Skip to main content

The Stigmatising Implications of Presenting Schizophrenia as a Genetic Disease


This study aimed to investigate the hypothesis that belief in a genetic aetiology of schizophrenia will increase the stigma associated with the disorder. Levels of five potentially stigmatising attitudes were compared in two groups of participants who had read a vignette describing an individual who has schizophrenia. In one group the disorder was explained as being caused by ‘genetic’ factors, and in the other by ‘environmental’ factors. This study found that three of the five potentially stigmatising attitudes measured were increased when participants read a vignette with a genetic causation rather than an environmental causation. Firstly, genetic attributions increased levels of associative stigma towards close relatives (p < 0.001). Secondly, participants viewed recovery as less likely when genetic factors were implicated as causative (p < 0.001). Finally, there was also an increased perception of the character’s “dangerousness” when the condition was explained by genetic factors (p < 0.05). Contrary to previous research was the finding that perceived aetiology had no effect on participant’s desire for social distance from an affected individual. Neither did perceived aetiology influence beliefs about moral accountability. The implications of these findings suggest that genetic counsellors and other health professionals, who are providing genetic information to those affected by schizophrenia should be aware of the possibility that a genetic explanation of schizophrenia could increase potentially stigmatising attitudes towards their clients and their clients’ families. It is also possible that individuals with a diagnosis of schizophrenia may themselves form deterministic interpretations of the genetic information they receive and subsequently be less likely to adopt behavioural advice or adhere to treatment. Counsellors and health professionals should strive to present information in a balanced manner, ensuring recipients understand the multi-factorial causes of the disease.

This is a preview of subscription content, access via your institution.


  1. Angermeyer, M., & Matschinger, H. (1996). Relatives’ beliefs about the causes of schizophrenia. Acta Psychiatrica Scandinavica, 93, 199–204. doi:10.1111/j.1600-0447.1996.tb10632.x.

    PubMed  Article  CAS  Google Scholar 

  2. Atkinson, R. L., Atkinson, R. C., Smith, E. E., Bem, D. J., Nolen-Hoeksema, S., & Smith, C. D. (2000). Hilgard’s introduction to psychology. London: Harcourt College.

    Google Scholar 

  3. Austin, J., & Honer, W. (2005). The potential impact of genetic counselling for mental illness. Clinical Genetics, 67(2), 134–142. doi:10.1111/j.1399-0004.2004.00330.x.

    PubMed  Article  CAS  Google Scholar 

  4. Biernat, M., & Dovidio, J. F. (2000). Stigma and stereotypes. In T. F. Heatherton, R. E. Kleck, M. R. Hebl, & J. G. Hull (Eds.), The social psychology of stigma. London: Guilford.

    Google Scholar 

  5. Birchwood, M., Mason, R., MacMillan, F., & Healy, J. (1993). Depression, demoralisation and control over psychotic illness: a comparison of depressed and non-depressed patients with a chronic psychosis. Psychological Medicine, 23, 387–395.

    PubMed  CAS  Article  Google Scholar 

  6. Bryne, P. (2000). Stigma of mental illness and ways of diminishing it. Advances in Psychiatric Treatment, 6, 65–72. doi:10.1192/apt.6.1.65.

    Article  Google Scholar 

  7. Chapman, E., & Bilton, D. (2004). Patients’ knowledge of cystic fibrosis: genetic determinism and implications for treatment. Journal of Genetic Counseling, 13(5), 369–385. doi:10.1023/B:JOGC.0000044199.38694.6c.

    PubMed  Article  Google Scholar 

  8. Conrad, P. (2001). Genetic optimism: framing genes and mental illness in the news. Culture, Medicine and Psychiatry, 25, 225–247. doi:10.1023/A:1010690427114.

    PubMed  Article  CAS  Google Scholar 

  9. Conrad, P., & Schneider, J. W. (1980). Looking at levels of medicalization: a comment on Strong’s critique of the thesis of medical imperialism. Social Science and Medicine, 14A, 75–79.

    CAS  Google Scholar 

  10. Corrigan, P. W., River, L. P., LundinR. K., , Penn, D. L., Uphoff-Wasowski, K., Campion, J., et al. (2001). Three strategies for changing attributions about severe mental illness. Schizophrenia Bulletin, 27(2), 187–195.

    PubMed  CAS  Google Scholar 

  11. Corrigan, P. W., Rowan, D., Green, A., Lundin, R., River, P., Uphoff-Wasowski, K., et al. (2002). Challenging two mental illness stigmas: personal responsibility and dangerousness. Schizophrenia Bulletin, 28(2), 292–309.

    Google Scholar 

  12. Crisp, A. H. (1999). The stigmatisation of sufferers with mental disorders. British Journal of General Practice, 49, 3–4.

    PubMed  CAS  Google Scholar 

  13. Eagly, A. H., & Chaiken, S. (1993). The Psychology of Attitudes. San Diego: Harcourt Brace Jovanovich.

    Google Scholar 

  14. Fink, P. (1996) Stigma: perpetuating misperceptions. Retrieved from Quoted by Allen, M. & Edwards, D.

  15. Finn, C., Wilcox, M., Bruce, K., Blacker, D., Racette, S., Sklar, P., et al. (2005). Psychiatric genetics: a survey of psychiatrists’ knowledge, opinions, and practice patterns. The Journal of Clinical Psychiatry, 66(7), 821–830.

    PubMed  Article  Google Scholar 

  16. Goffman, E. (1963). Stigma: notes of the management of a spoiled identity. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  17. Goldberg, J., & Schmidt, L. (2001). Shyness, sociability and social dysfunction in schizophrenia. Schizophrenia Research, 48(2–3), 343–349. doi:10.1016/S0920-9964(00)00143-2.

    PubMed  Article  CAS  Google Scholar 

  18. Golding, S., Becker, B., Sherman, S., & Rapport, J. (1975). The behavioural expectations scale: assessment of expectations for interaction with the mentally ill. Journal of Consulting and Clinical Psychology, 43, 109. doi:10.1037/h0076320.

    PubMed  Article  CAS  Google Scholar 

  19. Grausgruber, A., Maise, U., Katschnig, H., Schonnny, W., & Fleischacker, W. (2006). Patterns of social distance towards people suffering from schizophrenia in Austria: a comparison between the general public, relatives and mental health staff. Acta Psychiatrica Sczndanavica, 114(2), 146–147. doi:10.1111/j.1600-0447.2006.00865.x.

    Article  Google Scholar 

  20. Green, M. (2001). Schizophrenia revealed: from neurons to social interactions. New York: Norton.

    Google Scholar 

  21. Guest, J., & Cookson, R. (1999). Cost of schizophrenia to UK society. An incidence-based cost-of-illness model for the first 5 years following diagnosis. Pharmoeconomics, 15, 597–610. doi:10.2165/00019053-199915060-00007.

    Article  CAS  Google Scholar 

  22. Hedgecoe, A. (2001). Schizophrenia and the narrative of enlightened geneticization. Social Studies of Science, 31(6), 875–991. doi:10.1177/030631201031006004.

    PubMed  Article  CAS  Google Scholar 

  23. Hedgecoe, A. (2002). Reinventing diabetes: classification, division and the geneticization of disease. New Genetics & Society, 21(1), 7–27. doi:10.1080/14636770220122746.

    Article  Google Scholar 

  24. Herbert, W. (n.d.) The politics of biology. Retrieved October 2006 from

  25. Hinshaw, S. (2005). The stigmatization of mental illness in children and parents: developmental issues, family concerns, and research needs. Journal of Child Psychology and Psychiatry, and Allied Disciplines, 46, 714–734. doi:10.1111/j.1469-7610.2005.01456.x.

    PubMed  Article  Google Scholar 

  26. Hodgkinson, A., & Murphey, K. (2001). Genetic counselling for schizophrenia in the era of molecular genetics. Canadian Journal of Psychiatry, 46, 123–130.

    CAS  Google Scholar 

  27. Jones, I., Kent, L., Moli, P., & Craddock, C. (2001). Clinical implications of psychiatric genetics in the new millennium-nightmare or nirvana? Psychiatric Bulletin, 25, 129–131. doi:10.1192/pb.25.4.129.

    Article  Google Scholar 

  28. Jorm, A., Korten, F., Jacomb, A. E., et al. (1997). Public beliefs about the causes and risk factors for depression and schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 82, 143–148.

    Google Scholar 

  29. Kent, H., & Read, J. (1998). Measuring consumer participation in mental health services: are attitudes related to professional orientation? The International Journal of Social Psychiatry, 44, 295–310. doi:10.1177/002076409804400406.

    PubMed  Article  CAS  Google Scholar 

  30. Lencz, T. (2004). Nonspecific and attenuated negative symptoms in patients at clinical high-risk for schizophrenia. Schizophrenia Research, 68, 37–48. doi:10.1016/S0920-9964(03)00214-7.

    PubMed  Article  Google Scholar 

  31. Link, B., Phelan, J., Bresnahan, M., Stueve, A., & Pescosolido, B. (1999). Public conceptions of mental illness: labels, causes, dangerousness and social distance. American Journal of Public Health, 89, 1328–1336.

    PubMed  Article  CAS  Google Scholar 

  32. Link, B., Struening, E., Nesse-Todd, S., Asmussen, S., & Phelan, J. (2001). Stigma as a barrier to recovery: the consequences of stigma for the self-esteem of people with mental illness. Psychiatric Services (Washington, D.C.), 52, 1621–1626. doi:10.1176/

    CAS  Google Scholar 

  33. Lippman, A. (1991). Prenatal genetic testing and screening: constructing needs and reinforcing inequalities. American Journal of Law & Medicine, 17(1/2), 15–50.

    CAS  Google Scholar 

  34. Loftus, C. (2004). Mental health stigmatisation: a report of the neuroscience initiative. Neuroscience Initiative, 222–225

  35. Mahoney, L. (2002). Mindview: genetics of schizophrenia. Retrieved May 2006 from

  36. Mann, C., & Himelien, M. (2004). Factors associated with stigmatisation of persons with mental illness. Psychiatric Services (Washington, D.C.), 55, 185–187. doi:10.1176/

    Google Scholar 

  37. Matthias, C., Angermeyer, M., & Matschinger, H. (2005). Causal beliefs and attitudes to people with Schizophrenia. The British Journal of Psychiatry, 186, 331–334. doi:10.1192/bjp.186.4.331.

    Article  Google Scholar 

  38. Mcdonald, C., & Murphy, K. (2003). The new genetics of schizophrenia. The Psychiatric Clinics of North America, 26, 41–63. doi:10.1016/S0193-953X(02)00030-8.

    PubMed  Article  Google Scholar 

  39. McGuffin, P. (2001). ESI special topics. Retrieved October 2006 from http://www.

  40. Minnesota Department of Health. (2004). Chronic disease genomes project. Retrieved from

  41. Östman, M. (2002). Stigma by association: psychological factors in relatives of people with mental illness. The British Journal of Psychiatry, 181, 494–498. doi:10.1192/bjp.181.6.494.

    PubMed  Article  Google Scholar 

  42. Papadimitriou, G. N., & Dikeos, D. G. (2003). How does recent knowledge on the heredity of schizophrenia affect genetic counselling? Current Psychiatry Reports, 5, 239–240. doi:10.1007/s11920-003-0049-6.

    PubMed  Article  Google Scholar 

  43. Phelan, J. (2002). Genetic basis of mental illness—a cure for stigma? Trends in Neurosciences, 25(8), 430–431. doi:10.1016/S0166-2236(02)02209-9.

    PubMed  Article  CAS  Google Scholar 

  44. Phelan, J., Yang, L., & Cruz-Rojas, M. (2006). Effects of attributing serious mental illnesses to genetic causes on orientations to treatment. Psychiatric Services (Washington, D.C.), 57, 382–387. doi:10.1176/

    Google Scholar 

  45. Sarbin, T. R., & Mancuso, J. C. (1970). Failure of a moral enterprise: attitudes of the public towards mental illness. Journal of Consulting and Clinical Psychology, 35, 159–173. doi:10.1037/h0030056.

    PubMed  Article  CAS  Google Scholar 

  46. Sayce, L. (1998). Stigma, discrimination and social exclusion: what’s in a word? Journal of Mental Health, 7, 331–343.

    Article  Google Scholar 

  47. Sherwin, S., & Simpson, C. (1999). Ethical questions in the pursuit of genetic information: geneticization and BRCA1. In A. Thompson, & R. Chadwick (Eds.), Genetic information: acquisition, access and control. New York: Kluwer Academic.

    Google Scholar 

  48. Smith, M. (2002). Stigma. Advances in Psychiatric Treatment, 8, 317–323. doi:10.1192/apt.8.5.317.

    Article  Google Scholar 

  49. Thomson, A., Stuart, H., Bland, R., Arboleda-Florez, J., Warner, R., & Dickson, R. (2002). Attitudes about schizophrenia from the pilot site of the WPA worldwide campaign against the stigma of schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 37, 475–482. doi:10.1007/s00127-002-0583-2.

    Article  Google Scholar 

  50. Thornicroft, G. (2006). Shunned: discrimination against people with illness. Oxford: Oxford University Press.

    Google Scholar 

  51. Tooth, B., Kalyanasundaram, V., Glover, H., & Momenzadah, S. (2003). Factors consumers identify as important to recover from schizophrenia. Australasian Psychiatry, 11, s70–s77. doi:10.1046/j.1440-1665.11.s1.1.x.

    Article  Google Scholar 

  52. Tsuang, D., Faraone, S., & Tsuang, M. T. (2001). Genetic counseling for psychiatric disorders. Current Psychiatry Reports, 3(2), 138–143.

    PubMed  Article  CAS  Google Scholar 

  53. Vengopal, D., & Issac, M. (2000). A questionnaire survey of psychiatrists attitudes towards genetic counselling. Indian Journal of Psychiatry, 42(2), 163–166.

    Google Scholar 

  54. Wahl, O. F. (1987). Public versus professional conceptions of schizophrenia. Journal of Community Psychology, 15, 285–291. doi:10.1002/1520-6629(198704)15:2<285::AID-JCOP2290150217>3.0.CO;2-F.

    Article  Google Scholar 

  55. Walsh, E., Buchanan, A., & Fahy, T. (2002). Violence and schizophrenia: examining the evidence. The British Journal of Psychiatry, 180, 490–495. doi:10.1192/bjp.180.6.490.

    PubMed  Article  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Kathryn Thirlaway.


Appendix 1

Participant Instructions

I would be grateful if you would take a few minutes to take part in my research into how much people know about schizophrenia, and how they feel about people with the condition. All that is involved is a short questionnaire. However, in order that everyone taking part in this study has at least a minimal knowledge of schizophrenia, a short statement giving an example of somebody with the condition is outlined below for you to read before you complete the questionnaire.

Vignette 1 (Experiential Causes)

Simon is a 30-year-old man who has completed a degree at university. Up until a year ago, life was pretty ok for Simon. However, following the unexpected death of his wife, things began to change1. He began to think that people around him were making disapproving comments and talking behind his back. Simon was convinced that people were spying on him and that they could hear what he was thinking. Simon lost his drive to participate in his usual work and family activities and retreated to his home, eventually spending most of his day in his room. Simon became so preoccupied with what he was thinking that he skipped meals and stopped bathing regularly. At night, when everyone else was sleeping, he was walking back and forth in his room. Simon was also hearing voices even though no-one else was around. These voices told him what to do and what to think. He has been living this way since his wife died, 6 months ago2.

Vignette 2 (Genetic Causation)

The genetic vignette was identical to the experiential vignette apart from the sentences in bold in the experiential were replaced by the following sentences:

  1. 1.

    However, things began to change last year.

  2. 2.

    Doctors believe that Simon’s illness occurred due to a genetic predisposition towards schizophrenia within his family. He has been living this way for 6 months.

Appendix 2: Attitudes Questionnaire

Response categories are illustrated here for the first question only. They were identical for all subsequent questions. Question numbers are provided here to enable the make-up of each attitude scale to be illustrated, they were not present in the study instrument. Desire for social distance was measured by questions: 1, 7, 12, 16, 18, 20, 32 and 37. Associative stigma towards close family members was measured by questions: 3, 5, 8, 15, 21, 24, 31 and 36. The perceived potential for recovery was measured by questions: 2, 9, 25, 27 and 29. The perceived accountability of an affected individual was measured by questions: 6, 10, 13, 17, 23, 28, 33 and 35. Assumption of dangerousness was measured by questions: 4, 11, 14, 19, 22, 26, 30 and 34.

  1. 1.

    I would be happy to sit next to Simon on the bus

    □ Strongly agree □ Agree □ Don’t know □ Disagree □ Strongly disagree

  2. 2.

    Attending a support group for people with mental health problems would be likely to help Simon to recover.

  3. 3.

    Simon’s younger brother is at a high risk of developing Schizophrenia.

  4. 4.

    Simon should be detained in a hospital to ensure the public’s safety.

  5. 5.

    If my partner had a sister with Simon’s problems it would make me more wary of having children with them.

  6. 6.

    I think that Simon has some degree of control over whether or not to obey the voices he hears when they tell him what to do.

  7. 7.

    I would definitely never marry somebody with these problems.

  8. 8.

    I would be comfortable with a close relative marrying Simon’s brother/sister.

  9. 9.

    I don’t think Simon could ever be completely ‘cured’, although he could probably find ways to manage his symptoms.

  10. 10.

    If Simon neglected his children when he began experiencing symptoms then I would begin to lose sympathy for him.

  11. 11.

    I think it’s quite unlikely that Simon has aggressive thoughts.

  12. 12.

    I would feel uncomfortable inviting Simon along to a friend’s party.

  13. 13.

    If Simon obeyed voices that told him to steal from somebody, it would be unfair to treat him as if he had purposefully done something wrong.

  14. 14.

    There is no reason why Simon should not be trusted around vulnerable people, such as children.

  15. 15.

    I would feel uncomfortable being close friends with Simon’s sister.

  16. 16.

    I would be very concerned if a close relative told me they were planning to marry and start a family with Simon.

  17. 17.

    The law should apply to Simon in the same way that it applies to everybody else

  18. 18.

    I would happily share a flat with Simon.

  19. 19.

    I don’t think it’s very likely that Simon would act in an violent way towards anybody else

  20. 20.

    I wouldn’t mind if a friend invited Simon along on a holiday we had booked together.

  21. 21.

    I would never date a sibling of Simon’s.

  22. 22.

    I would feel unsafe if I were left alone with Simon.

  23. 23.

    Simon cannot use having Schizophrenia as an excuse for wrongdoings. His symptoms do not prevent him from knowing what is right from what is wrong.

  24. 24.

    It is unlikely that a child of Simon’s would develop the same problems as him.

  25. 25.

    Simon will always be ‘schizophrenic’. Even if his symptoms disappear they could come back at any time.

  26. 26.

    Simon is at risk of harming himself.

  27. 27.

    I think that Simon’s problems would pass with time, even with minimal intervention from others.

  28. 28.

    I don’t think it would be right to hold Simon entirely responsible if he were to cause somebody offence.

  29. 29.

    I don’t think that a ‘talking’ therapy (such as psychotherapy) would significantly improve Simon’s symptoms.

  30. 30.

    Simon is no more likely to become verbally abusive to others than anybody else.

  31. 31.

    If my partner told me that their father had problems just like Simon, this would not worry me.

  32. 32.

    I would feel a little uncomfortable if a friend introduced Simon into our social circle.

  33. 33.

    There is no way that Simon can control his paranoid thoughts.

  34. 34.

    It is highly likely that Simon will commit a crime.

  35. 35.

    If I knew Simon, and he threatened to harm me I wouldn’t feel anger towards him, as he is not responsible for his behaviour.

  36. 36.

    I would happily move into a flat with Simon’s younger brother.

  37. 37.

    If a close friend told me that her and Simon were in love I imagine I would be happy for her

    Have you ever known anybody with schizophrenia?

    □ Yes □ No

Thank you for spending the time to complete this questionnaire.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Bennett, L., Thirlaway, K. & Murray, A.J. The Stigmatising Implications of Presenting Schizophrenia as a Genetic Disease. J Genet Counsel 17, 550–559 (2008).

Download citation


  • Schizophrenia
  • Stigma
  • Geneticisation