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Themenschwerpunkt: Das Stigma psychischer Krankheit/CME-Beitrag

Reaktionen auf das Stigma psychischer Erkrankung

Sozialpsychologische Modelle und empirische Befunde

Published Online:February 28, 2015https://doi.org/10.1024/1661-4747/a000039

Abstract

In der jüngeren Forschung zu Stigma und Diskriminierung gewinnt die Frage an Bedeutung, wie Angehörige einer stigmatisierten Minderheit ihre eigene Stigmatisierung wahrnehmen und auf sie reagieren. Aus der sozialpsychologischen Literatur zu anderen Gruppen, etwa ethnischen Minderheiten, liegen gut belegte Modelle zu diesem Thema vor, die bisher jedoch noch kaum auf Menschen mit psychischen Erkrankungen angewandt wurden. Dazu zählen (1) ein Stress-Coping-Modell von Stigma, (2) das Modell, wie sich die Wahrnehmung der eigenen diskriminierten Gruppe (ingroup) auf Selbstbild und Stigma-Bewältigung Betroffener auswirkt, sowie (3) die Unterscheidung zwischen ausdrücklichen («expliziten») und automatisch aktivierten («impliziten») Aspekten stigmatisierender Einstellungen. Letztere können etwa durch den Implicit Association Test beurteilt werden. In dieser Übersicht werden einige Studien vorgestellt, die die Bedeutung dieser Modelle für das Stigma psychischer Erkrankung und Stigma-Bewältigung untersuchen, etwa zu Stigma als Stressor und Auswirkungen wie Angst, Scham, Coping-Reaktionen und Sozialverhalten; automatischen Scham-Reaktionen und Selbststigma; biogenetischen Modellen psychischer Erkrankung und Selbstvorwürfen Betroffener; implizitem Selbststigma; und zum Zusammenhang zwischen (Selbst-)Stigma und meritokratischen Weltanschauungen wie der Protestantischen Ethik. Schließlich werden Schlussfolgerungen für Anti-Stigma-Initiativen, Stigma-Messinstrumente und künftige Forschung skizziert.


Reactions to the Stigma of Mental Illness: Social-Psychological Models and Empirical Findings

Recent research on stigma and discrimination has focused on how members of a stigmatized group perceive and react to being discriminated. Well-established models from social-psychological work on other groups, e.g., ethnic minorities, exist, but so far they have not been applied to people with mental illness. They include (1) a stress-coping (or identity threat) model of stigma, (2) a model how the perception of one’s ingroup affects self-concept and coping with stigma among stigmatized individuals, and (3) the distinction between deliberately endorsed («explicit») versus automatically activated («implicit») aspects of stigmatizing attitudes. The latter can be assessed using the (Brief) Implicit Association Test. Here we present a number of studies that examine the relevance of these models for the stigma of mental illness and for coping with this stigma: Stigma as a stressor as well as consequences such as anxiety, shame, coping-reactions and social interactions; automatically activated shame reactions and self-stigma; biogenetic models of mental illness and self-blame of individuals with mental illness; implicit self-stigma; and the link between (self-)stigma and meritocratic worldviews such as the Protestant ethic. Finally we draw conclusions for anti-stigma initiatives, stigma measures and future research.

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