Analyse comparative de la stigmatisation de la schizophrénie chez deux publics de professionnels

Abstract

Objectives

The aim of this study is dual. On the one hand, it aims to compare two groups of professionals working with individuals with schizophrenia in different settings: psychiatric services and social services, in order to examine the stigma of schizophrenia across various indicators. On the other hand, it also seeks to compare explicit measures of stigmatization with more implicit ones. Explicit indicators of stigma were used, such as the scale of discrimination and social distance, as well as stereotypical traits attributed to these individuals. According to the stereotype content model, individuals or groups can be categorized along two dimensions: warmth and competence. Warmth refers to interpersonal intentions and social or moral qualities, while competence concerns individuals’ motivations or abilities to achieve their goals. An indicator of infrahumanization was also employed to measure the implicit stigma of these disorders. The theory of infrahumanization distinguishes between primary and secondary emotions, the latter being specific to humans, and posits that people tend to perceive outgroup members as less human than ingroup members. For example, people attribute fewer specifically human positive or negative emotions to members of certain outgroups compared to ingroup members.

Methods

We recruited 91 professionals (nurses, physicians/psychiatrists, social workers, and psychologists) from two types of facilities: psychiatric services and social services, who were randomly asked to complete an online questionnaire on schizophrenia. We used four scales of stigma measuring discrimination and social distance, stereotypes (warmth and competence), and infrahumanization. Sociodemographic variables as well as social dominance orientation were also tested. Social dominance orientation is a concept that refers to an individual's preference for hierarchy in social relations, where certain groups dominate others, and the belief that such inequalities should be maintained and justified. It leads to the adoption of beliefs that legitimize and perpetuate discrimination against people with schizophrenia.

Results

First, the descriptive analyses show an overall score for individuals working with people suffering from mental disorders that indicates that individuals with schizophrenia are moderately stigmatized. The competence and warmth scores attributed are also average and suggest that professionals working with people suffering from mental disorders are moderately agree that users with schizophrenia exhibit traits of warmth and competence. On the other hand, the obtained score reveals slight infrahumanization. In other words, participants, regardless of professional context, attributed more specifically human traits to themselves than to individuals with schizophrenia. Furthermore, a significant effect of the type of facility was found for all four discrimination measures. Firstly, mental health professionals in hospitals discriminate more against individuals with schizophrenia than professionals in social services. Moreover, they attribute significantly less competence, but more warmth to participants working in professional insertion associations. Lastly, the score of infrahumanization was higher among mental health professionals in hospitals, while it was much lower among other professionals. Finally, discrimination measures, warmth, and competence attribution are correlated, whereas infrahumanization is not. Social dominance orientation is also correlated with discrimination and competence but not with infrahumanization and warmth.

Conclusions

The various indicators of stigma show that they vary depending on the type of facilities in which professionals working with individuals with schizophrenia operate. The results of this study demonstrate the value of using diverse indicators to measure stigma associated with mental disorders. The subtle measure enabled by infrahumanization opens up new avenues of study in the field of mental health.