Stigmatization of Mental Health in a Managerial Environment. Statistical Analysis and Evaluation

Master's Thesis, 2021

71 Pages, Grade: 17/20


Table of Contents



Relevance for Research

Aims and Scope
I Definition of Mental Health and Illness
II The Role of Society in Mental Illness Stigma
III Impact of Mental illness Stigma at Work
IV Models Explaining Stigma
V Body and Mind Gap
VI The Case of the COVID19- Pandemic and its Relation to Mental Health/Stigma
VII Reduction of Stigma
VIII Conclusion Based on Theory

I Participants
II Materials
III Scales used within the Questionnaire



I Summary of Key Findings
II Interpretation of the Results
III Most Relevant Findings and their Managerial Implications
IV Potential Limitations
V Future Research





Title of Thesis: Statistical Analysis and Evaluation of Stigmatization in a Managerial Environment

Author: Nadja Büngers

The concept of mental health is not accepted universally in our society and, accordingly, does not enjoy the same attention as physical health. People suffering from a mental illness not only have to cope with their symptoms, they face prejudices, wrong stereotypes and stigma regularly. Hence, one intention should be to set an end to stigma, also within the working context. Especially during the ongoing Covid19-pandemic our health and the well-being of the people we care about is a matter of daily concern. The threat to our physical health is immense; nevertheless, due to lockdowns, minimization of social contacts and recommendations to stay home, we are further reminded that a good health itself is characterized not only by physical health, but also by our mental health. The aim of this dissertation is to clarify the process of stigma of mental illnesses and create awareness about it as understanding the concept of stigma is a prerequisite to decide on strategies for its reduction. The findings of this study illustrate that stigma is impacted by the causal attribution of illness; humans tend to make more stigmatizing judgments when an illness is a mental illness that is attributed to mind compared to an illness that is physical and attributed to the body. Furthermore, this research found that mere information about mental illness issues is not a sufficient way to reduce stigma which leads to the proposal of seminars and workshops within a managerial context to educate employees about stigma and reduce it.

Keywords: Mental Health; Mental Illness Stigma; Stigma; Stigma in a managerial context; Trait attribution; Strategies to end stigma.

O conceito de saúde mental nao é universal mente aceite na nossa sociedade e, consequentemente, nao goza da mesma atençao que a saúde física. As pessoas que sofrem de uma doença mental nao só têm de lidar com os seus sintomas, como também enfrentam o estigma. Assim, uma das intençoes deveria ser pôr fim ao estigma, também dentro do contexto de trabalho. Especialmente durante a actual pandemia de Covid19, a nossa saúde e bem-estar das pessoas de quem cuidamos é uma questao de preocupaçao diária. A ameaça à nossa saúde física é imensa; devido aos bloqueios e minimizaçao dos contactos sociais, somos ainda recordados de que uma boa saúde em si é caracterizada nao só pela saúde física mas também pela nossa saúde mental. O objectivo desta dissertaçao é esclarecer o processo de estigma das doenças mentais e criar consciência sobre o mesmo, pois a compreensao do conceito de estigma é um pré-requisito para decidir sobre estratégias para a sua reduçao. As conclusoes deste estudo ilustram que o estigma é afectado pela atribuiçao causal da doença; os seres humanos tendem a fazer julgamentos mais estigmatizantes quando uma doença mental é atribuída à mente em comparaçao com uma doença física e atribuída ao corpo. Além disso, esta investigaçao descobriu que a mera informaçao sobre questoes de doença mental é uma forma insuficiente de reduzir o estigma, levando à proposta de seminários e workshops num contexto de gestao para educar os funcionários sobre o estigma e reduzi-lo.

Palavras-chave: Saúde mental; Estigma de doença mental; Estigma; Estigma num contexto de gestao; Atribuiçao de traços; Estratégiaspara acabar com o estigma.


First of all, I would like to thank my parents for supporting me in every journey I plan and for giving me the opportunity to study at Católica University in Lisbon. It has always, and will always, mean a lot to me and I know that they will always be behind me giving me a huge security and support for every idea I have.

A special thank you goes to my brother who I consider as my biggest idol. He always supports me when I have already struggled in believing the impossible.

Furthermore, I would like to every one of my friends who supported me in the work that was created in this thesis, without the support of friends and colleagues this work would not have been the same.

I would also like to express my sincere gratitude to Professor Sofia Jacinto. Her knowledge and valuable insights into psychology and business inspired me throughout this process, alongside with her dedication, motivation and exceptional guidance.


“The single most important barrier to overcome in the community is the stigma and associated discrimination towards persons suffering from mental and behavioural disorders.” - The World Health Organisation (2001, p. 98)

Background and Problem Statement

More than 792 million people worldwide suffered from a mental illness in 2017. Specifically, anxiety disorder with 284 million and depression with 264 million patients mark the two most common mental conditions globally (Statista, 2017). Especially, these two mental illnesses have been found to be increasing due to the Covid-19 pandemic - 2020, 54 million more people than in 2019 suffered from a depressive disorder while there were 76 million more than in 2019 facing an anxiety disorder according to a study conducted by the Lancet in 2020. The study further alludes, the countries that had the highest numbers of Covid-19 patients also reflected the strongest increase of mental illnesses in their population (The Lancet Study, 2020). The numbers are considered as alarming, in part because available solutions are far from sufficient. This is especially troubling when taking into account the fact that people are not undergoing the treatment for mental illnesses offered and improved for them. Personal barriers and system-level barriers are potential reasons for this. Personal reasons for avoiding treatment could be poor mental health literacy or the conviction that treatment as such does not help. System barriers on the other hand include long waiting times for treatment therapies, financial struggle or insurance issues (Corrigan et al., 2014). All these negative reasons are further impacted in a negative way by stigma. Stigma does not only work as an impediment for treatment, but it also creates an additional burden for mentally ill individuals (Corrigan, 2006). Symptoms of a mental illness, if intense and untreated, may be associated with high psychological, and sometimes physical suffering which impacts the overall life quality, including social and work contexts. In addition, mental illnesses lead to negative social reactions due to the mentioned stigmatization which happens in various forms and makes life even more difficult for the affected (Corrigan, 2000). The beginnings of stigma research are traced back to Goffman, who was one of the first persons to state that patients with mental disorders do not only face the actual symptoms but also wrong prejudices, judgements, and treatment of others due to the overall stigmatization of psychological conditions (Goffman, 1963).

Relevance for Research

Generally speaking, stigma is a challenge for today's society and is especially difficult for those who suffer from a mental illness. Nevertheless, people with a mental condition strive for a normal everyday life and often pursue a job where they are treated in a normal manner, without being stigmatized. In order to make things more convenient for them to follow their intention, a societal shift is required in order to eliminate stigma. This is not limited to the responsibility of international- or national institutions to adapt new policies and regulations for more protection towards people who suffer from mental illness. However, the issue of stigma is also a managerial problem, implying the responsibility of the employer and every employee to reflect and correct possible stigmatizing behavior. The current working culture in most companies is required to change to a working culture in which mentally ill people are fully accepted. For this it is important for the employer to understand the concept of stigma and how it evolves in the workplace as well as within the overall working culture of a company. Once this precondition is fulfilled, the employer is able to start introducing measures that lead to more awareness and peoples' understanding of the topic, ultimately followed by the reduction of stigma. One reason for writing this thesis is the clarification of this specific topic: Establishing an in-depth understanding of the concept of stigma and raising the awareness about it.

Another reason for this research is to close the existing knowledge gap regarding stigma in the world of business compared to the extensive research that has been done in relation to stigmatization in the field of psychology. This connection will be established throughout this thesis and the problem will be elaborated from the perspective of a business environment.

Aims and Scope

This dissertation takes part in the research focused on better understanding stigma towards mental illnesses and possible ways to change the current, rather negatively characterized situation people with a mental illness are in. Firstly, the intention is to explore the impact of the level of awareness about mental illnesses on stigmatizing behaviour. Secondly, the impact of causal attribution of illnesses, namely when it is attributed to the body or the mind, on stigmatization will be researched. Following an experimental paradigm, in the present study participants were asked to share their evaluations on fictitious employees who were described to them in a managerial context.

The focus of this dissertation lies on stigma of mental illnesses, with a specific focus on the managerial and working environment. The overall research will allow the reader to better understand judgments about how a person's personal traits and working competence are evaluated given different conditions. Stigma will be measured in this thesis with social distance scales and the evaluation and prediction of the working performance in the given scenarios. Therefore, this thesis will answer the following research questions:

Research Question 1: Are levels of stigma of mental illness prevalent in the work environment?

Research Question 2: How does the level of awareness of mental illness influence stigmatizing behaviour?

Research Question 3: Has the Covid-19 pandemic an impact on stigma and if so, how?

Research Question 4: How does causal attribution of symptoms of illnesses affect perceptions about others and stigmatizing reactions in a managerial context?


Hypothesis 1

Individuals with a direct level of awareness make fewer stigmatizing responses when they are confronted with an illness that is attributed to mind compared to being introduced to an illness attributed to the body. The effect of level of awareness on stigmatizing responses therefore depends on the effect of causal attribution.

Hypothesis 2

Direct and indirect level of awareness about mental illness leads to less stigmatizing judgements and responses than an absent level of awareness.

Hypothesis 3

Individuals make more stigmatizing judgements towards a person suffering from a mental illness, being attributed to the mind, compared to a person that endures a physical illness that is attributed to body.

Dissertation Outline

This dissertation is divided into six chapters. The current chapter introduces the topic of mental illness stigma, the background and the problem statement, the aim and scope of this study and lastly, the relevance. In chapter two the existing literature review and possible theories for stigma are explained. The following chapter three states the methodology that was used to collect the required data for the study. The chapter is again divided into a detailed description of the participants of the survey, the materials and the procedure, the method, and the design. Afterwards, results are described in chapter four, followed by an extensive discussion about the impact of these results, their limitations, impact for the managerial context, and recommendations for future research. Finally, the most prominent results are summarized in the conclusion.

Literature Review

This chapter alludes general theories and studies with respect to mental illness and its stigma out of the psychological field. After the general definitions of mental health and mental illness, the term stigma as such is explained and different explanatory approaches are presented. Afterwards, the Social Attribution Model as proposed by Corrigan is examined, followed by the explanation of the Attribution Theory of Weiner. In the end of this chapter, cases of different stigma as well as the reason for them and strategies to reduce stigma are outlined.

I Definition of Mental Health and Illness

The research at hand focuses on stigma, specifically stigmatizing judgements towards individuals with a mental illness in a managerial context. The examination of the literature regarding mental illness stigma requires clarification of the concepts of mental health and mental illness. The World Health Organization (WHO) defines mental health as part of someone's overall well-being and highlights that this does not solely imply an absence of mental illness. However, besides the absence of mental illness, a mentally healthy person, according to the WHO, is presumed to be able to realize his or her abilities and to cope with stress on a normal level. Furthermore, a person with a good mental health has the capability to be productive and creates a contribution in any form to his or her community (WHO, 2018).

Mental illness, on the other hand, is defined as a health condition which impacts the human mind and impedes overall brain functions (Corrigan et al., 2014). A mental illness can lead to changes in one's identity and modifications in the perception of “self” (Malla & Garcia, 2015). Following the definition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) mental illness is characterized by a dysregulation within the mind or brain leading to either distress or a disruption of a person's function in everyday life (American Psychiatric Association, 2013).

Given the above definitions, it can be concluded that mental health is not considered as the direct opposite of mental illness. Although a person may experience peaks of suffering or has contextual lower performance associated to a lower emotional or cognitive ability, this person can still be considered healthy and capable when he or she gives a relevant and adequate contribution. Subsequently, someone who has no mental illness can still have a low level of mental health (Keyes, 2005). Keyes created a model in his study, claiming that mental health and mental illness are not opposite ends on a single continuum. However, they should rather be considered on a two continua model, in which mental health is viewed as a complete state and not only the absence of a mental illness (Keyes, 2005). Mental health and mental illness are related, however, they both indicate different amplitudes: While mental health implies the presence or absence of mental health, mental illness alludes presence or absence of mental illness (Wersterhoff & Keyes 2010). To sum it up, people who are affected by a mental illness can still have a good degree of mental health and therefore belong, by the definition of the WHO, to the ones being mentally healthy, as they fulfill the presumed conditions. However, despite the fact that people with mental illness are still capable to successfully conduct tasks, stigma is highly pervasive in our society (Follmer & Jones, 2017), also including the work and managerial contexts. Hence, the need arises to investigate the reasons for stigma and the conditions in which stigma responses are reduced at work, which will be done in the following.

Definition and Models of Stigma

The origin of the word ‘stigma' is traced back to the Greek and expresses; ‘a mark of shame' or ‘discredit or a sign' (Merriam-Webster Dictionary, 2021). Stigmatizing behavior towards people with mental illness is characterized by multifaceted behaviors (Penn & Martin, 1998) and exists towards various visible- (different skin color) as well as invisible­traits (sexuality or mental illness with symptoms being not as clear as other forms of attributes). This dissertation will focus on the stigma of the latter - mental illness.

Public Stigma and Self-Stigma

A distinction is made between two types of stigma, namely public stigma and self­stigma. Public stigma is defined as stigma that is endorsed by the public towards a stigmatized group. Self-stigma exists when the person who belongs to this stigmatized group starts to internalize the critics made from outside (Corrigan et al., 2014). With this process the people affected by stigma start to adapt the claims made from the external environment in the evaluation of themselves (Fung et al., 2009). Public stigma takes on various forms, for instance, people who suffer from a mental illness are often disadvantaged when it comes to housing search or employment processes compared to people without a mental illness (Corbière et al. 2011). The consequences of self-stigma can be observed when people who are faced by stigma in their environment start to stigmatize themselves. They decrease their self-esteem and their overall confidence levels in themselves are negatively influenced (Corrigan & Rao, 2012). Perhaps, the most drastic consequence of self-stigma, is the reduction of the intention and the behavior to seek help (Corrigan & Rao, 2012). This can lead to isolation and symptoms aggravation as well as, in the worst cases, to situations in which people commit suicide. Despite improvements in psychotherapy, people do not want to identify themselves as someone being mentally ill and thus, big parts of the now available treatment to heal psychological illnesses is not used due to stigma (Corrigan et al.,2014).

II The Role of Society in Mental Illness Stigma

On an overall societal level, the concepts of mental health and mental illness have not yet reached full acceptance and mental illness is still associated with increased levels of stigma. This lack of acceptance is, in part, sustained by media content that presents misconceptions about mentally ill people. In the media mentally ill are often times illustrated as dangerous, unpredictable people someone should be afraid of (Rössler, 2016). From a medical and psychological point of view significant improvements in the treatment of mental illnesses can be observed. Additionally, from an overall political perspective, there are improvements: Governments are assigning higher budgets for the mental health sector and more institutions are recognizing the importance of mental health and its awareness (The Lancet, 2020). For instance, the United Nations mentioned mental health as one of its sustainable development goals (Sustainable Goals UN, 2015) and the new elected German regime included a new paragraph for mental health in its new coalition agreement in 2021(Coalition Agreement SPD, 90 Alliance/Greens & FDP, 2021). All in all, the shift to a society becoming more aware of mental illnesses and existent stigma has been initiated, however, much has still to be understood and adapted.

III Impact of Mental Illness Stigma at Work

Studies prove that people with depression are impacted positively from regular work as their general health increases, their self-esteem becomes stronger (Gold et al., 2014) and they obtain more structure in their everyday life (Boot et al., 2015). Furthermore, mentally ill people who work frequently, have the feeling of a purpose in life and engage more often in the enhancing of social contacts (Boot et al., 2015). However, stigma overweighs many of these positive aspects as it presents an important barrier to find and keep work for individuals with mental illnesses (Brohan et. al, 2014) (Scheid, 1998). Stigma reactions happening at work can be categorized as public stigma which, for instance, can be observed when employers hesitate to hire persons who revealed their mental illness (Corrigan, 2004). An American study found that within 117 companies, 68% of those hired persons from minority groups, 41% employed persons with a general medical illness, however, only 33% of the questioned businesses were fine with hiring persons suffering from mental illnesses (Scheid, 1998). A further study found that the overall attitude towards people with mental illness was that people who suffer from a physical disability have an easier process to find work than those who suffer from a mental illness like schizophrenia, learning disability or depression. The study stated a significant difference in employers' opinion to hire people with mental illnesses compared to those who had physical illnesses existed (Zissi et. al, 2007). Within the daily working context, mentally ill individuals face the loss of credibility and generally speaking, they are not given much responsibility regarding working tasks (Brohan et al., 2012). In 2010, the costs for mental health were estimated to around USD 2.5 trillion worldwide due to low productivity or absentness. This number is expected to rise to approximately 6.0 trillion USD by 2030 (The Lancet, 2020). These numbers are alarming and further highlight a reason for people being reluctant to be honest and open about their mental illness as they are afraid of not being hired or stigmatized (The Lancet, 2020).

IV Models Explaining Stigma

Three models explain the origin of stigma, namely the sociological-, the motivational­, and the cognitive model. The sociological model takes the sociocultural perspective and alludes uneven social structures as the reason for stigma. The motivational model indicates basic psychological needs as the origin of stigma whereas the cognitive model examines that the reason for stigma is the result of how people process information. Within this model, the attention lies on the thinking process and how humans make categorizations and generalizations about others (Corrigan et al., 2004). The focus of this dissertation is placed on the explanation of social cognitive models.

Social Attribution Model

A generic social cognitive model of the process of stigma within an individual's thought-process is presented in the following. It illustrates the relationship between stigma signals, stereotypes and the resulting discrimination (Corrigan, 2000). The overall process is defined by an observed signal leading to a certain stereotype, which then ends in stigmatizing behavior.

Signals. Signals are the starting point of the thought-process and function as a trigger for a person to refer to a stereotype within one's mind. Examples for signals are labels, symptoms, skill deficits, and appearances (Penn & Martin, 1998). Firstly, the label of a mental illness by itself or the assumption of a label in some cases is sufficient as a signal leading to stereotypes. More specifically, it is possible that the mere observation of a person walking out of a psychological clinic implies a signal leading to stigma. Moreover, a study showed that individuals were stigmatized even though they did not show any abnormal symptoms, however, the label as such was enough to stigmatize them (Link, 1987). Another signal that accelerates negative stigmatizing behavior are actual symptoms observed. Studies have shown that irregularities in language, poor social skills or signals in body language lead to stigmatizing behaviors (Corrigan, 2000). The last possibility of a signal is appearance, meaning physical attractiveness and personal hygiene that can be considered as indicators of mental illness leading to stigmatizing behaviors (Corrigan, 2000).

Stereotypes. As soon as signals have been observed or recognized, these trigger stereotypes that add meaning to them. Stereotypes are defined as cognitive structures humans have in their minds and they influence the perception people take (Corrigan, 2000). These are created and developed through certain events and emotions. A stereotype as such does not directly lead to stigmatizing behavior. The person can still decide to act upon this stereotype or not. Typical stereotypes of people that are mentally ill are dangerous, mentally ill are inferior to healthy people or seen as unfortunate due to their condition (Coehen & Sturening, 1962).

Behavior. The last element of the cognitive model is the actual behavior. The behavior, in case of stigma is discrimination and is the end result of the observation of a signal and the action upon a negative stereotype by a person. This discrimination is categorized as stigma, more specifically public stigma (Corrigan, 2000).

Attribution Theory

The human brain always tries to find and use methods to work as efficient as possible when it comes to decision-making. Once a method has been found, decisions and judgments are made using a short-cut, also referred to as heuristics, instead of thinking completely rational (Marewski et al., 2010). This process mainly happens unconsciously and often times leads to biases. However, humans can also reflect rationally on their behavior, and are able to correct their behaviors. The Attribution theory, proposed by Fritz Heider in 1958, first formulated in 1972 by Bernard Weiner, further proves this process of human thinking. Individuals, according to this theory, aim to analyze and find causal connections of events that happen. Hereby, they are able to explain the situation and can name reasons for why certain things happened (Weiner, 1985). Consequently, once a causal link to a situation has been established, thought patterns, beliefs and stereotypes are created that are stored in the brain and can be retrieved at any time in the future. Important to note, is the overall outcome of attributions: Attributions are neither based upon factual assumptions nor are they from an objective perspective; they represent a subjective evaluation of the observer of the situation. Moreover, humans tend to neglect circumstances of situations and the overall picture of what happened. This bias is called correspondence bias, also known as fundamental attribution error (Gilbert & Malone, 1995). The correspondence bias can be traced back to the fact that once trait inferences are developed, they are revised automatically and used in a very spontaneous way. It is not easy to revert these as they function as a kind of habit in human brains. Overall, the Attribution Theory clarifies the process underlying stigma. Additionally, it gives explanations to why differences are prevalent when it comes to the causal attribution of an illness which will be elaborated in the following.

V Body and Mind Gap

In relation to illnesses, the construct of controllability was found as an attribution that impacts the perceptions people have (Corrigan, 2000). Controllability refers to the ill person's responsibility to his or her disease. Here, a distinction is drawn between onset and offset responsibility. Onset responsibility defines the responsibility of the sick person for having the illness. Offset responsibility is the responsibility of the person for the course and the maintenance of that condition, meaning how the person is coping with the illness and how much effort is given to change the situation. The aspect of controllability leads to the causal attribution and gives clarification about why humans seem to have higher stigma towards someone who has a mental illness compared to someone with a physical illness. When studying causal attribution, there are dispositional attributions and situational attributions. Dispositional attributions are caused by the person affected, whereas situational attributions are the outcome of something that happened in the environment of this person, also categorized as external causes (Ramachandran, 2012). The first group of attributions is considered as controllable, whereas the second group is categorized as uncontrollable. Based on research, mental illnesses generally received more negative reactions than physical illnesses (Crandall & Moriarity, 1995). A reason for this is the opinion of people that mental illness is more controllable, as it involves the mind, implying dispositional attributions since it is within oneself, than physical illnesses that is mainly caused by external factors. All in all, it can be concluded that due to humans' willingness to find an attribution to every event, they are at risk to make an attribution error. Humans tend to have higher stigma towards an illness which is considered to be controllable.

Examples for stigma towards people with physically illness

It is important to recognize that besides stigma towards mentally ill, stigmatizing responses also occur for physical illnesses conditions. This is also traced back to the attribution theory and the aspect of controllability. Studies show that people who have HIV or lung cancer are often viewed as being responsible for the onset of their illnesses and they are stigmatized based on this assumption (Dunn et al., 2016) (Miller et al., 2007). The same is applicable for people who suffer from obesity with the difference that besides onset responsibility, also offset responsibility is considered high and people therefore make stigmatizing evaluations. This is due to the fact that body weight is seen as controllable. Often, obesity is associated with laziness and irresponsibility even though the context of the situation of why the person is obese is not known (Stangl et al., 2019).

VI The case of the COVID19- pandemic and its relation to Mental Health/Stigma

Since the beginning of the Covid-19 pandemic lives of humans all over the world have been impacted dramatically. This impact is not solely attributable to the risk of being infected or the virus itself but to the negative consequences in form of economic crises, the fear of a possible collapse of the health system, social isolation, and the overall mental health conditions that are developed by individuals when facing the current situation. Besides the negative mental impacts there were also positive effects as the Covid-19 pandemic accelerated the awareness about the importance of mental health and the awareness about mental illnesses. It increased the accessibility to support in those matters and the services for the people who are affected by mental illnesses. People started talking about their mental illnesses, their anxiety, and their stress levels or other psychological issues. Moreover, people who open up about their mental illness recognize that they are not on their own as they get to know more people who face the same situation (UN, 2020).

VII Reduction of Stigma

Researchers all over the world are conducting studies on possible ways to reduce stigma on mental illnesses and to support individuals that are affected by it (Corrigan et al., 2014). Corrigan and Penn (1999) proposed three different strategies for mental stigma reduction, namely, protest, education, and having contact with a person who is mentally ill. Protest relates to the event where people protest against the existent stigmatization, education refers to the process of people being informed about mental illness, and contact involves the meeting of a healthy person and a person who is mentally ill. The strategy relevant to this dissertation and research, is the strategy of education and information. Studies show that the effects of stigma are moderated by more awareness about the topic (Corrigan et al., 2014). Awareness about mental illness does not only clarify the current situation of stigma but also leads to more sensibility of the person who is informed. Furthermore, it could be proven that humans who have a broader understanding of mental illnesses are less likely to stigmatize (Brockington et al.,1993). Therefore, it is assumed that increased awareness about mental illnesses reduces negative stereotypes and subsequently leads to lower levels of stigma (Weiner, 1985; Foersterling, 1985).

VIII Conclusion based on Theory

All in all, the theory and studies already done in relation to stigma, prove that stigma is prevalent within social life as well as in a managerial context. The process of stigma starts with the observance of a signal, triggering a negative stereotype and resulting in discrimination. The theory underlying stigmatizing behaviors is traced back to the attribution theory. Furthermore, the differences in stigmatizing behaviors towards different kinds of illnesses is referred to the construct of controllability. In order for institutions and the employer to reduce stigma, possible ways as protest, education, and contact were proposed.


The first goal of this dissertation is to find out if stigmatizing behaviours towards mental illness in a managerial context is influenced by different levels of awareness on the topic of mental illness. Secondly, the aim is to understand how stigma varies with the causal attribution of an illness, namely an illness attributed to the body compared to one attributed to the mind. To analyse these questions, a quantitative methodology was used following an experimental paradigm.

I Participants

In total a sum of 207 participant have answered the questionnaires, for each of the six possible surveys, more than 30 participants responded, creating a statistically relevant data collection. Of these 207 participants, 47.8% were female whereas 50.2% were male and 1.4% decided not to reveal their gender. The age ranged from 10 up to 65 years, however most of the participants were between 25 and 35. Most of the participants were from Germany, represented by 72.9%, second most people came from Portugal. Besides that, most of the questioned participants were full-time employees (62.3%). The questionnaire was conducted completely in English.

II Materials

The following paragraph elaborates on the materials that were used to support the questionnaire. The materials consist of independent and dependent variables, their measurements and the content of the presented vignettes. All elements and their contents that aimed to make the experience of the survey vivid and as realistic as possible, are examined in this chapter.

Involved variables

Derived from the hypotheses, two independent variables can be identified, namely the level of awareness of mental illness and causal attribution of illness. The dependent variable involved in this study is stigmatization, measured and explained by the responses made by the participants. This is measured with social distance scales and different types of evaluations of working traits of an introduced person.

(1) Level of awareness

The variable of level of awareness involved three conditions, namely a direct level of awareness, an indirect level of awareness, and an absent level of awareness. These were structured in three vignettes, each participant, however, only saw one of the optional vignettes. Within the condition of direct level of awareness, participants were informed about numbers of mental illness issues. This condition was chosen to analyse how participants stigmatize others when they are informed about mental issue and its impact. A positive impact was assumed on the way people stigmatize after being reminded of mental illness numbers. Within the indirect level of awareness, participants were reminded of the Covid-19 pandemic. It was used to examine the impact of the pandemic on how people stigmatize, since, based on the theories made, the pandemic increased the debate on mental health problems and its impact on work- environments and accomplishments. The underlying assumption for this variable was that this vignette would have a positive impact on stigmatizing as society was confronted with mental illnesses due to Covid-19 pandemic related lockdowns and the overall situation about risk and health. The last vignette, namely the vignette about heart disease, does not have a level of mental illness information as such . It functions as a control condition to compare its effect with the effects of the mental illness campaign and the Covid-19 pandemic reminder. The heart disease campaign was selected as it involves a serious disease that can compromise work accomplishments and success, without a direct connection to mental illness or Covid-19 pandemic.

These three possible scenarios were connected to a randomizer on Qualtrics, used to ensure that the participants were only confronted with one scenario and not all three.

(2) Causal attribution of illness

The second independent variable involved two possible conditions, namely an illness attributed to the mind, depression, and an illness attributed to the body - diabetes. A second vignette with two possibilities was presented to the participants, including the manipulation of causal attribution.

Both vignettes were built in an identical way, the only difference being the character and illness that was introduced. The participants were confronted with the scenario that they were given the responsibility for a project at work and they had to choose an employee to collaborate with. This information was introduced, as the focus of this research is to explore how participants decide in a scenario at workplace, in which responsibility is involved and the outcome of a project is decisive. To manipulate causal attribution of illness two different collaborators were introduced, one employee with depression, categorized a mental illness and another with diabetes, defined as physical illness. Both employees were presented as very good employees with the exact same characteristics and working traits, the only difference being that the first person had depression and the second had diabetes.

Dependent Variable

The dependent variable in this dissertation is the stigmatization of illnesses with a focus on the stigmatization of mental illnesses specifically. The variable is measured by managerial stigma, social distance scales, and an attribution score. The materials that were used in this regard consisted of the Managerial Decisions Scale created by the author of this dissertation, the Attribution Questionnaire created by Corrigan (AQ9), the social distance scale of Schomerus and the Workplace Social Distance Scale that was developed by Yoshii and colleagues.

III Scales used within the Questionnaire

Managerial Decisions scale

The first measurement that was introduced in the survey consisted of questions in a managerial context. In this part, participants had to decide regarding the employees who were introduced in the vignette before, namely Helena (depression) or Sara (diabetes). The first question was: “When you think about Helena/Sara, would you choose her for your project?”. The answers are given on a 7-point Likert Scale, labelled as “1” being “not likely at all” and “7” “totally likely”. It was the only question on this page as the intention was to receive an intuitive answer. The following page entailed the same 7-point Likert Scale and the following questions to evaluate (1) “How likely is it that Helena/Sara will close the next deal with success?” (2) “How likely is it that you would continue to collaborate with Helena/Sara after the project has finished?” (3) “How likely is it that you will meet Helena/Sara also besides work to have lunch or dinner together?”.


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Stigmatization of Mental Health in a Managerial Environment. Statistical Analysis and Evaluation
Católica Lisbon School of Business & Economics
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stigmatization, mental, health, managerial, environment, statistical, analysis, evaluation
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Nadja Büngers (Author), 2021, Stigmatization of Mental Health in a Managerial Environment. Statistical Analysis and Evaluation, Munich, GRIN Verlag,


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