The Double Stigma of Mental Illness Associated with Substance Use: Stereotypes, Causal Attributions and Emotional Reactions

Abstract

Despite the large body of research exploring mental illness stigma, few studies have examined the stigmatisation of comorbid mental and substance use disorders. The present study aims to expand this research by evaluating differences in stereotypes, causal attributions and emotions elicited by an individual with a mental illness and substance use issue compared to a mental illness alone. Participants (N = 121) were randomly assigned to one of two conditions (drug/no drug). Each condition contained a vignette describing a man experiencing psychotic symptoms, the drug condition also revealed he had been using illicit drugs for some time. Measures used to evaluate participant perceptions of the subject in the vignette included stereotype content (warmth, competence), emotional reactions (pity, anger, fear) and causal attributions (dispositional, biological, environmental). Mixed factorial analysis of variance (ANOVA) found significant interactions between condition (drug/no drug) and causal attributions, F(1.75, 206.18)=19.60, p< .000, hp 2=.142 and emotional reactions, F(2,236)=6.47, p=.002, hp 2=.052. A main effect of condition (drug/no drug) showed statistically significant differences in stereotyping across the two groups, F(1,118)=5.83, p=.017, hp 2 =.047. The comorbid substance abuse and psychotic disorder was significantly more negatively perceived than the psychotic disorder alone, presenting implications for future research and efforts to reduce stigma.