title: Public stigma in health and non-healthcare students: attributions, emotions and willingness to help with adolescent self-harm.
abstract: BACKGROUND
  For people who self-harm, there is growing evidence to suggest that services and treatment outcomes can be adversely affected by healthcare staffs' stigmatising attitudes and behaviours. To date, the empirical literature has tended to focus on the attitudes of experienced healthcare professionals working with adults who self-harm. Additionally, there has been few theory or model-driven studies to help identify what healthcare students think and feel about young people who self-harm.
  
  
  OBJECTIVE
  The aim of the present study was to explore the way healthcare and non-healthcare students think and feel about adolescent self-harm behaviour using Corrigan et al.'s [Corrigan, P.W., Markowitz, F.E., Watson, A., Rowan, D., Kubiak, M.A., 2003. An attribution model of public discrimination towards people with mental illness. Journal of Health and Social Behaviour 44, 162-179] attribution model of public discrimination towards people with mental illness.
  
  
  METHODS
  The study was a questionnaire-based, cross-sectional, survey that consisted of two hypothetical vignettes.
  
  
  METHODS
  Two universities in England, United Kingdom.
  
  
  METHODS
  One hundred and eighty-four final-year students, covering health (medicine, nursing, clinical psychology) and non-health care (physics) professions.
  
  
  METHODS
  Students were presented with vignettes describing a young female who self-harms. Attributions of controllability were experimentally manipulated across the vignette conditions and students were asked to complete self-report questionnaires measuring attitudes towards self-harm, familiarity with self-harm and social desirability.
  
  
  RESULTS
  Consistent with the public discrimination model, students who believed that a young person was responsible for their self-harm reported higher feelings of anger towards them. Anger, in turn, was associated with a belief in the manipulatory nature of the self-harm and with less willingness to help. Perceived risk was found to be associated with higher levels of anxiety and increased support for the use of coercive and segregatory strategies to manage self-harming behaviour. Gender and student type were important influences on public stigma, with both men and medical students reporting more negative attitudes towards self-harm.
  
  
  CONCLUSIONS
  This study provides evidence that a number of factors may adversely affect the care and treatment received by young people who self-harm, namely: students' causal attributions, the gender and profession of healthcare students, and familiarity with self-harm behaviour. To improve the effectiveness of service provision and treatment outcomes for people who self-harm, it is important that health care service providers and teaching institutions consider the implications of these factors when developing staff and services, and base interventions on theoretical models of stigma and discrimination.
authors.affiliation: School of Psychology, University of Birmingham, Edgbaston B15 2TT, UK.
authors.forename: G Urquhart
authors.initials: GU
authors.lastname: Law
authors.forename: H
authors.initials: H
authors.lastname: Rostill-Brookes
authors.forename: D
authors.initials: D
authors.lastname: Goodman
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D000786:Anger; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D004739:England; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006379:Helping Behavior; D006801:Humans; D008297:Male; D015404:Nursing Methodology Research; D011639:Public Opinion; D016728:Self-Injurious Behavior / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology; D012944:Social Support; D018709:Statistics, Nonparametric; D013240:Stereotyping; D013334:Students / Q000523:psychology*; D013336:Students, Health Occupations / Q000523:psychology*; D011795:Surveys and Questionnaires; D014495:Universities; D055815:Young Adult