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Stigma and discrimination associated with mental illness and other stigmatizing conditions in China using two cultural-sensitive measures of stigma: interpersonal distance and occupational restrictiveness

Published online by Cambridge University Press:  02 June 2020

Wei Xiong ,
Michael R. Phillips Open the ORCID record for Michael R. Phillips [Opens in a new window] ,
Zhizhong Wang ,
Yuhong Zhang ,
Hui G. Cheng  and
Bruce G. Link
Wei Xiong
Affiliation:
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Michael R. Phillips*
Affiliation:
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China Departments of Psychiatry and Epidemiology, Columbia University, NY, USA
Zhizhong Wang
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
Yuhong Zhang
Affiliation:
Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, China
Hui G. Cheng
Affiliation:
Department of Epidemiology & Biostatistics, Michigan State University, MI, USA
Bruce G. Link
Affiliation:
University of California Riverside, CA, USA
*
Author for correspondence: Michael R. Phillips, E-mail: mphillipschina@outlook.com
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Abstract

Background

Reducing stigma is a perennial target of mental health advocates, but effectively addressing stigma relies on the ability to correctly understand and accurately measure culture-specific and location-specific components of stigma and discrimination.

Methods

We developed two culture-sensitive measures that assess the core components of stigma. The 40-item Interpersonal Distance Scale (IDS) asks respondents about their willingness to establish four different types of relationships with individuals with 10 target conditions, including five mental health-related conditions and five comparison conditions. The 40-item Occupational Restrictiveness Scale (ORS) asks respondents how suitable it is for individuals with the 10 conditions to assume four different types of occupations. The scales – which take 15 min to complete – were administered as part of a 2013 survey in Ningxia Province, China to a representative sample of 2425 adult community members.

Results

IDS and ORS differentiated the level of stigma between the 10 conditions. Of the total, 81% of respondents were unwilling to have interpersonal relationships with individuals with mental health-related conditions and 91% considered them unsuitable for various occupations. Substantial differences in attitudes about the five mental health-related conditions suggest that there is no community consensus about what constitutes a ‘mental illness’.

Conclusions

Selection of comparison conditions, types of social relationships, and types of occupations considered by the IDS and ORS make it possible to develop culture-sensitive and cohort-specific measures of interpersonal distance and occupational restrictiveness that can be used to compare the level and type of stigma associated with different conditions and to monitor changes in stigma over time.

Keywords

Chinadiscriminationinterpersonal distancemental illnessoccupational restrictivenessstigma
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 16 , December 2021 , pp. 2804 - 2813
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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