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Audrey Zakriski

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The revision of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) led to a wealth of debate and speculation about the potential impact of DSM-5 revisions on mental illness stigma. Yet, no study has empirically investigated such concerns. Therefore, the aim of this study was to examine the influence of three controversial DSM-5 changes on mental illness stigma: 1) the diagnostic label change from gender identity disorder to gender dysphoria, 2) the establishment of premenstrual dysphoric disorder as an official diagnosis, and 3) the elimination of the bereavement exclusion for major depressive disorder. Potential moderating variables were examined (meritocratic worldviews, and familiarity with mental illness), and social desirability was controlled. Overall, participants (N=185) reported greater mental illness stigma in response to the DSM-5 conditions than to the DSM-IV conditions, p = .021, and men expressed greater stigmatizing attitudes than women did (social distance, p = .043; personal stigma, p = .045). Follow-up analyses by disorder type revealed the clearest influence of DSM-5 revisions on mental illness stigma for depression, with greater stigma toward grief labeled as major depression (DSM-5) than toward undiagnosed grief (DSM-IV). Furthermore, this effect was more pronounced in participants with less familiarity with mental illness. Additionally, gender differences in stigma were most notable in premenstrual distress. Finally, meritocratic worldviews (Protestant work ethic and belief in a just world) showed only weak relations to mental illness stigma, in both descriptive analyses and as moderators. Implications of these findings for research and practice are discussed, along with limitations and directions for future research.



The views expressed in this paper are solely those of the author.