ABSTRACT

Background: Limited research has investigated whether replacing psychiatric diagnosis with psychological formulation-based approaches has implications for lay attitudes to mental health. The present study investigates experimentally whether presenting psychosis in terms of a schizophrenia diagnosis vs. formulation narrative affects stigma and treatment attitudes in the general public.

Method: The study employed a between-groups experimental vignette design, with data collected online. 351 participants (64.1% female, aged 18–66,) read a vignette about a person experiencing psychosis, defined with either a diagnosis of schizophrenia or a narrative-based formulation. Participants completed a battery of scales measuring their attitudes to the vignette character (social distance, attribution, recommended treatment options, mental help-seeking attitudes).

Results: Desired social distance was significantly greater in participants exposed to the diagnostic label of schizophrenia. The schizophrenia label led participants to rate medical care as significantly more helpful relative to the formulation condition but did not affect ratings of specialist or community care or mental help-seeking attitudes.

Conclusions: These findings suggest that a psychological formulation approach may slightly lessen stigma-related attitudes, relative to traditional diagnostic systems. Popularisation of formulation models need not compromise general orientations to help-seeking or perceived helpfulness of specialist care but may lead to less medicalised treatment preferences.

摘要

背景：有限的研究调查了用基于心理公式的方法代替精神病学诊断是否对非专业人士对心理健康的态度有影响。本研究通过实验调查以精神分裂症诊断与表述叙述来呈现精神病是否会影响公众的耻辱感和治疗态度。

方法：该研究采用组间实验小插图设计，数据在线收集。351 名参与者（64.1% 女性，18-66 岁）阅读了一个关于精神病患者的小插曲，定义为精神分裂症的诊断或基于叙述的表述。参与者完成了一系列量表来衡量他们对小插曲角色的态度（社交距离、归因、推荐的治疗方案、心理求助态度）。

结果：暴露于精神分裂症诊断标签的参与者期望的社交距离显着更大。精神分裂症标签导致参与者将医疗护理评为相对于配方条件更有帮助的评分，但不影响专家或社区护理或心理求助态度的评分。

结论：这些发现表明，相对于传统诊断系统，心理公式化方法可能会略微减少与污名相关的态度。配方模型的普及不需要损害寻求帮助或感知专科护理的帮助的总体方向，但可能会导致医疗化治疗偏好降低。