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Stigma
Stigma refers to a perception of shame or discredit resulting from a particular condition, behavior, or experience. These conditions, behaviors, and experiences may include psychological issues such as substance abuse or schizophrenia; physical characteristics such as body weight, a need for corrective vision lenses, or skin color; medical conditions such as cancer, HIV, or skin lesions; and other issues such as sexual preference, gender identity, and age.
The topic of stigma may be closely related to trauma in general. In many cases, exposure to trauma may directly result in stigma (as in the case of combat veterans who perceive that others pity or scorn them because of their experiences). In others, the perception of stigma may itself result in trauma (as in the case of a Vietnam veteran being insulted and spat on by antiwar protesters). This entry briefly reviews current knowledge about types of stigma, stigma as a barrier to receiving medical or psychological care, and mitigation of stigma.
Definitions and Concepts
The concept of stigma may be thought of as two different, but related, types: public stigma and self-stigma. These two types of stigma have been most prominently described since the mid to late 1990s. Public stigma refers to attitudes or beliefs regarding those who are somehow different from oneself. This type of stigma may manifest as discrimination (such as differential employment practices based on race or ethnicity), stereotypes (such as a belief that all people who are overweight are slothful and eat too much), and knee-jerk reactions (such as holding one's personal belongings closer or more securely when somebody with multiple facial piercings enters the elevator), for example. Self-stigma, however, refers to individuals' own negative beliefs about themselves. As such, self-stigma may be thought of as public stigma directed inward or internalized. As a result of this form of stigma, an individual may experience reduced self-efficacy and self-esteem. These two types of stigma may affect each other directly: As individuals experience discrimination, they may be likely to internalize that experience, resulting in a belief that no matter what they do, they will be unable to achieve their goal (decreased self-efficacy).
Stigma may be felt differently by different people. Some evidence indicates that minority populations, women, and those of low socioeconomic status may perceive greater stigma regarding a range of physiological or psychological issues. Little research has been conducted, however, that seeks to identify risk factors for perceptions of stigma. Similarly, little is known about the phenomenon of resiliency exhibited by some individuals who might otherwise be expected to experience stigma.
Stigma as a Barrier to Care
Because stigma deals with perceptions—both of oneself and of others—it can represent a significant barrier to receiving treatment for a condition that warrants medical or psychological intervention. Those perceiving stigma are likely to feel guilt, shame, and embarrassment and are therefore less likely to seek medical or psychological care. They may also believe that if others knew they were receiving care for a condition, they might be viewed as weak, lazy, or inferior. As a result, the individual is more likely to continue suffering, rather than taking steps necessary for improvement or relief.
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- Anthropology and Archaeology
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