Managing the terror of a dangerous world: Political attitudes as predictors of mental health stigma

Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact of this approach with a 10-year comparison of public endorsement of treatment and prejudice. The authors analyzed responses to vignettes in the mental health modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigma. In 2006, 67% of the public attributed major depression to neurobiological causes, compared with 54% in 1996. High proportions of respondents endorsed treatment, with general increases in the proportion endorsing treatment from doctors and specific increases in the proportions endorsing psychiatrists for treatment of alcohol dependence (from 61% in 1996 to 79% in 2006) and major depression (from 75% in 1996 to 85% in 2006). Social distance and perceived danger associated with people with these disorders did not decrease significantly. Holding a neurobiological conception of these disorders increased the likelihood of support for treatment but was generally unrelated to stigma. Where associated, the effect was to increase, not decrease, community rejection. More of the public embraces a neurobiological understanding of mental illness. This view translates into support for services but not into a decrease in stigma. Reconfiguring stigma reduction strategies may require providers and advocates to shift to an emphasis on competence and inclusion. Show more

Three studies are conducted to assess the uncertainty- threat model of political conservatism, which posits that psychological needs to manage uncertainty and threat are associated with political orientation. Results from structural equation models provide consistent support for the hypothesis that uncertainty avoidance (e.g., need for order, intolerance of ambiguity, and lack of openness to experience) and threat management (e.g., death anxiety, system threat, and perceptions of a dangerous world) each contributes independently to conservatism (vs. liberalism). No support is obtained for alternative models, which predict that uncertainty and threat management are associated with ideological extremism or extreme forms of conservatism only. Study 3 also reveals that resistance to change fully mediates the association between uncertainty avoidance and conservatism, whereas opposition to equality partially mediates the association between threat and conservatism. Implications for understanding the epistemic and existential bases of political orientation are discussed. Show more