Internalised stigma in adults with autism: A German multi-center survey

Bachmann, Christian; Höfer, Juliana; Kamp‐Becker, Inge; Küpper, Charlotte; Poustka, Luise; Röepke, Stefan; Roessner, Veit; Stroth, Sanna; Wolff, Nicole; Hoffmann, Falk

doi:10.1016/j.psychres.2019.04.023

Cited by 35 publications

(33 citation statements)

References 48 publications

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“…The prevalence of elevated self-stigma in BPD was high, in line with other studies (mean IS = 2.45 [20]; mean IS = 2.37 [23]). Self-stigma in ASD was more frequent than in a recent German study (mean IS = 1.93, 15.4% [21]). This might be related to the levels of public stigma towards ASD in France [1].…”

Section: European Psychiatrycontrasting

confidence: 57%

“…This might be related to the levels of public stigma towards ASD in France [1]. Self-stigma should be more systematically investigated in patients with BPD or ASD [20,21]. Few socio-demographic and illness-related variables significantly predicted the level of self-stigma in our sample.…”

Section: European Psychiatrymentioning

confidence: 81%

“…IS refers to the process wherein a person's previously held social identity (defined by social roles such as son, brother, sister, friend, employee, or potential partner) is progressively replaced by a devalued and stigmatized view of oneself. IS is highly prevalent in Europe (41.7% in SZ, 21.7% in mood disorders [1,2]) and the United States (36.1% out of 144 people with SMI [5]). According to the "illness identity model" [6], IS can have pervasive effects on recovery-related outcomes, including self-esteem, hopefulness, wellbeing, motivation to achieve personal life goals, social interaction, employment, and symptom severity [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Considerably less is known about IS in borderline personality disorder (BPD), anxiety disorders, and ASD. Some studies found that self-stigma was higher in BPD than in SZ (Internalized Stigma of Mental Illness [ISMI] mean total score = 2.43 BPD vs. 2.34 SZ [20]) and lower in anxiety disorders (ISMI total score ranging from 1.98 to 2.24 in Europe [19]) or ASD (ISMI total = 1.93, 15.7% out of 149 participants showing elevated selfstigma [21]). Self-stigma was also associated with increased psychiatric symptoms, reduced hope, and lower treatment adherence in anxiety disorders or BPD [20,22,23].…”

Section: Introductionmentioning

confidence: 99%

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Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

Dubreucq

Plasse²,

Gabayet³

et al. 2020

Eur. Psychiatr.

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Background. Self-stigma is a major issue in serious mental illness (SMI) and is negatively associated with patient outcomes. Most studies have been conducted in schizophrenia (SZ). Less is known about self-stigma in other SMI and autism spectrum disorder (ASD). The objectives of this study are: (i) to assess the frequency of self-stigma in a multicentric nonselected psychiatric rehabilitation SMI and ASD sample; and (ii) to investigate the correlates of elevated self-stigma in different SMI conditions and in ASD. Methods. A total of 738 SMI or ASD outpatients were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluations included sociodemographic data, illness characteristics, and standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, personal recovery, a large cognitive battery, and daily functioning assessment. Results. 31.2% of the total sample had elevated self-stigma. The highest prevalence (43.8%) was found in borderline personality disorder and the lowest (22.2%) in ASD. In the multivariate analysis, elevated self-stigma was best predicted by early stages of personal recovery (moratorium, p = 0.001, OR = 4.0 [1.78–8.98]; awareness, p = 0.011, OR = 2.87 [1.28–6.44]), history of suicide attempt (p = 0.001, OR = 2.27 [1.37–3.76]), insight (p = 0.002, OR = 1.22 [1.08–1.38]), wellbeing (p = 0.037, OR = 0.77 [0.60–0.98]), and satisfaction with interpersonal relationships (p < 0.001, OR = 0.85 [0.78–0.93]). Conclusions. The present study has confirmed the importance of addressing self-stigma in SMI and ASD patients enrolled in psychiatric rehabilitation. The effectiveness of psychiatric rehabilitation on self-stigma and the potential mediating effects of changes in self-stigma on treatment outcomes should be further investigated.

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Section: European Psychiatrycontrasting

confidence: 57%

Section: European Psychiatrymentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

Dubreucq

Plasse²,

Gabayet³

et al. 2020

Eur. Psychiatr.

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“…If unfavorable impressions of autistic people only emerge later in development, this may suggest that TD and autistic individuals are socialized into these negative evaluations. If this is the case, stigma toward autism by TD individuals, 28 and the internalized stigma that occurs for some autistic adults, 29 may reflect the developmental acquisition of implicit and explicit cultural attitudes about autism. To counteract this process, greater societal inclusion and integration of autistic people from a very early age may be helpful.…”

Section: Discussionmentioning

confidence: 99%

Do First Impressions of Autistic Adults Differ Between Autistic and Nonautistic Observers?

DeBrabander

Morrison

Jones

et al. 2019

Autism in Adulthood

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Background: Autistic adults receive unfavorable first impressions from typically developing (TD) adults, but these impressions improve when TD adults are made aware of their diagnosis. It remains unclear, however, how autistic adults form first impressions of other autistic adults, and whether their impressions are similarly affected by diagnostic awareness. Methods: In this study, 32 autistic and 32 TD adults viewed brief videos of 20 TD and 20 autistic adults presented either with or without their diagnostic status and rated them on character traits and their interest in interacting with them in the future. Results: Findings indicated that autistic raters shared the TD tendency to evaluate autistic adults less favorably than TD adults, but these judgments did not reduce their social interest for interacting with autistic adults as they did for TD raters. Furthermore, informing raters of the diagnostic status of autistic adults did not improve first impressions for autistic raters as they did for TD raters, suggesting that autistic raters either already inferred their autism status when no diagnosis was provided or their impression formation is less affected by awareness of a person's diagnosis. Conclusions: Collectively, these results demonstrate that autistic observers make trait inferences about autistic adults comparable with those made by TD observers-suggesting a similar sensitivity to perceiving and interpreting social signifiers that differ between TD and autistic presentation styles-but unlike their TD counterparts, these trait judgments are not perceived as an impediment to subsequent social interaction and are relatively consistent regardless of diagnostic disclosure.

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A systematic review on autistic people's experiences of stigma and coping strategies

Han¹,

Scior²,

Avramides³

et al. 2021

Autism Research

106

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Autism can be understood as a concealable stigmatised identity. This is the first systematic review to synthesise the literature on autistic people's experiences of stigma and coping strategies. 2877 studies were screened and 27 were included in this review. The reviewed literature demonstrates that autistic individuals are acutely aware of being stereotyped, judged, and discriminated by others. Autistic people also show signs of internalising stigma, rendering them more vulnerable to low self-worth and poorer mental health. To manage the impact of stigma, the included studies suggest that autistic individuals may use these strategies: concealment and camouflaging, selective disclosure and self-advocacy, as well as positive reframing and reconstructing identity. However, the evidence is limited and mixed in terms of how helpful and effective these strategies are. Future studies should include autistic populations with a wider range of intellectual abilities and explore interventions that can support autistic people in managing stigma to supplement interventions that seek to reduce stigma towards autistic people. The power of language in perpetuating and challenging stigma also has important implications for research and practice, underscoring the need for researchers and practitioners to reflect carefully on the messages they are communicating about autism. Lay summaryThis review has found that autistic people often experience stigma, which refers to negative attitudes and treatment from others. Because of that, some autistic people also have negative beliefs about themselves, which may affect their self-worth and mental health.While research suggests that autistic people use a range of strategies to manage stigma, the evidence is limited and mixed in terms of how helpful these strategies are.

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Internalised stigma in adults with autism: A German multi-center survey

Cited by 35 publications

References 48 publications

Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

Self-stigma in serious mental illness and autism spectrum disorder: Results from the REHABase national psychiatric rehabilitation cohort

Do First Impressions of Autistic Adults Differ Between Autistic and Nonautistic Observers?

A systematic review on autistic people's experiences of stigma and coping strategies

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