Stigma
social rejection resulting from negatively perceived characteristics
4 qualities of stigma
- Individual differences are recognized
- These differences are perceived by society as negative
- The stigmatized group is seen as the outgroup
- The end result is loss of opportunity, power or status
Stereotype (cognitive)
overgeneralization about a person based on group membership.
Prejudice (affective)
agreement with the stereotype and negative emotions toward a person.
Discrimination (behavioral)
unfair acts toward groups or group members.
Public stigma
what society beliefs about people with mental illness.
Self-stigma
when public stigma becomes internalized (which might lead to low self-esteem, depression, or lack of motivation).
Structural stigma
when stigmatizing beliefs and attitudes lead to unfair social institutions and policies for the stigmatized
group.
Stigma of mental illness
Incompetence, dangerousness and responsibility are among the most commonly endorsed stereotypes applied to people with mental illness.
Stigma of borderline PD
Mood instability –> annoying
extreme sensitivity to abandonment –> undeserving
impulsivity –> frequent contact with law enforcement
self-multmilating behaviours –> frustrated police
difficulty controlling anger –> intentionally troublesome
Stigma of Obsessive-compulsive PD
Perfectionism, over-emphasis on order, interpersonal control –> attitudes more favourable, well-understood by general public
Stigma of narcissistic PD
lack of empathy –> fragile
exhibit a high need for admiration –> lacking self-esteem
over-developed sense of self-importance –> problematic social relationships
–> potential advantage in business context
Structural stigma consequences
• Can impact availability of services, quality of services, insurance coverage, and research on PDs.
• Stigma influences diagnosis and assessment, specifically for BPD.
• People with BPD are frequently misdiagnosed and may receive inappropriate treatments such as overuse of medications rather
than psychotherapy.
Anti-stigma interventions for PDs
- education
- involving members of the stigmatised group in personal contact with others
! anti-stigma interventions on neurobiological differences aren’t specifically effective in reducing stigma.
Associative stigma
a form of social disapproval because of its direct connection with a stigmatized individual.
- In children and adolescents bidirectional: parents are directly blamed for the mental disturbance of their children, and the children can be seen as part of a mentally disturbed family
subgroups vulnerable to higher stigma
young women, those dependent on others for self-worth validation, those with
previous experiences with social devaluation, and those with limited sources of identification
–> Adolescents with fragile identities and self-esteem might be especially prone to feeling stigmatized by other
Study by Catthoor - adolescent with psychiatric stigma
- Treatment-seeking individuals with severe mental health problems experience a higher burden of stigma.
- Treatment-seeking adolescents with PDs experience more stigma than treatment-seeking adolescents with other severe
and treatment refractory psychiatric Axis I disorder. - BPD is the strongest predictor of experiences of stigma, when controlled for other types of personality pathology.
- More severely personality disordered adolescents – as measured by the number of PD traits – tend to experience the
highest level of stigma.
stigma of PD treatment
- “Better not to make a diagnosis of PD in young people, because it’s a severe diagnosis and treatment is difficult so better not make
this diagnosis too early.” - “treatment of PD is very difficult or not possible”.
- Self-mutilation is thought to be a cry for attention and help instead of a symptom of a severe diagnosis.
BPD stress
Basic level of stress of people with BPD is much higher and stress increases more
with events: crosses threshold more easily (not able to think clearly anymore,
loses control over emotions –> self-mutilation, panic attacks, drinking).
