
Emotional Reactions Prejudice Prejudice
Components of Modern Conceptualizations of Stigma
Link & Phelan 2004 Corrigan & Watson 2002 Thornicroft 2006
Labelling
Stereotyping
Separating
Status loss + Discrimination
Dependence of Stigma on Power
Stereotype
Discrimination
Ignorance
Discrimination
„Prejudice also yields emotional responses (e.g. anger or fear) to stigmatized groups“
„The reactions of a host majority acting with
prejudice… involve not just negative thoughts but also
emotionally laden attitudes…“
Emotional Reactions Prejudice Prejudice
The Role of Emotions Seen From the Vantage Point of the Stigmatizer
• In personal encounters, the way others respond emotionally tells the stigmatised person how he or she is being perceived.
Example: “ A person who feels some combination of pity and anxiety in the presence of a person with mental illness might modulate his or her voice, speaking softly and in an unnaturally calm tone, signalling to the person with mental illness that he or she is being approached from a standpoint of differentness.” (Link et al. 2004)
• Emotional responses may shape subsequent behaviour toward the stigmatised person.
Example: A person who reacts with fear might feel a stronger desire for social distance and avoid contact with people with mental illness.
Example: “ A person who feels some combination of pity and anxiety in the presence of a person with mental illness might modulate his or her voice, speaking softly and in an unnaturally calm tone, signalling to the person with mental illness that he or she is being approached from a standpoint of differentness.” (Link et al. 2004)
Example: A person who reacts with fear might feel a stronger desire for social distance and avoid contact with people with mental illness.
The Role of Emotions Seen From the Vantage Point of the Stigmatized
• In interpersonal interaction, how the stigmatised individual responds emotionally may confirm misconceptions held by others.
Example: In interpersonal encounters, a person ashamed of her mental illness might keep her illness a secret. Preoccupation with his or her undisclosed status as mentally ill person may lead to anxiety, which in turn leads to social awkwardness. This may let others feel uncomfortable and confirm their perception that people with mental illness are strange and hard to talk to.
• Emotional responses may shape subsequent behaviour of the stigmatised person.
Example: Shame and anxiety might let people with mental illness avoid contact with mental health professionals, resulting in delayed help seeking or discontinuation of treatment.
Example: In interpersonal encounters, a person ashamed of her mental illness might keep her illness a secret. Preoccupation with his or her undisclosed status as mentally ill person may lead to anxiety,which in turn leads to social awkwardness. This may let others feel uncomfortable and confirm their perception that people with mental illness are strange and hard to talk to.
Example: Shame and anxiety might let people with mental illness avoid contact with mental health professionals, resulting in delayed help seeking or discontinuation of treatment.
• How prevalent are the various emotional reactions to people with mental disorder?
• Are there differences between mental disorders as concerns the public’s emotional reactions?
• How important are emotional reactions as compared with stereotypes?
• Does familiarity with mental illness work through modification of emotional reactions?
• How prevalent are the various emotional reactions to people with mental disorder?
• Are there differences between mental disorders?
• How important are emotional reactions as compared to stereotypes?
• Does familiarity with mental illness work through modification of emotional reactions?
0
10
20
30
40
50
60
70
80
90
100
Pity
Desire
to h
elp
Uneas
iness
Inse
curit
yFea
r
Empa
thy
Lack
of u
nder
standin
g
Irrita
tion
Anger
Ridicu
le
Emotional Reactions to People With SchizophreniaPopulation Study in Germany, 2001
Positive Emotions Fear Anger
%
0
10
20
30
40
50
60
70
80
90
100
Desire
to h
elp
Pity
Inse
curit
y
Uneas
iness
Empa
thy
Fear
Irrita
tion
Lack
of u
nder
standin
g
Anger
Ridicu
le
Emotional Reactions to People With SchizophreniaPopulation Study in Bratislava, 2003
%
Positive Emotions Fear Anger
0
10
20
30
40
50
60
70
80
90
100
Pity
Desire
to h
elp
Uneas
iness
Inse
curit
y
Irrita
tion
Lack
of u
nder
standin
gFea
r
Empa
thy
Anger
Ridicu
le
Emotional Reactions to People With SchizophreniaPopulation Study in Novosibirsk, 2002
%
Positive Emotions Fear Anger
0
10
20
30
40
50
60
70
80
90
100
Pity
Desire
to h
elp
Uneas
iness
Fear
Inse
curit
y
Lack
of u
nder
standin
g
Irrita
tion
Empa
thy
Anger
Ridicu
le
Emotional Reactions to People With SchizophreniaPopulation Study in Ulaanbaatar, 2002
%
Positive Emotions Fear Anger
0
10
20
30
40
50
60
70
80
90
100
Desire
to h
elp
Pity
Empa
thy
Uneas
iness
Inse
curit
yFea
r
Lack
of u
nder
standin
g
Irrita
tion
Anger
Ridicu
le
Emotional Reactions to People With Major DepressionPopulation Study in Germany, 2001
%
Positive Emotions Fear Anger
0
10
20
30
40
50
60
70
80
90
100
Desire
to h
elp
Pity
Empa
thy
Uneas
iness
Inse
curit
yFea
r
Lack
of u
nder
standin
g
Irrita
tion
Anger
Ridicu
le
Emotional Reactions to People With Major DepressionPopulation Study in Germany, 2001
%
Positive Emotions Fear Anger
0
10
20
30
40
50
60
70
80
90
100
Desire
to h
elp
Pity
Empa
thy
Inse
curit
y
Uneas
iness
Fear
Irrita
tion
Lack
of u
nder
standin
g
Anger
Ridicu
le
Emotional Reactions to People With Major DepressionPopulation Study in Bratislava, 2003
%
Positive Emotions Fear Anger
0
10
20
30
40
50
60
70
80
90
100
Pity
Desire
to h
elp
Uneas
iness
Inse
curit
y
Irrita
tion
Lack
of u
nder
standin
g
Empa
thy
Fear
Anger
Ridicu
le
Emotional Reactions to People With Major DepressionPopulation Study in Novosibirsk, 2002
%
Positive Emotions Fear Anger
0
10
20
30
40
50
60
70
80
90
100
Pity
Desire
to h
elp
Uneas
iness
Inse
curit
yFea
r
Lack
of u
nder
standin
g
Empa
thy
Irrita
tion
Anger
Ridicu
le
Emotional Reactions to People With Major DepressionPopulation Study in Ulaanbaatar, 2002
%
Positive Emotions Fear Anger
Emotional Reactions to People With SchizophreniaPopulation Studies in the Western Part of Germany, 1990 and 2001
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
1990 2001 1990 2001 20011990
Emotional Reactions to People With Major DepressionPopulation Studies in the Western Part of Germany, 1990 and 2001
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
1990 2001 1990 2001 20011990
Emotional Reactions to People With SchizophreniaPopulation Studies in the Eastern Part of Germany, 1993 and 2001
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
1993 2001 1993 2001 20011993
Emotional Reactions to People With Major DepressionPopulation Studies in the Eastern Part of Germany, 1993 and 2001
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
1993 2001 1993 2001 20011993
• How prevalent are the various emotional reactions to people with mental disorder?
• Are there differences between mental disorders as concerns the public’s emotional reactions?
• How important are emotional reactions as compared to stereotypes?
• Does familiarity with mental illness work through modification of emotional reactions?
Emotional Reactions to People With Schizophrenia, Major Depression and Alcohol Dependence
Population Studies in the Western Part of Germany, 1990
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
Schizophrenia Major Depression Alcohol Dependence
Emotional Reactions to People With Schizophrenia, Major Depression and Alcoholism
Population Studies in the Western Part of Germany, 1990
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
Schizophrenia Major Depression Alcoholism
Emotional Reactions to People With Schizophrenia, Major Depression and Alcoholism
Population Studies in the Western Part of Germany, 1990
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
Schizophrenia Major Depression Alcoholism
Emotional Reactions to People With Schizophrenia, Major Depression and Alcohol Dependence
Population Studies in the Western Part of Germany, 1990
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
Schizophrenia Major Depression Alcohol Dependence
Emotional Reactions to People With Schizophrenia, Major Depression and Alcoholism
Population Studies in the Western Part of Germany, 1990
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
-0,3
-0,2
-0,1
0
0,1
0,2
0,3
Score Score ScoreFear Positive emotions Anger
Schizophrenia Major Depression Alcoholism
• How prevalent are the various emotional reactions to people with mental disorder?
• Are there differences between mental disorders?
• How important are emotional reactions as compared to stereotypes?
• Does familiarity with mental illness work through modification of emotional reactions?
Model 1 Model 2 Model 3 Model 4
B p B p B p B p
Age
Gender
Educational attainment
.021 .007
-.302 .236
-.319 .049
.022 .003
-.253 .279
-.100 .509
.029 .000
-.225 .334
.108 .468
.028 .000
-.181 .420
-.073 .616
Dangerous
Unpredictable
Lack of willpower
1.019 .000
1.403 .000
.394 .699
.680 .000
1.036 .000
.011 .351
Fear
Positive emotions
Anger
1.781 .000
-2.154 .000
.181 .100
1.072 .000
-1.819 .000
.211 .061
Adj. R² .005 .165 .209 .270
Regression of Desire For Social Distance Towards People With Schizophrenia on Socio-Demographic Characteristics, Stereotypes
and Emotional Reactions.Population Study in Germany, 2001.
Model 1 Model 2 Model 3 Model 4
B p B p B p B p
Age
Gender
Educational attainment
.021 .007
-.302 .236
-.319 .049
.022 .003
-.253 .279
-.100 .509
.029 .000
-.225 .334
.108 .468
.028 .000
-.181 .420
-.073 .616
Dangerous
Unpredictable
Lack of willpower
1.019 .000
1.403 .000
.394 .699
.680 .000
1.036 .000
.011 .351
Fear
Positive emotions
Anger
1.781 .000
-2.154 .000
.181 .100
1.072 .000
-1.819 .000
.211 .061
Adj. R² .005 .165 .209 .270
Regression of Desire For Social Distance Towards People With Schizophrenia on Socio-Demographic Characteristics, Stereotypes
and Emotional Reactions.Population Study in Germany, 2001.
Model 1 Model 2 Model 3 Model 4
B p B p B p B p
Age
Gender
Educational attainment
.021 .007
-.302 .236
-.319 .049
.022 .003
-.253 .279
-.100 .509
.029 .000
-.225 .334
.108 .468
.028 .000
-.181 .420
-.073 .616
Dangerous
Unpredictable
Lack of willpower
1.019 .000
1.403 .000
.394 .699
.680 .000
1.036 .000
.011 .351
Fear
Positive emotions
Anger
1.781 .000
-2.154 .000
.181 .100
1.072 .000
-1.819 .000
.211 .061
Adj. R² .005 .165 .209 .270
Regression of Desire for Social Distance Towards People With Schizophrenia on Socio-Demographic Characteristics, Stereotypes
and Emotional Reactions.Population Study in Germany, 2001.
Model 1 Model 2 Model 3 Model 4
B p B p B p B p
Age
Gender
Educational attainment
.021 .007
-.302 .236
-.319 .049
.022 .003
-.253 .279
-.100 .509
.029 .000
-.225 .334
.108 .468
.028 .000
-.181 .420
-.073 .616
Dangerous
Unpredictable
Lack of willpower
1.019 .000
1.403 .000
.394 .699
.680 .000
1.036 .000
.011 .351
Fear
Positive emotions
Anger
1.781 .000
-2.154 .000
.181 .100
1.072 .000
-1.819 .000
.211 .061
Adj. R² .005 .165 .209 .270
Regression of Desire for Social Distance Towards People with Schizophrenia on Socio-Demographic Characteristics, Stereotypes
and Emotional Reactions.Population Study in Germany, 2001.
• How prevalent are the various emotional reactions to people with mental disorder?
• Are there differences between mental disorders?
• How important are emotional reactions as compared to stereotypes?
• Does familiarity with mental illness work through modification of emotional reactions?
0
10
20
30
Positive associations No associations Negative associations
Num
ber
of s
tudi
esFamiliarity with Mental Illness and Desire for Social Distance
Systematic Review of Population-Based Studies on Public BeliefsAbout Mental Disorders and Attitudes Towards the Mentally Ill
Association Between Familiarity, Emotional Reactions and Social Distance Towards People With Schizophrenia
Population Study in Germany, 2001
1.67
-0.2
0
Familiarity Social distance0.22 -2.09Positive emotions
Fear
-0.18
Anger
-1.60
Sum of indirect effects –1.61
0.22
Association Between Familiarity, Emotional Reactions and Social Distance Towards People With Major Depression
Population Study in Germany, 2001
-1.31
Familiarity Social distance0.25 -1.75Positive emotions
1.35
Fear
Sum of indirect effects –1.22
0.15
-0.23
Anger
0.33
• Positive emotional responses to people with mental illness are most prevalent, followed by fear and anger.
• This pattern appears relatively stable across different cultures.
• There are differences in the public’s emotional reactions to the various types of mental disorder.
• Emotional reactions have a substantial effect on the desire for social distance.
• The association between familiarity with mental disorder and the desire for social distance is to a considerable extent mediated through emotions.
Summary
• As compared to stereotypes and behavioural intentions, the public’s emotional reactions to people with mental disorders are relatively under-researched.• Our findings suggest that more research on the public’s emotional reactions may allow to better understand the complexities of the stigma surrounding mental illness.
• Interventions aimed at reducing the stigma of mental illness may benefit from paying more attention to emotions.
Conclusion
top related