American Sociological Association

Stigma Resistance and Well-being among People in Treatment for Psychosis

We examine whether individuals’ coping strategies help to explain the negative relationships of stigma-related stressors (perceived public devaluation, discrimination experiences, and internalized stigma) with their well-being (self-esteem, depressive symptoms, and quality of life). Two forms of stigma resistance (challenging and deflecting) were compared with concealment responses (maintaining secrecy, avoiding other people). Patients with psychoses at four psychiatric hospitals were interviewed (N = 65). Patients who perceived public devaluation made fewer attempts at stigma resistance. Those who experienced discrimination engaged in both concealing and resisting responses. Individuals with internalized stigma used concealment strategies only. Patients employing concealment tactics had lower self-esteem and greater depression, while those who challenged stereotypes or held deflection beliefs ("I am not mentally ill") trended to higher self-esteem and had more positive quality of life. Coping tactics rarely mediated the links between stigma-related stressors and well-being; given these data are cross-sectional, other plausible stress dynamics need examination. Longitudinal data verifying that stigma resistance is beneficial could lead to future interventions.


Thoits, P. A., Link, B. G.





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