Community Mental Health Journal

, Volume 49, Issue 3, pp 270–280 | Cite as

‘Individualism-Collectivism’ as an Explanatory Device for Mental Illness Stigma

Original Paper


The aim of this study is investigate whether the cross-cultural value paradigm ‘individualism-collectivism’ is a useful explanatory model for mental illness stigma on a cultural level. Using snowball sampling, a quantitative questionnaire survey of 305 individuals from four UK-based cultural groups (white-English, American, Greek/Greek Cypriot, and Chinese) was carried out. The questionnaire included the ‘Community Attitudes to Mental Illness scale’ and the ‘vertical-horizontal individualism-collectivism scale’. The results revealed that the more stigmatizing a culture’s mental illness attitudes are, the more likely collectivism effectively explains these attitudes. In contrast, the more positive a culture’s mental illness attitudes, the more likely individualism effectively explains attitudes. We conclude that a consideration of the individualism-collectivism paradigm should be included in any future research aiming to provide a holistic understanding of the causes of mental illness stigma, particularly when the cultures stigmatization levels are particularly high or low.


Stigma Mental illness Attitudes Individualism Collectivism Culture 


Conflict of interest

There are no known conflicts of interest. All authors in this study certify their responsibility for the conduct of this study, the analysis and interpretation of data, that they have helped write this manuscript, agree with decisions about it, that they meet the definition of an author as stated by the International Committee of Medical Journal Editors, and that they have seen and approved the final manuscript. The authors also certify that neither the article nor any essential part of it, including figures and tables, will be published or submitted elsewhere before appearing in the Journal.


  1. Abdullah, T., & Brown, T. L. (2011). Mental illness stigma and ethnocultural beliefs, values, and norms: an integrative review. Clinical Psychology Review, 31(6), 934–948.PubMedCrossRefGoogle Scholar
  2. Abu-Baker, K. (2005). The impact of social values on the psychology of gender among Arab couples: A view from psychotherapy. Israel Journal of Psychiatry, 42(2), 106–115.Google Scholar
  3. Addison, S. J., & Thorpe, S. J. (2004). Factors involved in the formation of attitudes towards those who are mentally ill. Social Psychiatry and Psychiatric Epidemiology, 39(3), 228–234.PubMedCrossRefGoogle Scholar
  4. Adewuya, A. O., & Makanjuola, R. O. (2008). Social distance towards people with mental illness in southwestern Nigeria. Australian and New Zealand Journal of Psychiatry, 42(5), 389–395.PubMedCrossRefGoogle Scholar
  5. Al-Issa, I. (1995). The illusion of reality or reality of illusion: Hallucinations and culture. British Journal of Psychiatry, 166(3), 368–373.PubMedCrossRefGoogle Scholar
  6. Al-Krenawi, A., Graham, J. R., Al-Bedah, E. A., Kadri, H. M., & Sehwail, M. A. (2009). Cross-national comparison of Middle Eastern university students: Help-seeking behaviors, attitudes toward helping professionals, and cultural beliefs about mental health problems. Community Mental Health Journal, 45(1), 26–36.PubMedCrossRefGoogle Scholar
  7. Al-Krenawi, A., Graham, J. R., Dean, Y. Z., & Eltaiba, N. (2004). Cross-national study of attitudes towards seeking professional help: Jordan, United Arab Emirates (UAE) and Arabs in Israel. International Journal of Social Psychiatry, 50(2), 102–114.PubMedCrossRefGoogle Scholar
  8. Anglin, D. M., Link, B. G., & Phelan, J. C. (2006). Racial differences in stigmatizing attitudes toward people with mental illness. Psychiatric Services, 57(6), 857–862.PubMedCrossRefGoogle Scholar
  9. Berry, J. W., Pootinga, Y. H., Breugelmans, S. M., Chasiotis, A., & Sam, D. L. (2011). Cross-cultural psychology: Research and applications (3rd ed.). Cambridge: Cambridge University Press.CrossRefGoogle Scholar
  10. Bhugra, D. (1989). Attitudes towards mental illness. A review of the literature. Acta Psychiatrica Scandinavica, 80(1), 1–12.PubMedCrossRefGoogle Scholar
  11. Bond, M. H. (2002). Reclaiming the individual form Hofstede’s ecological analysis: A 20-year Odyssey. Psychological Bulletin, 128, 73–77.PubMedCrossRefGoogle Scholar
  12. Brewer, M., & Chen, Y. (2007). Where (who) are collectives in collectivism? Toward conceptual clarification of individualism and collectivism. Psychological Review, 114(1), 133–151.PubMedCrossRefGoogle Scholar
  13. Brockington, I. F., Hall, P., Levings, J., & Murphy, C. (1993). The community’s tolerance of the mentally ill. British Journal of Psychiatry, 162, 93–99.PubMedCrossRefGoogle Scholar
  14. Broome, B. (1996). Exploring the Greek mosaic: A guide to intercultural communication in Greece. Boston: Intercultural Press Inc.,Google Scholar
  15. Byrne, P. (2001). Psychiatric stigma. British Journal of Psychiatry, 178, 281–284.CrossRefGoogle Scholar
  16. Carpenter, S. (2000). Effects of cultural tightness and collectivism on self-concept and causal attributions. Cross-Cultural Research, 34, 38–56.CrossRefGoogle Scholar
  17. Chick, G. (1997). Cultural complexity: The concept and its measurement. Cross-Cultural Research, 31, 275–307.CrossRefGoogle Scholar
  18. Corrigan, P. W., Kerr, A., & Knudsen, L. (2005). The stigma of mental illness: Explanatory models and methods for change. Applied and Preventative Psychology, 11(3), 179–190.CrossRefGoogle Scholar
  19. Crisp, A., Gelder, M., Goddard, E., & Meltzer, H. (2005). Stigmatization of people with mental illnesses: A follow-up study within the changing minds campaign of the Royal College of Psychiatrists. World Psychiatry, 4(2), 106–113.PubMedGoogle Scholar
  20. Dyduch, A., & Grzywa, A. (2009). Stigma and related factors basing on mental illness stigma. Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego, 26(153), 263–267.Google Scholar
  21. Eagles, J. M., Carson, D. P., Begg, A., & Naji, S. A. (2003). Suicide prevention: A study of patients views. British Journal of Psychiatry, 182, 261–265.PubMedCrossRefGoogle Scholar
  22. Finzen, A. (1996). Der Verwaltungsrat ist schizophren. Die Krankheit und das Stigma. Bonn: Psychiatrie-Verlag.Google Scholar
  23. Galletly, C., & Burton, C. (2011). Improving medical student attitudes towards people with schizophrenia. Australian and New Zealand Journal of Psychiatry, 45(6), 473–476.PubMedCrossRefGoogle Scholar
  24. Hall, E. T. (1976). Beyond culture. Garden City: Anchor Press.Google Scholar
  25. Heller, P. L., Chalfant, H. P., Worley, M. C., Quesada, G. M., & Bradfield, C. D. (1980). Socio-economic class, classification of “abnormal” behaviour and perceptions of mental health care: A cross-cultural comparison. British Journal of Medical Psychology, 53(4), 343–348.Google Scholar
  26. Hill, R. B. (2003). The strengths of black families (2nd ed.). Lanham: University Press of America.Google Scholar
  27. Hofstede, G. (1980). Culture’s consequences: International differences in work-related values. Newbury Park, CA: Sage.Google Scholar
  28. Hofstede, G. (2010). Cultures and organizations: Software of the mind (3rd ed.). New York: McGraw-Hill.Google Scholar
  29. Jaques, M. E., Burleigh, D., & Lee, G. (1973). Reactions to disabilities in China: A comparative, structural and descriptive analysis. Rehabilitation Counselling Bulletin, 16, 54–62.Google Scholar
  30. Koutsantoni, D. (2005). Greek cultural characteristics and academic writing. Journal of Modern Greek Studies, 23(1), 97–134.CrossRefGoogle Scholar
  31. Lauber, C., Nordt, C., Falcato, L., & Rossler, W. (2004). Factors influencing social distance toward people with mental illness. Community Mental Health Journal, 40, 265–273.PubMedCrossRefGoogle Scholar
  32. Link, B. G., Struening, E. L., Neese-Todd, S., Asmussen, S., & Phelan, J. C. (2001). Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illness. Psychiatric Services, 52, 1621–1626.PubMedCrossRefGoogle Scholar
  33. Link, B. G., Struening, E. L., Rahav, M., Phelan, J. C., & Nuttbrock, L. (1997). On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnosis of mental illness and substance abuse. Journal of Health and Social Behavior, 38, 177–190.PubMedCrossRefGoogle Scholar
  34. Morano, C. L., & DeForge, B. R. (2004). The views of older community residents toward mental health problems. Journal of Mental Health and Aging, 10, 45–64.Google Scholar
  35. Ng, P., & Chan, K. F. (2000). Sex differences in opinion towards mental illness of secondary school students in Hong Kong. International Journal of Social Psychiatry, 46(2), 79–88.PubMedCrossRefGoogle Scholar
  36. Oyserman, D., Coon, H., & Kemmelmeyer, M. (2002). Rethinking individualism and collectivism: Evaluation of theoretical assumptions and meta-analyses. Psychological Bulletin, 128(1), 3–72.PubMedCrossRefGoogle Scholar
  37. Papadopoulos, C., Leavey, G., & Vincent, C. (2002). Factors influencing stigma: A comparison of Greek-Cypriot and English attitudes towards mental illness in north London. Social Psychiatry and Psychiatric Epidemiology, 37(9), 430–434.PubMedCrossRefGoogle Scholar
  38. Pettigrew, T. F., & Tropp, L. R. (2006). A meta-analytic test of intergroup contact theory. Journal of Personality and Social Psychology, 90(5), 751–783.PubMedCrossRefGoogle Scholar
  39. Ritsher, J. B., & Phelan, J. C. (2004). Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Research, 129, 257–265.PubMedCrossRefGoogle Scholar
  40. Roman, P. M., & Floyd, H. H. (1981). Social acceptance of psychiatric illness and psychiatric treatment. Social Psychiatry, 16, 21–29.CrossRefGoogle Scholar
  41. Schimmack, U., Oishi, S., & Diener, E. (2005). Individualism: A valid and important dimension of cultural differences between nations. Personality and Social Psychology Review, 9(1), 17–31.PubMedCrossRefGoogle Scholar
  42. Sevigny, R., Yang, W., Zhang, P., Marleau, J. D., Yang, Z., Su, L., et al. (1999). Attitudes toward the mentally ill in a sample of professionals working in a psychiatric hospital in Beijing (China). International Journal of Social Psychiatry, 45(1), 41–55.PubMedCrossRefGoogle Scholar
  43. Song, L. Y., Chang, L. Y., Shih, C. Y., Lin, C. Y., & Yang, M. J. (2005). Community attitudes towards the mentally ill: The results of a national survey of the Taiwanese population. International Journal of Social Psychiatry, 51(2), 162–176.PubMedCrossRefGoogle Scholar
  44. Taylor, S. M., & Dear, M. J. (1981). Scaling community attitudes toward the mentally ill. Schizophrenia Bulletin, 7(2), 225–240.PubMedCrossRefGoogle Scholar
  45. Taylor, S. M., Dear, M. J., & Hall, G. B. (1979). Attitudes toward the mentally ill and reactions to mental health facilities. Social Science and Medicine. Medical Geography, 13D(4), 281–290.PubMedCrossRefGoogle Scholar
  46. Thornicroft, G. (2007). Most people with mental illness are not treated. Lancet, 370, 807–808.PubMedCrossRefGoogle Scholar
  47. Thornicroft, G., Brohan, E., Kassam, A., & Lewis-Holmes, E. (2008). Reducing stigma and discrimination: Candidate interventions. International Journal of Mental Health Systems, 2(1), 3–10.PubMedCrossRefGoogle Scholar
  48. Thornicroft, G., Brohan, E., Rose, D., Sartorius, N., & Leese, M. (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: A cross-sectional survey. Lancet, 373, 408–415.PubMedCrossRefGoogle Scholar
  49. Thornicroft, G., Rose, D., & Kassam, A. (2007). Discrimination in health care against people with mental illness. International Review of Psychiatry, 19(2), 113–122.PubMedCrossRefGoogle Scholar
  50. Triandis, H. C. (1995). Individualism and collectivism. Boulder, CO: Westview.Google Scholar
  51. Triandis, H. C. (2001). Individualism-collectivism and personality. Journal of Personality, 69(6), 907–924.PubMedCrossRefGoogle Scholar
  52. Triandis, H. C., & Suh, E. M. (2002). Cultural influences on personality. Annual Review of Psychology, 53, 133–160.PubMedCrossRefGoogle Scholar
  53. Triandis, H. C., & Vassiliou, V. (1972). Interpersonal influence and employee selection in two cultures. Journal of Applied Psychology, 56, 140–145.CrossRefGoogle Scholar
  54. Tyler, K. M., Uqdah, A. L., Dillihunt, M. L., Beatty-Hazelbaker, R., Conner, T., Gadson, N., et al. (2008). Cultural discontinuity: Toward a quantitative investigation of a major hypothesis in education. Educational Researcher, 37(5), 280–297.CrossRefGoogle Scholar
  55. Webb, A. K., Jacobs-Lawson, J. M., & Waddell, E. L. (2009). Older adults’ perceptions of mentally ill older adults. Aging & Mental Health, 13(6), 838–846.CrossRefGoogle Scholar
  56. Westbrook, M. L., Legge, V., & Pennay, M. (1993). Attitudes towards disabilities in a multi-cultural society. Journal of Social Science Medicine, 5, 615–623.CrossRefGoogle Scholar
  57. Whaley, A. (1997). Ethnic and racial differences in perceptions of dangerousness of persons with mental illness. Psychiatric Services, 48, 1328–1330.PubMedGoogle Scholar
  58. Whatley, C. D. (1959). Social attitudes toward discharged mental patients. Social Problems, 6, 313–320.CrossRefGoogle Scholar
  59. Wolff, G., Pathare, S., Craig, T., & Leff, J. (1996a). Community attitudes to mental illness. British Journal of Psychiatry, 168(2), 183–190.PubMedCrossRefGoogle Scholar
  60. Wolff, G., Pathare, S., Craig, T., & Leff, J. (1996b). Community knowledge of mental illness and reaction to mentally ill people. British Journal of Psychiatry, 168(2), 191–198.PubMedCrossRefGoogle Scholar
  61. Wolff, G., Pathare, S., Craig, T., & Leff, J. (1996c). Public education for community care. A new approach. British Journal of Psychiatry, 168(4), 441–447.PubMedCrossRefGoogle Scholar
  62. Yang, H. Y. (1989). Attitudes towards psychoses and psychotic patients in Beijing. International Journal of Social Psychiatry, 35(2), 181–187.PubMedCrossRefGoogle Scholar
  63. Yang, H., de Vliert, E. V., & Shi, K. (2007). Interpersonal relationship and lay third parties’ side-taking preference: A cross-cultural study among Chinese and Dutch. Journal of Cross-Cultural Psychology, 38(4), 438–457.CrossRefGoogle Scholar
  64. Yoshii, H., Watanabe, Y., Kitamura, H., Nan, Z., & Akazawa, K. (2011). Stigma toward schizophrenia among parents of junior and senior high school students in Japan. BMC Research Notes, 22(4), 558.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Institute for Health ResearchUniversity of BedfordshireBedfordshireUK
  2. 2.Department of Family Care and Mental HealthGreenwich UniversityEltham, LondonUK
  3. 3.Institute of Nursing and MidwiferyMiddlesex UniversityLondonUK

Personalised recommendations