Stigmatization and dehumanization perceptions towards psychiatric patients among nurses: A path-analysis approach

Fontesse, Sullivan; Rimez, Ximena; Maurage, Pierre

doi:10.1016/j.apnu.2020.12.005

Cited by 28 publications

(35 citation statements)

References 57 publications

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“…There is a large body of research that suggests that dehumanisation of out-groups is prevalent across cultures, population characteristics, social identities and medical diagnoses (Kteily and Bruneau, 2017), but our work is one of the few that has examined this in relation to PWUD and more specifically heroin use. Our findings extend previous research that has consistently found that diverse groups, including the general public and law enforcement, health and social care professionals, stigmatise PWUD (Lloyd, 2013) or blatantly dehumanise them (Harris and Fiske, 2006; Boysen et al , 2020; Fontesse et al , 2021). As we found differences in dehumanisation scores towards heroin and cannabis users compared to reference groups, our study confirms previous research, including survey and qualitative research, that suggests stigmatising attitudes are drug dependent and are not simply a function of the use of controlled substances (e.g.…”

Section: Discussionsupporting

confidence: 88%

“…Rai et al , 2017), these types of process may also be relevant to health, criminal justice and social care policy decisions. Subtle dehumanisation of people with mental health problems, for example, predicts increased public social distancing and perceptions of dangerousness (Martinez et al , 2011; Martinez, 2014; Krzyzanowski et al , 2017); blatant dehumanisation of people with obesity predicts public support for discriminatory policies (Kersbergen and Robinson, 2019); whilst dehumanisation of people with alcohol use disorders by healthcare workers has been associated with negative outcomes, such as reduced value paid to patient consent and pain when making a medical decision related to their treatment (Fontesse et al , 2021). Policymakers may take advantage of public perceptions towards out-groups to justify difficult political choices, subsequently reinforcing and maintaining the social contexts that originally shaped those attitudes (Harris, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…Previous research has shown blatant and subtle dehumanisation towards a number of stigmatised groups, including people with severe alcohol use disorders (Fontesse et al , 2021), those with obesity (Kersbergen and Robinson, 2019), those who have experienced homelessness (Bruneau et al , 2018a, b), refugees (Bruneau et al , 2018b) and ethnic minority groups (Kteily and Bruneau, 2017). Blatant dehumanisation has been shown towards a range of people described as mentally ill, including those described as having “drug addiction” (Boysen et al , 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Blatant dehumanisation has been shown towards a range of people described as mentally ill, including those described as having “drug addiction” (Boysen et al , 2020). Whereas dehumanisation may be functional in some care-giving situations where high levels of emotional attachment to patients has been associated with staff burnout (Vaes and Muratore, 2013; Fontesse et al , 2021), in general, dehumanising attitudes are reflected in a higher desire for social distancing, perceptions of dangerousness, violence and victimisation and higher levels of support for discriminatory and aggressive policies targeting out-groups (Rudman and Mescher, 2012; Kteily et al , 2015; Kersbergen and Robinson, 2019; Parker et al , 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Whilst a large number of studies have examined the experiences and consequences of stigma in PWUD (for useful reviews see Lloyd, 2013; Lancaster et al , 2017), few have specifically examined dehumanisation. Of those, and as described above, Fontesse and colleagues examined internalised dehumanisation in people with alcohol use disorders (2020) or attitudes of healthcare professionals towards this group (Fontesse et al , 2021), whilst Harris and Fiske (2006, 2009) primarily examined neural responses to visual stimuli of dehumanised groups. Based upon infrahumanisation theory and previous work undertaken with other highly stigmatised populations, we hypothesised that there would be both greater blatant and subtle dehumanisation towards people who use heroin compared with other stigmatised groups (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Less than human: dehumanisation of people who use heroin

Sumnall

Atkinson

Gage

et al. 2021

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PurposeStigma reduction is an important public health challenge because of the large morbidity and mortality associated with some forms of substance use. Extreme stigma can lead to dehumanisation of target groups, who are ascribed with lesser humanity. The authors examined whether there was blatant and subtle dehumanisation of people who use heroin, and if these were associated with levels of support for non-discriminatory drug policy.Design/methodology/approachA cross-sectional online study using a UK convenience sample (n = 307 [75.2% female, mean age 28.6 ± 12.2 years]) was conducted. Participants completed assessments of blatant (Ascent of Humans [AoH] scale) and subtle (an emotion attribution task) dehumanisation and a bespoke measure assessing support for non-discriminatory drug policies. Other measures controlled for stigma towards people who use drugs (PWUD) and moral disgust.FindingsThere was greater blatant dehumanisation of people who used heroin compared to the general population and other potentially stigmatised reference groups, including people who use cannabis. The authors also found evidence of subtle dehumanisation, and people who used heroin were rated as being less likely to feel uniquely human emotions, less likely to feel positive emotions and more likely to feel negative emotions. Blatant dehumanisation was associated with significantly lower probability of support for non-discriminatory drug policy.Social implicationsDehumanisation may present significant challenges for stigma reduction initiatives and in fostering public support for drug policy and treatment. Denial of the humanity of this group could be used to justify discriminatory policies or relative deprioritisation of support services in funding decisions. Activities that seek to “rehumanise” PWUD, including social inclusion, and encouraging compassionate media representations that portray the lived experiences of substance use may be useful areas of future work.Originality/valueThis is the first study to investigate blatant and subtle dehumanisation of people who use heroin, and how this relates to public support for drug policy.

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