Understanding familiarity: intimacy’s role in public stigma towards mental illness

Abstract

Background: The negative impact and barriers caused by mental health stigma are substantial, therefore understanding the context and underlying mechanisms that perpetuate stigma is crucial. Originally thought to be a linear relationship, Corrigan and Nieweglowski (2019) have proposed a U-shaped model to understand the effects of familiarity on stigma. However, research and empirical support for the suggested model is limited. Additionally, familiarity has predominantly been explored in terms of the type of relationship and overall closeness determined by relationship type. A potentially more accurate representation and understanding of the degree of familiarity could be examining the direct level of intimacy within an individual’s relationship. Objective: The present study aimed to explore whether the relationship between familiarity (in terms of intimacy) and public stigma is better fit by a linear model or a quadratic model. Additionally, this study examined the impact of personal mental illness on the relationship between public and self-stigma. Method: Participants (n = 523) completed a demographic questionnaire and three public stigma measures. Individuals who identified knowing someone with mental illness were assessed on the degree of intimacy within that relationship. Participants that identified as having a mental illness themselves completed a self-stigma questionnaire. Results: Across all three public stigma measures, a linear model better fit the relationship between intimacy and public stigma. The addition of a quadratic term did not significantly improve the fit. In the sub-group with lived experience (n = 227), similar results emerged. Exploratory analysis showed significant associations between public and self-stigma and intimacy was positively correlated with self-stigma. Discussion: Our findings did not support the quadratic model, but they did highlight the potential protective role intimacy may play in reducing stigma. However, increased intimacy may heighten internalized stigma for those with lived experiences suggesting the need for more targeted stigma-related interventions.