Abstract: People with schizophrenia are stigmatized by the general public and it can have a negative effect on themselves. However, only few studies report the social representations shared by health professionals. Therefore, L. Bourgeois, C. Guilbaud & M. Hériaud investigate the stigmatization of schizophrenia by students in psychology and medical students in order to highlight their social representations. This research is based on Abric’s central core theory (1976). By collecting the social representations of these two groups of students, the authors were able to compare them. They established that the representations of schizophrenia are different between psychology students and medical students.
People with psychiatric illnesses face significant and persistent stigma in society. This stigma is based, on one hand, on the lack of knowledge about psychiatric illness in the general population, and on the other hand, on a negative social construct about psychiatric disorders. This study focuses on schizophrenia. Using the DSM-5 criteria, schizophrenia is a severe, chronic mental disorder characterized by disturbances in thoughts, perception and behaviour. Lampropoulos, Fonte and Apostolidis (2019), point out that the stigmatization of people with schizophrenia can have an impact on their ability to act independently (Corrigan, 1998), on their social and professional integration (Rebeiro Gruhl and al., 2012), or on their risk of mortality (Acosta and al., 2013).
Numerous studies highlight the effect of negative social representations of mental pathology on the patients themselves, linked in particular to the general public’s lack of knowledge of the pathology. However, few studies show the social representations shared by health professionals (doctor, nurse, psychiatrist, psychologist, etc.). A study conducted by Morant (1995) on social representations of mental illness among French and English healthcare professionals highlights the idea that there is not a single understanding of mental illness. Indeed, their social representations of mental illness appear to be complex and characterized by uncertainty and ambivalence. However, the notion of otherness, strongly present in studies about representations in the general public, is also found among French and British health professionals. The predominance of the feeling of otherness can be explained by the inability felt by health professionals to understand the way people with psychiatric pathology see the world. But this study also pinpoints the notion of similarity because of the common experiences that everyone can live.
In order to highlight social representations of schizophrenia in psychology students and in medical students, the authors have relied on Abric’s theory of the central core. This theory starts from the premise that all elements of the representation are not equally important. Some elements are essential, primary and others are secondary. Using the theory of the central core to study the social representations of schizophrenia among students in the health sector allows us to identify the central elements that are shared by the students according to their educational profile and to link these elements in order to understand the meaning of their representations.
The authors question the social representations of schizophrenia according to the type of knowledge by comparing first year medical students and first year psychology students, using the free association method. They assume that psychology students and medical students have different representations of schizophrenia. Medical students’ representation would be centered on the biology aspect of the illness whereas psychology students’ representation would be centered on the psychology aspect of the illness.
The authors collected their data through a free association questionnaire with the inductive word ‘schizophrenia’ and posted the questionnaire on the Internet. The sample of participants is made up of thirty-tree people including twenty psychology students and thirteen medical students. The sample is predominantly female, as twenty-nine respondents are women. Three out of four participants come from psychological education. In the instruction, participants were asked to give between five and eight words which represent schizophrenia for them and to associate each word with a plus sign or a minus sign whether they think it’s a positive or negative term.
The authors realized prototypical analysis that aims to identify the structure of the representations for each group by highlighting the important elements (box 1) and the elements considered ambiguous (boxes 2 and 3). The results reveal that psychology students perceive the schizophrenic as a crazy person who has hallucinations, behavioural problems and who hears voices. As for medical students, schizophrenia is a disease of the mind, the schizophrenic has multiple personalities, psychiatric problems and behavioural disorders.
In conclusion, the authors have shown that the social representations of schizophrenia are not the same according to the students’ educational sector even though they all come from the health sector. The psychology students’ representation of schizophrenia is about being crazy which is a prejudice whereas medical students’ representation is more about schizophrenia being a mental illness. It can be explained by the many theories and one of them is that in their first year in college, psychology students don’t study schizophrenia or any psychiatric disease, it only happens in their third year. So, they don’t have any objective knowledge about a schizophrenic person, only their thoughts and what they have heard or read on what it could be.
References:
Abric, J. (2005). La recherche du noyau central et de la zone muette des représentations sociales. Dans : Jean-Claude Abric éd., Méthodes d’étude des représentations sociales (pp. 59-80). Toulouse, France: ERES. https://doi.org/10.3917/eres.abric.2003.01.0059″
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Alington, VA: Author.
Morant, N. (1995). What is mental illness? : social representations of mental illness among British and French mental health professionals. Papers on social representations, 4(1), 41-52.
Vergès, P. (1994). Approche du noyau central : propriétés quantitatives et structurales. Dans C. Guimelli (Ed.). Structure et transformations des représentations sociales. Neuchâtel/Paris : Delachaux et Niestlé.