Understanding labeling effects in the area of mental disorders : An assessment of the effects of expectations of rejection

This paper hypothesizes that official labeling gives personal relevance to an individual's beliefs about how others respond to mental patients. According to this view, people develop conceptions of what others think of mental patients long before they become patients. These conceptions include the belief that others devalue and discriminate against mental patients. When people enter psychiatric treatment and are labeled, these beliefs become personally applicable and lead to self-devaluation and/or the fear of rejection by others. Such reactions may have negative effects on both psychological and socialfunctioning. This hypothesis was tested by comparing samples of community residents and psychiatric patients from the Washington Heights section of New York city. Five groups were formed (1) first-treatment contact patients, (2) repeat-treatment contact patients, (3) formerly treated community residents, (4) untreated community cases, and (5) community residents with no evidence of severe psychopathology. These groups were administered a scale that measured beliefs that mental patients would be devalued and discriminated against by most people. Scores on this scale were associated with demoralization, income loss, and unemployment in labeled groups but not in unlabeled groups. The results suggest that labeling may produce negative outcomes like those specified by the classic concept of secondary deviance.

[1]  T. Scheff,et al.  Being Mentally Ill: A Sociological Theory. , 1967 .

[2]  Bruce G. Link,et al.  Stigma Perceived by Patients Attending Modern Treatment Settings: Some Unanticipated Effects of Community Psychiatry Reforms , 1987, Journal of Nervous and Mental Disease.

[3]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[4]  T. Cook,et al.  Quasi-experimentation: Design & analysis issues for field settings , 1979 .

[5]  I. Siassi,et al.  Contemporary attitudes toward mental illness , 1974 .

[6]  J. Clausen,et al.  Stigma and mental disorder: phenomena and terminology. , 1981, Psychiatry.

[7]  E. Goffman.  Stigma; Notes On The Management Of Spoiled Identity , 1964 .

[8]  W. Gove,et al.  The stigma of mental hospitalization. An attempt to evaluate its consequences. , 1973, Archives of general psychiatry.

[9]  S. Simmens,et al.  Responses to viewing symptomatic behaviors and labeling of prior mental illness , 1976 .

[10]  T. Harris,et al.  Social Origins of Depression: A Study of Psychiatric Disorder in Women , 1979 .

[11]  L. Cronbach,et al.  Construct validity in psychological tests. , 1955, Psychological bulletin.

[12]  J. Clausen,et al.  Madness and work: short- and long-term effects of mental illness on occupational careers. , 1979, Social forces; a scientific medium of social study and interpretation.

[13]  Bruce G. Link,et al.  Overview and initial results from a risk-factor study of depression and schizophrenia. , 1987 .

[14]  Harry Stack Sullivan,et al.  Psychiatric Aspects of Morale , 1941, American Journal of Sociology.

[15]  J. G. Allen,et al.  Mental illness and the ipact of believing others know about it. , 1971, Journal of abnormal psychology.

[16]  T. Abel,et al.  Mind, Self, and Society , 1934 .

[17]  J. Myers,et al.  Psychiatric labeling and the rehabilitation of the mental patient. Implications of research findings for mental health policy. , 1974, Archives of general psychiatry.

[18]  L. Robins,et al.  National Institute of Mental Health Diagnostic Interview Schedule. Its history, characteristics, and validity. , 1981, Archives of general psychiatry.

[19]  P E Shrout,et al.  A discriminant rule for screening cases of diverse diagnostic types: preliminary results. , 1986, Journal of consulting and clinical psychology.

[20]  A Farina,et al.  The role of the stigmatized person in affecting social relationships. , 1968, Journal of personality.

[21]  James Frank,et al.  The Social Rejection of Former Mental Patients: Understanding Why Labels Matter , 1987, American Journal of Sociology.

[22]  Mark S. Granovetter.  The Strength of Weak Ties , 1973, American Journal of Sociology.

[23]  J. Frank.  Persuasion and healing , 1961 .

[24]  J. Turner.  "The Mechanics of Social Interaction: Toward a Composite Model of Signaling and Interpreting" , 1986 .

[25]  Bruce G. Link,et al.  Reconsidering the social rejection of ex-mental patients: Levels of attitudinal response , 1983, American journal of community psychology.

[26]  M. Lieberman,et al.  The stress process. , 1981, Journal of health and social behavior.

[27]  B. Link.  Mental patient status, work, and income: an examination of the effects of a psychiatric label. , 1982, American sociological review.