{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T08:37:55Z","timestamp":1786523875659,"version":"build-2736575974"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Sci.","Behavioral Sciences"],"abstract":"<jats:p>Stigma-related beliefs toward mental illness may change during psychiatric clinical exposure, but individual differences in this process remain insufficiently understood. This single-center observational pre\u2013post study examined observed changes in mental illness-related beliefs among 185 medical interns who completed an approximately 30-day psychiatry clerkship between May 2025 and May 2026, with perceived dangerousness defined as the primary outcome. Beliefs were assessed before and after the exposure period using the Beliefs Toward Mental Illness Scale. Associations between baseline cognitive\u2013metacognitive characteristics and observed change were evaluated using paired comparisons, linear mixed-effects models, and sensitivity analyses. Dangerousness scores decreased by the end of the exposure period, mean change = \u22122.66, 95% CI [\u22123.48, \u22121.81], q &lt; 0.001, dz = \u22120.47. Smaller decreases were observed in Helplessness and Deterioration in Interpersonal Relationships, whereas no significant change was found in the two-item Shame subscale. Higher baseline ruminative thought style was associated with a more limited decrease in dangerousness scores; B = 1.70, SE = 0.55, 95% CI [0.62, 2.77], q = 0.023. Although this association was consistent across sensitivity analyses, its incremental contribution was small (\u0394R2marginal = 0.017; f2 = 0.018 in the focused model). The finding should therefore be interpreted as a quantitatively modest association with observed belief change, not as a clinically meaningful predictor. Because the study included no concurrent control group or experimental manipulation and was conducted at one center, it does not establish a causal clerkship effect or support educational screening based on ruminative thought style.<\/jats:p>","DOI":"10.3390\/bs16081383","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T07:57:26Z","timestamp":1786521446000},"page":"1383","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reappraisal of Mental Illness-Related Beliefs During Psychiatric Clinical Exposure: Perceived Dangerousness, Ruminative Thought Style, and Cognitive\u2013Metacognitive Characteristics"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4777-4524","authenticated-orcid":false,"given":"\u0130lker","family":"G\u00fcneysu","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Tokat Gaziosmanpa\u015fa University, 60250 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5706-0280","authenticated-orcid":false,"given":"Seda","family":"G\u00fcneysu","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry, Faculty of Medicine, Tokat Gaziosmanpa\u015fa University, 60250 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8609-3161","authenticated-orcid":false,"given":"Burcu","family":"Eser","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Tokat Gaziosmanpa\u015fa University, 60250 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5081-5983","authenticated-orcid":false,"given":"Sare","family":"Ayd\u0131n","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Tokat Gaziosmanpa\u015fa University, 60250 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8258-2600","authenticated-orcid":false,"given":"Figen","family":"\u00dcnal Demir","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Tokat Gaziosmanpa\u015fa University, 60250 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6304-9863","authenticated-orcid":false,"given":"Mehmet Eren","family":"Ya\u015faran","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Tokat Gaziosmanpa\u015fa University, 60250 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4368-6641","authenticated-orcid":false,"given":"Cansu","family":"Bak","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Faculty of Medicine, Tokat Gaziosmanpa\u015fa University, 60250 Tokat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref_1","first-page":"51","article-title":"Otomatik d\u00fc\u015f\u00fcnceler \u00f6l\u00e7e\u011finin ge\u00e7erlik ve g\u00fcvenirli\u011fi","volume":"7","year":"1990","journal-title":"Psikoloji Dergisi"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v067.i01","article-title":"Fitting linear mixed-effects models using lme4","volume":"67","author":"Bates","year":"2015","journal-title":"Journal of Statistical Software"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.2517-6161.1995.tb02031.x","article-title":"Controlling the false discovery rate: A practical and powerful approach to multiple testing","volume":"57","author":"Benjamini","year":"1995","journal-title":"Journal of the Royal Statistical Society: Series B (Methodological)"},{"key":"ref_4","first-page":"91","article-title":"Ruhsal hastali\u011fa y\u00f6nelik inan\u00e7lar \u00f6l\u00e7e\u011fi\u2019nin ge\u00e7erlili\u011fi ve g\u00fcvenilirli\u011fi","volume":"9","author":"Bilge","year":"2008","journal-title":"Anadolu Psikiyatri Dergisi"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/jclp.20542","article-title":"Ruminative thought style and depressed mood","volume":"65","author":"Brinker","year":"2009","journal-title":"Journal of Clinical Psychology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1017\/S0033291714000129","article-title":"What is the impact of mental health-related stigma on help-seeking? 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