Stigma by association and family burden among family members of people with mental illness: the mediating role of coping

Abstract

PurposeWhen someone has a mental illness, family members may share the experience of stigma. Past research has established that family members’ experiences of stigma by association predict psychological distress and lower quality-of-life.MethodsThe present study, conducted with 503 family members of people with mental illness examined the prevalence of 14 different coping strategies. Of greater importance, we examined the role of these coping strategies as mediators of the relationships between stigma by association and family burden, on the one hand, and outcomes, such as psychological distress and quality-of-life, on the other.ResultsThe results showed that both perceived stigma by association and family burden are associated with greater psychological distress and lower quality-of-life, and that most coping strategies mediate these relationships.Conclusions Adaptive coping strategies were related to reduced negative outcomes, while most maladaptive coping strategies were related to enhanced negative outcomes. Implications for intervention development are discussed.

Living with schizophrenia: Health‐related quality of life among primary family caregivers

“…This finding is consistent with results of previous research on relatives caring for people with mental illness (Chou et al, 2009;van der Sanden et al, 2016). In contrast to Western individualism, Confucian-based Asian regions advocate the value of sacrificing individual desires for the optimal interests of the family unit (Park & Chesla, 2007).…”

“…In this context, family caregivers of people with schizophrenia may feel ashamed of being closely associated with the affected individuals and attempt to keep the disease secret (Yin et al, 2014). Existing research has proposed that affiliate stigma negatively influences HRQoL of family caregivers of people with mental illness (Chou, Pu, Lee, Lin, & Kr€ oger, 2009;van der Sanden, Pryor, Stutterheim, Kok, & Bos, 2016). Chou et al (2009) found that affiliate stigma has a stronger impact on HRQoL of family caregivers of adults with mental illnesses than those of adults with intellectual disabilities.…”

Consequences of mental and physical health for reentry and recidivism: Toward a health‐based model of desistance*

“…In fact, there may well be several parallels between conflicts among family members of the formerly incarcerated with mental illness and recently released psychiatric patients (Goldman, ). Goffman's () notion of courtesy stigma—the negative result of associating with a stigmatized person—is particularly relevant here as family members of former prisoners with mental illnesses may be doubly stigmatized because of both their family member's mental condition (Corrigan & Miller, ; van der Sanden et al., ) and status as a former prisoner (Moran, )…”

“…In fact, there may well be several parallels between conflicts among family members of the formerly incarcerated with mental illness and recently released psychiatric patients (Goldman, 1982). Goffman's (1963) notion of courtesy stigma-the negative result of associating with a stigmatized person-is particularly relevant here as family members of former prisoners with mental illnesses may be doubly stigmatized because of both their family member's mental condition (Corrigan & Miller, 2004;van der Sanden et al, 2016) and status as a former prisoner (Moran, 2012). 2 Physical health limitations may also bring about family problems as a result of the increased need for transportation to and from medical or other appointments, reliance for housing needs, and perhaps financial assistance because of a lack of employability.…”

“…We draw on theory and research from several disciplines to propose a health‐based model of desistance , positing that both mental and physical health states have key implications for employment, financial stability, family relationships, and ultimately recidivism. In many processes, health limitations hamper fulfillment of prosocial adult roles, such as when former prisoners’ chronic health issues hinder their ability to secure or maintain employment (Visher, Debus, & Yahner, ) or when the stigma of having a physical disability or mental illness is extended to family members who provide critical instrumental and emotional support (Corrigan & Miller, ; van der Sanden, Pryor, Stutterheim, Kok, & Bos, ). Medical research findings indicate that having a physically or mentally ill family member can engender substantial strain between that person and his or her family (Ferrario, Zotti, Zaccaria, & Donner, ; Magliano, Fiorillo, De Rosa, Malangone, & Maj, ).…”