Stigma Ch 31 Flashcards
comprising cognitive, emotional, and behavioral aspects known as stereotypes, prejudice, and discrimination
Stigma
negative attitudes and a behavioral chain that begins by applying a stigmatizing mark to a person, progresses through the attitude structures, and results in discrimination.
Stigma
endorsement of negative stereotypes of individuals with the specific condition by others, such as family members and the general population
can include prejudice (i.e., a hostile attitude toward a person simply because she or he belongs to a group judged to have objectionable qualities) and can lead to discriminatory and potentially illegal behaviors
Public stigma
occurs when stigmatized individuals agree with and internalize negative stereotypes; the person believes that he or she is deviant or shamefully different
Self-stigma
predominant social science theories used to study stigma
These theories continue to be relevant to the understanding of stigma, and recent modifications and critiques of these frameworks are presented in the text that follows.
labeling theory and normalization
certain groups have sanctioned power to define or “label” what is and is not socially deviant
Labeling theory
Examples of labeling theory
Government officials
Medical professionals
a stigmatized person experiences three stages:
1) realization of stigma
2) development of coping skills
3) learning to “pass” or cover their disability and function in society
based on the work of labeling theorists, yet it provides an alternative view that people who are typically disenfranchised in our society are excluded; in other words, what has become normal in society is to stigmatize and exclude.
intervention should focus on reducing elements that emphasize difference and create opportunities for social participation in naturally occurring groups and settings within the broader community
Normalization theory
Application of normalization theory is apparent in the design of….
inclusive environments in which program and environmental designs that emphasize difference (e.g., “special” buses, camps, and congregate housing) are replaced with supporting interventions that emphasize opportunities for social role development. Other stigma theories
Normalization theory includes groups such as
Minority Group Perspective, Rite of Passage Theory, and the Modified Labeling Theory
Family members and friends of the person with the stigmatized condition may also feel the devaluation of being stigmatized.
Stigma by association
occurs when society and societal institutions operate in ways that weave inequities and injustices into their laws, policies, or practices
structural stigma
refers to the effect of the problem in terms of financial costs, morbidity, mortality, and overall years lost because of the disease
Disease burden
What public perceptions of ppl w/ mental illness that may deter help-seeking?
Negative attitudes and beliefs held by the public toward people with mental illness (public stigma)
Negative attitudes and beliefs about people with mental illness often lead to overt, negative stigmatizing responses including discrimination. For example, stigma can be demonstrated through….
Social distance
measure of how willing a person is to exclude those with mental illness in various social situations (e.g., not wanting the person to be a neighbor or marry into one’s family, or not wanting to work closely with someone with such an illness) coping, discrimination, and disclosure
Social distance
T/F: Although stigma may be a universal phenomenon, there is diversity in the ways that stigma is exhibited and experienced across different cultures and contexts.
True
cultural aspects of what matters most include “saving face” (avoiding humiliation) and preserving the family lineage. A person whose mental illness threatened his or her ability to effectively engage in interactions that could lead to marriage proposals to ensure the family lineage could be perpetuated would experience increased stigma because of this perceived deficit.
Stigmas of Chinese-American communities
three key attributes of family stigma:
unusualness
Threat
Contamination
unusualness of family stigma result in
negative perceptions, attitudes, and avoidant behavior toward a family
second attribute influencing family stigma
when others believe the family poses a danger or threat of being potentially harmful to the health and well-being of others.
Stigma of contamination within the family
When families are perceived as contaminated, every family member is viewed as dangerous, harmful, or unhealthy. These beliefs have the ability to create as negative an effect for the family as they do for the person with the mental illness.
Measuring the degree of stigmatization or the level of impact of stigma on an individual’s life can help….
both the stigmatized person and the occupational therapy practitioner better understand the impact of stigma and the individual’s response to stigma.
self-report tool is used to help people with mental illness assess dysfunctional beliefs about themselves, including the degree to which they are aware of or agree with common stereotypes
composed of four subscales: stereotype awareness, stereotype agreement, naming self-concurrence, and self-esteem decrement.
The Self-Stigma of Mental Illness Scale (SSMIS)
developed to examine the subjective experience of stigma for people with mental illnesses
self-report tool that contains 5 subscales: naming alienation, social withdrawal, stereotype endorsement, discrimination experience, and stigma resistance
The Internalized Stigma of Mental Illness (ISMI)
Educational interventions focus on educating individuals about mental illness
Social contact interventions are built around the concept that personal contact can reduce stigma.
Advocacy interventions include approaches that raise consciousness about mental illness, efforts to decrease negative attitudes and stigmatizing representations of people with mental illness, policy-focused strategies, and protests.
Types of Anti-Stigma Interventions
derivative of social justice, refers to the right of every individual to have access to, and the ability to engage in, the variety of occupations necessary to support health and wellness can impede occupational justice, including the chronic stress of self-deprecation, which in turn reduces self-determination and full participation in community life.
Occupational justice
three main social concepts of importance to occupational therapy practitioners employing a universalism approach as
marginality, exclusion, and disaffiliation
refers to individuals experiencing a lack of integration with cultural experiences and norms
Marginality
once defined in terms of banishment, confinement, or social control, now also includes those whose access to occupations is restricted by society because of their diagnosis or symptoms
Exclusion
refers to those whose circumstances have devolved to such a level of disruption that they are viewed as “other” (e.g., street people or the homeless)
Disaffiliation
Socially accepted occupations
Sanctioned occupations
Occupations considered socially deviant from the norm
unsanctioned occupations
universal phenomenon that can have significantly debilitating effects on people with mental illness, their families, and significant others
consistent feature in the social environment and can have a profound, negative impact on the recovery of persons with mental illness
can be understood in terms of public stigma, self-stigma, stigma by association, and structural stigma; each type of stigma warrants a different intervention approach
Stigma
can help practitioners address the impact of stigma through interventions
Adequate assessment of level of stigmatization
consistent with our profession’s emphasis on occupational justice
Anti-stigma efforts
Public stigma can be what two things?
Interpersonal
Societal-level conditions
Example of interpersonal public stigma
Social cues
Communication
Example of societal-level conditions of public stigma
Cancel culture
Public shame
Word of mouth
Examples of self-stigma
Wt
Color
Emotion
Hair
Infertility
HIV/AIDS
This theory emphasizes the need of the person w/ the disability to change and “fit in” rather than requiring society to accept such differences as part of human diversity.
Normalization theory
Minority group perspective
a group of people who, because of their physical or cultural characteristics, are singled out from the others in the society in which they live for differential and unequal treatment, and who therefore regard themselves as objects of collective discrimination
Rite of passage theory
introduces a structural model for resolving the problem of disrupted sequence of life experiences.
Modified labeling theory
begins with the idea that there are shared cultural beliefs (analogous to status beliefs in SCT) that mentally ill people are devalued and rejected that are learned by members of a culture as part of their socialization
Pryor and readers model of stigma
Structural stigma, stigma by association, and self stigma surround public stigma
Interventions to reduce self-stigma
Narrate enhancement and cognitive therapy (NECT)
Example of marginality
Special education
Example of exclusion
Field of dreams?
Example of sanctioned occupations
Dressing, cleaning, cooking
Unsanctioned occupation as example
Public intoxication, homelessness, public indecency
Gender dysphoria
general descriptive term refers to an individual’s affective/ cognitive discontent with the assigned gender but is more specifically defined when used as a diagnostic category
