Measuring Beliefs and Norms About Persons With Mental Illness

Study Overview
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Brief Summary
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Survey experiment to estimate drivers of mental illness stigma

Detailed Description
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Despite significant advances in scientific understanding of brain and substance use disorders accompanied by significant advances in treatment and improvements in prognosis, mental illness remains highly stigmatized throughout the world. Previous studies suggest that portraying mental illness as treatable can reduce negative attitudes toward persons with mental illness. This randomized controlled trial compares the effects of exposing study participants to vignettes portraying persons with untreated and symptomatic mental illness vs. treated mental illness with complete response vs. treated mental illness with relapse. It is hypothesized, based on prior work, that study participants exposed to vignettes depicting treated mental illness with completed response would have the greatest effect on reducing negative attitudes toward persons with mental illness, followed by treated mental illness with relapse and untreated and symptomatic mental illness.

Official Title
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Measuring Beliefs and Norms About Persons With Mental Illness in Rural Uganda: A Randomized Survey Experiment

Conditions
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Mental Illness, Schizophrenia, Bipolar Disorder, Depression

Intervention / Treatment
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* Other: Survey questionnaire


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: all persons who considered Nyakabare Parish their primary place of residence and who were capable of providing consent Exclusion Criteria: minors younger than 18 years of age, with the exception of emancipated minors persons who did not consider Nyakabare their primary place of residence, e.g., persons who happened to be visiting Nyakabare at the time of the survey or who owned a home in Nyakabare but spent most of their time outside the parish persons with whom research staff could not communicate, e.g., due to deafness, mutism, or aphasia persons with psychosis, neurological damage, acute intoxication, or other cognitive impairment (all of which were determined informally in the field by non-clinical research staff in consultation with a supervisor)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: V1: Control<br>This version of the survey questionnaire depicts a young woman with no symptoms of mental illness. | |
| Experimental: V2: Schizophrenia<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with untreated and symptomatic schizophrenia. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|
| Experimental: V3: Schizophrenia + Tx with Response<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with schizophrenia, successfully treated with complete response. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|
| Experimental: V4: Schizophrenia + Tx with Relapse<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with schizophrenia, successfully treated with partial relapse. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|
| Experimental: Version 5: Bipolar<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with untreated and symptomatic bipolar disorder. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|
| Experimental: V6: Bipolar + Tx with Response<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with bipolar disorder, successfully treated with complete response. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|
| Experimental: V7: Bipolar + Tx with Relapse<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with bipolar disorder, successfully treated with partial relapse. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|
| Experimental: V8: Depression<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with untreated and symptomatic major depressive disorder. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|
| Experimental: V9: Depression + Tx with Response<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with major depressive disorder, successfully treated with complete response. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|
| Experimental: V10: Depression + Tx with Relapse<br>As this is a survey experiment, the intervention involves random assignment to a survey questionnaire with specific wording. This version of the survey questionnaire depicts a young woman with major depressive disorder, successfully treated with partial relapse. | Other: Survey questionnaire<br>* Each version of the questionnaire portrays a young Ugandan woman with different profiles of illness severity, treatment, and treatment response.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Social Distance | Willingness to have the woman portrayed in the vignette to marry into the study participant's family (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) | 
| Perceived Norms about Social Distance | Study participant's perception of the extent to which other people would be willing to have the woman portrayed in the vignette to marry into their families (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) | 
| Negative Attitudes (Attribution) | Personal belief that the symptoms of the woman portrayed in the vignette represent divine punishment (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) | 
| Perceived Norms about Negative Attitudes (Attribution) | Study participant's perception of the extent to which other people believe that the symptoms of the woman portrayed in the vignette represent divine punishment (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) | 
| Negative Attitudes (Shame) | Personal belief that the symptoms of the woman portrayed in the vignette bring shame upon her family | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) | 
| Perceived Norms about Negative Attitudes (Shame) | Study participant's perception of the extent to which other people believe that the symptoms of the woman portrayed in the vignette bring shame upon her family (single item culturally adapted instrument developed specifically for this study) | Immediate (assessed with respect to the study participant's beliefs at a single time point, which is the time at which the survey is administered) |