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mental health disorders schizophrenia articles:Risk factor for mental disorders
mental healtharticles:Risk factor for mental .The first hypothesis explored whether those who have had direct experience with demonstrate a better overall understanding of the illness, as it is currently explained by mental health professionals. Direct experience was not found to cause significant improvements in overall understanding. However, having suffered from the illness oneself appears to produce improvements in schizophrenia literacy.
mental health disorders schizophrenia articles:Risk factor for mental disorders.Because the prevalence of mental disorders is so high, the mental health workforce is unable to help everyone who needs it; therefore, it is often family or friends who will first observe the early signs of mental illness. If this group is equipped with the necessary schizophrenia symptom-recognition skills, the illness is more likely to be recognized at an earlier stage, allowing for appropriate help-seeking and a reduction in the likelihood of prolonged suffering for an individual.
The majority of “real symptoms” were correctly identified by all respondents. However, both groups with personal experience demonstrated better recognition for avolition (inability to persist in tasks), as predicted by the first hypothesis. Alogia (severely reduced/ absent speech) was only correctly identified by people with schizophrenia, which was significant compared to those with no experience who revealed uncertainty, as did those with experience. Reduced awareness for these negative symptoms of schizophrenia is perhaps inevitable when considering how infrequently they are referred to in society compared with the positive symptoms (hallucinations, delusions,etc.).
Both groups with experience were found to demonstrate better knowledge compared to those with none, by correctly dismissing the split personality concept. People with schizophrenia demonstrated the most accuracy, however, by also dismissing lack of remorse, and deceitfulness. All groups, on average, were unsure about the descriptions of Obsessive Compulsive Disorder (OCD) and Bipolar Disorder.
This can be explained by taking into account the potential similarity between the OCD description and people's perceptions of catatonic behaviour, and the fact that depression can often co-occur alongside schizophrenia (schizoaffective disorder), despite not being listed as a principal symptom in the DSM-IV.
It is difficult to make direct comparisons between these findings and previous mental health literacy research on symptomrecognition because this study did not use vignette descriptions.
Overall, only people with schizophrenia demonstrated significantly better awareness of the condition. This finding may have occurred because schizophrenic symptoms have been found to overlap with other disorders in real life. A cluster analysis conducted by Everitt revealed clusters corresponding to both the depressive
and manic phases of manic depression and the diagnosis of paranoid schizophrenia. However, over 60% of the hospital patients studied fell into two or three clusters each. These findings suggest that schizophrenia symptoms may not be as exclusive and distinct as the DSMIV suggests, and provide a plausible explanation as to why respondents expressed uncertainty with regards to the trick symptoms of other diagnoses.
All three groups were inclined to disagree with psychological, social and theological causes (e.g. negative/detrimental parenting), and agree with biological factors as possible causes (e.g. chemical imbalances).
However, people with schizophrenia agreed with stressful life events, which was significant compared to those with no experience who were unsure, as were those with direct experience of people with schizophrenia. This may be because people with schizophrenia are more likely to form an emotional and personal association between particular life events and the onset of their illness. Alternatively, they have better awareness of the schizotaxia-schizotypy theory. It is possible that those with direct experience, either as a relative/friend or within a mental health career, demonstrate uncertainty due to their exposure to psychiatric services which emphasise biological causes.
Relatives/friends may also be less inclined to agree because of wanting to avoid any feelings of blame or guilt.
A significant difference was also found between the schizophrenic group and those with no experience in response to God's Will being a cause of the illness. People with schizophrenia disagreed less severely than both other groups, as they may feel victimized and thus more open to alternative rationalization to explain their distress.
about the causes of schizophrenia, as they are currently understood by mental health professionals. Both groups with experience show marginally better awareness, as predicted by the hypothesis, by agreeing with blood relatives pass the illness on. However, they also expressed uncertainty to illegal substances and abnormal genes, both of which have been linked to the aetiology of schizophrenia. Whilst there is ongoing debate regarding the extent to which abnormal genes play a causal role, according to the DSM-IV, schizophreniclike symptoms can be caused by the direct physiological effects of a substance (substance-induced disorder). The fact that all groups appeared uncertain regarding this latter association has direct implications for drug awareness campaigns.
Thus having direct experience does not appear to produce significantly more accurate beliefs about the causes of schizophrenia. Nevertheless, results are in accordance with Angermeyer, who demonstrated that relatives of people with schizophrenia are more likely to cite biological over psychosocial causes. There are, however, negative implications associated with these findings. If friends/family are not aware of, or deny the significance of stressful life events, they are less likely to monitor their own behaviour in regards to the illness, which may have increasingly exacerbating and detrimental effects upon the diagnosed individual.
People with schizophrenia agreed that the illness is “predominantly suffered by less than 1% of the population”; this was significant compared to both other groups, who were more inclined to respond “… suffered by 1–5%”. This suggests that people with schizophrenia consider themselves to be in more of a minority than non-sufferers believe people with schizophrenia to be. According to the National Institute of Mental Health, schizophrenia is experienced by 1.1% of the population, a figure which will vary depending on year and country, and therefore it is difficult to say which group(s) demonstrated the more accurate knowledge.
All groups expressed uncertainty in response to schizophrenia being “predominantly suffered by adults” which may be because the illness often emerges in adolescence, despite the majority of the diagnosis often persisting onwards into, and throughout, adult life.
The second hypothesis explored whether those who have had direct experience with schizophrenia show better awareness of related disorders and are more likely to express attitudes in line with spectrum and schizotypy theories. Results found little evidence to support hypothesis two and in fact people with schizophrenia appeared to express the least endorsement of spectrum/schizotypy concepts.
Overall recognition of schizophrenia-related disorders was very poor across all groups, although those with direct experience demonstrated some recognition of schizoaffective and residual disorders. No significant differences were found between groups, and all three groups correctly dismissed the two invented disorders.
One of the debates surrounding the different diagnostic categories
referred to in this questionnaire is that they do not refer to distinct illnesses,
which may explain why respondents failed to recognise those listed. When discriminant function analysis has been used to investigate schizoaffective disorder, data from patients diagnosed as either schizophrenic or schizoaffective generally suggest that no clear divide exists between the two. This observation raises the question as to why mental health professionals persist at categorising patients with one specific diagnosis over another, and has been the impetus for the theory that a schizophreniacontinuum of disorders exists.
It has also been theorized that there is a continuum between schizophrenia and normal functioning, with psychotic symptoms (for example, delusions) being described as exaggerations of normal mental functions. On average, all groups revealed mixed attitudes regarding the spectrum/schizotypy theories, tending to respond in accordance or with uncertainty. Significant differences
were found for “schizophrenia is different from and not related to the
personality disorders” and “many people in the world can exhibit bizarre
behaviour but will never develop schizophrenia”, which people with
schizophrenia were more inclined to agree with, suggesting this group place emphasis on the uniqueness of their individual experiences and distinguish themselves from the rest of society including people with other diagnoses. People with schizophrenia may be more inclined to dissociate the illness from descriptions of "bizarre behaviour", being aware of how many other more complex and debilitating factors the diagnosis can entail. Alternatively, they are revealing limited awareness of recent evidence that has been found to support schizotypy and continuum theory.
The third hypothesis explored whether those who have had direct experience with schizophrenia are less likely to agree with stereotypical attitudes concerning the nature of the illness. However, there was no substantial evidence to support this hypothesis.
It is of particular relevance to ascertain whether those who are in direct contact with schizophrenic patients possess attitudes which may be detrimental to them. For example, self-stigmatisation is where patients internalise the negative beliefs held by society and apply these to themselves. According to an Australian survey, “less stigma” was the number one factor both mental
health patients and their families thought would improve the patients’ lives. Stereotypical or discriminatory attitudes will not only increase the anguish experienced by someone who is already in distress, but may have direct influences on a person's behaviour. Barney found that adults who believed society would react negatively to them if they were to seek professional
help for a mental illness were less likely to do so.
On average, none of the groupswere found to endorse any of the stereotypical attitudes, but demonstrated uncertainty for “most people diagnosed with schizophrenia are likely to be unable to work”, “….lose control at any time” and “…..never fully recover”. In addition, people with schizophrenia were found to agree to “…be unable to lead normal lives”, whereas both other groups were unsure. This goes against our prediction that those with experience will be less likely to agree to such statements. It is possible that research which provides evidence in opposition to these stereotypical beliefs is representative of exceptional cases in which patients have been fortunate enough to receive adequate treatment and support, contributing to their recovery/rehabilitation. If so, our groupsmay not have been so fortunate in their experiences.
The only significant difference within the stereotypical attitudes section was for “…commit criminal and violent acts”, which people with schizophrenia were unsurprisingly more strongly opposed to compared to both other groups. It is encouraging that all experimental groups disagreed, implying that the stereotype of a violent schizophrenic may not be as widespread as originally expected.
The fourth hypothesis explored whether those who have had direct
experience with people with schizophrenia will accept greater contact
with a schizophrenic. The results were found to support this hypothesis. Significant differences were found for the majority of social contact items. On average both groups with experience were found to be more comfortable about various social interactions with a schizophrenic.
For the statements that were not significant, mean responses show that all groups, on average, were comfortable with “knowing a close friend had been diagnosed with schizophrenia” and “marrying into a family with schizophrenic member”.
These are encouraging findings which replicate research, and Angermeyer and Matschinger, who found that people familiar with a mental illness are associated with reduced anxiety towards people suffering from mental illnesses, and less distancing attitudes.
One clinical implication of this research is for lay people to meet, or hear the story of those diagnosed and living with schizophrenia. This may be done through video/youtube so as to make their story more immediate and real and hopefully dispense with some of the more common myths surrounding this complicated disorder.
With all questionnaire-based studies, and specifically those of a sensitive nature, there is always potential for social desirability biases. First, this was a small, somewhat unrepresentative sample with very few schizophrenics. Ninety respondents reported having studied psychology, psychiatry, medicine or psychoanalysis at degree level. This group may therefore have inflated the overall mental health literacy demonstrated throughout the questionnaire, although the depth of their knowledge regarding schizophrenia and/or other mental illnesses was not established. An ideal study might have used three or four groups, with 50–100 individuals in each, testing people with and without schizophrenia, relatives of those with schizophrenia as well as psychiatrists/clinical psychologists.
In addition, the design of the questionnaire did not allow us to fully explore the intensity/duration of the contact those with direct experience were referring to, or what form the experience took.
Some of our participants had had some training in mental health (psychology, psychiatry) and further studies would do well to examine the difference in attitudes and beliefs between those who had had academic instruction or not in this area.
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