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PubMed2004

Experience of stigmatization by relatives of patients with obsessive compulsive disorder.

Patients with mental illness and their relatives experience discrimination and stigmatization in their everyday lives. The stigma of mental illness has been investigated in numerous studies. However, the subjective experiences of patients with OCD and their relatives have not been reported up until now. Narrative interviews with 22 family members of patients with obsessive-compulsive disorder were performed as part of a study on the burden and distress among the families of those with mental illness. Stigma experiences were analyzed using a grounded theory approach. Different areas of life could be described, where stigmatization is anticipated or concretely experienced by relatives of patients with OCD. Concealing is an important coping strategy for the family members interviewed. Stigmatization can be reduced by handling the illness and the co-operation of patients, their relatives, and the professionals in an unbiased manner.

Adaptation, Psychological↗

PubMed2005

Stigmatizing experience and structural discrimination associated with the treatment of schizophrenia in Hong Kong.

This research examines the experience of stigma associated with psychiatric treatment among Chinese patients with schizophrenia in Hong Kong. In focus groups patients described stigma experiences related to clinic visits and the side effects of antipsychotic medications. Additionally, they revealed various adverse treatment experiences during hospitalization which point to the presence of structural discrimination. Based on the focus group findings, a questionnaire was developed and completed by 320 and 160 patients with schizophrenia and diabetes mellitus, respectively. Results showed that patients with schizophrenia were more likely to anticipate stigma, conceal illness, and default on clinic visits than patients with diabetes. Medication-induced stigma occurred in 48% of patients with schizophrenia. It brought about the unwelcome disclosure of illness, workplace difficulties, family rejection, and treatment non-adherence. Adverse experiences during hospitalization were reported by 44% of patients with schizophrenia. They included negative staff attitudes, excessive physical/chemical restraints, inadequate information/complaint systems, and limited rights. We conclude that stigma, at both individual and structural levels, represents a central experience of the treatment of schizophrenia in Hong Kong. Because inequitable health policy, resource allocation, and service organization privilege service providers' control over users, treatment-related stigma may be a prime example of the social production of stigma and discrimination based on power difference between the stigmatizers and the stigmatized. To examine this critically we need to redirect stigma research to tractable clinical circumstances and structural mechanisms that produce and maintain stigmatizing and discriminatory psychiatric practice. Destigmatization programs must be evaluated not only by change in public attitudes but also by how much they reduce structural stigma and improve patients' lives.

Adolescent↗

PubMed1998

Perceived stigmatization among overweight African-American and Caucasian adolescent girls.

PURPOSE: To explore how African-American and Caucasian adolescent girls describe weight-related stigmatization experiences and their responses to these experiences. METHODOLOGY: Fifty girls from five urban Midwest high schools participated in the study (mean age 16.1 years, mean body mass index 33.6). The girls participated in clinical research interviews, which were audiotaped, transcribed, and coded. RESULTS: All but two of the participants described stigmatizing experiences, the most frequently reported of which were direct and intentional, such as name calling and teasing. Hurtful comments and behaviors by family members and peers which appeared to be less intentional were also described by study participants. Responses to these experiences varied both within and across interviews and included ignoring or attempting to ignore hurtful experiences, feeling hurt, and getting mad. CONCLUSIONS: The results stress the importance of discussing issues of stigmatization and responses to these hurtful experiences with overweight youth within clinical and educational settings. Furthermore, family members, teachers, and nonoverweight peers need to increase their awareness of the impact of their remarks on and behavior toward overweight youth within a society that values thinness.

Adolescent↗

PubMed1978

Religious stigmatization: an historical and psychophysiological enquiry.

The historical accounts of religious stigmatization occurring during the past 750 years have been surveyed, with more detailed attention being given to late nineteenth- and twentieth-century medical investigations of some well-known cases. A case showing some features of religious stigmatization is described. The possible relationship of the phenomena of religious stigmatization to disease and psychophysiological processes in the subject is examined.

Adolescent↗

PubMed1998

Stigmatization of obesity in medieval times: Asia and Europe.

OBJECTIVE: To describe the stigmatization of obesity in medieval times in Asia and in Europe. DESIGN: Literature review. RESULTS: Obesity was stigmatized in medieval Japan in part, at least, because it was viewed as the karmic consequence of a moral failing in a Buddhist context. The stigma in Europe was based on the Christian deadly sin of gluttony. CONCLUSION: Stigmatization of obesity is not new. It was foreshadowed centuries ago by attitudes deriving from then extant theories of the origins of obesity.

Asia↗

PubMed2002

Experiences of stigmatization play a role in mediating the impact of disease severity on quality of life in psoriasis patients.

BACKGROUND: Psoriasis may have a severe impact on patients' quality of life (QOL) in several ways, an impact mediated by the mental or physical difficulties they have to deal with during the course of the disease and the various treatment regimens. In addition, psoriatic patients often suffer from experiences of stigmatization (EOS) related to the disease. OBJECTIVES: This study was designed to test the hypotheses that psoriasis patients report higher levels of stigmatization than a comparison group, and that their EOS play a role in mediating the impact of the severity of psoriasis on their QOL. METHODS: One hundred patients with psoriasis (study group) and 100 patients with mixed skin problems (comparison group) were matched according to age, sex and education. All subjects answered questionnaires on EOS and QOL. A dermatologist diagnosed the diseases and measured severity scores. The Psoriasis Area and Severity Index score was used for psoriasis and a linear severity score for the comparison patients. The mediating effect of EOS was analysed using structural equation modelling (SEM). SEM is a multivariate statistical method used to examine the consistency of a theory relating one group of variables (termed a 'latent construct') to another: in the present study, the relationship between EOS and QOL. RESULTS: Psoriatic patients were found to report significantly higher levels of EOS related to the disease, compared with the comparison group. No significant differences were found regarding QOL or severity of disease. Clinical severity of psoriasis was found to correlate negatively with QOL in psoriasis patients. EOS were found to have a complete mediating effect for the severity of disease on the QOL in patients with psoriasis. This result was not found among the comparison group patients. CONCLUSIONS: The results of this study indicate that psoriasis patients experience higher levels of stigmatization than do other dermatological patients, and that these EOS mediate the association between disease severity and patients' reported low levels of QOL. Treatment of psoriatic patients should consider these results and should include tools for psychosocial intervention.

Adult↗

PubMed2005

Significance of the stigmatization experience of psoriasis patients: a 1-year follow-up of the illness and its psychosocial consequences in men and women.

Feelings of stigmatization are an important somatopsychic consequence of psoriasis, affecting the quality of life. It is thus relevant to supplement reliable statements about the detailed changes of stigmatization experience and psoriasis over time. In this study we compared the Psoriasis Area and Severity Index (PASI), the 'self-administered PASI' (SPASI) and the 'Questionnaire on Experience with Skin Complaints' of 166 psoriasis patients (64 women, 102 men) in a 1-year follow-up to assess the relation between these factors over time. The results suggest a more pronounced feeling of discrimination in women with no significant somatic differences between gender at the first measurement. In a prospective evaluation we found a clear proportion of 'discordant' courses of these parameters, mainly in women, indicating a contradictory relation of somatic improvement or deterioration vs subjective experience with skin complaints. All in all, these results show a moderate but significant relevance of skin state for feeling of stigmatization over time only in men, thus suggesting a considerable influence of other psychic variables, probably coping skills, especially in women.

Adaptation, Psychological↗

PubMed1996

Stigmatization, discrimination and fear of AIDS in Greece: implications for health policy.

A prospective health-education research project about AIDS knowledge and attitudes towards AIDS was conducted in Athens and nine adjacent municipalities in west Attica, Greece. Socioeconomic and demographic data, AIDS knowledge, and attitudinal information were collected from 1552 respondents and analysed treating the attitudes of stigmatization, discrimination and fear towards AIDS as the dependent variable. Statistically significant correlations were found between each of the three attitudinal variables and the independent ones; specifically, age, place of residence, marital status and level of AIDS knowledge. Our working hypothesis--that the higher the level of AIDS knowledge, the lower the level of discrimination and stigmatization--was supported by our data. The relationship between AIDS knowledge and fear was less clear. Fear probably inhibits a rational approach to screening for HIV, and more empirical research is needed about fear and its interaction with stigmatizing and discriminatory attitudes and behaviours. Such research should be aimed at identifying population groups 'at risk' of expressing high levels of negative social attitudes about AIDS so that educational programmes can be appropriately designed.

Acquired Immunodeficiency Syndrome↗

PubMed2001

Stigmatized drug use, sexual partner concurrency, and other sex risk network and behavior characteristics of 18- to 24-year-old youth in a high-risk neighborhood.

BACKGROUND: Sex risks and drug use are related. This relation in youth is described. GOAL: To determine how stigmatized drug use is related to sexual risk behaviors and network characteristics among youth. STUDY DESIGN: In-person interviews were conducted with both a probability household sample (n = 363) and a targeted, street-recruited sample of cocaine, heroin, crack, or injected drug users (n - 165) comprising 18- to 24-year-olds in an inner city neighborhood. Drug use in the preceding 12 months was scaled hierarchically, lowest to highest social stigma, as none, marijuana, noninjected cocaine, noninjected heroin, crack, and injected drugs. RESULTS: Users of the more stigmatized drugs had more sex partners. They were more likely to report a history of concurrent sex partners, sex with someone who also had engaged in sex with a network member, commercial sex work, and unprotected sex. Findings showed crack use and drug injection to be associated more strongly with increased sex risk among women than among men. CONCLUSIONS: Young users of the more stigmatized drugs are at much greater network and behavior risk for sexually transmitted diseases. Drug use prevention, harm reduction interventions, or both may lower this risk.

Adolescent↗

PubMed2005

Stigmatized targets and evaluation: prejudice as a determinant of attribute scrutiny and polarization.

The authors provide evidence for a new mechanism for the more polarized evaluations of stigmatized than nonstigmatized target individuals that often follow positive versus negative target descriptions. The current research suggests that polarization can occur because low-prejudiced perceivers think more about information describing stigmatized than nonstigmatized targets (i.e., have polarized thoughts). Mediational path analyses revealed that polarized thoughts fully accounted for the impact of prejudice on evaluative polarization. These findings are most consistent with the watchdog hypothesis that people scrutinize information describing stigmatized targets in order to guard against possibly unfair reactions by themselves or others.

Analysis of Variance↗

PubMed2006

Stigmatization, physical illness and mental health in primary ciliary dyskinesia.

Primary ciliary dyskinesia (PCD) causes chronic cough, sinusitis and bronchiectasis, and half of patients also show situs inversus. The genetic basis and visible and concealed chronic symptoms provide potential for stigmatization. We describe a structural equation model linking a questionnaire measure of stigmatization to sex, age, personality (Big Five), symptoms (St George's Respiratory Questionnaire), health status (SF-36) and stress (GHQ-12). Stigma did not relate to physical symptoms or health, or to situs, but correlated with mental health and the social impact of symptoms. Neuroticism, extroversion, openness to experience, age, age at diagnosis and being female indirectly affected stigmatization via mental health.

Adult↗

PubMed2004

An exploratory study of the health problems, stigmatization, life satisfaction, and literacy skills of urban, street-level sex workers.

An exploratory study of 26 female urban, street-level sex workers was conducted to gather information about their health problems, feelings of stigmatizations, satisfaction with life, and literacy skills. Each woman completed the health questionnaire, Stigmatization Scale, Satisfaction with Life Scale, and the Rapid Estimate of Adult Literacy in Medicine. Twenty-one women had acute or chronic health problems; only eleven sought health care. Literacy scores revealed 7th to 8th grade reading levels. Feelings of stigmatization varied from low to high and all the women were found to be dissatisfied with their lives. Further research needs to address how these factors affect their use of health care and outreach services.

Educational Status↗

PubMed2002

Optical design of a stigmatic extreme-ultraviolet spectroscopic system for emission and absorption studies of laser-produced plasmas.

The design of a stigmatic spectroscopic system for diagnostics of laser-produced plasmas in the 2.5-40-nm region is presented. The system consists of a grazing-incidence toroidal mirror that focuses the radiation emitted by a laser-produced plasma onto the entrance slit of a spectrograph. The latter has a grazing-incidence spherical variable-line-spaced grating with flat-field properties coupled to a spherical focusing mirror that compensates for the astigmatism. The mirror is crossed with respect to the grating; i.e., it is mounted with its tangential plane coincident with the equatorial plane of the grating. The spectrum is acquired by an extreme-UV- (EUV-) enhanced CCD detector with high quantum efficiency. This stigmatic design also has spectral and spatial resolution capability for extended sources: The spectral resolution is also preserved for off-plane points, whereas the spatial resolution decreases for points far from the optical axis. The expected performance is presented and compared with that of a stigmatic design with a plane variable-line-spaced grating illuminated in converging light.

Journal Article↗

PubMed2002

Application of social identity theory in group therapy with stigmatized adults.

Social identity theory was applied in group therapy for adults with mild mental retardation. Social identity theory suggests that social group membership, also called collective identity, has an impact on self-esteem. Individuals will try to maintain self-esteem by viewing their social groups positively. This may not be possible for individuals who are members of a stigmatized group. However, it may be possible to enhance self-esteem by broadening one's awareness of collective identity. Furthermore, being able to positively view other individuals who are co-members of one's own stigmatized group can also have positive consequences for self-esteem. A clinical vignette demonstrates this process in group therapy. Results are discussed as being applicable to members of various stigmatized groups.

Adult↗

PubMed1981

Drinking status and stigmatization.

Research focused on the stigmatizing effects of alcohol-related labels has typically focused on social rejection (usually using a social distance scale). In the present study, affective reactions (or attitudes) were obtained with regard to four labels: alcoholic, problem drinker, recovered alcoholic, and social drinker. These attitudes were compared across four groups: an urban sample, a rural sample, a sample of graduate social work students, and a sample of alcoholics from a detoxification center. The results indicated that labeling persons as alcoholics or problem drinkers may lead to stigmatization, with the extent of stigmatization a function of the type of social group to which the respondents belonged. In addition, the destigmatization potential of certain labels that are used by self-help groups appeared to be questionable. The results are discussed in terms of their implications for treatment, particularly with respect to the similarities and differences between the alcoholic and the student-practitioner samples.

Adult↗

PubMed1990

Stigmatization: experiences of persons with acquired immune deficiency syndrome.

The purpose of this study was to understand the meaning that being stigmatized has for persons with Acquired Immune Deficiency Syndrome (AIDS). The research question for this investigation was, What is the perception of stigmatization as experienced by persons with AIDS? Phenomenology provided both the theoretical framework and the method for this study. The sample consisted of 10 homosexual men contacted through a New Orleans hospice, home health nurses, the investigator's own personal contacts, and referrals from men who were in the project. Participants were asked open-ended questions pertaining to changes in their relationships with others since diagnosis, changes in self-esteem, and examples of prejudice and discrimination. Interviews were audiotaped, transcribed verbatim, and analyzed using a qualitative approach. The phenomenon of stigmatization emerged as experiences of rejection and protection in social interactions.

Acquired Immunodeficiency Syndrome↗

PubMed2004

[Use of cluster analysis for the study of self-stigmatization phenomenon].

Cluster analysis was used in the study of self-stigmatization phenomenon measured with the original self-stigmatization questionnaire in 81 patients with schizophrenia, affective and neurotic disorders. The answers presented by digital codes were analyzed statistically. Six factors of self-stigmatization were as follows: "a victim of stigma", "deidentification from the healthy", "predisposition to identification with mentally ill", "avoidance of mentally ill", "excuse by mental illness" and "generalization of stigma".

Adult↗

PubMed1998

The dark side of nursing: impact of stigmatizing responses on patients.

The current emphasis in nursing is on caring, what it involves and why it is the profession's responsibility. This article focuses on the opposite behaviors--the "dark side of nursing" (Jameton, 1992). By developing a fuller understanding of nurse behaviors labeled the "dark side of nursing," the profession can better comprehend what caring involves and develop innovative ways to reduce dark-side behaviors. Although marginalizing, labeling and stereotyping, and stigmatizing are related, the focus will be on stigmatizing responses to patients. A number of investigators document nurse stereotyping of suicidal patients, persons with AIDS, racial/ethnic groups, and sex offenders and the impact on patients. Social psychological theories on stereotyping and deviant behavior provide some explanation for the nurse's behavior. The organizational perspective, however, has not been employed to enhance our understanding of nor to eliminate this phenomenon. Combining an organizational perspective with the social psychological theory of negative stereotyping (stigmatizing) and philosophical theory involving ethics provides a more comprehensive theory for understanding the "dark side of nursing" and designing interventions to reduce the occurrence of this damaging behavior.

Acquired Immunodeficiency Syndrome↗