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Understanding and Influencing the Stigma of Mental Illness
Abstract
Life goals and the opportunities that define them are impaired by the stigma of mental illness. Three kinds of stigma may act as barriers to personal aspirations: public stigma, self-stigma, and label avoidance. Challenging mental illness stigm is essential in helping individuals accomplish recovery-related goals. Public stigma may be changed through protest, education, and contact. Self-stigma can be addressed by fostering group identity, changing the perceived legitimacy of stigma through cognitive rehabilitation, and making strategic decisions about disclosing one's mental health history. Stigma change for label avoidance is not as well understood but may include the education and contact approaches used for public stigma. Evidence-based approaches to stigma change need to be substantiated by rigorous investigations.
... 13). In the case of mental health challenges, stigma beliefs are associated with stereotypes of people experiencing mental health challenges as incompetent, dangerous or to blame (Corrigan & Wassel, 2008). Stigma beliefs can cause harm to individuals, regardless of whether they reveal their stigma to others. ...
... Stigma beliefs can cause harm to individuals, regardless of whether they reveal their stigma to others. The desire to conceal a stigmatised identity, such as experience of mental health difficulties, chronic physical illness or minority sexual orientation, has been linked to reduced quality of life in those who actively conceal (Quinn et al., 2017) and is widely recognized as one of the major barriers to help-seeking for mental health challenges (Corrigan & Wassel, 2008). Conversely, those who reveal mental health challenges may be exposed to microaggressions (Barber et al., 2019), prejudice and discrimination in the community (Degnan et al., 2021) and the workplace (Hampson et al., 2020). ...
... The mechanisms of harm caused by stigma have been proposed by subsequent authors to Goffman (Angermeyer et al., 2011;Corrigan & Wassel, 2008;Link et al., 2004). Link and colleagues (2004) identified five main components of stigma: labelling, stereotyping, separation, status loss and discrimination. ...
Historically, professionals’ own experiences with distress, mental health crisis and help-seeking have been a taboo subject in the mental health workforce. However, growth in designated Lived Experience roles in mental health services has thrown into sharp relief differences between professionals and staff in designated roles, in the sharing of experiential knowledge, known as lived experience. This study aimed to explore the perspectives and experiences of mental health service staff relating to the sharing of lived experience with colleagues and supervisors. Specifically, it sought to compare the perspectives and experiences across staff with and without lived experience, in professional, Lived Experience and supervisory roles. Case study design employed semi-structured interviews and document analysis to explore similarities and differences between individuals and informant groups across two mental health service organisations. Descriptive, comparative, and relational analyses identified key concepts and factors supporting and constraining the sharing of lived experience. Perceived organisational and supervisor support, and an individual preference for openness supported staff with lived experience to share their experiences, privately or openly, in the workplace. Psychological safety within teams, explicitly and intentionally cultivated by team leaders, mediated the likelihood and impacts of staff sharing openly in the workplace. Sharing in supportive relationships and teams “lifted the burden” of secrecy from staff with lived experience and created opportunities for mutual emotional and practical support between colleagues. Those who felt supported to share openly in the workplace described satisfaction associated with “bringing their whole selves” to their work. Conversely, interpersonal fear and “defensive” responses to sharing “shut down” opportunities for reflection and growth. Cultures of non-disclosure in the mental health workplace reinforce epistemic violence by creating the illusory roles of “invulnerable professional” and “vulnerable service user.” Growth and reform within the mental health sector will not be achieved without acknowledging and attending to the common humanity of staff and service users.
... Gender. In line with previous studies, we expect stigma to be lower towards females because they are the object of benevolence stigma [23,26,30,31]. Males might be subject to higher stigma due to the gendered ideas of them being invulnerable, strong, independent, etc., and due to the fact that they are more likely to not comply with behavioral recommendations and thus act more irresponsibly. ...
... To understand the links between disease-related and individual attributes and stigmatization, this study utilized attribution theory [12,18,31]. Attribution theory explains how people interpret and react to signals and signaling events concerning causes of conditions and the consequences for others. ...
... While respondents hardly differentiated between males and females infected with COVID-19, females infected with the flu were blamed less compared to males. This finding may provide some empirical support for the existence of benevolence stigma towards these women, in line with other studies [23,26,30,31]. Furthermore, we did not find evidence for stigma of any kind (positive/benevolent or negative) regarding older vignette characters. ...
Background
The COVID-19 pandemic has created a global health crisis, leading to stigmatization and discriminatory behaviors against people who have contracted or are suspected of having contracted the virus. Yet the causes of stigmatization in the context of COVID-19 remain only partially understood. Using attribution theory, we examine to what extent attributes of a fictitious person affect the formation of stigmatizing attitudes towards this person, and whether suspected COVID-19 infection (vs. flu) intensifies such attitudes. We also use the familiarity hypothesis to explore whether familiarity with COVID-19 reduces stigma and whether it moderates the effect of a COVID-19 infection on stigmatization.
Methods
We conducted a multifactorial vignette survey experiment (2⁸-design, i.e., NVignettes = 256) in Germany (NRespondents = 4,059) in which we experimentally varied signals and signaling events (i.e., information that may trigger stigma) concerning a fictitious person in the context of COVID-19. We assessed respondents’ cognitive (e.g., blameworthiness) and affective (e.g., anger) responses as well as their discriminatory inclinations (e.g., avoidance) towards the character. Furthermore, we measured different indicators of respondents’ familiarity with COVID-19.
Results
Results revealed higher levels of stigma towards people who were diagnosed with COVID-19 versus a regular flu. In addition, stigma was higher towards those who were considered responsible for their infection due to irresponsible behavior. Knowing someone who died from a COVID infection increased stigma. While higher self-reported knowledge about COVID-19 was associated with more stigma, higher factual knowledge was associated with less.
Conclusion
Attribution theory and to a lesser extent the familiarity hypothesis can help better understand stigma in the context of COVID-19. This study provides insights about who is at risk of stigmatization and stigmatizing others in this context. It thereby allows identifying the groups that require more support in accessing healthcare services and suggests that basic, factually oriented public health interventions would be promising for reducing stigma.
... People that are stigmatized by others also experience self-stigmatization which is often accompanied by psychological harm, and they may be negatively affected in their uptake of health care services (6). As a consequence, stigmatization can impede the process of recovery, but also the ability to find a home, a job, or insurance (11,12). ...
... We thus need to better understand the factors driving stigmatization in the general population to design evidence-based programs to reduce it (11). Further research is also warranted given that, notwithstanding diverse efforts, stigmatization of people with mental illnesses such as drug addiction is a fact rather than a rudiment (13). ...
... Attribution Theory postulates that individuals have a tendency to attribute levels of controllability and responsibility in order to better understand and explain the causes of the behaviors and conditions (such as addiction) of others, or related events and outcomes (11,15,18). Thereby, individuals are receptive to or actively search for signals and signaling events which can evoke negative cognitive beliefs (such as blameworthiness and dangerousness), negative affective reactions (such as anger and fear), and discriminatory behaviors (such as coercion and segregation). ...
Drug abuse and addiction exist around the world. People addicted to drugs such as opium or heroin often encounter dehumanizing discriminatory behaviors and health-care systems that are reluctant to provide services. Experiencing discrimination often serves as a barrier to receiving help or finding a home or work. Therefore, it is important to better understand the mechanisms that lead to the stigmatization of drug addiction and who is more prone to stigmatizing behaviors. There is also a dearth of research on whether different patterns of stigma exist in men and women. Therefore, this study investigated factors affecting gender-specific stigmatization in the context of drug addiction. In our vignette study (N
Mensample
= 320 and N
Womensample
= 320) in Iran, we experimentally varied signals and signaling events regarding a person with drug addiction (i.e., N
Vignettes
= 32 per sample), based on Attribution Theory, before assessing stigmatizing cognitions (e.g., blameworthiness), affective responses (e.g., anger), and discriminatory inclinations (e.g., segregation) with the Attribution Questionnaire. We also tested assumptions from the Familiarity Hypothesis by assessing indicators of respondents' familiarity with drug addiction (e.g., knowledge about addiction). Results, for example, show higher stigma if the person used "harder" drugs, displayed aggressive behavior, or had a less controllable drug urge. Self-attributed knowledge about addiction or prior drug use increased some forms of stigma, but diminished others. These findings only partially converged between men and women. We suggest that anti-stigma initiatives should consider information about the stigmatized person, conditions of the addiction, and characteristics of stigmatizers.
... The historical, conceptual, and qualitative research cited above posits that, as the idea of an assistive BCI spreads, individuals and especially disabled people will be subjected to new responsibilities-"ability expectations" in the words of Wolbring and Diep (2016)-and thus new forms of ableist stigma when those responsibilities are not fulfilled. This argument implicates an extensive literature on the social psychology of stigma (Corrigan and Wassel, 2008;Goffman, 1963;Link and Phelan, 2001;Major and O'Brien, 2005), which has not been applied to the specific case of BCIs. While several causal factors have been identified for stigmatization (Jones et al., 1984), Attribution Theory is well-suited for investigating the above concerns about BCIs, as it emphasizes the role of responsibility judgments (Weiner et al., 1988). ...
... Corrigan, 2006;Weiner, 1993). These signals and signaling events can be obvious or hidden marks of the person (Corrigan and Wassel, 2008). They include (1) causes of being in a certain condition (here disability) and the control a person has over those causes (e.g. ...
As brain-computer interfaces are promoted as assistive devices, some researchers worry that this promise to "restore" individuals worsens stigma toward disabled people and fosters unrealistic expectations. In three web-based survey experiments with vignettes, we tested how refusing a brain-computer interface in the context of disability affects cognitive (blame), emotional (anger), and behavioral (coercion) stigmatizing attitudes (Experiment 1, N = 222) and whether the effect of a refusal is affected by the level of brain-computer interface functioning (Experiment 2, N = 620) or the risk of malfunctioning (Experiment 3, N = 620). We found that refusing a brain-computer interface increased blame and anger, while brain-computer interface functioning did change the effect of a refusal. Higher risks of device malfunctioning partially reduced stigmatizing attitudes and moderated the effect of refusal. This suggests that information about disabled people who refuse a technology can increase stigma toward them. This finding has serious implications for brain-computer interface regulation, media coverage, and the prevention of ableism.
... Stigma is a significant social determinant of health and a driver of poor health outcomes [1][2][3]. Stigma can be manifested in negative stereotypes that cause discrimination and disadvantages for stigmatized persons [4,5]. However, most health-related stigma studies concentrate on an individual level of stigma experience, limiting a broader socioecological perspective to understanding the stigmatization process and interventions [3,5,6]. ...
... When stigma is applied to people, it is usually manifested in stereotypes based on misconceptions, such as believing that people with mental illness are incapable of holding down a "real" job or living independently [4]. These negative stereotypes may cause discrimination contributing to unequal outcomes for the stigmatized person [5]. ...
This paper explores the barriers to supporting South Asian (Pakistani, Nepalese and Indian) migrant children with special needs that their families encountered navigating Hong Kong’s special needs system and accessing education and healthcare services. It adopts concepts of stigma and disability rights. It draws on semi-structured interviews with fifteen South Asian children and young people with special needs (age 5–21; M = 10; F = 5) and their families, and seven professional practitioners based on the qualitative descriptive method. Informants experienced intersecting stigmatization that included (1) institutional exclusion, (2) daily life microaggressions, and (3) misunderstandings and a lack of awareness education. Simultaneously, some were empowered through (4) support and accommodation, and (5) spiritual support from religion. This paper reveals a paradox embodied by Hong Kong; it is an Asian multicultural city committed to embracing the vision of disability inclusion while failing to ensure necessary support to reduce the stigma experienced by culturally diverse children with a disability. It makes recommendations based on a socioecological framework and concludes that concerted efforts by relevant authorities and organizations should be made to reduce stigma by taking into consideration the intersecting stigmas, specific resources unique to migrant communities, disability rights and cultural sensitivity.
... Open access From a stigmatised person's viewpoint, stigma can be understood as taking three forms. [16][17][18][19][20] First, experienced stigma refers to a person experiencing discrimination due to social unacceptability. 16 19 Second, perceived stigma occurs when a person fears shameful, discriminatory situations and/or detrimental treatment because of their condition. ...
... 16 19 Third, self-stigma is when people are aware of negative stereotypes, prejudices, and discrimination regarding themselves, agree with them, and direct these negative and biased beliefs, feelings and behaviours internally. 17 18 20 Perceived stigma occurs in individuals with T2DM before their diagnosis and affects a wide range of individuals' health behaviours. 1 21-26 For example, avoiding screening tests, refusing a diabetes diagnosis, delaying treatment and concealing a diagnosis from family members are forms of perceived stigma. 1 21-26 In contrast, selfstigma occurs in individuals with T2DM during disease management. Empirical research has demonstrated that increased self-stigma negatively impacts the quality of patients' interactions with healthcare professionals and their self-management behaviours, 27 specifically patients' activation to engage in self-care, which it affects directly and indirectly through self-esteem and self-efficacy. 2 28 29 Activating patients to engage in self-care is critical for increasing patients' ability to gain the knowledge, skills, confidence, and behaviours required to manage their illness. ...
Objectives
To examine the associations between self-stigma and diabetes duration in a sample of Japanese people with type 2 diabetes.
Design
A secondary analysis of a cross-sectional study.
Setting
Two university hospitals, one general hospital and one clinic in Tokyo, Japan.
Participants
Outpatients with type 2 diabetes aged 20–74 years and receiving treatment from diabetes specialist physicians (n=209) completed a self-administered questionnaire.
Primary and secondary outcome measures
Self-stigma was measured as the primary outcome. Patient Activation Measure, body mass index and haemoglobin A1c were measured as secondary outcomes.
Results
One-way analysis of covariance showed significant differences in self-stigma levels between the five groups of diabetes duration (≤5 years, 6–10 years, 11–15 years, 16–21 years and 22 years or more) after controlling for age, gender, education, marital status, diabetes treatment (insulin use) and diabetes-related complications, F(4,198)=2.83, p=0.026. Multiple comparisons using Bonferroni correction showed statistically significant differences in self-stigma levels between the groups with ≤5 years (95% CI 59.63 to 69.73) and 11–15 years with diabetes (95% CI 71.12 to 80.82; p=0.020). The highest mean level of self-stigma was observed in the group having diabetes for 11–15 years.
Conclusions
Self-stigma was associated with diabetes duration and was lowest after diagnosis and gradually increased, with its highest levels being observed in those having diabetes for 11–15 years. Self-stigma takes time to develop and gradually increases in individuals as it is learnt through direct experiences of diabetes-related stigma after self-administering treatment in everyday social situations.
... When it comes to mental illness, stigma "refers to the social judgment, degradation, or devaluation of individuals because they have mental illness symptoms or have been labeled as having a mental illness" (Abdullah & Brown, 2011, p. 936). There are three types of mental illness stigma: public stigma, self-stigma (Corrigan & Wassel, 2008), and perceived stigma (Barney et al., 2006). Public stigma refers to the discrimination of the mentally ill by the public, self-stigma is the internalization of the public stigma regarding their illness by an individual (Corrigan & Wassel, 2008), and perceived stigma is the belief that others hold stigmatizing thoughts (Barney et al., 2006). ...
... There are three types of mental illness stigma: public stigma, self-stigma (Corrigan & Wassel, 2008), and perceived stigma (Barney et al., 2006). Public stigma refers to the discrimination of the mentally ill by the public, self-stigma is the internalization of the public stigma regarding their illness by an individual (Corrigan & Wassel, 2008), and perceived stigma is the belief that others hold stigmatizing thoughts (Barney et al., 2006). Any presence of one or more of these stigmas can impede the efforts of those suffering from mental illness to seek help (Barney et al., 2006). ...
Depression is a serious mental illness affecting a large proportion of the global population, especially the youth. Research has shown that people suffering from depression are at a higher risk of suicide. Tumblr is an online microblogging social media platform, which has been accused of romanticizing mental illnesses such as depression, however, very little research has been done to investigate this issue. The Arab World is the home of most ongoing armed conflicts today and with almost half of the population under 30 and problems like poverty, lack of mental health institutions, stigmatization, war, and refugees, the population is one of the most at risk of depression and its complications. Furthermore, Suicide rates in the region have increased in age groups until 20- 24. Thus, considering its large young population vulnerable to mental illness any research is an important addition to the almost non-existing literature of depression in the Arab World. Identifying the differences between depression manifestations of Western and other cultures could lay the foundation for future research to examine social media as a predictor of depression in other populations by understanding the role of individuals' linguistic expressions and cultural background, while acknowledging the Western influence on non-Western users of a Western platform. We have content analyzed a sample of 609 Tumblr posts (208 Arabic and 401 English language posts) regarding depression symptoms and expressions and our results regarding depression symptoms found depressed mood present in almost all of the posts regardless of their users. Feelings of worthlessness and/or guilt were found in almost equal percentages in both groups, whereas suicidal ideation was found more in Western posts. Finally, the study has also found some differences between the Arab- and English-language posts in that Arabs preferred quoting fictional novels and non-fiction real-life authors to express their symptoms, while Western users preferred quoting and creating gifs of TV and Film scenes and characters – however, both can be interpreted as a way of romanticizing depression. In contrast to these differences, we have found only few gender differences in the posts.
... Patients with serious mental illnesses, such as schizophrenia, have been reported to encounter different forms of stigmatization [2,3]. Corrigan et al. categorized these types of stigma into "public stigma," "self-stigma," and "label avoidance" [4]. Self-stigma arises when people with psychiatric disorders who live in a society that endorses stigmatizing ideas internalize such ideas and believe that they are less valuable because they have a mental illness [5]. ...
... A Japanese version has been prepared and validated by Tanabe et al. [22]. The ISMI consists of 29 items assessed using a 4-point Likert scale ranging from 1. "I do not think so" to 4. "I very much think so," and five subscales (alienation [1,5,8,16,17,21], stereotype endorsement [2,6,10,18,19,23,24], perceived discrimination [3,15,22,25,26], social withdrawal [4,9,[11][12][13]20], and stigma resistance [7,14,[27][28][29]). The average ISMI score is interpreted as follows: 1.00-2.00, ...
Background
Several studies have indicated that self-stigma is associated with depressive symptoms and could be a barrier to recovery in patients with schizophrenia-spectrum disorders. More recently, an association between autistic symptoms and self-stigma was found in schizophrenia-spectrum patients. This study aimed to investigate the association between self-stigma, autistic and depressive symptoms, and recovery in patients with schizophrenia.
Methods
In total, 105 participants were evaluated using the Autism Spectrum Quotient, the Internalized Stigma of Mental Illness Scale, the Quick Inventory of Depressive Symptomatology, and the Recovery Assessment Scale to investigate autistic symptoms, self-stigma, depressive symptoms, and recovery, respectively. The relationship between self-stigma, autistic symptoms, depressive symptoms, and recovery was assessed using structural equation modeling analysis.
Results
Impaired attention switching, one symptom of autism, was found to positively affect stereotype endorsement, which negatively influenced recovery through depressive symptoms. Moreover, problems with communication skills negatively affected recovery through depressive symptoms. Concerning self-stigma, stereotype endorsement and perceived discrimination had a negative effect on recovery through depressive symptoms, whereas stigma resistance had a direct negative effect on recovery.
Conclusions
This study may provide meaningful insight into the psychological structure of recovery and could inform effective interventions for patients with schizophrenia-spectrum disorders. This was a cross-sectionally designed study; therefore, further longitudinal studies are needed to identify the causal relationships between self-stigma, autistic and depressive symptoms, and recovery.
... Societal discrimination, prejudice, and stereotypes affect the recovery process, quality of life, and well-being of people with SMI and their families. They also represent the main gap toward accessing mental health services for the general population, leading to a delay in diagnosis and lower adherence to specialized treatment 7,8 . ...
Background: Stigma toward people with serious mental illnesses (SMI), like schizophrenia, is a serious global public health challenge that limits the quality of life of those affected and poses a major barrier that keeps people from seeking professional help. There is an urgent need for novel, effective, and scalable interventions to decrease stigmatized perceptions of chronic psychotic disorders and to reduce the health burden imposed by them.
Method: We conducted a randomized controlled trial to assess the impact of a new immersive virtual reality game (Inclúyete-VR) on the level of stigma toward people with SMI, measured by the Attribution questionnaire (AQ-27). Participants in the experimental group were exposed in an immersive way to hallucinations common in schizophrenia, then shown different psychosocial resources available for their recovery and social inclusion; those in the control group used VR software unrelated to mental health. VR sessions were delivered through Oculus headgear and lasted 25 minutes.
Results: We randomly assigned 124 university students (55% female) to experimental or control conditions (n = 62 each). We used mixed ANOVA to compare outcomes before and after the intervention between the two groups. We found a significant intervention-by-time interaction (P < 0.001), with a reduction in the experimental group of overall stigma levels on the AQ-27 scale and its three subscales: dangerousness-fear, avoidance, and lack of solidarity (P < 0.001 for all).
Conclusions: The Inclúyete-VR software proved effective in the short term in reducing stigma toward people with severe mental illness. The program's longer-term efficacy, scalability, and dissemination remain to be studied.
ClinicalTrials.gov Identifier: NCT05393596.
... The national online survey that included 2,605 people found stronger prejudicial attitudes toward men, people labeled as "drug users," and people who obtained prescription opioids from friends [48]. Men with SUDs were regarded as more dangerous because they would cause more negative consequences (e.g., aggressive or dangerous behavior) [49], while women with SUDs were regarded as more vulnerable, thus requiring protection and help [50]. ...
Purpose: Due to the lack of reliable stigma assessment tools and the stigma faced by people with substance use disorders (SUDs), especially in China. Therefore, this study aimed to validate the Chinese version of the Substance Use Stigma Mechanism Scale (SU-SMS-C) and set its cut-off point.
Methods: We recruited 1005 individuals with SUDs from Chinese rehabilitation centers. These participants completed a battery of questionnaires that included the SU-SMS-C, MSPSS, CES-D, GSES, and PDD. Confirmatory factor analysis was used to assess the construct validity of the scale. Additionally, the Naive Bayes Classifier was used to establish the cut-off point for the SU-SMS-C. We additionally explored the correlation between patient demographic characteristics and stigma.
Results: A confirmatory factor analysis was utilized, revealing a second-order five-factor model. Based on the Naive Bayes Classifier, the Area Under the Receiver Operating Characteristic (AUCROC) of 0.746, the cut-off point for the SU-SMS-C was established at 44.5. The prevalence of stigma observed in the study population was 49.05%. Significant disparities were observed in the distribution of stigma across genders, with males experiencing more pronounced stigma than females. Moreover, patients consuming different primary substances reported diverse levels of stigma. Notably, those primarily using heroin endured a higher degree of stigma than users of other substances.
Conclusion: The study is the first to identify a cut-off point for the SU-SMS-C by Naive Bayes Classifier, bridging a major gap in stigma measurement research. SU-SMS-C may help treat and manage SUDs by reducing stigma.
... The individuals affected by mental illness included in the study perceived the diagnostic process as very complex and difficult and, especially in the case of mental illnesses, The individuals affected by mental illness included in the study perceived the diagnostic process as very complex and difficult and, especially in the case of mental illnesses, as a simplification of symptoms and labeling a person. Unwanted side effects of clinical diagnoses on self-perception and negative societal reactions have long been described in research literature [41,42]. To decrease negative emotional (e.g., feeling of powerlessness) and behavioral (e.g., reduced help-seeking behavior) consequences, involving affected individuals in interpreting their mental health symptomatology could contribute to a desirable shift in perception of one's own mental illness, strengthen their recovery orientation, and reveal complementary internal resources, as described by Eads et al. [43]. ...
(1) Background: There is a fundamental shift in healthcare toward shared decision making (SDM). This study explores SDM from the perspective of individuals affected by mental illness and their family members and investigates factors which promote and hinder the process. (2) Methods: We conducted N = 15 telephone interviews (n = 4 adults affected by mental illness, n = 5 family members, n = 6 both applicable, the majority reporting experiences with affective and anxiety disorders). Data were recorded, transcribed, and analyzed according to procedures established by Mayring. (3) Results: Individuals affected by mental illness and their family members have a strong desire to be involved in treatment decisions and to participate in finding a diagnosis. Often these stakeholders are denied the opportunity to participate; sometimes enabling behaviors impede participation. The stigmatization of mental illnesses is a major barrier. There are also structural barriers to SDM within the healthcare system. Peer support, self-help associations, and psychosocial counseling services are important to empowering individuals and promoting SDM. (4) Conclusions: SDM has the potential to improve the quality of mental healthcare. Barriers can be mitigated and new approaches for interventions in the psychiatric sector have been identified. This study has also shown the importance of understanding SDM as a process that should begin at the diagnostic phase.
... For instance, in a study of 14-year-old children in England, the youngsters identified 250 names for people with mental illness (Rose et al., 2007). Attributes given to individuals with mental illness include violent tendencies, laziness, weak morals or upbringing, and helplessness (Corrigan & Wassel, 2008;Ross & Goldner, 2009;Thornicroft et al., 2007). These attitudes can lead to mentalism, discrimination based on mental health diagnosis or history (Chamberlin, 1979). ...
... For instance, in a study of 14-year-old children in England, the youngsters identified 250 names for people with mental illness (Rose et al., 2007). Attributes given to individuals with mental illness include violent tendencies, laziness, weak morals or upbringing, and helplessness (Corrigan & Wassel, 2008;Ross & Goldner, 2009;Thornicroft et al., 2007). These attitudes can lead to mentalism, discrimination based on mental health diagnosis or history (Chamberlin, 1979). ...
This study examines how extracurricular activities affect students’ leadership development outcomes including international students.
... Stigma can present an obstacle to life opportunities and personal ambition. It can hinder the ability to find jobs, seek housing [18], obtain indemnity, as well as treatment [19,20]. Personality traits are another critical factor that is responsible for causing a person to use drugs. ...
The present study was intended to examine the effect of psychosocial factors on the stigma of mental illness among people addicted to drugs who have relapsed in Punjab, Pakistan. A sample composed of 116 people addicted to drugs and who have relapsed was collected through the purposive sampling technique. Certain self-report measures were used to assess the pertinent study variables. The results elucidated that self-efficacy, social support, and conscientiousness were found to be negative predictors and neuroticism a positive predictor of stigma. The results also confirmed social support as being a significant moderator in the relationship between self-efficacy and stigma, and self-efficacy as being a significant moderator in the relationship between social support and stigma. It was safe to conclude that psychosocial factors such as self-efficacy, social support, personality traits and stigma have a significant role in causing addiction relapse. The conclusions made have been discussed thoroughly.
... In this sense, the participants were unanimous regarding the experience of stigmatization affecting the identity of those with mental illness, leaving scars, and resulting in loss of self-esteem, attributing to themselves characteristics of incompetency [61]. ...
Evidence highlights the need for professionals to be aware of their stigmatizing attitudes and discriminatory practices in order to minimize the negative impact on the people they take care of. However, nursing students' perceptions of these issues have been poorly studied. This study explores the perspective of senior undergraduate nursing students on mental health and the stigma around it, by considering a simulated case vignette of a person with a mental health problem. A descriptive qualitative approach was chosen and involved three online focus group discussions. The findings show various manifestations of stigma, both at an individual and collective level, which indicates that it is an obstacle to the wellbeing of people with mental illness. Individual manifestations of stigma concern its effect on the person with mental illness, while at the collective level they concern the family or society in general. Stigma is a multifactorial, multidimensional, and complex concept, in terms of identifying and fighting it. Thus, the strategies identified involve multiple approaches at the individual level, aimed at the patient and family, namely through education/training, communication, and relationship strategies. At the collective level, to intervene with the general population and specific groups, such as groups of young people, strategies suggested include education/training, use of the media, and contact with people with mental disorders as ways to fight stigma.
... Stigma is the societal labeling, stereotyping, and rejecting of or discriminating against people with a trait that is considered to be undesirable. [1][2][3][4][5][6][7] Throughout history and today, people with mental and behavioral health disorders have been labeled as dangerous, volatile, weak, frail, and unintelligent or lacking in self-control. 8 These stereotypes contribute to systematic discrimination and have multiple adverse effects that compromise the quality of medical care. ...
Purpose:
Stigma related to mental health is well documented and a major barrier to using mental and physical health care. Integrated behavioral health (IBH) in primary care, in which behavioral/mental health care services are located within a primary care setting, may reduce the experience of stigma. The purpose of this study was to assess the opinions of patients and health care professionals about mental illness stigma as a barrier to engagement with IBH and to gain insight into strategies to reduce stigma, encourage discussion of mental health, and increase uptake of IBH care.
Methods:
We conducted semistructured interviews with 16 patients referred to IBH in a prior year and 15 health care professionals (12 primary care physicians and 3 psychologists). Interviews were transcribed and inductively coded separately by 2 coders for common themes and subthemes under the topic headings of barriers, facilitators, and recommendations.
Results:
We identified 10 converging themes from interviews with patients and the health care professionals, representing important complementary perspectives, with respect to barriers, facilitators, and recommendations. Barriers included professionals, families, and the public as sources of stigma, as well as self-stigma or avoidance, or internalizing negative stereotypes. Facilitators and recommendations included normalizing discussion of mental health and mental health care-seeking action, using patient-centered and empathetic communication strategies, sharing by health care professionals of their own experiences, and tailoring the discussion of mental health to patients' preferred understanding.
Conclusions:
Health care professionals can help reduce perceptions of stigma by having conversations with patients that normalize mental health discussion, use patient-centered communication, promote professional self-disclosure, and are tailored to patients' preferred understanding.
... Stigma beliefs are the assumptions that we make about people based on stereotypes associated with the category we or others have put them in (e.g., 'consumer,' 'schizophrenic,' 'borderline'). Common stigma beliefs associated with people with lived experience are that they are incompetent, to blame or dangerous (Corrigan & Wassel, 2008). These beliefs cause harm to people with lived experience through the processes of: labelling, stereotyping, separation, status loss, and discrimination (Link, Yang, Phelan, & Collins, 2004). ...
This report describes the findings of doctoral research conducted at two Australian mental health services. Interviews explored perspectives and experience of staff relating to the sharing of lived experience by mental health professionals in the workplace. Document analysis provided organisational context to the findings.
... Respondents felt that certain learned skills and elements of peer support were difficult to implement, for instance, muscle relaxation or tactical breathing while on shift, some forms of de-escalation, and the ability to reach out to colleagues appearing to be in mental distress. What is clear here is that the stigma of mental health prevails such that persons are unable to comfortably, and with confidence, approach colleagues who they feel may have compromised mental health (Corrigan & Rüsch, 2002;Corrigan & Wassel, 2008;Mak et al., 2007). Thus, despite the efforts and training, there appears to be a disconnect between select skills taught and what is able to be applied in the context of correctional work. ...
Background:
Mental health frameworks, best practices, and the well-being of public safety personnel in Canada are topics of increasing interest to both researchers and organizations. To protect and improve worker mental health, different training programs have been implemented to serve this population. The Road to Mental Readiness (R2MR) training regimen is one such program specialized to build cultural awareness of mental health, reduce stigma, and mitigate the cumulative impacts of exposures to potentially psychologically traumatic events among public safety personnel. However, limited research has been conducted to evaluate the effectiveness of R2MR, especially among correctional workers.
Methods:
The current study analyzed 307 open-ended survey responses to four (4) questions about R2MR garnered from 124 Canadian provincial and territorial correctional workers between 2018-2020 to reveal their understandings and perceptions of R2MR training, and to identify what learned skills they found challenging or easy to implement.
Results:
The results suggest that R2MR training plays a significant role in decreasing stigma and increasing mental health awareness. Across jurisdictions, R2MR creates a supportive space for open dialogue around mental health meant to shift cultural and individual barriers that often hinder treatment-seeking. Some respondents also indicated that R2MR was a starting point for intervention.
Conclusions:
Further research is necessary to understand how R2MR and other programs could support the mental health and well-being of correctional workers.
... Stigma in turn has been identified as a major barrier, hindering both self-identification and help-seeking initiation [13]. The types of stigma [17] differ in their influence towards help-seeking [18]. While evidence of the impact on perceived public and anticipated stigma on help-seeking is mixed [19,20], internalized stigma has consistent negative influences on help-seeking attitudes and intention [13,[20][21][22][23][24]. ...
Background
Only about half the people with depression seek professional health care services. To constitute the different predictors and associating variables of health care utilisation, we model the process and aim to test our hypothesised Seeking Mental Health Care Model . The model includes empirical influences on the help-seeking process to predict actual behaviour and incorporates superordinate (stigma, treatment experiences) as well as intermediate attitudinal variables (continuum and causal beliefs, depression literacy and self-efficacy).
Method
All variables are examined in an online study (baseline, three- and six-month follow-up). The sample consisted of adults with depressive symptoms (PHQ-9 sum score ≥ 8), currently not receiving mental health care treatment. To examine the prediction of variables explaining help-seeking behaviour, a path model analysis was carried out ( lavaan package , software R ).
Results
Altogether, 1368 participants ( M age = 42.38, SD age = 15.22, 65.6% female) were included, 983 participating in at least one follow-up. Model fit was excellent (i.e., RMSEA = 0.059, CFI = 0.989), and the model confirmed most of the hypothesised predictions. Intermediary variables were significantly associated with stigma and experiences. Depression literacy ( ß = .28), continuum beliefs ( ß = .11) and openness to a balanced biopsychosocial causal model ( ß = .21) significantly influenced self-identification ( R 2 = .35), which among the causal beliefs and self-efficacy influenced help-seeking intention ( R 2 = .10). Intention ( ß = .40) prospectively predicted help-seeking behaviour ( R 2 = .16).
Conclusion
The Seeking Mental Health Care Model provides an empirically validated conceptualisation of the help-seeking process of people with untreated depressive symptoms as a comprehensive approach considering internal influences. Implications and open questions are discussed, e.g., regarding differentiated assessment of self-efficacy, usefulness of continuum beliefs and causal beliefs in anti-stigma work, and replication of the model for other mental illnesses.
Trial registration
German Clinical Trials Register: DRKS00023557. Registered 11 December 2020. World Health Organization, Universal Trial Number: U1111–1264-9954. Registered 16 February 2021.
... (2) Refers to the expectation that patients may be discriminated against or the fear that they may encounter discriminatory situations. (3) Refers to the application of a negative stereotype to patients themselves due to their condition or characteristics and the expression of a negative attribute toward themselves 5 . When the patient feels stigmatized, they may hesitate to seek consultation or may conceal their illness, which may interfere with appropriate self-management. ...
Aims/introduction:
To investigate the recognition status of stigma/advocacy in patients with type 2 diabetes in clinical practice settings.
Method:
A questionnaire survey on stigma/advocacy of patients with diabetes was carried out for members of the Kanagawa Physicians Association in July 2021.
Results:
The respondents consisted of 33 (16.6%) physicians specializing in diabetes (the D group) and 166 (83.4%) non-specialists (the ND group). 100% of the D group and 48.8% of the ND group knew that patients may be prejudiced or discriminated against because of diabetes. In the question of whether they know the terms 'stigma' and 'advocacy', 'know' was 97.0% and 94.0% in the D group, compared with 45.8% and 36.7% in the ND group, respectively. 97.0% of the D group and 19.9% of the ND group know the advocacy activities of the Japanese Diabetes Society (JDS) and the Japan Association for Diabetes Education (JADEC). The specific contents of the stigma were often unknown or never experienced in the ND group. A free description of the strategy for reducing or eliminating stigma was analyzed by text mining. 'Giving consideration to the patients' feelings', 'Commitment to the problem', and 'Dialogue' were frequent, and there was no significant difference between the two groups.
Conclusions:
The clinician's understanding of stigma/advocacy associated with having diabetes was insufficient, and activities that alert clinicians to stigma/advocacy, especially those in the ND group, was a theme to be addressed. More awareness-raising activities for stigma/advocacy will lead to better treatment and a better quality of life for patients with diabetes.
... It enables a range of social inequalities and discrimination to occur (Parker & Aggleton, 2003), and is evident within structural frameworks of society (Feldman & Crandall, 2007). People may internalize stigma and this can diminish one's sense of self and identity, causing psychological harm (Corrigan et al., 2008). ...
Objective:
To systematically review evidence regarding prevalence and choices of disclosure of psychological distress, by mental health professionals within the workplace.
Methods:
Six databases were searched in June 2020. Studies were included if they were published in English language and included empirical quantitative, qualitative or mixed-methods data. Studies were excluded if they focused on general healthcare professionals or the general population, or on stress or physical health problems. Study quality was assessed using the Mixed Methods Quality Appraisal tool.
Results:
Nine studies, with a total of 1891 participants, were included. Study quality varied, with studies generally reporting descriptive surveys using hypothetical disclosure scenarios. Distress was often conceptualized in psychiatric terms. These limitations mean conclusions should be treated with caution. Individuals were less likely to disclose in work and had negative experiences of doing so compared to social circles. Fear of stigma inhibited disclosure. There were differing levels of disclosure relating to recipient, trust, quality of supervision, how distress was conceptualized, and type of problem. Disclosure was experienced by some as valuable.
Conclusion:
There is a need for further research, which addresses the nuanced complexities surrounding disclosure choices for mental health professionals.
... The stigma of mental illness is a reality in our society, especially among healthcare professionals [1,2]. Empathy among mental health nurses is a key element helping to reduce stigma towards patients with mental disorders [3]. ...
Mental health nurses, together with psychiatrists, are the healthcare professionals who display the highest levels of empathy and the best attitudes towards patients with mental disorders. However, burnout is a common problem among these professionals. The aim of our study is to describe the association between empathy, burnout, and attitudes towards patients with mental disorders among mental health nurses in Spain. A descriptive cross-sectional design was used involving a sample of 750 specialist nurses working in mental health facilities in Spain. An intentional, non-probability, non-discriminative, exponential snowball sampling method was used. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, and the Community Attitudes towards Mental Illness Inventory were used to measure the study variables. A positive correlation was observed between empathy and all the study variables, with the exception of the personal accomplishment dimension of burnout and the social restrictiveness and authoritarianism dimensions of attitudes towards mental illness, where a negative relation was observed. Our findings suggest that empathy is associated with an increase in positive attitudes towards patients with mental disorders, decreasing associated stigma, but did not act as a protective factor against burnout in the study sample.
... Again, there are complex reasons for low utilization of mental health services. The stigma surrounding poor mental health appears to a major contributor to a lack of contact with services (Schomerus & Angermeyer 2008) and anticipated discrimination appears to deter people from coming into contact with services (Corrigan & Wassel 2008). Individuals may be fearful of being discriminated against if they are labelled as having a mental health problem. ...
International health system comparisons: from measurement challenge to management tool
... [9][10][11][12][13] Four types of stigma toward people with mental illness are common: a) social or public stigma; b) structural stigma; c) family stigma; and d) self or internalized stigma. [14][15][16] All these types of stigma are associated with increased functional impairment among those who experience stigma and discrimination, 17 affecting their health, social inclusion, and quality of life. 7,[18][19][20] Considering the consequences of stigma toward people with mental illness, the World Health Organization (WHO) 21 ...
Objective:
To describe the translation and adaptation of the Mental Illness Clinicians' Attitudes Scale version 4 (MICA v4) to Spanish and Portuguese.
Methods:
The questionnaire was administered to primary care physicians (PCPs) from four Latin-American countries, Brazil, Bolivia, Chile and Cuba. The validation process included four phases: 1) translation of the questionnaire to Spanish and Portuguese; 2) assessment of the face validity; 3) assessment of reliability; and 4) evaluation of construct validity through confirmatory factor analysis (CFA).
Results:
The study sample comprised 427 PCPs. The mean age of the Spanish sample (n= 252) was 40.1 (S.D=9.7) and from the Portuguese sample (n= 150) was 40.2 (S.D=10.9). The two models demonstrated "appropiate" internal reliability, the omega total was 0.91 in the Spanish sample and 0.89 in the Portuguese sample. The CFA of both questionnaires had an appropriate fit for a three factors model (Portuguese: CFI=0.927; TLI=0.913; RMSEA= 0.066; Spanish: CFI=0.945; TLI=0.935; RMSEA= 0.068).
Conclusions:
The Latin-American versions of the MICA v4 in Spanish and Brazilian Portuguese have appropriate psychometric properties, good internal consistency, and are applicable and acceptable to the Latin-American context. The instrument proved its validity to produce data concerning stigmatizing attitudes from health professionals in different contexts and cultures.
... This is especially important as a number of studies have demonstrated that there is little training on sexuality and disability in the health professions [6,39,43,52]. Corrigan's work on stigma supports a framework for contact as decreasing stigma specific to individuals with psychiatric disabilities [53,54]. The advocacy for inclusion of people with disabilities into recreational, vocational, and educational settings can positively influence attitudes towards people with disabilities as well as impacting the quality of life for people with disabilities. ...
Individuals with disabilities face many misconceptions regarding their sexuality, the most common of which are that they are either asexual or unable to control themselves sexually. These misconceptions are present in members of the general public, parents of individuals with disabilities, and professionals who work with individuals with disabilities. This systematic literature review explores the extant literature on attitudes of the general public towards the sexuality of individuals with disabilities. Thirty-four articles were included in this systematic review, representing attitudes towards individuals with physical disabilities, intellectual disabilities, and psychiatric disabilities. Results were coded into three main themes: People with Disabilities as Sexual Beings, Factors Influencing Societal Attitudes, and Factors Related to the Sexuality of People with Disabilities. Topics such as sexual rights, sexual behavior, relationships, partner factors, sexual orientation, sexual and reproductive health, parenting, and stigma are addressed. Also addressed are the nine measures of attitudes towards sexuality and disability utilized studies included in the systematic review.
... On the other hand, when there is training in the knowledge and belief acquisition that improves the recognition, handling, and prevention of mental illness a reduction of these discriminatory attitudes towards people with mental disorders is generated, which in turn is associated to a minor gap in the treatment and in a better quality of life for the patients and their families (Lam et al., 2010). In a similar vein, it has been seen in health professionals a positive attitude boosted when there is experience in psychiatric services for more than a month (Hsiao et al., 2015), also presenting minor indicators of restrictive attitudes and major benevolent attitudes when a link and contact with users affected by a mental pathology are stablished (Corrigan & Wassel, 2008), particularly in those who have a family member or close friend with this diagnosis (Yuan et al., 2017), which indicates a synergic relation when there is a greater proximity towards this population (Corrigan, 2016). ...
Psychiatric illnesses affect more than 450 million people worldwide, with several consequences for those who are affected, along with the presence of high numbers of discrimination, stigmatization, and negative attitudes of the general population. These negative attitudes have been observed even in health professionals, negatively impacting on the quality of care, adherence to treatment and well-being of affected users. This study describes attitudes of medical students towards people with psychiatric illness from a qualitative perspective, through the analysis of thematic content of 12 semi-structured interviews conducted with first- to fourth-year medical students. Among the results, a diversity of identified attitudes outstands, including empathy, frustration, indifference and rejection, uncertainty and fear, tolerance and social acceptance. As a discussion, it is stated that most of the findings were consistent with the international literature, however there are new findings that are not described, highlighting the attitude of fear of being harmed and the rejection towards people with psychiatric pathologies. The design and implementation of educative interventions that facilitate contact with users, in order to reduce stigma and negative attitudes in future medical professionals, is concluded as an urgent challenge. Finally, it is proposed for future research to develop longitudinal and comparative studies that consider measuring the effectiveness of these interventions.
... The results of this research showed that students at secondary school held various views about mentally ill people, but that overall, they had adverse perception toward patients with mental health issues. This result is broadly in line with studies on biases against mentally ill people that discovered that stigma is assigned to people with mental illnesses by the public (Crowe et al., 2016;Corrigan and Wassel, 2008;Timmins et al., 2011). On the other hand, in research undertaken among graduate students in Jordan, it was found that the students had some important favorable attitudes toward people with mental illnesses that can be classified into four categories (Hamaideh and Mudallal, 2009). ...
Aim
Mental health disorders in many countries are regarded as taboo and are often concealed. This study aimed to (a) explore students in secondary school' stigma perceptions of mental disorder; (b) examine whether there is a connection between religiosity and stigma toward people with mental illnesses; and (c) identify stigma correlates for stigma perceptions toward people with mental illnesses based on the religiosity and demographic features of the students.
Method
A cross-sectional correlational study was undertaken among 357 students from two high schools. The participants completed a structured research instrument that consisted of (1) a sociodemographic characteristics questionnaire, (2) a religiosity questionnaire and (3) a devaluation-discrimination scale.
Results
The regression model was able to forecast a moderate percentage of stigma perception variance (F = 4.74, p = .01). Gender was the only important correlate in the model at p = .05.
Conclusion and implications
This study found that among students in secondary school in Jordan there is an association between religiosity and stigma toward mental disorders. This result implies that there is a need to increase policy maker information about the importance of applying religious principles to decrease stigma and enhance a positive non-stigmatizing attitude toward mental disorders. Moreover, improving the curriculum content concerning the problems associated with mental ill health may allow students to gain a more precise understanding of mental disorders more generally.
... In both studies, the education of our samples was consistent with the general U.S. population, while race/ ethnicity was also consistent with the exception of underrepresentation of non-White Hispanic/Latinx participants (U.S. Census Bureau, 2019). However, the predominance of White participants in both samples obscures our ability to examine racial or ethnic differences in how labels affect stigma, which is an important limitation given differences in how Black Americans manifest mental health stigma and respond to stigma mitigation efforts (Abdullah & Brown, 2020;Corrigan & Wassel, 2008;Rao et al., 2007), and other potential racial/ ethnic differences (see Parcesepe & Cabassa, 2013). Both samples had a slightly higher median income than the general U.S. population (U.S. Census Bureau, 2019), which is notable given that higher SES has predicted greater stigma about some conditions (e.g., clinical depression) but not schizophrenia (Foster et al., 2018). ...
Borderline personality disorder (BPD) is highly stigmatized. Although person-first labels are now used for most mental illnesses (e.g., a person with schizophrenia) rather than premodified noun labels (e.g., “he is a schizophrenic”), it is still common to hear people referred to as “borderlines.” In a series of two experimental studies, we examined how diagnostic labels influence negative attitudes about BPD. In Study 1, we presented vignettes with no diagnostic label, a person-first label, or a premodified noun label and compared BPD vignettes to schizophrenia vignettes. In Study 2, we again examined the influence of diagnostic label on attitudes about BPD and manipulated the gender depicted in the BPD vignettes. In Study 1, negative attitudes related to anger and blame were greater for BPD than schizophrenia. Diagnosis and label construction did not interact. In Study 2, we found little evidence of gender effects, except that male characters with BPD were considered more dangerous and evoked more fear, while female characters were viewed with greater pity. Gender and label construction did not interact. Although we expected that attitudes would be most negative in the premodified noun label condition and least negative in the person-first condition, this was not the case. In both Studies 1 and 2, the condition with no diagnostic label produced the greatest negative attitudes in some but not all stigma domains, while person-first and premodified noun labels did not differ. Results suggest that in some contexts, diagnostic labels reduce negative attitudes about BPD regardless of their specific construction. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
... At the international level, several strategies have been implemented within the general population, as well as medical students, to reduce stigma toward mental disorders (19), and the most successful ones have been those involving direct contact with patients (20,21) as well as programs with strong educational components (16,(22)(23)(24). It has been shown that direct, personto-person contact and activities where the participants and patients share thoughts and experiences around mental health are key to the success of these programs (25)(26)(27). ...
Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p < 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p < 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.
... Past research shows that selfstigma is strongly associated with both depression (Yen et al., 2005;Zahn et al., 2015) and anxiety (Busby Grant et al., 2016). Consequently, individuals with mental health concerns avoid seeking treatment and social support (Corrigan & Matthews, 2003;Corrigan & Wassel, 2008;Vogel et al., 2007). Given that people with depression and anxiety tend to be more sensitive and vulnerable to negative stereotypes, it reflects that they tend to suffer from numerous negative mental health consequences (Ociskova et al., 2013). ...
Literature on the cultural psychological aspect of mental health suggests that antecedents of mental health in individualistic cultures, or societies that prioritize independence, autonomy, and personal uniqueness do not always apply in collectivistic cultures, or societies that prioritize interdependence, social connection, interpersonal harmony, and norms. The aim of the present study was to determine the mechanisms underlying the impact of self-stigma on depression and anxiety in a collectivistic culture such as the Philippines. Specifically, this study sought to examine: (1) the mediating role of self-criticism on the impact of self-stigma on depression and anxiety, and (2) the moderating role of interdependent self-construal on the impact of self-criticism on depression and anxiety in Filipinos. Surveys measuring self-stigma, self-criticism, interdependent self-construal, depression, and anxiety symptoms were administered to 312 adolescents in rural communities in the Philippines. Using structural equation modeling, findings revealed indirect effects of self-stigma on both depression and anxiety via self-criticism. Findings confirmed that interdependent self-construal attenuate the detrimental impact of self-criticism on depression and anxiety in collectivistic contexts. This study offers novel insights about the underlying mechanisms that operate in the impact of self-stigma on depression and anxiety symptoms among individuals in collectivist contexts. We highlight that self-criticism may have both adaptive and maladaptive functions in collectivist cultures. The study provides implications on the importance of culturally sensitive clinical interventions in preventing depression and anxiety by combating self-stigma and the negative aspect of self-criticism in collectivist cultures. Limitations and future directions are discussed.
Research has given limited attention to family and friends bereaved by a drug-overdose death. To examine the ways in which stigma may uniquely impact the grieving processes of the bereaved, a thematic analysis of 35 semistructured in-depth interviews with family members and adult peers who lost a loved one to an overdose was conducted. Our findings demonstrate that the bereaved experience stigmatization after their loss. Specifically, respondents emphasized stigmatizing interactions with law enforcement, alienation from friends and family, a lack of social support, exchanges that enforced feeling rules, and being confronted by narratives of blame and individual choice as contributing to the degrees of stigmatization they experienced. Our findings highlight how bereavement becomes stigmatized to varying degrees through multiple interactions that have a compounding effect on mourners. We refer to this process as stigmatized bereavement, whereby the frequency of such interactions informs the degree of stigmatization the bereaved faces.
The need for emergency food aid is increasing across the United Kingdom (UK). Prior to the COVID-19 pandemic, an estimated 2.5% of UK households accessed food banks. As of June 2022, 15% of households were using food banks, and emerging evidence suggested increased stigma, shame and embarrassment associated with food aid use, food poverty, and food insecurity. This ethnographic study explored food aid user experiences of stigma-power, and antistigma strategies utilized by both food aid users and volunteers, at one North East of England Independent Community Food Hub (ICFH) during the COVID-19 pandemic. Findings revealed that stigma-power and the negative dominant narrative adversely affected food aid users, who created stigma avoidance techniques to reduce the perceived stigma of food bank usage. Findings also showed ways in which the ICFH implemented numerous antistigma strategies to reduce the stigma, shame, and embarrassment felt by food aid users.
Background:
Eating disorders are highly stigmatized, but stigma against binge eating disorder (BED) specifically is relatively understudied, especially in men. We compared perceptions of a male target with BED to one with alcohol use disorder (AUD), which shares the key characteristic of subjective loss of control over consumption. We also investigated how participants' eating and alcohol use behaviors and attitudes towards psychotherapy influence perceptions of these disorders.
Methods:
Participants (n = 402) viewed vignettes describing a male target engaged in excess alcohol use or binge eating and rated the target on various attributes and as being responsible for or in control of their behavior and suffering from an addiction warranting treatment. Participants completed the Alcohol Use Disorders Identification Test, Binge Eating Scale, and questions about attitudes towards and experience with psychological treatment.
Results:
The BED target was rated as significantly less "thin," more "overweight" and "obese", and higher on several positive attributes and traits traditionally associated with femininity; the AUD target was thought more likely to be suffering from an addiction and in need of psychological treatment (all p < .05), with no differences between targets in ratings of responsibility for or control over the problematic behavior. Ratings were unrelated to participants' attitudes towards or experience with psychological treatment and personal alcohol consumption or binge eating behaviors.
Conclusions:
BED in men appears less stigmatized than AUD but is implicitly associated with weight status and femininity, which may increase reluctance to seek treatment. Both AUD and BED were generally recognized as pathological and warranting intervention.
Laws and public policies can change social norms by signaling which behaviors are legal or illegal. Recent cannabis legalization policies might have this effect. Does cannabis legalization increase social acceptance toward its users? This article focuses on understanding the impact of Uruguayan cannabis legalization on attitudes toward cannabis users by taking advantage of having legal and illegal mechanisms for getting cannabis under the same national context. To do so, we conducted a conjoint experiment in a national face-to-face survey (N = 2,181). Participants were presented with two different profiles of potential neighbors and asked to choose one. These profiles randomized attributes such as being a registered user, mechanism of cannabis acquisition, frequency of cannabis use, as well as sociodemographic characteristics. Participants rated each profile from 1 to 7 based on how much they would like to have them as neighbors. Subsequently, we estimated the average marginal component effect as the critical causal quantity of interest. Results reveal that users who access cannabis through a legal mechanism are more preferred as neighbors than those who do not. Thus, the evidence presented in this article indicates that regulation, by proving legal access, increases the social acceptance of cannabis users.
Stigma is a socially constructed phenomenon that occurs on multiple levels and has broad implications for both individuals with mental illness and society as a whole. Theoretical orientations provide a framework for organizing and advancing research on the stigma of mental illness. This chapter describes theoretical perspectives on types of mental illness stigma, including public stigma, self-stigma, associative stigma, and structural stigma. In terms of public stigma (stereotypes, prejudice, and discrimination directed at people with mental illness), we discuss five theories: (1) modified labeling theory, (2) social-cognitive model, (3) stereotype content model, (4) implicit stigma, and (5) attribution theory. In terms of self-stigma (the internalization of public stigma), we describe the progressive model of self-stigma, stigma resistance, and two theoretical approaches to understand disclosure of mental illness: the disclosure process model and the disclosure decision-making model. While theoretical models to guide research on associative and structural stigma are limited, we review these concepts and suggest areas for future scholarship. Finally, we describe and critique several multi-level models of stigma including the Mental Illness Stigma Framework and the Health and Stigma Discrimination Framework.
The persistence of stigma of mental illness and seeking therapy perpetuates suffering and keeps people from getting the help they need and deserve. This volume, analysing the most up-to-date research on this process and ways to intervene, is designed to give those who are working to overcome stigma a strong, research-based foundation for their work. Chapters address stigma reduction efforts at the individual, community, and national levels, and discuss what works and what doesn't. Others explore how holding different stigmatized identities compounds the burden of stigma and suggest ways to attend to these differences. Throughout, there is a focus on the current state of the research knowledge in the field, its applications, and recommendations for future research. The Handbook provides a compelling case for the benefits reaped from current research and intervention, and shows why continued work is needed.
Stigma and discrimination of people with substance use disorders (SUD) contribute massively to the harm done by their condition: stigma has negative effects on service engagement, life opportunities, and personal shame, both for those who struggle with substance abuse and their families. Overcoming the stigma of substance use disorders is essential to aid recovery in those with SUD. This book provides an in-depth understanding of the stigma of SUD, and proposes ways to overcome it in different settings from the criminal justice system to healthcare. Combining a multitude of viewpoints within a consistent theoretical framework, this book both summarizes the latest evidence and gives hands-on advice and future directions on how to combat the stigma of SUD. People with lived experience of SUD, advocates, family members, policy makers, providers and researchers in the field of addiction stigma will greatly benefit from reading this book.
Introducción: Las personas con trastornos mentales están muy estigmatizadas por poblaciones de todo el mundo y son vistas como una carga para la sociedad. Muchas personas con trastornos mentales son discriminadas, lo que genera oportunidades de vida limitadas. Dado que las creencias sobre los trastornos mentales pueden variar según la cultura, la religión, la nacionalidad y la etnia, es importante comprender los diferentes tipos de estigma relacionados con el trastorno mental que se experimentan en todo el mundo. Materiales y Métodos: Se utilizó la metodología de Whittemore y Knafl (2005) para revisiones integrativas para analizar 18 estudios sobre experiencias vividas de estigma relacionado con el trastorno mental en América del Sur. Resultados: Los resultados sugieren que ciertos tipos de estigma en América del Sur. se basan en normas sociales y de género, como la posición social de hombres y mujeres en la sociedad. Esto conduce a la discriminación, el aislamiento y la violencia por parte de la familia, la pareja íntima, los amigos, la sociedad y los profesionales de la salud. El empleo también es limitado para los sudamericanos con trastornos mentales. Otras consecuencias, como el autoestigma, también afectan la vida de las personas con trastornos mentales en muchos contextos sudamericanos. Discusión: Las relaciones familiares, de amistad y sociales, incluidos los profesionales de la salud, pueden involucrar procesos que conducen al estigma vivido por las personas con trastornos mentales. Conclusión: Esta revisión integradora destaca cómo el estigma relacionado con el trastorno mental afecta a las personas en América del Sur.
Como citar este artículo: Raquel Helena Hernandez Fernandes, Bruna Sordi Carrara, Brenda Alice Andrade Vidigal, Arthur Luís Barbosa Martins, Sireesha Jennifer Bobbili, Carla Aparecida Arena Ventura. Stigma experienced by people with mental illness in South America: an integrative review. Revista Cuidarte. 2022; 13(2): e2014 http://dx.doi.org/10.15649/cuidarte.2014
Background:
Public stigma is a significant deterrent to mental health service use for U.S. veterans. Media campaigns are often used to dispel stigmatizing beliefs and actions. Segmentation is an evidence-based practice for their effective use; however, little data has been published on veteran segments to target with anti-stigma messages.
Aims:
This article aims to identify and describe initial typologies of stigmatizing attitudes within a group of U.S. military veterans.
Methods:
Telephone-based cross-sectional surveys were conducted with a national random sample of veterans from 2014 to 2016 (N = 2142). Stigma outcomes were measured using a brief, validated instrument used in population-based surveys of public perceptions toward people with mental illness. Cluster analysis was conducted to identify specific groupings along multiple dimensions.
Results:
A final four-cluster solution was identified among veterans with distinct patterns of attitudes toward mental illness and include: 1) the undecided, 2) the influencer, 3) the ambivalent, and 4) the potential ally. Several strategies were also identified for designing anti-stigma messaging toward these segments.
Conclusions:
This research demonstrates veterans can be segmented by attitudes to target with anti-stigma campaign messages.
Résumé
La stigmatisation existe depuis l’antiquité. Il n’en demeure pas moins qu’elle persiste encore aujourd’hui et apporte son lot de conséquences négatives. Les aspects structuraux, interpersonnels et intrapersonnels s’entrecroisent et affectent la vie de plusieurs personnes en termes d’accès aux soins, de rétablissement et de qualité de vie. Même si la réduction et la prévention de la stigmatisation furent une priorité pour les chercheurs et les intervenants du milieu au moyen de campagne de sensibilisation, les résultats demeurent mitigés. S’il est difficile d’expliquer un tel échec, nous pensons que la philosophie peut être utile pour explorer d’autres possibilités. Nous introduirons une perspective philosophique selon la pensée de Georges Canguilhem et de Judith Butler afin d’aborder autrement la stigmatisation. Pour conclure, nous pensons qu’il devient nécessaire d’introduire de nouvelles manières de pratiquer la médecine, la psychiatrie, la psychologie et la sociologie en évitant le piège de la logique binaire du tiers exclu et en élargissant le spectre des possibilités. Promouvoir la subjectivation peut devenir une manière d’aider les personnes à comprendre leur maladie comme une réalité qui favorise le changement et la créativité.
Background
Service-learning is a powerful tool to promote attitudinal change; however, most findings center the experience of white, middle-class, continuing-generation students and do not reflect the shifting demographics of higher education. Little is known about the impact of service-learning at Hispanic-Serving Institutions (HSIs) on attitudes toward others, and even less is known based on studies experimentally manipulating the presence of service-learning.
Objective
This study investigated how a service-learning project conducted at an HSI impacted changes in attitudes toward those experiencing homelessness.
Method
Sixty-three students taking Social Psychology either participated in a course with a service-learning project or one that did not. Attitudes related to those experiencing homelessness and the self were assessed over time.
Results
Students that participated in service-learning saw increased positive attitudes toward those experiencing homelessness over time compared to those that did not participate in service-learning.
Conclusion
Service-learning seems to have helped foster positive attitudes toward those experiencing homelessness for students at an HSI.
Teaching Implications
The current study hopes to encourage wider use and study of service-learning by highlighting positive impacts service-learning may have on students. Service-learning may have profound effects on students, and these effects need to be studied at a variety of institutions.
The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students’ responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5%; 1-4 grades, 189; 5-6 grades, 68); 268 Turkish (females, 43.3%; 1-4 grades, 90; 5-6 grades, 178); 450 Kazakh (females, 28.4%, 71.6%; 1-4 grades, 312; 5-6 grades, 138); 512 Azerbaijani (females, 24%; 1-4 grades, 468; 5-6 grades, 44; females, 24%), and 317 Polish (females, 59.0%; 1-4 grades, 208; 5-6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across at all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of greater opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.
The purpose of this study was to validate the use and interpretation of scores derived from the Stigma of Loneliness Scale (SLS) with a sample of college students from a large, Midwestern university. A two-factor oblique solution with 10 items was selected through exploratory factor analysis and cross-validated through confirmatory factor analysis. Correlational evidence was demonstrated through positive correlations with loneliness and shame scores, and a negative correlation with social connectedness scores. Construct evidence was demonstrated through positive correlations with self-concealment and depression scores, and a negative association with distress disclosure scores. For incremental validity, items on the SLS accounted for additional variance in predicting contingent self-worth based on approval from others, shame, self-esteem, and social self-efficacy above and beyond scores on a measure of loneliness. The internal structure of the SLS was invariant across gender groups and across Time 1 and Time 2 assessments.
Undetectable = Untransmittable (U = U) is the scientific fact that HIV cannot be transmitted when an individual is virally suppressed. This breakthrough discovery has the potential to greatly reduce HIV stigma and its negative effects. However, U = U is not widely known. Given that Twitter has the potential to raise awareness of health issues, the purpose of this study was to analyze the content of the #UequalsU on Twitter. The results showed that mentioning sex and mentioning love were strong predictors that a tweet would be liked and retweeted. This information could help to spread the message of U = U more widely and potentially lessen HIV stigma.
The Rosetta Wheel framework is a framework for design teams to guide the development of games for health behaviour change. The framework is grounded in evidence-based research of the psychology of behaviour change. It is further informed by game analysis and expert design techniques in order to understand how psychological processes map with game design patterns.
The Rosetta Wheel has 10 Change Keys, assisting design teams to create game mechanics which foster the psychological processes of change, alongside 19 Key Considerations which support the overall development process.
The presentation will cover the research process that led to the development of the framework, along with an overview of the Rosetta Wheel Framework, and will finish off by introducing some implementation ideas of how the framework can be applied in practice.
This research study explored the mental health seeking behaviour of racialized and non-racialized female students at a large size public university located in Ontario, Canada. A sample consisting of 570 students participated in the cross-sectional survey. The majority (n = 413, 84.1%) were identified as Canadian racialized female students. The remainder (n = 78, 15.9%) were Canadian non-racialized female students, identifying with dominant Canadian culture. We contended that intersectionality, an emergent theoretical and methodological public health framework, provides a powerful tool for understanding these complex interlocking experiences in the context of mental health. High levels of depression and anxiety symptoms were reported by both the racialized non-racialized female students. The proportion of students with CES-D scores > 16 (indicating that may suffer from depression) was higher among the female racialized students (n = 265, 64.2%) than the non-racialized female students (n = 39, 50.0%). Approximately, half of the racialized students (n = 202, 48.9%) had BAS scores > 10 indicating that they may suffer from anxiety. About half (n = 38, 48.7%) of the non-racialized students also had BAS scores > 10 indicating that they may suffer from anxiety. The findings of this research study advocate university governance, healthcare professionals, and counsellors need to improve their services to address the specific needs and concerns of racialized students. Future research should focus on how findings can be translated into practice by designing culturally adaptive treatment modalities, that focus on resolving mental health problems in racialized and non-racialized female students especially in times of crisis similar to the Corvid-19 pandemic.
Mental health courts (MHCs) are increasingly used across the United States as a means of reducing contact with the criminal justice system for individuals experiencing serious mental health conditions. MHCs rely on diversion from incarceration to rehabilitation, services, and treatment to reduce recidivism and other negative outcomes among individuals with mental health disorders. While MHCs are a potential evidence-based remedy for the intensifying mental health and criminal justice crises in America, there is limited research indicating the overall effects these courts have on recidivism, and whether the effects vary across different sub-groups or research design and analytic features. Therefore, we present a meta-analysis of 38 effect sizes collected from 30 evaluations conducted from 1997 through 2020 on the impact of mental health courts on recidivism for adults and juveniles with mental health issues in the United States. Weighted meta-analytic results indicate that MHC participation corresponds to a 74% decrease in recidivism (OR = 0.26). Notably, the strength of MHC effects are similar for adult and juvenile participants, and stable across varied follow-up periods, study design features, and when prior criminal history, gender and race/ethnicity are controlled for in the analyses. Implications for the criminal justice system are also discussed.
The aim of the study is to identify the level of mental health literacy among undergraduate
students to explore the relationship between mental health literacy and help seeking
behavior among UPSI students and to identify the significant difference in mental health
literacy score for students who have encountered people with mental health disorders. The study adapted cross-sectional quantitative survey design. Mental Health Literacy Scale (MHLS) and General Help-Seeking Questionnaire are used in this study. N=130 UPSI students (n=25 male, n=105 female) completed the online survey which measure multiple dimensions of mental health literacy and help seeking behavior. The level of mental health literacy of undergraduate students was measured through the mean score of the MHLS. Result revealed a mean score of the MHLS obtained from the sample is (M=117.97, SD=14.62). This score is lower as compared to previous studies using the same scale. The Pearson correlation between mental health literacy and help-seeking behavior showed a negative, weak correlation (r= -.139) which is in contrast with the previous studies using the same scale. There is a significant difference in the mean score of the students who answer Yes and No for the screening question on knowing people with mental health disorders. In summary, the topic of mental health literacy is a new area to be explored in Malaysia and limited number of researches is available to compare the data.
Viewing a stigmatized group as different from everyone else is believed to be a contentless stigma that leads to disdain. This study tests whether three emotions-intergroup anxiety, anger, and empathy-mediate the path between difference and disdain. Six hundred thirty-eight research participants from MTurk provided valid responses to an online survey via Qualtrics. The survey used standardized measures of difference, disdain, intergroup anxiety, anger, and empathy. The hypothesized path model was tested using structural equation modeling (SEM). Fit indicators from SEM and corresponding betas supported a two-mediator model. Specifically, difference was found to be significantly associated with disdain. The path between the two was positively mediated by anger and negatively mediated by empathy. Difference and disdain may become important constructs in predicting and assessing stigma change. Perspective-taking that enhances empathy may prove especially useful for decreasing difference and disdain perceptions about people with mental illness.
For a variety of reasons, social perceivers may often attempt to actively inhibit stereotypic thoughts before their effects impinge on judgment and behavior. However, research on the psychology of mental control raises doubts about the efficacy of this strategy. Indeed, this work suggests that when people attempt to suppress unwanted thoughts, these thoughts are likely to subsequently reappear with even greater insistence than if they had never been suppressed (i.e., a "rebound" effect). The present research comprised an investigation of the extent to which this kind of rebound effect extends to unwanted stereotypic thoughts about others. The results provide strong support for the existence of this effect. Relative to control Ss (i.e., stereotype users), stereotype suppressors responded more pejoratively to a stereotyped target on a range of dependent measures. We discuss our findings in the wider context of models of mind, thought suppression, and social stereotyping. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Cognitive-behavioral therapy for psychosis is described. It draws on the cognitive models and therapy approach of Beck and colleagues, combined with an application of stress-vulnerability models of schizophrenia and cognitive models of psychotic symptoms. There is encouraging evidence for the efficacy of this approach. Four controlled trials have found that cognitive-behavioral therapy reduces symptoms of psychosis, and there is some evidence that it may contribute to relapse reduction. Studies that have examined factors that predict treatment response are reviewed. There is preliminary evidence that a good outcome is partially predicted by a measure of cognitive flexibility or a “chink of insight.” People who present with only negative symptoms may show poorer outcome. However, there is no evidence that intelligence or symptom severity is associated with outcome. Implications for selecting patients and for optimal duration of treatment are discussed. Finally, the importance of taking account of the heterogeneity of people with psychosis, so that individual treatment goals are identified, is discussed.
Advocacy, government, and public-service groups rely on a variety of strategies to diminish the impact of stigma on persons with severe mental illness. These strategies include protest, education, and promoting contact between the general public and persons with these disorders. The authors argue that social psychological research on ethnic minority and other group stereotypes should be considered when implementing these strategies. Such research indicates that (a) attempts to suppress stereotypes through protest can result in a rebound effect; (b) education programs may be limited because many stereotypes are resilient to change; and (c) contact is enhanced by a variety of factors, including equal status, cooperative interaction, and institutional support. Future directions for research and practice to reduce stigma toward persons with severe mental illness are discussed.
The effects of three strategies for changing stigmatizing attitudes--education (which replaces myths about mental illness with accurate conceptions), contact (which challenges public attitudes about mental illness through direct interactions with persons who have these disorders), and protest (which seeks to suppress stigmatizing attitudes about mental illness)--were examined on attributions about schizophrenia and other severe mental illnesses. One hundred and fifty-two students at a community college were randomly assigned to one of the three strategies or a control condition. They completed a questionnaire about attributions toward six groups--depression, psychosis, cocaine addiction, mental retardation, cancer, and AIDS--prior to and after completing the assigned condition. As expected, results showed that education had no effect on attributions about physical disabilities but led to improved attributions in all four psychiatric groups. Contact produced positive changes that exceeded education effects in attributions about targeted psychiatric disabilities: depression and psychosis. Protest yielded no significant changes in attributions about any group. This study also examined the effects of these strategies on processing information about mental illness.
Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia.
To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables.
Historic prospective study. Standardised assessments of course and outcome.
About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery.
A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.
Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care. Stigma yields 2 kinds of harm that may impede treatment participation: It diminishes self-esteem and robs people of social opportunities. Given the existing literature in this area, recommendations are reviewed for ongoing research that will more comprehensively expand understanding of the stigma-care seeking link. Implications for the development of antistigma programs that might promote care seeking and participation are also reviewed.
Stigma impedes the life opportunities of people with mental illness. Research suggests that stigma may be reduced by three approaches: protest, education, and contact. Three programs that adapt these approaches for mass audiences are described: StigmaBusters, which is a form of protest; Elimination of Barriers Initiative, which involves education or social marketing; and In Our Own Voice, which relies on direct contact between people with mental illness and the public. The authors review preliminary research that offers initial support for the feasibility and impact of these programs, with a particular focus on how the components of social marketing (problem identification, description of target audiences, development of the change technology, and process and outcome evaluation) can be adapted to antistigma campaigns.
This paper hypothesizes that official labeling gives personal relevance to an individual's beliefs about how others respond to mental patients. According to this view, people develop conceptions of what others think of mental patients long before they become patients. These conceptions include the belief that others devalue and discriminate against mental patients. When people enter psychiatric treatment and are labeled, these beliefs become personally applicable and lead to self-devaluation and/or the fear of rejection by others. Such reactions may have negative effects on both psychological and social functioning. This hypothesis was tested by comparing samples of community residents and psychiatric patients from the Washington Heights section of New York city. Five groups were formed (1) first-treatment contact patients, (2) repeat-treatment contact patients, (3) formerly treated community residents, (4) untreated community cases, and (5) community residents with no evidence of severe psychopathology. These groups were administered a scale that measured beliefs that mental patients would be devalued and discriminated against by most people. Scores on this scale were associated with demoralization, income loss, and unemployment in labeled groups but not in unlabeled groups. The results suggest that labeling may produce negative outcomes like those specified by the classic concept of secondary deviance.
This paper reviews evidence pertaining to the Common Ingroup Identity Model for reducing intergroup bias. This model proposes that intergroup bias and conflict can be reduced by factors that transform members cognitive representations of the memberships from two groups to one more inclusive social entity. Theoretically, a common ingroup identity extends or redirects the cognitive and motivational processes that produce positive feelings toward ingroup members to former outgroup members. It is proposed that the prerequisite features specified by the contact Hypothesis (Allport, 1954; Cook, 1985), such as equal status between the memberships, cooperative interdependence, opportunity for self-revealing interactions and egalitarian norms, successfully reduce bias, in part, because they help transform members' perceptions of the memberships from “Us” and “Them” to a more inclusive “We”. Evidence from a laboratory experiment, two survey studies involving students attending a multi-ethnic high school and executives who have experienced a corporate merger, and a field experiment involving fans attending a college football game are summarized. In general, across these diverse settings, greater perceptions of a superordinate identity predicted lower levels of intergroup bias toward original outgroup members. In particular, this presentation of our research discusses the promise of exploring the role of a dual identity, in which both sub-group and superordinate group identities exist simultaneously, and how contextual features of the situational context may moderate the relation between the strength of a dual identity and intergroup attitudes.
With the exception of a few studies, little systematic attention has been given to individuals in their postdeviant careers. Drawing on data collected through participant observation and informal interviews with 146 nonchronic ex-psychiatric patients, this article explicates dimensions of their exit process and social reintegration. Specifically, attention is given to ex-patients' perceptions of mental illness as a stigmatizable/stigmatizing attribute, the problems they faced, the manner by which they manage discreditable/discrediting information about themselves, and the consequences of such for altering their deviant identities and social reintegration. This article suggests that ex-psychiatric patients are strategists and negotiators who play active roles in attempting to shape their deviant outcomes, techniques which have implications for identity transformation and reintegration.
Social science research on stigma has grown dramatically over the past two decades, particularly in social psychology, where researchers have elucidated the ways in which people construct cognitive categories and link those categories to stereotyped beliefs. In the midst of this growth, the stigma concept has been criticized as being too vaguely defined and individually focused. In response to these criticisms, we define stigma as the co-occurrence of its components–labeling, stereotyping, separation, status loss, and discrimination–and further indicate that for stigmatization to occur, power must be exercised. The stigma concept we construct has implications for understanding several core issues in stigma research, ranging from the definition of the concept to the reasons stigma sometimes represents a very persistent predicament in the lives of persons affected by it. Finally, because there are so many stigmatized circumstances and because stigmatizing processes can affect multiple domains of people's li...
Disclosure of HIV infection can lead to important social support that can mitigate the negative effects of stress (R. B. Hays et al., 1993). However, disclosure can also result in rejection, discrimination, and stigma, making the decision to disclose a dilemma for individuals infected with HIV. This decision may be particularly difficult for Asian/Pacific Islander (A/PI) women, owing to HIV's association with topics considered "taboo" in Asian cultures (T. S. Gock, 1994; G. Yep, 1993). This study explored the process, influencing factors, and consequences of disclosure among a sample of 9 HIV-positive A/PI women. On the basis of qualitative interviews and quantitative social network data, findings suggest that these women are acutely aware of and affected by the stigma attached to HIV and that the decision to disclose is influenced by fears about being stigmatized, concerns about disappointing or burdening others, and concerns about discrimination. The consequences of disclosure were generally positive, with variations over time that include both the exacerbation and amelioration of stress. Results suggest the need for research and interventions to address the cultural factors that affect the disclosure process as well as the varying levels and sources of stress over time. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
This chapter begins with a simple question: What is mental illness? After a brief review of the phenomenology and epidemiology, the authors address a question relevant to stigma: Do the problems that seemingly arise from stigma actually represent the results of prejudice, or a "normal" response to eccentric or dangerous behavior of people with mental illness? The chapter reviews Bruce Link's work on the modified labeling theory to answer this question. The remainder of the chapter describes the ways in which stigma impacts people affected by mental illness. The authors distinguish between public stigma (the results of a naive public endorsing the stereotypes of mental illness) and self-stigma (the consequences of people with mental illness applying stigma to themselves). The discussion of public stigma considers how key power groups negatively impact the lives of people affected by mental illness: landlords, employers, members of the criminal justice system, and health providers, to name a few. Self-stigma examines the impact on the person's psychological well-being, health care choices, and decisions about life goals. The chapter ends with a discussion of societal manifestations of stigma and its impact on people with mental illness. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A six-stage model of homosexual identity formation is outlined within the framework of interpersonal congruency theory. Stages are differentiated on the basis of the person's perceptions of his/her own behavior and the actions that arise as a consequence of this perception. The person is seen to have an active role in the acquisition of a homosexual identity. Alternative paths of development are proposed within each stage. The notion that people can accept homosexuality as a positively valued status is assumed. Several factors believed to be influential in determining whether a person takes one line of development or another are discussed. The model is intended to be applied to both female and male homosexuals.
Although thought suppression is a popular form of mental control, research has indicated that it can be counterproductive, helping assure the very state of mind one had hoped to avoid. This chapter reviews the research on suppression, which spans a wide range of domains, including emotions, memory, interpersonal processes, psychophysiological reactions, and psychopathology. The chapter considers the relevant methodological and theoretical issues and suggests directions for future research.
Experimenting on social issues: The case of school desegregation
- Cook S.W.
Reducing prejudice and discrimination: Social psychological perspectives
- T F Pettigrew
- L R Tropp
Is empathy-induced helping due to self-other merging
- Batson C.D.
Self-stigma and the why try effect
- P W Corrigan
- J E Larson
- S A Kuwabara
The Negro-to-Black conversion experience
- Cross W.E.
Controlling other people: The impact of power on stereotyping
- Fiske S.T.
Social marketing: Improving the quality of life
- P Kotler
- N Roberto
- N Lee