Understanding Stigma Among Mental Health Clinicians: Implicit, Explicit and Dissociation-Specific Beliefs

Jones, Christopher (2026) Understanding Stigma Among Mental Health Clinicians: Implicit, Explicit and Dissociation-Specific Beliefs. Doctoral thesis, University of East Anglia.

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Abstract

Aims: This thesis examined stigma among mental health clinicians towards people with mental health conditions. The systematic review investigated the relationship between implicit (automatic) and explicit (conscious) stigma. The empirical project focused on the explicit attitudes and beliefs of NHS clinicians concerning dissociation, including the endorsement of stigma and misinformation.

Methods: Eight databases were systematically searched to provide a review of studies investigating implicit and explicit stigma. Random-effects meta-analyses of Fisher r-to-z transformed correlations were conducted. The empirical project offered a mixed methods survey of NHS clinicians working in secondary mental healthcare. Quantitative data (e.g., rating scales) were analysed descriptively, and qualitative (free-text) data were examined using content analysis.

Results: Ten studies (1,404 clinicians) were included in the systematic review and meta-analysis. This revealed a weak, positive association between implicit and explicit stigma (r = .13). Moderate heterogeneity was largely accounted for by diagnostic category, with studies examining substance use disorder finding a stronger association (r = .27) than studies investigating other mental health conditions (r = .08). The empirical paper analysed responses from 135 clinicians. Awareness of dissociation was high, but confidence and training varied. Beliefs about its prevalence, severity and dangerousness appeared moderate, while dissociation was perceived as treatable and psychological. Misinformed beliefs were endorsed by some staff, and were negatively correlated with a belief that ‘dissociation is caused by trauma’. Qualitative data revealed mostly neutral or supportive language, although stigmatising words were more frequently directed towards patients than dissociation itself.

Conclusions: This thesis revealed stigma to be a multifaceted construct among clinicians. It found implicit and explicit stigma to be largely distinct processes, while the empirical paper highlighted the value of mixed methods to explore the variation in attitudes, beliefs and stigma towards dissociation. This has implications for stigma theories, stigma reduction initiatives, and training for clinicians.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	Bethany Turner
Date Deposited:	13 Nov 2026 11:51
Last Modified:	13 Nov 2026 11:51
URI:	https://ueaeprints.uea.ac.uk/id/eprint/105104
DOI:

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