title: Causal beliefs of the public and social acceptance of persons with mental illness: a comparative analysis of schizophrenia, depression and alcohol dependence.
abstract: BACKGROUND
  There is an ongoing debate whether biological illness explanations improve tolerance towards persons with mental illness or not. Several theoretical models have been proposed to predict the relationship between causal beliefs and social acceptance. This study uses path models to compare different theoretical predictions regarding attitudes towards persons with schizophrenia, depression and alcohol dependence.
  
  
  METHODS
  In a representative population survey in Germany (n = 3642), we elicited agreement with belief in biogenetic causes, current stress and childhood adversities as causes of either disorder as described in an unlabelled case vignette. We further elicited potentially mediating attitudes related to different theories about the consequences of biogenetic causal beliefs (attribution theory: onset responsibility, offset responsibility; genetic essentialism: differentness, dangerousness; genetic optimism: treatability) and social acceptance. For each vignette condition, we calculated a multiple mediator path model containing all variables.
  
  
  RESULTS
  Biogenetic beliefs were associated with lower social acceptance in schizophrenia and depression, and with higher acceptance in alcohol dependence. In schizophrenia and depression, perceived differentness and dangerousness mediated the largest indirect effects, the consequences of biogenetic causal explanations thus being in accordance with the predictions of genetic essentialism. Psychosocial causal beliefs had differential effects: belief in current stress as a cause was associated with higher acceptance in schizophrenia, while belief in childhood adversities resulted in lower acceptance of a person with depression.
  
  
  CONCLUSIONS
  Biological causal explanations seem beneficial in alcohol dependence, but harmful in schizophrenia and depression. The negative correlates of believing in childhood adversities as a cause of depression merit further exploration.
authors.affiliation: Department of Psychiatry, Greifswald University, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Schomerus
authors.affiliation: Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Matschinger
authors.affiliation: Department of Public Health, University of Cagliari, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Angermeyer
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000523:psychology; D005858:Germany / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012929:Psychological Distance; D012559:Schizophrenia; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult