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Does labeling matter? An examination of attitudes and perceptions of labels for mental disorders

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Abstract

Purpose

Labeling research in various domains has found that attitudes and perceptions vary as a function of the different labels ascribed to a group (e.g., overweight vs. obese). This type of research, however, has not been examined extensively in regards to labels for mental disorders. The present study examined whether common psychiatric labels (i.e., mental disease, mental disorders, mental health problems, and mental illness) elicited divergent attitudes and perceptions in a group of participants. These labels were also compared to the specific label of depression.

Methods

Undergraduate psychology students (N = 124) were given identical questionnaire packages with the exception of the label used. That is, each participant received a set of questionnaires that referred to only one of the five labels. The questionnaire package contained various quantitative measures of attitudes and social distance, in addition to a short qualitative measure.

Results

Analyses demonstrated equivalence among the four general psychiatric labels on measures of attitudes, social distance, and general perceptions. However, results also suggested that the general labels diverged from the depression label, with the latter being generally more negatively perceived. Some analyses demonstrated that participants’ understanding of the terminology might be incorrect. The results of the investigation are discussed with a focus on its relationship with current research in stigma.

Conclusion

Within the current sample, general psychiatric labels did not appear to distinguish themselves from each other on measures of attitude and social distance but did so when compared to a relatively more specific term. Future research should examine the underlying mechanism driving this finding, with the ultimate goal of reducing the stigma faced by those with mental disorders.

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Notes

  1. The Youth Opinions Survey is a 22-item scale created by Koller, Stuart, and the Opening Minds Youth Evaluation Network. It is currently being used in evaluations of youth mental illness anti-stigma programs by the authors and Opening Minds (see “Setting for study” section).

References

  1. Rose D, Thornicroft G, Pinfold V, Kassam A (2007) 250 Labels used to stigmatise people with mental illness. BMC Health Serv Res 7:97

    Article  PubMed  Google Scholar 

  2. Angermeyer MC, Matschinger H (2003) The stigma of mental illness: effects of labelling on public attitudes towards people with mental disorder. Acta Psychiatri Scand 108:304–309

    Article  CAS  Google Scholar 

  3. Grausgruber A, Meise U, Katschnig H, Schöny W, Fleischhacker WW (2007) Patterns of social distance towards people suffering from schizophrenia in Austria: a comparison between the general public, relatives and mental health staff. Acta Psychiatri Scand 115:310–319

    Article  CAS  Google Scholar 

  4. Martin JK, Pescosolido BA, Tuch SA (2000) Of fear and loathing: the role of “disturbing behavior”, in shaping public attitudes labels, and causal attributions toward people with mental illness. J Health Soc Behav 41:208–223

    Article  Google Scholar 

  5. Corrigan PW, Cooper AE (2005) Mental illness and dangerousness: fact or misperception, and implications for stigma. In: Corrigan PW (ed) On the stigma of mental illness. American Psychological Association, Washington DC, pp 145–164

    Google Scholar 

  6. Thornicroft G (2006) Shunned: Discrimination against people with mental illness. Oxford University Press, Oxford

    Google Scholar 

  7. Brochu PM, Esses VM (2011) What’s in a name? The effects of the labels “Fat” versus “Overweight” on weight bias. J Appl Soc Psychol 41:1981–2008

    Article  Google Scholar 

  8. Smith CA, Schmoll K, Konik J, Oberlander S (2007) Carrying weight for the world: influence of weight descriptors on judgments of large-sized women. J Appl Soc Psychol 37:989–1006

    Article  Google Scholar 

  9. Boatswain SJ, Lalonde RN (2000) Social identity and preferred ethnic/racial labels for blacks in Canada. J Black Psychol 26:216–234

    Article  Google Scholar 

  10. Fairchild HH (1985) Black, Negro, or Afro-American? The differences are crucial! Soc Psychol 16:47–55

    Google Scholar 

  11. Donakowski DW, Esses VM (1996) Native Canadians, First Nations, or Aboriginals: the effect of labels on attitudes toward native peoples. Can J Behav Sci 28:86–91

    Article  Google Scholar 

  12. Hecht M, Ribeau S (1987) Afro-american identity labels and communication effectiveness. J Lang Soc Psychol 6:319–326

    Article  Google Scholar 

  13. Katz I, Cohen S, Glass D (1975) Some determinants of cross-racial helping behavior. J Personal Soc Psychol 32:964–970

    Article  Google Scholar 

  14. Larkey LK, Hecht ML, Martin J (1993) What’s in a name?: African American ethnic identity terms and self-determination. J Lang Soc Psychol 12:302–317

    Article  Google Scholar 

  15. Barke A, Nyarko S, Klecha D (2011) The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients’ views. Soc Psychiatry Psychiatr Epidemiol 46:1191–1202

    Article  PubMed  Google Scholar 

  16. Corrigan PW, Kuwabara SA, O’Shaughnessy J (2009) The public stigma of mental illness and drug addiction: findings from a stratified random sample. J Soc Work 9:139–147

    Article  Google Scholar 

  17. Leiderman AE, Vazquez G, Berizzo C, Bonifacio A, Bruscoli N, Capria JI, Ehrenhaus B et al (2011) Public knowledge, beliefs and attitudes towards patients with schizophrenia: Buenos Aires. Soc Psychiatry Psychiatr Epidemiol 46:281–290

    Article  PubMed  Google Scholar 

  18. Pescosolido BA, Martin JK, Long JS, Medina TR, Phelan JC, Link BG (2010) “A disease like any other”? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence. Am J Psychiatry 167:1321–1330

    Article  PubMed  Google Scholar 

  19. Sartorius N (2010) Short-lived campaigns are not enough. Nature 468:6–8

    Article  Google Scholar 

  20. Angermeyer MC, Holzinger A, Matschinger H (2009) Mental health literacy and attitude towards people with mental illness: a trend analysis based on population surveys in the eastern part of Germany. Eur Psychiatry 24:225–232

    Article  PubMed  CAS  Google Scholar 

  21. Anderson K, Austin JC (2011) Effects of a documentary film on public stigma related to mental illness among genetic counselors. J Genet Counsel. doi:10.1007/s10897-011-9414-5

    Google Scholar 

  22. Beldie A, Boer JAD, Brain C, Constant E, Luisa M, Igor F (2012) Fighting stigma of mental illness in midsize European countries. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-012-0491-z

    PubMed  Google Scholar 

  23. Brown SA, Evans Y, Espenschade K, O’Connor M (2010) An examination of two brief stigma reduction strategies: filmed personal contact and hallucination simulations. Community Ment Health J 46:494–499

    Article  PubMed  Google Scholar 

  24. Corrigan PW, Larson JE, Kuwabara SA (2007) Mental illness stigma and the fundamental components of supported employment. Rehabil Psychol 52(4):451–457

    Article  Google Scholar 

  25. Gaebel W, Baumann AE (2003) Intervention to reduce the stigma associated with severe mental illness: experiences form the Open the Doors Program in Germany. Can J Psychiatry 48:657–662

    PubMed  Google Scholar 

  26. Henderson C, Thornicroft G (2009) Stigma and discrimination in mental illness: time to change. Lancet 373:1928–1930

    Article  PubMed  Google Scholar 

  27. Knifton L, Gervais M, Newbigging K, Mirza N, Quinn N, Wilson N, Hunkins-Hutchison E (2010) Community conversation: addressing mental health stigma with ethnic minority communities. Soc Psychiatry Psychiatr Epidemiol 45:497–504

    Article  PubMed  Google Scholar 

  28. Quinn N, Shulman A, Knifton L, Byrne P (2011) The impact of a national mental health arts and film festival on stigma and recovery. Acta Psychiatr Scand 123:71–81

    Article  PubMed  CAS  Google Scholar 

  29. Spagnolo AB, Murphy AA, Librera LA (2008) Reducing stigma by meeting and learning from people with mental illness. Psychiatr Rehabil J 31:186–193

    Article  PubMed  Google Scholar 

  30. Szeto ACH, Dobson KS (2011) Reducing the stigma of mental disorders at work: a review of current workplace anti-stigma intervention programs. Appl Prev Psychol. doi:10.1016/j.appsy.2011.11.002

    Google Scholar 

  31. Link BG (1982) Mental patient status, work and income: an examination of the effects of a psychiatric label. Am Sociol Rev 47:202–215

    Article  PubMed  CAS  Google Scholar 

  32. Link BG (1987) Understanding labeling effects in the area of mental disorders: an assessment of the effects of expectations of rejection. Am Sociol Rev 52:96–112

    Article  Google Scholar 

  33. Link BG, Cullen FT, Frank J, Wozniak JF (1987) The social rejection of former mental patients: understanding why labels matter. Am J Sociol 92:1461–1500

    Article  Google Scholar 

  34. Link BG, Phelan JC (2001) Conceptualizing Stigma. Annu Rev Sociol 27:363–385

    Article  Google Scholar 

  35. Goffman E (1961) Asylums: Essay on the social situation of mental patients and other inmates. Doubleday, Garden City

    Google Scholar 

  36. Gove W (1970) Societal reaction as an explanation of mental Illness: an evaluation. Am Sociol Rev 35:873–884

    Article  PubMed  CAS  Google Scholar 

  37. Link BG, Cullen FT, Struening E, Shrout PE, Dohrenwend BP (1989) A modified labeling theory approach to mental disorders: an empirical assessment. Am Sociolog Rev 54:400–423

    Article  Google Scholar 

  38. Scheff T (1966) Being mentally ill: A sociology theory. Aldine, Chicago

    Google Scholar 

  39. Thoits P (2010) Sociological approaches to mental illness. In: Scheid TL, Brown TN (eds) A handbook for the study of mental health, 2nd edn. Cambridge University Press, New York, pp 106–124

    Google Scholar 

  40. Krailes JI (1985) Watch your language, please! J Rehabil 51:68–69

    Google Scholar 

  41. Reynaert CC, Gelman SA (2007) The influence of language form and conventional wordingon judgments of illness. J Psycholinguist Res 36:273–295

    Article  PubMed  Google Scholar 

  42. Shattell MM (2009) Stigmatizing language with unintended meanings: “Persons with mental illness” or “mentally ill persons”? Issues Ment Health Nurs 30:199

    Article  PubMed  Google Scholar 

  43. Gardiner M, Radian E, Neiman A, Neiman R (2011) Declaring label preferences: terminology research in mental health. Can J Community Ment Health 30:121–137

    Google Scholar 

  44. Wright A, Jorm AF, Mackinnon AJ (2011) Labels used by young people to describe mental disorders: which ones predict effective help-seeking choices? Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-011-0399-z

    Google Scholar 

  45. Covell NH, McCorkle BH, Weissman EM, Summerfelt T, Essock SM (2007) What’s in a name? Terms preferred by service recipients. Adm Policy Mental Health 34:443–447

    Article  Google Scholar 

  46. Lloyd C, King R, Bassett H, Sandlord S, Savige G (2001) Patient, client or consumer? A survey of preferred terms. Australasian Psychiatry 9:321–324

    Article  Google Scholar 

  47. Mueser KT, Glynn SM, Corrigan PW, Baber W (1996) A survey of preferred terms for users of mental health services. Psychiatr Serv 47:760–761

    PubMed  CAS  Google Scholar 

  48. Penn DL, Nowlin-Drummond (2001) Politically correct labels and schizophrenia: a rose by any other name? Schizophr Bull 27:197–203

    Article  PubMed  CAS  Google Scholar 

  49. Yang LH, Lo G, Wonpat-Borja AJ, Singla DR, Link BG, Phillips MR (2011) Effects of labeling and interpersonal contact upon attitudes towards schizophrenia: implications for reducing mental illness stigma in urban China. Soc Psychiatry Psychiatr Epidemiol. doi:10.1007/s00127-011-0452-y

    Google Scholar 

  50. Arnusch S (2011) Your mental health primer: Understanding the different types of mental disorders. Balance Fall: pp 10–11

  51. Ceusters W, Smith B (2010) Foundations for a realist ontology of mental disease. J Biomed Semant 1:10

    Article  Google Scholar 

  52. Government of Alberta (2011) Creating connections: Alberta’s addiction and mental health strategy. Accessed http://www.health.alberta.ca/documents/Creating-Connections-2011-Strategy.pdf

  53. Geller JL (2000) Excluding institutions for mental diseases from federal reimbursement for services: strategy or tragedy? Psychiatr Serv 51:1397–1403

    Article  PubMed  CAS  Google Scholar 

  54. Kessler RC, Berglund P, Demler O, Jin R, Merikangas KR, Walters EE (2005) Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey replication. Archiv Gen Psychiatry 62:593–602

    Article  Google Scholar 

  55. Kessler RC, Chiu WT, Demler O, Walters EE (2005) Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey replication. Archiv Gen Psychiatry 62:617–627

    Article  Google Scholar 

  56. World Health Organization (2008) The global burden of disease 2004 update. World Health Organization Press. http://www.who.int/healthinfo/global_burden_disease/GBD_report_2004update_full.pdf

  57. Deacon BJ, Baird GL (2009) The chemical imbalance explanation of depression: reducing blame at what cost? J Soc Clin Psychol 28:415–435

    Article  Google Scholar 

  58. Deacon BJ, Lickel JJ (2009) On the brain disease model of mental disorders. Behav Ther 32:113–118

    Google Scholar 

  59. Read J, Haslam N, Sayce L, Davies E (2006) Prejudice and schizophrenia: a review of the “mental illness is an illness like any other” approach. Acta Psychiatr Scand 114:303–318

    Article  PubMed  CAS  Google Scholar 

  60. Rüsch N, Todd AR, Bodenhausen GV, Corrigan PW (2010) Biogenetic models of psychopathology, implicit guilt, and mental illness stigma. Psychiatry Res 179:328–332

    Article  PubMed  Google Scholar 

  61. Norman RMG, Gawronski B, Hampson E, Sorrentino RM, Szeto ACH, Ye Y (2010) Physical proximity in anticipation of meeting someone with schizophrenia: the role of explicit evaluations, implicit evaluations and cortisol levels. Schizophr Res 124:74–80

    Article  PubMed  Google Scholar 

  62. Norman RM, Sorrentino R, Windell D, Manchanda R (2008) Are personal values of importance in the stigmatization of people with mental illness? Can J Psychiatry 53:848–856

    PubMed  Google Scholar 

  63. Bogardus ES (1925) Social distance and its origins. J Appl Sociol 9:216–226

    Google Scholar 

  64. Norman RMG, Sorrentino RM, Gawronski B, Szeto ACH, Ye Y, Windell D (2010) Attitudes and seating proximity to an individual with schizophrenia: the moderating effect of self transcendence value. Soc Psychiatry Psychiatr Epidemiol 45:751–758

    Article  PubMed  Google Scholar 

  65. Statistics Canada (2011). Canadian Community Health Survey: Annual Component—2010 Questionnaire. Accessed http://www.statcan.gc.ca/imdb-bmdi/instrument/3226_Q1_V7-eng.pdf

  66. Loya F, Reddy R, Hinshaw SP (2010) Mental illness stigma as a mediator of differences in caucasian and south Asian college students’ attitudes toward psychological counseling. J Counsel Psychol 57:484–490

    Article  Google Scholar 

  67. Vogel DL, Shechtman Z, Wade NG (2010) The role of public and self-stigma in predicting attitudes towards group counseling. Counsel Psychol 38:904–922

    Article  Google Scholar 

  68. Vogel DL, Wade NG, Hackler AH (2007) Perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling. J Counsel Psychol 54:40–50

    Article  Google Scholar 

  69. Griffiths KM, Nakane Y, Christensen H, Yoshioka K, Jorm AF, Nakane H (2006) Stigma in response to mental disorders: a comparison of Australia and Japan. BMC Psychiatry 6:21

    Article  PubMed  Google Scholar 

  70. O’Reilly CL, Bell JS, Chen TF (2010) Pharmacists’ beliefs about treatments and outcomes of mental disorders: a mental health literacy survey. Aust N Z J Psychiatry 44:1089–1096

    Article  PubMed  Google Scholar 

  71. Silton NR, Flannelly KJ, Milstein G, Vaaler ML (2011) Stigma in America: has anything changed? Impact of perceptions of mental illness and dangerousness on the desire for social distance: 1996 and 2006. J Nerv Ment Dis 199:361–366

    Article  PubMed  Google Scholar 

  72. Link BG, Phelan JC, Bresnahan M, Stueve A, Pescosolido BA (1999) Public conceptions of mental illness: labels, causes, dangerousness, and social distance. Am J Public Health 89:1328–1333

    Article  PubMed  CAS  Google Scholar 

  73. Marie D, Miles B (2008) Social distance and perceived dangerousness across four diagnostic categories of mental disorder. Aust N Z J Psychiatry 42:123–133

    Google Scholar 

  74. Schomerus G, Lucht M, Holzinger A, Matschinger H, Carta MG, Angermeyer MC (2011) The stigma of alcohol dependence compared with other mental disorders: a review of population studies. Alcohol Alcohol 46:105–112

    Article  PubMed  CAS  Google Scholar 

  75. Evans-Lacko S, Brohan E, Mojtabai R, Thornicroft G (2011) Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med. doi:10.1017/S0033291711002558

    PubMed  Google Scholar 

  76. Angermeyer MC, Matschinger H, Corrigan PW (2004) Familiarity with mental illness and social distance from people with schizophrenia and major depression: testing a model using data from a representative population survey. Schizophr Res 69:175–182

    Article  PubMed  Google Scholar 

  77. Corrigan PW, Edwards AB, Green A, Diwan SL, Penn DL (2001) Prejudice, social distance, and familiarity with mental illness. Schizophr Bul 27:219–225

    Article  CAS  Google Scholar 

  78. Blumenthal R, Endicott J (1997) Barriers to seeking treatment for major depression. Depress Anxiety 4:273–278

    Article  CAS  Google Scholar 

  79. My Consumer Place (2010) So you have a ‘Mental Illness’…what now? Accessed http://www.ourconsumerplace.com.au/files/MentalIllnessbook.pdf

  80. Angermeyer MC, Dietrich S (2006) Public beliefs about and attitudes towards people with mental illness: a review of population studies. Acta Psychiatri Scand 41:163–179

    Article  Google Scholar 

  81. Norman RMG, Sorrentino RM, Windell D, Ye Y, Szeto ACH, Manchanda R (2010) Predicting behavioural intentions to those with mental illness: the role of attitude specificity and norms. Int J Soc Psychiatry 56:239–254

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Terry Krupa, Scott Patten, and Heather Stuart for their helpful comments on earlier versions of this manuscript.

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Authors and Affiliations

  1. Department of Psychology, University of Calgary, 2500 University Dr. NW, Calgary, AB, T2N 1N4, Canada

    Andrew C. H. Szeto & Keith S. Dobson

  2. c/o Bonnie Kirsh, Department of Occupational Science and Occupational Therapy, University of Toronto, 500 University Avenue, Toronto, ON, M5G 1V7, Canada

    Dorothy Luong

  3. Mental Health Commission of Canada, 10301 Southport Lane SW, Suite 800, Calgary, AB, T2W 1S7, Canada

    Andrew C. H. Szeto

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  1. Andrew C. H. Szeto
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Correspondence to Andrew C. H. Szeto.

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Szeto, A.C.H., Luong, D. & Dobson, K.S. Does labeling matter? An examination of attitudes and perceptions of labels for mental disorders. Soc Psychiatry Psychiatr Epidemiol 48, 659–671 (2013). https://doi.org/10.1007/s00127-012-0532-7

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