 Subjects -> DISABILITY (Total: 100 journals)
|
|
|
- Is it Time to Retire the Term Stigma'
Authors: Amir Tal
Abstract: The term stigma has undergone a number of re conceptualizations since it was first popularized by Goffman (1963) to refer to a mark of shame. Since that time, the term has become common parlance to refer to socially undesirable conditions or affiliations. The term ‘stigma’ has been used throughout the academic literature to refer to a wide range of social and psychological processes ranging from cognitive and attitudinal processes (Corrigan, Markowitz, Watson, Rowan, & Kubiak, 2003) to the structural elements that create and maintain social inequity and oppression (Link & Phelan, 2001). However, not everyone is comfortable with the term stigma or its connotations. Critics have argued that it places a heavy focus on the characteristics of the stigmatized and not enough focus on the social and structural mechanisms that create and maintain discrimination (Everett, 2004). Recently, several governmental and non-governmental organizations have called to retire the term stigma, instead favouring terms such as discrimination or social oppression. Following these voices, Stigma Research and Action called for papers debating this issue. In this issue we present four commentaries that address this debate from different perspectives. We hope that they will provoke thought and discussion.
PubDate: 2012-01-31
Issue No: Vol. 1 (2012)
- Reconceptualizing Stigma: Toward a Critical Anti-Oppression Paradigm
Authors: Lynn C. Holley, Layne K. Stromwall, Kathy E. Bashor
Abstract: Theorists concerned with mental health prejudice and discrimination have conceptualized these problems as stigma, typically defined as a labeling process that triggers stereotyping, followed by acts of discrimination that result in loss of status and reduced life options for people who are perceived to have mental illnesses (Goffman, 1963; Link & Phelan, 2001). Other stigma theorists have advocated for a social justice perspective (e.g., Corrigan, Watson, Byrne, & Davis, 2005; Perlin & Dorfman, 1993) or have recognized the need to consider meso- and macro-level factors (Pescosolido, Martin, Lang, & Olafsdottir, 2008) or structural arrangements (e.g., Corrigan, Markowitz, & Watson, 2004). Informed by critical theories and oppression literature, this paper offers theoretical arguments for replacing the current stigma model with a critical anti-oppression paradigm. This paradigm expands our lens to emphasize transforming the power dynamics inherent in system-level arrangements and structures that privilege those who are perceived as not having mental illnesses while disadvantaging others who are perceived to have mental illnesses. We conclude with implications of this paradigm for practice and research.
PubDate: 2012-01-31
Issue No: Vol. 1 (2012)
- The Implications of Stigma for Institutionalized Violence
Authors: Cameron Ross McCordic
Abstract: The retirement of the stigma term is currently up for debate among advocacy groups. This debate questions the relevance and utility of the term for the conceptualization of discriminatory treatment against individuals who deviate from some societal norm. In Goffman’s (1963) seminal conceptualization of stigma, he described how stigma can be used to demonstrate an individual’s disqualified humanity. Further research has suggested that stigma can be used both to represent the disqualification of an individual’s humanity and to create humanity disqualification by inciting discrimination. While discrimination is a common result of stigma, there has been little discussion in academia regarding the use of stigma to promote the discrimination of certain groups or individuals by propagating prejudicial ideologies. This discrimination has implications for the justification and sanctioning of violence by institutions of power. Due to the fact that this is an area of stigma research which is largely uninvestigated, it would be premature to retire the stigma term without fully understanding its implications. This article will examine the implications of stigma for state sanctioned violence and review the limitations of this subject as a research topic.
PubDate: 2012-01-31
Issue No: Vol. 1 (2012)
- Stigma Shrinks my Bubble: A Qualitative Study of Understandings and
Experiences of Stigma and Bipolar Disorder
Authors: Melinda Suto
Abstract: Purpose: This study contributes to the stigma and bipolar disorder literature focused on understanding structural, social, and self-stigma experiences from the perspectives of individuals living with bipolar disorder and their family members. Methods: Community-based participatory research (CBPR) principles guided our engagement of individuals with bipolar disorder and community partners in the initiation, development, implementation, and reporting of this study. We collected data through focus groups with individuals living with bipolar disorder (3 groups) and family members (2 groups) during an annual bipolar disorder community engagement event. Thematic analysis was conducted as an iterative process and aided by several research team meetings. Results: Three core themes emerged: (1) explicit and implicit exclusionary practices linked to structural stigma; (2) social stigma (e.g., If my child had leukemia you would all be bringing me lasagna) and; (3) the burden of self-stigma (e.g., What’s wrong with me'). These findings address issues arising in work, school, social, and health care settings that shape stigma phenomena. Conclusion: Parallels between the present findings and stigma experiences regarding other types of mental illnesses suggest considerable overlap. Individuals with bipolar disorder expressed hope for change that included (a) working with health care professionals who use a psychosocial rehabilitation approach and (b) implementing personal strategies for unloading the burden of self-stigma in their lives. Implications: The conceptualization of stigma as self, social and structural resonated well with the experiences and understandings of study participants. This conceptualization offers a bridge for communication between people with bipolar disorder, their families and health care practitioners and may be a useful framework for guiding efforts to reduce stigma. CBPR principles and lived experiences are crucial elements in stigma reduction endeavors.
PubDate: 2012-01-31
Issue No: Vol. 1 (2012)
- The stigma of mental illness in Sri Lanka: the perspectives of community
mental health workers
Authors: Namali Samarasekara, Matthew Lloyd Millins Davies, Sisira Siribaddana
Abstract: Background While the prevalence of mental illness is increasing, stigma associated with mental illness in Sri Lanka remains unexplored. Aims To gain an understanding of how stigma associated with mental illness exists in Sri Lanka, from the perspectives of community mental health workers (CMHWs). Furthermore, to explore their views on how any arising issues regarding stigma may be tackled in the future. Methods Purposive and snowball sampling methods were used to recruit community mental health workers for this small qualitative study. Nine semi-structured interviews were conducted, using an interview guide designed by the first author. The data was analysed using the ‘thematic framework’ approach. Results Stigma is associated with the family unit; there is strong faith in traditional beliefs and healers; and negative attitudes and behaviours exist regarding mental illness. CMHWs are influenced by poor health seeking behaviours and low prioritisation of mental health services in the country. CMHWs can contribute to reducing stigma by increasing awareness of mental illness in various ways but also believe that increasing availability of services within Sri Lanka is key in reducing stigma. Conclusions This study provides insight into how stigma exists specifically in Sri Lankan communities and influences the work of CMHWs. Many findings reinforce existing international health literature and thus convey that stigma is an important issue that must be tackled globally.
PubDate: 2012-01-31
Issue No: Vol. 1 (2012)
- The psychometric assessment of internalized stigma instruments: a
systematic review
Authors: Sharon Anne Maria Stevelink, Ingeborg C Wu, Carlijn G.N. Voorend, Wim H. van Brakel
Abstract: Objective: Many instruments have been developed to assess stigma and related constructs across health conditions. The objective of this study was to provide an overview of the best validated instruments to measure internalized (or self-) stigma in health conditions where stigma plays a major role. Method: A systematic literature review was conducted by searching relevant databases and by reviewing the bibliographies of relevant papers. Quantitative studies were included if the items used, or a sample of the instrument, were presented in the paper and if the studies focussed on the initial development of the instrument or a further validation. Health conditions included were HIV/AIDS, mental health, leprosy, asthma, epilepsy, cancer, obesity and tuberculosis. Psychometric properties of the included studies were assessed using several quality criteria: content validity, internal consistency, construct validity, criterion validity, reproducibility, responsiveness, floor and ceiling effects and interpretability. We rated the quality of the psychometric testing of the instruments using criteria proposed by Terwee et al. and the COSMIN consortium. Results: Thirty-three papers were included of which 21 were identified as actual instrument development studies. Of the 21 instruments included only two instruments received three positive ratings on the quality criteria. Twelve instruments were rated at least three times as indeterminate, especially for the criteria internal consistency and construct validity. This was due to insufficient samples sizes for factor analyses and hypotheses that were not formulated properly. At least one negative rating was given for five instruments. Content and construct validity as well as internal consistency were most often assessed, whereas agreement and responsiveness received least attention. Conclusions: This review attempted to rate the available instruments to measure internalized stigma using current standard quality criteria for testing psychometric properties. Only the Child Attitude Towards Illness Scale and the Internalized Stigma of Mental Illness received three positive ratings on the quality criteria. Based on the results, we conclude that the majority of the instruments needs further testing of their psychometric properties. Implications: The need was identified for a simplified testing protocol to design an instrument development study, to assess certain psychometric properties and to specify the preferred statistical methods for testing these. In addition, researchers should be aware that re-validation of instruments is necessary once application will take place in cultures and study populations other than the one(s) the instrument was initially developed for.
PubDate: 2012-01-31
Issue No: Vol. 1 (2012)
- Shifting our conceptualization of social inclusion
Authors: Virginie Cobigo, Hélène Ouellette-Kuntz, Rosemary Lysaght, Lynn Martin
Abstract: Objective. Social inclusion is a right, as well as a goal for community-based services and supports. Yet, there is a lack of consensus as to what constitutes social inclusion which means that there is no real way to determine and measure services effectiveness. This paper aims to identify current key components, definitions and conceptual approaches to social inclusion, and determine gaps in the scope and clarity of existing conceptualizations. Method. We conducted a synthesis review on the social inclusion of persons with intellectual and developmental disabilities. We extracted data relevant to the definition of social inclusion, its key principles and elements, as well as its main challenges. We adopted a narrative approach to synthesize the findings. Results. The main challenges in our understanding of social inclusion are: Social inclusion is at risk of being an ideology and may lead to ineffective and potentially harmful strategies; Social inclusion is still mainly defined as the acceptance and achievement of the dominant societal values and lifestyle which may lead to moralistic judgements; Social inclusion is often narrowly defined and measured as productivity and independent living, which is inappropriate for people with more severe disabilities; Social inclusion is often limited to the measure of one’s participation in community-based activities. Conclusion and implications. Shifting our understanding of social inclusion is essential. It means: Adopting a pro-active perspective that moves beyond theoretical discourse and leads to the identification of tools to improve social inclusion; Abandoning the moralistic perspective that tends to impose the view of the dominant group and leaning toward an approach respectful of individuals' expectations, choices and needs; Defining social inclusion from a developmental perspective where one's social inclusion improves with increased opportunities to interact with others and participate in activities; Including sense of belonging and well-being to our definition and measure of social inclusion.
PubDate: 2012-01-31
Issue No: Vol. 1 (2012)
- What’s In a Name'
Authors: Bill George
Abstract: ‘What’s in a name' This is an open letter about a new name for schizophrenia in the DSM-5. Anoiksis, the Dutchpatient society of and for people with a susceptibility to psychoses or schizophrenia, has lobbied the American Psychiatric Association for a new name for schizophrenia. The most recent suggestion —Schizophrenia (Bleuler’s Syndrome) — is intended to do justice also to the negative and cognitive symptoms in the syndrome. This appears to correspond in part with the ideas of the chair of the appropriate American Psychiatric Association’s Work Group. The issue now is to gain support from the international mental health community.
PubDate: 2012-01-31
Issue No: Vol. 1 (2012)
|
Open Access journal
