Beyond Case Vignettes: Do Diagnostic Labels Affect How Symptoms of Mental Illness are Perceived?

A long-standing question in clinical psychology concerns the merits and drawbacks of using diagnostic labels in communication about mental illness. A frequent view is that such labels contribute to mental illness stigma, for example by fostering a categorical view of affected people as part of a distinct out-group. Previous research has found some evidence to support such claims, but results are mixed. The current study investigates the effects of diagnostic labels at the level of specific behaviors, rather than subsuming them in a case vignette, in a sample of psychology undergraduates in Germany. Results indicate that when behaviors are presented along with a diagnostic label, participants perceive them as less common, less blameworthy and less typical for themselves, but not as less acceptable, normal or treatable. With a label, behaviors are also perceived as more indicative of a person dependent on outside help. These results held true for behaviors across both actual DSM-5 symptoms of mental illnesses and similar behaviors that were not genuine diagnostic criteria. Labeling effects were most pronounced among symptoms of schizophrenia and autism but were generally similar across heterogenous diagnoses and items. Factor analyses showed that the different behaviors associated with a particular diagnosis were rated more uniformly when they were accompanied by a diagnostic label than when they were not.