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Published Online: 26 April 2021

Sustained Effect of a Brief Video in Reducing Public Stigma Toward Individuals With Psychosis: A Randomized Controlled Trial of Young Adults

Abstract

Objective:

Public stigma is a barrier to care and increases the duration of untreated psychosis among individuals with first-episode psychosis. The authors recently demonstrated the efficacy of a 90-second social contact–based video intervention in reducing such stigma. That proof-of-concept study was the first to employ so brief an antistigma intervention in a sample of young adults. The authors now present a randomized controlled replication study with baseline, postintervention, and 30-day follow-up assessments. The authors aimed to replicate their previous findings and to show a persisting benefit for the video intervention.

Methods:

Using a crowdsourcing platform (Amazon Mechanical Turk), the authors recruited and assigned 1,055 participants ages 18–30 years to a brief video-based intervention, to a written vignette intervention containing the same material, or to a nonintervention control condition. In the 90-second video, a 22-year-old African American woman with schizophrenia humanized the illness through her emotional description of living a meaningful and productive life.

Results:

A three-by-three group-by-time multivariate analysis of variance showed a significant group-by-time interaction for the total scores of all five stigma-related domains: social distance, stereotyping, separateness, social restriction, and perceived recovery. Post hoc pairwise tests showed greater reductions in the video group compared with the vignette and control groups at the postintervention and 30-day follow-up assessments, while the vignette group differed from the control group at the postintervention assessment but not at the 30-day assessment.

Conclusions:

This randomized controlled study replicated and strengthened the authors’ earlier findings, further showing month-long sustained stigma reduction in the social contact–based video intervention arm. A 90-second video sufficed to humanize schizophrenia and reduce stigma. Further research should examine longer-term sustainability, assess changes in behavior, and determine optimal effective video length.

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Supplementary Material

File (appi.ajp.2020.20091293.ds001.pdf)

Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 635 - 642
PubMed: 33900809

History

Received: 1 September 2020
Revision received: 28 October 2020
Accepted: 4 January 2021
Published online: 26 April 2021
Published in print: July 2021

Keywords

  1. Sociopolitical Issues
  2. Stigma / Discrimination
  3. First-Episode Psychosis
  4. Schizophrenia Spectrum and Other Psychotic Disorders

Authors

Affiliations

Doron Amsalem, M.D. [email protected]
New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria)
John C. Markowitz, M.D.
New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria)
Samantha E. Jankowski, M.A.
New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria)
Lawrence H. Yang, Ph.D.
New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria)
Linda Valeri, Ph.D.
New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria)
Sarah A. Lieff, M.P.H.
New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria)
Yuval Neria, Ph.D.
New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria)
Lisa B. Dixon, M.D., M.P.H.
New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York (Amsalem, Markowitz, Jankowski, Neria, Dixon); Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York (Yang, Lieff); Department of Epidemiology (Yang) and Department of Biostatistics (Valeri), Columbia University Mailman School of Public Health, New York; Department of Epidemiology, Columbia University Irving Medical Center, New York (Neria)

Notes

Send correspondence to Dr. Amsalem ([email protected]).

Author Contributions

The authors thank the video participant, who shared her story and contributed to stigma reduction.

Funding Information

The authors report no financial relationships with commercial interests.

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