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Behavior or Diagnosis? Effects of Irritable Patient Behavior and Diagnostic Labels on Mental Illness Stigma

Although research demonstrates significant stigma towards individuals with mental illness, the relative importance of observed behavior and a psychiatric diagnosis in eliciting stigma remains poorly understood. Using video vignettes, three experiments (ns = 195, 749, and 791) examined the effect of irritable (vs. calm) behavior and the presence (vs. absence) of a psychiatric diagnosis (schizophrenia in Studies 1 and 2; schizophrenia and depression in Study 3) on attitudinal, emotional, and behavioral dimensions of stigma towards a fictitious emergency room patient seeking migraine treatment. In line with labeling theory, irritable behavior resulted in greater blameworthy attributions for behavior, greater fear and anger, less caring emotions, and lower perceived warmth. Both a depression and schizophrenia diagnosis elicited stigma by leading to greater endorsements of other stigmatizing attributions (e.g., substance use) as a reason for behavior. Irritable behavior and both psychiatric diagnoses resulted in patients being rated as less predictable and more dangerous, whereas irritable behavior and schizophrenia only resulted in decreased competence. Irritable behavior and psychiatric diagnosis also interacted to predict desire for social distance. When calm, a psychiatric diagnosis predicted greater distance, such that a patient with no label was least stigmatized, one with depression was moderately stigmatized, and one with schizophrenia was most stigmatized. When irritable, the patient elicited a higher desire for distance regardless of psychiatric diagnosis. Mediational analyses show that when controlling for behavior, perceived dangerousness and fear mediate the effect of a diagnosis on desire for distance. In all, results suggest both diagnostic labels and irritable behavior result in stigma via different attitudinal and emotional mechanisms, and that individuals with psychiatric diagnoses face stigma even if behaving calmly. By enriching understanding of the relative importance of irritable behavior and a psychiatric diagnosis on multiple dimensions of mental illness stigma, this work has implications for anti-stigma interventions.

Identiferoai:union.ndltd.org:UMASS/oai:scholarworks.umass.edu:masters_theses_2-2207
Date21 March 2022
CreatorsHuff, Nathan R.
PublisherScholarWorks@UMass Amherst
Source SetsUniversity of Massachusetts, Amherst
Detected LanguageEnglish
Typetext
Formatapplication/pdf
SourceMasters Theses

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