The labeling paradox: Stigma, the sick role, and social networks in mental illness

Department of Sociology, University of Kentucky, Lexington, KY 40506, USA.
Journal of Health and Social Behavior (Impact Factor: 2.72). 12/2011; 52(4):460-77. DOI: 10.1177/0022146511408913
Source: PubMed

ABSTRACT Although research supports the stigma and labeling perspective, empirical evidence also indicates that a social safety net remains intact for those with mental illness, recalling the classic "sick role" concept. Here, insights from social networks theory are offered as explanation for these discrepant findings. Using data from individuals experiencing their first contact with the mental health treatment system, the effects of diagnosis and symptoms on social networks and stigma experiences are examined. The findings suggest that relative to those with less severe affective disorders, individuals with severe diagnoses and more visible symptoms of mental illness have larger, more broadly functional networks, as well as more supporters who are aware of and sympathetic toward the illness situation. However, those with more severe diagnoses are also vulnerable to rejection and discrimination by acquaintances and strangers. These findings suggest that being formally labeled with a mental illness may present a paradox, simultaneously initiating beneficial social processes within core networks and detrimental ones among peripheral ties.

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Available from: Brea L Perry, Sep 12, 2014
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    • "In contrast, rejection due to the stigma and nonnormative behavior associated with SMI is likely to be fully operative among strangers, acquaintances, casual friends, and other peripheral members of the social network (Perry, 2011). Weaker relationships are unlikely to be characterized by a strong sense of obligation, reciprocity, and shared history that helps to preserve social bonds when relationships are strained (Wellman, 2000). "
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    ABSTRACT: Research has documented social network instability among people with serious mental illness focusing on (1) psychiatric symptoms that interfere with social skills and interaction and (2) stigma, discrimination, and social rejection. However, the social network consequences of disruptive events that often accompany onset of serious mental illness (e.g., divorce, job loss, and residential instability) are seldom considered. In this study, the relative impact of symptoms, stigma, and secondary disruptive events on membership turnover was examined using data from 100 people experiencing first contact with the mental health treatment system. Findings indicated that disruptive events and, to a lesser degree, psychiatric symptoms predicted membership turnover. A theory of relationship and network dynamics in mental illness integrating insights from the psychiatric, labeling, and social network perspectives is proposed.
    Journal of Social and Personal Relationships 02/2014; 31(1):32-53. DOI:10.1177/0265407513484632 · 1.29 Impact Factor
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    • "selective disclosure (Corrigan & Rao, 2012) and be more open about their psychiatric diagnosis with doctors, parents, and friends than with employers or police (Pandya, Bresee, Duckworth, Gay, & Fitzpatrick, 2011). The responses from social networks may be paradoxical, simultaneously enacting social support in core networks yet initiating detrimental consequences among peripheral ties (Pandya et al., 2011; Perry, 2011). Because evidence shows that people with larger social network size and higher network satisfaction were more likely to experience mental health recovery than their counterparts (Corrigan & Phelan, 2004), understanding how disclosure of mental illness influences a person's relationships with existing social networks has crucial implications. "
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    ABSTRACT: To assess the perception of diseases and the willingness to use public-tax revenue for their treatment among relevant stakeholders. A population-based, cross-sectional mailed survey. Finland. 3000 laypeople, 1500 doctors, 1500 nurses (randomly identified from the databases of the Finnish Population Register, the Finnish Medical Association and the Finnish Nurses Association) and all 200 parliament members. Respondents' perspectives on a five-point Likert scale on two claims on 60 states of being: '(This state of being) is a disease'; and '(This state of being) should be treated with public tax revenue'. Of the 6200 individuals approached, 3280 (53%) responded. Of the 60 states of being, ≥80% of respondents considered 12 to be diseases (Likert scale responses of '4' and '5') and five not to be diseases (Likert scale responses of '1' and '2'). There was considerable variability in most states, and great variability in 10 (≥20% of respondents of all groups considered it a disease and ≥20% rejected as a disease). Doctors were more inclined to consider states of being as diseases than laypeople; nurses and members were intermediate (p<0.001), but all groups showed large variability. Responses to the two claims were very strongly correlated (r=0.96 (95% CI 0.94 to 0.98); p<0.001). There is large disagreement among the public, health professionals and legislators regarding the classification of states of being as diseases and whether their management should be publicly funded. Understanding attitudinal differences can help to enlighten social discourse on a number of contentious public policy issues.
    BMJ Open 10/2012; 2(6). DOI:10.1136/bmjopen-2012-001632 · 2.27 Impact Factor
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