The silent sorrow in psychiatric stigma: Exploration of stigma experiences in adolescents and adults with personality disorders, family members of persons with psychotic disorders, and psychiatric trainees
5 September 2016
UAntwerpen, Campus Drie Eiken, Gebouw Q, Promotiezaal - Universiteitsplein 1 - 2610 WILRIJK (route: UAntwerpen, Campus Drie Eiken
Organization / co-organization:
Faculty of Medicine and Health Sciences
Prof B. Sabbe & Prof D. Schrijvers
PhD defence Kirsten Catthoor - Faculty of Medicine and Health Sciences
This thesis on psychiatric stigma was an attempt to provide more in-depth insight into the nature of this familiar, but also still largely unknown phenomenon. The first question raised in this respect was whether people with a personality disorder feel comparably stigmatized to those with a psychosis spectrum and/or bipolar disorder. Research on adolescents with a personality disorder (PD) demonstrates that 1) treatment-seeking adolescents with severe mental health problems experience a high burden of stigma; 2) treatment-seeking adolescents with PD experience more stigma than treatment-seeking adolescents with other severe and treatment refractory psychiatric Axis I disorders; 3) Borderline PD is the strongest predictor of experiences of stigma, when controlled for other types of personality pathology; and 4) more severely personality disordered adolescents—as measured by the number of personality disorder traits—tend to experience the highest levels of stigma. Taken together, these findings highlight the importance of stigmatization among adolescents suffering from PDs, with more severely disordered—and more specifically, borderline PD—patients experiencing the highest level of stigma. Surprisingly and in contrast to the findings in the adolescent sample, the main finding from the study on stigmatization in adults with PD is that there are no differences in stigma between treatment-seeking people with PD and others with severe mental health conditions. The following was found in this study: 1) mean total stigma scores were generally low in all patient groups; 2) there was no impact of a diagnosis of PD on the experienced stigma; 3) there was no effect of the number of PDs on experienced stigma; 4) there were no differences found between different types of PDs. Subsequently, the extent of associative stigma on relatives of people with psychosis in Flanders was examined. This study's research shows that associative stigma is rising at an alarming rate in Flanders. The fact that 86% of the interviewed relatives have felt stigmatized at least once is a clear proof of this. Finally, the question of whether associative stigma has a negative impact on a current generation of psychiatric trainees was answered. Far reaching implications for the future of the psychiatric profession, that is slowly but surely becoming less popular and even endangered, are mentioned. Attention for an innovative "psychiatric" medical model with emphasis on the complementarity between biological, social, and psychological factors, quality of life, participation, self-determination and equal partnership might be the key to achieve respectful contact and stigma reduction.