[The stigma of mental illness: Α historical overview and conceptual approaches].

The present article explores the concept of stigma from a historical and theoretical perspective. At first, the conceptual origin of the term "stigma" is presented as well as its subsequent course and incorporation in the scientific field. The term stigma originates from ancient Greek language and in particular from the verb «στίζω¼, which means "to carve, to mark as a sign of shame, punishment or disgrace". In contemporary thinking about stigma, the work of Erving Goffman is seminal. According to him, stigmatization is elicited by the presence of a socially undesirable characteristic, which signals otherness. When this characteristic becomes conspicuous during a social interaction, it may act in a disqualifying manner for the identity of the person who bears it. One of the first theories on social stigma which attracted increased scientific attention is labeling theory by Thomas Scheff. Later on, the conceptual model of Corrigan and Watson underscored the main constituents of stigma, namely stereotypes, prejudices and discrimination; whereas the theoretical framework of Link and Phelan stressed labeling, stereotyping, separation, status loss and discrimination as interconnected components in a power situation. During the last half of the previous century, the concept of stigma came to the fore and gained growing research attention, especially due to shedding light on the ways whereby people with mental disorders were treated socially. Most of the literature has focused on recording the general population's level of knowledge and lay beliefs about mental illness as well as on exploring social attitudes and desired social distance from people with mental disorders. Converging evidence indicates that stereotypical beliefs and discriminatory attitudes against people with mental illness prevail worldwide; while illness severity, poor therapeutic outcome, disturbances in patients' emotional expression during a social interaction, incidents of violent or dangerous behaviours and labeling have all been shown to influence public stigma. Regarding lay respondents' correlates of public stigma; male gender, older age, lower socio-economic status, lower educational attainment and residence in semi-urban or rural areas have been linked to unfavourable attitudes towards people with mental disorders; while of outmost importance is personal experience/ familiarity with mental illness.

[Representations of mental illness in the Greek Press: 2001 vs 2011].

The media seem to have played a prominent role in shaping the contemporary social image of people with mental illness, by perpetuating the stigma attached to it. Worldwide, a vast amount of research findings converge to the stigmatizing representation of people with mental illness by the media, with reference to the dominant stereotype of violence. The present study aims to explore the representations of mental illness in the Greek Press using a quantitative and qualitative approach. Potential changes in the media portrayal of mental illness during the last decade are also being examined: findings are compared to those of a previous research that took place in 2001, following the same methodology. The sample consisted of press articles referring to mental illness, that were indexed daily from the Greek newspapers during the period July-November 2011. The items were categorized into thematic categories and further analyzed taking in account the use of stigmatizing vocabulary, the reproduction of common myths concerning mental illness, the overall valence of each article (stigmatizing, neutral or anti-stigmatizing) towards people with mental illness, as well as the contextual implications conveyed in the use of psychiatric terms as a metaphor. The largest thematic category that emerged from the sample was that referring to the repercussions of the economic crisis to mental health, followed by the category of articles where psychiatric terms are used as a metaphor. The comparisons made between 2001 and 2011 revealed an improved representation of mental illness in terms of stigma, especially regarding schizophrenia. The public expression of stigma has decreased, with fewer stigmatizing articles and notably more neutral in valence articles. The findings of this study suggest a decline of the media propensity for emotionally charged descriptions and a shift towards objective journalism regarding mental illness. This is most likely to be attributed to the anti-stigma campaigns, targeting media workers, that have been implemented during the last decade in Greece. Nevertheless, the public expression of stigma remains present by taking more subtle forms. Such examples are demonstrated by the semantic context of articles in which psychiatric terms are used as a metaphor, or by the recurrent reference of (unspecified) mental illness on the occasion of violent crime.

[Social Distance Scale: Greek adaptation and psychometric properties].

Literature on stigma refers to social distance as the most widely used index of attitudes towards mental illness and it involves the desire to avoid contact with patients with psychiatric disorders in social contexts of varied intimacy. Social distance scales have been utilized in more than 100 studies internationally, including those that have been conducted under the auspices of the Global Programme against Stigma and Discrimination Because of Schizophrenia run by the World Psychiatric Association (WPA). The Greek site broadened the scale that was used in the WPA pilot studies in order to adjust and validate it in Greece. The extended version consisted of 14 items enquiring about social encounters of varied intimacy with a patient with schizophrenia and were rated on a 5-point Likert scale. Face to face interviews were conducted on a random and representative sample of the Greek general population. The results showed that the scale displayed good reliability and validity, with the principal component analysis revealing 3 underlying factors and thus providing evidence for the multifaceted nature of social distance. The first factor describes stable social relations of moderate intimacy with long duration and consistency in contact; the second factor concerns more close relations which necessitate feelings of trust and a sense of security during the contact with the patient; and the third factor aggregates items describing transient relations of limited intimacy. The investigation of associations between socio-demographic variables and the three factors of the scale constitutes the next step in this process of standardization and validation of the scale in Greece.