Essentialist Thinking May Drive Stigma Against People Diagnosed with Schizophrenia

Researchers find that both psychological and biological essentialism result in stigma against people diagnosed with schizophrenia.

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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.

“Subjects reported a stronger agreement with the etiology they had been presented. Against our expectations, this did not result in higher levels of stigmatizing attitudes in the biogenetic vignette group. Correspondingly, mediation through essentialism could not be tested.”

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:

“We found a pervasive positive association of essentialism with all three facets of stigmatizing attitudes in the psychosocial group and assumptions of dangerousness in the biogenetic group. This indicates a role of essentialist thinking for the social acceptance of people diagnosed with schizophrenia that is not congruent with biogenetic essentialism. It might be adequate to conceptualize essentialism as an independent predictor of stigmatizing attitudes rather than a mediator of the effect of biogenetic causal explanations.”

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)

5 COMMENTS

  1. I cavort with stigma. Stigma emboldens me. I am the Picasso of my stigma. I create beautiful art from what society regards as rubbish. That means all the intense feelings and ideas that society wants to pat pat pat patacake into comformity are my lovely daubs and splashes of radiant colour. The day I stop being stigmatizable is the day society has won complete and utter dominance of me. The day I stop being excluded, vilified, patronized, usurped, is the day I will truly have arrived at an illness called conformity. An illness caused by bullying me into that which passes muster with everyone else.

    A society without eccentrics is frightening.

    Eccentrics are artists, poets, visionaries, writers, free thinkers and free feelers.

    A time is coming when your difference, that aspect that previously excluded you from a hollow illusion of a society that has nothing much to offer you anyway, will be a difference “healed” from you in the same way Father Girolamo Savonarolla “healed” the stigmatized “sinner”.

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

    And assigning a psychiatric diagnosis and wrapping it in a “biologically-based mental illness” package causes essentialist thinking.

    In other words, psychiatry causes stigma.

  3. —-In other words, psychiatry causes stigma.

    There are SOME in society who promulgate that prejudice, mainly out of long habit, very rarely out of viciousness.

    No not everyone does, and not every psychiatrist does. We have learned to promulgate the term. We are overcoming that lesson.

    Harold A Maio

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