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Finally, although previous research identified high rates of coercive measures for male gender 12 , and other studies have shown female persons to be more often exposed to coercion 15 , our study revealed no significant difference in approval of coercion regarding the gender of the fictitious person or participants.
Limitations A first limitation consists in possible threats to external validity, i. Since then, the public's perception of psychiatry has changed significantly due to intensified media reporting. Moreover, participation was limited to inhabitants of the Swiss canton of Basel-Stadt, which might limit the generalizability of the results.
Furthermore, our results are pending replication in other independent surveys. Finally, stigmatization is operationalized in this study by the construct of desired social distance. Actually, it remains unclear to what extent this behavioral intention will translate into concrete behavior. Conclusion In Basel, the public attitude regarding approval of coercion in psychiatry largely follows the current legal framework, with higher approval in situations of self-harm or harm to others and when coercive measures are thought to have a beneficial effect for the affected persons.
In this context, a close cooperation with additional inputs of the general population in scientific and treatment-associated questions in psychiatry might be seminal and of additional value for the future. However, a considerable part of the approval for coercion is predicted by stigmatization, which align with the modified labeling theory.
Therefore, reducing stigmatization and misconceptions about the dangerousness of persons with mental illness and increasing familiarity with psychiatric patients seem a vital and essential task for clinical psychiatry to further decrease coercive measures in the treatment of persons with mental disorders.
Informed consent was obtained from all study participants. They agreed to return the completed survey material. Participants were informed about the scope of the study and their rights in an accompanying letter. JS and CH collected the data. SS and CH wrote the initial draft of the paper. SS had full access to all data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors have contributed to read and approved the final version of the manuscript.
The funding body had no role in the design, collection, analysis, or interpretation of the data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. Conflict of Interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's Note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers.
Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. References 1. Zinkler M. Detention of the mentally ill in Europekes responsActa Psychiatr Scand.
Preventing compulsory admission to psychiatric inpatient care through psycho-education and crisis focused monitoring. BMC Psychiatry. Haglund K, Von Knorring L. Psychiatric wards with locked doors—advantages and disadvantages according to nurses and mental health nurse assistants. J Clin Nurs. Lay B, Nordt C. Variation in use of coercive measures in psychiatric hospitals. Eur Psychiatry. Variations in involuntary admission rates at three psychiatry centres in the Dublin Involuntary Admission Study DIAS : can the differences be explained?
Int J Law Psychiatry. Same, same but different: how the interplay of legal procedures and structural factors can influence the use of coercion. Front Psychiatry. Do patient and ward-related characteristics influence the use of coercive measures?
Social Psychiatry Psychiatr Epidemiol. Characteristics of patients frequently subjected to pharmacological and mechanical restraint—a register study in three Norwegian acute psychiatric wards. Psychiatry Res. Schizophr Res. Korkeila JA, Tuohim0. Salize HJ. Epidemiology of involuntary placement of mentally ill people across the European Union. Br J Psychiatry. Exploring and explaining involuntary care: the relationship between psychiatric admission status, gender and other demographic and clinical variables.
Risk factors of coercion among psychiatric inpatients: a nationwide register-based cohort study. Soc Psychiatry Psychiatr Epidemiol. Compulsory admission to psychiatric wardspsychiatric inpa and who appeals against admission? Indu NV, Vidhukumar K. Determinants of compulsory admissions in a state psychiatric hospital—case control study. Asian J Psychiatr. Mental health laws that require dangerousness for involuntary admission may delay the initial treatment of schizophrenia.
The danger of dangerousness: why we must remove the dangerousness criterion from our mental health acts. J Med Ethics. A systematic review of the safety and effectiveness of restraint and seclusion as interventions for the short-term management of violence in adult psychiatric inpatient settings and emergency departments.
Worldviews Evid Based Nurs. Forced medication in psychiatric care: patient experiences and nurse perceptions. J Psychiatr Ment Health Nurs. Special section on seclusion and restraint: Patients' reports of traumatic or harmful experiences within the psychiatric setting.
Psychiatr Serv. Subjective distress after seclusion or mechanical restraint: one-year follow-up of a randomized controlled study. Therapeutic relationship in the context of perceived coercion in a psychiatric population. Long-term treatment of schizophrenia spectrum disorders: focus on pharmacotherapy. Reavley NJ. Stigmatizing attitudes towards people with mental disorders: findings from an Australian National Survey of Mental Health Literacy and Stigma.
Aust N Z J Psychiatry. Angermeyer MC. Stigmatisierung psychisch Kranker in der Gesellschaft. Psychiatrische Praxis. Das Stigma psychischer Krankheit aus der Sicht schizophren und depressiv Erkrankter. Individuals with mental illness are commonly perceived as being relatively dangerous, as multiple representative studies have shown 4. This finding is mirrored in everyday life, for instance by stereotyped media portrays that highlight a high risk for violence in mental illness 3.
Yet, these perceptions are biased: Although there is a significantly elevated risk for violence, the risk is small and the majority of individuals with mental illness are not violent 5. Perceptions of dangerousness gain special importance as they are hypothesized to influence other facets of stigmatization such as desire for social distance 6 or for coercion 7. Perceptions of dangerousness might be influenced by different sources of information.
One source might be information about symptoms or deviant behavior dangerousness associated with psychiatric symptoms. However, psychiatric symptoms are, in contrast to other stigmatized conditions such as ethnicity, often invisible. Consequently, information about psychiatric service use e.
This in turn negatively influences psychiatric service use and adherence: To avoid stigmatization, individuals with mental illness tend to avoid the treatment they are in need for 8 , 9. More precisely, individuals with alcoholism are perceived as more dangerous than individuals with psychosis Yet, research on the stigmatization of individuals with symptoms of personality disorders is still scarce.
The only existent studies suggest that mental health professionals 11 , 12 perceive individuals with borderline personality disorder BPD as more dangerous than individuals with alcoholism. However this effect might be specific to professionals, as individuals with BPD tend to evoke a intense disorder-specific countertransference in treatment Thus, supplemental studies in the general population are needed. To the best of our knowledge, there is as yet no research on dangerousness associated with psychiatric service use that studies differences across different types of service institutions.
However, there is one previous study showing that hospitalizations in a psychiatric unit at a general hospital evoke less desire for social distance the latter being another facet of stigmatization as mentioned above It is plausible that the concrete type of institution also influences perceptions of dangerousness. For instance, by often being geographically dislocated, psychiatric hospitals might evoke associations of confinement and thus foster perceptions of dangerousness In addition, familiarity with psychiatric illness 16 is known to influence the stigma associated with displaying psychiatric symptoms.
For instance, Angermeyer et al. The present study is the first to compare the amount of perceived dangerousness associated with psychiatric symptoms versus with psychiatric service use. Furthermore, we pitted perceived dangerousness associated with symptoms of BPD in the general population against perceived dangerousness associated with symptoms of alcohol dependency and schizophrenia.
Finally, our study is the first to compare the amount of perceived dangerousness across different psychiatric inpatient institutions, including forensic-psychiatric settings. Methods Sample and Procedure Data come from a survey on psychiatric service use and stigmatization that was conducted from autumn to spring among citizens of Basel, Switzerland The current study used questionnaires that were sent out to the general population aged 18 or above.
It included a letter detailing study procedures, stating that participation was completely optional, and that non-participation would not be followed by any consequence. Persons agreed to participate by sending in their questionnaire. This procedure was accepted as informed consent by the EKNZ. The manuscript does not contain information or images that could lead to identification of a study participant.
A sample of 10, individuals was randomly drawn from the cantonal resident register and was mailed study material. To be eligible, participants had to be registered in a private household in Basel-City, Bettingen, or Riehen for a minimum of two years, had to be aged from 18 to 65 years, and had to have sufficient knowledge of the German language. This approach was chosen in a consensus procedure together with the Statistical Office of Basel-City and an external advisory committee to generate a representative study sample.
Participants had to read a vignette and answer several questionnaires. Vignettes described a fictitious character and depicted either the psychiatric symptoms of the character case vignette or a clinic the character had been admitted to clinic vignette. Between both types of vignettes, gender and dangerousness of the fictitious patient were systematically varied: Half of the case vignettes contained a male Sebastian M.
Moreover, it was explicitly stated that within the last month the main character case vignette or the patients of the clinic clinic vignette , either displayed no dangerous behavior, self-endangering behavior, or behavior endangering others. Additionally, between the case vignettes, type of psychiatric symptoms was systematically varied. They either described a case of acute psychotic disorder, a case of alcohol dependency, or a case of borderline personality disorder, not being labeled directly, but with symptoms fulfilling the relevant DSM-V criteria Case vignettes were constructed based on the vignettes that had been used in previous stigma research 19 , However, some modifications were introduced to eliminate potential confounders.
Apart from the characteristics that were systematically varied i. Supporting the validity of the case vignettes, each diagnosis was labeled correctly by all of the clinical experts. Moreover, between the clinic vignettes, type of the psychiatric service institution to which the fictitious character was admitted was systematically varied.
Vignettes either described a general hospital including a psychiatric unit, or a psychiatric hospital, or a psychiatric hospital also including a forensic unit. Thus, we systematically manipulated the characteristics that are per definition specific to the respective types of clinics, as well as gender and dangerousness, whereas all other information e.
Considering the variations described above there were 36 individual vignette conditions, so that each condition was sent to about participants for the concrete wording of exemplary vignette conditions see Sowislo et al. The final sample consisted of 2, individuals Mean age of participants was To assess representativeness of our sample, respondent characteristics were compared to official census data as published in the statistical almanac of Basel-City However, this comparison has to be interpreted with caution, as the data available from the statistical almanac represent the whole population of Basel-City without the restrictions posed by our in- and exclusion criteria.
At the end of , , persons were registered in Basel-City. Mean age was The comparison shows that questionnaires were sent out to over 5. The study sample represents more than 1. However, there seems to be an overrepresentation of women and of persons with higher education in our sample. Measures Perceived Dangerousness Perceived dangerousness was measured with the dangerousness scale 22 , The scale consists of eight items that assess individual beliefs about the dangerousness of the fictitious person in the vignette.
Responses were made on a 4-point scale and a composite with higher values indicating higher perceived dangerousness was derived by totaling the sum of all items. Familiarity with Mental Illness Familiarity with mental illness was measured with four items asking participants whether they themselves had ever undergone psychiatric inpatient or outpatient treatment, and whether anyone within their family or anyone within their circle of friends had ever undergone psychiatric treatment.
Similar to Angermeyer et al. If more than one category applied for one respondent, we chose the one with the highest familiarity. We examined differences in social distance between case and clinic vignettes using an independent t-test. Then, we conducted two separate multiple regression analyses for the case and clinic vignettes respectively, with perceived dangerousness as dependent variable.
Categorical predictors with more than two categories i. In the first regression analysis, type of psychiatric symptoms, gender and dangerousness of the fictitious person in the vignette, and familiarity with psychiatric illness of the respondent were entered as independent variables. In the second regression analysis, type of psychiatric service, gender of the fictitious person in the vignette, dangerousness, and familiarity with psychiatric illness of the respondent were entered as independent variables.
Multiple regression analysis offers a significance test for the difference between the chosen reference category e. However, it does not allow statistically comparing the comparison groups e. To do so, we statistically pitted the available standardized regression weights e. As suggested by Cohen et al. Second, the regression predicting dangerousness of the fictitious person in the case vignettes revealed that familiarity, type of psychiatric symptoms, dangerousness, and gender of the fictitious person were significant predictors see Table 1.
Concerning familiarity, perceived dangerousness was significantly lower when the participant, a family member, or a friend versus none of them had undergone psychiatric treatment.
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Research Colloquium March 2, 2021: Dr Claudia Maria Riehl
Psychology Abstract There has been little research exploring the relationship between personality traits, self-esteem, and stigmatizing attitudes toward those with mental disorders.
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| Alpari forex contest weekly | Psychology Abstract There has been little research exploring the relationship between personality traits, self-esteem, and stigmatizing attitudes toward those with mental disorders. Thus, the current study aims to 1 examine the relationship between Big Five personality traits, self-esteem, and familiarity with stigmatization towards mental illness; and 2 to explore whether perceived dangerousness mediates the relationship between personality traits and stigmatization. There were no significant click here between other Big Five variables and desire for social distance. Publisher's Note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Social distance and perceived dangerousness across four diagnostic categories of mental disorder. |
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