Self-stigma and the Social Interactions of Mental Health Patients

We examine whether self-stigmatization may affect the everyday social interactions of individuals with a diagnosed, affective mental health disorder. Past research demonstrates self-stigmatization lowers self-esteem, efficacy, and personal agency, leading to the likely adoption of role-identities that are at the periphery of major social institutions. We advance research on self-stigma by examining the likely interactional and emotional consequences of enacting either a highly stigmatized self-identity or a weakly stigmatized self-identity.

Using affect control theory (ACT), we form predictions related to the interactional and emotional consequences of self-stigmatization. We use the Indianapolis Mental Health Study and Interact, a computerized instantiation of ACT, to generate empirically based simulation results for patients with an affective disorder (e.g., major depression and bipolar disorder), comparing simulations where the focal actor is a person with a mental illness who exhibits either high or low levels of self-stigma.

Self-stigma is predicted to negatively influence patients’ behavioral expression, leading the highly self-stigmatized to enact behaviors that are lower in goodness, power, and liveliness than the weakly self-stigmatized. Their corresponding emotional expressions during these types of interactions are similarly negatively impacted. Even though these likely interactions are the most confirmatory for people with high levels of self-stigma, they lead to interactions that are behaviorally and emotionally more negative than those who have been better able to resist internalizing stigmatizing beliefs.

This piece has implications for the literature on the interactional and life course challenges faced by psychiatric patients and contributes to the self-stigma literature more broadly. This work will hopefully inform future research involving the collection of non-simulation-based data on the everyday interactional experiences of people with mental health problems.