The effectiveness of efforts designed to address mental illness stigma will rest on our ability to understand stigma processes, the factors that produce and sustain such processes, and the mechanisms that lead from stigmatization to harmful consequences. Critical to such an understanding is our capacity to observe and measure the essential components of stigma processes. This article is designed to assist researchers in selecting or creating measures that can address critical research questions regarding stigma. Our conceptualization of stigma processes leads us to consider components of labeling, stereotyping, cognitive separating, emotional reactions, status loss, and discrimination. We review 123 empirical articles published between January 1995 and June 2003 that have sought to assess mental illness stigma and use these articles to provide a profile of current measurement in this area. From the articles we identify commonly used and promising measures and describe those measures in more detail so that readers can decide whether the described measures might be appropriate for their studies. We end by identifying gaps in stigma measurement in terms of concepts covered and populations assessed.

Measuring Mental Illness Stigma

Objective: To provide a review of population-based attitude research in psychiatry during the past 15 years.

Method:  An electronic search using PubMed, Medline, and Academic Search Premier plus a hand search of the literature was carried out for studies on public beliefs about mental illness and attitudes towards the mentally ill published between 1990 and 2004.

Results:  Thirty-three national studies and 29 local and regional studies were identified, mostly from Europe. Although the majority are of descriptive nature, more recent publications include studies testing theory-based models of the stigmatization of mentally ill people, analyses of time trends and cross-cultural comparisons, and evaluations of antistigma interventions.

Conclusion:  Attitude research in psychiatry made considerable progress over the past 15 years. However, there is still much to be done to provide an empirical basis for evidence-based interventions to reduce misconceptions about mental illness and improve attitudes towards persons with mental illness.

Public beliefs about and attitudes towards people with mental illness: a review of population studies

Patients' preferences in the treatment of depressive disorder in primary care

This paper discusses factors associated with low rates of help-seeking and poorer quality of physical healthcare among people with mental illnesses. Evidence is reviewed on the associations between low rates of mental health literacy, negative attitudes towards people with mental illness, and reluctance to seek help by people who consider that they may have a mental disorder. People with mental illness often report encountering negative attitudes among mental health staff about their prognosis, associated in part with 'physician bias'. 'Diagnostic overshadowing' appears to be common in general health care settings, meaning the misattribution of physical illness signs and symptoms to concurrent mental disorders, leading to underdiagnosis and mistreatment of the physical conditions.

Discrimination in health care against people with mental illness.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/j.2051-5545.2010.tb00296.x

WPA guidance on how to combat stigmatization of psychiatry and psychiatrists.

The purpose of this study is to test the two-component theory of news selection. Its components are (a) news factors included in articles and (b) news values of news factors. It is assumed that news factors have different news values for various media outlets. The theory was tested comparing the empirical (measured) with the theoretical (calculated) newsworthiness of news stories. First, news values of five news factors for national quality papers, regional papers, and tabloids were identified. Then, based on theory, the theoretical newsworthiness of news stories was calculated. The independent variables were the news factors included in these articles and the news values of these news factors. In addition, in a laboratory setting, the empirical newsworthiness of the news stories was measured. Finally, measured newsworthiness was compared to the predicted one. Results confirmed the two-component theory and demonstrated that the chances of news stories to get published can be predicted by news factors and their news values.

Predicting news decisions. An empirical test of the two-component theory of news selection

Widespread negative attitudes and irrational beliefs about psychotropic drugs held by the public affect patients' treatment compliance. This study was an attempt to identify factors influencing people's acceptance or rejection of psychotropic drugs. An opinion poll was taken by a representative group of 2,176 adults in Germany. In addition to their attitudes toward psychotropic and cardiac drugs and their ratings of perceived risks and benefits, they were also asked about their drug knowledge, their fear of losing self-control, and their fundamental political values. Our results show that even for the treatment of severe mental disease, psychotropic drugs generally are not well accepted compared to cardiac drugs. Psychotropic drugs are believed to cause significantly more severe side effects and provoke more fear of losing control compared with cardiac drugs. Knowledge about psychotropic drugs and experiences with patients suffering from mental disorders are rather limited. Therefore, other sources of information such as negatively tainted reports in the mass media have a significant impact on opinions about psychotropic drugs. Unexpectedly, negative media reports are even more important for the discrimination of distinct subtypes like "acceptors" and "rejecters" of psychotropic drugs than fundamental value orientation. It is recommended that educational and information measures must be enacted to achieve balanced presentation of psychotropic drugs, their effects, and their side effects in the mass media. Improved communication and linguistic elements used in psychotherapeutic settings should be integrated into biological psychiatry to improve understanding of the concepts of mental diseases and their treatment.

Public opinion on psychotropic drugs: an analysis of the factors influencing acceptance or rejection.

Alltägliche Skandale : eine repräsentative Analyse regionaler Fälle

In 1989, just before German reunification, 498 German journalists were asked to indicate which, from a list of 34 major historical events, such as the end of World War II, the 1949 German currency reform, the building of the Berlin wall, the student movement, and the Chernobyl disaster, they vividly remembered, which still oriented their political thinking, and their political reaction to these events. While some events stand out for all ages, younger journalists, having no memory of World War II and its aftermath, focused more exclusively on such recent events as Chernobyl and the discovery of the AIDS virus. The dominant thrust from recent historical experiences on all age groups was toward the left, even though some events, such as cold war experiences, have caused some backlash. The influence of time of birth on memory, on intergenerational discontinuity, and on sensitivity to specific types of historical experiences are analyzed in relation to the concept of generations.

Collective memory and political generations: A survey of German journalists

Kaum ein anderes gesellschaftliches Phanomen illustriert die Interdependenz von Politik und Medien so klar wie Skandale. Zur Entstehung von Skandalen genugt nicht allein die Existent von Missstanden in Politik und Gesellschaft. Vielmehr bedarf es ihrer Anprangerung im offentlichen Raum und einer entsprechenden Resonanz innerhalb des Mediensystems. Sie erst lasst Missstande in den Augen der Bevolkerung als nicht tolerierbar und damit anderungsbedurftig erscheinen. Fast alle Skandale beruhen auf Missstanden — sozialen Tatsachen, die in mehr oder weniger zahlreichen Segmenten der Gesellschaft mehr oder weniger homogen als falsch empfunden werden. Nicht alle Missstande entwickeln sich zu Skandalen. Zum Skandal wird ein Missstand erst durch die Perspektive, aus der man ihn betrachtet. Ein Missstand wird zu einem Skandal, wenn er in relevanten Teilen der Medien bzw. der Gesellschaft Emporung hervorruft. Die Voraussetzung dafur ist in modernen Gesellschaften fast immer eine entsprechende Darstellung in den Medien. Die Medien machen Missstande zu Skandalen, indem sie sie anprangern, wobei sie haufig die Sichtweisen anderer Akteure im vormedialen, u. a. politischen Raum ubernehmen.1

Ist die funktionalistische Skandaltheorie empirisch haltbar? Ein Beitrag zur Interdependenz von Politik und Medien im Umgang mit Missständen in der Gesellschaft

Simone Christine Ehmig

Papers

Predicting news decisions. An empirical test of the two-component theory of news selection

Public opinion on psychotropic drugs: an analysis of the factors influencing acceptance or rejection.

Alltägliche Skandale : eine repräsentative Analyse regionaler Fälle

Collective memory and political generations: A survey of German journalists

Ist die funktionalistische Skandaltheorie empirisch haltbar? Ein Beitrag zur Interdependenz von Politik und Medien im Umgang mit Missständen in der Gesellschaft