The Measurement Of Implicit Stigma Toward Mental Illness And Its Predictive Factors

Mental illness stigma is negative attitudes toward people with mental illness, concluding negative cognition, passive emotion and discrimination tendency. WHO pointed out that stigmatization of mental illness was the biggest impediment to the rehabilitation of patients with mental illness. Many studies have shown that it is a significant barrier to the seeking of mental health service, successful treatment and rehabilitation. More and more contryies have taken various interventions to reduce mental illness stigma. In China, Mental Health Act going into effect in May this year also clearly defined prohibiting discrimination, insults and abuse agsinst persons with mental illness, in attempt to achieve respect, understanding and care toward people with mental illness in our society.To erase mental illness stigma and its negative impact, first of all have accurate measurements, which is the prerequisite and foundation. Previous studies indicated that explicit measures were likely to underestimate the true levels of mental illness stigma because they are subject to social desirability biases, and that also ignored the atuomaitically-activated stigma aspects. Referring the theories and methods of implicit social cognition, stigma researchers have placed more interest on automatic attitudes toward people with mental illness to better understand mental illness stigma, and have found many new knowledges about mental illness stigma by implicit measurements. However, very little has been done to explore the property and components implicit stigma toward mental illness, and to discover what category was in implicit stigma mental representation. In addition, there were some shortcomings in the measurement methods used in previous studies, and almost no studies have examined the factors impacting implicit stigma. Obviously, these problems or deficiencies affect the accurate measurement of implicit stigma toward mental illness.On the basis of past studies, and combining the ABCs of Attitudes, the present study considered that the implicit stigma toward was the introspectively (or inaccurately) unidentified traces about mental illness, which unconsciously regulate the individual’s belief and reaction of people with mental illness; these traces include three automatically activated aspects that are negatively cognitive evaluations, affective reactions and discriminatory tendencies. At the top of this definition and conceptions, the current research designed five sub-studies takeing the evaluation of implicit stigma as the centre. Study1collated and assessed the evaluative and concept words of implicit stigma toward mental illness by literature-reviewing and open-ended questions, as the attribute and category of stigma’ mental representation. Study2examined the property and component of implicit stigma and its relationship with explicit stigma, using self-designed materials and Single Category Implicit Association Test (SC-IAT). Study3exmined the semantic categories of stigma representation and the validity of the categories of mental representation in previous implicit stigma research by IAT. Study4used the attribute and category information of stigma representation exmined by study2and3to explore the electrophysiology evidence of implicit stigma by piming task and event-related potentials (ERP). Study5preliminary explore the predictive factors of implicit stigma on the basis of the literature review. The findings of these studies were as follows:1, self-designed materials, reflecting the attribute and category information of stigma representation, was reliable and valid. Prepared implicit stigma SC-IAT also had good reliability, validity, and was a reliable tool for implicit stigma assessment.2, the three-component model of implicit stigma (negative cognition, negative affect, and discriminatory tendencies) was supported by measurements of response times using three independent SC-IATs. Explicit and implicit measures of stigma toward mental illness were unrelated.3, the associated labels (e. g. psychological problems) and specific labels of mental illness had closer automatic association with negative words relative to positive words and were the representing categories of implicit stigma. Both categorical labels could be used as representing categories for implicit stigma measurement, and the sort of mental illness labels used in previous research was valid.4, behavior and ERP results found the negative words consistent with the implicit attitude toward mantal illness more easily were extracted from the memory after mental illness words were presented, and the positive words conflict with the implicit attitude were extracted more difficult, taking longer reaction time and activating N400amplitude greater relative negative words. This indicated that the N400reflecting the semantic conflicts can be regard as the electrophysiological evidence of the activation of implicit stigma toward mental illness.5, the cause of mental illness (mental attribution and interpersonal attribution) and responsibility judgment (individuals responsible judgment) attributed to people with metanl illnes were significantly associated with implicit stigma, but the relationships between mental health literacy, interpersonal contact and implicit stigma were unrelated. Gender and individuals responsible judgment were predictive factors of implicit stigma. 6, most college students had negative implicit attitudes toward people with mental illness. College mental health education and psychological counseling services should pay attention to theis issue, and improve stigma intervention in order to enhance the quality and utilization of mental health services.This present research had some innovations and implications in the thory, relative to the previous studies. First, this study clearly defined implicit stigma toward mental illness, determined its property basing on the theoretical and empirical evidence. Second, we systematically examined the semantic categories of stigma representation and the validity of the categories of mental representation in previous research. Third, the study primarly explored the predictive factors of implicit stigma. There were also some innovation or breakthrough in the method. First, this study designed valid materials assessing imiplicit stigma toward mental illness. Second, implicit stigma SC-IAT programmed by this study also had good reliability, validity, and was a reliable tool for implicit stigma assessment. Third, we primarly used ERP to examine implicit stigma activation, enriching the implicit stigma measurement methods.Despite its implications, select limitations of the current study must be acknowledged. First, self-designed materials assessing implicit stigma had some limitations because of balanceing their semantic information. This issue may lead to these matrials could not completely reflecting implicit stigma. Second, the components of implicit stigma were not the same as the structure of implicit stigma, and could not reflect its main dimensions. Third, this study only discussed the semantic categories of stigma representation, and did not explore other categories.