Stigma and Shame

Question 1

Stigma

Answer 1

The possession of an “attribute that is deeply discrediting” that reduces an afflicted individual “from a whole and usual person to a tainted, discounted one.”

Stigmatizing messages:
- distinguish people
- categorize them as a separate group
- blame them for being categorized in the separate group
- associate the stigmatized group with dangerous or undesirable outcomes

Question 2

Components of stigma

Answer 2

Labeling
- Oversimplification of their identities
- Social, economic, cultural forces that create human difference
Stereotyping
- Cognitive efficiency hypothesis: we make the quickest judgements and assumptions about people
Separation
- Us vs them
Status loss and discrimination
- SL: impact of hierarchies
- D: connects attitudes to behaviors

Question 3

Stigma and health

Answer 3

Stigma can negatively impact access to health-promoting resources in 3 ways:
1. Treatment: people who feel that their medical condition is stigmatized delay or avoid medical treatment
2. Medication adherence: people who feel that their medical condition is stigmatized don’t take their medication (embarrassed around others)
3. Support: people who feel that their medical condition is stigmatized don’t disclose their condition to friends and family, so there’s no support

Question 4

Shame

Answer 4

• Emotion that arises from self-perception as if one has experienced a detrimental change in social status
• Occurs when someone experiences failure relative to their own moral standards or those of others, and believes this failure makes them inferior
• Shame = negative self-evaluation

Question 5

External and internal shame

Answer 5

External shame: thoughts about how one is seen by others, and perceived to be viewed negatively

Internal shame: focus of attention is on the self = self-devaluation and self-criticism

Question 6

Stigma, shame and communication

Answer 6

Health campaigns can actually stigmatize people even when they don’t mean to.
- Media works to reinforce stigma
- In media, people with mental illness are portrayed as criminal/violent or childish
- Media makes it sound like people with mental illness look different, they can’t recover, and mental health professionals are untrustworthy
- Popular culture can also work to challenge mental health stigma, like reality TV.

Healthcare providers can stigmatize patients:
- Lack of cultural competency
- Lack of empathy
- Lack of patient-centered communication