Cited by 1,407Mental Health Treatment and AccessSocial and Intergroup PsychologyPsychology and Mental Health

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An Attribution Model of Public Discrimination Towards Persons with Mental Illness

Corrigan, Patrick, Markowitz, Fred E., Watson, Amy, Rowan, David, Kubiak, Mary Ann·2003·Journal of Health and Social Behavior

DOI 10.2307/1519806

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Abstract

In this study, we build on previous work by developing and estimating a model of the relationships between causal attributions (e.g., controllability, responsibility), familiarity with mental illness, dangerousness, emotional responses (e.g., pity, anger, fear), and helping and rejecting responses. Using survey data containing responses to hypothetical vignettes, we examine these relationships in a sample of 518 community college students. Consistent with attribution theory, causal attributions affect beliefs about persons' responsibility for causing their condition, beliefs which in turn lead to affective reactions, resulting in rejecting responses such as avoidance, coercion, segregation, and withholding help. However, consistent with a danger appraisal hypothesis, the effects of perceptions of dangerousness on helping and rejecting responses are unmediated by responsibility beliefs. Much of the dangerousness effects operate by increasing fear, a particularly strong predictor of support for coercive treatment. The results from this study also suggest that familiarity with mental illness reduces discriminatory responses.

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“…su abuso de alcohol es probable que estén enojados con ellos y no estarán dispuestos a ayudarles; la segunda, que las personas que en general ven a los individuos que consumen alcohol como víctimas de su abuso de alcohol estarán propensas a experimentar lástima hacia ellos (Corrigan et al., 2003).”
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“[25] Apart of these, contacts with person having mental illness to reduce stigma are competing ideas.”
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“In regards to blame, Christians ought to refrain from blaming people with mental illness for their condition, given that it can promote anger and discourage withholding of help (Corrigan et al., 2003; Corrigan & Miller, 2004).”
Background
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“Causal attributions (such as the function of a behaviour) can affect beliefs and affective responses towards others, resulting in rejecting behaviour such as avoidance and withholding of help (Corrigan et al., 2003).”
Background
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“The CAB model was initially designed to understand public stigma [39, 40] and further used to explore self-stigma in minority groups with concealable identities, such as people with mental illness or HIV/AIDS [38, 41].”
Method
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Leung, D. K. Y., Wong, F. H. C., Yau, J. H.-Y., Zhang, A. Y., Au, W. S. H., Liu, T., Wong, G. H. Y., & Lum, T. Y. S. (2023) · Aging & Mental Health · doi:10.1080/13607863.2023.2179973 · Cited by 5
“, 2018) and item 4 in DSS-personal that measured perceived dangerousness does not directly describe emotions, the belief that people with mental illness are dangerous may prompt the specific emotion of fear (Corrigan, 2002; Corrigan et al., 2003).”
Background
Association between self-compassion and cyber aggression in the COVID-19 context: roles of attribution and public stigma
Wu, Q., & Zhang, T. (2023) · BMC Psychology · doi:10.1186/s40359-023-01100-x · Cited by 7
“, controllability, responsibility, and blame) to an individual’s illness that affect their likelihood of exhibiting hostile attitudes and behaviors [60].”
Background
Programa Saúde Mental Sem Estigma: Efeitos de Estratégias Diretas e Indiretas nas Atitudes Estigmatizantes
Oliveira, S. E. H., Carolino, L., & Paiva, A. (2012) · Revista Portuguesa de Enfermagem de Saúde Mental · doi:10.19131/rpesm.0068 · Cited by 5
Using Facebook to Supplement Participant Pools for Class Research Projects
Sciutto, M. J. (2015) · Teaching of Psychology · doi:10.1177/0098628315573140 · Cited by 5
“Attributions were all measured using adaptations of Corrigan’s Attribution Questionnaire (Corrigan et al., 2003).”
Method
The role of television in perceptions of dangerousness
Alexander, L., Sheen, J. A., Rinehart, N., Hay, M., & Boyd, L. (2018) · The Journal of Mental Health Training Education and Practice · doi:10.1108/jmhtep-02-2017-0006 · Cited by 5
Predicting the U.S. Public’s Prosocial Responses during the COVID-19 Pandemic
Wong, J. C. S., & Yang, J. Z. (2021) · Journal of Health Communication · doi:10.1080/10810730.2021.1983671 · Cited by 5
Knowledge (K), Attitude (A), and Practice (P) of Women and Men about Menstruation and Menstrual Practices in Ahmedabad, India: Implications for Health Communication Campaigns and Interventions
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Short, Animated Storytelling Video to Reduce Addiction Stigma in 13,500 Participants Across Multiple Countries Through an Online Approach: Protocol for a Randomized Controlled Trial
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“The AQ-18 is highly reliable and subscales have Cronbach α ranging from fair (0.6, responsibility) to good (0.93, fear/dangerousness) [25,26].”
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“This aligns with the attribution theory, which posits that perceptions of controllability influence compassion and willingness to help (Corrigan et al. 2003).”
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“We measured the stigma associated with mental illness using a modified 21-item stigma scale adapted from Corrigan et al. (2003) and Tamul and Hotter (2019).”
Method
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“67 This theory may have relevance for mental health education and how experiences of mental health challenges are presented to learners.”
Background
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“• Attribution questionnaire children’s version (AQ-8-C) is a shorter, modified eight-item children’s version of the attribution questionnaire of public stigma towards mental illness [40] designed for ages 10–18 years old [41].”
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“These beliefs can result in emotional reactions from the public, like anger or pity, that may influence behaviors related to wanting to help or punish people with OUD (Corrigan et al., 2003).”
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“However, the public perception of treatment optimism, a proxy of controllability [61], might also create an expectation that individuals should be able to manage their alcohol use problems with available treatments.”
Self-citation
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Background
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“…that compassion is associated with reduced punitive tendencies, while anger is linked with decreased helping intentions (Condon & DeSteno, 2011; Corrigan et al., 2003), which is partly due to compassion and anger’s potentially contrasting appraisals that may reduce the action tendencies…”
Background
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“It is important to note that the frameworks identified in this scoping review (attribution model of public discrimination and tripartite attitude framework) were developed with mental illness in mind (P. Corrigan et al., 2003; Eagly & Chaiken, 1993; Pryor & Reeder, 2011).”
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“Additionally, people familiar with mental illness tend to be more empathetic and compassionate and more helpful toward people living with mental illness (4).”
Background
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“On a personal level, stigma or negative attitudes held by others is known to be a significant and prevalent barrier to receiving mental health treatment (Corrigan et al., 2003).”
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Pescosolido, B. A. (2024) · Medical Research Archives · doi:10.18103/mra.v12i7.5471 · Cited by 5
“With this comes a shift away from stigma to support for seeking treatment, much like any other disease 15,16 .”
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Li, W., & Li, Q. (2024) · BMC Psychiatry · doi:10.1186/s12888-024-05998-4 · Cited by 4
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Harhaji, S., Tomori, S., Nakov, V., Chihai, J., Radić, I., Mana, T., Stoychev, K., Esanu, A., & Pîrlog, M. C. (2024) · Slovenian Journal of Public Health · doi:10.2478/sjph-2024-0025 · Cited by 4
“Higher scores indicate more stigmatising attitudes (30, 31).”
Background
Analyzing the impacts of race, addiction, drug type, and criminal record on public support for criminalized and medicalized sentencing approaches toward illegal drug use
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“Indeed, research suggests that the public may become less inclined to demand harsher and criminalized pun-ishments by attributing behavior to external factors such as a psychiatric or medical condition, like an addiction disorder (Corrigan et al., 2003).”
Public Attitudes and Feelings of Warmth Toward Women and Men Experiencing Depression During the Perinatal Period
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“Eighteen items were generated for the Attitudes and Beliefs About Perinatal Depression Questionnaire on the basis of a review of qualitative literature about perceived depression stigma among pregnant women andmothers in the postpartum period (14–17), a review of mental illness and depression stigma measures (29,35–37…”
Method
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BackgroundInfluential
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Dawson, J., & SZMUKLER, G. I. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108979016.009 · Cited by 4
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“, the attribution model [2]) by using control conditions and explore changes in specific motivations or perceptions that might facilitate a reduction in stigmatic beliefs.”
BackgroundMethodResultInfluential
Borderline personality disorder subtypes and public stigma
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Background
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“stigma in mental health populations [28, 29].”
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“Contact is sometimes defined as familiarity, which has been described as knowledge and experience with a particular group that can vary in degree of intensity (Corrigan, 2002). Without direct experience, little emotional and behavioral responding is likely to occur, and attitudes will be based mainly on beliefs (Eagly…”
Background
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Raley, K. (2011) · Cited by 4
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“The research team also investigated how the terms identified within the review fit in with three models of stigma, based on the Attribution Theory [7, 8], the Modified Labeling Theory [9], and the regressive model of self-stigma [22].”
Influential
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“Nevertheless, we did not directly assess willingness to help as a component of stigma (Brown, 2015; Corrigan et al., 2003) and future research should further explore participant attitudes on these dimensions.”
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“…and definition of the construct, even if they did not meet all inclu-Elizalde-Resano sion criteria, such as the publication date, since they were original and foundational studies in the field (Corrigan & Watson, 2002; Corrigan et al., 2003; Goffman, 2006; Link & Phelan, 2001; Muñoz et al., 2009).”
Influential
Navigating mental health issues: exploring cultural causal attribution, stigmatization, and care recommendation behavior in Pakistani adolescents and young adults
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“Lastly, causal attribution theory [44, 45] infers that an individual’s causal explanation of illness depends on the available information and cues in society, which subsequently influence their attitudes and behaviors towards those experiencing illness [46, 47].”
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“The chatbot questions presented in Table 1 were adapted from the original attribution model [48] and the Attribution Questionnaire-27 (AQ-27) [9, 47], which was developed based on the attribution model and operationalized concepts into measurable items (i.e., blame , fear , pity , anger , helping ,…”
Influential
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“…in a future study to determine if contact reduces explicit biases as previous studies have demonstrated (Anagnostopoulos & Hantzi, 2011; Angermeyer et al., 2004; Burke et al., 2015; Corrigan et al., 2001a; 2001b; 2002; 2003; GonzalezSanguino et al., 2019; Kobau et al. 2010; West et al., 2014).”
Result
Age Differences in Psychological Antecedents and Behavioral Consequences of Stigmatization Associated with COVID-19 among Koreans
Kang, S., & Kang, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19148594 · Cited by 3
Mental Health Nurses’ Social Representations of People Who Experience Mental Illness: A Story of Paradoxes
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“These beliefs are pointed to as the main and most investigated dimensions accounting for stigma toward PEMI in the literature (Corrigan et al., 2003; Johnson-Kwochka et al., 2021; Schomerus et al., 2014).”
Background
Ambiguous calls: Public preferences for law enforcement responses to people in crisis
Brady, C. M., Dieterich, G., & Graham, A. (2024) · Journal of Criminal Justice · doi:10.1016/j.jcrimjus.2024.102172 · Cited by 3
Intersectional Anticipated Discrimination Among Women Experiencing Homelessness in Argentina
Lenta, M. M., Iorio, J. D., & Vázquez, J. J. (2024) · Journal of Community Psychology · doi:10.1002/jcop.23171 · Cited by 4
Challenging Forensic Stigma: The Efficacy of Education and Indirect Contact Interventions in Addressing Stigma Towards Forensic Patients
Doyle, E. C., Healey, L. V., Seto, M. C., & Forth, A. E. (2025) · International Journal of Forensic Mental Health · doi:10.1177/14999013241301093 · Cited by 3
“Discrimination can be overt (e.g. physical harm or threats of harm), or it can be more discreet (e.g. coercive treatment, segregation, and avoidance) (Corrigan et al., 2003; Fox et al., 2018).”
Influential
Conservatism and the Underidentification of Students with Emotional and Behavioral Disorders in Special Education
Wiley, A., Kauffman, J. M., & Plageman, K. (2014) · Exceptionality · doi:10.1080/09362835.2013.872566 · Cited by 4
“Research in mental health suggests that people who are more conservative tend to hold more negative attitudes toward treatment for people with mental illness (Corrigan et al., 2003; Furr, Usui, & HinesMartin, 2003; Watson, Corrigan, & Angell, 2005).”
Background
Attitudes among medical and law students toward decision-making in regard to involuntary psychiatric hospitalization
Abramowitz, M. Z., Bentov-Gofrit, D., Khawaled, R., Bauer, A., & Cohen, T. (2011) · International Journal of Law and Psychiatry · doi:10.1016/j.ijlp.2011.08.009 · Cited by 3
A randomised trial of ethnicity and stigmatised attitudes towards learning disability and alcoholism
Asamoah, G., Varughese, S. J., Mushtaq, S. A., Butterworth, L., Abraham, A., & Luty, J. S. (2009) · Ethnicity and Inequalities in Health and Social Care · doi:10.1108/17570980200900011 · Cited by 3
Exploring the Relationships Among Level of Contact, Nature of Contact, and Mental Illness Stigma in Adolescent Girls
Greenblatt, A. M., Pinto, M. D., Higgins, M. K., & Berg, C. J. (2016) · Issues in Mental Health Nursing · doi:10.3109/01612840.2015.1087604 · Cited by 3
Examining the Attributions of Discrimination toward People with Mental Illness among Chinese College Students
Zheng, L. X., Keegan, J. P., Rosenthal, D. A., Talley, W., & Hunter, C. (2016) · Australian Journal of Rehabilitation Counselling · doi:10.1017/jrc.2016.3 · Cited by 3
“Instead of considering mandatory treatment as a form of behavioural discrimination that may regularly undermine the opportunities of those with mental illness as is the case in the West (Corrigan et al., 2003), the availability of any free or affordable treatment in China might be more appreciated by the family member…”
BackgroundMethodResultInfluential
Examining courtesy stigma among foreign health care workers caring for persons with Alzheimer’s disease: A focus group study
Werner, P., & Hess, A. (2016) · Home Health Care Services Quarterly · doi:10.1080/01621424.2016.1227011 · Cited by 3
Making the Case for Specialized Caseloads Among Vocational Rehabilitation Counselors Working With Ex-Offenders: A Pilot Study
Bates-Maves, J. K., & O’Sullivan, D. (2017) · Rehabilitation Research Policy and Education · doi:10.1891/2168-6653.31.2.121 · Cited by 3
Critical School Mental Health Praxis (CrSMHP)
Ulie-Wells, J., Bruna, K. R., & Romo, C. (2020) · Cambridge University Press eBooks · doi:10.1017/9781108551830.012 · Cited by 4
Seher’s “Circle of Care” Model in Advancing Supported Decision Making in India
Davar, B. V., Pillai, K., & Lacroix, K. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108979016.017 · Cited by 3
Divergent Human Rights Approaches to Capacity and Consent
Neuman, G. L. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108979016.007 · Cited by 3
Social Anxiety Disorder: Associations with Peer-Liking, Discrimination, and Prejudicial Feelings in Early Adolescent Girls
Brookman, R., Bird, F., Harris, C. B., & Grant, K. (2022) · Child Psychiatry & Human Development · doi:10.1007/s10578-022-01336-5 · Cited by 4
“Each feeling was measured using a single item from the Revised Attribution Questionnaire (r-AQ: [47]).”
Method
How Bereaved Parents Experience Public, Self Stigma Years After a Child’s Death
Heo, S.-J., Kim, Y. A., Lee, D. H., & Shin, J. Y. (2022) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228221100902 · Cited by 4
“According to Corrigan and Watson ’ s situational model, identi ﬁ cation with another group mitigates self-stigma (Corrigan et al., 2003).”
Effects of scenario‐based attribution on collective emotions and stigma toward persons with COVID‐19: A cross‐sectional survey
Boo, H. I., & Choi, Y. (2023) · Health Science Reports · doi:10.1002/hsr2.1039 · Cited by 3
“According to the risk assessment hypothesis, perceived risk can influence fear and lead to discriminatory behavior toward the person with the disease, irrespective of the type of attribution to the cause of the disease.(9) Previous studies(8,10) showed that the stigma”
Background
Rural US residents recognize anxiety better than urbanites and suburbanites but hold similar stigma
Loveridge, S., Skidmore, M. L., Shupp, R., Miller, P. K., Cuthbertson, C. A., & Goetz, S. J. (2023) · The Journal of Rural Health · doi:10.1111/jrh.12757 · Cited by 3
Explaining the Impact of Legal Access to Cannabis on Attitudes toward Users
Queirolo, R., Repetto, L., Sotto, B., & Álvarez, E. (2023) · International Journal of Public Opinion Research · doi:10.1093/ijpor/edad010 · Cited by 3
Exemplar typicality in interventions to reduce public stigma against people with mental illness
Maunder, R. D., & White, F. A. (2023) · Journal of Applied Social Psychology · doi:10.1111/jasp.12970 · Cited by 3
Behavioral Addiction from the Asian Americans Perspective: Exploration of Public and Help-Seeking Stigma
Li, Q., & Whelan, J. (2023) · Journal of Gambling Studies · doi:10.1007/s10899-023-10210-5 · Cited by 3
“Public stigma was measured in two ways: (1) the desired social distance scale (SDS), and (2) Corrigan et al. (2003, 2004) model including attribution theory of stigma and danger appraisal hypothesis.”
Influential
How to measure mental illness stigma at work: development and validation of the workplace mental illness stigma scale
Matousian, N., & Otto, K. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1225838 · Cited by 3
“(53) by extracting 9 items from the AQ-27 with the highest factor loadings measuring the domains of blame, anger, pity, help, dangerousness, fear, avoidance, segregation, and coercion.”
Method
Atribuições de causalidade sobre as pessoas vivendo com HIV: perspectiva de uma análise Bayesiana
Costa, Â. B., Vilanova, F., de Azevedo, F. M., & Steins, G. (2023) · Actualidades en Psicología · doi:10.15517/ap.v37i134.46758 · Cited by 3
“This is consistent with Corrigan et al (2003) study, which indicates that anger and fear were highly correlated in the context of the attributional process.”
Result
Beliefs about the function of self-harm and stigmatizing responses: Testing the attribution model and a novel psychophysical response measure
Dawson, K., Deane, F. P., & Miller, L. M. (2023) · Current Psychology · doi:10.1007/s12144-023-05492-2 · Cited by 3
“Several iterations of the Attribution Questionnaire (AQ) that correspond to Corrigan et al. (2003) model exist containing various adaptations to examine specific stigmatised experiences across many different populations (Johnson-Kwochka et al., 2021).”
Influential
WeARTolerance: Evaluating the impact of an arts-based program to reduce mental health-related stigma in young people
Beato, A. F., da Costa, L. P., Carvalho, Á., Albuquerque, S., & Santos, I. (2024) · PLoS ONE · doi:10.1371/journal.pone.0314994 · Cited by 5
How Karma Harms and Helps Generosity Toward Those in Need
White, C., & Willard, A. K. (2025) · Personality and Social Psychology Bulletin · doi:10.1177/01461672251313829 · Cited by 3
“…decreasing help has been observed among those experiencing poverty and financial hardship (Bullock et al., 2003; Piff et al., 2020), mental illness (Corrigan et al., 2003) and self-harm (Silva & Tsay, 2019), physical illnesses (Kogut, 2011), bullying (Desrumaux et al., 2018), and intimate partner…”
The Community Attitudes Towards Mental Illness (CAMI) Scale 40 Years Later: An Investigation Using Confirmatory Factor Analysis and Free‐Response Data
Huff, N. R., Arnold, D. H., & Isbell, L. M. (2025) · Journal of Community Psychology · doi:10.1002/jcop.70005 · Cited by 3
Nurses' attitudes towards breastfeeding among women with schizophrenia in southern Israel
Artzi‐Medvedik, R., Chertok, I. R. A., & Romem, Y. (2011) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2011.01846.x · Cited by 3
Mental illness etiology beliefs among African American men with serious mental illness and their social support networks
Hack, S. M., Larrison, C. R., Bennett, M. E., Klingaman, E. A., & Peeples, A. (2016) · Social Work in Mental Health · doi:10.1080/15332985.2016.1188194 · Cited by 3
Factors Affecting Stigma Toward People with Schizophrenia and Video - Based Interventions for Stigma Reduction
Martinez, V., Vasquez, C., Nava, E., Smith, K., & Avilla, R. (2017) · UC Merced Undergraduate Research Journal · doi:10.5070/m4101037213 · Cited by 3
Contextual influences on the perception of pregnant women who use drugs: Information about women’s childhood trauma history reduces punitive attitudes
Delker, B. C., Scoyoc, A. V., & Noll, L. K. (2019) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2019.1675221 · Cited by 3
Legal Myth Busting and Frontline Mental Health Decision Making
Bronitt, S. (2013) · Advances in police theory and practice/Advances in police theory and practice series · doi:10.1201/b14853-15 · Cited by 3
THE CONCORDANCE BETWEEN SELF-RATINGS OF CHILDHOOD AND CURRENT SYMPTOMS OF ATTENTION DEFICIT HYPERACTIVITY DISORDER
Murphy, P. G. (2003) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000066158.18608.c8 · Cited by 3
The Increased Awareness of Physician Assistant Student Mental Health
Brown, M. H. (2004) · The Journal of Physician Assistant Education · doi:10.1097/01367895-200415020-00007 · Cited by 3

Authors: Corrigan, P., Markowitz, F. E., Watson, A., Rowan, D., & Kubiak, M. A.
Affiliations: University of Chicago (US)
Northern Illinois University (US)
Prairie State College (US)
ORCID: Corrigan, Patrick
Markowitz, Fred E.
Watson, Amy
Venue: Journal of Health and Social Behavior
Publisher: SAGE Publications
Published: 2003-06
Volume: 44
Issue: 2
Pages: 162
ISSN: 0022-1465 (ISSN-L)
DOI: 10.2307/1519806
OpenAlex: W2104804522
Cited by: 1,407
References: 81
Citations by year: 2026: 73 · 2025: 98 · 2024: 83 · 2023: 88 · 2022: 95 · 2021: 123 · 2020: 99 · 2019: 85 · 2018: 57 · 2017: 71 · 2016: 76 · 2015: 63 · 2014: 56 · 2013: 50 · 2012: 52
FWCI: 19.68
Type: journal article
Language: en
Open access: closed
Locations: Journal of Health and Social Behavior (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5r24mh062198-06)
National Institute of Mental Health (5 R24 MH62198)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Social Sciences › Sociology and Political Science › Social and Intergroup Psychology
Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
Keywords: mental illness, causal attribution, attribution theory, perceived dangerousness, responsibility beliefs, fear, pity, anger, rejection response, involuntary treatment, segregation, community college students, stigma
MeSH terms: Adult, Attitude to Health, Mental Disorders, Female, Humans, Male, Models, Psychological, Prejudice, Social Environment, Stereotyping, Students, Universities, Midwestern United States, Behavioral Research

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An Attribution Model of Public Discrimination Towards Persons with Mental Illness

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