Longitudinal investigation into implicit stigma of epilepsy among Japanese medical students before and after mass media coverage of car accidents associated with people with epilepsy

•We studied implicit stigma toward epilepsy among medical students over 6 years.•We used the implicit association test (IAT) to measure stigma toward epilepsy.•Car accidents involving people with epilepsy in Japan increased from 2011 to 2012.•Attitudes toward epilepsy were worse in 2013 than in 2010 but improved in 2016.•This is the first longitudinal study on implicit attitudes using the IAT in Japan.

ObjectivePublic attitudes and stigma toward epilepsy may limit patient motivation for treatment and participation in social activities. Stigma research requiring individuals to report personal beliefs is useful but is subject to social desirability bias. Self-reporting methods often do not capture implicit attitudes; therefore, in this study, implicit stigma was measured using the implicit association test (IAT), which is a word sorting task to minimize this bias. Recently, in Japan, several serious car accidents caused by people with epilepsy (PWE) resulted in pedestrian fatalities. 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 among medical students in 2010, 2013, and 2016.MethodsWe recruited 41 medical students in 2010, 44 medical students in 2013 and 42 medical students in 2016. We investigated the strength of conceptual associations between the words “Epilepsy” or “Hypertension”, and “Safety” or “Danger” in the IAT.ResultsThe association between the words “Epilepsy” and “Danger” was stronger in 2013 compared with that in 2010; however, the association was weaker in 2016 compared with that in 2013. There was no significant difference between 2010 and 2016.ConclusionThe change in IAT results between 2010 and 2013 might be due to the traffic accident involving PWE in Japan. However, the result in 2016 might indicate that the implicit attitudes toward epilepsy were improved to the same level as those in 2010.