Internalized Stigma

MSK pain sufferers who have depression or anxiety had lower SRH than who do not have psychological issues133,134. Further, depression has a negative impact on SRH among individuals with chronic LBP135 and individuals with chronic pain136. Other studies showed non-significant correlation between psychological symptoms and SRH for chronic LBP137,138. In addition, pain intensity and pain chronicity were significantly associated with the deterioration of physical and the mental function overtime139. Moreover, chronicity of pain, depression and anxiety, and pain related to social difficulty were significant predictors of the physical function140.

One determinant for the above feelings is stigma. Stigma is a mark of disgrace or shame that sets the person apart and is a social sanction which dehumanises an individual, by branding them or labelling them based on their illness (Epstein, Olsen, & Grey, 2012) . When they are labelled they are

Barrier studies show that stigma is the fourth highest barrier to seeking help (Clement et al, 2014) proving why it is fundamental to research stigma.

Predictors of fear-avoidance beliefs in patients with acute low back pain: Investigting the effects of pain characteristics and functional disability

Another stigmatizing attitude that was affected by news event and disorder label was anger. The results suggested that a mass shooting incited more anger in participants than a suicide. This result makes sense because of the amount of people killed or injured by the character; participants were angry that the character targeted innocent people. With regard to disorder label, the results indicated that there was no anger differences toward Jake Robinson in any of the disorder label conditions. This result does not make much sense because of previous studies regarding schizophrenia and depression. A previous study demonstrated that people negatively perceived labels of schizophrenia (i.e., “person with schizophrenia” and “schizophrenic);

According to Horgas & Miller (2008), older adults with cognitive or physical limitations, have difficulty expressing details about their pain. These include pain location, duration, onset, type, precipitating factors, and relieving factors of pain. Pain is a subjective experience without valid and reliable objective tests to measure it. The existence and intensity of pain are measured by patient self-report. Unfortunately, older populations with cognitive disability may have difficulty expressing pain via verbal or body language. In some cases, it is astounding to know that pain in older

This type of pain can have severe economic and societal burdens, in addition to the biological, psychological, and social consequences for the individual. It is estimated that individuals with chronic pain miss about five or more days of work per year compared to individuals with no pain (Institute of Medicine, 2011). In addition, the amount of pain related medical care is extremely high. In 2008, pain related medical care alone was found to account for about 14% of all Medicare costs (Institute of Medicine, 2011). In addition, an association between chronic pain and substance abuse, specifically prescription opiate, illicit drug, and alcohol abuse, has also been found (Taft, Schwartz, & Liebschutz, 2010). It is clear that chronic pain has significant costs to the economy. However, these estimates exclude emotional and social costs related to the individuals and their families. Individuals with chronic pain often experience disruptions in ability to work, attend school, and participate in family and leisure activities (Leonard, Cano, & Johansen, 2006). These problems may also lead to an increase in stress which may result in psychological problems such as anxiety and depression, as well as

These representations most often theorize care seeking as a process that is influenced by various factors, both public and traditional, and one that involves the appraising and acting on the appraisal of symptoms (7, 8). Empirical research fortifies these models, and documents that postures and credence about noetic health and treatment have major influence on avail-seeking comportment, even after the astringency of symptoms are controlled for (9). As of recent, these models have now been extended to include perceived public stigma as an important factor that affects ones search for care (10). “Public stigma”, is defined as the extent that the public not only stereotypes, but also discriminates against a stigmatized group negatively, and “perceived public stigma”, is the extent that an individual perceives how the public not only stereotypes, but also discriminates against a stigmatized group (10). We hypothesized that higher perceived public stigma is associated with a lower probability of receiving phrenic health care. Students may eschew seeking care that could potentially result in being labeled as having a noetic health disorder, in order to evade any potential status loss or discrimination from belonging to a stigmatized group. This is not intended to suggest that this study tells the whole story about the overall effects of

Participants in the study had been experiencing chronic pain for a minimum of 15 years. The primary outcome measure in this study was the Brief Pain Inventory Short Form Interference Scale (BPI) (Cleeland, 1991; Wetherell et al., 2011). The BPI was originally designed to measure cancer related pain but has since been validated as a measure of chronic pain and the level of interference it has on an individual’s life experiences (Cleeland, 1991). The treatment protocol in the ACT group was focus on changing expectations from eliminating pain to the possibility of living well with chronic pain (Wetherell et al., 2011). Each ACT session focused on one of the 6 core processes of ACT. Alternatively, the CBT protocol focused on interventions such as relaxation techniques, psychoeducation about the pain cycle, identifying and challenging negative thoughts, and skills training (Wetherell et al.,

Chan, 2000). Recent studies have found that there is another important component of stigma i.e.

Stigma and Barriers to Care is a self-report measure that was adapted from the original 11-item version. The original scale was reported as having Cronbach alphas for the perceived stigma scale at .82 and .70 for the barriers to care scale (Britt et al., 2008). Britt and colleagues added additional items based on literature to create a more robust measure (Britt, Pury, Zinzow, & Raymond, 2013). The self-report measure consists of 16 items exploring topics of stigma (including self-stigma), attitudes toward mental health care, attitudinal, logistical, and perceived barriers. Items are scored on a likert scale with response options of strongly agree, agree, neither agree nor disagree, disagree, and strongly disagree. Sample items read, “I don’t

There are many stigmas, or misconceptions and misperceptions in our society which need to be shattered. I believe that one of the worse possible effects of stigma is that it causes those affected by psychological disorders, or mental illness, to crawl more deeply into themselves because it provokes a sense of shame. Stigma thrusts those suffering with mental illness into a sense of isolation, social exclusion, and discrimination. “Stigma can lead to discrimination … It may be obvious or direct … Or it may be unintentional or subtle…” (Staff). Stigma is often as big as the illness itself and I confess to having been a perpetuator of this dreaded thing, although not consciously aware and without the intent of furthering the harm of someone.

Human Society Within human society there are many pressures, expectations, and stigmas. Men are expected to care for their families by working outside the home, to always stay strong, and to be the dominant figure in their family. While women are expected to obey their male counterparts, care for her family within the home, and follow dress codes. Whether or not these pressures, expectations, or stigmas are big or small they affect people at different levels.

Incidentally, this then leads to the issue of self-stigma of those who have BPD which has to be taken into account. In a study held by Grambal, et al, they looked into the self-stigma BPD compared to other mental health disorders, which included schizophrenia spectrum disorder, major depressive disorder, bipolar affective disorder, and anxiety disorders (2439). Their results yielded that self-stigma levels were significantly different among the other diagnostic groups, with the largest difference being between those with anxiety disorders. It has been found through meta-analysis by Livingston and Boyd; self-stigma has been associated with the lower quality of life, levels of hope, self-esteem, self-efficacy, empowerment, social support and

The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage” (1979). Pain is actually the culprit behind warranting a visit to a physician office for many people (Besson, 1999). Notoriously unpleasant, pain could also pose a threat as both a psychological and economic burden (Phillips, 2006). Sometimes pain does happen without any damage of tissue or any likely diseased state. The reasons for such pain are poorly understood and the term used to describe such type of pain is “psychogenic pain”. Also, the loss of productivity and daily activity due to pain is also significant. Pain engulfs a trillion dollars of GDP for lost work time and disability payments (Melnikova, 2010). Untreated pain not only impacts a person suffering from pain but also impacts their whole family. A person’s quality of life is negatively impacted by pain and it diminishes their ability to concentrate, work, exercise, socialize, perform daily routines, and sleep. All of these negative impacts ultimately lead to much more severe behavioral effects such as depression, aggression, mood alterations, isolation, and loss of self-esteem, which pose a great threat to human society.