Perceptions of difference and disdain on the self-stigma of mental illness

Abstract

Background People with mental illness are viewed as different and disdained by the general population leading to public stigma. When public stigma becomes internalized, it results in self-stigma. Content-less measures of stigma have shown to benefit studying public stigma, but research on self-stigma is limited. Aims This study sought to validate the use of content-less measures (Difference and Disdain) to assess self-stigma of mental illness. Methods Participants with lived experience (N = 291) completed a survey including measures of Difference and Disdain for self-stigma and outcomes assessing depression, self-esteem, recovery and the “Why Try” effect. Factor structure of Difference and Disdain across stages of self-stigma and their effects on harmful outcomes were analyzed. Results Factor structure was not supported. Reliability analysis suggested a two-stage conceptualization of self-stigma for Difference and Disdain characterized by early (i.e. aware, agree) and late stages (i.e. apply, harm). Disdain was found to independently contribute to significant harmful outcomes, especially in the late stages. Conclusions Disdain seems to be the driver of the egregious effects of self-stigma for people with mental illness. Anti-stigma efforts should focus on stereotypes of Disdain in the future.