Stigma as a Barrier to Recovery: The Consequences of Stigma for the Self-Esteem of People With Mental Illnesses

Link, Bruce G.; Struening, Elmer L.; Neese-Todd, Sheree; Asmussen, Sara; Phelan, Jo C.

doi:10.1176/appi.ps.52.12.1621

Cited by 1,023 publications

(728 citation statements)

References 17 publications

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“…Consistent with a widely ranging literature (Link et al, 2001;Wright et al, 2000), results revealed that among our sample the experience of greater levels of stigma was generally related to poorer self-esteem. Examining individual components of self-esteem using stepwise multiple regression equations controlling for response style, results suggest that participants who accepted stereotyped beliefs tended to view themselves as less competent and tended to have less moral self-approval.…”

Section: Discussionsupporting

confidence: 91%

“…As a consequence, while identifying oneself as "a person with schizophrenia" may be linked to greater awareness of illness and possibly treatment adherence, it is also associated with threats to self-esteem, self efficacy and hope for the future (Link et al, 2001;Lysaker et al, in press;Lysaker et al, 2007a,b;Markowitz, 1998;Roe, 2003;Ritsher and Phelan, 2004;Wright et al, 2000;Watson et al, in press). In fact research has suggested that stigma may reduce self-esteem regardless of symptom level and cognitive function and lead to poorer outcome including depression, humiliation and shame (Birchwood et al, 2005;Landeen et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

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Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia

Lysaker

Tsai

Yanos

et al. 2008

Schizophrenia Research

120

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Research suggests global self-esteem among persons with schizophrenia may be negatively affected by stigma or stereotyped beliefs about persons with severe mental illness. Less clear however, is whether particular dimensions of self-esteem are linked to particular domains of stigma. To examine this we surveyed a range of self-esteem dimensions including lovability, personal power, competence and moral self-approval and four domains of stigma: Stereotype endorsement, Discrimination experience, Social withdrawal and Stigma rejection. Participants were 133 adults with diagnoses of schizophrenia or schizoaffective disorder. Stepwise multiple regressions controlling for a possible defensive response bias suggested that aspects of self-esteem related to lovability by others were more closely linked with lesser feelings of being alienated from others due to mental illness. Aspects of self-esteem related to the ability to manage one's own affairs were more closely associated with the rejection of stereotypes of mental illness. A sense of being able to influence others was linked to both the absence of discrimination experiences and the ability to ward off stigma. Implications for treatment are discussed.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia

Lysaker

Tsai

Yanos

et al. 2008

Schizophrenia Research

120

View full text Add to dashboard Cite

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“…Second, the results are also consistent with research showing that levels of stigma change in association with treatment (31). Finally, the relationship between PDD and depression had already been established (7), and the current measures’ correlations with depression were comparable with those of the PDD. In fact, despite the statelike nature of depression, all four stigma measures demonstrated a stable relationship with the PHQ-9.…”

Section: Discussionsupporting

confidence: 66%

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Interian¹,

Ang²,

Gara³

et al. 2010

Psychiatric Services

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Objectives Stigma associated with mental illness is an important yet understudied issue among Latinos. This study examined the psychometric properties of four stigma measures with a sample of Spanish-speaking Latino primary care patients. The study evaluated the scale for Perceived Discrimination Devaluation (PDD), Stigma Concerns About Mental Health Care (SCMHC), the Latino Scale for Antidepressant Stigma (LSAS), and the Social Distance (SD) scale. Methods Participants (N=200) were low-income Latinos who were screened for depression with the Patient Health Questionnaire (PHQ-2) and asked about their depression treatment history, and they completed the four stigma measures at two time points. The four stigma measures were examined for internal consistency, convergent validity, construct validity, and criterion-related validity. Results The factor-analytic results generally provided support for the construct validity of the measures. The four stigma measures also demonstrated internal consistency between two time points. Patients who reported greater social distance from individuals with depression were more likely to have been receiving treatment for emotional care in the past three months (OR=.70, p<.05). Also, Latinos who scored high on the SCMHC (OR=.64, p<.05) and LSAS (OR=.77, p<.05) were less likely to have been taking antidepressant medications. Conclusions The SCMHC, LSAS, and SD scales received support for their reliability and construct validity. Results also showed some support for their criterion-related validity. A more mixed picture emerged for the PDD. Stigma ratings were associated with depression treatment utilization. Stigma ratings changed over time and were associated with treatment experiences.

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“…One study of over 80,000 participants across 16 countries concluded that perceived stigma is frequently and strongly associated with mental disorders worldwide (Alonso et al, 2008). Whether accurately interpreted or not, perceived stigma has been associated with negative outcomes when held by people with the stigmatizing attribute, including lower self-esteem; adherence to treatment; social adjustment and quality of life; and higher work, role, and social limitations (Alonso et al, 2009;Link, Struening, Neese-Todd, Asmussen, & Phelan, 2001;Perlick et al, 2001;Pyne et al, 2004;Sirey et al, 2001).…”

mentioning

confidence: 99%

Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems

Hing

Nuske

Gainsbury

et al. 2015

International Gambling Studies

106

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Stigma as a Barrier to Recovery: The Consequences of Stigma for the Self-Esteem of People With Mental Illnesses

Abstract: The stigma associated with mental illness harms the self-esteem of many people who have serious mental illnesses. An important consequence of reducing stigma would be to improve the self-esteem of people who have mental illnesses.

Cited by 1,023 publications

References 17 publications

Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia

Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia

Stigma and Depression Treatment Utilization Among Latinos: Utility of Four Stigma Measures

Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems

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