Perceived Discrimination, Internalized Stigma and Psychological Well-Being of People with Mental Illness

  1. Pérez Garín, Daniel
  2. Molero Alonso, Fernando
  3. Bos, A.E.R.
Revista:
The Spanish Journal of Psychology

ISSN: 1138-7416

Año de publicación: 2015

Volumen: 18

Tipo: Artículo

DOI: 10.1017/SJP.2015.74 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: The Spanish Journal of Psychology

Resumen

The present study examines the relationships between perceived discrimination, internalized stigma, and well-being in a sample of people with mental illness. We conducted a cross-sectional study with 213 outpatients from the Spanish public network of social care. Perceived discrimination was positively and significantly correlated with internalized stigma (p < .01 for all measures of perceived discrimination). Blatant individual discrimination, subtle individual discrimination, and internalized stigma were negatively correlated with life satisfaction, affect balance, and psychological well-being (p < .01 for all cases, except for blatant individual discrimination and affect balance, for which is p < .05). Regression and mediation analyses indicate that subtle individual discrimination is the kind of discrimination most negatively associated to the well-being measures (life satisfaction: B = �.18, p < .10; affect balance: B = �.19, p < .10; psychological well-being: B = �.21, p < .05), and that this association is mediated by internalized stigma. Future research should confirm these findings in a longitudinal or experimental model. In light of our findings, we suggest the development and implementation of intervention programs that target subtle discrimination, and point at the importance of implementing programs to reduce internalized stigma.

Referencias bibliográficas

  • Anderson K. J. (2010). Benign bigotry: The psychology of subtle prejudice. New York, NY: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511802560
  • Baker F., & Intagliata J. (1982). Quality of life in the evaluation of community support systems. Evaluation and Program Planning, 5(1), 69–79. http://dx.doi.org/10.1016/0149-7189(82)90059-3
  • Bos A. E. R., Pryor J. B., Reeder G. D., & Stutterheim S. E. (2013). Stigma: Advances in theory and research. Basic and Applied Social Psychology, 35(1), 1–9. http://dx.doi.org/10.1080/01973533.2012.746147
  • Bradburn N. M. (1969). The structure of psychological well-being. Chicago, IL: Aldine.
  • Carlson J., Ochoa S., Haro J. M., Escartín G., Ahuir M., Gutierrez-Zotes A., … Gallo P. (2009). Adaptation and validation of the quality-of-life scale: Satisfaction with life domains scale by baker and intagliata. Comprehensive Psychiatry, 50(1), 76–80. http://dx.doi.org/10.1016/j.comppsych.2008.05.008
  • Cihangir S. (2008). The dark side of subtle discrimination: How targets respond to different forms of discrimination (Unpublished Doctoral Dissertation). The Netherlands: Leiden: Leiden University. Retrieved from https://openaccess.leidenuniv.nl/handle/1887/13066
  • Corrigan P. (2004). How stigma interferes with mental health care. American Psychologist, 59, 614–625. http://dx.doi.org/10.1037/0003-066X.59.7.614
  • Corrigan P. W., & Kosyluk K. A. (2013). Erasing the stigma: Where science meets advocacy. Basic and Applied Social Psychology, 35(1), 131–140. http://dx.doi.org/10.1080/01973533.2012.746598
  • Corrigan P. W., Kosyluk K. A., & Rüsch N. (2013). Reducing self-stigma by coming out proud. American Journal of Public Health, 103, 794–800. http://dx.doi.org/10.2105/AJPH.2012.301037
  • Corrigan P. W., & Rao D. (2012). On the self-stigma of mental illness: Stages, disclosure, and strategies for change. Canadian Journal of Psychiatry, 57, 464–469.
  • Corrigan P. W., & Watson A. C. (2002). Understanding the impact of stigma on people with mental illness. World P). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Psychiatry, 1(1), 16.
  • Corrigan P. W., Watson A. C., & Barr L. (2006 ). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social and Clinical Psychology, 25, 875–884. http://dx.doi.org/10.1521/jscp.2006.25.8.875
  • Díaz D., Rodríguez-Carvajal R., Blanco A., Moreno Jiménez B., Gallardo I., Valle C., & Van Dierendonck D. (2006). Adaptación española de las escalas de bienestar psicológico de Ryff [Spanish adaptation of Ryff’s wellbeing scales]. Psicothema, 18, 572–577.
  • Diener E., Oishi S., & Lucas R. E. (2002). Subjective well-being: The science of happiness and life satisfaction. In C. R. Snyder & S. J. Lopez (Ed.), Handbook of Positive Psychology. Oxford, UK and New York, NY: Oxford University Press.
  • Jones K. P., Peddie C. I., Gilrane V. L., King E. B., & Gray A. L. (2013). Not so subtle a meta-analytic investigation of the correlates of subtle and overt discrimination. Journal of Management. http://dx.doi.org/10.1177/0149206313506466
  • Link B. G., Struening E. L., Neese-Todd S., Asmussen S., & Phelan J. C. (2001). Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services, 52, 1621–1626. http://dx.doi.org/10.1176/appi.ps.52.12.1621
  • Livingston J. D., & Boyd J. E. (2010). Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science & Medicine, 71, 2150–2161. http://dx.doi.org/10.1016/j.socscimed.2010.09.030
  • Lysaker P. H., Yanos P. T., Outcalt J., & Roe D. (2010). Association of stigma, self-esteem, and symptoms with concurrent and prospective assessment of social anxiety in schizophrenia. Clinical Schizophrenia & Related Psychoses, 4(1), 41–48. http://dx.doi.org/10.3371/CSRP.4.1.3
  • Magallares A., Perez-Garin D., & Molero F. (2013). Social Stigma and well-being in a sample of schizophrenia patients. Clinical Schizophrenia & Related Psychoses, 1–20. http://dx.doi.org/10.3371/CSRP.MAPE.043013
  • Markowitz F. E. (1998). The effects of stigma on the psychological well-being and life satisfaction of persons with mental illness. Journal of Health and Social Behavior, 39, 335–347. http://dx.doi.org/10.2307/2676342
  • Mittal D., Sullivan G., Chekuri L., Allee E., & Corrigan P. W. (2012). Empirical studies of self-stigma reduction strategies: A critical review of the literature. Psychiatric Services, 63, 974–981. http://dx.doi.org/10.1176/appi.ps.201100459
  • Molero F., Recio P., García-Ael C., Fuster M. J., & Sanjuán P. (2013). Measuring dimensions of perceived discrimination in five stigmatized groups. Social Indicators Research, 114, 901–914. http://dx.doi.org/10.1007/s11205-012-0179-5
  • Muñoz M., Sanz M., Pérez-Santos E., & Quiroga M. D. L. Á. (2011). Proposal of a socicognitive–behavioral structural equation model of internalized stigma in people with severe and persistent mental illness. Psychiatry Research, 186, 402–408. http://dx.doi.org/10.1016/j.psychres.2010.06.019
  • Operario D., & Fiske S. T. (2001). Ethnic identity moderates perceptions of prejudice: Judgments of personal versus group discrimination and subtle versus blatant bias. Personality and Social Psychology Bulletin, 27, 550–561. http://dx.doi.org/10.1177/0146167201275004
  • Preacher K. J., & Hayes A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879–891. http://dx.doi.org/10.3758/BRM.40.3.879
  • Ritsher J. B., & Phelan J. C. (2004). Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Research, 129, 257–265. http://dx.doi.org/10.1016/j.psychres.2004.08.003
  • Ritsher J. B., Otilingam P. G., & Grajales M. (2003). Internalized stigma of mental illness: Psychometric properties of a new measure. Psychiatry Research, 121(1), 31–49. http://dx.doi.org/10.1016/j.psychres.2003.08.008
  • Rüsch N., Corrigan P. W., Todd A. R., & Bodenhausen G. V. (2010). Implicit self-stigma in people with mental illness. The Journal of Nervous and Mental Disease, 198, 150–153. http://dx.doi.org/10.1097/NMD.0b013e3181cc43b5
  • Ryff C. D., & Keyes C. L. M. (1995). The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69, 719–727. http://dx.doi.org/10.1037/0022-3514.69.4.719
  • Sandín B., Chorot P., Lostao L., Joiner T. E., Santed M. A., & Valiente R. M. (1999). Escalas PANAS de afecto positivo y negativo: Validación factorial y convergencia transcultural [PANAS positive and negative affect scales: Factorial validation and transcultural convergence]. Psicothema, 11(1), 37–51.
  • Schmitt M. T., Branscombe N. R., Postmes T., & Garcia A. (2014). The consequences of perceived discrimination for psychological well-being: A meta-analytic review. Psychological Bulletin, 140, 921–948. http://dx.doi.org/10.1037/a0035754
  • Vogel D. L., Bitman R. L., Hammer J. H., & Wade N. G. (2013). Is stigma internalized? The longitudinal impact of public stigma on self-stigma. Journal of Counseling Psychology, 60, 311–316. http://dx.doi.org/10.1037/a0031889
  • Watson D., Clark L. A., & Tellegen A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063. http://dx.doi.org/10.1037/0022-3514.54.6.1063
  • Watson A. C., Corrigan P., Larson J. E., & Sells M. (2007). Self-stigma in people with mental illness. Schizophrenia bulletin, 33, 1312–1318. http://dx.doi.org/10.1093/schbul/sbl076
  • World Health Organization. (2005). Mental health declaration for Europe: Facing the challenges, building solutions. World Health Organization Regional Office for Europe. Copenhagen, Denmark: Author. Retrieved from http://www.euro.who.int
  • Yanos P. T., Roe D., Markus K., & Lysaker P. H. (2008). Pathways between internalized stigma and outcomes related to recovery in schizophrenia spectrum disorders. Psychiatric Services, 59, 1437–1442. http://dx.doi.org/10.1176/ps.2008.59.12.1437
Fuente de los datos: Dialnet