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Influence of contact with schizophrenia on implicit attitudes towards schizophrenia patients held by clinical residents.

Omori A, Tateno A, Ideno T, Takahashi H, Kawashima Y, Takemura K, Okubo Y - BMC Psychiatry (2012)

Bottom Line: Fifty-one clinical residents participated.However, quite opposite to our expectation, after clinical training the new term had become even more congruent with criminal than the old term.There was no significant correlation between Link's scale and IAT effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neuropsychiatry, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan.

ABSTRACT

Background: Patients with schizophrenia and their families have suffered greatly from stigmatizing effects. Although many efforts have been made to eradicate both prejudice and stigma, they still prevail even among medical professionals, and little is known about how contact with schizophrenia patients affects their attitudes towards schizophrenia.

Methods: We assessed the impact of the renaming of the Japanese term for schizophrenia on clinical residents and also evaluated the influence of contact with schizophrenia patients on attitudes toward schizophrenia by comparing the attitudes toward schizophrenia before and after a one-month clinical training period in psychiatry. Fifty-one clinical residents participated. Their attitudes toward schizophrenia were assessed twice, before and one month after clinical training in psychiatry using the Implicit Association Test (IAT) as well as Link's devaluation-discrimination scale.

Results: The old term for schizophrenia, "Seishin-Bunretsu-Byo", was more congruent with criminal than the new term for schizophrenia, "Togo-Shitcho-Sho", before clinical training. However, quite opposite to our expectation, after clinical training the new term had become even more congruent with criminal than the old term. There was no significant correlation between Link's scale and IAT effect.

Conclusions: Renaming the Japanese term for schizophrenia still reduced the negative images of schizophrenia among clinical residents. However, contact with schizophrenia patients unexpectedly changed clinical residents' attitudes towards schizophrenia negatively. Our results might contribute to an understanding of the formation of negative attitudes about schizophrenia and assist in developing appropriate clinical training in psychiatry that could reduce prejudice and stigma concerning schizophrenia.

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Ex.) Congruent condition. Strong implicit associations should lead to fast congruent (CC) and slow incongruent (IC) categorizations. As a result, the IAT effect (reaction time for IC minus CC) provides a measure of the strength of implicit associations.
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Figure 1: Ex.) Congruent condition. Strong implicit associations should lead to fast congruent (CC) and slow incongruent (IC) categorizations. As a result, the IAT effect (reaction time for IC minus CC) provides a measure of the strength of implicit associations.

Mentions: IAT was performed according to standard procedures to assess the strength of the automatic association between schizophrenia and criminal[26]. IAT tasks corresponded to those of the previous study[22]. While diabetes mellitus was used as a physical chronic illness for comparison in that study, we chose hypertension as a physical illness to contrast schizophrenia, as it is a more common medical condition in Japan. The associations of schizophrenia (both “Seishin-Bunretsu-Byo” version and “Togo-Shitcho-Sho” version) and hypertension with two attributes (criminal and victim) were then assessed. Target words were the same as in the study of Takahashi et al. (2009)[22], and for hypertension the target words were surveyed in the same way. Five words related to hypertension (vessel, sphygmomanometer, antihypertensive, salt, palpitation) were consensually finally selected. Schizophrenia (hallucination, delusion, psychiatry, bizarre, seclusion), criminal (violence, jail, murder, theft, robbery) and victim (disaster, family, accident, casualty, the bereaved) stimuli appeared in the center of the computer screen (see Figure1). Subjects were asked to respond to a series of items belonging to either the schizophrenia or criminal categories on the left, and those belonging to either the hypertension or victim categories on the right, as rapidly as possible with left- or right-hand key press. In the congruent condition (CC), the concept “schizophrenia” and the attribute “criminal” were paired in the top left corner, while “hypertension” and “victim” were coincidentally paired in the opposite corner. In the incongruent condition (IC), the key assignments for one of the pairs were switched and the same sorting task was completed while pairing “schizophrenia” with “victim” and “hypertension” with “criminal”. Sorting should be easier and faster when the two concepts sharing a response are implicitly associated. Consequently, the IAT effect (reaction time for IC minus CC) showed a measure of the strength of implicit associations. Since negative attitudes toward mental illness are observed in many cultures[38], CC categorizations can be expected to be easier and faster than IC ones. The order of the two versions of IAT was counterbalanced across the subjects.According to Greenwald et al. (1998)[26], response latencies below 300 ms were converted to 300 ms and those above 3,000 ms to 3,000 ms. Latencies were then log-transformed. We analyzed the effect and interaction of term (old term vs. new term), condition (CC vs. IC), and period (before vs. after) using 3-way analysis of variance (ANOVA).


Influence of contact with schizophrenia on implicit attitudes towards schizophrenia patients held by clinical residents.

Omori A, Tateno A, Ideno T, Takahashi H, Kawashima Y, Takemura K, Okubo Y - BMC Psychiatry (2012)

Ex.) Congruent condition. Strong implicit associations should lead to fast congruent (CC) and slow incongruent (IC) categorizations. As a result, the IAT effect (reaction time for IC minus CC) provides a measure of the strength of implicit associations.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3539926&req=5

Figure 1: Ex.) Congruent condition. Strong implicit associations should lead to fast congruent (CC) and slow incongruent (IC) categorizations. As a result, the IAT effect (reaction time for IC minus CC) provides a measure of the strength of implicit associations.
Mentions: IAT was performed according to standard procedures to assess the strength of the automatic association between schizophrenia and criminal[26]. IAT tasks corresponded to those of the previous study[22]. While diabetes mellitus was used as a physical chronic illness for comparison in that study, we chose hypertension as a physical illness to contrast schizophrenia, as it is a more common medical condition in Japan. The associations of schizophrenia (both “Seishin-Bunretsu-Byo” version and “Togo-Shitcho-Sho” version) and hypertension with two attributes (criminal and victim) were then assessed. Target words were the same as in the study of Takahashi et al. (2009)[22], and for hypertension the target words were surveyed in the same way. Five words related to hypertension (vessel, sphygmomanometer, antihypertensive, salt, palpitation) were consensually finally selected. Schizophrenia (hallucination, delusion, psychiatry, bizarre, seclusion), criminal (violence, jail, murder, theft, robbery) and victim (disaster, family, accident, casualty, the bereaved) stimuli appeared in the center of the computer screen (see Figure1). Subjects were asked to respond to a series of items belonging to either the schizophrenia or criminal categories on the left, and those belonging to either the hypertension or victim categories on the right, as rapidly as possible with left- or right-hand key press. In the congruent condition (CC), the concept “schizophrenia” and the attribute “criminal” were paired in the top left corner, while “hypertension” and “victim” were coincidentally paired in the opposite corner. In the incongruent condition (IC), the key assignments for one of the pairs were switched and the same sorting task was completed while pairing “schizophrenia” with “victim” and “hypertension” with “criminal”. Sorting should be easier and faster when the two concepts sharing a response are implicitly associated. Consequently, the IAT effect (reaction time for IC minus CC) showed a measure of the strength of implicit associations. Since negative attitudes toward mental illness are observed in many cultures[38], CC categorizations can be expected to be easier and faster than IC ones. The order of the two versions of IAT was counterbalanced across the subjects.According to Greenwald et al. (1998)[26], response latencies below 300 ms were converted to 300 ms and those above 3,000 ms to 3,000 ms. Latencies were then log-transformed. We analyzed the effect and interaction of term (old term vs. new term), condition (CC vs. IC), and period (before vs. after) using 3-way analysis of variance (ANOVA).

Bottom Line: Fifty-one clinical residents participated.However, quite opposite to our expectation, after clinical training the new term had become even more congruent with criminal than the old term.There was no significant correlation between Link's scale and IAT effect.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Neuropsychiatry, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan.

ABSTRACT

Background: Patients with schizophrenia and their families have suffered greatly from stigmatizing effects. Although many efforts have been made to eradicate both prejudice and stigma, they still prevail even among medical professionals, and little is known about how contact with schizophrenia patients affects their attitudes towards schizophrenia.

Methods: We assessed the impact of the renaming of the Japanese term for schizophrenia on clinical residents and also evaluated the influence of contact with schizophrenia patients on attitudes toward schizophrenia by comparing the attitudes toward schizophrenia before and after a one-month clinical training period in psychiatry. Fifty-one clinical residents participated. Their attitudes toward schizophrenia were assessed twice, before and one month after clinical training in psychiatry using the Implicit Association Test (IAT) as well as Link's devaluation-discrimination scale.

Results: The old term for schizophrenia, "Seishin-Bunretsu-Byo", was more congruent with criminal than the new term for schizophrenia, "Togo-Shitcho-Sho", before clinical training. However, quite opposite to our expectation, after clinical training the new term had become even more congruent with criminal than the old term. There was no significant correlation between Link's scale and IAT effect.

Conclusions: Renaming the Japanese term for schizophrenia still reduced the negative images of schizophrenia among clinical residents. However, contact with schizophrenia patients unexpectedly changed clinical residents' attitudes towards schizophrenia negatively. Our results might contribute to an understanding of the formation of negative attitudes about schizophrenia and assist in developing appropriate clinical training in psychiatry that could reduce prejudice and stigma concerning schizophrenia.

Show MeSH
Related in: MedlinePlus