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Article

Mental-Health-Related Stigma in a Conservative and Patriarchal Community

by
Aleksandar Popović
1,* and
Nada Marić
2,3
1
Clinical Center of Montenegro, Clinic for Psychiatry, 81 000 Podgorica, Montenegro
2
Institute of Occupational Health and Sports Medicine, 76 300 Bijeljina, The Republic of Srpska, Bosnia and Herzegovina
3
Faculty of Medicine, University of Banja Luka, 78 000 Banja Luka, The Republic of Srpska, Bosnia and Herzegovina
*
Author to whom correspondence should be addressed.
Soc. Sci. 2023, 12(5), 262; https://doi.org/10.3390/socsci12050262
Submission received: 30 December 2022 / Revised: 10 April 2023 / Accepted: 17 April 2023 / Published: 25 April 2023
Versions Notes

Abstract

:
Background: Mental health disorders are a significant global disease burden, and the stigma towards people with them is the strongest obstacle to improving mental health and dealing with an enormous public health problem. Montenegro is a small country with a conservative society and a deeply ingrained patriarchy. The aim of this study was to determine attitudes toward mental health disorders in the general population of Montenegro and identify the influence of socio-demographic characteristics. Methods: The research was conducted as an online cross-sectional study. The questionnaire included a demographic section and a section on attitudes towards mental health as well as the CAMI scale (community attitudes toward mental health disorders). Results: The subjective opinions of the respondents showed a lack of awareness about mental health campaigns in the country. Stigma towards mental health was present in younger and more highly educated populations. Conclusions: The obtained data indicate the magnitude of the problem when it comes to the stigma towards mental health disorders in Montenegro. Furthermore, there is a need for a systematic nationwide and metacentric study, identifying and exploring a wide range of individual factors contributing to the stigma of mental health problems.

1. Introduction

Goffman explains that the word “stigma” serves as an attribute that tends to deeply discredit a person, and according to him, there are three types of stigma: stigma related to various physical deformities; stigma related to belonging to a certain nation, religion, or tribe; and stigma regarding some character traits, where mental health disorders can also be classified (Economou et al. 2020). According to published data (Gary 2005), only a few medical conditions in history, such as leprosy, had such a social impact as mental health disorders have today. Stigma means giving negative characteristics to people, ultimately leading to their exclusion from society. The presence of stereotypical views, such as that people with mental health disorders are unpredictable, could lead to discrimination against them and denial of their civil and human rights, so people with mental health disorders are more often exposed to significant social inequalities, such as an inability to gain employment and other social intolerances (Arboleda-Flórez and Stuart 2012). Individuals with mental health disorders are also often characterized as dangerous and aggressive so people are afraid of them. Because of that, people with mental health disorders may more often face segregation, isolation, and social rejection (Ahmedini 2011; Corrigan et al. 2012). Furthermore, the presence of stigmatizing attitudes toward mental health disorders could represent obstacles to individuals seeking care because people tend to avoid the label of mental health disorders (Corrigan et al. 2014). The stigma of mental health disorders greatly affects social support, social cohesion, and the possibility of recovery (Thompson et al. 2004).
Stigma is important because of its impact. Mental health disorders contribute to the global burden of disease and are a leading cause of disability (Ferrari et al. 2022). The stigmatization of mental health disorders is the strongest obstacle to improving mental health (Beldie et al. 2012; Yin et al. 2022). According to data (Verhaeghe et al. 2008), stigma can affect the self-esteem of people with mental health disorders and make their recovery longer than expected, and there are data (Niedzwiedz 2019) on the possible negative impact of stigma on the physical health of individuals with mental health disorders. Stigma is associated with lower self-esteem, poorer mental health and poorer quality of life so it could lead to chronic stress and chronic physiological stress through hazardous habits, including smoking, drinking, or taking drugs, related to cardiovascular and metabolic health (Niedzwiedz 2019). Finally, stigma represents an enormous public health problem (Gary 2005).
Attitudes toward people with mental health disorders have been widely researched and the results indicate that religion and ethnicity influence them, as well as racial differences (Wong et al. 2017; Eylem et al. 2020; Adams et al. 2018). According to the data (Adams et al. 2018), religious fundamentalism is associated with more negative attitudes toward individuals with mental health disorders. Some data suggest that political ideology plays a role in the stigma toward mental health disorders (Link and Phelan 2001; DeLuca and Yanos 2016) such as conservative ideology (Love et al. 2019). Moreover, in addition to the political ideology and media image, data indicate that healthcare and social security systems could also have a role in people’s attitudes toward mental health disorders, as the authors hypothesized that the healthcare and social security systems affect people’s attitudes based on the visibility of people with mental health disorders in everyday life (Love et al. 2019). Furthermore, the results showed that international students had lower scores than Romanian students on social distance toward mental health disorders (Popescu et al. 2017). In addition, some data suggest that urbanity also plays a role in the perception of stigma toward mental health disorders (Tam Ta et al. 2016). There is evidence that culture, values and norms affect beliefs about mental health disorders (Abdullah and Brown 2011). Finally, the literature outlines the importance of investigating cultural attitudes, beliefs, and norms on the problem of stigma (Abdullah and Brown 2011; Von Lersner et al. 2019; Nohr et al. 2021).
Durham, in the early 20th century, asserted that Montenegro represents the final instance in Europe of a tribal nation’s evolution into a state (Seedlenieks 2015). The hierarchical structure of Montenegrin families was based on two primary criteria: gender (male) and age. The patriarchal family system subordinated women, with the husband serving as the family’s head and assuming responsibility for protecting and providing for his wife and children. A woman’s primary role was to bear children, particularly sons (“luck”), and care for them. Over time, social and economic progress has created opportunities for overcoming discriminatory practices. However, despite these advances, many forms of male dominance persist, imbuing contemporary Montenegrin families with patriarchal characteristics (Vujačić 1973; Davidović 2021).
Mental health disorders are a major global disease burden and a leading cause of disability (Ferrari et al. 2022), and the literature emphasizes that stigma toward mental health disorders is widespread and that it is the strongest obstacle for improving mental health (Beldie et al. 2012; Yin et al. 2022), as well as an enormous public health problem (Arboleda-Flórez and Stuart 2012).
Today, the problem of stigma persists, and finding a solution is one of every society’s most important duties (Beldie et al. 2012; Lagunes-Cordoba et al. 2021; Skinner et al. 1995; Walsh and Foster 2022). Given that the literature emphasizes the need for additional research on the stigma toward mental health disorders and the influence of geographic area, culture and gender (Popescu et al. 2017; Tam Ta et al. 2016; Abdullah and Brown 2011; Schroeder et al. 2021; Zhang et al. 2020; Henderson and Gronholm 2018), as well as the fact that we found only one study in Montenegro that deals only with the validation of the instrument and not with the problem of stigma (Žiropađa and Dulović 2014), the goal of this study was to analyze the presence of stigma, determine attitudes towards mental health disorders in the general population of Montenegro, and determine the influence of socio-demographic variables, thereby contributing to scientific information about the stigma surrounding people with mental health disorders from other cultural areas, and, based on the findings, establish suggestions for stigmatization prevention. Bearing in mind the specific characteristics of patriarchal and political organization in Montenegro and data from the literature, we hypothesized that the presence of stigma toward mental health disorders in Montenegro would be high. Stigma toward mental health disorders would be higher in the male and the less-educated general population in Montenegro.

2. Materials and Methods

2.1. Research Design, Time, and Place

The study was conducted as a three-week cross-sectional study (9–30 November 2021). The research was conducted in accordance with the Declaration of Helsinki, and related data were collected voluntarily and anonymously. At the beginning of the questionnaire, the aim and procedure of the research were explained to the participants in written form, and they gave their consent to participate in the research.

2.2. Material

The Google platform was used to build the questionnaire. To ensure data accuracy, the questionnaire can only be viewed from a single IP address, and it was distributed online (E-mail, Viber, social networks). The questionnaire consisted of a general part that included socio-demographic data (gender, age, place of residence, vocational training, marital status, and parenthood) and data related to the respondent’s opinions and attitudes about mental health disorders.
The second section of the questionnaire dealt with attitudes toward people with mental health disorders in Montenegro, for which the translated and validated CAMI scale was used (CAMI questionnaire, “Community Attitudes toward the Mentally Ill”) (Ukpong and Abasiubong 2010; Jerotić et al. 2019). Research conducted around the world and in Montenegro shows that this scale has an acceptable level of internal consistency in its entirety—the Cronbach alpha coefficient ranges from 0.68 to 0.88. The scale has 40 items and measures 4 dimensions:
1. Authoritarianism: the authoritarian rejection of the sick (the attitude that people with mental health disorders are inferior to others and have more limited rights, emphasizing the importance of their care, hospitalization, and isolation from the rest of society, as well as the belief that the sick are responsible for their problems).
2. Benevolence: a benevolent attitude towards mental health disorders (highlighting the requirement to allocate additional funds for aiding and treating the ones with such disorders; rejection of punitive measures directed towards the ones with mental health problems).
3. Social restrictions: distancing from people with mental health disorders (attitudes that people with mental health disorders are dangerous for society, perceptions about one’s capacity for marriage, and care for children).
4. The community’s attitude toward mental health disorders: community attitudes toward resocialization (acceptance of the ideology of social psychiatry, which seeks to keep people with mental health disorders in institutions for as little time as possible while delivering complete therapy and rehabilitation in the patient’s social environment).
On each of the 40 items, the respondents made an assessment on a pre-adjusted Likert scale (1—completely disagree to 5—completely agree) according to a certain scoring method in relation to whether the item is for or against. A higher score on the scales of benevolence and community attitudes ideology, as well as lower scores on the scale of authoritarianism and social restrictiveness, indicates the prevalence of positive attitudes towards mental health disorders.
In the section related to the respondents’ opinions and attitudes about mental health disorders, we used questions about the frequency of mental health disorders (“Mental health disorders are common in the community?” and “There are people in your community who have mental health problems/disorders?”), a question addressing professional help in case of need for them and their loved ones (“Would you advise people from your community to seek professional help?”), a question about providing help to people with mental health disorders on the street (“On the street, would you approach and/or help a person with mental health problems/disorders?”), and questions about the campaign on mental health or the need for organizing one in the following period (“Is there a campaign on mental health in your community?” and “It would be useful to organize a campaign on mental health in your community?”). In this section, participants answered that they agreed, did not agree, and, as an additional part (not necessary), explained their answers if they wanted.

2.3. Sample

The target audience consisted of Montenegrins over the age of 18. The original participants were invited to further distribute the questionnaire to their contacts. The criteria for exclusion from the research were: non-residents of Montenegro, under the age of 18, those who refused to accept to take part in the study, and those who did not respond to all of the survey questions. Thus, 592 residents of Montenegro participated in the research; 1 (0.16%) did not give consent to participate, and 10 (1.7%) participants stated that they do not reside in Montenegro, so they were excluded from the research. The final sample included 581 residents of Montenegro.

2.4. Statistical Analysis

Descriptive and inferential statistical methods were used in this work. Among the methods of descriptive statistics, measures of central tendency (arithmetic mean and median), measures of variability (standard deviation), and relative numbers were used. The CAMI questionnaire is presented as an outcome variable with its four continuous scales (authoritarianism, benevolence, social restrictions, and community attitudes towards mental health disorders). The normality of the distribution was assessed using the Kolmogorov–Smirnov and Shapiro–Wilk tests. Differences in the distribution of independent variables among different categories of outcome variables were tested using the Student T test or the Mann–Whitney test, and for variables with multiple levels of significance, the ANIVA or Kruskal–Wallis tests were applied, depending on the normality of the distribution. The Pearson Chi-square test was used to measure the difference in the distribution of categorical variables. We also used linear regression to assess the predictive value. The CAMI scales were used as dependent variables, and the socio-demographic characteristics of the respondents (gender, place of residence, age, marital status, parentage, and professional education) were used as independent variables. The results are presented tabularly and graphically. Probabilities are marked in the tables with * p < 0.05; ** p < 0.01; *** p < 0.001 and those p values were given. Statistical data analysis was performed using IBM SPSS Statistics 25 software.

3. Results

3.1. Socio-Demographic Characteristics

The sociodemographic characteristics of the respondents are shown in Table 1.

3.2. Respondents’ Opinions

Table 2 shows the respondents’ opinions on the frequency of mental health disorders in their community, the accessibility of expert assistance for them and their family members, assistance for the individuals with a mental health condition, the existence of a campaign on mental health, and the need for organizing one in the future.

3.3. CAMI Scale

Table 3 shows the mean values for the four dimensions of the CAMI scale. The dimensions benevolence and the community’s attitude towards mental health disorders had slightly higher scores (24.5 ± 4.60 and 34.03 ± 3.97).
For the dimensions of benevolence, social restrictions, and the community’s attitude towards mental health disorders, a statistically significant difference was found in relation to gender (p ≤ 0.001, p ≤ 0.003 and p ≤ 0.021). Female residents of Montenegro had statistically significantly higher scores on the benevolence scale compared to male residents (41.82 ± 4.40 compared to 40.18 ± 4.18) and on the scale of community’s attitudes towards mental health disorders (21.31 ± 5.16 compared to 22.66 ± 4.87). A statistically significant difference was found in the dimensions of benevolence and social restrictions in relation to parenting (p < 0.05). Montenegrins without children scored statistically substantially higher on the benevolence dimension (41.64 ± 4.64) compared to residents who have children (40.39 ± 4.31). Residents’ social limitation ratings are higher when they have children. (22.65 ± 4.78) compared to residents who do not have children (21.42 ± 5.18). In relation to the professional education of the residents, a statistically significant difference was found in the dimension of authoritarianism (p < 0.05).
According to post hoc analysis, there is a statistically significant difference between Montenegrins with only primary school or no education and those with a high school diploma (p = 0.04), a university degree (p = 0.003), or a PhD/master’s degree (p = 0.05). In comparison to Montenegrins with a high school diploma (24.73 ± 4.62), a university degree (23.85 ± 4.70), and a PhD/master’s degree (24.06 ± 4.1), those with only primary school education or no education at all had statistically considerably higher authoritarian scores (27.63 ± 2.95).
Table 4 shows the dimensions of the CAMI scale in relation to the socio-demographic characteristics of the respondents.
The connection and contribution of the investigated items to the variances in the CAMI questionnaire scales was also investigated using standard regression. Preliminary analysis proved that the assumptions of normality, linearity, multicollinearity, and homogeneity of variance were not violated. The model explains 2.9% of the variance in authoritarianism (p < 0.009), 5.0% of the variance in benevolence (p < 0.001), 2.1% of the variance in social restrictions (p < 0.005), and 0.5% of the variance in the community’s attitude towards mental health disorders (p > 0.05). The variable of gender significantly contributed to all four variances on the CAMI scale, whereas the authoritarianism dimension was also influenced by professional education and the benevolence dimension by parenthood. Table 5 shows the results of linear regression.

4. Discussion

Montenegro is a small country with a conservative society and a deeply rooted patriarchy (Seedlenieks 2015). Data suggest (Dulović 2011) that people in Montenegro frequently seek help for mental health problems in religious institutions or other non-medical institutions. This traditional attitude within the family milieu spreads over generations. Bearing in mind that the literature emphasizes the need for additional research on the stigma toward mental health disorders, the aim of this study was to analyze the presence of stigma, determine attitudes towards mental health disorders in the general population of Montenegro, and determine the influence of socio-demographic variables. We hypothesized that the presence of stigma toward mental health disorders would be high and that it would be higher in men and less-educated populations.
The survey included 581 residents of Montenegro. More female residents participated in the research (69.9%). It is possible that men participated less because they have less free time. The traditional patriarchal organization makes demands of the men to be the financial head of the family. This assumption that men work more is not in accordance with the statistical data from Montenegro. Data show that the percentage of women in the total number of employees in 2021 was circa 45% (Statistical Office of Montenegro 2022). Another assumption is that females are more communal (selfless and concerned with others) and, as the data suggested, more frequent users of social media (Kimbrough et al. 2013; Eagly and Steffen 1984). Further, only 2.9% of the population aged 45 and above participated in the study, and they were mostly highly educated; more than 60% had a higher education or university degree and a master’s degree or doctorate, which is likely due to the way the research was conducted (online), i.e., easier access and greater IT knowledge.
The subjective opinion of respondents is that mental health disorders are very frequent. In detail, 75.7% of respondents have the opinion that mental health disorders are common in the community. Almost 80% have, in their community, someone who has mental health problems/disorders. We did not find data about the prevalence of mental health disorders in Montenegro. According to data from Serbia in 2017 (Šantrić-Milićević et al. 2017), a country with similar history and culture, almost the half of the population suffers from poor mental health. These results indicate that there is a need for investigation of all the problems associated with mental health.
The current research shows that 17.9% of participants would not approach and/or help a person with mental health disorders/problems on the street. Individuals with mental health disorders are also often characterized as dangerous and aggressive so people are afraid of them (Jorm et al. 2012). This stereotypical view is probably the reason for these results. In accordance with this assumption is the result of one study in Montenegro showing that two-thirds of people in Montenegro do not have basic knowledge about mental health disorders (Akcija za ljudska prava. Centar za žensko I mirovno obrazovanja—ANIMA 2006). A study from Bosnia and Herzegovina (Federalno ministarstvo zdravlja. Zavod za javno zdravstvo Federacije BIH 2012) showed that people who have someone in their community with mental health problems/disorders have more understanding of other people with the same problems. We have results that almost 80% of respondents have someone in their community with mental health problems/disorders, but the results also showed that almost 18% of respondents would not approach and help a person with a mental health condition on the street. The results indicate that in Montenegro, there is definitely a problem concerning mental health disorders. Some authors believe that stigmatization results from insufficient knowledge about mental health (Abdullah and Brown 2011; Nohr et al. 2021) and others show no association between them (de Almeida et al. 2023). The knowledge about mental health in Montenegro needs to be examined more in the future.
Nearly 78% of respondents reported that there is no mental health campaign in their community, and 97.2% thought it would be helpful to have one. The results indicate that there is a lack of mental health promotion in Montenegro; we were also unable to locate any data about ongoing or planned campaigns regarding mental health. The COVID-19 pandemic has harmed mental health, as evidenced by the up to 25% increase in depression and anxiety disorders in developing countries, according to WHO data (World Health Organization 2022), contributing further to the mental health impairment already present across society (Ferrari et al. 2022). Unavoidably, there will be a pressing need for national research and a well-coordinated campaign that is accessible to a large portion of the population.
The first aim of this study was to analyze the presence of stigma in the population of Montenegro. We hypothesized that the stigma toward mental health disorders in Montenegro will be high. Our evidence was not consistent with this hypothesis because most data from the literature were not comparable. Just one study from Spain was partially comparable (using the same instrument and the same statistical analysis) (Aznar-Lou et al. 2016). In Spain, the mean score for subscale authoritarianism was 24.9, which is similar to our result. The mean value for benevolence was 27.6 and, in our study, it was 41.3. The result showed that the population in Montenegro has a more benevolent attitude towards people with mental health conditions. Authors from Bosnia and Herzegovina have conclusions that the residents show more benevolence toward mental health disorders, but we did not find mean data (BIH) (Federalno ministarstvo zdravlja. Zavod za javno zdravstvo Federacije BIH 2012). The authors concluded that attitudes towards mental health disorders in Serbia were similar to Western attitudes (Jerotić et al. 2019). A Czech study showed that stigma toward mental health disorders is high (Winkler et al. 2016). Most data were not comparable, because the study was conducted with a different instrument or different statistical analysis. It is inevitable that we do not have clear data about stigma toward mental health disorders in different countries and cultures. In future, we need to plan a multicultural study to obtain representative data. With the COVID-19 pandemic’s effects on mental health in mind, as well as the fact that stigma is important because it affects wellbeing, we should focus more on the issues of stigma and mental health in the future.
The second aim of this study was to determine the influence of socio-demographic variables. We hypothesized that stigma toward mental health disorders will be higher in men and the less-educated general population in Montenegro, and our evidence was consistent with this hypothesis. Males have statistically significantly lower values on the benevolence subscale and community attitudes toward mental health disorders subscale and higher on the social restriction subscale. Less-educated people had statistically significant values on the authoritarianism subscale. These results correlate with other studies (Federalno ministarstvo zdravlja. Zavod za javno zdravstvo Federacije BIH 2012; Aznar-Lou et al. 2016). People who have children have statistically lower values on the benevolence subscale and social restriction subscale. People with primary education have higher values on the authoritarian subscale than more-educated people and this is similar in Spain (Aznar-Lou et al. 2016). In future, we need to plan a study to investigate the reasons for these differences in sociodemographic characteristics and stigma to form adequate preventive measure or campaigns for the promotion of mental health and psycho-education, especially those started in the earliest period of life, in order to provide sufficient information and knowledge, all with the aim of reducing stigma. Furthermore, this study discovered that socio-demographic variables only account for a small percentage of variance on the CAMI scale. The study found that the examined socio-demographic characteristics in a patriarchal and conservative country (including Montenegro) contribute only a small amount to the variances on the scales of authoritarianism (2.9%), benevolence (2.1%), social restrictions (2.1%), and the community’s attitude toward mental health disorders (0.5%), implying the need to investigate other factors that contribute more significantly.
There are several weak points in our study that could be improved in future studies. The cross-sectional design of the study limits the interpretation of the causality of various factors identified on this scale, and the use of surveys is not ideal. One of the limitations is that we used an online questionnaire to collect data, so the participants were only those who had online access. Future research needs to be followed-up and might consider the use of traditional methods (face-to-face). In addition, in future research, we should collect more detailed information using semi-structured interviews or qualitative approaches. The influence of respondents on factors other than socio-demographics was not taken into account. In future, we need to explore other variables that could influence personality traits, religious beliefs, and other cultural differences. The sample does not reflect the age, gender, and educational structure of the population in Montenegro. The study included fewer men who were older and less educated, and this could have affected the findings; future studies should attempt to collect a larger number of participants in each category to make a statistically representative comparison. In the first part of the questionnaire, we did not include any questions concerning the presence of mental health disorders in respondents and this could influence the results and interpretations.
Nevertheless, this is the first study from Montenegro in which we managed to gather a large sample of residents. The instruments used in our study are validated and reliable and have already been translated and used. The study offers valuable input for future studies and preventive measures.

5. Conclusions

The results acquired show the severity of the issue when it comes to Montenegro’s stigma around mental health conditions. Subjective opinions from respondents about a lack of campaigns and the presence of stigma among young and educated people point to the importance of planning campaigns and psycho-education in this population.
A thorough comprehensive and metacentric study that will identify and look at a variety of individual characteristics that have an impact on mental health in Montenegro is required in the future.

Author Contributions

Conceptualization, A.P. and N.M. methodology, A.P. and N.M.; software, N.M., formal analysis, N.M.; investigation, A.P. and N.M.; writing—original draft preparation, A.P.; writing—review and editing, A.P. and N.M. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the U.S. Embassy in Montenegro, Podgorica. Award No SMJ19021GR3029.

Institutional Review Board Statement

The study was conducted in accordance with the Declaration of Helsinki.

Informed Consent Statement

Informed consent was obtained from all subjects involved in the study.

Data Availability Statement

Not applicable here.

Acknowledgments

This research is part of the “Deconstructing the stigma about mental health issues in MNE” project, supported through the U.S. Embassy Podgorica’s Democracy Commission Small Grants Program. The opinions, findings, and conclusions or recommendations expressed herein are those of the author(s) and do not necessarily reflect those of the Department of State.

Conflicts of Interest

The authors declare no conflict of interest.

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Table
Table 1. Socio-demographic characteristics.
Table 1. Socio-demographic characteristics.
Sociodemographic CharacteristicsNumber (N)Frequency (%)
Gender
     Male17530.1
     Female40669.9
Age
     18–2421637.2
     25–3420936.0
     35–4413923.9
     45+172.9
Residence
     Central region38165.6
     South region10818.6
     North region9215.8
Marital status
     Single38967.0
     Married/in a relationship19733.0
Parenthood
     Yes14024.1
     No44175.9
Professional qualifications
     Primary school/without educ.193.3
     High school17029.3
     University degree32656.1
     PhD/Master6611.4
Table
Table 2. Respondents’ opinions.
Table 2. Respondents’ opinions.
Respondents Opinions Number
N		Frequency
(%)
Mental disorders are common in the communityYes44075.7
No 14124.3
There are people in your community who have mental health problems/disordersYes46379.7
No 11820.3
Would you advise people from your community to seek professional helpYes54894.3
No 335.7
Would you seek professional help if it’s neededYes55896.0
No 234.0
On the street, would you approach and/or help a person with mental health problem/disorderYes47782.1
No 10417.9
Is there a campaign on mental health in your communityYes12922.2
No 45277.8
It would be useful to organize a campaign on mental health in your communityYes56597.2
No 162.8
Table
Table 3. Mean values from CAMI scale.
Table 3. Mean values from CAMI scale.
CAMI ScaleNMinMaxASSD
Authoritarianism581103924.254.62
Benevolence581255041.334.60
Social restrictions581103721.725.11
Community attitudes towards mental health disorders581215034.033.97
Table
Table 4. CAMI scale in relation to the sociodemographic characteristics.
Table 4. CAMI scale in relation to the sociodemographic characteristics.
Sociodemographic
Characteristic’s		Authoritarianism BenevolenceSocial RestrictionsCommunity Attitudes towards Mental Health Disorders
AS
(SD)		pAS
(SD)		pAS
(SD)		pAS
(SD)		p
Gender
Male2481 (4.67)0.06140.18 (4.84)0.00022.66 (4.86)0.00333.45 (3.91)0.021
Female24.01 (4.58) 41.82 (4.40) 21.31 (5.16) 34.27 (3.97)
Residence
Central region24.17 (4.63)0.4041.48 (4.50)0.46621.81 (5.00)0.80134.09 (3.95)0.528
North region24.84 (4.52) 40.85 (4.46) 21.66 (5.05) 33.61 (3.53)
South region24.04 (4.67) 41.19 (5.03) 21.44 (5.56) 34.18 (4.39)
Age
18–2424.69 (4.91)0.23341.74 (4.78)0.19421.09 (5.32)0.6633.99 (4.25)0.659
25–3424.13 (4.40) 41.36 (4.43) 21.67 (4.87) 34.31 (3.91)
35–4424.09 (4.27) 40.82 (4.42) 22.83 (5.02) 33.77 (3.69)
45–5423.41 (4.93) 39.68 (4.52) 22.90 (4.91) 33.22 (3.48)
Marital status
Single24,45 (4.74)0.57241.59 (4.62)0.27421.49 (5.20)0.44930.07 (4.04)0.937
Married/in a relationship23.90 (4.45) 40,87 (4.59) 22.11 (4.99) 33.92 (3.87)
Parenthood
Yes24.08 (4.30)0.59140.34 (4.31)0.00322.65 (4.78)0.01033.76 (3.71)0.331
No24.31 (4.72) 41.54 (4.64) 21.42 (5.18) 34.12 (4.05)
Professional qualifications
Primary school/without education27.63 (2.95)0.00240.05 (3.58)0.59322.79 (3.17)0.82733.53 (3.83)0.753
High school24.73 (4.62) 41.22 (4.57) 21.74 (5.11) 33.88 (3.90)
University degree23.85 (4.70) 41.48 (4.73) 21.66 (5.17) 34.05 (4.09)
PhD24.06 (4.16) 41.24 (4.28) 31.62 (5.29) 34.42 (3.63)
Table
Table 5. Linear regression.
Table 5. Linear regression.
CAMIBS.E.Stand(B)TSig.95.0% CIToleranceVIF
LowerUpper
Authoritarianism
Gender−0.9340.416−0.093−2.2430.025−1.752−0.1160.9881.012
Residence0.2080.2570.0340.8070.420−0.2970.7120.9631.038
Age−0.3740.281−0.069−1.3310.184−0.9270.1780.6311.584
Marital status−0.5710.557−0.058−1.0260.305−1.6650.5230.5251.903
Parenthood−0.7040.659−0.065−1.0670.286−1.9990.5920.4532.205
Professional qualifications−0.7140.286−0.107−2.4980.013−1.276−0.1530.9251.081
Benevolence
Gender1.6890.4100.1694.1240.0000.8852.4940.9881.012
Residence−0.4600.253−0.075−1.8200.069−0.9570.0370.9631.038
Age−0.1400.277−0.026−0.50800.612−0.6840.4030.6311.584
Marital status0.2410.5480.0250.439.661−0.8361.3170.5251.903
Parenthood 1.4500.6490.1352.2340.0260.1752.7240.4532.205
Professional qualifications0.3530.2810.531.2570.209−0.1990.9060.9251.081
Social restrictions
Gender−1.3240.460−0.119−2.8790.004−2.227−0.4120.9981.012
Residence0.0430.2840.0060.1500.881−0.5150.6000.9631.038
Age0.5020.3110.0841.6180.106−0.1081.1120.6311.584
Marital status−0.4510.615−0.042−0.7320.464−1.6590.7520.5251.903
Parenthood−1.0600.728−0.089−1.4550.146−2.4900.3710.4532.205
Professional qualifications−0.3940.316−0.053−1.2460.213−1.0140.2270.9251.081
Community attitudes towards mental health disorders
Gender0.8640.3600.1002.4000.0170.1571.5710.9881.012
Residence−0.2390.222−0.045−1.0750.283−0.6760.1980.9631.038
Age−0.0550.243−0.012−0.2270.821−0.5330.4220.6311.584
Marital status0.1000.4820.0120.2070.836−0.8461.0460.5251.903
Parenthood0.4470.5700.0480.7830.434−0.6731.5670.4532.205
Professional qualifications0.3090.2470.051.2510.212−0.1760.7950.9251.081
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Popović, A.; Marić, N. Mental-Health-Related Stigma in a Conservative and Patriarchal Community. Soc. Sci. 2023, 12, 262. https://doi.org/10.3390/socsci12050262

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Popović A, Marić N. Mental-Health-Related Stigma in a Conservative and Patriarchal Community. Social Sciences. 2023; 12(5):262. https://doi.org/10.3390/socsci12050262

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Popović, Aleksandar, and Nada Marić. 2023. "Mental-Health-Related Stigma in a Conservative and Patriarchal Community" Social Sciences 12, no. 5: 262. https://doi.org/10.3390/socsci12050262

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