Self-Perceived Stigmatization in Female Patients with Anorexia Nervosa - Results from an Explorative Retrospective Pilot Study of Adolescents

Abstract

Background: The stigma of mental illness has been identified as an important barrier to treatment and recovery. Previous research reported the stigmatization of individuals with eating disorders by both health professionals and the general public. The aim of this pilot study was to empirically assess the previous stigmatization and discrimination experiences of young female patients with anorexia nervosa (AN) using a retrospective explorative approach. Methods: An in-house questionnaire that was developed to survey experiences of stigmatization was mailed to 75 former adolescent patients with AN. The mean time of assessment after discharge was 5.6 ± 1.2 years. The patients were asked to respond anonymously. The response rate was approximately 48% (n = 36). Results: Feelings that society held negative stereotypes of individuals with AN, concrete experiences of stigmatization and discrimination, and rejection by peers were reported. A remarkable degree of self-stigmatization, as indexed by high rates of agreement to stigmatizing statements, was detected. Approximately one third of the participants reported delayed initiation of treatment due to fear of stigmatization and discrimination. Conclusion: Stigmatization plays a decisive role in young patients with AN and impacts their motivation to seek professional help and engage in treatment. Clinicians should be aware of the stigmatization related to eating disorders and its burden for affected patients.

The Effects of Stigma on Recovery Attitudes in People With Anorexia Nervosa in Intensive Treatment

“…In line with our finding, a previous study on families of people with AN similarly found that stigma towards families rather than stigma towards individuals with this illness was an important predictor of family functioning (Dimitropoulos et al, 2008). The finding 0.56* from our study is further supported by a study of adolescents with eating disorders who reported that they perceived their parents, especially their mothers, as being criticized for the development of their illness (Maier et al, 2014). Qualitative research also suggests that families of people with eating disorders believe that others hold them responsible for their child's illness (Hillege et al, 2006).…”

“…Negative stereotypes of people with AN are held by the general public, college age students, and service providers (Crisafulli et al, 2008;Geerling and Saunders, 2015;Iles et al, 2015;Puhl and Suh, 2015;Stewart et al, 2006Stewart et al, , 2008. In contrast to other mental illnesses, AN evokes significant envy and admiration of the person with AN for achieving weight loss and obtaining self-control over eating (Geerling and Saunders, 2015;Holliday et al, 2005;Katterman and Klump, 2010;Maier et al, 2014;Mond et al, 2006;Roehrig and McLean, 2010;Stewart et al, 2006;Zwickert and Rieger, 2013). Researchers have begun to shift their attention from examining stigma from the perspective of the general public to investigating the internalization of stigma in those experiencing and living with this mental illness (Griffiths et al, 2015a(Griffiths et al, , 2015b).…”

“…Self-stigma occurs when individuals internalize or assign negative stereotypes about those with a mental illness to themselves resulting in shame, a reduction in self-esteem, self-efficacy, and a diminishment in opportunities for recovery Link and Phelan, 2001). Several studies demonstrate that people with AN are acutely aware that the general public trivializes their struggles by not acknowledging that AN is indeed a serious mental illness (Easter, 2012;Maier et al, 2014). A recent qualitative study found that the trivialization of AN leads individuals to experience shame for pursuing intensive treatment for their illness (Dimitropoulos et al, 2016).…”

Perceived barriers and facilitators towards help‐seeking for eating disorders: A systematic review

“…A number of studies in the present review reported stigmatizing attitudes of families, friends and health professionals surrounding eating disorders, a phenomenon described by Griffiths, Christensen, Jorm, Evans, and Groves as perceived stigma. Similarly, previous research has shown that adult women with eating disorder symptoms believed that people with bulimia nervosa would be discriminated against and they might therefore not wish to disclose their problems .…”

Stigma and treatment of eating disorders in Ireland: healthcare professionals’ knowledge and attitudes

“…In addition, studies with patient groups indicate that individuals with EDs are acutely sensitive to disparaging attitudes, which can either be internalised or construed as a deterrent to service engagement (Easter, 2012;Maier et al 2014). Stigmatising attitudes held by healthcare providers may, therefore, impair the experience, extent and quality of the care available to young people with EDs.…”