Causal beliefs of the public and social acceptance of persons with mental illness: a comparative analysis of schizophrenia, depression and alcohol dependence
Causal beliefs of the public and social acceptance of persons with mental illness: a comparative analysis of schizophrenia, depression and alcohol dependence
复制标题
DOI：
10.1017/s003329171300072x
复制
发表时间：
2014-01-01
影响因子：
6.9
通讯作者：
Angermeyer, M. C.
中科院分区：
文献类型：
--
作者：
Schomerus, G.;Matschinger, H.;Angermeyer, M. C.
背景目前关于生物疾病的解释是否可以提高对精神疾病患者的耐受性一直存在争论。已经提出了几种理论模型来预测因果信念与社会接受度之间的关系。本研究使用路径模型来比较关于对精神分裂症、抑郁症和酒精依赖症患者的态度的不同理论预测。方法在德国的一项代表性人口调查中（n=3642），我们得出了以下观点的共识：生物遗传原因、当前的压力和童年逆境是这两种疾病的原因，如未标记的病例小插图中所述。我们进一步引出了与关于生物遗传因果信念的后果的不同理论（归因理论：起始责任、抵消责任；遗传本质主义：差异性、危险性；遗传乐观主义：可治疗性）和社会接受度相关的潜在中介态度。对于每个小插图条件，我们计算了包含所有变量的多中介路径模型。结果生物遗传学信念与精神分裂症和抑郁症的较低社会接受度相关，而与酒精依赖的较高接受度相关。在精神分裂症和抑郁症中，感知到的差异和危险性介导了最大的间接影响，生物遗传学因果解释的后果因此与遗传本质主义的预测一致。心理社会因果信念具有不同的影响：相信当前压力是导致精神分裂症的原因与较高的接受度相关，而相信童年的逆境则导致对抑郁症患者的接受度较低。结论生物学因果解释似乎对酒精依赖有益，但对精神分裂症和抑郁症有害。相信童年时期的逆境是抑郁症的原因，其负面影响值得进一步探讨。
BackgroundThere is an ongoing debate whether biological illness explanations improve tolerance towards persons with mental illness or not. Several theoretical models have been proposed to predict the relationship between causal beliefs and social acceptance. This study uses path models to compare different theoretical predictions regarding attitudes towards persons with schizophrenia, depression and alcohol dependence.MethodIn a representative population survey in Germany (n=3642), we elicited agreement with belief in biogenetic causes, current stress and childhood adversities as causes of either disorder as described in an unlabelled case vignette. We further elicited potentially mediating attitudes related to different theories about the consequences of biogenetic causal beliefs (attribution theory: onset responsibility, offset responsibility; genetic essentialism: differentness, dangerousness; genetic optimism: treatability) and social acceptance. For each vignette condition, we calculated a multiple mediator path model containing all variables.ResultsBiogenetic beliefs were associated with lower social acceptance in schizophrenia and depression, and with higher acceptance in alcohol dependence. In schizophrenia and depression, perceived differentness and dangerousness mediated the largest indirect effects, the consequences of biogenetic causal explanations thus being in accordance with the predictions of genetic essentialism. Psychosocial causal beliefs had differential effects: belief in current stress as a cause was associated with higher acceptance in schizophrenia, while belief in childhood adversities resulted in lower acceptance of a person with depression.ConclusionsBiological causal explanations seem beneficial in alcohol dependence, but harmful in schizophrenia and depression. The negative correlates of believing in childhood adversities as a cause of depression merit further exploration.