AccScience Publishing / GHES / Online First / DOI: 10.36922/ghes.3363
Submit to GHES
Cite this article
10
Download
285
Views
Journal Browser
Volume | Year
Issue
Search
Forthcoming Issue
Current Issue
View All
News and Announcements
View All
ORIGINAL RESEARCH ARTICLE

Effectiveness of a digital single-session cognitive behavioral psychoeducational intervention in reducing public stigma associated with psychosis: A randomized controlled trial

Pawel D. Mankiewicz1* ,  Jaye J.Y. Wong2
Show Less
1 Clinical Psychology Programme and Clinical and Health Psychology Centre, Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
2 Department of Psychology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
GHES, 3363 https://doi.org/10.36922/ghes.3363
Submitted: 4 April 2024 | Accepted: 12 August 2024 | Published: 7 October 2024
© 2024 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Download PDF
Cite
XML
Abstract

Psychosis is a severe mental health condition that is highly stigmatized, significantly increasing the costs of mental healthcare and reducing the productivity of those affected. Due to public stigma, individuals with psychosis often delay seeking professional help, exacerbating the socioeconomic burden of their ill-health. Psychoeducation, delivered in a structured and systematic manner, has been a key part of evidence-based psychological treatments and has been gradually adopted in stigma reduction efforts. This study evaluated the effectiveness of a digital single-session cognitive behavioral psychoeducation intervention in reducing public stigma toward people with psychosis in a collectivist society through a randomized controlled trial. Stigma was assessed using standardized self-report tools at pre-intervention, post-intervention, and 1-month follow-up. A significant reduction was observed in stereotyping, prejudice, and discrimination on seven out of 10 public stigma components post-intervention. However, the desired effects were maintained for only two components at the 1-month follow-up. No significant changes were found in negative emotions, tolerance, and support from pre-intervention to post-intervention. Attribution of responsibility significantly increased after the intervention, contrary to predictions. The findings of this study provide empirical support for the short-term effectiveness of a brief cognitive behavioral psychoeducation intervention in reducing public stigma toward individuals with psychosis while highlighting the potential benefits of delivering this intervention digitally. At the same time, the limitations of individual-level interventions in sustaining long-term effects are discussed from a sociocultural perspective. This study also examined the relevance of these findings in the context of health economics.

Keywords
Mental ill-health
Psychosis
Public stigma
Psychoeducation
Economic burden
Cognitive behavioral therapy
Randomized controlled trial
Funding
None.
Conflict of interest
The authors declare that they have no competing interests.
References
  1. Abdullah, T., & Brown, T.L. (2011). Mental illness stigma and ethnocultural beliefs, values, and norms: An integrative review. Clinical Psychology Review, 31(6):934-948. https://doi.org/10.1016/j.cpr.2011.05.003

 

  1. Alonso, M., Guillén, A.I., & Muñoz, M. (2019). Interventions to reduce internalized stigma in individuals with mental illness: A systematic review. The Spanish Journal of Psychology, 22:e27. https://doi.org/10.1017/sjp.2019.9

 

  1. Ang, M.S., Rekhi, G., & Lee, J. (2020). Vocational profile and correlates of employment in people with schizophrenia: The role of avolition. Frontiers in Psychiatry, 11:856. https://doi.org/10.3389/fpsyt.2020.00856

 

  1. Angermeyer, M.C., & Dietrich, S. (2006). Public beliefs about and attitudes towards people with mental illness: A review of population studies. Acta Psychiatrica Scandinavica, 113(3):163-179. https://doi.org/10.1111/j.1600-0447.2005.00699.x

 

  1. Angermeyer, M.C., & Matschinger, H. (2004). The stereotype of schizophrenia and its impact on discrimination against people with schizophrenia: Results from a representative survey in Germany. Schizophrenia Bulletin, 30(4): 1049-1061. https://doi.org/10.1093/oxfordjournals.schbul.a007120

 

  1. Arciniegas, D.B. (2015). Psychosis. Continuum (Minneap Minn), 21(3):715-736. https://doi.org/10.1212/01.con.0000466662.89908.e7

 

  1. Benbow, A. (2007). Mental illness, stigma, and the media. The Journal of Clinical Psychiatry, 68 Suppl 2:31-35.

 

  1. Blair Irvine, A., Billow, M.B., Eberhage, M.G., Seeley, J.R., McMahon, E., & Bourgeois, M. (2012). Mental illness training for licensed staff in long-term care. Issues in Mental Health Nursing, 33(3):181-194. https://doi.org/10.3109/01612840.2011.639482

 

  1. Bodenhausen, G.V., & Richeson, J.A. (2010). Prejudice, stereotyping, and discrimination. In: Baumeister, R.F., & Finkel, E.J. (eds). Advanced Social Psychology: The State of the Science. Oxford: Oxford University Press, p.341-383.

 

  1. Brohan, E., Slade, M., Clement, S., & Thornicroft, G. (2010). Experiences of mental illness stigma, prejudice and discrimination: A review of measures. BMC Health Services Research, 10(1):80. https://doi.org/10.1186/1472-6963-10-80

 

  1. Brown, S.A. (2008). Factors and measurement of mental illness stigma: A psychometric examination of the attribution questionnaire. Psychiatric Rehabilitation Journal, 32(2):89-94. https://doi.org/10.2975/32.2.2008.89.94

 

  1. Chang, W.C., Wong, W.K., & Koh, J.B.K. (2003). Chinese values in Singapore: Traditional and modern. Asian Journal of Social Psychology, 6(1):5-29. https://doi.org/10.1111/1467-839x.t01-1-00007

 

  1. Cheon, B.K., & Chiao, J.Y. (2012). Cultural variation in implicit mental illness stigma. Journal of Cross-Cultural Psychology, 43(7):1058-1062. https://doi.org/10.1177/0022022112455457

 

  1. Chong, H.Y., Teoh, S.L., Wu, D.B.C., Kotirum, S., Chiou, C.F., & Chaiyakunapruk, N. (2016). Global economic burden of schizophrenia: A systematic review. Neuropsychiatric Disease and Treatment, 12:357-373. https://doi.org/10.2147/NDT.S96649

 

  1. Chua, Y.C., Abdin, E., Tang, C., Subramaniam, M., & Verma, S. (2019). First-episode psychosis and vocational outcomes: A predictive model. Schizophrenia Research, 211:63-68. https://doi.org/10.1016/j.schres.2019.07.009

 

  1. Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans- Lacko, S., Bezborodovs, N., et al. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1):11-27. https://doi.org/10.1017/s0033291714000129

 

  1. Cohen, J. (1988). Statistical Power Analysis for the Behavioural Sciences. 2nd Oxfordshire: Routledge. https://doi.org/10.4324/9780203771587

 

  1. Corrigan, P.W. (2006). Mental health stigma as social attribution: Implications for research methods and attitude change. Clinical Psychology: Science and Practice, 7(1):48-67. https://doi.org/10.1093/clipsy.7.1.48

 

  1. Corrigan, P.W., & Bink, A.B. (2016). The stigma of mental illness. In: Encyclopedia of Mental Health. Netherlands: Elsevier Inc., p.230-234. https://doi.org/10.1016/b978-0-12-397045-9.00170-1

 

  1. Corrigan, P.W., & Kleinlein, P. (2005). The impact of mental illness stigma. In: Corrigan, P.W. (eds). On the Stigma of Mental illness: Practical Strategies for Research and Social Change. American Psychological Association, p.11-44. https://doi.org/10.1037/10887-001

 

  1. Corrigan, P.W., & 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

 

  1. Corrigan, P.W., & Watson, A.C. (2002a). Understanding the impact of stigma on people with mental illness. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 1(1):16-20.

 

  1. Corrigan, P.W., & Watson, A.C. (2002b). 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

 

  1. Corrigan, P.W., Bink, A.B., Fokuo, J.K., & Schmidt, A. (2015). The public stigma of mental illness means a difference between you and me. Psychiatry Research, 226(1):186-191. https://doi.org/10.1016/j.psychres.2014.12.047

 

  1. Corrigan, P.W., Green, A., Lundin, R., Kubiak, M.A., & Penn, D.L. (2001). Familiarity with and social distance from people who have serious mental illness. Psychiatric Services, 52(7):953-958. https://doi.org/10.1176/appi.ps.52.7.953

 

  1. Corrigan, P.W., Markowitz, F.E., & Watson, A.C. (2004). Structural levels of mental illness stigma and discrimination. Schizophrenia Bulletin, 30(3):481-491. https://doi.org/10.1093/oxfordjournals.schbul.a007096

 

  1. Corrigan, P.W., Markowitz, F.E., Watson, A., Rowan, D., & 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

 

  1. Corrigan, P.W., Morris, S.B., Michaels, P.J., Rafacz, J.D., & Rüsch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services, 63(10):963-973. https://doi.org/10.1176/appi.ps.201100529

 

  1. Corrigan, P.W., River, L.P., Lundin, R.K., Uphoff Wasowski, K., Campion, J., Mathisen, J., et al. (2000). Stigmatizing attributions about mental illness. Journal of Community Psychology, 28(1):91-102. https://doi.org/10.1002/(SICI)1520-6629(200001)28:1<91:AID-JCOP9>3.0.CO;2-M

 

  1. Corrigan, P.W., Rowan, D., Green, A., Lundin, R., River, P., Uphoff-Wasowski, K., et al. (2002). Challenging two mental illness stigmas: Personal responsibility and dangerousness. Schizophrenia Bulletin, 28(2):293-309. https://doi.org/10.1093/oxfordjournals.schbul.a006939

 

  1. Corrigan, P.W., Watson, A.C., Heyrman, M.L., Warpinski, A., Gracia, G., Slopen, N., et al. (2005). Structural stigma in state legislation. Psychiatric Services, 56(5):557-563. https://doi.org/10.1176/appi.ps.56.5.557

 

  1. Cox, W.T.L., Abramson, L.Y., Devine, P.G., & Hollon, S.D. (2012). Stereotypes, prejudice, and depression. The integrated perspective. Perspectives on Psychological Science, 7(5):427-449. https://doi.org/10.1177/1745691612455204

 

  1. Crisp, A.H., Gelder, M.G., Rix, S., Meltzer, H.I., & Rowlands, O.J. (2000). Stigmatisation of people with mental illnesses. British Journal of Psychiatry, 177(1):4-7. https://doi.org/10.1192/bjp.177.1.4

 

  1. Dalky, H.F. (2011). Mental illness stigma reduction interventions. Review of intervention trials. Western Journal of Nursing Research, 34(4):520-547. https://doi.org/10.1177/0193945911400638

 

  1. Devine, P.G. (1989). Stereotypes and prejudice: Their automatic and controlled components. Journal of Personality and Social Psychology, 56(1):5-18. https://doi.org/10.1037/0022-3514.56.1.5

 

  1. Dovidio, J., Hewstone, M., Glick, P., & Esses, V. (2010). Prejudice, Stereotyping and Discrimination: Theoretical and Empirical Overview. United States: Sage Publications Ltd., p.3-28.

 

  1. Economou, M.P. (2015). Psychoeducation: A multifaceted intervention. International Journal of Mental Health, 44(4):259-262. https://doi.org/10.1080/00207411.2015.1076288

 

  1. Evensen, S., Wisløff, T., Lystad, J.U., Bull, H., Ueland, T., & Falkum E. (2016). Prevalence, employment rate, and cost of schizophrenia in a high-income welfare society: A population-based study using comprehensive health and welfare registers. Schizophrenia Bulletin, 42(2):476-483. https://doi.org/10.1093/schbul/sbv141

 

  1. Girón, M., Nova-Fernández, F., Mañá-Alvarenga, S., Nolasco, A., Molina-Habas, A., Fernández-Yañez, A., et al. (2014). How does family intervention improve the outcome of people with schizophrenia? Social Psychiatry and Psychiatric Epidemiology, 50(3):379-387. https://doi.org/10.1007/s00127-014-0942-9

 

  1. Grusec, J.E., Davidov, M., & Lundell, L. (2002). Prosocial and helping behavior. In: Smith, P.K., & Hart, C.H. (eds.). Blackwell Handbook of Childhood Social Development. United States: Blackwell Publishing, p.457-474.

 

  1. Hajjar, S.T. (2018). Statistical analysis: Internal-consistency reliability and construct validity. International Journal of Quantitative and Qualitative Research Methods, 6(1):27-38.

 

  1. Hatzenbuehler, M.L., & Link, B.G. (2014). Introduction to the special issue on structural stigma and health. Social Science and Medicine, 103:1-6. https://doi.org/10.1016/j.socscimed.2013.12.017

 

  1. Heider, F. (1958). The Psychology of Interpersonal Relations. United States: John Wiley and Sons Inc. https://doi.org/10.1037/10628-000

 

  1. Henderson, C., Evans-Lacko, S., & Thornicroft, G. (2013). Mental illness stigma, help seeking, and public health programs. American Journal of Public Health, 103(5):777-780. https://doi.org/10.2105/AJPH.2012.301056

 

  1. Hinshaw, S.P., & Stier, A. (2008). Stigma as related to mental disorders. Annual Review of Clinical Psychology, 4(4):367-393. https://doi.org/10.1146/annurev.clinpsy.4.022007.141245

 

  1. Idris, F.M., Seraj, M., & Ozdeser, H. (2024). Impact of health expenditure on poverty in low- and middle-income countries: An autoregressive distributed lag bounds approach. Global Health Economics and Sustainability, 2(1):2383. https://doi.org/10.36922/ghes.2383

 

  1. Johnson-Kwochka, A., Aalsma, M.C., Monahan, P.O., & Salyers, M.P. (2021a). Development and examination of the attribution questionnaire-substance use disorder (AQ-SUD) to measure public stigma towards adolescents experiencing substance use disorders. Drug and Alcohol Dependence, 221:108600. https://doi.org/10.1016/j.drugalcdep.2021.108600

 

  1. Johnson-Kwochka, A., Minor, K.S., Ashburn-Nardo, L., Wu, W., Stull, L.G., & Salyers, M.P. (2021b). A new look at the attribution model: Considerations for the measurement of public mental illness stigma. Stigma and Health, 9(1):1-8. https://doi.org/10.1037/sah0000288

 

  1. Johnstone, M.J. (2001). Stigma, social justice and the rights of the mentally ill: Challenging the status quo. Australian and New Zealand Journal of Mental Health Nursing, 10(4):200-209. https://doi.org/10.1046/j.1440-0979.2001.00212.x

 

  1. Jorm, A.F., & 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

 

  1. Kadakia, A., Catillon, M., Fan, Q., Williams, R., Marden, J., Anderson, A., et al. (2022). The economic burden of schizophrenia in the United States. Journal of Clinical Psychiatry, 83(6):22m14458. https://doi.org/10.4088/JCP.22m14458

 

  1. Kapadia, D. (2023). Stigma, mental illness and ethnicity: Time to centre racism and structural stigma. Sociology of Health and Illness, 45(4):855-871. https://doi.org/10.1111/1467-9566.13615

 

  1. Kellett, S., Clarke, S., & Matthews, L. (2007). Delivering group psychoeducational CBT in primary care: Comparing outcomes with individual CBT and individual psychodynamic-interpersonal psychotherapy. British Journal of Clinical Psychology, 46(2):211-222. https://doi.org/10.1348/014466506x146188

 

  1. Kimmerle, J., & Cress, U. (2013). The effects of TV and film exposure on knowledge about and attitudes toward mental disorders. Journal of Community Psychology, 41(8):931-943. https://doi.org/10.1002/jcop.21581

 

  1. Knaak, S., Mantler, E., & Szeto, A. (2017). Mental illness-related stigma in healthcare: Barriers to access and care and evidence-based solutions. Healthcare Management Forum, 30(2):111-116. https://doi.org/10.1177/0840470416679413

 

  1. Knaak, S., Modgill, G., & Patten, S.B. (2014). Key ingredients of anti-stigma programs for health care providers: A data synthesis of evaluative studies. Canadian Journal of Psychiatry, 59(10 Suppl 1):S19-S26. https://doi.org/10.1177/070674371405901s06

 

  1. Kotzeva, A., Mittal, D., Desai, S., Judge, D., & Samanta, K. (2023). Socioeconomic burden of schizophrenia: A targeted literature review of types of costs and associated drivers across 10 countries. Journal of Medical Economics, 26(1):70-83. https://doi.org/10.1080/13696998.2022.2157596

 

  1. Kutcher, S., Wei, Y., & Coniglio, C. (2016). Mental health literacy: Past, present, and future. The Canadian Journal of Psychiatry, 61(3):154-158. https://doi.org/10.1177/0706743715616609

 

  1. Lai, Y., Hong, P., Chee, Y., & Yew, L. (2000). Stigma of mental illness. Singapore Medical Journal, 42(3):111-114.

 

  1. Lampridis, E., & Papastylianou, D. (2014). Prosocial behavioural tendencies and orientation towards individualism-collectivism of Greek young adults. International Journal of Adolescence and Youth, 22(3):268-282. https://doi.org/10.1080/02673843.2014.890114

 

  1. Lee, S., Chiu, M.Y.L., Tsang, A., Chui, H., & Kleinman, A. (2006). Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong. Social Science and Medicine, 62(7):1685-1696. https://doi.org/10.1016/j.socscimed.2005.08.016

 

  1. Leviton, L.C. (2017). Generalizing about public health interventions: A mixed-methods approach to external validity. Annual Review of Public Health, 38:371-391. https://doi.org/10.1146/annurev-publhealth-031816-044509

 

  1. Li, J., Li, J., Thornicroft, G., Yang, H., Chen, W., & Huang, Y. (2015). Training community mental health staff in Guangzhou, China: Evaluation of the effect of a new training model. BMC Psychiatry, 15(1):263. https://doi.org/10.1186/s12888-015-0660-1

 

  1. Lincoln, T.M., Arens, E., Berger, C., & Rief, W. (2008). Can antistigma campaigns be improved? A test of the impact of biogenetic vs psychosocial causal explanations on implicit and explicit attitudes to schizophrenia. Schizophrenia Bulletin, 34(5):984-994. https://doi.org/10.1093/schbul/sbm131

 

  1. Livingston, J.D. (2013). Mental Illness-Related Structural Stigma: The Downward Spiral of Systemic Exclusion Final Report. Ontario: Mental Health Commission of Canada. Available from: https://mentalhealthcommission.ca/resource/mental-illness-related-structural-stigma-the-downward-spiral-of-systemic-exclusion-final-report [Last accessed on 2024 Apr 04].

 

  1. Lowenstein, J.A., Butler, D.W., & Ashcroft, K. (2010). The efficacy of a cognitively orientated carers group in an early intervention in psychosis service--a pilot study. Journal of Psychiatric and Mental Health Nursing, 17(7):628-635. https://doi.org/10.1111/j.1365-2850.2010.01564.x

 

  1. Lucksted, A., & Drapalski, A.L. (2015). Self-stigma regarding mental illness: Definition, impact, and relationship to societal stigma. Psychiatric Rehabilitation Journal, 38(2):99-102. https://doi.org/10.1037/prj0000152

 

  1. Lucksted, A., McFarlane, W., Downing, D., & Dixon, L. (2012). Recent developments in family psychoeducation as an evidence-based practice. Journal of Marital and Family Therapy, 38(1):101-121. https://doi.org/10.1111/j.1752-0606.2011.00256.x

 

  1. Madianos, M., Economou, M., Peppou, L.E., Kallergis, G., Rogakou, E., & Alevizopoulos, G. (2012). Measuring public attitudes to severe mental illness in Greece: Development of a new scale. The European Journal of Psychiatry, 26(1):55-67. https://doi.org/10.4321/s0213-61632012000100006

 

  1. Mander, H., & Kingdon, D. (2015). The evolution of cognitive-behavioural therapy for psychosis. Psychology Research and Behaviour Management, 8:63-69.

 

  1. Mankiewicz, P.D. (2013). Cognitive behavioural symptom-oriented understanding of psychosis: Abandoning the disease paradigm of schizophrenia. Counselling Psychology Review, 28(1):53-63. https://doi.org/10.53841/bpscpr.2013.28.1.53

 

  1. Mankiewicz, P.D. (2015). Toward positive psychosocial practice in psychosis: In pursuit of subjective wellbeing in severe mental ill-health. International Journal of Wellbeing, 5(4):120-134. https://doi.org/10.5502/ijw.v5i4.346

 

  1. Mankiewicz, P.D. (2019). Cognitive restructuring and graded behavioural exposure for persecutory paranoia and agoraphobic anxiety in complex psychosis. Clinical Case Studies, 18(2):143-158. https://doi.org/10.1177/1534650119826713

 

  1. Mankiewicz, P.D., & Kam, W.S. (2024). The perception of psychosis among young adults in Southeast Asia: A Singaporean perspective. Journal of Asia Pacific Counseling, 14(1):1-26. https://doi.org/10.18401/2024.14.1.1

 

  1. Mankiewicz, P.D., & Tan, A.S.Y. (2024). Reducing discrimination against service users with psychosis through brief contact-based video interventions: A randomised control trial. British Journal of Healthcare Management, 30(1):14-24. https://doi.org/10.12968/bjhc.2023.0074

 

  1. Mankiewicz, P.D., & Turner, C. (2012). Do assertive outreach clients with experiences of psychosis receive the NICE recommended cognitive behavioural interventions? An audit. Clinical Psychology Forum, 240:32-37. https://doi.org/10.53841/bpscpf.2012.1.240.32

 

  1. Mankiewicz, P.D., & Turner, C. (2014). Cognitive restructuring and graded behavioural exposure for delusional appraisals of auditory hallucinations and comorbid anxiety in paranoid schizophrenia. Case Reports in Psychiatry, 14:124564. https://doi.org/10.1155/2014/124564

 

  1. Mankiewicz, P.D., Reid, J., Hughes, E.A., & Attard, A. (2021). Management of demographic equality of access to family intervention for psychosis in specialist community mental healthcare teams. British Journal of Healthcare Management, 27(8):1-11. https://doi.org/10.12968/bjhc.2020.0136

 

  1. Markus, H.R., & Kitayama, S. (1991). Culture and the self: Implications for cognition, emotion, and motivation. Psychological Review, 98(2):224-253. https://doi.org/10.1037/0033-295X.98.2.224

 

  1. Martí-Vilar, M., Serrano-Pastor, L., & Sala, F.G. (2019). Emotional, cultural and cognitive variables of prosocial behaviour. Current Psychology, 38(4):912-919. https://doi.org/10.1007/s12144-019-0168-9

 

  1. Mojtabai, R., Stuart, E.A., Hwang, I., Eaton, W.W., Sampson, N., & Kessler, R.C. (2015). Long-term effects of mental disorders on educational attainment in the national comorbidity survey ten-year follow-up. Social Psychiatry and Psychiatric Epidemiology, 50(10):1577-1591. https://doi.org/10.1007/s00127-015-1083-5

 

  1. Morgan, A.J., Reavley, N.J., Ross, A., Too, L.S., & Jorm, A.F. (2018). Interventions to reduce stigma towards people with severe mental illness: Systematic review and meta-analysis. Journal of Psychiatric Research, 103(1):120-133. https://doi.org/10.1016/j.jpsychires.2018.05.017

 

  1. Muñoz, M., Guillén, A.I., Pérez-Santos, E., & Corrigan, P.W. (2015). A structural equation modeling study of the Spanish mental illness stigma attribution questionnaire (AQ-27-E). American Journal of Orthopsychiatry, 85(3):243-249. https://doi.org/10.1037/ort0000059

 

  1. Na, J.J., Park, J.L., LKhagva, T., & Mikami, A.Y. (2022). The efficacy of interventions on cognitive, behavioral, and affective public stigma around mental illness: A systematic meta-analytic review. Stigma and Health, 7(2):127-141. https://doi.org/10.1037/sah0000372

 

  1. O’Hanlon, B., Hayes, L., Perlesz, A., & Harvey, C. (2018). Understanding the complex family experiences of Behavioural Family Therapy. Journal of Family Therapy, 40(1):45-62. https://doi.org/10.1111/1467-6427.12139

 

  1. Ong, W.J., Shahwan, S., Goh, C.M.J., Tan, G.T.H., Chong, S.A., & Subramaniam, M. (2020). Daily encounters of mental illness stigma and individual strategies to reduce stigma-perspectives of people with mental illness. Frontiers in Psychology, 11:590844. https://doi.org/10.3389/fpsyg.2020.590844

 

  1. Onwumere, J., Jansen, J.E., & Kuipers, E. (2018). Editorial: Family interventions in psychosis change outcomes in early intervention settings-how much does the evidence support this? Frontiers in Psychology, 9:406. https://doi.org/10.3389/fpsyg.2018.00406

 

  1. Pang, S., Liu, J., Mahesh, M., Chua, B.Y., Shahwan, S., Lee, S.P., et al. (2017). Stigma among Singaporean youth: A cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population. British Medical Journal Open, 7(10):1-11. https://doi.org/10.1136/bmjopen-2017-016432

 

  1. Pingani, L., Forghieri, M., Ferrari, S., Ben-Zeev, D., Artoni, P., Mazzi, F., et al. (2011). Stigma and discrimination toward mental illness: Translation and validation of the Italian version of the attribution questionnaire-27 (AQ-27-I). Social Psychiatry and Psychiatric Epidemiology, 47(6):993-999. https://doi.org/10.1007/s00127-011-0407-3

 

  1. Pinto, M.D., Hickman, R., Logsdon, M.C., & Burant, C. (2012). Psychometric evaluation of the revised attribution questionnaire (r-AQ) to measure mental illness stigma in adolescents. Journal of Nursing Measurement, 20(1):47-58. https://doi.org/10.1891%2F1061-3749.20.1.47

 

  1. Ramaprasad, A., Martinez, V., Nunez, A., & Sreeganga, S.D. (2023). Pathways to Universal Digital Access to Inclusive Healthcare in the G20. Available from: https:// t20ind.org/wp-content/uploads/2023/05/t20_policybrief_tf6_6154.pdf [Last accessed on 2024 Apr 04].

 

  1. Ran, M.S., Chan, C.L.W., Ng, S.M., Guo, L.T., & Xiang, M.Z. (2015). The effectiveness of psychoeducational family intervention for patients with schizophrenia in a 14-year follow-up study in a Chinese rural area. Psychological Medicine, 45(10):2197-2204. https://doi.org/10.1017/S0033291715000197

 

  1. Rao, D., Elshafei, A., Nguyen, M., Hatzenbuehler, M.L., Frey, S., & Go, V.F. (2019). A systematic review of multi-level stigma interventions: State of the science and future directions. BMC Medicine, 17(1):41. https://doi.org/10.1186/s12916-018-1244-y

 

  1. Read, J., Haslam, N., & Magliano, L. (2013). Prejudice, stigma and ‘schizophrenia’: The role of bio-genetic ideology. In: Read, J., & Dillon, J. (eds.). Models of Madness: Psychological, Social and Biological Approaches to Psychosis. Oxfordshire: Routledge, p.157-177.

 

  1. Rüsch, N., Angermeyer, M.C., & Corrigan, P.W. (2005). Mental illness stigma: Concepts, consequences, and initiatives to reduce stigma. European Psychiatry, 20(8):529-539. https://doi.org/10.1016/j.eurpsy.2005.04.004

 

  1. Schomerus, G., Stolzenburg, S., Freitag, S., Speerforck, S., Janowitz, D., Evans-Lacko, S., et al. (2019). Stigma as a barrier to recognizing personal mental illness and seeking help: A prospective study among untreated persons with mental illness. European Archives of Psychiatry and Clinical Neuroscience, 269(4):469-479. https://doi.org/10.1007/s00406-018-0896-0

 

  1. Schrack, A., Romaker, E., Joyce-Beaulieu, D., & Zaboski, B.A. (2021). Psychoeducation, relaxation training, and mindfulness. In: Joyce-Beaulieu, D., & Zaboski, B.A. (eds.). Applied Cognitive Behavioral Therapy in Schools. Oxford: Oxford University Press, p.83-100. https://doi.org/10.1093/med-psych/9780197581384.001.0001

 

  1. Shamblaw, A.L., Botha, F.B., & Dozois, D.J.A. (2015). Accounting for differences in depression stigma between Canadian Asians and Europeans. Journal of Cross-Cultural Psychology, 46(4):597-611. https://doi.org/10.1177/0022022115575076

 

  1. Sheehan, L., Nieweglowski, K., & Corrigan, P.W. (2016). Structures and types of stigma. In: Gaebel, W., Rössler, W., & Sartorius, N. (eds.). The Stigma of Mental Illness: End of the Story? Cham: Springer, p.43-66. https://doi.org/10.1007/978-3-319-27839-1_3

 

  1. Sijbrandij, M., Kunovski, I., & Cuijpers, P. (2016). Effectiveness of internet-delivered cognitive behavioral therapy for posttraumatic stress disorder: A systematic review and meta-analysis. Depression and Anxiety, 33(9):783-791. https://doi.org/10.1002/da.22533

 

  1. Singapore Department of Statistics. (2021). Census of Population 2020 Statistical Release 1: Demographic Characteristics, Education, Language and Religion. Singapore Department of Statistics. Available from: https://www.parliament.gov.sg/ docs/default-source/default-document-library/cop2020sr1. pdf [Last accessed on 2024 Apr 04].

 

  1. Sousa, S.D., Marques, A., Rosário, C., & Queirós, 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

 

  1. Stuart, H. (2006). Mental illness and employment discrimination. Current Opinion in Psychiatry, 19(5):522-526. https://doi.org/10.1097/01.yco.0000238482.27270.5d

 

  1. Stuart, H., & Arboleda-Flórez, J. (2012). A public health perspective on the stigmatization of mental illnesses. Public Health Reviews, 34(2):12. https://doi.org/10.1007/bf03391680

 

  1. Stuart, H., Milev, R., & Koller, M. (2005). The inventory of stigmatizing experiences: Its development and reliability. World Psychiatry, 4(Suppl 1):33-37.

 

  1. Subramaniam, M., Abdin, E., Picco, L., Pang, S., Shafie, S., Vaingankar, J.A., et al. (2017). Stigma towards people with mental disorders and its components: A perspective from multi-ethnic Singapore. Epidemiology and Psychiatric Sciences, 26(4):371-382. https://doi.org/10.1017/S2045796016000159

 

  1. Subramaniam, M., Zhang, Y., Shahwan, S., Vaingankar, J.A., Satghare, P., Teh, W.L., et al. (2022). Employment of young people with mental health conditions: Making it work. Disability and Rehabilitation, 44(10):2033-2043. https://doi.org/10.1080/09638288.2020.1822932

 

  1. Subu M.A., Wati D.F., Netrida N., Priscilla, V., Dias, J.M., Abraham, M.S., et al. (2021). Types of stigma experienced by patients with mental illness and mental health nurses in Indonesia: A qualitative content analysis. International Journal of Mental Health Systems, 15(1):77. https://doi.org/10.1186/s13033-021-00502-x

 

  1. Suto, M. (2012). Stigma shrinks my bubble: A qualitative study of understandings and experiences of stigma and bipolar disorder. Stigma Research and Action, 2(2):85-92.

 

  1. Tan, A.S.Y., & Mankiewicz, P.D. (2024). Does a brief contact-based video intervention reduce public mental health stigma associated with psychosis in a collectivistic society? A randomised control trial. Journal of Mental Health Education, Training and Practice, 19(1): 21-35. https://doi.org/10.1108/jmhtep-05-2023-0053

 

  1. Tan, G.T.H., Shahwan, S., Goh, C.M.J., Ong, W.J., Wei, K.C., Verma, S.K., et al. (2020). Mental illness stigma’s reasons and determinants (MISReaD) among Singapore’s lay public: A qualitative inquiry. BMC Psychiatry, 20(422):1-13. https://doi.org/10.1186/s12888-020-02823-6

 

  1. Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International Journal of Medical Education, 2:53-55. https://doi.org/10.5116/ijme.4dfb.8dfd

 

  1. Vass, V., Morrison, A.P., Law, H., Dudley, J., Taylor, P., Bennett, K.M., et al. (2015). How stigma impacts on people with psychosis: The mediating effect of self-esteem and hopelessness on subjective recovery and psychotic experiences. Psychiatry Research, 230(2):487-495. https://doi.org/10.1016/j.psychres.2015.09.042

 

  1. Villafana, F. (2017). Coercion as Cure: A Critical History of Psychiatry. Oxfordshire: Routledge. https://doi.org/10.4324/9781315080994

 

  1. Waqas, A., Malik, S., Fida, A., Abbas, N., Mian, N., Miryala, S., et al. (2020). Interventions to reduce stigma related to mental illnesses in educational institutes: A systematic review. Psychiatric Quarterly, 91(3):887-903. https://doi.org/10.1007/s11126-020-09751-4

 

  1. Weiner, B. (1995). Judgments of Responsibility: A Foundation for a Theory of Social Conduct. New York: Guilford Press.

 

  1. Weiner, B., Perry, R.P., & Magnusson, J. (1988). An attributional analysis of reactions to stigmas. Journal of Personality and Social Psychology, 55(5):738-748. https://doi.org/10.1037/0022-3514.55.5.738

 

  1. Wen, S., & Mankiewicz, P.D. (2024). Practitioner psychologists’ perspectives on working with clients with psychosis in a South-East Asian city-state: A qualitative investigation. Counselling and Psychotherapy Research, 1-14. https://doi.org/10.1002/capr.12739

 

  1. Wood, L., Birtel, M., Alsawy, S., Pyle, M., & Morrison, A. (2014). Public perceptions of stigma towards people with schizophrenia, depression, and anxiety. Psychiatry Research, 220(1-2):604-608. https://doi.org/10.1016/j.psychres.2014.07.012

 

  1. Yamaguchi, S., Mino, Y., & Uddin, S. (2011). Strategies and future attempts to reduce stigmatization and increase awareness of mental health problems among young people: A narrative review of educational interventions. Psychiatry and Clinical Neurosciences, 65(5):405-415. https://doi.org/10.1111/j.1440-1819.2011.02239.x

 

  1. Yang, L.H. (2007). Application of mental illness stigma theory to Chinese societies: Synthesis and new directions. Singapore Medical Journal, 48(11):977-985.

 

  1. Yang, L.H., Cho, S.H., & Kleinman, A. (2008). Stigma of mental illness. International Encyclopedia of Public Health. Netherlands: Elsevier, p.219-230. https://doi.org/10.1016/b978-012373960-5.00047-2

 

  1. Yang, L.H., Kleinman, A., Link, B.G., Phelan, J.C., Lee, S., & Good, B. (2007). Culture and stigma: Adding moral experience to stigma theory. Social Science and Medicine, 64(7):1524-1535. https://doi.org/10.1016/j.socscimed.2006.11.013

 

  1. Yuan, Q., Abdin, E., Picco, L., Vaingankar, J.A., Shahwan, S., Jeyagurunathan, A., et al. (2016). Attitudes to mental illness and its demographic correlates among general population in Singapore. PLoS One, 11(11):e0167297. https://doi.org/10.1371/journal.pone.0167297

 

  1. Yuan, Q., Picco, L., Chang, S., Abdin, E., Chua, B.Y., Ong, S., et al. (2017). Attitudes to mental illness among mental health professionals in Singapore and comparisons with the general population. PLoS One, 12(11):e0187593. https://doi.org/10.1371/journal.pone.0187593

 

  1. Zhai, J., Guo, X., Chen, M., Zhao, J., & Su, Z. (2013). An investigation of economic costs of schizophrenia in two areas of China. International Journal of Mental Health Systems, 7(26):26. https://doi.org/10.1186/1752-4458-7-26

 

  1. Zhang, Z., Sun, K., Jatchavala, C., Koh, J., Chia, Y., Bose, J., et al. (2019). Overview of stigma against psychiatric illnesses and advancements of anti-stigma activities in six Asian societies. International Journal of Environmental Research and Public Health, 17(1):280. https://doi.org/10.3390/ijerph17010280

 

  1. Zvonkovic, A., & Lucas-Thompson, R.G. (2015). Refuting the myth of the “violent schizophrenic”: Assessing an educational intervention to reduce schizophrenia stigmatization using self-report and an implicit association test. Social Work in Mental Health, 13(3):201-215. https://doi.org/10.1080/15332985.2014.924463
Share
Back to top
Global Health Economics and Sustainability, Electronic ISSN: 2972-4570 Published by AccScience Publishing
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here
Accept