Discriminant function analysis (DFA) was used. The predicted variable was country of membership: El Salvador and the U.S. The predictors were recognition, knowledge, social distance, help-seeking attitudes, and negative attribution toward schizophrenic patients.

Three hundred forty subjects participated in the study, 136 college students from a university in southern California, and 204 students from a university in San Salvador, El Salvador. The mean age of the participants was 22.02 years, and 54.7% were women. Demographics are shown in Table 1.

TABLE 1 TABLE 1 Sociodemographic characteristics of participants by country (in percentages) Source: own work.

A survey was designed, using a case vignette of a person with schizophrenia (Jorm et al., 2005) that met the diagnostic criteria of DSM-IV and ICD-10. Participants were asked whether the person was normal or abnormal, and attached a self-generated diagnosis. The items about knowledge of the disorder were derived from Furnham and Chan (2004). The participants were asked about biological and sociological factors in the etiology and treatment of schizophrenia. Misconceptions of the disorder were also included. The social distance attitudes scale measured how much people wished to avoid social interaction with schizophrenic patients (Lauber et al., 2004; Link et al., 1999; van ‘t Veer, Kraan, Drosseart, & Modde, 2006). A scale, based on Furnham and Chan (2004) and van ‘t Veer et al. (2006), appraised the negative value the participants attributed to schizophrenia in terms of intelligence, trustworthiness, socioeconomic level, self-control, and aggressiveness. Finally, a help seeking attitude scale was designed ad hoc. All scales used a Likert design in which responses ranged from 1 to 5, denoting the level of agreement with the sentences: “disagree”, “somewhat disagree”, “neutral”, “somewhat agree”, and “agree”. A native Spanish speaker from El Salvador translated the questionnaire into Spanish. The translation was checked and validated by a Spanish major professor at the university in southern California.

The participants were randomly selected from both university campuses. College students interested in participating in this study were interviewed individually. A consent form was applied. Students were given the first section of the questionnaire. They read the case vignettes, and based on their impression they answered items on the following sections. Sociodemographic information was requested.

Principal component analyses (PCA) using oblimin rotation were conducted to build composite factors from the observed variables. The new composite factors represented each of the following scales: social distance, negative attribution, help-seeking attitude, knowledge on sociological and biological factors, and misconceptions of schizophrenia. Bartlett’s test of sphericity indicated that the matrices were factorable (all p < 0.05). Items that reached statistical and practical (coefficients > 0.30) significance were selected to build the new measures. Follow up PCA were computed only with the selected items to obtain the new factor loadings or coefficients that were used in the composite scales (see Table 2). A DFA was performed using recognition and the six MHL factors to determine how each of these constructs contributed most to country differences.

TABLE 2 TABLE 2 Principal Components Analysis with Oblimin Rotation: Items per scale Source: own work

Notes: The respecified loadings correspond to a follow-up PCA.

TABLA 2 (cont.) TABLA 2 (cont.) Principal Components Analysis with Oblimin Rotation: Items per scale Source: own work

Notes: The respecified loadings correspond to a follow-up PCA.

Recognition. Recognition rates of schizophrenia differed between the U.S. and E.S. college students, χ² (1, 340) = 19.98, p < 0.001. The U.S. rate (45.6%) was about double the E.S. rate (22.5%).

Social distance. The social distance scores showed that individuals from E.S. were more likely to avoid interacting with schizophrenic patients than were those from the U.S. (p < 0.001). The differences in social distance were most pronounced when considering these patients as potential coworkers, in-law family members, neighbors, and roommates (p < 0.05). No differences between countries were found when participants considered these patients as friends or when they considered having a rehabilitation center near their houses (see Table 3).

Help seeking attitudes. Salvadorans had lower scores on the composite measure of help-seeking attitudes than did Americans (p = 0.019). Although no differences between countries were found when asked if they would seek help for a schizophrenic family member, they differed when asked for a specific action to seek help (see Table 3). Individuals from E.S. were less willing to go with this potential family member to a doctor’s appointment than were those from the U.S. (p = 0.002).

Negative attributions. Higher mean scores on the negative attribution scale were found among the E.S. students (see Table 3). In particular, Salvadorans attributed more negative values to schizophrenic patients in terms of aggressiveness and untrustworthiness (p < 0.001).

Knowledge. The E.S. students placed more importance on sociological causal factors, such as family social rejection and a stressful society than did the U.S. students, who were more likely to cite biological causes such as genetics, chemical imbalance, and to recommend pharmacological treatment (see Table 3). Among the E.S. students, misconceptions of schizophrenia were more frequent, than in the U.S. (p < 0.001). Salvadorans agreed more than did Americans that childhood sexual abuse, lack of will power, and a ‘sick’ society were causes of schizophrenia (p < 0.05).

TABLE 3 TABLE 3 Mean scores (Standard Deviations) of the items and scales of Social Distance, Help-Seeking attitude, Negative attribution, Knowledge on Sociological factors, Biological factors, and Misconceptions of schizophrenia by country Source: own work.

Notes: The respecified loadings correspond to a follow-up PCA.

TABLA 3 (cont.) TABLA 3 (cont.) Mean scores (Standard Deviations) of the items and scales of Social Distance, Help-Seeking attitude, Negative attribution, Knowledge on Sociological factors, Biological factors, and Misconceptions of schizophrenia by country Source: own work.

Notes: The respecified loadings correspond to a follow-up PCA.

All factors loaded on one discriminant function, indicating that the differences between countries are maximized on a single dimension. The discriminant function was significant, χ² (7) = 106.92, p < 0.001, and accounted for 100% of the between-group variability. This function maximally discriminated E.S. students (M = 0.50) from the U.S. students (M = -0.75). The loadings or structure coefficients were as follows: misconceptions (= 0.73), sociological factors (= 0.52), negative attributions (= 0.44), recognition (= -0.41), social distance (= 0.31), biological factors (= -0.23), and help-seeking attitudes (= -0.21). These loadings suggest that all variables are statistically significant predictors for distinguishing between individuals from these two countries, although, knowledge on biological factors and help-seeking attitudes did not reach practical significance (factor loadings < 0.30). The function and loadings indicate that individuals from E.S. differ from those in the U.S. by having more misconceptions, preferring greater social distance, supporting more sociological causal factors, and attributing more negative values to those who suffer from schizophrenia (see Figure 1).

Figure 1. Figure 1. Country differences as a function of MHL. Source: own work.

Overall, the discriminant function accurately predicted 74.4% of the participants’ country of membership, χ² (1) = 75.23, p < 0.001. At the individual level, 69.9% of individuals from the U.S. and 77.5% of individuals from E.S. were correctly classified.

A composite score was built taking into account recognition of case vignette and knowledge of the disease. This composite score was named MHL.

Effect of MHL and country on social distance. A two factor ANOVA was carried out to examine the effect of MHL and country on social distance attitudes. No difference was found on these attitudes at each level of MHL on both countries, (F < 1). When isolating each sample group by country, differences appeared on the relationship between MHL and social distance. In the E.S. sample, social distance attitudes differed with level of MHL, F (1, 167) = 5.24, p < 0.023. Those Salvadorian students with low level of MHL had more social distance attitudes (M = 21.13), compared to those with a high level of MHL (M = 19.75) (see Figure 1). No differential effect of MHL was found in the U.S. sample (F < 1).

Figure 2.

* p < 0.05.