Stigma Susceptibility

The Concept of Stigma

Since the concept of stigma is multidisciplinary, it has been applied to a vast amount of events. Within the contributions of many disciplines, different theoretical approaches were used putting different emphasis on its conceptualization. Bearing this ambiguity in mind, the following attempt to describe stigma is done particularly with regard to its application in the medical context.

Stigma is differentiated in several perspectives. One important distinction is made between public stigma and self-stigma. The first implies stereotypical perceptions by the public. For instance, the health insurance system and other health providers or professionals all inherit specific attributes when dealing with a stigmatized person. Self-stigma, however, subsumes the behavior of the stigmatized individual himself or herself. Therefore, it may affect the well-being, healthcare choices, and even life goals of the person involved. Self-stigmatization generally results from a previously experienced public stigma.

An additional perspective can be derived by an early attempt of Erving Goffman to differentiate observable marks of stigma, the discrimination between discredited and discreditable stigma. Discredited stigma refers to perceivable marks of the individual in question. Hence, the stigmatized individual is labeled by physiognomy or behavior, not having the opportunity to hide these marks from the public (e.g., a blind person is easily identified by his or her white cane). In contrast, a discreditable stigma is characteristic for individuals who have the possibility to hide their condition in front of others. For instance, this could be the case for patients who suffer from mental illnesses, cancer in an early stage, or HIV.

The Process of Stigmatization

Several sociocognitive processes contribute to stigmatization. At first, social and physical cues are subsumed into a category or a label. Every dimension on which people vary can be selected during this process of categorization (e.g., gender, age, race, social class, physical health). For the purpose of information reduction, individuals are mostly categorized by only a single or a few dimensions— although they belong to many. Once a person is categorized, it appears that all social interactions are pervaded by this category (e.g., the blind lawyer). Labeling is a similar process, but based on categories which involve rather vague membership criteria (e.g., mental illness). Labels can only be obtained from three sources: (1) the information given by others (e.g., doctors, nurses), (2) the information given by the stigmatized person, and (3) observed associations (a person coming out of a psychiatrist's office).

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