The Measure of Disease-Related Stigma: Construction, validation, and application across three disease contexts.

Abstract

Patients with chronic illness are often stigmatized, which can lead to distress and poorer health. To address these problems, researchers must be able to effectively measure disease stigma. In line with Weiner's attribution theory (Weiner, 1985), we developed the Measure of Disease-Related Stigma (MDRS) to assess the cognitive, emotional, and behavioral components of enacted disease stigma. In each of 3 studies, participants read about a hypothetical patient who developed a condition through controllable, uncontrollable, or unknown means. In Study 1, participants rated a hypothetical HIV patient using a pool of 81 items that we wrote or adapted from past studies. This pool was reduced to a 28-item scale following psychometric analyses. The MDRS subscales that assess the cognitive and emotional components were reliable in 2 other disease contexts-lung cancer (Study 2) and anorexia nervosa (Study 3). Using this scale, participants reported greater stigma of a patient described as having control over disease onset. In addition, in all studies, the theorized mediation model of cognitive attribution predicting behavioral intentions through emotions was significant, supporting the construct validity of the scale. The MDRS is a reliable measure that improves the measurement of disease stigma.

Lay people's psychological reactions and helping intention after friends’ cancer disclosure: An exploratory analysis using vignettes

“…This may reflect that the ways of thinking of membership of relation, namely in‐group versus out‐group members in Japan. Many questionnaires relating social stigma developed by western countries included items of practical support such as doing laundry, feeding and changing bedding (Stump, LaPergola, Cross, & Else‐Quest, ). The present study may suggest that not providing these supports with friends with cancer does not mean the avoidance of the friend or create social distance, which was reported by previous studies among patients with cancer (Breuer et al, ; Dakof & Taylor, ; Weiner et al, ).…”

Born that way or became that way: Stigma toward congenital versus acquired disability

“…Controllability attributions about stigmatized identities elicit specific attitude components (i.e., cognitions, emotions, behaviors; Weiner, 1993). When people believe a condition is controllable, they are consequently more likely to believe the person is to blame, which elicits a variety of stigmatizing responses, including feelings of anger and less sympathy toward the person, leading them to distance themselves from the person and be unlikely to help them (Juvonen, 1991, 1992; Stump, LaPergola, Cross, & Else-Quest, 2016; Weiner et al, 1988).…”

“…Consequently, further reducing essentialist thinking about this group (making them seem more similar to the self) should highlight that the disability could happen to anyone, increasing disability acquisition threat. It is these conditions that heighten a need to blame someone for their condition (as if it were controllable), and blaming someone for their disability should increase stigma (Juvonen, 1991, 1992; Stump et al, 2016; Weiner et al, 1988). In contrast, essentializing those with acquired disability (which makes them seem essentially different from those without disability), should reduce blame (i.e., people will be less concerned about acquiring a disability when it seems so far removed from the self).…”

“…2 We operationalize stigma by first focusing on social distance (Studies 1 and 2), as has been done in the disability hierarchy and attribution literatures (Grue et al, 2015; Olkin & Howson, 1994; Richardson et al, 1961; Shears & Jensema, 1969; Thomas, 2000; Tringo, 1970; Westbrook et al, 1993). Subsequently, in Study 3, we examine stigmatizing cognitions (i.e., blame), emotions (i.e., anger, pity), and behaviors (i.e., social distance, help), as has been done in the disability attribution research (Juvonen, 1991, 1992; Stump et al, 2016; Weiner et al, 1988).…”

Arab-Israeli Mothers’ Attribution, Affective, and Behavioral Responses Toward Their Child With a Learning Disability: Examining an Attribution Model of Reactions to Stigma

“…Furthermore, the lion’s share of these studies used a two-dimensional approach to measure causal attributions. In most cases, these studies compared participants who were assigned vignettes that depict a person who had control over the onset of the stigma (e.g., contracting HIV through unprotected sex) with participants who were asked to refer to vignettes which outlined individuals who had no control over the onset of the stigma (e.g., contracting HIV through a blood transfusion) (see, for example, studies by Corrigan et al, 2003; Stump et al, 2016; Weiner et al, 1988).…”