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Survey experiment to estimate drivers of mental illness stigma
Despite significant advances in scientific understanding of brain and substance use disorders accompanied by significant advances in treatment and improvements in prognosis, mental illness remains highly stigmatized throughout the world. Previous studies suggest that portraying mental illness as treatable can reduce negative attitudes toward persons with mental illness. This randomized controlled trial compares the effects of exposing study participants to vignettes portraying persons with untreated and symptomatic mental illness vs. treated mental illness with complete response vs. treated mental illness with relapse. It is hypothesized, based on prior work, that study participants exposed to vignettes depicting treated mental illness with completed response would have the greatest effect on reducing negative attitudes toward persons with mental illness, followed by treated mental illness with relapse and untreated and symptomatic mental illness.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| V1: Control | No Intervention | This version of the survey questionnaire depicts a young woman with no symptoms of mental illness. | |
| V2: Schizophrenia | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with untreated and symptomatic schizophrenia. |
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| V3: Schizophrenia + Tx with Response | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with schizophrenia, successfully treated with complete response. |
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| V4: Schizophrenia + Tx with Relapse | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with schizophrenia, successfully treated with partial relapse. |
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| Version 5: Bipolar | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with untreated and symptomatic bipolar disorder. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Survey questionnaire | Other | Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response. |
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| Measure | Description | Time Frame |
|---|---|---|
| Social Distance | Willingness to have the woman portrayed in the vignette to marry into the study participant's family (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) |
| Perceived Norms about Social Distance | Study participant's perception of the extent to which other people would be willing to have the woman portrayed in the vignette to marry into their families (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) |
| Negative Attitudes (Attribution) | Personal belief that the symptoms of the woman portrayed in the vignette represent divine punishment (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) |
| Perceived Norms about Negative Attitudes (Attribution) | Study participant's perception of the extent to which other people believe that the symptoms of the woman portrayed in the vignette represent divine punishment (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) |
| Negative Attitudes (Shame) | Personal belief that the symptoms of the woman portrayed in the vignette bring shame upon her family |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alexander C Tsai, MD | Massachusetts General Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Mbarara University of Science and Technology | Mbarara | Uganda |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31539373 | Derived | Rasmussen JD, Kakuhikire B, Baguma C, Ashaba S, Cooper-Vince CE, Perkins JM, Bangsberg DR, Tsai AC. Portrayals of mental illness, treatment, and relapse and their effects on the stigma of mental illness: Population-based, randomized survey experiment in rural Uganda. PLoS Med. 2019 Sep 20;16(9):e1002908. doi: 10.1371/journal.pmed.1002908. eCollection 2019 Sep. |
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| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D012559 | Schizophrenia |
| D001714 | Bipolar Disorder |
| D003863 | Depression |
| ID | Term |
|---|---|
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
| D000068105 | Bipolar and Related Disorders |
| D019964 | Mood Disorders |
| D001526 | Behavioral Symptoms |
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| ID | Term |
|---|---|
| D011795 | Surveys and Questionnaires |
| ID | Term |
|---|---|
| D003625 | Data Collection |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D017531 | Health Care Evaluation Mechanisms |
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| V6: Bipolar + Tx with Response | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with bipolar disorder, successfully treated with complete response. |
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| V7: Bipolar + Tx with Relapse | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with bipolar disorder, successfully treated with partial relapse. |
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| V8: Depression | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with untreated and symptomatic major depressive disorder. |
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| V9: Depression + Tx with Response | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with major depressive disorder, successfully treated with complete response. |
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| V10: Depression + Tx with Relapse | Experimental | As this is a survey experiment, the "intervention" involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with major depressive disorder, successfully treated with partial relapse. |
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| Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) |
| Perceived Norms about Negative Attitudes (Shame) | Study participant's perception of the extent to which other people believe that the symptoms of the woman portrayed in the vignette bring shame upon her family (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) |
| D001519 | Behavior |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |