Immediate and Delayed Effects of Imagined Contact with an Individual with Schizophrenia on Mental Illness Stigma and Interaction Quality

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Mental illness stigma is pervasive and has detrimental consequences for those experiencing various mental illness diagnoses (Crisp, Gelder, Rix, Meltzer, & Rowlands, 2000). Among mental illnesses, schizophrenia elicits uniquely strong negative biases (Angermeyer & Dietrich, 2006). One particularly effective mental illness stigma reduction strategy is the “contact hypothesis,” which postulates that face-to-face contact with an outgroup member will reduce intergroup anxiety (i.e., the emotional discomfort caused by contact with an outgroup member), and will encourage future intergroup interaction (Allport, 1954). As with many stigmatized conditions, individuals with schizophrenia tend to conceal their disorder (Smart & Wegner, 2000), which makes interaction between the general public and people with schizophrenia difficult to facilitate. To remedy this problem, researchers have shown that even imagining a face-to-face encounter with an outgroup member could have benefits that are on par with direct, face-to-face contact (Giacobbe, Stukas, & Farhall, 2013; Turner, Crisp, and Lambert, 2007). The effects of imagined contact as a means to change negative attitudes, emotional reactions, behavioral intentions, and behaviors have been tested immediately following the imagined contact intervention, however, the delayed effects (tested at 1 week following the intervention) have yet to be substantiated.

The present research investigated the impact of imagined contact as a tool to reduce schizophrenia stigma among college students both immediately following the imagined contact (Immediate Version) and one week after (Delayed Version). In the imagined contact with schizophrenia group (experimental condition), participants listened to a recording which asked them to imagine a pleasant interaction with an individual with schizophrenia. The control group listened to a recording which asked them to imagine a pleasant interaction with an individual with no diagnosis. In the study, participants filled out self-report measures of attitudes, perception of dangerousness, and affect toward individuals with schizophrenia in a pretest survey and after the imagined contact task. Additionally, as behavioral measures, participants were asked to set up chairs in anticipation of a conversation with an individual with schizophrenia so that desired distance could be measured, as well as have a brief conversation with an individual they were told had schizophrenia. The longevity of the potential benefits from imagined contact were assessed by having about half of the participants in both the control and experimental conditions complete these measures immediately following the imagined contact intervention and about half complete the measures one week following the imagined contact.

It was hypothesized that participants in the experimental group of both the immediate and delayed versions of the experiment would have a significant decrease in all the measures that reflect stigma toward individuals with schizophrenia and would perceive a higher interaction quality in the experimental conversation task, whereas the control group would remain stable. Instead, the present research failed to replicate previous research in the immediate version, and the delayed version had a similar pattern. The one exception to this pattern was that imagined contact was shown to improve perceived quality of the interaction from the perspective of the participant in the immediate version, however this effect did not hold true for participants in the delayed version of the experiment. Thus, the present study raises questions regarding the efficacy of imagined contact as an effective means to reduce mental illness stigma and in doing so underscores the value of replicating findings before extending investigations to new areas.


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Hofstra University
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Participants Participants were recruited from the undergraduate human subjects pool at a midsize private liberal arts institute in suburban New York based on their responses to an online screening survey. The present research excluded students who scored in the bottom 10 percent on the three preliminary self-report stigma scales, indicating that they endorsed few or no stigma attitudes toward individuals with schizophrenia. Additionally, potential participants were excluded if they indicated that they themselves, a family member, or close friend had a diagnosis of schizophrenia, as their association with the disorder is likely different than that of the general public. The total sample included 107 participants. Some participants were excluded from portions of the analyses if data was unavailable. [...]

Design A between subjects, two conditions (imagined contact with an individual with schizophrenia vs. control contact condition) x two times (immediate stigma testing vs. delayed stigma testing) design was employed in this study.

Imagined contact condition. Participants listened to a recording which guided them to imagine a 10-minute interaction with an individual with either schizophrenia (experimental condition) or no diagnosis (control group).

Time (following intervention). Participants were either tested for schizophrenia stigma immediately following the imagined contact intervention (Immediate condition) or tested one week [...] after the intervention [...]. Participants were randomly assigned to one of four conditions [...]: 1) Experimental-immediate: Imagined contact of interacting with an individual with a diagnosis script followed by self-report measures and interaction task (described below) immediately after. 2) Control-immediate: Imagined contact of interacting with an individual without a diagnosis of schizophrenia script followed by self-report measures and interaction task immediately after. 3) Experimental-delayed: Imagined contact of interacting with an individual with a diagnosis of schizophrenia script followed by self-report measures and interaction task 5-9 days after having engaged in the imagined task. 4) Control-delayed: Imagined contact of interacting with an individual with no diagnosis script followed by self-report measures and interaction task 5-9 days after imagined task.

Social distance. Social distance was measured by the Social Distance Scale. This is a 10-item scale used to measure willingness to engage with an individual belonging to an outgroup in a number of social domains such as professional [...], personal [...], and romantic [...].

Perceived dangerousness. The Perceived Dangerousness of Individuals with Schizophrenia Scale was used to assess participant’s belief that individuals with schizophrenia are dangerous. The scale consists of 8 statements that describe sentiments one may hold in response to dangerous individuals. [...]

Affective reaction. Participant’s predicted affective reaction toward encountering individuals with schizophrenia was measured by the Affective Reaction Scale. The scale assesses ten pairs of emotional terms, such as fearful - confident, irritable - patient, supportive - resentful. Participants rated their predicted affective reactions on a 7-point scale with 1 being the positive emotional extreme, 7 being the negative emotional extreme, with 4, being neutral. [...]

Behavioral Dependent Measure

Chair distance. [...] The participant was asked to set up two chairs in preparation for a conversation between him or herself and the individual they believed had a diagnosis of schizophrenia. Distance between the two chairs is measured in centimeters upon completion of the session. [...]

Measures of Interaction Quality

Self-report interaction quality. Following the conversation task, participants and confederate each rated how much they agree with the following statements on a 7-point Likert scale ranging from 1 (completely disagree) to 7 (completely agree): 1) I enjoyed the conversation 2) I would not like to see this person on campus ever again (reverse scored) 3) I found the individual to be interesting 4) I was frightened to be in the room with that individual (reverse scored) 5) I found the conversation uncomfortable (reversed scored). [...]

Non-verbal behaviors reflective of interaction quality. Unbeknownst to the participant, a hidden camera was placed in the room where the participant and confederate’s interaction took place. Ratings of the first two minutes of the videos by an independent judge were used to determine the quality of interaction between the confederate and the participant. Specifically, the judge rated quality as demonstrated by nonverbal behaviors of 1) eye contact, 2) nodding, and 3) laughing. [...]


Potential participants were recruited from the participant pool comprised of undergraduate students enrolled in Introduction to Psychology courses at Hofstra University. [...] Participants who met the study criteria described earlier were randomly assigned to one of four experimental conditions [...].

Imagined contact task. [...] Participants sat in a comfortable chair in a quiet room and were asked to take a moment to clear their minds and try to bring their attention to the present moment. The experimenter then said [Verbal Stimulus A].

Experimental condition. Participants who were in the experimental condition (both immediate and delayed, N=51) listened to the script recorded by the experimenter about having a pleasant, enjoyable, and relaxed conversation with an individual who has been diagnosed with schizophrenia. [...]

Control condition. The 56 participants who were randomly assigned to the control group (both immediate and delayed) listened to a similar script which differed only in that the imagined conversation partner described had been recruited to the study due to his work in the IT department and was doing a project for the Psychology department. [...]

Assessment of stigma. The effects of the imagined contact on schizophrenia stigma were tested either immediately following the imagined contact task (immediate version) or at a separate session one week (+/- two days) following the imagined contact task (delayed version). [...] Participants were given the three stigma survey measures described above which were identical to those completed during the prescreen survey. [...]

Type of Prejudice/Bias