Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-11T05:55:33.076Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  13 October 2015

Daniel Pérez-Garín ,
Fernando Molero  and
Arjan E.R. Bos
Daniel Pérez-Garín*
Affiliation:
UNED (Spain)
Fernando Molero
Affiliation:
UNED (Spain)
Arjan E.R. Bos
Affiliation:
Open Universiteit (the Netherlands)
*
*Correspondence concerning this article should be addressed to Daniel Pérez-Garín. Departamento de Psicología Social y de las Organizaciones. Facultad de Psicología. C/ Juan del Rosal, 10. 28040. Madrid (Spain). Phone: +34–913988744. E-mail: dperez@madridsur.uned.es
Get access Rights & Permissions [Opens in a new window]

Abstract

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.

Keywords

stigmadiscriminationwell beingmental health
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 18 , 2015 , E75
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, K. J. (2010). Benign bigotry: The psychology of subtle prejudice. New York, NY: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511802560 Google Scholar
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 Google Scholar
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 Google Scholar
Bradburn, N. M. (1969). The structure of psychological well-being. Chicago, IL: Aldine.Google Scholar
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 Google Scholar
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 Google Scholar
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 CrossRefGoogle ScholarPubMed
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 Google Scholar
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 Google Scholar
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.CrossRefGoogle ScholarPubMed
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.Google Scholar
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 Google Scholar
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 well-being scales]. Psicothema, 18, 572–577.Google Scholar
Diener, E., Oishi, S., & Lucas, R. E. (2002). Subjective well-being: The science of happiness and life satisfaction. In Snyder, C. R. & Lopez, S. J. (Ed.), Handbook of Positive Psychology. Oxford, UK and New York, NY: Oxford University Press.Google Scholar
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 Google Scholar
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 CrossRefGoogle ScholarPubMed
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 Google Scholar
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 CrossRefGoogle ScholarPubMed
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 Google Scholar
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 Google Scholar
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 Google Scholar
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 Google Scholar
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 Google Scholar
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 Google Scholar
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 CrossRefGoogle ScholarPubMed
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 Google Scholar
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 Google Scholar
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 Google Scholar
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 Google Scholar
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.Google Scholar
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 Google Scholar
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 Google Scholar
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 CrossRefGoogle ScholarPubMed
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 Google Scholar
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 Google Scholar
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 CrossRefGoogle ScholarPubMed