Cross-Cultural Comparison of College Students' Stigmatizing Attitudes Towards ASD Between the United States and Japan

Background:  

Despite evidence that the prevalence of ASD is increasing worldwide (Elsabbagh et al., 2012), ASD is often misunderstood in various cultures (Japan: Koyama et al., 2008; Nigeria: Bakare et al., 2009; Saudi Arabia: Alqahtani, 2012). Moreover, while stigma associated with ASD is apparent worldwide (Australia: Gray, 2002; Hong Kong; Ling et al., 2010; Iran; Dehvani et al., 2011), perception of individuals with ASD may vary depending on the culture.  For instance, compared to Caucasians, Asians tend to perceive those with mental disorders as more dangerous (Whaley, 1997), which might lead them to hold more stigmatizing attitudes, including greater desire for social distance (Griffiths et al., 2006). Within country variability may provide important insights into differences between countries. Given that women and students in fields emphasizing understanding of others may exhibit more acceptance towards ASD in the US (Gardiner & Iarocci, 2013), cross-cultural similarities or differences in associations between gender, major and stigma towards ASD may elucidate mechanisms underlying potential cross-cultural differences in stigma.

Objectives:

1) Compare stigma towards ASD among students in the US and Japan; 

2) Examine between- and within-country predictors of stigma.

Methods:  

Students were recruited from American and Japanese universities: US sample (N = 369; 201 women, 168 men), Japanese sample (N= 220; 119 women, 101 men). Following a pretest assessing knowledge about ASD (adapted from the "Autism Awareness Survey" by Stone, 1987) and stigma associated with ASD (adapted from the "Social Distance Scale" by Bogardus, 1933), participants completed an online training about ASD, followed by a posttest identical to the pretest. 

Results:  

American students indicated less stigma towards ASD than Japanese students across all items of the social distance scale (see Table 1). In both countries, mean scores tended to increase (i.e., indicating less willingness to engage with an individual with ASD) with closer social distance (i.e. participants indicated less willingness to marry than to spend an evening with someone on the spectrum).

American women reported lower stigma than men (see Table 2). However, there were no significant differences in stigma between women and men in the Japanese sample. In both countries, students who majored in “helping majors” (e.g., Psychology, Education, Nursing [PEN]) reported less stigma towards ASD than students with other majors (see Table 2).

Autism knowledge was lower in Japan than the US, Z = -3.31, p = .001. In Japan, r (217)= -.19, p = .004, and the US, r (367)= -.26, p< .001, more knowledge was associated with less stigma. However, no differences in knowledge based on gender or major were observed in either country.

Conclusions:  

As expected, Japanese college students exhibited higher levels of stigma towards ASD than US students. While students in helping majors exhibited less stigma than their counterparts in both countries, women reported less stigma towards ASD in the US but not in Japan. Differences in ASD knowledge may contribute to cross-cultural differences between Japan and the US in stigma. However, other factors (such as empathy, desire to conform or quality of contact) likely underly within-country variability.