Essentialist Thinking May Drive Stigma Against People Diagnosed with Schizophrenia

In a new article in Current Psychology, Daniel Dittrich and his colleagues examine the role of essentialism in stigma towards schizophrenia. Prior research has established a likely link between biogenetic understandings of mental illness and stigmatizing attitudes. The current study seeks to understand how essentialism – the tendency to assume an underlying essence that makes things what they are – affects stigmatizing attitudes.

The authors recruited 367 online participants and had them read either a biogenetic or psychosocial explanation for schizophrenia. They then showed the participants a vignette describing someone with schizophrenia. Finally, they measured several variables associated with stigma and essentialism.  Predictably, the subjects agreed more with the researchers’ explanation (biogenetic or psychosocial). However, the authors did not observe the expected increase in stigmatizing attitudes in the biogenetic vignette group. The current research found evidence in the psychosocial vignette group suggesting that biogenetic understandings of mental illness, greater stigma, and essentialist thinking may be linked.

Many authors have reported the link between biogenetic understandings of mental illness – the belief that mental illness is an inherited brain disease – and stigmatizing attitudes towards those diagnosed with mental illness. Research has also linked the biomedical model of health with discrimination towards those with mental health diagnoses.

Conversely, research has shown that those with a preference for psychosocial explanations of mental illness – the belief that mental illness is caused by stress and lack of access to necessities – have less stigmatizing attitudes towards those with diagnoses. Beliefs in a continuum of mental health – the idea that mental health exists on a sliding scale rather than in discrete categories of mental health/mental illness – are also associated with reduced stigmatizing attitudes.

Critics have pointed out that the concept of stigma can be co-opted by the pharmaceutical industry in order to sell more medication. Under the guise of combating stigma, pharma-funded patient advocacy groups commonly come up against lawmakers and insurers, demanding that high-priced psychotropics be made available.

Service users who choose to withdraw from psychotropic medications have been accused of promoting pill-shaming, stigmatizing attitudes towards others diagnosed with mental illness for simply sharing their withdrawal stories. Research has also found that anti-stigma campaigns may hinder efforts to withdraw from psychotropic medications.

Additionally, research has found anti-stigma campaigns ineffective in changing attitudes towards service users with mental health diagnoses. Sociologists have also argued that anti-stigma campaigns may enable inequality.

The current research examines essentialist thinking as it relates to stigmatizing attitudes around mental health. Using the “Mixed-Blessings Model” of biogenetics and stigma, the authors tested the claim that the biogenetic model reduces stigma around blame while raising it in terms of desire for social distance from the diagnosed, perceived dangerousness, and prognostic pessimism – the belief that recovery is extremely difficult or impossible.

The authors recognize two related forms of essentialism. Psychological essentialism is the tendency to experience an underlying essence that makes things what they are. Genetic essentialism is the tendency to overestimate the contributions of genetics in questions of attribution.

As it relates to mental illness, essentialist thinking tends to create an attitude that mental illness is immutable and contributes to stigmatizing attitudes around the prognosis, dangerousness, and desirable social distance from those diagnosed with mental illness.

In the present research, participants were given either biogenetic or psychosocial explanations for schizophrenia. The researchers then measured each group in terms of (a) causal beliefs on the etiology of schizophrenia (as a manipulation check), (b) the degree of essentialist beliefs (mediator), (c) the extent to which subjects subscribed to assumptions of dangerousness, (d) prognostic pessimism, and (e) desire for social distance.

Participants in the biogenetic group showed a preference for biogenetic explanations. Similarly, participants in the psychosocial group showed a preference for psychosocial explanations. Mean biogenetic beliefs were higher than mean psychosocial ones. The authors found no significant difference between the two groups in terms of essentialist beliefs.

In the biogenetic group, stigmatizing attitudes were not associated with biogenetic causal beliefs. In the same group, psychosocial causal beliefs were associated with less pessimism around prognosis. Essentialist perspectives were linked with an increase in the assumed dangerousness of people diagnosed with schizophrenia.

In the psychosocial group, both the desire for greater social distance and the assumptions of dangerousness towards people diagnosed with schizophrenia were associated with biogenetic causal beliefs. In addition, essentialist beliefs were correlated with desire for social distance, prognostic pessimism, and assumptions of dangerousness.

The authors describe the role of essentialism as follows:

In other words, essentialist thinking alone is likely to indicate stigmatizing attitudes towards people diagnosed with schizophrenia.

The authors list several limitations to the current study. First, the current research was limited to the diagnosis of schizophrenia. Second, the convenience sample used participants that were predominantly young, female, well educated, and had some previous contact with people diagnosed with schizophrenia, limiting the study’s generalizability. Finally, vignette responses as utilized in the current study have been linked with several types of response bias.

 

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Dittrich, D., Dernbach, K., Speerforck, S., Schindler, S., Häusser, J. A., & Schomerus, G. (2021). Testing the mixed-blessings model: What is the role of essentialism for stigmatizing attitudes towards schizophrenia? Current Psychology. https://doi.org/10.1007/s12144-021-01653-3 (Link)