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28-09-2009 | Mental health | Article

Mental illness stigma resilience linked to positive ingroup, stigma perception


Free abstract

MedWire News: Study results suggest people with psychiatric disorders are more resilient to stigma if they hold others with mental disorders in high regard or reject stigma as unfair.

“Group value and perceived legitimacy of discrimination may be useful targets to help people with mental illness to better cope with stigma,” say Nicolas Rüsch (University of Freiburg, Germany) and co-authors.

The stigma associated with psychiatric disorders is common, but it is not clear why it affects some people with mental illness more than others.

To investigate, the researchers assessed ingroup perceptions (group value, group identification, group entitativity), perceived legitimacy and level of discrimination and reactions to stigma (education or helping others, social performance, secrecy, social distance, hopelessness) among 85 individuals with a psychiatric disorder using standardized questionnaires and a role-play test.

A third of participants had current major depression, 61% a life-time bipolar I/II disorder, 53% a life-time psychotic disorder, with 39% of all patients experiencing a comorbid current alcohol- or substance-related abuse or dependence in addition to other axis I diagnoses.

Individuals with mental illness valued their ingroup to a greater extent than members of the public, and identified with it more strongly and perceived it as more meaningful unit in society. However, perceived group value showed the smallest difference between groups.

“This could mean that people with mental illness internalize negative public views of their group to a large degree, leaving them vulnerable to stigma,” say the authors.

The study further showed that even after controlling for depression and the level of perceived discrimination, high group value and low perceived legitimacy of discrimination predicted positive reactions to stigma.

All negative behavioral intentions to stigma were predicted either by low group value or by high perceived legitimacy of discrimination. Furthermore, low group value was strongly associated with secrecy and hopelessness – two common and particularly harmful reactions to stigma.

“This further emphasizes the risks faced by people with mental illness who hold their ingroup in low regard,” write Rüsch and team in the journal Acta Psychiatrica Scandinavica.

On the other hand, high group identification and entitativity predicted positive reactions to stigma only in the context of high group value or low perceived legitimacy of discrimination.

The researchers say that cognitive methods could be used to increase perceived group value and decrease perceived legitimacy of discrimination in individuals with mental disorders in order to help them deal with stigma in a more positive way.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

By Ingrid Grasmo

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