[Self-Stigma of Depression Scale SSDS - Evaluation of the German Version]. / Self-Stigma of Depression Scale SSDS ­ Evaluation der deutschen Skalenversion.

OBJECTIVES: A better understanding of self-stigma facilitates the development and evaluation of anti-stigma measures. In this study, the Self-Stigma of Depression Scale (SSDS) is applied for the first time in Germany. The focus lies on feasibility and psychometric characteristics of the scale. METHODS: Data stem from a representative population survey in Germany (N = 2,013). The 16 items of the original SSDS are used to assess anticipated self-stigma in case of depression. Main component analysis is applied to analyze the factor structure. RESULTS: The original version of the SDSS could not be replicated in the German sample. Instead of four, three factors emerged in the German version. They are similar to three subscales of the original SSDS: "social inadequacy", "help-seeking inhibition" and "self-blame". The internal reliability of the total scale as well as of the first two subscales is acceptable. CONCLUSION: SSDS is a multidimensional construct and can serve as an important instrument in research regarding self-stigma of depression in Germany. A further development of the German scale is recommended in order to gain greater insight into the nature of (anticipated) depression self-stigma.

Continuum beliefs in the stigma process regarding persons with schizophrenia and depression: results of path analyses.

BACKGROUND: Individuals with mental illness often experience stigmatization and encounter stereotypes such as being dangerous or unpredictable. To further improve measures against psychiatric stigma, it is of importance to understand its components. In this study, we attend to the step of separation between "us" and "them" in the stigma process as conceptualized by Link and Phelan. In using the belief in continuity of mental illness symptoms as a proxy for separation, we explore its associations with stereotypes, emotional responses and desire for social distance in the stigma process. METHODS: Analyses are based on a representative survey in Germany. Vignettes with symptoms suggestive of schizophrenia (n = 1,338) or depression (n = 1,316) were presented to the respondents, followed by questions on continuum belief, stereotypes, emotional reactions and desire for social distance. To examine the relationship between these items, path models were computed. RESULTS: Respondents who endorsed the continuum belief tended to show greater prosocial reactions (schizophrenia: 0.07; p < 0.001, depression: 0.09; p < 0.001) and less desire for social distance (schizophrenia: -0.13; p < 0.001, depression: -0.14; p < 0.001) toward a person with mental illness. In both cases, agreement with the stereotypes of unpredictability and dangerousness was positively associated with feelings of anger and fear as well as desire for social distance. There were no statistically significant relations between stereotypes and continuum beliefs. DISCUSSION: Assumptions regarding continuum beliefs in the stigma process were only partially confirmed. However, there were associations of continuum beliefs with less stigmatizing attitudes toward persons affected by either schizophrenia or depression. Including information on continuity of symptoms, and thus oppose perceived separation, could prove helpful in future anti-stigma campaigns.

Changes in beliefs and attitudes toward people with depression and schizophrenia - results of a public campaign in Germany.

We examined the impact of a mental health awareness campaign on public attitudes. The campaign was embedded in the project psychenet - Hamburg Network for Mental Health. Beliefs and attitudes were examined before and after specific awareness measures in Hamburg (intervention region) and Munich (control region). Analyses were based on representative surveys (2011: N=2014; 2014: N=2006). Vignettes with symptoms suggestive of depression respectively schizophrenia were presented, followed by questions on social distance, beliefs and emotional reactions. Analyses of variance tested variations between regions over time and differences between those aware of the campaign and those not aware. In 2014, 7.3% (n=74) of the Hamburg respondents were aware of the psychenet campaign. Regarding the total sample, there were minor changes in attitudes. Differentiated according to campaign awareness among Hamburg respondents, those who were aware showed less desire for social distance toward a person with depression. Moreover, respondents aware of the campaign stated less often that a person with schizophrenia is in need of help. The campaign had small impact on attitudes. A substantial change in ingrained attitudes toward persons with mental health problems is difficult to achieve with interventions targeting the general public.

[Evaluation of a Public Campaign on Mental Disorders - Results from "psychenet"]. / Evaluation einer bevölkerungsbezogenen Kampagne zu psychischen Erkrankungen ­ Erfahrungen aus dem Projekt "psychenet".

Objective: From 2011 to 2014, an information and awareness campaign was conducted in the framework of psychenet - Hamburg network for mental health. Evaluation is focused on two aspects: First, the reach of the campaign is examined. Second, effects of the campaign's key messages on public attitudes concerning mental disorders are analyzed. Methods: Analyses are based on two representative telephone surveys, conducted in Hamburg (intervention region) and Munich (control region) in 2011 prior (N = 2014) and 2014 post-campaign (N = 2006). Respondents were asked about their awareness of the psychenet campaign and to state their agreement or disagreement regarding attitudes and beliefs about mental disorders. Results: 7.3 % (74 of 1005) of the respondents from Hamburg were aware of psychenet. Compared to the other respondents, this subgroup displayed a stronger accordance with the campaign's key messages. However, regarding the total population over the course of time, differences in attitudes towards mental disorders were minor. Conclusion: Information and awareness campaigns seem to have minor effects on public attitudes towards mental disorders. Effects of specific campaign messages need to be examined more systematically.

[What does the Public Know and Think About Mental Disorders?]. / Was weiß und denkt die Bevölkerung über psychische Erkrankungen?

Public knowledge about and attitudes towards mental illness were analyzed. Furthermore, changes in knowledge and attitudes after an information and awareness campaign were examined. The basis were two telephone surveys in 2011 (t0) and 2014 (t1) in Hamburg (intervention) and Munich (control). In 2011, the public was relatively well informed about mental disorders. Regarding the level of information of the public before the campaign and inconsistent results of previous evaluation studies the anticipated impact of the awareness campaign at t1 are moderate.

[psychenet - Hamburg Network for Mental Health: Results of the Process Evaluation]. / psychenet - Hamburger Netz psychische Gesundheit: Ergebnisse der Prozessevaluation.

Aspects of implementation, functionality, acceptability and sustainability of the network psychenet - Hamburg network for mental health were examined.In March 2012 and September 2013, 19 expert interviews were carried out with leaders of subprojects and representatives of insurances, public authorities and patients.The complexity of the network was hindering. Positive aspects were communication, clear hierarchies and qualified staff.The implementation of a complex network requires shared goals. The establishment of a steering committee has proved as crucial.

Sex differences in attitudes towards females with eating disorders.

BACKGROUND: This study aims to examine the public's attitudes and predictors of social distance towards women afflicted by eating disorders (anorexia nervosa [AN] and bulimia nervosa [BN]) under specific consideration of the respondents' sex. Eating disorders are still often seen as a women's health issue, and those afflicted remain stigmatized in Western societies. The concept of social distance is a frequently used indicator in awareness campaigns. Sex-specific results could add important information to destigmatization programs. METHODS: Data originate from a German telephone survey which was conducted in 2011. Vignettes with signs and symptoms either suggestive of AN or BN were presented to the respondents randomly, who subsequently answered questions regarding beliefs about causes, contact to persons afflicted as well as desire for social distance. Stratified multiple linear regression analyses according to disorder under study were performed to examine associations between different predictors and desire for social distance. RESULTS: There were significant sex differences in desire for social distance, causal attributions, and emotional reactions towards women with eating disorders. E.g., with respect to AN, women exhibited a significantly greater desire for social distance than men (p<.001), and more frequently believed that AN could be caused by sexual abuse during childhood. Regarding predictors of social distance, there was a significant positive association between age and desire for social distance equally among men and women. However, distinct sex differences came into effect concerning other predictors depending on the eating disorder under study. In BN, attribution of brain disease emerged as significant predictor of social distance among men. This is not true for women, where the attribution of weak will significantly predicted the desire for social distance. CONCLUSION: Sex-dependent differences in attitudes and predictors of social distance towards females afflicted should be met with tailored measures in anti-stigma campaigns, addressing women and men on different levels.