Abstract
Purpose
People with mental illness face the dilemma whether or not to disclose their condition. We examined stigma variables and their relationship with comfort disclosing.
Methods
Comfort with disclosure, well-being, symptoms and aspects of experiencing and reacting to stigma were assessed among 202 individuals with mental illness.
Results
Controlling for symptoms, greater comfort disclosing one’s mental illness was associated with lower anticipated discrimination and lower stigma stress; more comfort disclosing was related to greater well-being.
Conclusions
Anticipated discrimination as an external threat and stigma-related stress as an internal process may reduce comfort with disclosure and could be targeted in interventions.
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References
Schomerus G, Schwahn C, Holzinger A, Corrigan PW, Grabe HJ, Carta MG, Angermeyer MC (2012) Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand 125:440–452
Link BG, Mirotznik J, Cullen FT (1991) The effectiveness of stigma coping orientations: Can negative consequences of mental illness labeling be avoided? J Health Soc Behav 32:302–320
Brohan E, Henderson C, Wheat K, Malcolm E, Clement S, Barley EA, Slade M, Thornicroft G (2012) Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace. BMC Psychiatry 12:11
Brohan E, Evans-Lacko S, Henderson C, Murray J, Slade M, Thornicroft G (2014) Disclosure of a mental health problem in the employment context: qualitative study of beliefs and experiences. Epidemiol Psychiatry Sci. doi:10.1017/S2045796013000310 (published online)
Henderson C, Brohan E, Clement S, Williams P, Lassman F, Schauman O, Dockery L, Farrelly S, Murray J, Murphy C, Slade M, Thornicroft G (2013) Decision aid on disclosure of mental health status to an employer: feasibility and outcomes of a randomised controlled trial. Br J Psychiatry 203:350–357
Rüsch N, Abbruzzese E, Hagedorn E, Hartenhauer D, Kaufmann I, Curschellas J, Ventling S, Zuaboni G, Bridler R, Olschewski M, Kawohl W, Rössler W, Kleim B, Corrigan PW (2014) The efficacy of coming out proud to reduce stigma’s impact among people with mental illness: pilot randomised controlled trial. Br J Psychiatry. doi:10.1192/bjp.bp.113.135772 (published online)
Corrigan PW, Kosyluk KA, Rüsch N (2013) Reducing self-stigma by coming out proud. Am J Public Health 103:794–800
Lasalvia A, Zoppei S, van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, Bacle SV, van Audenhove C, van Weeghel J, Reneses B, Germanavicius A, Economou M, Lanfredi M, Ando S, Sartorius N, Lopez-Ibor JJ, Thornicroft G (2013) Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381:55–62
Thornicroft G, Brohan E, Rose D, Sartorius N, Leese M (2009) Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373:408–415
Rüsch N, Corrigan PW, Wassel A, Michaels P, Olschewski M, Wilkniss S, Batia K (2009) A stress-coping model of mental illness stigma: I. Predictors of cognitive stress appraisal. Schizophr Res 110:59–64
Rüsch N, Corrigan PW, Powell K, Rajah A, Olschewski M, Wilkniss S, Batia K (2009) A stress-coping model of mental illness stigma: II. Emotional stress responses, coping behavior and outcome. Schizophr Res 110:65–71
Corrigan PW, Watson AC (2002) The paradox of self-stigma and mental illness. Clin Psychol Sci Pract 9:35–53
Rüsch N, Hölzer A, Hermann C, Schramm E, Jacob GA, Bohus M, Lieb K, Corrigan PW (2006) Self-stigma in women with borderline personality disorder and women with social phobia. J Nerv Mental Dis 194:766–773
Henderson C, Williams P, Gabbidon J, Farrelly S, Schauman O, Hatch S, Thornicroft G, Clement S (2014) Mistrust of mental health services: ethnicity, hospital admission and unfair treatment. Epidemiol Psychiatr Sci. doi:10.1017/S2045796014000158
Rüsch N, Evans-Lacko S, Henderson C, Flach C, Thornicroft G (2011) Knowledge and attitudes as predictors of intentions to seek help and disclose a mental illness. Psychiatric Serv 62:675–678
Rüsch N, Evans-Lacko S, Thornicroft G (2012) What is a mental illness? Public views and their effects on attitudes and disclosure. Aust NZ J Psychiatry 46:641–650
Gabbidon J, Brohan E, Clement S, Henderson C, Thornicroft G (2013) The development and validation of the questionnaire on anticipated discrimination. BMC Psychiatry 13:297
Rüsch N, Corrigan PW, Heekeren K, Theodoridou A, Dvorsky D, Metzler S, Müller M, Walitza S, Rössler W (2014) Well-being among persons at risk for psychosis: the role of self-labeling, shame and stigma stress. Psychiatric Serv. doi:10.1176/appi.ps.201300169 (published online)
Rüsch N, Müller M, Lay B, Corrigan PW, Zahn R, Schönenberger T, Bleiker M, Lengler S, Blank C, Rössler W (2014) Emotional reactions to involuntary psychiatric hospitalization and stigma as a stressor among people with mental illness. Eur Arch Psychiatry Clin Neurosci 264:35–43
Brohan E, Clement S, Rose D, Sartorius N, Slade M, Thornicroft G (2013) Development and psychometric evaluation of the discrimination and stigma scale. Psychiatry Res 208:33–40
Ritsher JB, Otilingam PG, Grajales M (2003) Internalized stigma of mental illness: psychometric properties of a new measure. Psychiatry Res 121:31–49
Tennant R, Hiller L, Fishwick R, Platt S, Joseph S, Weich S, Parkinson J, Secker J, Stewart-Brown S (2007) The Warwick-Edinburgh Mental Well-being scale: development and UK validation. Health Qual Life Outcomes 5:63
Lukoff D, Liberman RP, Nuechterlein KH (1986) Symptom monitoring in the rehabilitation of schizophrenic patients. Schizophr Bull 12:578–602
Edwards JR, Cooper CL (1990) The person-environment fit approach to stress: recurring problems and some suggested solutions. J Org Behav 11:293–307
Rindskopf D (1984) Linear equality restrictions in regression and loglinear models. Psychol Bull 96:597–603
Corrigan PW, Morris S, Larson JE, Rafacz J, Wassel A, Michaels P, Wilkniss S, Batia K, Rüsch N (2010) Self-stigma and coming out about one’s mental illness. J Community Psychol 38:1–17
Chaudoir SR, Fisher JD (2010) The disclosure processes model: understanding disclosure decision making and postdisclosure outcomes among people living with a concealable stigmatized identity. Psychol Bull 136:236–256
Corrigan PW (2011) Strategic stigma change : five principles for social marketing campaigns meant to erase the prejudice and discrimination of mental illness. Psychiatric Serv 62:824–826
Henderson C, Thornicroft G (2013) Evaluation of the Time to Change programme in England 2008–2011. Br J Psychiatry Suppl 55:s45–s48
Acknowledgments
This paper summarises independent research funded by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research scheme (RP-PG-0606-1053). GT is supported by the National Institute for Health Research under its Programme Grants for Applied Research scheme (Improving Mental Health Outcomes by Reducing Stigma and Discrimination: RP-PG-0606-1053). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Conflict of interest
The authors declare that they have no conflict of interest.
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Rüsch, N., Brohan, E., Gabbidon, J. et al. Stigma and disclosing one’s mental illness to family and friends. Soc Psychiatry Psychiatr Epidemiol 49, 1157–1160 (2014). https://doi.org/10.1007/s00127-014-0871-7
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DOI: https://doi.org/10.1007/s00127-014-0871-7