Cross-Country Variation in the Stigmatization of People with Schizophrenia

The stigmatization of people with schizophrenia is widespread and its consequences are often severe. However, despite the apparent ubiquity of schizophrenia stigmatization, there is extensive variation in its form and intensity between countries. This dissertation addresses the question of what can explain these cross-country differences. One major strain of research has focused on the role of culturally available understandings of mental illness. A large and influential subset of this work, most often done in Europe and America, focuses on how biogenetic and psychosocial understandings of illness differ in their stigma consequences. Studies of this type that connect mental illness-related beliefs and experiences to stigma take individuals as their unit of analysis. Their conclusions help explain why a given person might have a more stigmatizing view of a someone with schizophrenia than do others. This is turn might shed some light on why countries have differing average levels of stigma: it might be because beliefs or other individual characteristics that lead to higher stigma scores are more prevalent in one country than in another. However, there are almost certainly a variety of supra-individual reasons for why countries exhibit variation in severity of schizophrenia stigmatization. Unfortunately, theories regarding personal beliefs about illness allow for limited consideration of how macro-level social phenomena are implicated, a problem which has repeatedly been observed by scholars. To explore reasons for variations in schizophrenia stigma intensity from country to country, this dissertation proceeds in three parts. First, I address the gaps in existing knowledge about the individual-level relationships between illness beliefs and stigmatization of people with schizophrenia. Using these results, I consider the explanatory value of individual-level characteristics in explaining why countries’ levels of public stigma differ from each other. Finally, I turn away from individual-level characteristics to consider how and why the structure of countries’ economies (specifically, the relative availability of self-employed work) is related to stigma intensity. I illustrate that the explanatory power of this characteristic outweighs those of all individual-level characteristics considered