***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This study examined how two types of public education programs influenced how the public perceived persons with mental illness  , their potential for violence , and the stigma of mental illness .  A total of 161 participants were r and omly assigned to one of three programs : one that aim ed to combat stigma , one that highlighted the association between violence and psychiatric disorders , and a control group . Participants who completed the education-about-violence program were significantly more likely to report attitudes related to fear and dangerousness , to endorse services that coerced persons into treatment and treated them in segregated areas , to avoid persons with mental illness in social situations , and to be reluctant to help persons with mental illness Background : Studies regarding the effectiveness of CME programmes on physicians ’ behaviour and communication skills showed inconsistent results . Few r and omized controlled trials have been conducted in Asia . Methods : To evaluate the effectiveness of a 4 2-hour education programme to improve GP interviewing behaviours , 16 general practitioners were r and omized to the intervention and control groups , respectively . Physicians assigned to the intervention group received 8 hours of training emphasizing interviewing behaviours in the diagnosis and treatment of depression and generalized anxiety disorders ( GDS ) . Those assigned to the control group did not receive any training until the completion of study . St and ardized patients were used to evaluate the performance of physicians .  Two consultations before and after enrolling in the education programme were videotaped . Independent evaluations of consultations were made by a trained clinical psychologist and a social worker blinded to the study status of physicians . The rating schedule for the videotapes was based on the tasks listed on the Calgary Cambridge Observation Guide . Results : The change of score between the intervention and control physicians was significantly different in ‘ active listening and facilitating patients ’ response ’ ( p = 0.011 ) with the intervention physicians having improvement of score . For ‘ non-verbals ’ , ‘ underst and ing patient 's perspective ’ and ‘ negotiating mutual plan of action ’ , positive change of score in the intervention physicians were seen when compared to that of the control , although the difference did not reach statistical significance ( p = 0.06 , p = 0.05 , p = 0.06 , respectively ) . However , for ‘ opening ’ , ‘ structuring the consultation ’ , ‘ explanation and planning ’ and ‘ closure ’ , there were no statistical significant differences between control and intervention group . Conclusions : Our results showed that only certain communication skills , such as active listening and facilitating patient 's response , can be taught in the management of depression and generalized anxiety disorder ( GAD ) in Chinese primary care physicians This study examines the personal and attitudinal variables that are associated with helping behavior in a hypothetical general practice setting . We explored the effect of an antistigma seminar during a psychiatric clerkship on medical students ’ attitudes toward the mentally ill . We r and omly assigned  three rotations of students ( 81 students ) to receive the seminar and three rotations ( 85 students ) as controls .  The students expressed views about patients with schizophrenia or depressive disorder portrayed in video vignettes . How dangerous the students perceived target individuals to be was the major determinant of helping behavior . The students ’ gender , religious affiliation , affective reaction , skill assessment , and controllability attribution were less consistent in predicting behavior . Exposure to the seminar and clerkship experience significantly improved attitudes , but attributes of responsibility and readiness to provide medical care for psychiatric patients were the most resistant to change . We identified certain issues that should be highlighted in future antistigma programs Stigmatizing , or discriminatory , perspectives and behaviour , which target individuals on the basis of their mental health , are observed in even the youngest school children . We conducted a systematic review of the published and unpublished , scientific literature concerning the benefits and harms of school-based interventions , which were directed at students 18 years of age or younger to prevent or eliminate such stigmatization . Forty relevant studies were identified , yet only a qualitative synthesis was deemed appropriate . Five limitations within the evidence base constituted barriers to drawing conclusive inferences about the effectiveness and harms of school-based interventions : poor reporting quality , a dearth of r and omized controlled trial evidence , poor methods quality for all research design s , considerable clinical heterogeneity , and inconsistent or null results . Nevertheless , certain suggestive evidence derived both from within and beyond our evidence base has allowed us to recommend the development , implementation and evaluation of a curriculum , which fosters the development of empathy and , in turn , an orientation toward social inclusion and inclusiveness . These effects may be achieved largely by bringing especially but not exclusively the youngest children into direct , structured contact with an infant , and likely only the oldest children and youth into direct contact with individuals experiencing mental health difficulties . The possible value of using educational activities , material s and contents to enhance hypothesized benefits accruing to direct contact also requires investigation . Overall , the curriculum might serve as primary prevention for some students and as secondary prevention for others Background A Mental Health First Aid course has been developed which trains members of the public in how to give initial help in mental health crisis situations and to support people developing mental health problems . This course has previously been evaluated in a r and omized controlled trial in a workplace setting and found to produce a number of positive effects . However , this was an efficacy trial under relatively ideal conditions . Here we report the results of an effectiveness trial in which the course is given under more typical conditions . Methods The course was taught to members of the public in a large rural area in Australia by staff of an area health service . The 16 Local Government Areas that made up the area were grouped into pairs matched for size , geography and socio-economic level . One of each Local Government Area pair was r and omised to receive immediate training while one served as a wait-list control . There were 753 participants in the trial : 416 in the 8 trained areas and 337 in the 8 control areas . Outcomes measured before the course started and 4 months after it ended were knowledge of mental disorders , confidence in providing help , actual help provided , and social distance towards people with mental disorders . The data were analysed taking account of the clustered design and using an intention-to-treat approach . Results Training was found to produce significantly greater recognition of the disorders , increased agreement with health professionals about which interventions are likely to be helpful , decreased social distance , increased confidence in providing help to others , and an increase in help actually provided . There was no change in the number of people with mental health problems that trainees had contact with nor in the percentage advising someone to seek professional help . Conclusions Mental Health First Aid training produces positive changes in knowledge , attitudes and behaviour when the course is given to members of the public by instructors from the local health service BACKGROUND AND OBJECTIVES Although many studies have investigated the impact of causal models on public attitudes toward people with psychosis , the effect of causal models on patients with psychosis is unclear . Clinicians must therefore decide about providing causal information without knowing how it will impact on patient and treatment . This study investigates the effect of causal models on different aspects of treatment motivation . METHODS In an experimental online study healthy individuals ( n = 461 ) were instructed to imagine experiencing psychotic symptoms and seeking professional help . The imagination was supported by an audio play cover story . Subsequently , participants were r and omized to four conditions differing in the content of the causal model given for the occurring symptoms ( biological , psychological , combined and no causal explanation ) . RESULTS Different causal models impacted on different aspects of treatment motivation : Participants who had received a biological causal model showed high willingness to take medication , whereas participants who had received a psychological model reported high perceived personal control over symptoms . Participants who had received a causal model that combined biological and psychological aspects reported high acceptance of medication and high motivation to undergo treatment by this clinician . CONCLUSIONS The results underline the impact the content of a causal model may have on patients ' treatment motivation and - as a consequence - on treatment success . Overall , the integration of psychological and biological aspects within a causal model seems most promising in terms of adherence to various types of treatment This study attempted to determine the effects of a direct-mail campaign on the attitudes of managers and presidents of industries toward the mentally retarded . The participants in the study were 99 managers and presidents selected from a total population of 4290 within the State of Alabama , USA . R and om sampling techniques were utilized to select and assign managers and presidents into an experimental group ( n = 50 ) and a control group ( n = 49 ) , giving a total usable sample size of 99 . The size of this sample was adequate to insure that , in 19 out of 20 cases , the sample mean was within 0.50 points of the population mean on the response scale according to Elliot ( 1980 ) . The pre-test of the attitude scale was administered to the experimental and control groups by mail . A post-test was administered to the control and experimental groups one week after the mailing of the final pamphlet . The major finding of this study revealed positive attitude gains from pre-test to post-test for the experimental group following the direct-mail campaign . No significant difference was noted for the control group from pre-test and post-test . Pre-test scores of the experimental and control groups were not significantly different ; however , post-test scores between these groups were significantly different . The results of this research contribute further information on a direct-mail approach for changing attitudes of managers and presidents of industries toward mentally retarded persons OBJECTIVES The authors used nationwide survey data to characterize current public conceptions related to recognition of mental illness and perceived causes , dangerousness , and desired social distance . METHODS Data were derived from a vignette experiment included in the 1996 General Social Survey .  Respondents ( n = 1444 ) were r and omly assigned to 1 of 5 vignette conditions . Four vignettes described psychiatric disorders meeting diagnostic criteria , and the fifth depicted a " troubled person " with sub clinical problems and worries . RESULTS Results indicate that the majority of the public identifies schizophrenia ( 88 % ) and major depression ( 69 % ) as mental illnesses and that most report multicausal explanations combining stressful circumstances with biologic and genetic factors . Results also show , however , that smaller proportions associate alcohol ( 49 % ) or drug ( 44 % ) abuse with mental illness and that symptoms of mental illness remain strongly connected with public fears about potential violence and with a desire for limited social interaction . CONCLUSIONS While there is reason for optimism in the public 's recognition of mental illness and causal attributions , a strong stereotype of dangerousness and desire for social distance persist . These latter conceptions are likely to negatively affect people with mental illness Authors examined the combined effects of descriptive and explanatory information on peers ' perceptions and behavioral intentions toward an unfamiliar child with autism . Children ( N = 576 ; M age = 10.06 ) were r and omly assigned to view two videotapes of a boy engaging in typical and autistic behaviors receiving either descriptive ( AUT-D ) or descriptive and explanatory information ( AUT-D + E ) . Children responded to measures of attitudes ( Adjective Checklist ) and behavioral intentions ( Shared Activities Question naire ) . Children rated the typical boy more favorably than the boy showing autistic symptoms . When compared to descriptive information alone , the combination of descriptive and explanatory information result ed in improved third- and fourth- grade rs ' but not fifth- grade rs ' attitudes toward the child with autism . Combined information improved behavioral intentions across grade s ; however , girls ( vs. boys ) were more responsive to information as evidence d by differences in academic intentions . The combination of descriptive and explanatory information about autism appears to have a positive effect on  children 's attitudes and behavioral intentions . Implication s of the findings are briefly discussed as well as study limitations and recommendations for future research BACKGROUND Direct social contact interventions are known to reduce mental health stigma .  Filmed social contact may be equally effective and have practical and cost advantages . AIMS To compare the effectiveness of a DVD , a live intervention and a lecture control , in reducing stigma , testing the hypotheses that : ( a ) DVD and live interventions will be equally effective ; and ( b ) the interventions with social contact ( DVD/live ) will be more effective than the lecture .  Cost-effectiveness , process and acceptability are also assessed . METHOD Student nurses were r and omised to : ( a ) watch a DVD of service users/informal carers talking about their experiences , ( b ) watch a similar live presentation , or ( c ) attend a lecture . Primary outcomes were changes in attitudes ( using the Mental Illness : Clinicians Attitudes Scale , MICA ) , emotional reactions ( using the Emotional Reactions to Mental Illness Scale , ERMIS ) , intended proximity ( using the Reported and Intended Behaviour Scale , RIBS ) , and knowledge ( using the Social Contact Intended Learning Outcomes , SCILO ) , immediately after the intervention and at 4-month follow-up . RESULTS For the 216 participants , there were no differences between the DVD and live groups on MICA , ERMIS or RIBS scores . The DVD group had higher SCILO ( knowledge ) scores . The combined social contact group ( DVD/live ) had better MICA and RIBS scores than the lecture group , the latter difference maintained at 4 months . The DVD was the most cost-effective of the interventions , and the live session the most popular . CONCLUSIONS Our hypotheses were confirmed . This study supports the wider use of filmed social contact interventions to reduce stigma about mental illness The issue of suicide warning signs on the Internet is considered . In addition to review ing some of the relevant conceptual issues about warning signs , a r and om sample of Internet sites was selected and review ed . Warning signs were grouped and agreement across sites was examined , with results confirming broad disparity in what is presented to the public . The implication s of a lack of consensus on warning signs for suicide are discussed Acceptance and commitment therapy ( ACT ) has previously been shown to alter stigmatizing attitudes and to be relatively useful for psychologically inflexible participants . The present study is the first to bring those two findings together by comparing ACT to an education intervention for reducing stigma toward people with psychological disorders , and examining whether results differ for psychologically inflexible versus flexible individuals . A sample of college students ( N = 95 ) was r and omly assigned to a 2(1)2h ACT or educational workshop . Measures were taken before and after the workshop and at a 1-month follow- 
    Output:
    
The median SMDs indicate that mass media interventions may have a small to medium effect in decreasing prejudice , and are equivalent to reducing the level of prejudice from that associated with schizophrenia to that associated with major depression .
AUTHORS ' CONCLUSIONS Mass media interventions may reduce prejudice , but there is insufficient evidence to determine their effects on discrimination .