Epilepsia, 46(5):736–742, 2005 Blackwell Publishing, Inc. C  2005 International League Against Epilepsy Predictors for Negative Attitudes toward Subjects with Epilepsy: A Representative Survey in the General Public in Austria ∗ Josef Spatt, †Gerhard Bauer, ‡Christoph Baumgartner, §Martha Feucht, ‖Martin Graf, ∗ Bruno Mamoli, and †Eugen Trinka for the Austrian Section of the International League Against Epilepsy ∗ LBI for Epilepsy and Neuromuscular Disorders, Neurological Hospital Rosenh¨ ugel, Vienna; †Neurological University Clinic, Innsbruck; ‡Department of Clinical Epilepsy Research, Neurological University Clinic, §University Hospital for Child and Adolescent Neuropsychiatry, and // Department of Neurology, Donauspital-SMZO der Stadt Wien, Vienna, Austria Summary: Purpose: To assess knowledge of and attitudes to- ward epilepsy in the Austrian general public and to identify in- dependent predictors of negative attitudes. Methods: A survey consisting of a representative sample of 2,128 Austrian adults was commissioned. A questionnaire simi- lar to the ones used in earlier studies in other countries was used. The independent influence of socioeconomic variables and of knowledge and concepts about epilepsy on attitudes were ana- lyzed by using logistic stepwise regression procedure. Results: Nearly 10% of respondents expressed negative at- titudes toward people with epilepsy. These figures are similar to those of other studies performed in comparable societies. In addition to being male and of low socioeconomic background, having little theoretical knowledge about epilepsy, misconcep- tions of epilepsy as a form of insanity, and no personal acquain- tance with someone with epilepsy independently predispose to unfavorable attitudes toward epilepsy. Conclusions: Information campaigns on epilepsy are likely to improve attitudes toward epilepsy when they target miscon- ceptions about epilepsy and when they offer opportunities for personal acquaintance with people with epilepsy. Key Words: Epilepsy—Psychosocial—Education. Impaired quality of life in epilepsy patients results from restrictions in the way one is able to lead a “normal” life. Two sets of causes for these limitations can be identi- fied: the “objective” sometimes legislative limitations like the ones in driving or in operating dangerous machines, and more “subjective” limitations stemming from opin- ions and attitudes in the society toward epilepsy, often considered under the label of stigmatization. Two aspects of stigma, real acts of discrimination (“enacted stigma”) and fears of stigma or shame (“felt stigma”), have been differentiated (1). The second aspect may still be relevant, even when social or legal barriers that prevented patients from taking part in normal life have been removed. Generally, it is believed that measures to improve knowledge about epilepsy in the general public should ameliorate prejudices. As a prerequisite, studies to assess knowledge of and attitudes toward epilepsy have been carried out in very different settings in America (2–4), Accepted December 26, 2004. Address correspondence and reprint requests to Univ.-Doz. Dr. Josef Spatt at 2 Neurologische Abteilung, Neurologisches Krankenhaus Rosenh¨ ugel, Riedelgasse 5, 1130 Vienna, Austria. E-mail: josef.spatt@ chello.at. Europe (5–9), Asia (10–13), Africa (14), and in Ocea- nia (15). Although generally in agreement, the studies also revealed the different social and historic backgrounds of the countries and societies involved. In most studies, however, older age and/or lower level of education were associated with a higher proportion of negative attitudes (2,6,9,11,12,15). Not all of the studies used procedures that guarantee representative sampling (9–11,15), and with one exception (11), no effort has been made to disentangle the roles of the individual predictors by methods of multivariate statistics. This is the first survey of this kind in Austria, but we intended to achieve more than just to add another study from another country with its cultural peculiarities. While keeping the format similar and therefore comparable to earlier studies, we tried to analyze, in a multivariate way, risk factors for prejudices and negative attitudes. To form an unbiased picture, we took pains to use a representative sample of the whole society. The purpose of this study was to survey awareness about and attitudes toward epilepsy in the Austrian society and to find out the variables that predispose for negative atti- tudes toward the disorder. Better knowledge about these 736