Public Responses to Schizophrenia:

Avoidance and Education

By Stephen Butler 2184262

PSYC1102B

17/10/2017

Word Count-
Public Responses to Schizophrenia 2

Abstract

This study investigated the intrapersonal factors stigma surrounding

Schizophrenia including, social distance pertaining to ‘perceived strangeness’ and a participant’s

willingness to socialise with a subject suffering from schizophrenia. Symptomology was

assessed using a blind Likert scale. All participants were given a hypothetical situation. One

group had to individually decide if they would socialize with a person suffering from either

positive or negative symptoms of schizophrenia. The other group were given a hypothetical

situation to determine their individual rating of social distance from a person that was also

suffering from positive or negative symptoms of schizophrenia. The results showed that people

were more likely to socialize with a subject suffering from positive, as opposed to negative

symptoms of schizophrenia, and that social distance was increased with subjects suffering from

negative versus positive symptoms of schizophrenia. The entire study was researched with an

aim of reducing stigma associated with schizophrenia.

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Introduction

Over the years, many studies have shown a correlation between the stigma surrounding

those suffering from severe mental illness (SMI) and how intrusively their positive or negative

symptoms are exhibited (Dickson, 2002; Ertugrul & Uluğ, 2004; Penn, Kohlmaier, & Corrigan,

2000; Penn & Link, 2002; Penn & Martin, 1998; Schumacher, Corrigan, & Dejong, 2003;

Thompson, et al., 2002). Schizophrenia is one such SMI that is characterised by positive

symptoms which include hallucinations, delusions, or racing thoughts, and negative symptoms

displayed as apathy, lack of emotion or a minimal social life. Stigma towards people with

schizophrenia can involve avoidance or alienation. Through continued research there is the

potential to gain a better understanding of what contributes to the stigma surrounding people

affected by SMI. Through this research there is also the potential to create and administer

positive programs that will educate about schizophrenia and promote understanding. Thus,

reducing stigma and assisting with the integration of people suffering with SMI. This study and

its accompanying literature review will explore how the types of symptoms, both negative,

meaning less obvious and positive meaning more obvious, like hallucinations and delusions. This

study will also have the potential to impact a person’s perception and response to a person

suffering with schizophrenia.

The foundation of this study is influenced by the work of the following two hypotheses.

First, in Penn, Kohlmaier, & Corrigan (2000), it was expected that a higher percentage of

participants would indicate that they would be willing to talk to a person with schizophrenia

when reading about a person with positive symptoms of schizophrenia compared to participants

readings about a person with negative symptoms of schizophrenia. Second is a study conducted

by Schumacher, Corrigan, & Dejong (2003) wherein it was expected that participants reading

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Public Responses to Schizophrenia 4

about a person with positive symptoms of schizophrenia will report a higher mean score on

avoidance of the person with schizophrenia, compared to participants reading about a person

with negative symptoms of schizophrenia. Much of the empirical data throughout the research

agrees that the stigma around those suffering from SMI have similar key characteristics, or

triggers. Two studies in particular found that by portraying poor social skills and awkward, or

“weird”, behaviour, the confederates’ level of dishevelment in appearance played a large role in

whether the participant maintained existing stigmatisms towards the confederate (Ertugrul &

Uluğ, 2004; Penn, Kohlmaier, & Corrigan, 2000). Many participants in the study reported

feelings of discomfort, avoidance, and prejudice towards the subjects, all of which are

characteristics of a SMI stigma (Ertugrul & Uluğ, 2004; Penn, Kohlmaier, & Corrigan, 2000). It

was found that participants were more likely to acoid a person displaying negative symptoms

than positive symptoms because of perceived danger elicited from proximity to the schizophrenia

sufferer causing an accentuated stigma (Ertugrul & Uluğ, 2004; Penn, Kohlmaier, & Corrigan,

2000). This was achieved when actors playing the part of a SMI sufferer exaggerated negative

symptoms, such as aggression and unpredictability, to elicit a true response in a controlled

environment (Ertugrul & Uluğ, 2004; Penn, Kohlmaier, & Corrigan, 2000). Both poor social

skills and unkept appearances, along with proximity and unpredictability, were specifically used

to increase a sense of danger to the participants (Ertugrul & Uluğ, 2004; Penn, Kohlmaier, &

Corrigan, 2000). Schumacher found that participants were more likely to avoid subjects

displaying positive symptoms, compared to those displaying negative symptoms. Negative

symptoms in conjunction with an unkept appearance exacerbates the existing stigma towards

schizophrenia (Schumacher, Corrigan, & Dejong, 2003; Thompson, Stuart, Bland, Arboleda-

Florez, Warner, & Dickson, 2002). Gender variables also play a role in the exacerbation of the

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Public Responses to Schizophrenia 5

stigma surrounding schizophrenia It was found that, during proximity experiments, avoidance

and perceived danger greatly increased when the participant was a female as opposed to that of a

male (Schumacher, Corrigan, & Dejong, 2003; Penn & Link, 2002). When these factors are

compounded, they paint a vivid picture of stigma and fear towards people that suffer from SMI.

According to Penn & Link (2002) and Dickson (2002), there have been many pilot

programs introduced worldwide in the form of a campaign of factual education, awareness, and

tolerance to reduce the stigma surrounding SMI. Empirical data was collected from these

programs to gain a knowledge of how SMI stigmatism could be further reduced. According to

this research, the behaviour of males was more likely to be affected by mental illness stigmas

then the behaviour of women. The expected result was less than perfect. There was found to be

limitations on the effect of mental illness stigma from the educational awareness campaigns

(Penn & Link, 2002). Even though there were limited effects with factual awareness, there was

still a measurable effect which produced increased levels of acceptance and, in turn, reduced the

existing stigma of SMI.

As a result, the hypothesis of this study is that it is expected that a higher mean of

participants is more likely to exhibit higher social avoidance to a person who exhibits positive

symptoms of schizophrenia, as opposed to negative symptoms of schizophrenia. It is also

expected that a higher percentage of participants will socialise with the individuals displaying

positive symptoms of schizophrenia compared to the individual displaying negative symptoms of

schizophrenia. This study is intended to aid in the research to lower the stigma surrounding

schizophrenia. This theory will be tested using the Likert Scale. The information collected

through this study has the potential to increase the effectiveness of future schizophrenia

awareness programs and reduce the stigma surrounding schizophrenia.

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Method

Participants

Participants were 220 first-year psychology students recruited from Flinders University (173

females, 47 males). Participants ranged in age from 17 to 60 years, with a modal age of 18-20

years.

Materials and Procedure

Participants completed the experiment during a first-year psychology class. Participants

were randomly assigned to one of two conditions, and received one of two different versions of

the questionnaire were utilised: one involving a scenario with a man at a bus stop exhibiting

positive symptoms of schizophrenia, and the other with a man at a bus stop exhibiting negative

symptoms of schizophrenia. The questionnaire contained questions which assessed participants’

intention to socialise with the person (e.g., “Would you talk to this person at the bus stop”).

Intention to avoid this person was measured on a Likert scale ranging from 1 (strongly disagree)

to 7 (strongly agree), with a mid-point of 4 (neither disagree or agree).

Results

The first hypothesis predicted that a greater percentage of people in the positive symptom

condition would be happy to socialise with the man in the scenario in comparison to participants

in the negative symptom condition. Overall, 54% of the participants in the positive symptom

condition reported that they would talk to the man at the bus stop. In comparison, 46 % of the

participants in the negative symptom condition reported that they would be happy to talk to the

man at the bus stop.

54 – 46 = 8%, 8% ≤ 30% There is no significant group difference.

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The second hypothesis predicted that the mean avoidance score would be higher for the

condition where the man in the scenario displayed negative symptoms of schizophrenia

compared to the condition where the person displayed positive symptoms of schizophrenia.

Results showed the mean avoidance score in the positive symptom condition was (M = 3.63, SD

= 1.35) whereas the mean avoidance score in the negative symptom condition was (M = 4.05,

SD = 1.41).

4.05(M1) - 3.63(M2) = 0.42, SD 1.41 ∕ 2 = 0.705. 0.705 ≥ 0.42 Quantitative shows no

significant difference.

Discussion

As a result, the hypothesis of this study agrees with the findings that a higher mean of

participants is more likely to exhibit higher degrees of social avoidance to a person who exhibits

positive symptoms, as opposed to negative symptoms of schizophrenia. This study also agrees

with the hypothesis that a higher percentage of participants will socialise with the individuals

displaying positive symptoms compared to negative symptoms of schizophrenia. However, one

unforeseen outcome of the study shows that there is no significant difference between positive

and negative symptoms of social distance, or a participant’s willingness to socialise with a

subject.

The findings of this study clearly show that the hypothesis of this study was clearly

defined and appear to be sound, even though there was shown to be no significant difference

between participants views regarding subjects with positive or negative views of schizophrenia.

In agreement with the outcome of Schumacher’s study, it was found that participants that were

more willing to socialize with subjects exhibiting positive symptoms, as opposed to negative

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Public Responses to Schizophrenia 8

symptoms (Schumacher, et al., 2003). Likewise, Penn’s study agrees that social distance would

increase among participants viewing a subject exhibiting negative versus positive symptoms of

schizophrenia (Penn et al., 2000). The context of the theory did well to outline some general

parameters to better understand stigma. This research has the potential to assist in promoting

education and understanding with the goal of integration in regard to schizophrenia.

The method used throughout this study used the Likert Scale to gain a general

understanding of how participants might react to subjects with positive or negative symptoms of

schizophrenia in hypothetical situations. Both Penn and Schumacher’s studies also used a blind

Likert scale. The results of this study could have possibly been impacted very differently had

situations been produced , instead of hypothetically. One variant between this study and

Schumacher’s was that Schumacher’s study described the subjects looking either more or less

attractive. One subject might be well dressed and another with an unkept appearance. The more

unkept a person was perceived, the more the increase in social distance. Penn’s study in contrast

looked at a more danger, threat, avoidance model for research. Though not significant in this

study, it had great significants in Penn’s study when coupled with gender segregation. It showed

that social distance was greatly increased when the subject looked unkept, and the participant

was a female when testing perceived danger as to that of male participant (Penn, D. L., & Link,

B., 2002).

This study was limited by a few different factors that lay almost solely in the method.

One such limitation was the ratio of males to females. Even though it did not show significant

difference in this study, it showed great significants in the Penn study to determine which sex

viewed a subject as danger level by their perceived attractiveness. Second, all participants were

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first year psych students from a single University. This could show a bias one way or the other

that is divided by what the students think they know, and what they have learned since attending

psychology class. Third, even though the participants ages ranged from 17 to 60 the average age

of all participants was between 18 and 20. This could be considered a significant limitation, due

factors such as age that limit perspectives. The 18 to 20-year-old students, likely either still live

at home, or have not long been away from home, and are still a product of their upbringing

where participation trophies and social inclusion is a norm, as opposed to a 60-year-old that grew

up in a different culture. Even though this shows a good idea of the population of a university, it

does not attest to population in general. Finally, the use of theoretical subjects measured with the

Likert scale would clearly have a different impact on the participant that would a subject

observed in real life when the participant was unaware of the parameters of the study. In

conclusion, future research must include more real-life scenarios that segregate gender, and use a

much broader spectrum of the population from different location, ages, and walks of life to gain

better empirical data for research into the stigmas surrounding schizophrenia.

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References

Check references against APA 6th

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Psychiatry and Psychiatric Epidemiology, 39(1), 73-77.

Penn, D. L., Kohlmaier, J. R., & Corrigan, P. W. (2000). Interpersonal factors contributing to the

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Stuart, H., Bland, R. C., Arboleda-Florez, J., Warner, R., & Dickson, R. A. (2002). Attitudes

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