Academic journal article Asian Social Science

Dependence on Cultural Contexts of the Factors Influencing Social Acceptance toward Schizophrenia: Evidence from Comparative Study between Japan and Vietnam

Academic journal article Asian Social Science

Dependence on Cultural Contexts of the Factors Influencing Social Acceptance toward Schizophrenia: Evidence from Comparative Study between Japan and Vietnam

Article excerpt


This paper explores the factors influencing social acceptance toward persons with schizophrenia by examining the effects of perceived dangerousness, having knowledge, and social instability and investigates these conditions in a cross-cultural comparison of Japan and Vietnam. Social distance scales and random sample survey questionnaires based on vignettes were used to reconstruct social acceptance in Japan (n = 488) and Ho Chi Minh City in Vietnam (n = 185). Structural equation modeling was applied to explore the relation between social acceptance, perceived dangerousness, beliefs in Western psychiatric treatments, contact with people with schizophrenia, and cohorts having grown up during the Vietnam War.

In both countries, contact reduced the perceived dangerousness of persons with schizophrenia and increased their social acceptance. Beliefs in Western psychiatric treatments informed by education-based knowledge, however, intensified perceived dangerousness in Japan, but increased social acceptance in Vietnam. The effects of education-based knowledge emerge differently according to each society's mental health system history. The Vietnamese cohort born during the Vietnam War showed greater social acceptance than others, while no effects were observed in Japanese cohorts. Social instability seems to change social values and negative social attitudes related to schizophrenia.

Keywords: Asian countries, cross-cultural study, schizophrenia, social acceptance, sociology, structural equation modeling

1. Introduction

1.1 The Importance of Social Acceptance

Social attitudes toward persons with mental health problems are closely linked to political decisions and mental health service policies. After psychiatry emerged in Western Europe as a medical domain, the confinement of "patients" to psychiatric wards in the name of protecting the public was enforced. In recent years, most developed countries have tried shifting mental health services "from institutionalization to deinstitutionalization," including financial aspects and the human rights of patients. During this political transition, medical professionals, politicians, and the public need to reconsider why people with chronic mental disorders have been penned in psychiatric wards and how they can change such stigmatizing attitudes toward them. To create an environment that allows people with chronic mental disorders and the public to coexist and lead satisfying lives, it is essential to understand how the public presently regards living in the same community with them.

In this paper, I define public view of living with people having chronic mental disorders as social attitudes. A great deal of research has been conducted measuring social attitudes, especially in psychiatric epidemiology. These studies indicated the following three characteristics of social attitudes: (a) persons with schizophrenia are the most stigmatized and less expected to live and socialize in communities with others compared to those with other mental health problems (Durand-Zaleski, Scott, Rouillon, & Leboyer, 2012; Griffiths et al., 2006; Lauber, Nordt, Falcato, & Rössler, 2004); (b) the perceived dangerousness of persons with mental health problems is a primordial factor leading to negative social attitudes and stereotypes, particularly related to schizophrenia (Angermeyer, 2003; Durand-Zaleski et al., 2012); (c) social attitudes and the degree of tolerance toward people with schizophrenia orients the outcomes of their disorder (Warner, 1994). Additionally, people with schizophrenia feel that they experience prejudice related to their perceived dangerousness (González-Torres, Oraa, Arístegui, Fernández-Rivas, & Guimon, 2007). As a result, patients living in communities tend to avoid having intimate relationships or stop themselves from applying for work opportunities for fear of being discriminated (Uçok et al., 2012). Exclusion, which leads to a decline in the quality of life of deinstitutionalized patients, has been one of the greatest obstacles in promoting their social inclusion. …

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