title: Public beliefs about and attitudes towards bipolar disorder: testing theory based models of stigma.
abstract: BACKGROUND
  Given the vast literature into public beliefs and attitudes towards schizophrenia and depression, there is paucity of research on attitudes towards bipolar disorder despite its similar prevalence to schizophrenia. This study explored public beliefs and attitudes towards bipolar disorder and examined the relationship between these different components of stigma.
  
  
  METHODS
  Using an online questionnaire distributed via email, social networking sites and public institutions, 753 members of the UK population were presented with a vignette depicting someone who met DSM-IV criteria for bipolar disorder. Causal beliefs, beliefs about prognosis, emotional reactions, stereotypes, and social distance were assessed in response to the vignette. Preacher and Hayes procedure for estimating direct and indirect effects of multiple mediators was used to examine the relationship between these components of stigma.
  
  
  RESULTS
  Bipolar disorder was primarily associated with positive beliefs and attitudes and elicited a relatively low desire for social distance. Fear partially mediated the relationship between stereotypes and social distance. Biomedical causal beliefs reduced desire for social distance by increasing compassion, whereas fate causal beliefs increased it through eliciting fear. Psychosocial causal beliefs had mixed effects.
  
  
  CONCLUSIONS
  The measurement of stigma using vignettes and self-report questionnaires has implications for ecological validity and participants may have been reluctant to reveal the true extent of their negative attitudes.
  
  
  CONCLUSIONS
  Dissemination of these findings to people with bipolar disorder has implications for the reduction of internalised stigma in this population. Anti-stigma campaigns should attend to causal beliefs, stereotypes and emotional reactions as these all play a vital role in discriminatory behaviour towards people with bipolar disorder.
authors.affiliation: Clinical, Educational and Health Psychology Research Department, University College London, 1-19 Torrington Place, London WC1E 7HB, UK. Electronic address: nell.ellison.10@ucl.ac.uk.
authors.forename: Nell
authors.initials: N
authors.lastname: Ellison
authors.affiliation: Clinical, Educational and Health Psychology Research Department, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
authors.forename: Oliver
authors.initials: O
authors.lastname: Mason
authors.affiliation: Clinical, Educational and Health Psychology Research Department, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
authors.forename: Katrina
authors.initials: K
authors.lastname: Scior
mesh_terms: D000328:Adult; D001714:Bipolar Disorder; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D012929:Psychological Distance; D011639:Public Opinion; D057566:Self Report; D057545:Social Stigma; D013240:Stereotyping; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Bipolar disorder; Causal beliefs; Cognitive reactions; Emotional reactions; Stereotypes; Stigma