A vignette-based study examining attitudes toward mental and brain illness in the United States and Pakistan.

Abstract

Research from both Pakistan and the United States shows a relatively higher stigma for mental illness than physical illness. However, research comparing mental and brain illness is limited. Therefore, using an online survey, the present study examined mental and brain illness stigma, discriminatory potential as manifested via social distance, and perceived causes (biogenetic/moral) in a cross-cultural sample. A total of 918 students (458 Pakistani and 460 American) were recruited from academic institutions. They completed a within-group design survey where measures of stigma (Attribution Questionnaire–9), discriminatory potential (Social Distance Scale), and causal beliefs were administered in the context of mental (either depression or schizophrenia) and brain illness (either dementia or traumatic brain injury) vignettes. The primary analysis of variance results showed that Pakistan had a relatively higher stigma and discriminatory potential than the United States. However, there was no difference in stigma and discriminatory potential between mental and brain illness. Moreover, Pakistani respondents highly endorsed moral causal beliefs, whereas the U.S. respondents endorsed biogenetic causal beliefs, which were relatively higher for mental illness than brain illness in both countries. Notably, these results were sensitive to covariates as investigated in the exploratory model. Hence, this study should be a precursor for future research aimed at the identification of moderators and mediators that account for cross- and within-culture variation. Last, given the cultural variation in causal beliefs and experiences of symptoms, it is essential to engage those with lived experience and locals to identify and include the unique cultural factors that are crucial to the success of an intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved)