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000479882

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Short Report
Received: September 5, 2016
Accepted after revision: July 28, 2017
Published online: September 7, 2017
Psychopathology
DOI: 10.1159/000479882
Stereotype Knowledge and Endorsement
in Schizophrenia
Luigi Castelli a Francesca D’Alpaos a Luciana Carraro a Florencia Pavan a
Giovanni Galfano a Bruno Forti b
a
Dipartimento di Psicologia dello Sviluppo e della Socializzazione, Università di Padova, Padova, and b Unità Locale
Socio Sanitaria, Belluno, Italy
Abstract
Background: Social cognition is severely impaired in schizophrenia. Emotion processing, attributional biases, and theory of mind are often impaired, as well as the understanding
of shared social knowledge. So far, little is known about stereotype knowledge and endorsement in schizophrenia.
Sampling and Methods: White patients with schizophrenia
and matched healthy respondents reported both their personal beliefs and the predicted beliefs of other people toward Black (study 1) and Gypsy individuals (study 2). Results:
Results showed that respondents in the clinical sample displayed less stereotype endorsement as compared to the
matched healthy respondents. Most importantly, the contents of the responses provided by the 2 samples were
strongly overlapped. Conclusions: Findings indicate that individuals with schizophrenia tend to hold less negative attitudes toward stigmatized outgroups and, most notably,
that knowledge about culturally transmitted stereotypes is
relatively preserved in schizophrenia. Future research should
address the generalizability of the findings in relation to the
perception of other stigmatized social groups.
Introduction
Schizophrenia is a disabling illness that severely impacts all aspects of individual life. Cognitive functions are
compromised [1], but social cognition is also significantly altered [2, 3]. Several components of social cognition
appear to be impaired, including emotion processing, attributional biases, and theory of mind [4, 5]. In addition,
patients with schizophrenia often display an altered understanding of shared social knowledge, defined as the
“representational templates of social situations, or awareness of the roles, rules, expectations, and goals that govern
social situations” [5, p. 980; see also 6, 7]. Importantly,
social cognition comprises both the understanding of the
internal states of others during social interactions (e.g.,
emotions and intentions) as well as more declarative
knowledge about abstract rules and typical features associated with social groups [8; see also 9].
Recent evidence suggests that some aspects of social
(declarative) knowledge might be relatively intact in
schizophrenia. For instance, judgments provided by individuals with schizophrenia about the appropriateness of
social behaviors in relation to existing social norms do
not significantly differ from the judgments of healthy
control respondents [8]. It has been proposed that most
© 2017 S. Karger AG, Basel
© 2017 S. Karger AG, Basel
E-Mail karger@karger.com
www.karger.com/psp
Luigi Castelli
Dipartimento di Psicologia dello Sviluppo e della Socializzazione
Università degli Studi di Padova
Via Venezia 8, IT–35131 Padova (Italy)
E-Mail castelli.luigi @ unipd.it
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Keywords
Schizophrenia · Social cognition · Stereotypes
Table 1. Demographic and clinical information of participants
(study 1)
Schizophrenic Healthy
patients
controls
(n = 25)
(n = 25)
Mean age, years
Gender M/F
Mean education, years
Mean age at illness onset, years
Mean duration of illness, years
47.44 (9.13)
15/10
11.28 (3.32)
26.12 (4.40)
21.32 (8.50)
47.12 (9.64)
15/10
11.80 (2.98)
Standard deviations in parentheses.
theory of mind, children affected by this syndrome know
race and gender stereotypes just like healthy children
[16]. In line with this stream of research, we specifically
explored stereotype knowledge among patients with
schizophrenia. In study 1, we focused on the perception
of Black people among White individuals with schizophrenia and matched healthy respondents. Importantly,
we not only measured the overall level of stereotype endorsement, but we also specifically examined the content
of such representations in order to assess the overlap between the traits ascribed to the stigmatized outgroup by
respondents in the 2 samples.
Study 1
2
Psychopathology
DOI: 10.1159/000479882
Methods
Twenty-five White outpatient clinical participants were recruited (Table 1). Diagnosis of schizophrenia was made by a boardcertified attending research team of psychiatrists using the International Classification of Diseases (ICD-10) [17]. They were all
under antipsychotic medication treatment. Twenty-five White
healthy participants who perfectly matched the clinical sample in
terms of gender, age, and education were also recruited. They reported neither personal nor family history of psychiatric/neurological illness. The experiment was approved by the local ethics
committee, and participants provided an informed consent.
Participants were presented with 20 traits, pretested as being
either stereotypical (e.g., aggressive, lazy) or counterstereotypical
of Black immigrants in Italy [e.g., hard-working, educated; see 18],
and asked to indicate the percentage of Black immigrants they believed could be described by each trait. Next, the same traits were
presented with the request to guess the typical responses of people
living in their geographical area, in order to assess the perceived
level of stereotype endorsement in the population [19].
Results
As for stereotype endorsement, for each respondent 2
average scores were computed in relation to the stereotypical (i.e., the average of the percentage values that the
respondent provided for each of the 10 stereotypical
traits) and counterstereotypical traits (i.e., the average of
the percentage values that the respondent provided for
each of the 10 counterstereotypical traits) that were personally believed to be associated with Black immigrants.
The scores were analyzed through a 2 (trait: stereotypical
vs. counterstereotypical) × 2 (group: clinical sample vs.
healthy controls) ANOVA. A main effect of trait emerged,
F(1, 48) = 11.85, p < 0.001, η2p = 0.198, indicating that
stereotypical traits (mean = 60.25, SD = 16.61) were attributed more than counterstereotypical traits (mean =
44.90, SD = 21.3). The main effect of group was also significant, F(1, 48) = 5.408, p = 0.024, η2p = 0.101, indicating
Castelli/D’Alpaos/Carraro/Pavan/
Galfano/Forti
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people who develop schizophrenia acquire relevant social
knowledge before the illness onset, and this declarative
knowledge may be retained after that onset.
One important category of socially shared expectations about the characteristics and behaviors of others is
given by stereotypes, namely the set of features ascribed
to members of social groups [10, 11]. Thus far, research
has mainly examined stereotype knowledge in schizophrenia in relation to one specific context, namely the
perception that patients with schizophrenia hold about
their own group. Research evidence indicates that participants with schizophrenia are aware that their group is
stigmatized and perceived as lacking social competence
[12; see also 13]. Individuals with schizophrenia thus appear to have a relatively accurate representation about
how they are perceived by people around them, at least in
relation to the domain of social functioning. However, it
is not yet clear whether the representation of other stigmatized social groups is preserved in schizophrenia. On
the one hand, it may be predicted that deficits in social
knowledge extend to the mental image about the stereotypical characteristics of other groups. On the other hand,
because stereotypical representations are acquired very
early in life [14] and are very resistant to change [10], they
might be relatively unaltered in patients with schizophrenia. One relevant study provides preliminary evidence
that stereotypes impact social judgments of patients with
schizophrenia to a similar extent as compared to healthy
control respondents [15]. In particular, the authors found
that social knowledge, such as the speaker occupation stereotype, was also used by patients with schizophrenia in
order to understand the likely ironic intent of the speaker.
It is interesting to note that research on other mental disorders showed, for instance, that although autism is associated with severe impairments in social cognition and
Stereotypes in Schizophrenia
Table 2. Demographic and clinical information of participants
(study 2)
Schizophrenic Healthy
patients
controls
(n = 18)
(n = 18)
Mean age, years
Gender M/F
Mean education, years
Mean age at illness onset, years
Mean duration of illness, years
43.06 (8.37)
11/9
12.28 (4.06)
31.83 (8.47)
11.22 (6.46)
43.06 (8.37)
11/9
12.28 (4.06)
Standard deviations in parentheses.
tized target group of Black immigrants. In study 2 we carried out a conceptual replication focusing on the perception of another stigmatized group, namely the group of
Gypsies.
Study 2
Methods
Eighteen outpatient clinical participants with a diagnosis of
schizophrenia (ICD-10) [17] were recruited (Table 2). They were
all under antipsychotic medication treatment. Healthy participants (n = 18) had no personal or family history of psychiatric/
neurological illness and perfectly matched the clinical sample in
terms of gender, age, and education. None of the participants in
the 2 groups had taken part in study 1.
Participants were presented with 11 negative stereotypical (e.g.,
criminal, lazy) and 6 positive stereotypical (e.g., musical, close to
one’s family) traits about Gypsies. The same questions as used in
study 1 were administered. In addition, participants were presented with a 8.6-cm continuum from “very positive” to “very negative” and asked to report both their personal attitude and the predicted attitude of people living in their geographical area.
Results
The personal attribution of traits was analyzed through
a 2 (trait: positive vs. negative) × 2 (group: clinical sample
vs. healthy controls) ANOVA. The main effect of group
was not significant, F(1, 34) = 2.949, p = 0.09, η2p = 0.08,
but an inspection of the means indicated that healthy
controls tended to attribute more stereotypical traits than
participants in the clinical sample. This tendency was
more evident in the case of negative, t(34) = 1.877, p =
0.069, than positive stereotypical traits, p > 0.72, although
in no case did a significant effect emerge.
As for the predicted responses of people in general, a
2 × 2 ANOVA yielded a significant main effect of the vaPsychopathology
DOI: 10.1159/000479882
3
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that, overall, patients with schizophrenia attributed more
traits. Most importantly, a significant 2-way interaction
emerged, F(1, 48) = 9.05, p = 0.004, η2p = 0.159, indicating
that stereotypical traits were more likely attributed by
healthy respondents than by people with schizophrenia
(means = 64.22 and 56.28, SDs = 15.55 and 16.98, respectively), whereas the opposite occurred for counterstereotypical traits (means = 35.45 and 54.34, SDs = 16.34 and
21.75).
A 2 × 2 ANOVA on the predicted responses of people
in general yielded similar findings. The main effect of
trait, F(1, 48) = 47.82, p < 0.001, η2p = 0.499, showed that
it was believed that stereotypical traits (mean = 67.34,
SD = 19.03) would be attributed to a greater extent as
compared to counterstereotypical traits (mean = 37.90,
SD = 21.03). The main effect of group was also significant,
F(1, 48) = 4.688, p = 0.035, η2p = 0.089, indicating that
people with schizophrenia believed that others would attribute more traits in general. These 2 main effects were
qualified by a significant 2-way interaction, F(1, 48) =
17.61, p < 0.001, η2p = 0.268, demonstrating that respondents with schizophrenia, as compared to healthy respondents, considered stereotypical traits to be less likely attributed (means = 61.35 and 73.33, SDs = 21.64 and 14.00,
respectively), whereas the opposite occurred for counterstereotypical traits (means = 49.78 and 26.03, SDs = 22.06
and 11.09). Overall, respondents with schizophrenia
showed a reduced personal endorsement of stereotypical
views and a belief about a more limited endorsement of
stereotypes in the general population.
Finally, for each sample of respondents we separately
calculated the mean level of personal attribution for each
of the 20 traits (i.e., the average percentage of group members who are perceived as being characterized by each
specific trait). Similar scores were computed in relation
to the predicted attribution of traits. As for personal attributions, the responses provided by individuals with
schizophrenia and healthy controls were significantly
correlated, r(20) = 0.581, p = 0.007, and the overall pattern
was the same for both stereotypical, r(10) = 0.619, p =
0.06, and counterstereotypical traits, r(10) = 0.810, p =
0.004, although it was not significant in the case of stereotypical traits. As for the predicted attribution of traits, a
significant correlation emerged when considering the responses about all traits, r(20) = 0.758, p < 0.001, as well as
when stereotypical, r(10) = 0.730, p = 0.017, and counterstereotypical traits, r(10) = 0.894, p < 0.001, were separately analyzed. The strong overlap between the responses provided by the 2 samples demonstrated that they
shared largely similar representations about the stigma-
Discussion
In the last 2 decades there has been a flourishing research about social cognition in schizophrenia and about
how dysfunctions in this domain contribute to the relevant interpersonal problems that are characteristic of
schizophrenia [5, 20]. However, social knowledge in
schizophrenia has been so far relatively understudied,
and, in particular, few empirical studies have addressed
the expectations about the typical characteristics of members of other stigmatized social groups (i.e., stereotypes).
The present studies, although based on a limited number
of participants, consistently indicated that respondents
with schizophrenia tend to have an overall lower level of
stereotype endorsement towards stigmatized outgroups
as compared to healthy respondents. Research with nonclinical samples suggests that the perception of being stigmatized and discriminated is often associated with more
4
Psychopathology
DOI: 10.1159/000479882
negative attitudes towards other minorities in different
domains. For instance, perceived racial discrimination
leads to stronger biases towards sexual minorities [21]
whereas the perception of being a target of sexism enhances racial biases [22]. Interestingly, individuals with
schizophrenia, even though they are severely stigmatized,
did not show any increased outgroup derogation and, in
contrast, they were less prone to attribute stereotypical
features to both Black and Gypsy individuals as compared
to healthy respondents.
Most importantly, this pattern cannot be attributed to
reduced stereotype knowledge, as correlational analyses
from both studies showed a very strong overlap between
the contents of the stereotypical representations displayed by respondents with schizophrenia and healthy
controls. In sum, patients with schizophrenia and healthy
controls displayed very similar perceptions about the relative typicality of the presented traits. The present findings are strongly in line with those reported by Champagne-Lavau and Charest [15], who found that patients
with schizophrenia and healthy control respondents were
equally sensitive to social stereotypes in the domain of
professional occupations. Overall, this is consistent with
the idea that individuals with schizophrenia have a relatively intact knowledge about socially shared stereotypes.
Overall, the obtained pattern of findings supports the
conclusion that, as in the case of autism [16], social knowledge about culturally transmitted stereotypes may be less
compromised in schizophrenia as compared to other facets of social cognition.
As discussed before, social cognition is a multifaceted
construct that comprises both the understanding of the
mental states of others in a given social context as well as
more declarative knowledge about abstract rules and the
typical characteristics that are associated with others as a
function of their group membership [8, 11]. Importantly,
both aspects are critical to social functioning. For instance, according to prevalent models of social perception [11, 23] the early activation of stereotypes represents
the basic process that sets the background for all the subsequent stages of impression formation and social interaction. The present and previous findings [15] suggest
that individuals with schizophrenia hold the same stereotypical knowledge and expectations as healthy individuals, and likely rely on them in their daily life marked by
multiple interactions with other people belonging to a variety of different social groups. A notable limitation of the
present studies is that participants were asked to provide
rather abstract judgments about the estimated prevalence
of stereotypical and counterstereotypical traits in the tarCastelli/D’Alpaos/Carraro/Pavan/
Galfano/Forti
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lence of the trait, F(1, 34) = 27.08, p < 0.001, η2p = 0.44,
demonstrating that negative traits were expected to be
more likely attributed (mean = 76.40, SD = 18.87) as compared to positive traits (mean = 47.56, SD = 21.86). No
other effect was significant (all p values >0.13).
As in study 1, for each sample of respondents we separately calculated the mean level of personal attribution for
each trait. Similar scores were computed in relation to the
predicted attribution of traits. As for personal attributions, the responses provided by respondents in the 2
samples were significantly correlated, r(17) = 0.661, p <
0.005, and the pattern was the same for both negative,
r(11) = 0.608, p < 0.05, and positive stereotypical traits,
r(6) = 0.845, p < 0.05. As for the predicted attribution of
traits, a significant correlation emerged when considering
the responses about all traits, r(17) = 0.898, p < 0.001.
More specifically, the correlation was significant in the
case of negative traits, r(11) = 0.691, p < 0.05, but not for
positive traits, p = 0.57.
The analysis on responses to the attitude continuum
showed that healthy controls reported a more negative
attitude toward Gipsy individuals as compared to participants in the clinical group, t(33) = 2.087, p < 0.05
(means = 6.18 and 4.40, SDs = 2.27 and 2.21, respectively). No difference emerged in relation to the predicted
responses of people in general along the same continuum,
p > 0.46, suggesting that the aforementioned difference in
the reported personal attitudes is unlikely to simply reflect a difference in the way in which participants in the 2
groups used the response scale.
get groups. Future studies will have to further explore the
role of those stereotypical representations while people
with schizophrenia are engaged in social interactions
with members of stigmatized groups [24]. This would enable to more closely explore how declarative knowledge
about the perceived typical characteristics of social groups
contributes to shape the attribution of mental states to
interaction partners.
Disclosure Statement
There is no conflict of interest declared.
Author Contributions
Conceived the studies: L.Cas., L.Car., F.D., F.P., G.G., B.F.; collected the data: F.D., F.P.; analyzed the data: L.Cas., F.D., F.P.;
wrote the paper: L.Cas., L.Car., F.D., G.G.
Acknowledgement
The present research was financially supported by the Italian
Ministry of Education, University, and Research (Futuro in Ricerca, 2012 grant RBFR128CR6).
References
Stereotypes in Schizophrenia
8 Langdon R, Connors MH, Connaughton E:
Social cognition and social judgment in
schizophrenia. Schizophr Res Cogn 2014; 1:
171–174.
9 Ochsner KN: The social-emotional processing stream: five core constructs and their
translational potential for schizophrenia and
beyond. Biol Psychiatry 2008;64:48–61.
10 Hilton JL, von Hippel W: Stereotypes. Annu
Rev Psychol 1996;47:237–271.
11 Macrae CN, Bodenhausen GV: Social cognition: thinking categorically about others.
Annu Rev Psychol 2000;51:93–120.
12 Henry JD, von Hippel C, Shapiro L: Stereotype threat contributes to social difficulties in
people with schizophrenia. Br J Clin Psychol
2010;49:31–41.
13 Rüsch N, Corrigan PW, Todd AR, Bodenhausen GV: Implicit self-stigma in people with
mental illness. J Nerv Ment Dis 2010; 198:
150–153.
14 Aboud FE: Children and Prejudice. New
York, Blackwell, 1988.
15 Champagne-Lavau M, Charest A: Theory of
mind and context processing in schizophrenia: the role of social knowledge. Front Psychiatry 2015;6:98.
16 Hirschfeld L, Bartmess E, White S, Frith U:
Can autistic children predict behavior by social stereotypes? Curr Biol 2007;17:R451–452.
17 World Health Organization: The ICD-10
Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic
Guidelines. Geneva, World Health Organization, 1992.
Psychopathology
DOI: 10.1159/000479882
18 Castelli L, Vanzetto K, Sherman SJ, Arcuri L:
The explicit and implicit perception of ingroup members who use stereotypes: blatant
rejection but subtle conformity. J Exp Soc
Psychol 2001;37:419–426.
19 Stangor C, Sechrist GB, Jost JT: Changing racial beliefs by providing consensus information. Pers Soc Psychol B 2001;27:484–494.
20 Roberts DL, Penn DL: Social Cognition in
Schizophrenia: From Evidence to Treatment.
New York, Oxford University Press, 2012.
21 Craig MA, Richeson JA: Discrimination divides across identity dimensions: perceived
racism reduces support for gay rights and increases anti-gay bias. J Exp Soc Psychol 2014;
55:169–174.
22 Craig MA, DeHart T, Richeson JA, Fiedorowicz L: Do unto others as others have done
unto you? Perceiving sexism influences women’s evaluations of stigmatized racial groups.
Pers Soc Psychol B 2012;38:1107–1119.
23 Fiske ST, Neuberg SL: A continuum of impression formation, from category-based to
individuating process: influences of information and motivation on attention and interpretation. Adv Exp Soc Psychol 1990;23:1–73.
24 Billeke P, Aboitiz F: Social cognition in
schizophrenia: from social stimuli processing
to social engagement. Front Psychiatry 2013;
4:4.
5
Downloaded by:
Florida State University
34.195.88.230 - 10/28/2017 8:29:02 PM
1 Nuechterlein KH, Barch DM, Gold JM, Goldberg TE, Green MF, Heaton RK: Identification of separable cognitive factors in schizophrenia. Schizophr Res 2004;72:29–39.
2 Green MF, Horan WP: Social cognition in
schizophrenia. Curr Dir Psychol Sci 2010;19:
243–248.
3 Penn DL, Sanna LJ, Roberts DL: Social cognition in schizophrenia: an overview. Schizophr
Bull 2008;34:408–411.
4 Green MF, Bearden CE, Cannon TD, Fiske
AP, Helleman GS, Horan WP, Kee K, Kern
RS, Lee J, Sergi MJ, Subotnik KL, Sugar CA,
Ventura J, Yee CM, Nuechterlein KH: Social
cognition in schizophrenia. 1. Performance
across phases of illness. Schizophr Bull 2012;
38:854–864.
5 Savla GN, Vella L, Armstrong CC, Penn DL,
Twamley EW: Deficits in domains of social
cognition in schizophrenia: a meta-analysis of
the empirical evidence. Schizophr Bull 2013;
39:979–992.
6 Addington J, Piskulic D: Social cognition and
functional outcome are separate domains in
schizophrenia. Schizophr Res 2011; 127: 262–
263.
7 Upthergrove R, Oyebode F, George M, Haque
MS: Insight, social knowledge and working
memory in schizophrenia. Psychopathology
2002;35:341–346.
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