Reducing college students' stigma toward people with schizophrenia

Abstract

Abstract Public stigma has been shown to have multidimensional negative impacts on people with schizophrenia (PWS). However, theory-based interventions with structured sessions are rare in Hong Kong. In the current study, a one-day intervention grounded on the inter-group contact theory was developed to reduce college students’ stigma toward PWS. The new intervention invited college students to have direct contact with PWS over three sessions with zero, moderate, and intimate levels of contact, respectively. The first section of the study aimed to develop a validated and brief instrument measuring stigmatizing attitudes in the Chinese context. The Community Attitudes towards the Mentally Ill (CAMI) scale, which measured the core elements of stigmatizing attitudes, was adapted for the purpose. The final 17-item, four-factor version of the shortened Chinese version of the CAMI scale (the Chinese version of the CAMI-SF) presented satisfying psychometric properties and conceptual coherence. Factor loadings of all the 17 items ranged from 0.51 to 0.81. The Cronbach’s alpha coefficients of the Chinese version of the CAMI-SF scale were revealed to be 0.58, 0.57, 0.75, and 0.68 for each subscale, respectively. Although only one subscale had a Cronbach’s alpha coefficient higher than 0.70, the reliability of this coefficient was acceptable for subscales with only three to five items. The pilot trial in the second section of the study provided quantitative evidence supporting the feasibility and effectiveness of the one-day intervention for stigma reduction toward PWS. The results indicated that different levels of contact with PWS had different functions in the reduction of public stigma toward PWS. Zero contact with the introduction of accurate information contributed most to participants’ knowledge improvement, but knowledge improvement alone may not be effective in curbing stigmatizing attitudes and prompting intended behaviour changes. Moderate level of contact (guided group discussion) and intimate level of contact (cooperative work), however, led to an obvious improvement in participants’ stigmatizing attitudes and intended behaviour changes. A randomized control trial was conducted with an active control design in the third section of the study. Again, the results indicated great improvement in stigma reduction toward PWS with large effect sizes. The function of each level of contact was in line with the findings in the pilot trial. A new point was that shifts in the opposite direction, such as less tolerant attitudes, could also emerge after a knowledge session. Although improvement on the three stigma components could also be found in the control group, the magnitude was significantly lower than that of the intervention group. The main task of the current study was to provide an effective as well as efficient solution to alleviate the public stigma toward PWS. The results demonstrated the improvement in participants’ knowledge of schizophrenia, stigmatizing attitudes, and social distance from PWS. The results also revealed the functions of different levels of contact on stigma reduction. In summary, the current study provided practical evidence for reducing public stigma toward PWS among college students and represents a theoretical contribution to the function of different levels of contact on stigma reduction.