Lecture 3 Flashcards
Stigma
article Sheehan et al. (2016) “The stigma of personality disorders
Sheehan et al., (2016)
- Difining stigma
- Stigma - mental illness
- Stigma - pd
- Provider stigma
- Self-stigma
- Structural stigma
- Anti-stigma interventions for PD
What are PDs with highest prevalence?
Sheehan et al., (2016)
- Antisocial pd (3.8%)
- Borderline pd (2.7%)
- OCPD (1.2%)
Cluster B is most common cluster (5.5%)
Ervin Goffma’s definition of stigma
Sheehan et al., (2016)
“Social rejection resulting from negatively perceived characteristics”
–> This rejection leads to “spoiled identity” (societal outcast) of stigmatized individuals
Link and Phelan identified 4 qualities of stigma
Sheehan et al., (2016)
- Individual differences are recognized
- Differences are perceived by society as negative
- Stigmatized group is seen as outgroup
- End result is loss of opportunity, power, or status
From a social-cognitive perspective: what are cognitive, affective and behavioral componants of stigma?
Sheehan et al., (2016)
- Stereotypes
- Prejudice
- Discrimination
What is self-stigma?
Sheehan et al., (2016)
If person believes that negative societal attitudes imposed upon them are true.
This may lead to: low self-esteem, depression or lack of motivation
What is structural stigma?
Sheehan et al., (2016)
Occurs when stigmatizing beliefs and attitudes leads to unfair social institutions and policies for stigmatized groups.
What are most common stigma’s towards those with mental illness?
Sheehan et al., (2016)
- Incompetence
- Dangerousness
- Responsibility
Schizophrenia is stereotypes as incompetent –> employers doubt ability to perform (predudice) and avoid hiring (discrimination)
The fear associated with mental illness fuels behaviors like:
Sheehan et al., (2016)
- Segregation
- Avoidance/withdrawal
Have attitudes towards mental illness improved over time?
Sheehan et al., (2016)
No
Research highlights continued prejudice and discrimination
Public stigma of PDs
Sheehan et al., (2016)
There is evidence that especially PDs are stigmatized.
There are beliefs that people with PDs can control their behavior –> leads to that society sees them as difficult and misbehaving instead of sick.
Also, general public has less knowledge of PDs than other mental illnesses
Mental health literacy
Sheehan et al., (2016)
Public knowledge about PDs
- Connected with treatment-seeking behavior and public stigma
- Individuals with PDs are maybe ostracized (verstoten) rather than referred to treatment and less likely to recognize their own behaviors as symptoms of illness
Which PD is most stigmatized (and most stigma research)?
Sheehan et al., (2016)
BPD
- Characterized by mood instability, extreme sensitivity to abandonment, impulsivity, self-mutilating behavior and difficulty controlling anger
How are people with BPD seen?
Sheehan et al., (2016)
As annoying and undeserving –> resulting in inadequate treatment and help (may have frequent contact with law enforcement due to anger and suicidality)
Symptoms of ASPD
Sheehan et al., (2016)
- Lack of remorse and empathy
- Aggressiveness
- Recklessness
Beginning in childhood
How are children is ASPD symptoms labeled?
Sheehan et al., (2016)
Often as delinquents –> leads to self-fulfilling prophecy
Results stigma ASPD
Sheehan et al., (2016)
- Can lead to individuals being denied prospects of treatment and recovery
- Most court officials don’t consider ASPD to be a mental illenss
New research connecting ASPD to brain changes –> revising its importance in legal settings.
Stigma OCPD
Sheehan et al., (2016)
Because of similarity OCD, OCPD is understood by public.
- Public sees it as quite amenable to treatment
NPD stigma
Sheehan et al., (2016)
- Not familiar to general public
- Not a lot of research: suggesting that people with NPD are viewed as being fragile, lacking self-esteem and excperiencing problematic relationships.
Stigma in healthcare providers
Sheehan et al., (2016)
- Studies indicate negative attitudes of healthcare professionals towards people with PDs (especially BPD)
- Perceived discrimination is common occurrence for patients with PDs when seeking hospital admission
Consequences stigmas health care
Sheehan et al., (2016)
Negative provider attitudes can lead to differential treatment of people with PDs
Stigma may reduce amount of services available, reduce quality of those services and discourage people from seeking treatment
For which PD is self-stigma established problem?
Sheehan et al., (2016)
BPD
- May feel shame about diagnosis and stay away from treatment to avoid self-labeling as sick/weak
- People with BPD have more existential shame
What are effects of structural stigma?
Sheehan et al., (2016)
Can impact:
- Availability of services
- Quality of services
- Insurance coverage
- Research on PDs
- Diagnosis and assessment (diagnostic or screening tools are absent or not precise enough)
- Misdiagnosis –> wrong treatment
- Psychiatrists may avoid diagnosis of PDs to protect people from stigma, or avoid telling person their diagnosis
What are anti-stigma interventions for PDs?
Sheehan et al., (2016)
- Education
- Members of stigmatized groups engaging in personal contact with others
- Interventions targetting providers (anti-stigma training, self-management, skills training)
- Provide neurobiological differences (critics say this increases separation and decreases idea of change and recovery)
- Combining neurobiological info with recovery info was more effective