(PS4-B26) The Folk Psychiatry Model: Developing a Measure of Lay Perceptions of PTSD

Existing literature suggests that problematic perceptions of PTSD in members of the general public are associated with a range of negative outcomes among survivors (e.g., Kern et al., 2019; Ullman & Peter-Hagene, 2016). Current models propose that public explanations about the etiology of mental health difficulties may influence subsequent beliefs about those with mental illness. Haslam’s (2005) Folk Psychiatry model suggests that lay explanations about the development and maintenance of psychological difficulties can be quantified on distinct moralizing (i.e., mental health conditions are the result of moral failings), medicalizing (i.e., mental health conditions are the result of biomedical causes), and psychologizing (i.e., mental health conditions are the result of contextual and other external factors) dimensions. The current project aimed to develop a trauma-specific measure capturing lay explanations of PTSD consistent with hypotheses outlined in the Folk Psychiatry framework.

            Three independent samples were collected using Amazon’s Mechanical Turk. An initial item pool was developed based on hypotheses from the Folk Psychiatry model, outlining specific moralizing, medicalizing, and psychologizing beliefs about PTSD. Respondents were instructed to indicate agreement with various statements (e.g., PTSD is caused by a lack of willpower) on a 1 (Completely Disagree) to 8 (Completely Agree) Likert scale. Exploratory factor analyses (EFA) in Study 1 (N = 365; 56% female; 79% White/Non-Hispanic) offered initial support for the hypothesized 3-factor solution containing correlated moralizing, medicalizing, and psychologizing dimensions. EFA in an expanded item pool for Study 2 (N = 367; 72% female; 76% White/Non-Hispanic) provided continued support for the 3-factor model.

Confirmatory factor analyses in Study 3 (N = 401) provided evidence for close fit for the hypothesized 3-factor model in items selected for the final measure (RMSEA = .050 [.037, .063]; SRMR =.039; CFI = .965; TLI = .955). Correlations of observed scales indicated moderate associations between moralizing and medicalizing (r = .34) and between medicalizing and psychologizing (r = .35) dimensions, but a near-null association between psychologizing and moralizing (r = .06) scores. Correlations with external measures of general beliefs about mental health difficulties showed strong convergence of moralizing with problematic attitudes including authoritarianism, blame, and anger. Medicalizing was associated with increased blame, anger, and pity, but reductions in social restrictiveness. Psychologizing demonstrated smaller-magnitude associations with increased pity and decreased social restrictiveness. 

            Results of the current project support the application of the Folk Psychiatry model to lay perceptions about PTSD and offer initial support for structural stability and utility of the novel measure. Data also provide insight into how different explanatory dimensions are associated with broader beliefs about people with mental illness and how this may translate into stigmatizing/prejudicial behavior.