Date of Degree

5-2015

Document Type

Dissertation

Degree Name

Ph.D.

Program

Psychology

Advisor

Philip T. Yanos

Subject Categories

Clinical Psychology | Psychology

Keywords

forensic psychiatric patients; mental illness; offenders; race; self-stigma; stigma

Abstract

Stigma involves negative beliefs and devaluations of people in socially identified groups (e.g. race, mental illness). Although people have many reactions to social stigma, some labeled people internalize these attitudes. Research has increasingly explored mental illness self-stigma, when people with mental illness begin to believe that society's negative beliefs are true of them (e.g., that they are hopeless due to mental illness). Self-stigma predicts poorer functional and treatment outcomes. Stigma research has typically investigated stigmatized labels individually. Forensic psychiatric patients, people with mental illness with history of criminal conviction, by definition experience multiple stigmas, yet no research has explored how stigmas due to mental illness, race, and criminal history influence each other. Forensic psychiatric stigma is particularly relevant given increasing social attention on violence, incarceration, mental illness, and race. This dissertation sought to integrate research and theory on these stigmatized identities, to extend previous research on mental illness self-stigma to a forensic psychiatric sample, and to investigate the impact of multiple stigmatized identities on self-esteem, depression, treatment adherence, and therapeutic alliance. Results indicated that mental illness self-stigma, expectations of discrimination due to criminal history, and less positive racial self-concept, all exhibited some predicted relationships with outcome variables. There was also evidence of a combinatory effect of these types of stigma. Conclusions discuss clinical implications and targets for future research.

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