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Overcoming stigmatization: social and personal implications of the human immunodeficiency virus diagnosis.

All diseases have attached metaphors. Social and personal reactions to people with human immunodeficiency virus are influenced by the metaphor, "fear of polluting people," and have in common with sexually transmitted diseases, the irrational fear of easy contagion. These issues negatively affect clients' response to their diagnosis and their treatment and care. Many clients have suffered as a result of receiving care from professionals who are condemning of the person with the disease. Others, though have found supportive care givers and have experienced positive reactions to the diagnosis through achieving emotional and spiritual development. The response of nursing to this stigmatized disease is explicated.

Acquired Immunodeficiency Syndrome↗

Adapting to the stigmatizing label of mental illness: foregone but not forgotten.

In a study ostensibly about memory ability, a condition was created experimentally in which half of the subjects believed that they were participating in the study with mental patients and half believed they were participating with physical injury patients. Behavioral measures of each subject were made as well as having the subjects give self-reports of their perceptions of the other people who were in the study. The results indicated that the label of mental illness was stigmatizing even in the absence of bizarre behaviors. Although subjects interacted with the mental patients normally when in the adaptively unimportant waiting room situation, the subjects scored higher on the adaptively significant memory test when participating in the study with "mental patients." The discussion included consideration for stigma theory, for social adaptation, and for community placement programs.

Adaptation, Psychological↗

Self-fulfilling effects of stigmatizing information on children's social interactions.

The stigmatizing effects of negative expectancies were examined in observations of interactions between children with and without a behavior problem. Ss were 68 pairs of unacquainted boys in Grades 3-6. In each dyad, a normal boy was either told that his partner had a behavior problem or given no expectancy; this expectancy manipulation was crossed with the partner's actual diagnostic status with respect to hyperactivity. The perceivers' expectancy that their partner had a behavior problem as well as the actual diagnostic status of the target adversely affected the boys' interactions. Behavioral data suggest how the expectancies were communicated to the target. The processes underlying interpersonal expectancy effects and the ways in which a childhood stigma can act as a self-fulfilling prophecy are discussed.

Attention Deficit Disorder with Hyperactivity↗

Evolutionary origins of stigmatization: the functions of social exclusion.

A reconceptualization of stigma is presented that changes the emphasis from the devaluation of an individual's identity to the process by which individuals who satisfy certain criteria come to be excluded from various kinds of social interactions. The authors propose that phenomena currently placed under the general rubric of stigma involve a set of distinct psychological systems designed by natural selection to solve specific problems associated with sociality. In particular, the authors suggest that human beings possess cognitive adaptations designed to cause them to avoid poor social exchange partners, join cooperative groups (for purposes of between-group competition and exploitation), and avoid contact with those who are differentially likely to carry communicable pathogens. The evolutionary view contributes to the current conceptualization of stigma by providing an account of the ultimate function of stigmatization and helping to explain its consensual nature.

Adaptation, Psychological↗

The reliability and validity of the Perceived Stigmatization Questionnaire (PSQ) and the Social Comfort Questionnaire (SCQ) among an adult burn survivor sample.

In this study, 361 adult burn survivors completed the Perceived Stigmatization Questionnaire (PSQ), the Social Comfort Questionnaire (SCQ), and other measures. Both the PSQ and SCQ had good internal consistency indices. Factor analysis of the PSQ yielded 3 factors (absence of friendly behavior, confused/staring behavior, and hostile behavior). The SCQ had 1 factor. Conjoint factor analysis with measures of related constructs (body esteem, body-esteem importance, depression, social support) suggested that PSQ and SCQ measure distinct constructs. Correlations with the related psychosocial constructs and burn characteristics suggested the PSQ and SCQ have good convergent and discriminant validity. Limitations of the study are discussed.

Adult↗

Getting worse: the stigmatization of obese children.

OBJECTIVE: The prevalence of childhood obesity more than doubled in the period from 1961 to 2001. We replicated a 1961 study of stigma in childhood obesity to see what effect this increased prevalence has had on this stigma. RESEARCH METHODS AND PROCEDURES: Participants included 458 5th- and 6th-grade children attending upper-middle and lower-middle income U.S. public schools. Children ranked six drawings of same-sex children with obesity, various disabilities, or no disability ("healthy"), in order of how well they liked each child. RESULTS: Children in both the present and the 1961 study liked the drawing of the obese child least. The obese child was liked significantly less in the present study than in 1961 [Kruskal-Wallis H(1) = 130.53, p < 0.001]. Girls liked the obese child less than boys did [H(1) = 5.23, p < 0.02]. Children ranked the healthy child highest and significantly higher than in 1961 [H(1) = 245.40, p < 0.001]. The difference in liking between the healthy and obese child was currently 40.8% greater than in 1961. DISCUSSION: Stigmatization of obesity by children appears to have increased over the last 40 years.

Child↗

Weight-based stigmatization in children.

OBJECTIVE: To examine sex differences in children's weight-based stigmatization. DESIGN: School-based sample of children evaluating qualities of children of varying weights. SUBJECTS: Thirty-four children (age, 7-9 y; body mass index (BMI) 12.1-31.2 kg/m2). MEASURES: Drawings of children that varied by sex (boy, girl) and weight (thin, average, chubby) were presented to children. Parents provided written consent and demographic data. RESULTS: Children evaluated drawings of thin children most favorably and drawings of chubby children least favorably. Thin girls were rated more favorably than average or chubby girls, for whom ratings did not differ significantly. Conversely, chubby boys were rated less favorably than average or thin boys for whom ratings did not differ significantly. CONCLUSION: These patterns may further explain gender differences in motivation to lose weight.

Child↗

[From the person to an isolated case: Frank Schmökel in the discourses of power and stigmatization].

OBJECTIVE: Representations of psychiatry in the media reflect the societal perception of psychiatries. These representations are influential in terms of society and health politics in that the societal perception of psychiatry is determined by the media, and the media convey what is thinkable and sayable. METHOD: A formal textual analysis, employing a discoursive analytical method (M. Foucault), will be carried out based on the concrete example of the daily coverage of the case of Frank Schmökel. RESULTS: It will be demonstrated that the means by which the media sketched an image of Frank Schmökel left little understanding for the person and his action. Schmökel was exposed to a sphere of control which arose from various competing discourses. The crystallization of the participating discourses (psychiatry, law, publicity) in power shows, in addition to repeated stigmatization and the generation of clichés, the isolation of the individual: the person Frank Schmökel is made into an isolated case. CONCLUSIONS: Images of this type are quickly generalized and lead to a public image of psychiatry (psychiatries) that distort reality. Such conveyance of opinion is amazingly influential in terms of societal politics and health politics, and has repercussions in law and politics.

Adult↗

The effect of temperature on pollen germination, pollen tube growth, and stigmatic receptivity in peach.

Temperature is a major climatic factor that limits geographical distribution of plant species, and the reproductive phase has proven to be one of the most temperature-vulnerable stages. Here, we have used peach to evaluate the effect of temperature on some processes of the progamic phase, from pollination to the arrival of pollen tubes in the ovary. Within the range of temperatures studied, 20 degrees C in the laboratory and, on average, 5.7 degrees C in the field, the results show an accelerating effect of increasing temperature on pollen germination and pollen tube growth kinetics, as well as an increase in the number of pollen tubes that reach the style base. For the last two parameters, although the range of temperature registered in the field was much lower, the results obtained in the laboratory paralleled those obtained in the field. Increasing temperatures drastically reduced stigmatic receptivity. Reduction was sequential, with stigmas first losing the capacity to sustain pollen tube penetration to the transmitting tissue, then their capacity to offer support for pollen germination and, finally, their capacity to support pollen grain adhesion. Within a species-specific range of temperature, this apparent opposite effect of temperature on the male and female side could provide plants with the plasticity to withstand changing environmental effects, ensuring a good level of fertilization.

Flowers↗

Stigmatization of the psychiatric patient: future perspectives for healthcare professionals.

This article offers some explanations for the mismanagement of the patient who has a psychiatric history but enters the healthcare system for treatment of a medical disorder, and it explores the perceptual differences among the various hospital personnel who interact with the psychiatric patient in the hospital. By examining relevant research on cognitive processes, the author discusses the impact that thought habits have on the formation of these perceptual differences. She concludes by offering a resolution to the problem of stigmatization.

Attitude of Health Personnel↗

Stigmatization of Hispanic children, pre-adolescents, and adolescents with mental illness: exploration using a national database.

This paper examines descriptive statistics for the primary payer, length of stay, and admission source of an acute care hospitalization of Hispanic children--pre-adolescents, and adolescents with a primary psychiatric Diagnostic Related Group (DRG)--and relates these variables to the concept of stigma. This paper was a secondary analysis that used data from the National Inpatient Sample database. Psychosis was the most frequent diagnosis of Hispanic youth who were hospitalized. More Hispanic pre-adolescents had a psychiatric DRG than any other ethnic group but fewer Hispanic adolescents were diagnosed with a psychiatric DRG than any other ethnic group. For Hispanic pre-adolescents and adolescents, the primary payer was Medicaid versus private insurance for White pre-adolescents and adolescents. The length of stay was approximately the same for all ethnic groups. The admission source differed for Hispanic pre-adolescents and adolescents with the majority of pre-adolescents being admitted routinely and the majority of Hispanic adolescents being admitted through emergency departments. Recommendations are made for future research, clinical practice, and public policy related to the stigmatization of Hispanic children and adolescents with mental illness.

Acute Disease↗

Acceptance and stigmatization of PLWA in Nigeria.

There is now an acknowledged burden of AIDS and the HIV in Nigeria. In treatment centres, AIDS-related disorders account for up to 40% of admissions, while many communities have recorded regular losses within the last five years. In December 1999, the federal government announced that 2.9 million people (or 5.4% of the Nigerian population) were already infected by HIV. An important aspect of HIV/AIDS programmes is the care of persons living with AIDS (PLWA), both in curative centres and in communities. Based on operations research of a STD/AIDS Management Project, this paper examines acceptance of PLWA in communities in Southern Benue State, an area of high prevalence. From interviews with PLWA, their family members and others in the communities, it was found that the level of stigmatization is high and acceptance of PLWA is low. These reactions stem mainly from the fear of contracting 'the disease that has no cure', believed to be transmittable through any form of physical contact. Based on beliefs, which are further reinforced by the local terms for AIDS, some suggested that PLWA be eliminated before they infect others. These findings suggest that the challenges of AIDS control programmes include coming to terms with the epidemic and fostering more acceptance for PLWA and, above all, changing the current perception of HIV/AIDS from a personal to public health problem. The challenges are daunting but urgent, particularly because Nigeria's HIV/AIDS epidemic is reaching an explosion phase and more care will be provided at home.

Acquired Immunodeficiency Syndrome↗

Portraying stigmatized conditions: disabling images in public health.

In promoting people's good health, health communication may help reduce the incidence of disabling injuries. Yet little is known about the broader question of how health communication efforts contribute to the production of stigma and the negative implications for effective and ethical health promotion. In the United States alone, as many as 49 million people have a physical or a cognitive disability. This article considers the paradox that health communication approaches to prevent injury--with the implicit message "Don't let this happen to you!"--may portray people with disabilities in a stigmatizing way. The psychosocial consequences of stigma heighten the stakes for people with disabilities who strive for fair treatment in employment, social interaction, and policy outcomes. In an era in which health communication is hailed as a remedy for an unprecedented array of health conditions, this article poses a starting point for critically examining how health communication may better prevent the many ailments of humankind.

Adult↗

A psychological model of social control and stigmatization: evolutionary background and practical implications.

The strengths and limitations of three main theoretical approaches to social control and stigmatization are discussed, originating from social psychology, sociology and anthropology, and evolutionary psychology, respectively. A theoretical model is proposed that integrates universal (evolutionary derived) psychological aspects of social control and the great variation that can be observed in responding to deviance within and between cultures and historical periods. Practical implications of the model are discussed.

Humans↗

The effects of stigmatizing discourse on the quality of on-line relationships.

Previous research has demonstrated that a societal stigma exists against individuals involved in on-line relationships. This study was designed to examine the impact that stigmatizing discourse from off-line family and friends has on the overall quality of such relationships. Participants in this study consisted of 159 on-line relationship partners who completed a web-based survey. The survey asked participants to recall messages that they had received about their online relationship from their off-line family and friends, and to fill out a questionnaire addressing their level of stigma consciousness and their perceptions of the quality of their on-line relationship. Trained coders then rated the messages from family and friends for levels of disapproval, severity, and explicitness. Results demonstrated that more severe, disapproving, and explicit messages from off-line family and friends correlated with higher levels of stigma consciousness on the part of the on-line relationship participant. Additionally, relationship participants who experienced more stigma consciousness were less satisfied with the overall quality of their on-line relationships. The theoretical and methodological implications of these results for on-line relationship are discussed.

Adolescent↗

Awareness, acceptance, and action: an emerging framework for understanding AIDS stigmatizing attitudes among community leaders in Barbados.

AIDS stigma must be acknowledged and reduced to advance HIV prevention and HIV/AIDS care in a variety of settings worldwide, including in the West Indies where national epidemics are thought to be growing rapidly. Regarded by international health organizations as a formidable barrier to service delivery and receipt, AIDS stigma refers to prejudice and discrimination directed toward people living with HIV/AIDS (PLHA), persons perceived as being at risk for HIV infection, and the informal and formal service providers who care for PLHA. However, there is little evidence of successful antistigma interventions in the literature. Furthermore, beyond studies of willingness in various professions to serve clients or patients with HIV/AIDS, the stigmatizing attitudes and behaviors of service delivery personnel, paraprofessionals and volunteers have been inadequately studied. This paper uses data obtained during an AIDS awareness workshop with sports coaches in Barbados to illustrate principles of an antistigma intervention framework being developed for social service and health personnel. The Awareness/Acceptance/Action Model (AAAM) draws on principles of mindfulness, rooted in ancient Asian traditions, and recently adapted to a range of physical and mental health interventions in Western contexts. Mindfulness techniques encourage awareness of one's current state and environment, acceptance of the implications of one's attitudes and behaviors, and the development of intentional responses rather than habitually patterned reactions. In this initial effort, community leaders were guided through a series of self-reflective exercises focusing AAAM principles on their tendencies toward AIDS stigma, and exploring more compassionate and functional alternatives.

Acquired Immunodeficiency Syndrome↗

The pollination of Trimenia moorei (Trimeniaceae): floral volatiles, insect/wind pollen vectors and stigmatic self-incompatibility in a basal angiosperm.

Trimenia moorei (Oliv.) Philipson is an andromonoecious liane with >0.40 of the total flower buds maturing as bisexual flowers. Male and bisexual flowers are strongly scented with pollen, anther sacs and receptacle scars testing positively for volatile emissions. Scent analyses detect over 20 components. The major fatty acid derivative is 8-heptadecene, and 2-phenylethanol dominates the benzenoids. While hover-flies in the genera Melangyna and Triglyphus contact the stigma with their probosces, the stigma secretes no free-flowing, edible fluids. Copious pollen is the only edible reward consumed by hover-flies (Syprhidae), sawflies (Pergidae) and bees in the families Apidae, Colletidae and Halictidae. All these insects carried pollen of T. moorei on their heads, legs and thoraces and female bees in the genera Apis, Exoneura, Leioproctus and Lasioglossum stored pollen on their hind legs. Pollen traps also indicate that pollen is shed directly into the air, permitting wind pollination. When bisexual flower buds are bagged (isolated from insect foragers) on the liane then subjected to a series of hand-pollination experiments after perianth segments open, the structural analyses of pollen-carpel interactions indicate that T. moorei has a trichome-rich dry-type stigma with an early-acting self-incompatibility (SI) system. Bicellular pollen grains deposited on stigmas belonging to the same plant germinate but fail to penetrate intercellular spaces, while grains deposited following cross-pollination reach the ovule within 24 h. Fluorescence analyses of 76 carpels collected at random from unbagged (open-pollinated) flowers on five plants indicates that at least 64% of carpels are cross-pollinated in situ. Trimenia moorei is the first species within the ANITA group, and second within reilictual-basal angiosperm lineages, to exhibit stigmatic SI in combination with dry-type stigma and bicellular pollen, a condition once considered to be atypical for angiosperms as a whole but now known to be present in numerous taxa.

Animals↗

Body size stigmatization in preschool children: the role of control attributions.

OBJECTIVE: The current study assessed preschool-age children's control attributions for weight and the relationship of these attributions to attitudes and behavioral intentions toward children of different body sizes. METHODS: Forty-two children (mean age = 5.2 years) were interviewed about the adjectives they attributed to figures of different sizes, their preference for size in playmates, and their beliefs about children's ability to control their own weight. RESULTS: Adjective ratings for obese figures were the most negative, with no differences found for thin and average figures; the heaviest figure was also chosen less often than other figures to be a playmate. Internal attributions of control for weight were related to less positive adjective ratings for the heavier figure but not to children's friendship selections. CONCLUSION: Results suggest that the relationship between body size stigmatization and control attributions are consistent with attribution theory for young children. Practical implications of these results and possible interventions are discussed.

Affect↗