How adolescents perceive the stigma of mental illness and alcohol abuse

OBJECTIVES: Research among adults has yielded three sets of conclusions about the stigma of mental illness. First, people with mental illness are stigmatized more severely than those with physical health conditions; those who abuse alcohol are viewed more harshly than those with mental illness. Second, stereotypes of mental illness related to responsibility and dangerousness lead to negative emotional reactions and discriminatory behaviors. Third, familiarity with people with mental illness tends to diminish stigma. This study attempted to validate these findings with a large and diverse sample of adolescents. METHODS: A total of 303 adolescents completed a revised version of the Attribution Questionnaire (rAQ) that presented four vignettes, each describing a different type of peer: a peer with mental illness, with mental illness caused by a brain tumor, with alcohol abuse problems, and with leukemia. The rAQ comprises seven Likert scale items of agreement that research participants rated for each vignette. Items included pity, danger, fear, responsibility, anger, help, and avoidance. Participants also completed a revised Level of Contact Report to assess their familiarity with mental illness. RESULTS: As with adults, adolescents stigmatized peers who abuse alcohol most severely, followed by those with mental illness. Peers with leukemia were treated more benignly than the other groups. Having a brain tumor mediated the stigmatizing effect of mental illness. Adolescents who agreed that persons with mental illness are responsible for their illness and are dangerous demonstrated more discrimination toward these persons. However, this finding was not supported for alcohol abuse. Familiarity yielded an unexpected effect among adolescents; those who reported more familiarity with mental illness were more likely to endorse stigma of mental illness. CONCLUSIONS: Adolescents tended to discriminate among conditions, viewing substance abuse more harshly than the other disorders. Blame and dangerousness were important variables leading to discrimination, and contact with persons with mental illness led to more discrimination.