Degree Of Stigma Research Articles

Effects of Stigmatized Identities on Interpersonal Influence and Social Distance

In order to reveal the processes through which status differentiation and stigmatization occur in daily interactions between migrant workers and out-groups, the present study investigated the effects a stigmatized status characteristic had on influence in the interaction and on the social rejection suffered during this process. This is a multiple site experimental study. Participants were 151 undergraduate students from freshman to senior level. The participants included seventy three male students and seventy eight female students in YanTai. In the experiment, the participants cooperated with a fictitious partner through a local area network to answer questions described as measuring "contrast sensitivity ability." On the task, participants had the opportunity to be influenced by the partners. Participants then chose partners for the next period task. In accordance with the different identities of the partners, the study has five conditions that differentiated the participants' partners(all partners were in fact fictitious). In the control condition, the partners are described as male college students just like the participants. In two conditions, the partners are high school students with either a low or high score on an initial contrast sensitivity task. In the remaining two conditions, the partners are migrant workers with either low or high initial test scores. In the study, influence and social distance were the indicators of social status and the degree of stigmatization respectively. Influence was measured as how often participants switched answers to correspond to answers provided by partners, and social distance was measured by whether participants selected the same or a new partner for the future session., The study expects to find out that education level and task ability are status markers that affect influence. It also predicts that migrant workers identity will act as a status marker and stigma, affecting both influence and social distance. The study also predicts that the influence effects of task ability can imply a strategy to decrease the legitimacy of the existing status order. The status measurement results turned out to be that, ① in cooperative tasks, participants in the migrant workers partner group were more inclined to underestimate the partners' performance and were less influenced by them than the participants in control group and low education partner group, ②the participants who found out that their partners were migrant workers and the partners' score were higher than them, referred to the partners' answers more frequently than those who were only informed of their partners' migrant worker identity. The stigma measurement results indicated that, ① participants in the migrant workers partner group obviously intended to keep longer social distance with the partners, than the participants in control group and low education partner group, ② emphasizing partners' significant skills in the task did not decrease the social distance that participants sought from migrant workers. The results indicate that "migrant worker" is a status characteristic and a stigmatized identity that indicates a person's inferior position in the social hierarchy. The low performance expectation and weak influence brought about by status characteristics can be counterpoise and changed by introducing new status characteristics of the partners. However, this method did not attenuate the social distance that accompanies stigma.

Public stigma against people with mental illness in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia.

BackgroundPublic understanding about mental illnesses and attitudes towards people with mental illness (PWMI) play a paramount role in the prevention and treatment of mental illness and the rehabilitation of PWMI. The aim of this study was to measure public stigma against PWMI and the factors associated with stigma in the Gilgel Gibe Field Research Center (GGFRC) in Southwest Ethiopia.MethodsThis community-based, cross-sectional study was conducted from June to August 2012 among 845 randomly selected respondents by using the Community Attitudes towards the Mentally Ill (CAMI) scale, an interviewer-administered questionnaire. Data was entered with EPI-DATA and then exported to STATA for analysis. Simple descriptive and linear regression analyses were performed to identify predictors of stigma against PWMI.ResultsOf the total of 845 respondents, 68.17% were from rural districts. The mean stigma score was 2.62 on a 5-point score. The majority of the respondents (75.27%) believed that mental illness can be cured. Stress, poverty, and rumination were the most often perceived causes of mental illness. Rural residents had significantly higher stigma scores (std. β = 0.61, P<0.001). A statistically significant inverse relationship was found between the level of education and degree of stigma (std. β = −0.14, P<0.01), while higher income was significantly associated with more stigma (std. β = 0.07, P<0.05). Respondents with higher scores for perceived supernatural causes (std. β = −0.09, P<0.01) and perceived psychosocial and biological causes (std. β = −0.14, P<0.001) had significantly lower stigma levels.ConclusionsThe study found a more undermining but less avoidant attitude towards PWMI. Rural residents showed higher levels of stigma. Stigma against PWMI was lower in people with an explanatory concept about the causes of mental illness and a higher level of education. Information, education, and communication about the causes, signs, and nature of mental illnesses would help to reduce stigma.

Familiarity with and Attitudes to Tourette's Syndrome in Healthcare Students: A Pilot Comparison with Epilepsy

Background and Objectives: Tourette�s Syndrome (TS) is a common developmental neuropsychiatric disorder; people with TS are vulnerable to stigmatization. Public attitudes to TS have seldom been studied. This study examines knowledge of and attitudes to TS and to epilepsy in healthcare students, in an attempt to explore and compare the stigma which might be attached to the two conditions. Methods: Questionnaire survey of healthcare students at one UK medical school. Results: 94 students responded. Though more students knew someone with epilepsy than someone with TS (57% vs 15%; p<0.0001), they were more likely to know a public figure with TS (37% vs 12%; p<0.0001). Among medical students, a higher proportion has seen someone showing evidence of TS (63%) than had seen anyone having a fit (43%; p<0.05). As many as 26% of medical students would object to having a son or daughter of theirs marry a person with TS and 19% of people would object to the marriage of one of their children to a person with epilepsy. Conclusions: The majority of healthcare students had some familiarity with and did not have negative attitudes towards people with TS. However there is still some degree of stigmatization towards both conditions. There remains scope for education in this area as well as for extending such survey research on TS to the general population. Study limitations include the small sample size, and the fact that healthcare students are unrepresentative of broader public opinion.

Stigma and hostility towards pregnant smokers: Does individuating information reduce the effect?

Australia is at the forefront of tobacco control, yet 17% of Australian women smoke during pregnancy. Negative attitudes to smoking are intensified when the smoker is pregnant, consistent with a discourse that encourages surveillance of pregnant women. Such overt anti-smoking attitudes create a context which may make it difficult for pregnant smokers to seek assistance to stop. However, there is little evidence on the extent to which pregnant smokers are stigmatised by community members. We used vignettes to examine the degree of smoking-related stigma expressed by 595 Australian university students who rated a woman, described as a mother who was smoking or not, and pregnant or not. Further, we examined whether provision of individuating information reduced the degree of stigma. Mothers described as smokers were rated more negatively than those not, particularly if they were pregnant: smokers were perceived as unhealthy, and also as bad mothers. Provision of individuating information slightly reduced these effects. These findings support the view that smokers – particularly if pregnant – are subject to negative moral judgement. Our findings contribute to the ethical debate about stigma-inducing tobacco control efforts, and suggest that anti-smoking campaigns that contextualise smoking in pregnancy might reduce stigma and assist cessation.

HIV- and AIDS-Related Stigma: Psychosocial Aspects in a Representative Spanish Sample

This study evaluates the prevalence of HIV stigma in Spain and analyzes some variables that may affect its existence. In 2008, we conducted a computer-assisted telephone survey of 1607 people, representative of the Spanish population. Two-wave random stratified sampling was performed, first selecting the home and then the person, depending on the rates of age and sex. About 50% of the population feels discomfort about potential contact with people with HIV and tries to avoid it and 20% advocate discriminatory policies involving physical or social segregation of people with HIV. The belief that HIV is easily transmitted through social contact (15%) and blaming people with HIV for their disease (19.3%) are associated with stigmatization. Degree of proximity to people with HIV, political ideology, educational level, and age are also associated with the degree of stigmatization. According to these results, we suggest that, in order to reduce stigma, we need to modify the erroneous beliefs about the transmission pathways, decrease attributions of blame to people with HIV, and increase contact with them. These interventions should particularly target older people, people with a low educational level, and people with a more conservative political ideology.

Gender Inequality and Gender Differences in Authoritarianism

Authoritarianism may be endorsed in part as a means of managing and buffering psychological threats (e.g., Duckitt & Fisher, 2003; Henry, 2011). Building on this research, the authors postulated that authoritarianism should be especially prevalent among women in societies with high levels of gender inequality because they especially face more psychological threats associated with stigma compared with men. After establishing that authoritarianism is, in part, a response to rejection, a psychological threat associated with stigma (Study 1), the authors used multilevel modeling to analyze data from 54 societies to find that women endorsed authoritarian values more than men, especially in individualistic societies with high levels of gender inequality (Study 2). Results show that the threats of stigma for women are not uniform across different cultures and that the degree of stigma is related to the degree of endorsement of psychologically protective attitudes such as authoritarianism.

‘Who will comfort me?’ Stigmatization of girls formerly associated with armed forces and groups in eastern Congo

This empirical article is based on a study of stigmatization of girls formerly associated with armed forces and groups (AFG) in the eastern Congo, and presents a detailed description of how these girls are perceived when returning home. The study reveals that the society views with suspicion those who are or have been part of an armed force or group. People believe that girls having been with an armed group will attract male soldiers to their villages, they are perceived as violent, thieves, promiscuous, and carriers of transmittable diseases, and they are thought to have a bad influence on the behaviour of their peers. These fears and prejudices are translated into stigmatizing behaviour such as name-calling, rejection, social exclusion, and discriminating treatment. Women are identified as those most actively involved in the stigmatization. The stigmatization the girls formerly associated with AFG experience hampers their reintegration process, and can be likened to a second traumatisation. In its discussion the article identifies some important factors impacting on the degree of stigmatization, and distinguishes between two categories: (1) pre-return factors; and (2) post-return factors that may reinforce or reduce the stigmatization. The evidence in this study supports the view that stigmatization is prevalent and poses a major challenge to the reintegration process of girls formerly associated with AFG. The article concludes that the more empowered and financially independent these girls become the less problems and stigmatization they will face

Epilepsy perception amongst education professionals

INTRODUCTION: Epilepsy is a prevalent neurological disorder that may cause school failure due to several factors such as seizure severity, lack of information about the condition and stigma. This study aimed to evaluate the degree of perceived stigma and knowledge towards epilepsy among education professionals, and additionally, provide them correct information about epilepsy to reduce stigma through a training course. METHODS: Social and demographic data, as well as the degree of stigma were obtained through the Stigma Scale of Epilepsy. To estimate the level of educational professionals' knowledge about epilepsy we used the Questionnaire about Epilepsy. Statistical analysis consisted of Pearson's or Spearman's correlation tests for numerical parametric or non-parametric variables were used to determine potential significant associations. A p &lt;0.05 was considered significant. RESULTS: Two hundred and twenty-five education professionals were interviewed in three different cities in Southern Brazil. Approximately 65% of subjects would attempt to open the mouth of a student during a seizure and the stigma measured by Stigma Scale of Epilepsy before the course was 45.4±16.61. CONCLUSION: The data indicate that education professionals have partial knowledge about epilepsy and a short duration course would be able to improve it and reduce its stigma in this population.

Articulating a rights-based approach to HIV treatment and prevention interventions.

Since the beginning of the epidemic, the protection of human rights has been an integral component in the response to Human Immunodeficiency Virus (HIV). The high degree of stigma and discrimination associated with acquired immune deficiency syndrome (AIDS) has made human rights protection not only a priority to ensure the rights of people living with and at-risk for HIV, but to address public health goals as well. Advances in understanding the impact of antiretroviral treatment on HIV prevention provide exciting opportunities and even a paradigm shift in terms of AIDS prevention. However, this potential cannot be reached unless the advancement of human rights is a primary component of treatment and prevention programme and policy development. The use of antiretroviral treatment as prevention reinforces the value of basic principles related to the dignity and agency of people living with HIV to participate in the design and implementation of programmes, to be informed and to make informed decisions about their health and lives, to be protected from harm, and to have opportunities to seek redress and accountability for abuses. The possibility of using HIV treatment as a prevention tool means that now, more than ever, legal reform and community empowerment and mobilisation are necessary to realize the rights and health of people affected by HIV.

The stigma of obesity in the general public and its implications for public health - a systematic review

BackgroundUp to this date, prevalence rates of obesity are still rising. Aside from co-morbid diseases, perceived discrimination and stigmatization leads to worsen outcomes in obese individuals. Higher stigmatizing attitudes towards obese individuals may also result in less support of preventive and interventive measures. In light of the immense burden of obesity on health care systems and also on the individuals' quality of life, accepted and subsidized preventive measures are needed. Policy support might be determined by views of the lay public on causes of obesity and resulting weight stigma. This study seeks to answer how representative samples of the lay public perceive people with obesity or overweight status (stigmatizing attitudes); what these samples attribute obesity to (causal attribution) and what types of interventions are supported by the lay public and which factors determine that support (prevention support).MethodsA systematic literature search was conducted. All studies of representative samples reporting results on (a) stigmatizing attitudes towards overweight and obese individuals, (b) causal beliefs and (c) prevention support were included.ResultsOnly 7 articles were found. One study reported prevalence rates of stigmatizing attitudes. About a quarter of the population in Germany displayed definite stigmatizing attitudes. Other studies reported causal attributions. While external influences on weight are considered as well, it seems that internal factors are rated to be of higher importance. Across the studies found, regulative prevention is supported by about half of the population, while childhood prevention has highest approval rates. Results on sociodemographic determinants differ substantially.ConclusionsFurther research on public attitudes toward and perception of overweight and obesity is urgently needed to depict the prevailing degree of stigmatization. Introducing a multidimensional concept of the etiology of obesity to the lay public might be a starting point in stigma reduction.

P02-165 - Impact of disease concepts on attitudes towards alcohol dependent patients

IntroductionStigmatizing attitudes regarding mentally ill people are common (Rusch et al., 2010). Study result suggest that the degree of stigmatization may depend on concepts of psychiatric diseases (Crisafulli et al., 2008).AimsWe aimed to investigate the impact of a sole neurobiological vs. a sole sociodynamic disease concept on the attitudes of students towards the alcohol dependent patients (Crisafulli et al., 2008).Methods200 students were randomly assigned to read information explaining alcohol dependence sole neurobiologically/sociodynamically. Subsequently, the students completed a series of questionnaires (adapted from Crisafulli et al. (2008)) regarding their attitudes towards the alcohol dependent patients. Attitudes were compared to attitudes of students not exposed to any disease concept.ResultsConsistent with former study results we found increased blaming and decreased willingness to finance therapy in those students exposed to the sociodynamic explanation. Attitudes regarding blaming and harmfulness of the alcohol dependent patients were increased in the neurobiological and sociodynamic group compared to the un-exposed control group.ConclusionsInformation regarding possible causalities regarding the development of alcohol dependence is associated with more negative attitudes towards alcohol dependent patients in the questioned students compared to unexposed controls. This may be reasoned by the recognition of alcohol dependence as a manifestation of mental illness and the subsequent inclusion of the alcohol dependent patients in the prejudices and acts of discrimination commonly leveled against the mentally ill. Therefore, multimodal interventions rather than medicinal information seem to be necessary in order to decrease stigmatization of the alcohol dependent patients.

Support Group Needs for People Living with HIV and AIDS (PLWHA) in Communities around Durban, South Africa

The study constructed a participant centred perspective of what members of a support group for people living with HIV and AIDS (PLWHA) desired from their group meetings. The study sample (n = 34) was from three support groups of PLWHA in a province of South Africa (males = 7, female = 27, mean age = 34.2 years, SD = 6.8 years). Participants completed a brief survey and participated in focus group discussion on views on the ideal support group, actual experience with the support group, and solutions for effective support groups. Findings suggest most members of the support group experienced a high degree of stigma at home and needed a so-called ‘safe space’ to escape to and discuss issues with people experiencing similar problems. Respondents wanted to acquire skills to allow them to help themselves and others in the community. They also desired HIV education so that they could properly understand the virus and help the community understand it to reduce stigma.

Professionals with Hearing Loss: Maintaining That Competitive Edge

The goals of this investigation were to gauge how hearing loss affects the self-perceived job performance and psycho-emotional status of professionals in the workforce and to develop a profile of their aural rehabilitation needs. Forty-eight participants who had at least a high school education and who hold salaried positions participated in one of seven focus groups. Participants first answered questions about a hypothetical executive who had hearing loss and considered how she might react to various communication issues. They then addressed questions about their own work-related predicaments. The sessions were audiovideo recorded and later transcribed for analysis. Unlike workers who have occupational hearing loss, the professionals in this investigation seem not to experience an inordinate degree of stigmatization in their workplaces, although most believe that hearing loss has negatively affected their job performance. Some of the participants believe that they have lost their "competitive edge," and some believe that they have been denied promotions because of hearing loss. However, most report that they have overcome their hearing-related difficulties by various means, and many have developed a determination and stamina to remain active in the workforce. The majority of the participants seemed to be unfamiliar with the Americans with Disability Act, Public Law 101-336. The overriding theme to emerge is that professionals desire to maintain their competency to perform their jobs and will do what they have to do to "get the job done." The situations of professionals who have hearing loss can be modeled, with a central theme of maintaining job competency or a competitive edge. It is hypothesized that five factors affect professionals' abilities to continue their optimal work performance in the face of hearing loss: (a) self-concept and sense of internal locus of control, (b) use of hearing assistive technology, (c) supervisor's and co-workers' perceptions and the provision of accommodations in the workplace, (d) use of effective coping strategies, and (e) communication difficulties and problem situations. The implications that the present findings hold for aural rehabilitation intervention plans are considered, and a problem-solving approach is reviewed.

Coping With HIV: Caribbean People in the United Kingdom

Although Caribbean people in the United Kingdom are increasingly being affected by HIV/AIDS, there has been no examination of how they are coping with the illness. We investigate the coping strategies of HIV-positive Caribbean people using in-depth interviews with a purposively selected group of 25 residents of South London. The main coping strategies were more cognitive than behavioral: restricted disclosure, submersion, faith, and positive reappraisal. These strategies were intertwined in complex ways, and most were rooted in contextual factors, particularly cultural ones. Themes of loss, silence, and reinvention suffused respondents' narratives. Interventions should consider the high degree of stigmatization of HIV/AIDS in the Caribbean community, reluctance to disclose, the likelihood of an initial severe reaction to diagnosis, and external stressors. HIV-positive Caribbean people who are coping well could serve as mentors and role models for poor copers and newly diagnosed patients; establishing Caribbean-specific support groups might also assist coping.

What young people know about epilepsy and how they are affected by recurrent seizures

This study's aim was to investigate what young people with epilepsy know about their disorder and how epilepsy and epilepsy treatment affects their lives. By means of a self-reporting questionnaire, information about their knowledge of epilepsy, clinical, demographic, and psychosocial data were collected. The subjects were recruited at a summer camp for young people with epilepsy in Norway. Forty-five people aged 14–30 years volunteered to participate. The majority of those questioned reported that epilepsy and its treatment had a negative impact on their daily lives and their social adjustment. Approximately 50% reported that suffering from epilepsy made them feel useless and more dependent on others; 39% felt they were a burden to their family and friends; and 40% experienced a moderate or high degree of stigmatization. However, none of those with a high level of epilepsy knowledge reported that they felt stigma. Findings from this study emphasize the need for continued education and support for young people with epilepsy. In order to prevent psychological and psychosocial problems it is important to include both medical and psychosocial sessions in educational programmes.

Stigmatization of obese children and adolescents, the importance of gender

To review the literature on stigmatization of overweight girls and boys, with a specific attention to gender differences, a search was performed in the medical as well as the psychological literature. The following databases, Medline, PsycINFO, EMBASE, Scopus, Web of Science and Cochrane as well as Google were used to retrieve information. Finally, chain references were sought. The search was concluded mid-2006. In total, 17 studies were identified. The results from the studies generally indicated that overweight girls seemed to experience a higher degree of stigmatization than overweight boys. The overweight girls were to a larger degree teased about their weight and relationally, verbally and physically bullied. In addition, they were more socially marginalized in respect to friendships and romantic relationships. Stigmatization of overweight children and adolescents indeed occurs, but is more prevalent in overweight girls than overweight boys. There is a need to conduct further studies that are specifically designed to evaluate gender differences in stigmatization of overweight children and adolescents, and for studies focusing on preventing this stigmatization.

David E Shuttleton, Smallpox and the literary imagination 1660–1820, Cambridge and New York, Cambridge University Press, 2007, pp. xiii, 265, illus., £48.00, $85.00 (hardback 978-0-521-87209-6).

Uniting their forces, it seems, by sheer dint of scholarly writing, literary historians of the last generation have rewritten the cultural profile of numerous diseases: cancer, consumption, gout, heart disease, obesity and others. David Shuttleton, a literary historian interested in the interface of literature and medicine, has rounded out this record with his fine study of smallpox's profile in the eighteenth century, its most transformative epoch before inoculation and vaccination turned around its fortunes after 1800. Shuttleton revises smallpox's harsh realities, social effects, and especially its verbalizations and mentalizations by onlookers, close and distant. Smallpox's narrower medical history is, of course, far from certain. Identified in the ancient world, first described by the Arab physician Rhazes, and distinguished from measles by Fracastoro, its progress from the Middle Ages to 1600 still conceals mysteries. What can safely be affirmed is that by 1700 it was killing many thousands each year: the scourge from which the eighteenth century could never be free. Jenner's vaccinations at the end of the century, building on Lady Mary Wortley Montagu's earlier inoculations, were the Enlightenment's best hope for prevention. But the resistance to inoculation was immense. It was only when empire and imperialism in the Indian subcontinent made plain that smallpox would become a menace as dire as cholera, that the benefits of vaccination were securely applied. “Medical history” is a smaller field than “medical profile”, which extends to a malady's public understanding: here think of mental illness and AIDS. Shuttleton appropriately begins with this larger, bewildering profile in mind and augments our sense of smallpox's cultural casualties. A scourge that disfigures its victims through visible sores, scars, and red spots erupting hot pus will be moralized despite attempts to neutralize the condition. Yet if disease clusters possess inherent symbolic resonances, as cultural historians have been demonstrating for three decades that they do, smallpox's salient sign was disfigurement: disfigurement more than death. This perception did not sit easily with a Georgian civilization steeped in the lure of widely disseminated cults of beauty—aesthetic, physical, moral and sublime—and beauty's opposites in the realms of the ugly and grotesque. Historians have interpreted much Enlightenment culture through this specific opposition. Yet read the pathetic accounts of those dying of smallpox and the horror of disfigurement terrorizes them far more than death does. If obesity in our time has become the site of fiercely contested debates trading on our obsession with symmetrically trim bodies—so slim that they are often anorexic—smallpox before 1800 took a similar toll on the faces and figures of women and men, rich and poor. Shuttleton's accounts are often riveting, demonstrating the part played by imagination in the framing of this condition, especially the literary imagination that conceptualizes malady by first verbalizing it. This is not another pedestrian representation of a disease cluster: Shuttleton also embeds perplexing philosophical dimensions of “representing malady”—its degree of stigma—and takes sides in the ongoing debate about the need for demystification. Students of medical history know how assiduously Susan Sontag campaigned in the 1980s to demystify disease, which (in her view) should be a scientific category rather than moral sign or cultural stigma. Her aim was noble and eloquently argued, but history from time immemorial—continuing into the present—weighs against her position. People have always given meaning to disease; infected individuals cannot refrain from attaching morally loaded significance to their maladies that exceed the limits of the pathological signs and literal physical symptoms. For centuries smallpox was living proof of the moral tendency rather than its exception, just as psychological depression is today.

Attitudes of nurses towards schizophrenia

ObjectivesAccording to the recent literature, stigma connected to schizophrenia has a negative impact on the commencement, process and the outcome of the treatment. The aim of this study was to investigate the attitude of nurses from our local community towards schizophrenia.MethodsThis study engaged 166 nurses (8 male, 158 female) employed at the Clinical Hospital in Osijek and the Primary Medical Care in Osjecko-baranjska County. The subjects have filled out the Canadian Community Antistigma Questionnaire during 3 mental health lectures for nurses.ResultsOut of total of 166 nurses, 74.7% (124) of them has heard something about schizophrenia in the last couple of months. 45.8% (76) of nurses was employed at the institution that treated patients with mental illness. 34.3% (57) of nurses personally knew someone who was diagnosed with schizophrenia or were treated for schizophrenia themselves. The results have shown an extensive knowledge of the facts related to schizophrenia among the nurses in our local community. It has also emerged that the attitude to the person with schizophrenia is more negative, and the level of stigma is higher as the higher emotional involvement is required.ConclusionMedical staff has a good level of knowledge about schizophrenia. Emotional acceptance of the person with schizophrenia is lower as the closer contact is required. Because the results show a certain degree of stigma to schizophrenia in the population of nurses in our local community, it would be necessary to develop specific anti-stigma programs for medical staff.

Dimensions of Mental Illness Stigma: What About Mental Illness Causes Social Rejection?

The stigma of mental illness can be as harmful as the symptoms, leading to family discord, job discrimination, and social rejection. The existence of mental illness stigma has been well established, but stigma theory must go beyond demonstrations and mere descriptions. This article addresses which characteristics across mental disorders lead to stigmatization and social rejection. Participants (N = 270) read case histories depicting individuals with 40 mental disorders, rated those individuals on 17 dimensions (e.g., dangerousness to others, treatability, social disruptiveness), and indicated how willing they were to reject these individuals on a social distance scale. This yielded a ranking of mental disorders by degree of stigmatization; most importantly it reveals the structure of mental illness stigmatization. Only three dimensions were essential in accounting for rejection: personal responsibility for the illness, dangerousness, and rarity of the illness. These dimensions provide an efficient and effective account of the causes of social rejection in mental illness (Multiple–R of .78, p < .0001).

Perceptions of a South African schizophrenia population with regards to community attitudes towards their illness

With the worldwide shift towards a more community-based psychiatric service delivery approach, stigma and the issues surrounding it have received much attention. However, very little South African data exist and the aim of our study was therefore to investigate the experience of internalized stigma in a South African schizophrenia population with specific emphasis on abuse as a form of stigmatization. A total of 100 subjects at various stages of schizophrenic illness were subjected to a the Internalized Stigma of Mental Illness scale (ISMI) that was modified to include six items focusing specifically on investigating the experience of stigmatization within the South African context. A high overall degree of stigmatization was perceived by most subjects, but not equally so for all ISMI areas. When looking at the modified items, 29% felt media-influence to be negative, this seemed to be specifically true for those with matriculation and higher as well as a home-language other than Afrikaans. Thirty nine percent indicated that they had been victims of physical abuse due to their mental illness, with the data suggesting that especially Xhosa-speaking patients, male subjects and those with more admissions and a longer duration of illness experienced this excessively. Our study confirmed a high overall degree of perceived stigmatization as well as suggesting some evidence for cultural influences on stigma. It was the first to provide South African data and as such can be regarded as central to our efforts in restructuring psychiatric services and clinical practices in a way that would minimize the effects of stigma and ultimately benefit our clients.