Week 2: Personality Disorders
The Stigma of Personality Disorders
Introduction
PDs – among the most commonly experienced psychiatric conditions
- Between 5-15% of the population are affected
PD – diagnosed when long-term cultural deviations in (1) cognition, (2) emotion, and (3)
behavior – that begin in adolescence or young adulthood – disrupt daily activities or cause
distress
People with PDs – experience the destructive impact of social stigma
- In addition to problematic symptoms of illness
Characteristics and Prevalence of Personality Disorder
PDs – with the highest prevalence – include:
1. Antisocial – 3.8%
2. Borderline – 2.7%
3. OCPD – 1.9%
4. Paranoid – 1.9%
5. Avoidant – 1.2%
People experiencing a PD – more likely to (1) self-harm, (2) abuse substances, and (3) have
co-occurring psychiatric problems – such as mood disorders and PTSD
- Comorbidity with at least on other psychiatric diagnosis – 67%
Defining Stigma
Stigma – described as social rejection – resulting from negatively perceived characteristics
- This rejection – leads to the ‘spoiled identity’ of the one stigmatized
There are four qualities of stigma – whereby:
, (1) Individual differences are recognized
(2) These differences are perceived by society as negative
(3) The stigmatized group is seen as the outgroup
(4) The end result is loss of opportunity, power or status
From a social-cognitive perspective – stigma includes the cognitive, affective, and
behavioral components – called:
- Stereotypes – Prejudice – Discrimination
A Model for Understanding Mental Illness Stigma
Stigma Components
Overgeneralization about a person – based on group
Stereotype (cognitive) membership
Agreement with the stereotype and negative emotions
Prejudice (affective) toward the person
Unfair acts toward groups or group members
Discrimination (behavioral)
Stigma Types
What society believes about individuals with mental
illness – e.g., lack of eye contact, complete ostracization
Public Stigma
of individuals based on membership in stigmatized group
When public stigma becomes internalized; one starts to
believe the negative societal attitudes – may result in low
Self-Stigma
self-esteem, depression, or lack of motivation
Structural Stigma When stigmatizing beliefs and attitudes – lead to unfair
, social institutions and policies for the stigmatized group
Stigma of Mental Illness
Specific stereotypes and prejudices towards those with mental illness – incite discriminatory
treatment against these individuals
1. Incompetence – this stereotype can prejudice employers and limit job opportunities –
i.e., discrimination
- This stereotype can also result in coercive behavior – e.g., forced hospitalization,
guardianship, restriction of independence
2. Dangerousness – media exaggerates the link between mental illness and violence –
leading to public fear of the mentally ill
- Fuels behaviors – such as segregation of mentally ill in poor neighborhoods,
avoidance, or withdrawal
3. Responsibility – the mentally ill viewed as the ones to blame for the illness
- The public believes these individuals have made choices that led to their
symptoms – or have not made sufficient recovery efforts
Individuals with mental illness – have either:
1. Internalized the public stigma – feeling shame or having low self-esteem
2. Experience the “wry try” effect – in which recovery efforts stall when one has fully
incorporated the stigmatized mentality of incompetence
3. Miss out on treatment – due to fear of being seen as crazy
Public Stigma of Personality Disorder
PDs – may be even more stigmatized than other psychiatric diagnoses
- With both fear and frustration – among the common public reactions to PDs
The belief – that people with PDs should be able to exhibit control over behavior – results in
symptoms being viewed as manipulations or rejections of help
The Stigma of Personality Disorders
Introduction
PDs – among the most commonly experienced psychiatric conditions
- Between 5-15% of the population are affected
PD – diagnosed when long-term cultural deviations in (1) cognition, (2) emotion, and (3)
behavior – that begin in adolescence or young adulthood – disrupt daily activities or cause
distress
People with PDs – experience the destructive impact of social stigma
- In addition to problematic symptoms of illness
Characteristics and Prevalence of Personality Disorder
PDs – with the highest prevalence – include:
1. Antisocial – 3.8%
2. Borderline – 2.7%
3. OCPD – 1.9%
4. Paranoid – 1.9%
5. Avoidant – 1.2%
People experiencing a PD – more likely to (1) self-harm, (2) abuse substances, and (3) have
co-occurring psychiatric problems – such as mood disorders and PTSD
- Comorbidity with at least on other psychiatric diagnosis – 67%
Defining Stigma
Stigma – described as social rejection – resulting from negatively perceived characteristics
- This rejection – leads to the ‘spoiled identity’ of the one stigmatized
There are four qualities of stigma – whereby:
, (1) Individual differences are recognized
(2) These differences are perceived by society as negative
(3) The stigmatized group is seen as the outgroup
(4) The end result is loss of opportunity, power or status
From a social-cognitive perspective – stigma includes the cognitive, affective, and
behavioral components – called:
- Stereotypes – Prejudice – Discrimination
A Model for Understanding Mental Illness Stigma
Stigma Components
Overgeneralization about a person – based on group
Stereotype (cognitive) membership
Agreement with the stereotype and negative emotions
Prejudice (affective) toward the person
Unfair acts toward groups or group members
Discrimination (behavioral)
Stigma Types
What society believes about individuals with mental
illness – e.g., lack of eye contact, complete ostracization
Public Stigma
of individuals based on membership in stigmatized group
When public stigma becomes internalized; one starts to
believe the negative societal attitudes – may result in low
Self-Stigma
self-esteem, depression, or lack of motivation
Structural Stigma When stigmatizing beliefs and attitudes – lead to unfair
, social institutions and policies for the stigmatized group
Stigma of Mental Illness
Specific stereotypes and prejudices towards those with mental illness – incite discriminatory
treatment against these individuals
1. Incompetence – this stereotype can prejudice employers and limit job opportunities –
i.e., discrimination
- This stereotype can also result in coercive behavior – e.g., forced hospitalization,
guardianship, restriction of independence
2. Dangerousness – media exaggerates the link between mental illness and violence –
leading to public fear of the mentally ill
- Fuels behaviors – such as segregation of mentally ill in poor neighborhoods,
avoidance, or withdrawal
3. Responsibility – the mentally ill viewed as the ones to blame for the illness
- The public believes these individuals have made choices that led to their
symptoms – or have not made sufficient recovery efforts
Individuals with mental illness – have either:
1. Internalized the public stigma – feeling shame or having low self-esteem
2. Experience the “wry try” effect – in which recovery efforts stall when one has fully
incorporated the stigmatized mentality of incompetence
3. Miss out on treatment – due to fear of being seen as crazy
Public Stigma of Personality Disorder
PDs – may be even more stigmatized than other psychiatric diagnoses
- With both fear and frustration – among the common public reactions to PDs
The belief – that people with PDs should be able to exhibit control over behavior – results in
symptoms being viewed as manipulations or rejections of help
