Felicia Meyer & William BukowskiConcordia University, Montreal, Canada

4th International Stigma ConferenceJanuary 23rd, 2009

Children’s views of mental health and illness have received far less research attention than:

• the views of adults (Wahl, 2002; Watson, Miller & Lyons, 2005)

• children’s understanding of physical health (e.g. Bibace & Walsh, 1980)

Peer relationships are an important part of children’s socialization (Rubin, Bukowski & Parker, 2006; Sullivan, 1953).

Children who have socio-emotional and/or behavioural problems are more likely to be excluded or rejected (Deater-Deckard, 2001; Hay et al., 2004).

Less is known about how children develop attitudes towards peers with such problems (Hennessy, Swords & Heary, 2007).

Purpose

• To integrate research on children’s perceptions of others, understanding of psychopathology and peer relationships.

Specific aim

• To assess children’s understanding of mental illness so as to learn why children with problems may be excluded from their peer group.

96 fifth and sixth graders• 46 girls, 50 boys• Mean age = 11 years old

Community-based sample• Four classes in a public elementary school in Montreal, Quebec,

Canada

Children read four vignettes describing hypothetical boys/girls with different forms of psychopathologyo Depression and conduct disorder

o based on work by Hennessy & Heary (2003)o ADHD and anxiety

o based on DSM-IV-TR (2004) symptomatology

Order of presentation of vignettes and gender of hypothetical peer were randomized across participants.

Although Clara usually does ok in school, she sometimes thinks that she is stupid and no good at anything. Clara doesn’t smile much and she doesn’t enjoy things as much as she used to. She spends a lot of time feeling sad and is rarely happy. She has little energy and often feels tired during the day.

1) Following each description, participants were asked:Why do you think Clara is like this?

A list of reasons explaining why a child would have this disorder was presented.

Participants rated each reason according to whether it explained why the child would have this disorder.

2) Participants were then asked to imagine that the child described in the vignette was in their class and to rate how much they would like the hypothetical peer.

Why do you think (hypothetical peer) is like this? Family experiences (3 items) …because of how her parents brought her up.

Peer experiences (3 items) …because he has no friends.

Psychological states (3 items) …because she thinks other children are better than her.

Physical conditions (2 items) …because there is something wrong with his brain.

Inability to control (3 items) …because he can’t control how he feels.

Lack of effort (2 items) …because she doesn’t try hard enough to:

- relax (anxiety) - be happy (depression) - behave herself (conduct disorder) - pay attention and to focus (ADHD)

To examine…

1) How children explained the etiology of four forms of psychopathology.

2) How much children liked each of the four hypothetical peers.

3) Whether liking of the hypothetical peer was associated with children’s use of reasons to explain psychopathology.

Children used different explanations to describe the etiology of the four disorders.

Lack of effort was rated as the most likely explanation across the four disorders.

• more for externalizing disorders (ADHD and conduct disorder) than for internalizing disorders (anxiety and depression)

1

1.2

1.4

1.6

1.8

2

2.2

2.4

ADHD ANXIETY DEPRESSION CONDUCT DISORDER

Inability to control

Lack of effort

Psychological

Physical

Peer

Family

Ratings of Reasons for Each DisorderRatings of Reasons for Each Disorder

ADHD Anxiety Depression Conduct Disorder

1

1.2

1.4

1.6

1.8

2

2.2

2.4

ADHD ANXIETY DEPRESSION CONDUCT DISORDER

Ratings of Lack of Effort for Each DisorderRatings of Lack of Effort for Each Disorder

ADHD Anxiety Depression Conduct Disorder

Liking Ratings of Hypothetical Peers with Symptoms of Liking Ratings of Hypothetical Peers with Symptoms of Psychological DisordersPsychological Disorders

1

1.5

2

2.5

3

ADHD ANXIETY DEPRESSION CONDUCT DISORDERNot at all

A little

Somewhat

ADHD Anxiety Depression Conduct Disorder

1.8

1.9

2

2.1

Low emphasis High emphasis

Family

Peer

Psychological

Physical

Lack of effort

Inability to control

Lik

ing

Liking Ratings as a Function of Use of ReasonsLiking Ratings as a Function of Use of Reasons

Differential use of reasons was found to affect the level of liking of the hypothetical peer.

Attributing disorder to

o family reasons, psychological reasons or lack of effort was associated with lower levels of liking.

o reasons related to peer experiences was associated with higher levels of liking.

1) Children’s beliefs about the causes of psychological problems• are multidimensional (incorporate individual and environmental factors)• ascribe particular importance to lack of effort.

2) Children’s liking of their peers depends in part on the symptoms of psychopathology exhibited by peers.

3) Children’s liking of their peers depends in part on the reasons they use to explain the peer’s psychological problem.

The findings of this study

• show a link between children’s understanding of psychological disorders and their affective response to a hypothetical peer with a disorder.

• have implications for how children perceive and respond to actual peers with psychological difficulties.

Recent work points to the importance of children’s beliefs about peers’ personal responsibility for psychological problems (e.g., Corrigan et al., 2005; Hennessy, Swords & Heary, 2007).

Future research should examine the possible peer rejection and stigma experienced by children with such problems.

Further analyses will examine • hypothetical helping• children’s liking of hypothetical peers versus actual peers with

symptoms of psychopathology

This work can contribute to the development of prevention and intervention programs targeting children’s understanding and possible stigmatization of mental illness.   

Participants, parents and elementary school staff

Social Sciences and Humanities Research Council of Canada (SSHRC)

Fonds de recherche sur la société et la culture (FQRSC)

Concordia University Research Chair to W. M. Bukowski

South London and Maudsley NHS Foundation Trust Charitable Funds

Thank you!Thank you!

Questions? Comments?Questions? Comments?

For more information: felicia.meyer@gmail.comFor more information: felicia.meyer@gmail.com