Comparing accuracy of knowledge of functional effects of schizophrenia and brain injury

Abstract

This study developed and validated the Brain Injury and Schizophrenia Awareness Scale (BISAS) to compare accuracy of knowledge of functional effects of schizophrenia and TBI. The BISAS displayed good internal consistency and evidence of construct validity. Overall, general community participants (n=143) lacked understanding of the shared effects of these conditions, and attributed emotional and behavioural deficits to schizophrenia and cognitive deficits to TBI.

Introduction

Schizophrenia and traumatic brain injury (TBI) are the two leading causes of chronic disability worldwide (World Health Organisation, 2010). Despite different aetiologies, schizophrenia and TBI are both neurocognitive disorders in which brain pathology interacts with environmental and personal factors to influence functioning. Characteristic symptoms of schizophrenia that are similar to severe TBI include emotional and behavioural difficulties and cognitive impairments (Singh et al., 2010). However, lateralised sensory-perceptual and physical impairments are distinctly associated with TBI (Ponsford et al., 2012), whereas positive symptoms are a primary feature of schizophrenia but not TBI (Compton et al., 2007).

Health literacy research highlights that greater knowledge of neurological and psychiatric disorders influences social attitudes and behaviour (Furnham and Blythe, 2012, Hux et al., 2006, Reavley and Jorm, 2011). Rather than focusing on a single condition, some studies have compared knowledge and attitudes towards different health conditions (e.g., Melas et al., 2013, Scior et al., 2013). The ability to both accurately identify and distinguish symptoms is likely to reduce generalisations made about people with disability and increase public awareness and support. For example, positive symptoms of schizophrenia such as hallucinations and delusions are more recognised by the public than negative symptoms and cognitive effects (Lauber et al., 2005). The public typically overgeneralises the effects of TBI (Ono et al., 2011), and views TBI as akin to mental illness (Swift and Wilson, 2001).

Existing studies of public knowledge and attitudes about schizophrenia and TBI (e.g., Compton et al., 2007, Hux et al., 2006) have focused on broader knowledge of each condition (e.g., prevention, aetiology, onset, and symptoms), rather than the everyday effects. Current knowledge scales either contain few items assessing functional effects or tap symptoms in specific domains, such as positive symptoms for schizophrenia (Compton et al., 2007) and memory problems for TBI (Hux et al., 2006, Swift and Wilson, 2001).

To advance understanding of mental health literacy on two prevalent neurocognitive disorders, this study aimed to develop and validate the Brain Injury and Schizophrenia Awareness Scale (BISAS) and compare accuracy of knowledge of the functional effects of schizophrenia and TBI.