Abstracts

Rationale: Public attitudes and stigma toward epilepsy may limit patient motivation for treatment and social attendance. Recently, several serious car accidents caused by people with epilepsy (PWE) that resulted in pedestrian fatalities occurred in Japan. Traffic accidents involving PWE have been reported extensively and repeatedly in the media since 2011. The present study aimed to examine differences in implicit stigma toward epilepsy in medical students between 2013 and 2016. Methods: We recruited 42 medical students in 2013 and 42 medical students in 2016. Implicit stigma was measured with the implicit association test (IAT), developed to assess implicit attitudes that cannot be captured by self-report measures. We used two types of IAT, with "epilepsy" and "diabetes" as target categories. The attribute categories in the first IAT were "refusal" and "reception," and those in the second IAT were "bad" and "good." Each category included five stimulus words. Participants used a keyboard to sort stimulus words to the appropriate superordinate category as fast as possible when the word was displayed in the center of the computer screen. Responses are generally faster when the two categories that share a response key in the combined phases are associated than when they are not. We defined the condition where the epilepsy cues shared the response key with reception/good as the "compatible condition" and that where epilepsy cues shared the response key with refusal/bad as the "incompatible condition." We calculated the IAT effect, which involved subtracting the mean reaction time for compatible conditions from that of incompatible conditions. A positive IAT effect reflected a relatively strong positive association between epilepsy and refusal/bad. Participants also answered questions covering knowledge about epilepsy and diabetes. Analysis of variance was used to compare the mean reaction times and scores. Results: The reaction time for the incompatible condition was significantly longer than for the compatible condition in the second IAT (good and bad). A similar tendency was seen in the first IAT (refusal and reception). Both IATs revealed positive IAT effects in both years, indicating that participants associated epilepsy with bad/refusal implicit images more often than diabetes. There were no significant differences in IAT effects or in knowledge scores between 2013 and 2016. Conclusions: We found the same level of implicit stigma attitudes among medical students in Japan in 2016 and 2013, despite the efforts of the Japan Epilepsy Society. More activities are needed to reduce stigma toward epilepsy, and provide people with accurate knowledge about epilepsy and PWE. Funding: The Japan Epilepsy Research Foundation (2012)