Stigmatization and mental illness: The effects of illness feature on attribution

Debra Shepard Nelson (2003)

Individuals who suffer from a mental illness are often judged unfairly and viewed as unpredictable, dangerous, and untrustworthy (Mehta & Farina, 1988; Wahl & Harman, 1989). The goal of this research was to examine stigmatization of the mentally ill by incorporating both attribution theory and counterfactual thinking to help identify what leads observers to stigmatize those who suffer from mental illness. Participants read a scenario in which they are to imagine that they are waiting for a subway train and observing the behavior of another individual. The observed behavior was manipulated across four scenarios (i.e., illness feature: positive symptoms, negative symptoms, dangerousness, and no unusual behavior). Participants were then asked to generate counterfactuals, or ways in which the situation could have been different, and answer Likert-scale questions relating to the scenario. The primary hypothesis was that presence of each of the illness features would be associated with increases in observer judgments related to stigmatization. A 4 (Illness feature) x 2 (Gender of Rater) factorial ANOVA with a stigmatization composite score as the dependent measure was used to test the hypothesis and a significant main effect of illness feature was confirmed, supporting the hypothesis that variation in illness feature is significantly related to observers' stigmatization-related ratings. A Bonferroni post-hoc test of multiple comparisons indicated that the dangerousness condition was significantly different from each of the other conditions, and both the positive and negative symptom conditions were significantly different from the no illness condition. No other main effects, interactions or correlations were found to be significant with any of the other hypotheses. The significant results with each of the illness features may have been related to participants' response to a violation of social rules within the scenarios. The dangerousness condition was the most extreme example in which participants responded to the social rule violation with a heightened emotional response. While this "fight or flight" response may be adaptive for the observer in the moment, on a societal level this stigmatization may lead to a general diffusion of responsibility to ensure that the mentally ill have the opportunity for treatment.