Transcript Folie 1

Determinants of Social Distance
towards People suffering from
Schizophrenia. Results from a
Trend Analysis of two Population
Surveys in Austria.
Paper presented at
Fourth International Stigma Conference 2009
21st – 23rd January 2009, London UK
Grausgruber, Alfred*
Schöny, W.*/Grausgruber-Berner, R.*/Meise, U.*/Koren, G.*
*Department of Sociology, Johannes Kepler University of Linz
A-4040 Linz, Altenbergerstr. 69, Austria
e-mail: [email protected]
** pro mente praevention Austria, Linz
A-4020 Linz, Lohnstorferplatz 28, Austria
Background
- Anti-Stigma-Campaigne of the WPA – Austria
member
- To get a baseline: First nationwide survey in
Austria in 1998
- Many activities to combat stigmatization and
discrimination
- Second representative survey in 2007
- Attitude comparison of public in 1998 and 2007
- Impact evaluation of the activities
Aims of the presentation
- To examine the impact of various potential
determinants of the desire to avoid contacts
with people suffering from schizophrenia
- To observe any substantial changes in the
general structure of the impact factors
Method
Representative surveys (16 years +)
Table 1: Method – type of vignettes
Year
Data collection
Sample size
Vignettes
- unlabelled
presented
1998
Face to face interviews
N = 1035
1 vignette randomly
allocated
Schizophrenia:
- woman feels shadowed (n=252)
- or man feels shadowed
- or woman shows
withdrawal
- or man shows withdrawal
2007
N = 998
2 vignettes
1st vign: all Schizophrenia:
- woman feels shadowed (n=988)
2nd vignette randomly
allocated: Depression, or
anxiety, or Alzheimer
disease
Method
Table 2: Determinants of social distance
Year
Dependent
variable
Independent
variables
Determinants
1998
2007
Social distance (5 items guttman scale)
4 dimensions causal attribution (sum-scores
of 8 items, 4 point Likert scale)
Perceived treatment success (2 items)
Perceived dangerousness (2 items)
Course of disease (2 items)
Knowing people suffering from schizophrenia
Socio-demogra- Gender, age, education, size of residence,
phic variables
household income
(e.g. Link et al 1999, Martin et al 2000, Stuart et al 2001,
Gaebel et al 2002, Lauber 2003, Angermeyer/Matschinger
2005)
Statistical analysis: Factor analysis (causal
attribution), Guttman and Mokken analysis
(social distance), OLS-Regression
Results
Table 3. Regression coefficients (stand. ß) of social distance from people with schizophrenia on causal attribution, perceived treatment success, perceived dangerousness, knowing
people suffering from schizophrenia, course of disease and year of survey (n=1240)
ß
p
95% CI
Causal attribtion (often)
Stress
0.122
.000
0.058 - 0.185
Genetics
-0.065
.020
-0.119- -0.010
Social circumstances
0.002
.944
-0.065 - 0.069
Weak character
-0.070
.021
-0.130- -0.010
Perceived treatment success (yes)
Schizophrenia in general
0.142
.000
0.083 - 0.201
Schizophrenia vignette
0.165
.000
0.104 - 0.225
Perceived dangerousness (yes)
People with mental problems
-0.129
.000
-0.197- -0.060
People suffering from schizophrenia
-0.143
.000
-0.213- -0.073
Knowing people suffering from
0.097
.001
0.042 – 0.152
schizophrenia (yes)
Course of schizophtrenia (disappear)
Course without treatment
0.132
.000
0.074 – 0.189
Course with treatment
0.005
.851
-0.051 – 0.061
Year of the survey (1998)
-0.035
.222
-0.092 – 0.021
Corr R = 0.416; F = 14.864; p = 0.000; n = 1240
Controlling for size of residence, gender, age, education, household income
- increasing distance/decreasing contacts, + decreasing distance/increasing contacts
Results
Table 4. Regression coefficients (stand. ß) of social distance from people with schizophrenia on causal attribution, perceived treatment success, perceived dangerousness,
knowing people suffering from schizophrenia, course of disease 1998 and 2007
ß
1998
95% CI
ß
2007
95% CI
Causal attribtion (often)
Stress
0.224**
0.079 - 0.369
0.090**
0.020 - 0.162
Genetics
-0.150*
-0.274- -0.026 -0.034
-0.096 - 0.027
Social circumstances
0.129
-0.023 - 0.282
-0.021
-0.097 - 0.054
Weak character
-0.128
-0.269- -0.012 -0.069*
-0.136 - 0.002
Perceived treatment success (yes)
Schizophrenia in general
0.123
-0.011 - 0.257
0.154**
0.086 - 0.221
Schizophrenia vignette
0.145
-0.009 - 0.280
0.165**
0.096 - 0.234
Perceived dangerousness (yes)
People with mental problems
-0.113
-0.269 - 0.042
-0.123** -0.200- -0.045
People suffering from schizo-0.181*
-0.338- -0.024 -0.142** -0.221- -0.062
phrenia
Knowing people suffering from
0.096
-0.028 - 0.220
0.098**
0.036 - 0.160
schizophrenia. (yes)
Course of schizophrenia (disapp.)
Course without treatment
0.051
-0.073 - 0.176
0.151**
0.090 - 0.211
Course with treatment
-0.025
-0.155 - 0.106
0.020
-0.044 - 0.085
Corr R
0.377
0.429
F
3.508
13.400
p
0.000
0.000
1998: n=242; 2007: n=877; *p<0.05, ** p<0.01
Controlling for size of residence, gender, age, education, household income
- increasing distance/decreasing contacts, + decreasing distance/increasing contacts
1)
l t l > 2,0 2) interaction: time (year) x stress stand. ß = 0.107, p=0.000.
t
1) 2)
1)
1)
1)
Discussion
- Causal attribution, perceived dangerousness,
perceived treatment success, perceived course of
schizophrenia and familiarity have an independent
impact on the desire to contact people suffering
from schizophrenia.
- Causal Attribution:
- Assumed biological factors and personality
characteristics (weak character) increase social
distance
- Assumed social stress increases contacts
- Perceived success of treatment, course of
treatment and knowing people suffering from
schizophrenia have a direct independent positive
effect on contacts
Discussion
- No independent effect of the year when the
survey was conducted
- There are modifications in the structure of the
determinants between 1998 and 2007, but they do
not differ substancially except perceived stress as
cause of schizophrenia
- No increased influence of perceived success of
treatment
- Limitations: Not a panel study, social desirability,
only one vignette, other factors (e.g. personality,
values) not included
Conclusion
- Genetics as important causes of schizophrenia
leads to more distance: Unintended consequencies
of the favoured medical model
- Education people about treatment options
increases contacts
- The most important single impact factor on social
contacts is still perceived dangerousness.
Perceived dangerousness leads to more distance
- How much is the influence of mass media‘s
reporting about mental illness and violence?
Conclusion
Influence of mass
media?
On 28th August
last year (2007) a
19 year old man
confessed, that he
had killed another
man.
Survey conducted:
September/October 2007
Acknowledgement
The survey 2007 was funded by the Ministry of
Health, Family and Youth.
In 1998 the study was unconditional financially
supported by Österreichische Schizophreniegesellschaft.
The authors are grateful to Hans Bacher and Joachim
Gerich (Linz), and Wolfgang Fleischhacker (Innsbruck)
for their advice and helpful comments.