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Effect of Program Type & Presence of
    Public Service Announcements
   on Attitudes toward People with
             Mental Illness
          Tamara Daily, Ph.D.
       University of Mount Union

           Faculty Lecture
          October 17th, 2012
Hillibish asks, “Why zombies? Blame the media – who else?”
I ask, “Why did this writer choose to invoke the image of the
psychotic serial killer?”
Media & Mental Illness
• Mainstream media is filled with images of people
  with mental illness.
• Much of that imagery is negative (often
  associating mental illness with violence)
  (Wahl, 1995).
• What is the impact of negative portrayals on
  attitudes toward people with mental illness?
• What impact do public service announcements
  designed to reduce stigma have on attitudes
  when placed in different types of programs?
• Does violent content (no discussion of mental
  illness) have a negative effect on attitudes?
What is the Stereotype?
•   Dangerous
•   Unpredictable
•   Childlike
•   Incompetent
•   Blameworthy/Malingering
•   Contagious/Untreatable
Can this….   …reduce the impact of this?
Method
• Participants:
  – 163 Mount Union College (now University of Mount
    Union) students.
  – 108 Females and 55 Males
  – The majority of participants were freshmen (n = 62) or
    sophomores (n = 57).
  – The vast majority (91%) reported having had an
    encounter with a person with a mental illness (n =
    148).
  – Fewer than half (45%) reported working with
    someone with a mental illness (n = 73).
  – 33% (n = 53) reported having a family member with a
    mental illness.
Method
• Materials:
  – DVD’s:
     • CSI: Committed (Season 5); CSI: Crow’s Feet (Season 5);
       When Weather Changed History: Challenger.
     • PSA’s from SAMHSA and the AD Council which were
       available on the internet for download.
     • Episodes were edited: one commercial/PSA per break.
  – Questionnaires:
     • Demographic items.
     • The General Attribution Questionnaire (GAQ-20) and
       the Psychiatric Disability Attribution Questionnaire
       (PDAQ) were used to assess attitudes.
     • Subscales were modified in some cases.
Method
• Design & Procedure
  – 3 X 2 between-subjects factorial design with 6
    groups.
  – Participants arrived at a lab where they watched
    their assigned television program.
  – They then completed the questionnaire on-line
    using SurveyMonkey.

  Committed with PSAs   Crow’s Feet with PSAs   Challenger with PSAs
       (n = 32)                (n = 28)               (n = 33)

   Committed no PSAs    Crow’s Feet no PSAs     Challenger no PSAs
       (n = 26)               (n = 21)                (n = 23)
Fear & Dangerousness
• The main effect for television program was
  significant, F(2, 162) = 15.43, p = .000.
  – Collapsing across PSA conditions, Committed (M =
    4.41, SD = 1.52) viewers tended to report significantly
    greater fear and dangerousness than viewers of
    Crow’s Feet (M = 3.32, SD = 1.44, p = .000) and
    Challenger (M = 2.92, SD = 1.37, p = .000).
  – Scores for Crow’s Feet and Challenger did not differ
    significantly, p = .334.
• There was a trend toward lessened stigma when
  participants saw PSA’s (M = 3.40 , SD = 1.48)
  when compared to when they didn’t (M = 3.79
  , SD = 1.68). However, the main effect for PSA
  was non-significant, F(1, 162) = 2.77, p = .098.
Fear & Dangerousness
                         9.00
                         8.00
                         7.00
 Mean Scale Score




                         6.00
                         5.00
                         4.00
                         3.00
                         2.00
                         1.00
                                      PSA's                 No PSA's
                    Committed         4.38                    4.45
                    Crow's Feet       2.97                    3.77
                    Challenger        2.80                    3.08

Higher scores reflect greater fear and dangerousness associated with people with
mental illness (α = .93). Sample: People with mental illness terrify me (GAQ-20).
Anger & Irritation
• Overall levels of anger and irritation were low.
• There was some tendency for Committed (M =
  2.93 , SD = 1.46) viewers to report higher
  levels of anger and irritation than viewers of
  Crow’s Feet (M = 2.77 , SD = 1.21) and
  Challenger (M = 2.36 , SD = 1.13).
• The main effect for television program was
  non-significant, F(2, 157) = 2.81, p = .063, as
  was the main effect for PSA, F(1, 157) =
  .519, p = .472.
Anger & Irritation
                         9.00
                         8.00
                         7.00
 Mean Scale Score




                         6.00
                         5.00
                         4.00
                         3.00
                         2.00
                         1.00
                                    PSA's                    No PSA's
                    Committed       2.84                       3.04
                    Crow's Feet     2.71                       2.84
                    Challenger      2.31                       2.44

Higher scores reflect greater anger and irritation (α=.765). Sample: How irritated
would you be made by a person with mental illness? (GAQ-20).
Avoidance
• Across conditions, participants did not differ
  significantly in terms of their desire to avoid people
  with depression.
• When asked about avoiding those with
  psychosis, however, the main effect for television
  program was significant (F(2, 157) = 8.72, p = .000).
   – Committed (M = 4.26 , SD = 1.10) viewers expressed a
     greater preference for avoidance of those with psychosis
     than viewers of Crow’s Feet (M = 3.67, SD =.75, p = .004)
     or Challenger (M = 3.55 , SD =.89, p = .000).
   – Scores for Crow’s Feet and Challenger did not differ
     significantly, p = .183.
• The main effect for PSA was also significant with those
  who did not see PSA’s (M = 4.01 , SD =.93) preferring
  greater avoidance from those with psychosis than
  those who did (M = 3.71 , SD = 1.00), F(1, 157) = 3.79, p
  = .053.
Avoidance of People with Psychosis
                        7.00

                        6.00
Mean Scale Score




                        5.00

                        4.00

                        3.00

                        2.00

                        1.00
                                 PSA's                       No PSA's
                   Committed     4.16                          4.38
                   Crow's Feet   3.54                          3.86
                   Challenger    3.42                          3.74

  Higher scores reflect stronger need to avoid people with mental illness.
  Sample: I would try to avoid people with mental illness (PDAQ)
Provide Help
• Collapsing across PSA conditions, Committed viewers
  tended to express significantly less willingness to help
  than did participants in the other two groups, F(2, 157)
  = 9.20, p = .000.
   – Committed (M = 5.08 , SD = 1.44) viewers tended to be
     less willing to help than Crow’s Feet (M = 4.02 , SD =
     1.50, p = .001) viewers and Challenger viewers (M = 3.97
     , SD = 1.49, p = .000) viewers.
   – Scores for Crow’s Feet and Challenger did not differ
     significantly, p = .985.
• Collapsing across television programs, participants
  exposed to PSA’s (M = 4.04 , SD = 1.53) tended to
  express significantly greater willingness to help than
  did those who were not exposed to PSA’s (M = 4.84
  , SD = 1.49), F(1, 157) = 12.28, p = .001.
Provide Help
                         9.00
                         8.00
                         7.00
 Mean Scale Score




                         6.00
                         5.00
                         4.00
                         3.00
                         2.00
                         1.00
                                  PSA's                        No PSA's
                    Committed     4.97                           5.21
                    Crow's Feet   3.52                           4.69
                    Challenger    3.58                           4.54

Higher scores reflect less willingness to help (α=.512). Sample: How likely is it
that you would help a person with a mental illness? (GAQ=20)
Sympathy & Concern and Pity
• In terms of sympathy and concern (higher scores
  reflect less sympathy or concern for people with
  mental illness) the main effect for television
  program was non-significant, F(2, 157) = .099, p =
  .906, as was that for PSA, F(1, 157) = 1.64, p =
  .201.
• In terms of pity, participants’ responses were
  very similar across conditions. The main effect for
  television program was non-significant, F(2, 157)
  = .261, p = .771, as was that for PSA, F(1, 157) =
  .732, p = .394.
Feeling Sorry
• In terms of how sorry participants felt for people with
  depression, there was little variation across conditions
  and neither main effect was significant (for both p >
  .05).
• For psychosis, however, there was a significant main
  effect for television program, F(2, 157) = 3.92, p = .022.
   – Committed (M = 5.71 , SD = 2.09) viewers reported feeling
     less sorry for people with psychosis than Crow’s Feet
     viewers (M = 5.35 , SD = 2.60, p = .019) and somewhat less
     so than Challenger viewers (M = 5.52 , SD = 2.44, p = .08).
   – Scores for Crow’s Feet and Challenger did not differ
     significantly, p = .801.
• The main effect for PSA was non-significant, F(1, 157) =
  1.13, p = .29.
Feeling Sorry for People with Psychosis
                         7.00

                         6.00
 Mean Scale Score




                         5.00

                         4.00

                         3.00

                         2.00

                         1.00
                                  PSA's                   No PSA's
                    Committed     2.75                      3.12
                    Crow's Feet   3.50                      3.43
                    Challenger    3.24                      3.48

Higher scores reflect feeling more sorry for the person. Sample: How much
sympathy would you feel for a person with a mental illness? (PDAQ).
Discussion
• Watching a television program which overtly
  paired mental illness and violence had a negative
  impact on attitudes in the domains of fear and
  dangerousness, avoidance of those with
  psychosis, willingness to help and feeling sorry
  for those with psychosis.
  – Violence alone (Crow’s Feet) did not produce this
    effect.
• Viewing stigma-reduction PSAs had an overall
  positive effect in the domains of avoidance of
  people with psychosis and willingness to help.
  – This effect was most pronounced in the context of
    mental illness neutral programming (Crow’s Feet and
    Challenger) and less so in stigmatizing programming
    (both violence and mental illness).
Discussion
• These findings may suggest, first, that programs
  communicating the message that people with
  mental illness are violent and dangerous do in
  fact have the potential to make viewers’ attitudes
  more negative.
   – This counters the media argument that viewers know
     what they are seeing is fictional and will therefore not
     allow it to affect their opinions and beliefs.
• Second, PSAs, while positive in their impact
  overall in specific domains, are limited in their
  ability to cancel out the negative impact of highly
  stigmatizing material.
   – Changing program content should remain a priority.
American Horror Story: Asylum
• Set in 1964, American Horror Story: Asylum takes us into a
  Church-run haven for the criminally insane, ruled with an
  iron fist by Sister Jude (Jessica Lange), a nun with a troubled
  past. Inside this locked down facility, danger lurks around
  every corner. From Nazis and serial killers, to mutants and
  aliens, no one is safe inside these walls.
• Starring Jessica Lange as “Sister Jude”, Sarah Paulson as
  “Lana Winters”, James Cromwell as “Dr. Arthur Arden,”
  Evan Peters as “Kit Walker,” Lily Rabe as “Sister Mary
  Eunice,” Lizzie Brocheré as “Grace,” Zachary Quinto as “Dr.
  Oliver Thredson,” and Joseph Fiennes as “Monsignor
  Timothy Howard.” Guest stars for the miniseries will include
  Frances Conroy, Chloe Sevigny, Adam Levine and Mark
  Consuelos.
References
• The Advertising Council. (2007). Door [Video file]. Available from
  http://www.whatadifference.samhsa.gov/index.html
• The Advertising Council. (2007). Friends [Video file]. Available from
  http://www.whatadifference.samhsa.gov/index.html
• Berman, J. (Writer), & Lewis, R. J. (Director). (2004). Crow’s Feet
  [Television series episode]. In J. Bruckheimer (Executive
  producer), CSI: Crime Scene Investigation. New York, NY: CBS
  Productions.
• Goldfinger, S. (Writer), Narsu, U. (Writer), & Lewis, R. J. (Director).
  (2005). Committed [Television series episode]. In J. Bruckheimer
  (Executive producer), CSI: Crime Scene Investigation. New York, NY:
  CBS Productions.
• Towers, J. (Executive producer). (2008). Challenger Disaster
  [Television series episode]. In J. Towers (Executive producer), When
  Weather Changed History. Chicago, IL: Towers Productions.
• Wahl, O. (1995). Media madness: Public images of mental illness.
  New Brunswick, NJ: Rutgers University Press.

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UMU Faculty Lecture 2012

  • 1. Effect of Program Type & Presence of Public Service Announcements on Attitudes toward People with Mental Illness Tamara Daily, Ph.D. University of Mount Union Faculty Lecture October 17th, 2012
  • 2. Hillibish asks, “Why zombies? Blame the media – who else?” I ask, “Why did this writer choose to invoke the image of the psychotic serial killer?”
  • 3. Media & Mental Illness • Mainstream media is filled with images of people with mental illness. • Much of that imagery is negative (often associating mental illness with violence) (Wahl, 1995). • What is the impact of negative portrayals on attitudes toward people with mental illness? • What impact do public service announcements designed to reduce stigma have on attitudes when placed in different types of programs? • Does violent content (no discussion of mental illness) have a negative effect on attitudes?
  • 4. What is the Stereotype? • Dangerous • Unpredictable • Childlike • Incompetent • Blameworthy/Malingering • Contagious/Untreatable
  • 5. Can this…. …reduce the impact of this?
  • 6. Method • Participants: – 163 Mount Union College (now University of Mount Union) students. – 108 Females and 55 Males – The majority of participants were freshmen (n = 62) or sophomores (n = 57). – The vast majority (91%) reported having had an encounter with a person with a mental illness (n = 148). – Fewer than half (45%) reported working with someone with a mental illness (n = 73). – 33% (n = 53) reported having a family member with a mental illness.
  • 7. Method • Materials: – DVD’s: • CSI: Committed (Season 5); CSI: Crow’s Feet (Season 5); When Weather Changed History: Challenger. • PSA’s from SAMHSA and the AD Council which were available on the internet for download. • Episodes were edited: one commercial/PSA per break. – Questionnaires: • Demographic items. • The General Attribution Questionnaire (GAQ-20) and the Psychiatric Disability Attribution Questionnaire (PDAQ) were used to assess attitudes. • Subscales were modified in some cases.
  • 8.
  • 9. Method • Design & Procedure – 3 X 2 between-subjects factorial design with 6 groups. – Participants arrived at a lab where they watched their assigned television program. – They then completed the questionnaire on-line using SurveyMonkey. Committed with PSAs Crow’s Feet with PSAs Challenger with PSAs (n = 32) (n = 28) (n = 33) Committed no PSAs Crow’s Feet no PSAs Challenger no PSAs (n = 26) (n = 21) (n = 23)
  • 10. Fear & Dangerousness • The main effect for television program was significant, F(2, 162) = 15.43, p = .000. – Collapsing across PSA conditions, Committed (M = 4.41, SD = 1.52) viewers tended to report significantly greater fear and dangerousness than viewers of Crow’s Feet (M = 3.32, SD = 1.44, p = .000) and Challenger (M = 2.92, SD = 1.37, p = .000). – Scores for Crow’s Feet and Challenger did not differ significantly, p = .334. • There was a trend toward lessened stigma when participants saw PSA’s (M = 3.40 , SD = 1.48) when compared to when they didn’t (M = 3.79 , SD = 1.68). However, the main effect for PSA was non-significant, F(1, 162) = 2.77, p = .098.
  • 11. Fear & Dangerousness 9.00 8.00 7.00 Mean Scale Score 6.00 5.00 4.00 3.00 2.00 1.00 PSA's No PSA's Committed 4.38 4.45 Crow's Feet 2.97 3.77 Challenger 2.80 3.08 Higher scores reflect greater fear and dangerousness associated with people with mental illness (α = .93). Sample: People with mental illness terrify me (GAQ-20).
  • 12. Anger & Irritation • Overall levels of anger and irritation were low. • There was some tendency for Committed (M = 2.93 , SD = 1.46) viewers to report higher levels of anger and irritation than viewers of Crow’s Feet (M = 2.77 , SD = 1.21) and Challenger (M = 2.36 , SD = 1.13). • The main effect for television program was non-significant, F(2, 157) = 2.81, p = .063, as was the main effect for PSA, F(1, 157) = .519, p = .472.
  • 13. Anger & Irritation 9.00 8.00 7.00 Mean Scale Score 6.00 5.00 4.00 3.00 2.00 1.00 PSA's No PSA's Committed 2.84 3.04 Crow's Feet 2.71 2.84 Challenger 2.31 2.44 Higher scores reflect greater anger and irritation (α=.765). Sample: How irritated would you be made by a person with mental illness? (GAQ-20).
  • 14. Avoidance • Across conditions, participants did not differ significantly in terms of their desire to avoid people with depression. • When asked about avoiding those with psychosis, however, the main effect for television program was significant (F(2, 157) = 8.72, p = .000). – Committed (M = 4.26 , SD = 1.10) viewers expressed a greater preference for avoidance of those with psychosis than viewers of Crow’s Feet (M = 3.67, SD =.75, p = .004) or Challenger (M = 3.55 , SD =.89, p = .000). – Scores for Crow’s Feet and Challenger did not differ significantly, p = .183. • The main effect for PSA was also significant with those who did not see PSA’s (M = 4.01 , SD =.93) preferring greater avoidance from those with psychosis than those who did (M = 3.71 , SD = 1.00), F(1, 157) = 3.79, p = .053.
  • 15. Avoidance of People with Psychosis 7.00 6.00 Mean Scale Score 5.00 4.00 3.00 2.00 1.00 PSA's No PSA's Committed 4.16 4.38 Crow's Feet 3.54 3.86 Challenger 3.42 3.74 Higher scores reflect stronger need to avoid people with mental illness. Sample: I would try to avoid people with mental illness (PDAQ)
  • 16. Provide Help • Collapsing across PSA conditions, Committed viewers tended to express significantly less willingness to help than did participants in the other two groups, F(2, 157) = 9.20, p = .000. – Committed (M = 5.08 , SD = 1.44) viewers tended to be less willing to help than Crow’s Feet (M = 4.02 , SD = 1.50, p = .001) viewers and Challenger viewers (M = 3.97 , SD = 1.49, p = .000) viewers. – Scores for Crow’s Feet and Challenger did not differ significantly, p = .985. • Collapsing across television programs, participants exposed to PSA’s (M = 4.04 , SD = 1.53) tended to express significantly greater willingness to help than did those who were not exposed to PSA’s (M = 4.84 , SD = 1.49), F(1, 157) = 12.28, p = .001.
  • 17. Provide Help 9.00 8.00 7.00 Mean Scale Score 6.00 5.00 4.00 3.00 2.00 1.00 PSA's No PSA's Committed 4.97 5.21 Crow's Feet 3.52 4.69 Challenger 3.58 4.54 Higher scores reflect less willingness to help (α=.512). Sample: How likely is it that you would help a person with a mental illness? (GAQ=20)
  • 18. Sympathy & Concern and Pity • In terms of sympathy and concern (higher scores reflect less sympathy or concern for people with mental illness) the main effect for television program was non-significant, F(2, 157) = .099, p = .906, as was that for PSA, F(1, 157) = 1.64, p = .201. • In terms of pity, participants’ responses were very similar across conditions. The main effect for television program was non-significant, F(2, 157) = .261, p = .771, as was that for PSA, F(1, 157) = .732, p = .394.
  • 19. Feeling Sorry • In terms of how sorry participants felt for people with depression, there was little variation across conditions and neither main effect was significant (for both p > .05). • For psychosis, however, there was a significant main effect for television program, F(2, 157) = 3.92, p = .022. – Committed (M = 5.71 , SD = 2.09) viewers reported feeling less sorry for people with psychosis than Crow’s Feet viewers (M = 5.35 , SD = 2.60, p = .019) and somewhat less so than Challenger viewers (M = 5.52 , SD = 2.44, p = .08). – Scores for Crow’s Feet and Challenger did not differ significantly, p = .801. • The main effect for PSA was non-significant, F(1, 157) = 1.13, p = .29.
  • 20. Feeling Sorry for People with Psychosis 7.00 6.00 Mean Scale Score 5.00 4.00 3.00 2.00 1.00 PSA's No PSA's Committed 2.75 3.12 Crow's Feet 3.50 3.43 Challenger 3.24 3.48 Higher scores reflect feeling more sorry for the person. Sample: How much sympathy would you feel for a person with a mental illness? (PDAQ).
  • 21. Discussion • Watching a television program which overtly paired mental illness and violence had a negative impact on attitudes in the domains of fear and dangerousness, avoidance of those with psychosis, willingness to help and feeling sorry for those with psychosis. – Violence alone (Crow’s Feet) did not produce this effect. • Viewing stigma-reduction PSAs had an overall positive effect in the domains of avoidance of people with psychosis and willingness to help. – This effect was most pronounced in the context of mental illness neutral programming (Crow’s Feet and Challenger) and less so in stigmatizing programming (both violence and mental illness).
  • 22. Discussion • These findings may suggest, first, that programs communicating the message that people with mental illness are violent and dangerous do in fact have the potential to make viewers’ attitudes more negative. – This counters the media argument that viewers know what they are seeing is fictional and will therefore not allow it to affect their opinions and beliefs. • Second, PSAs, while positive in their impact overall in specific domains, are limited in their ability to cancel out the negative impact of highly stigmatizing material. – Changing program content should remain a priority.
  • 23. American Horror Story: Asylum • Set in 1964, American Horror Story: Asylum takes us into a Church-run haven for the criminally insane, ruled with an iron fist by Sister Jude (Jessica Lange), a nun with a troubled past. Inside this locked down facility, danger lurks around every corner. From Nazis and serial killers, to mutants and aliens, no one is safe inside these walls. • Starring Jessica Lange as “Sister Jude”, Sarah Paulson as “Lana Winters”, James Cromwell as “Dr. Arthur Arden,” Evan Peters as “Kit Walker,” Lily Rabe as “Sister Mary Eunice,” Lizzie Brocheré as “Grace,” Zachary Quinto as “Dr. Oliver Thredson,” and Joseph Fiennes as “Monsignor Timothy Howard.” Guest stars for the miniseries will include Frances Conroy, Chloe Sevigny, Adam Levine and Mark Consuelos.
  • 24.
  • 25. References • The Advertising Council. (2007). Door [Video file]. Available from http://www.whatadifference.samhsa.gov/index.html • The Advertising Council. (2007). Friends [Video file]. Available from http://www.whatadifference.samhsa.gov/index.html • Berman, J. (Writer), & Lewis, R. J. (Director). (2004). Crow’s Feet [Television series episode]. In J. Bruckheimer (Executive producer), CSI: Crime Scene Investigation. New York, NY: CBS Productions. • Goldfinger, S. (Writer), Narsu, U. (Writer), & Lewis, R. J. (Director). (2005). Committed [Television series episode]. In J. Bruckheimer (Executive producer), CSI: Crime Scene Investigation. New York, NY: CBS Productions. • Towers, J. (Executive producer). (2008). Challenger Disaster [Television series episode]. In J. Towers (Executive producer), When Weather Changed History. Chicago, IL: Towers Productions. • Wahl, O. (1995). Media madness: Public images of mental illness. New Brunswick, NJ: Rutgers University Press.

Editor's Notes

  1. The interaction was non-sig. (p = .417)
  2. The interaction was also non-significant, p = .986.
  3. The interaction between television program and PSA was non-significant, p = .958.