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Title: Reducing the sense of separation : investigating the temporal association of continuum beliefs and interconnected explanations with stigma and advocacy for individuals with anxiety disorders and schizophrenia
Authors: Yu, BCL 
Peng, SX 
Chen, SX 
Ng, JCK 
Issue Date: Dec-2025
Source: SSM Mental health, Dec. 2025, v. 8, 100490
Abstract: Background and aims: Social stigma has been adversely affecting various aspects of life for people with mental illness across different cultural contexts, highlighting an urgent need to reduce this stigma. It has been theorized that a sense of separation is a key component of stigmatization, and addressing this component is considered a feasible way to reduce social stigma. This study aimed to investigate the temporal relationship between continuum belief and interconnected explanations—constructs thought to address the sense of separation—and their impact on stigma and collective action for people with anxiety disorders and schizophrenia and their mechanism. Continuum belief views mental illness as existing on a spectrum of severity, rather than as a binary state of normality versus mental disorder. Interconnected explanation refers to the perception that individuals see themselves as contributing factors to the welfare of those with mental illness.
Methods: Valid responses were collected from 377 participants who reported that they did not have a history of clinical diagnosis of mental illness (57 % women; mean age = 21.55 years, SD = 5.15) from a public university in Hong Kong at baseline. A total of 308 (82 %) and 305 (81 %) valid responses were collected from the same group of participants at 1-month and 2-month follow-up assessments, respectively.
Results: Perceived similarity did not mediate the relationship between continuum belief and stigma or collective action, both concurrently and prospectively, after controlling for interconnected explanation, interconnected accountability, and previous contact experiences. However, interconnected accountability significantly mediated the relationship between interconnected explanation and both the intention to participate in and actual participation in collective action, but not stigma, for people with anxiety disorders and people with schizophrenia, both concurrently and prospectively.
Conclusion: This study provides evidence supporting the potential of interconnected explanation in promoting collective action for people with mental illness. It also offers insights into how continuum belief might be utilized for stigma reduction and advocacy promotion.
Keywords: Advocacy
Collective action
Continuum belief
Interconnected explanation
Interconnectedness
Perceived similarity
Stigma
Publisher: Elsevier Ltd
Journal: SSM Mental health 
EISSN: 2666-5603
DOI: 10.1016/j.ssmmh.2025.100490
Rights: © 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
The following publication Yu, B. C. L., Peng, S. X., Chen, S. X., & Ng, J. C. K. (2025). Reducing the sense of separation: Investigating the temporal association of continuum beliefs and interconnected explanations with stigma and advocacy for individuals with anxiety disorders and schizophrenia. SSM - Mental Health, 8, 100490 is available at https://doi.org/10.1016/j.ssmmh.2025.100490.
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