Schizophrenia in Turkish newspapers : retrospective scanning study

Schizophrenia on Turkish Twitter: an exploratory study investigating misuse, stigmatization and trivialization

PURPOSE

This study aims to investigate use and misuse of the word 'schizophrenia' and its derivatives to assess the prevalence of stigmatizing and trivializing attitudes and the meanings attributed to the condition on Turkish Twitter.

METHODS

Using R programming language, we collected Turkish Twitter posts containing the terms used for schizophrenia in Turkish through Twitter's Search API over a 47-day period between July and June 2019. After removing retweets, we randomly sampled 3000 tweets and manually categorized them in three dimensions: use type (metaphorical/non-metaphorical), topic and attitude. Qualitative analysis on representative tweets were performed and word frequencies were calculated.

RESULTS

In total 44,266 tweets were collected and after removing retweets, 24,529 tweets were obtained. Overwhelming majority of the tweets (91.7%) used the terms metaphorically and the majority displayed stigmatizing (68.3%) and trivializing (23%) attitudes. Politics was the most common topic (58.2%) followed by everyday/social chatter (28.5%). Only a small number of tweets were part of awareness campaigns (0.2%) or displayed a supportive attitude (0.8%). Terms were often used metaphorically in a stigmatizing manner as personal or political insults, while in everyday/social contexts, they were used in a trivializing manner to label eccentricity, oddness, overthinking and suspiciousness. Popularity and reach metrics show that these tweets were extensively retweeted, liked and reached millions of users.

CONCLUSION

This is the first study investigating attitudes towards schizophrenia on Turkish Twitter. Significantly higher rates of stigmatizing attitudes demonstrate the urgent need for public health and social awareness campaigns targeting stigma surrounding schizophrenia in Turkey.

The Ins and Outs of 'Schizophrenia': Considering Diagnostic Terms as Ordinary Linguistic Expressions

Diagnostic terms in psychiatry like 'schizophrenia' and 'bipolar disorder' are deeply contested in the professional community, by mental health activists and the public. In this paper, we provide a theoretical framework for considering diagnostic terms as ordinary linguistic expressions and illustrate this approach by a corpus linguistic analysis of 'schizophrenia.' Our aim is to show how a focus on language itself can inform current and future debates about psychiatric terminology and provide new insights on relevant processes concerning their actual usage and change over time. We hope that this contributes to enhancing mutual understanding between different discourse spheres and stakeholders.

An Exploratory Analysis of the Portrayal of Mental Illness in Qatar's Newspapers

BACKGROUND

Concerns have been raised about the role of the media influencing the public's understanding of mental illness.

AIM

This study explored the extent and nature of mental health coverage in Qatar's newspapers. A secondary aim was to compare the mental health-related coverage with that of diabetes.

METHODS

This was a retrospective quantitative and qualitative analysis of textual data published in Qatari newspapers. Quantitative descriptive analysis was employed to determine the extent of media coverage while qualitative content analysis was employed to examine the discourse tone and assess the stigmatization of the main messages on the text.

RESULTS

A total of 659 mental health-related articles were published; the main focus of the articles was on autism, depression, and non-pharmacological therapies for mental illness. Analysis of the retrieved articles revealed a predominantly informative content, with mostly non-stigmatizing tone except for non-national news that often linked mental illness with dangerousness or violence. A higher number of articles with mental health-related content than about diabetes were found.

CONCLUSION

Although the newspaper content analysis revealed mostly a non-stigmatizing tone in mental health reporting in newspapers, there is a need to increase representation of people with mental illness in print media, increase awareness of the diversity of treatments available, and increase more scientific reporting to raise mental health literacy in Qatar.

A retrospective examination of the content of violence in headlines of news related to individuals with mental disorders

BACKGROUND

Headlines are usually read first. Since headlines are designed to be remarkable and memorable in terms of form and meaning, their impact on the positive or negative attitudes of the society towards individuals with mental illness may be greater than the news texts.

AIMS

This study aimed to retrospectively examine and analyze the content of violence headlines related to people with mental disorders.

METHOD

The study was designed to examine headlines retrospectively. Six-hundred-ten headlines on the websites of four nationally published newspapers in Turkey were reviewed. Headlines mentioned people with mental disorders and violent events. The News Headline Review Form was used to evaluate the headlines. Descriptive statistics, the chi-square test and logistic regression analysis were used in data analysis.

RESULTS

It was determined that violent events in headlines were mostly associated with homicidal behaviors (72%; n = 439), self-harming behaviors (20.2%; n = 123) and exploitation by others (7.8%; n = 40), respectively. The most common actions in headlines were, within the homicidal behaviors, "murder" (30.4%; n = 186); within the self-harming behaviors, "commit suicide" (13.6%; n = 83) and within the exploitation-by-others category, "being murdered" (4.4%; n = 27). People with mental disorders were in an active position in three fourths of the headlines on violence/aggression (77.3%; n = 471).

CONCLUSION

Headlines have the effect of normalizing the relationship between violence and mental disorders, which already exists in society. Portraying violence as a typical part of a mental disorder could create social perceptions that it is the nature of these individuals to exhibit violent behavior.

Turkish newspaper articles mentioning people with mental illness: A retrospective study

BACKGROUND

Because a great majority of the public knows about mental disorders primarily through printed or visual media, the attitudes exhibited in mass media might be predictive in stigmatizing individuals with mental disorders.

AIM

The aim of this study was to retrospectively assess the articles in Turkish newspapers that mention individuals with mental disorders.

METHOD

This study was designed to retrospectively investigate and analyze newspaper content in Turkey; the newspapers' circulation information was collected by examining the websites of the four newspapers with above 1% of the total circulation. The News Evaluation Form was used to evaluate a sampling of articles that met the inclusion criteria of having appeared in the lifestyle and agenda pages of newspapers, and of using neutral or negative labeling keywords about psychiatric patients.

RESULTS

Almost all the articles reviewed were negative toward individuals with mental disorders. Three quarters of the reports were forensic, among which two thirds of the individuals with mental disorders were criminalized, and one third were victims of crime. In approximately half of the news reports, most images were related to the news and were not protected. Although not all the articles contain stigmatizing elements directed toward people with mental disorders, two thirds of the subjects' images in the news were found to have stigmatizing elements.

CONCLUSION

Media has an impact on attitudes toward people with mental disorders mostly negatively along with individual experiences and peer interactions.

Psychiatric framing affects positive but not negative schizotypy scores in psychology and medical students

When testing risk for psychosis, we regularly rely on self-report questionnaires. Yet, the more that people know about this condition, the more they might respond defensively, in particular with regard to the more salient positive symptom dimension. In two studies, we investigated whether framing provided by questionnaire instructions might modulate responses on self-reported positive and negative schizotypy. The O-LIFE (UK study) or SPQ (New Zealand study) questionnaire was framed in either a "psychiatric", "creativity", or "personality" (NZ only) context. We tested psychology students (without taught knowledge about psychosis) and medical students (with taught knowledge about psychosis; UK only). We observed framing effects in psychology students in both studies: positive schizotypy scores were lower after the psychiatric compared to the creativity instruction. However, schizotypy scores did not differ between the creativity and personality framing conditions, suggesting that the low scores with psychiatric framing reflect defensive responding. The same framing effect was also observed in medical students, despite their lower positive schizotypy scores overall. Negative schizotypy scores were not affected by framing in either study. These results highlight the need to reduce response biases when studying schizotypy, because these might blur schizotypy-behaviour relationships.

Analyzing the presentation and the stigma of schizophrenia in French newspapers

PURPOSE

It has been suggested that the stigmatizing presentation of people with schizophrenia by newspapers is an example of structural stigma. In this study, we explore how French newspapers contribute to the stigma of people with schizophrenia.

METHODS

All the articles of eight major newspapers (four national and four regional) that include the term schizophr* and that were published in 2015 were therefore analyzed using a coding scheme that we developed inductively.

RESULTS

This analysis showed that among the identified themes, 40.4% of the articles used the term schizophrenia metaphorically and 28.3% referred to dangerousness. The first concerned mostly national newspapers, while the second were mostly published by regional newspapers. A more selective analysis was also carried out on these major themes in order to investigate how the "us" against "them" distinction is created and how negative stereotypes are associated with this distinction. In the case of the metaphorical use of the term, schizophrenia was presented as a "split personality" disorder and the label used in order to devalue the political opposition. Schizophrenia was presented either as a deterministic cause of dangerousness or as a potential cause of crime. In either case, the question of control was clearly present in these articles.

CONCLUSIONS

These results are discussed in terms of the "us" against "them" distinction as a double process of stigmatization of people with schizophrenia and of reinforcement of one's own identity and security.

How the media cover mental illnesses: a review

Purpose

Mental illness has become an important public health issue in society, and media are the most common sources of information about mental illnesses. Thus, it is important to review research on mental illnesses and media. The purpose of this paper is to provide a narrative review of studies on mental illnesses in the media and identifies important research gaps.

Design/methodology/approach

A combination of searching key databases and examining reference lists of selected articles was used to identify relevant articles. In total, 41 empirical studies published in the last 12 years were reviewed.

Findings

The review found that substantial research had been done to investigate media portrayals of mental illnesses and the effects of such portrayals might have on the public. Media still portray mental illnesses negatively in general, which contributes to the ongoing mental illness stigmatization. Nonetheless, discussions of mental illnesses in direct-to-consumer advertisements and social media tend to be more objective and informative. These objective portrayals could help improve mental health literacy and reduce stigma. More importantly, media can also reduce the stigma if used strategically. Research has found that entertainment-education programs and web-based media have strong potential in reducing mental illness stigma. Recommendations for future research are also discussed.

Practical implications

Findings can guide future efforts to use media to educate the public about mental illnesses and reduce mental illness stigma.

Originality/value

This study reviews the most recent research on mental illnesses in the media and provides important references on the media representation of mental illnesses, media effects of such representation, and using media to reduce stigma.

Should the label "schizophrenia" be abandoned?

The term schizophrenia is increasingly contested by researchers, clinicians, patients and families. Mental health users and professionals around the world have started calling for a change of the name, seeing it as stigmatizing and harmful. This paper reviews the literature published so far on the issue of renaming schizophrenia, carefully weighing the pros and cons of the proposed changes. Forty seven papers have been published so far, encompassing editorials, research papers, commentaries to editorials, letters, forum papers and narrative reviews. The advantages of renaming schizophrenia far outweigh the disadvantages. It would reduce stigma and benefit communication between clinicians, patients and families. The most conservative option for renaming schizophrenia would be the use of eponyms since they are neutral and avoid adverse connotations. Renaming schizophrenia is not only a matter of semantics, but also an attempt to change the stigma carried by the present name. Nevertheless, a change will not be useful unless accompanied by parallel changes in legislation, services and the education of professionals and the public.

Comparing gendered and generic representations of mental illness in Canadian newspapers: an exploration of the chivalry hypothesis

PURPOSE

The 'chivalry hypothesis' posits that woman are treated more compassionately by the media when compared with men. To our knowledge, no research study has explored the chivalry hypothesis as applied to people with mental illness. As such, we set out to compare three types of newspaper articles, those that focus on (1) mental illness generically; (2) a woman with mental illness; and (3) a man with mental illness.

METHODS

We conducted a content analysis of 1,168 newspaper articles relating to mental health over 6 months. We obtained articles through media retrieval software using various search terms. We read and coded articles for the presence or absence of themes and content. Frequency counts and proportions were generated for each theme, which were compared across the three types of articles using Chi-square tests.

RESULTS

Generic articles were more positive than articles about individuals. They were significantly more likely to quote mental health experts, and have recovery, inadequate resources, and etiology as themes. Articles that depicted men were significantly more likely to have stigmatizing content and violence as themes. Articles depicting women were significantly more likely to quote mental health experts, discuss mental health interventions, and have recovery and inadequate resources as themes.

CONCLUSION

The findings lend some support to the chivalry hypothesis, in as much as articles about women were significantly more positive. Articles about men were significantly more negative, though this may be partially accounted for by elevated rates of violent crime in men. Generic articles were the most extensively well informed.

Reinforcing stigmatization: coverage of mental illness in Spanish newspapers

Because the media influences society's perceptions of reality, the treatment of mental illness in the news can have an effect on the societal stigma related to it. This study aimed to analyze the content and form of news items related to mental illness in Spanish newspapers in order to understand their role in propagating or attenuating stereotypes, prejudices, and stigma. The authors conducted a cross-sectional descriptive study on the basis of a review of news items related to mental illness appearing in the Spanish print media. A sample was taken from articles published on the subject in the 20 Spanish newspapers with the widest circulations over the course of the year 2010. Formal elements and content were analyzed by means of a structured evaluation system. The authors analyzed 695 news items. The content of 47.9% (n = 333) of the articles was not strictly related to mental illness, but rather clinical or psychiatric terms were used metaphorically, and frequently in a pejorative sense. The remaining 52.1% (n = 362) consisted of news items related specifically to mental illness. Of these, news items linking mental illness to danger were the most common (178 texts, 49.2%), specifically those associating mental illness with violent crime (130 texts, 35.9%) or a danger to others (126 texts, 34.8%). The results confirm the hypothesis that the press treats mental illness in a manner that encourages stigmatization. The authors appeal to the press's responsibility to society and advocate an active role in reducing the stigma towards mental illness.

Development of the PICMIN (picture of mental illness in newspapers): instrument to assess mental illness stigma in print media

PURPOSE

The aim of this paper is to report on the development and applicability of a standardised and objective measure of stigma of mental illness in print media. Picture of mental illness in newspapers (PICMIN) instrument consists of eleven descriptive and five analytical categories. It is intended to allow comparison among countries and different studies over time.

METHODS

The research team conducted a three-phase study to develop the instrument based on the principles of content analysis and test its inter-coder reliability (ICR). In the first phase, keyword search and ICR assessment was performed on articles from Croatia (75), Czech Republic (203), and Slovakia (172). The second phase consisted of instrument revision and training, along with ICR reassessment on 40 articles from USA and UK. In the third, main phase articles from Croatia (238), Czech Republic (226), and Slovakia (158) were analysed with the final version of the PICMIN instrument.

RESULTS

Across three countries, ICR was found acceptable to assess mental illness representations related to stigma in print media. Print media representations of the mental illness in Croatia, Czech Republic, and Slovakia significantly differed in the type of media distribution, whether headline of the article was positioned on the media cover, in the use of a sensationalistic style of writing, in the association of aggressive behaviour with persons with mental illness and in the distribution of the global impression of the headline.

CONCLUSIONS

PICMIN instrument allows comparison among countries and different studies over time.

Use of the terms "schizophrenia" and "schizophrenic" in the South Korean news media: a content analysis of newspapers and news programs in the last 10 years

OBJECTIVE

In this study, we explored the meaning attributed to the words "jungshinbunyeolbyung" (schizophrenia) and "jungshinbunyeol" (schizophrenic) in South Korean newspapers and news programs in the last 10 years.

METHODS

We screened the websites of three national newspapers and the broadcasts of three nationwide television news programs from January 1, 2001, to December 31, 2010. We classified a total of 490 articles and 257 news segments by category and quantitatively and qualitatively analyzed them. The articles and news segments were assigned to one of the following categories based on their use of the term "schizophrenia": 1) negative, 2) neutral or positive, 3) incidental, and 4) metaphorical.

RESULTS

The negative viewpoint accounted for 349 incidences (46.7%), while the neutral and positive viewpoints included 225 incidences (30.1%). Incidental uses accounted for 95 incidences (12.7%), and metaphorical uses accounted for 78 incidences (10.4%). The majority of the negative uses focused on violence or dangers posed by patients (137 mentions, 37.8%), while the metaphorical uses mainly focused on the idea of splitting (51 mentions, or 65%).

CONCLUSION

This study showed that the South Korean news media do not provide balanced information about schizophrenia to the public. This study also showed that no significant move has been made toward a more positive use of the term since a previous study was conducted on the subject. Although the term schizophrenia has given way to "attunement disorder," it will be difficult to establish the new term as the standard if the South Korean media continue to use the term "schizophrenic symptom." Even though the term has been changed, guidelines are necessary to encourage the mass media to provide balanced articles and reduce prejudice.

Stigma, schizophrenia and the media: exploring changes in the reporting of schizophrenia in major U.S. newspapers

Newspaper media are a major source of information about mental illness in the United States. Previous research has shown that some printed material has been both negative and stigmatizing, which can have a detrimental impact on individuals with mental illnesses. Such perceptions represented in the media may cause those with mental illnesses to internalize a negative and stigmatizing stereotype and hinder the public's understanding of mental illness. In recent years, advocacy groups have increased their efforts to combat stigmatization of those with mental illnesses. This study focused specifically on the use of stigmatizing language concerning schizophrenia in U.S. newspapers. Because advocacy to decrease stigmatization of mental illness has increased in recent years, this study compared media depictions of schizophrenia in 2000 and 2010 to determine if there had been a reduction in reporting of dangerousness and perpetration of crime by people with schizophrenia or in stigmatizing language. All articles published in five high-circulation newspapers from diverse urban geographical regions between January 1 and June 1 in 2000 and 2010 that contained the words "schizophrenia" or "schizophrenic" were reviewed. Articles were categorized under the categories of education, incidental reference, medical and pharmaceutical news, metaphorical use, charity, obituary, medically inappropriate, and human interest. Human interest articles were further subcategorized into advocacy, crimes committed by people with schizophrenia, crimes committed against those suffering from schizophrenia, and issues related to poor mental health care. There was a statistically significant decrease in reporting of crime committed by people with schizophrenia in 2010 compared with 2000. However, no significant difference was found in metaphorical usage of the terms schizophrenia and schizophrenic between 2000 and 2010.

Metaphoric and non-metaphoric use of the term "schizophrenia" in Italian newspapers

PURPOSE

This study examines how the term "schizophrenia" is used in Italian newspapers.

METHODS

The survey was carried out on the 22 Italian newspapers which allow word scanning on their online website. In each newspaper, the terms "schizophrenia" and "schizophrenic" were scanned in all articles, from January 1, 2008 to December 31, 2008. Each article containing these terms was analyzed in relation to metaphorical usage to describe or denigrate people or groups not diagnosed "schizophrenic" and in relation to non-metaphoric, direct descriptions of people using mental health services, or the illness itself.

RESULTS

"Schizophrenia/schizophrenic" was reported in 1,087 articles. It was used far more frequently as a metaphor (73.7%) than in reference to people actually given the diagnosis (19.2%) or to the disorder itself (7.1%). The 801 metaphoric uses were classified into the following categories: incoherence/contradiction/split (682, 85.1%), dangerousness/aggressiveness (34, 4.4%), and eccentricity/oddness (84, 10.5%). 117 out of 209 (55.9%) articles on people diagnosed with the disorder were in news section of which 57 (48.7%) referred to homicides, 17 (14.5%) to other assaults by the person, and 33 (28.2%) to assaults directed at the person.

CONCLUSIONS

These data confirm previous studies showing that the media disproportionately report negative stories about people diagnosed with "schizophrenia", and in particular, equate the diagnosis with violence. The study also demonstrates that the metaphorical use of the term to denigrate groups or individuals may be an equal or greater contributor to the stigma and prejudice experienced by people with this mental disorder.

The picture of mental health/illness in the printed media in three Central European countries

Even in the era of the Internet, printed media are still among the most frequently identified sources of mental health information. Many studies have shown that this information is frequently negative and contributes to stigmatization of people with mental illness. This international comparative study describes the content of media messages about mental health/illness in terms of stigma in three Central European countries. The study sample comprised all articles pertaining to the topic of mental health/illness (N = 450) identified during five week-long periods in 2007 chosen from the six most widely read newspapers and magazines in each country. The authors used content analysis methods to achieve quantitative and qualitative objectives. More than half of all articles contained negative statements reflecting stigma toward persons with mental illness. Substance abuse disorders are the most frequent mental conditions covered in all three countries (22%), and psychotic disorders are the most stigmatized. Countries significantly differ in length of articles, in the association of aggressive behavior with persons with mental illness, and in the use of a sensationalized style of writing. Coverage of mental health/illness issues differs to some extent across countries but is generally of poor quality. On the basis of the authors' findings, practical recommendations for journalists can be tailored specifically for each country.

A comprehensive systematic review on the perception and experience of stigma among people with schizophrenia

BACKGROUND

Research has shown that stigma associated with mental illness is pervasive in many countries. Schizophrenia is considered one of the most highly stigmatised psychiatric disorders due to an array of negative stereotypes associated with it. Stigma has deleterious consequences for people suffering a mental illness. A review on the subjective perception and experience of stigma may aid the development of effective anti-stigma programs and raise awareness of clinicians about the meaning of stigma for individuals in order to minimise harmful health outcomes.

OBJECTIVE

The overall objective of this systematic review was to determine perception and experience of stigma among people with schizophrenia.

INCLUSION CRITERIA

Types of participants Studies that included adults (18 years and over) diagnosed with any types of schizophrenia.Phenomena of interest Primary studies which explored the perception and experience of stigma among people with schizophrenia.Context Studies conducted in either inpatient, outpatient, or community settings and published in English.Types of studies Any interpretive studies and quantitative descriptive studies which explored the phenomena of interest.

SEARCH STRATEGY

The literature search sought published studies and papers. Electronic databases searched were: METHODOLOGICAL QUALITY: Qualitative and quantitative studies selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardised critical appraisal instruments from the JBI-SUMARI.

DATA EXTRACTION

Information was extracted by two independent reviewers from each paper using standardised JBI data extraction tools.

DATA SYNTHESIS

Meta-synthesis was carried out which resulted in eight synthesised findings. A narrative summary of the quantitative study findings is also presented.

RESULTS

Both qualitative and quantitative studies revealed similar findings, including negative attitudes, discrimination and lack of understanding from community, friends, colleagues, family members, as well as mental health professionals due to negative stereotypes and media portrayals. Self stigmatisation among individuals was revealed too.

CONCLUSION

Stigma affects important domains of individuals' lives, and is mainly due to a lack of knowledge and understanding of others towards people with schizophrenia. Self stigma, which contributes to negative self concept and perceptions, appears to be a prominent problem too.

IMPLICATIONS FOR PRACTICE

Education programs should be developed and targeted at various groups of people to enhance knowledge and understanding of mental illness. Additional legislation may be required to protect the rights of individuals. Media can help to disseminate accurate information to the public. Healthcare professionals have the responsibility to advocate for individuals, empower them in decision making, and understand the meaning and experience of stigma for individuals, in order to plan appropriate interventions to help them cope effectively.

IMPLICATIONS FOR RESEARCH

Further qualitative research investigating stigma could be conducted in different cultural settings. A systematic review on the association between stigma experiences and clinical or demographic characteristics may aid mental health professionals in recognising individuals at risk of the adverse effects of stigma. Periodic research in this area could evaluate the effectiveness of community-based educational programs or interventions introduced which combat stigma.