The Effect of Autism Knowledge and Diagnostic Labels on Stigma Towards Autism

Background: Although neurotypical (NT) adults evaluate peers with autism more favorably when they are made aware of their diagnosis, this pattern does not occur for NTs harboring high stigma about autism (Morrison et al., under review).

Objectives: The current study examines whether stigma-related attitudes in NTs are activated differently depending upon how an autism diagnosis is presented.

Methods: Neurotypical college students (n=266) (mean age = 21.55; SD = 4.61) completed six surveys answering questions in regard to one of eight labels, four referring to autism (Autistic, Autism, Autism Spectrum Disorder, Asperger’s), and four comparison labels (Schizophrenia, Schizophrenic, Clinical Disorder, Clinical Diagnosis). The Prejudice Scale (Hori et al., 2011) and the Social Distance Scale (SDS; Gillespie-Lynch et al., 2015) measured the raters’ stigma and willingness to interact with individuals with each label. The Attributes and Reactions Scale (AAR; Angermeyer & Matschinger, 2003) evaluated the perceived negative attributes (danger, dependency on others) and emotional reactions (fear, pity, anger) ascribed to different labels. The General Knowledge Questionnaire (Jensen et al., 2016) was used to assess raters’ beliefs about the prognosis and level of intelligence of people with each label, while the Autism Awareness Survey (AAS; Gillespie-Lynch et al., 2015) assessed autism knowledge.

Results: For the four autism labels, greater autism knowledge among NTs was associated with less evoked fear (R²= -.273; p=.001), less perception of danger (R²= -.401, p< .001), and reduced belief that autism requires dependency on others (R²= -.288, p=.001). NTs with greater autism knowledge also endorsed a more positive prognosis (R² = .401, p<.001) and perceived greater functioning within relationships (R²=.218, p=.01) for individuals with autism. Autism knowledge also correlated with social distance (R²=.207, p=.015): NTs with higher autism knowledge were more willing to interact with autistic individuals.

For stigma, levels of social distance and endorsements of fear and pity differed across labels (ps<.01). The schizophrenic label evoked more fear than the autistic, autism, and clinical diagnosis labels (ps<.01), but no label comparisons survived the correction for social distance (ps>.052) and pity (ps>.09).

NTs provided different intelligence and prognosis ratings across labels (ps<.004). The label Asperger’s was associated with more intelligence than the schizophrenia, schizophrenic, and generic clinical disorder labels (ps<.04), and raters endorsed more positive life outcomes for individuals with autism and Asperger’s compared to the generic clinical diagnosis label.

Conclusions: Levels of stigma did not differ across the four autism labels, suggesting that how autism is described does not induce distinct stigma-related attitudes. However, the label Asperger’s produced higher ratings of intelligence, and both autism and Asperger’s were rated as having better prognoses, suggesting each may be associated with perceptions of higher functioning. Additionally, higher autism knowledge was associated with better perceptions and decreased stigma of autism. Autism also was perceived more favorably than schizophrenia or a general clinical diagnosis. Although autism may therefore be viewed more favorably than some other conditions, results suggest that efforts to increase autism knowledge among NTs may help to further reduce stigma and prejudice.