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The Self-Stigma of Psychiatric Patients: Implications for Identities, Emotions, and the Life Course

Sarah K. Harkness

Amy Kroska

Bernice A. Pescosolido

50 Years After Deinstitutionalization: Mental Illness in Contemporary Communities

ISBN: 978-1-78560-403-4, eISBN: 978-1-78560-402-7

Publication date: 4 July 2016

Abstract

Purpose

We argue that self-stigma places patients on a path of marginalization throughout their life course leading to a negative cycle of opportunity and advancement. Mental health patients with higher levels of self-stigma tend to have much lower self-esteem, efficacy, and personal agency; therefore, they will be more inclined to adopt role-identities at the periphery of major social institutions, like those of work, family, and academia. Similarly, the emotions felt when enacting such roles may be similarly dampened.

Methodology/approach

Utilizing principles from affect control theory (ACT) and the affect control theory of selves (ACTS), we generate predictions related to self-stigmatized patients’ role-identity adoption and emotions. We use the Indianapolis Mental Health Study and Interact, a computerized version of ACT and ACTS, to generate empirically based simulation results for patients with an affective disorder (e.g., major depression and bipolar disorder) with comparably high or low levels of self-stigmatization.

Findings

Self-stigma among affective patients reduces the tendency to adopt major life course identities. Self-stigma also affects patients’ emotional expression by compelling patients to seek out interactions that make them feel anxious or affectively neutral.

Originality/value

This piece has implications for the self-stigma and stigma literatures. It is also one of the first pieces to utilize ACTS, thereby offering a new framework for understanding the self-stigma process. We offer new hypotheses for future research to test with non-simulation-based data and suggest some policy implications.

Keywords

Acknowledgements

Acknowledgments

We would like to thank the editor of this volume, Brea L. Perry, and the anonymous reviewers for their incisive feedback on this chapter.

Citation

Harkness, S.K., Kroska, A. and Pescosolido, B.A. (2016), "The Self-Stigma of Psychiatric Patients: Implications for Identities, Emotions, and the Life Course", 50 Years After Deinstitutionalization: Mental Illness in Contemporary Communities (Advances in Medical Sociology, Vol. 17), Emerald Group Publishing Limited, Leeds, pp. 207-233. https://doi.org/10.1108/S1057-629020160000017008

Publisher

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Emerald Group Publishing Limited