The Effect of Familiarity with Mental Illness on the Discrimination - Mediating Effect of Fear and Helping response -

정신장애인에 대한 친숙함이 차별에 미치는 영향 - 두려움과 도움의향을 매개로 -

  • Received : 2016.08.16
  • Accepted : 2016.09.17
  • Published : 2016.11.30

Abstract

This study analyzed the mediator effect of fear and helping responses on relationship between familiarity and discrimination based on the contact theory. We presented typical vignettes of schizophrenia, depression and alcoholism to 922 adults randomly. All respondents were asked for direct and indirect contact experiences with mental illness, fear and helping responses and discrimination against persons with mental illness. Our findings suggest that contact theory was not supported in every types of mental disorders. In schizophrenia, fear and help were the full mediator between familiarity and discrimination. In depression, only helping response was the mediator between familiarity and discrimination. But in alcoholism, familiarity did not predict discrimination. Based on theses findings, we suggest various anti-stigma strategies depending on the types of mental disorders.

본 연구는 접촉이론에 근거하여 정신장애인과의 다양한 접촉경험을 통한 친숙함이 두려움을 감소시키고, 돕고자 하는 의향을 증가시켜 차별을 의미 있게 감소시킬 수 있다는 가설을 설정하였다. 전국에서 표집된 성인 922명을 대상으로 조현병, 우울증, 알코올중독의 모의 사례 중 1사례를 무작위로 제시하였다. 가설검증을 위해, 제시된 해당사례에 대한 친숙함이 두려움(경로 1)과 도움의향(경로 2)을 매개로 차별에 대한 예측력을 Baron과 Kenny의 분석법을 활용하여 분석하였다. 연구결과 조현병의 경우, 경로 1과 경로 2 모두 지지되어 조현병 사례에 대한 친숙함은 두려움을 감소시키고, 도움의향을 증가시켜 차별을 의미 있게 감소시키는 것으로 나타났다. 우울증의 경우, 경로 2만 지지되어 우울증 사례에 대한 친숙함은 도움의향을 증가시켜 차별을 의미 있게 감소시키는 것으로 나타났다. 그러나 알코올중독의 경우 친숙함이 차별을 의미 있게 예측하지 못해 정서의 매개효과 뿐만 아니라 직접 효과도 없는 것으로 나타났다. 이러한 결과를 바탕으로 연구자들은 정신장애 유형별로 반낙인 전략이 달라져야 함을 주장하였다.

Keywords

References

  1. 김재훈.서미경, 2011, "정신장애 유형에 따른 편견과 차별: 사례를 활용한 대학생 조사 결과", 정신보건과 사회사업, 37(4): 35-64.
  2. 박근우.서미경, 2012a, "정신장애인에 대한 대학생의 편견과 차별: AIDS, 수형자 사례 유형과의 비교", 사회과학연구, 28(4): 383-408.
  3. 박근우.서미경, 2012b, "정신장애인의 사회적 거리감에 대한 수정된 귀인정서모형 적용: 정신장애 유형 별 모형비교", 한국사회복지학, 64(4): 209-231.
  4. 보건복지부, 2015, 국가 정신건강보고서,.
  5. 서미경, 2015, 정신장애인의 인권: 자유와 평등을 향한 긴 여정, 서울: 집문당.
  6. 서미경.김정남.이민규, 2008, 정신질환자에 대한 차별과 편견 실태조사, 2008년 국가인권위원회 인권상황실태조사 연구용역보고서.
  7. 서미경.김정남.이민규, 2010, "정신장애의 원인에 대한 생물학적 이해와 친숙함이 사회적 거리감에 미치는 영향", 한국심리학회지: 건강, 15(1): 123-141.
  8. 서미경.이민규, 2013, "한국인의 정신건강이해력 평가와 취약집단분석", 한국사회복지학, 65(2): 313-334.
  9. 이민화.서미경, 2015, "정신장애인이 진행하는 접촉-교육 프로그램이 반낙인에 미치는 영향", 정신보건과 사회사업, 43(3): 166-191.
  10. Alexander, L., and Link, B., 2003, "The impact of contact on stigmatizing attitudes toward people with mental illness", Journal of Mental Health, 12(3): 271-289. https://doi.org/10.1080/0963823031000118267
  11. Allport, G. W., 1954, The nature of prejudice, Cambridge, MA: Addison-Wesley.
  12. Anagnostopoulos, F., and Hantzi, A., 2011, "Familiarity with and social distance from people with mental illness: Testing the mediating effects of prejudiced attitudes", Journal of Community and Applied Social Psychology, 21(5): 451-460. https://doi.org/10.1002/casp.1082
  13. Angermeyer, M. C., and Matschinger, H., 1996, "The effect of personal experience with mental illness on the attitude towards individuals suffering from mental disorders", Social Psychiatry and Psychiatric Epidemiology, 31(6): 321-326. https://doi.org/10.1007/BF00783420
  14. Angermeyer, M. C., Matschinger, H., and Corrigan, P. W., 2004a, "Familiarity with mental illness and social distance from people with schizophrenia and major depression: testing a model using data from a representative population survey", Schizophrenia Research, 69(2): 175-182. https://doi.org/10.1016/S0920-9964(03)00186-5
  15. Angermeyer, M. C., Buyantugs, L., Kenzine, D. V., and Matschinger, H., 2004b, "Effects of labelling on public attitudes towards people with schizophrenia: are there cultural differences?", Acta Psychiatrica Scandinavica, 109(6): 420-425. https://doi.org/10.1111/j.1600-0047.2004.00310.x
  16. Angermeyer, M. C., and Matschinger, H., 2005, "Have there been any changes in the public's attitudes towards psychiatric treatment? Results from representative population surveys in Germany in the years 1990 and 2001", Acta Psychiatrica Scandinavica, 111(1): 68-73. https://doi.org/10.1111/j.1600-0447.2004.00441.x
  17. Baron, R. M., and Kenny, D. A., 1986, "The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations", Journal of Personality and Social Psychology, 51(6): 1173-1182. https://doi.org/10.1037/0022-3514.51.6.1173
  18. Bizub, A. L., and Davidson, L., 2011, "Stigma-Busting, Compeer, and the Psychology Student: A Pilot Study on the Impact of Contact with a Person Who Has a Mental Illness", The Humanistic Psychologist, 39(4): 312-323. https://doi.org/10.1080/08873267.2011.618039
  19. Clement, S., van Nieuwenhuizen, A., Kassam, A., Flach, C., Lazarus, A., de Castro, M., McCrone, P., Norman, I., and Thornicroft, G., 2012, "Filmed v. live social contact interventions to reduce stigma: randomised controlled trial", The British Journal of Psychiatry, 201(1): 57-64. https://doi.org/10.1192/bjp.bp.111.093120
  20. Corrigan, P. W., Green, A., Lundin, R., Kubiak, M. A., and Penn, D. L., 2001a, "Familiarity with and social distance from people who have serious mental illness", Psychiatric Service, 52(7): 953-958. https://doi.org/10.1176/appi.ps.52.7.953
  21. Corrigan, P. W., Edwards, A. B., Green, A., Diwan, S. L., and Penn, D. L., 2001b, "Prejudice, Social distance, and Familiarity with mental illness", Schizophrenia Bulletin, 27(2): 219-225. https://doi.org/10.1093/oxfordjournals.schbul.a006868
  22. Corrigan, P. W., and Watson, A. C., 2002, "The paradox of self-stigma and mental illness", Clinical Psychology: Science and Practice, 9(1): 35-53. https://doi.org/10.1093/clipsy.9.1.35
  23. Corrigan, P. W., Markowitz, F. E., Watson, A., Rowan, D., and Kubiak, M. A., 2003, "An attribution model of public discrimination towards persons with mental illness", Journal of Health and Social Behavior, 44(2): 162-179. https://doi.org/10.2307/1519806
  24. Corrigan, P. W., and Gelb, B., 2006, "Three programs that use mass approaches to challenge the stigma of mental illness", Psychiatric Services, 57(3): 393-398. https://doi.org/10.1176/appi.ps.57.3.393
  25. Corrigan, P. W., Larson, J., Sells, M., Niessen, N., and Watson, A. C., 2007, "Will filmed presentations of education and contact diminish mental illness stigma?", Community Mental Health Journal, 43(2): 171-181. https://doi.org/10.1007/s10597-006-9061-8
  26. Corrigan, P. W., and O'Shaughnessy, J. R., 2007, "Changing mental illness stigma as it exists in the real world", Australian Psychologist, 42(2): 90-97. https://doi.org/10.1080/00050060701280573
  27. Corrigan, P. W., and Shapiro, J. R., 2010, "Measuring the impact of programs that challenge the public stigma of mental illness", Clinical Psychology Review, 30(8): 907-922. https://doi.org/10.1016/j.cpr.2010.06.004
  28. Couture, S. N., and Penn, D. L., 2003, "Interpersonal contact and the stigma of mental illness: A review of the literature", Journal of Mental Health, 12(3): 291-305. https://doi.org/10.1080/09638231000118276
  29. Couture, S. M., and Penn, D. L., 2006, "The effects of prospective naturalistic contact on the stigma of mental illness", Journal of Community Psychology, 34(5): 635-645. https://doi.org/10.1002/jcop.20119
  30. Crespo, M., Perez-Santos, E., Muñoz, M., and Guillen, A. I., 2008, "Descriptive study of stigma associated with severe and persistent mental illness among the general population of Madrid(Spain)", Community Mental Health Journal, 44(6): 393-403. https://doi.org/10.1007/s10597-008-9142-y
  31. Holmes, E. P., Corrigan, P. W., Williams, P., Canar, J., and Kubiak, M., 1999, "Changing public attitudes about schizophrenia", Schizophrenia Bulletin, 25(3): 447-456. https://doi.org/10.1093/oxfordjournals.schbul.a033392
  32. Jorm, A. F., and Griffiths, K. M., 2008, "The public's stigmatizing attitudes towards people with mental disorders: how important are biomedical conceptualizations?", Acta Psychiatrica Scandinavica, 118(4): 315-321. https://doi.org/10.1111/j.1600-0447.2008.01251.x
  33. Lauber, C., Nordt, C., Falcato, L., and Rossler, W., 2004, "Factors influencing social distance toward people with mental illness", Community Mental Health Journal, 40(3): 265-274. https://doi.org/10.1023/B:COMH.0000026999.87728.2d
  34. Link, B. G., and Cullen, F. T., 1986, "Contact with the mentally ill and perception of how dangerous they are", Journal of Health and Social Behavior, 27(4): 289-303. https://doi.org/10.2307/2136945
  35. Mann, C. E., and Himelein, M. J., 2004, "Factors associated with stigmatization of persons with mental illness", Psychiatric Services, 55(2): 185-187. https://doi.org/10.1176/appi.ps.55.2.185
  36. Marques, A., Barbosa, T., and Queiros, C., 2011, "Stigma in mental health: perceptions of students who will be future health professionals", European Psychiatry, 26(supl.): 1.
  37. Martin, J. K., Pescosolido, B. A., and Tuch, S. A., 2000, "Of fear and loathing : the role of 'disturbing behavior', labels, and causal attributions in shaping public attitudes toward people with mental illness", Journal of Health and Social Behavior, 41(2): 208-223. https://doi.org/10.2307/2676306
  38. Overton, S. L., and Medina, S. L., 2008, "The stigma of mental illness", Journal of Counseling and Development, 86(2): 143-151. https://doi.org/10.1002/j.1556-6678.2008.tb00491.x
  39. Penn, D. L., Guynan, K., Daily, T., Spaulding, W. D., Garbin, C. P., and Sullivan, M., 1994, "Dispelling the stigma of schizophrenia: What sort of information is best?", Schizophrenia Bulletin, 20(3): 567-578. https://doi.org/10.1093/schbul/20.3.567
  40. Pettigrew, T. F., 2008, "Future directions for intergroup contact theory and research", International Journal of Intercultural Relations, 32(3): 187-199. https://doi.org/10.1016/j.ijintrel.2007.12.002
  41. Phelan, J. E., and Basow, S. A., 2007, "College Students' Attitudes Toward Mental Illness: An Examination of the Stigma Process1", Journal of Applied Social Psychology, 37(12): 2877-2902. https://doi.org/10.1111/j.1559-1816.2007.00286.x
  42. Pittman, J. O., Noh, S., and Coleman, D., 2010, "Evaluating the effectiveness of a consumer delivered anti-stigma program: replication with graduate-level helping professionals", Psychiatric Rehabilitation Journal, 33(3): 236-238. https://doi.org/10.2975/33.3.2010.236.238
  43. Rusch, L. C., Kanter, J. W., Angelone, A. F., and Ridley, R. C., 2008, "The impact of In Our Own Voice on stigma", American Journal of Psychiatric Rehabilitation, 11(4): 373-389. https://doi.org/10.1080/15487760802397660
  44. Schnittker, J., 2000, "Gender and reactions to psychological problems: An examination of social tolerance and perceived dangerousness", Journal of Health and Social Behavior, 41(2): 224-240. https://doi.org/10.2307/2676307
  45. Sousa, S. D., Marques, A., Rosario, C., and Queiros, C, 2012, "Stigmatizing attitudes in relatives of people with schizophrenia: a study using the Attribution Questionnaire AQ-27", Trends in psychiatry and psychotherapy, 34(4): 186-197. https://doi.org/10.1590/S2237-60892012000400004
  46. Vezzoli, R., Archiati, L., Buizza, C., Pasqualetti, P., Rossi, G., and Pioli, R., 2001, "Attitude towards psychiatric patients: a pilot study in a northern Italian town", European Psychiatry, 16(8): 451-458. https://doi.org/10.1016/S0924-9338(01)00606-X
  47. WPA, 2014, "Information on the global program", http://www.openthedoors.com/engli sh/01_01.html.