Dissertations / Theses on the topic 'Resistance to stigma'

Theory suggests and research provides evidence that stigma can have a negative impact on the self-concept for individuals with severe and persistent mental illness. Labeling theory and modified labeling theory suggest that individuals who are labeled with a socially undesirable status (e.g. mental illness) may develop negative cognitions, self-perceptions and emotions as a result of the associated stigma. However, some evidence suggests that the harmful effects of stigma on self-concept may not have as strong or an enduring of an impact as labeling theories might predict. In this dissertation, I utilize longitudinal survey data of 221 individuals with mental illness to consider the role of empowerment and defensive responses that individuals use to resist the potentially negative effects of stigma. Specifically, I examine defensive strategies, such as secrecy and social withdrawal, and empowerment-oriented responses to stigma, including community activism and righteous anger, as factors that may moderate the effect of stigma on self-concept. I found limited support of the negative effect that perceived stigma has on self-concept. While I did find some evidence that stigma is negatively associated with both self-esteem and mastery, these associations were only of modest strength. There was no finding suggesting that the stigma response items moderate the relationship between stigma and self-concept, but mediating relationships are present. Further research is needed in order to better understand how stigma resistance strategies influence the varying effects of the stigma of mental illness on self-concept.

People who are voluntarily childless, or ‘‘childfree,’’ face considerable stigma. Researchers have begun to explore how these individuals respond to stigma, usually focusing on interpersonal stigma management strategies. We explored participants’ responses to stigma in a way that is cognisant of broader social norms and gender power relations. Using a feminist discursive psychology framework, we analysed women’s and men’s computer-assisted communication about their childfree status. Our analysis draws attention to ‘‘identity work’’ in the context of stigma. We show how the strategic use of ‘‘choice’’ rhetoric allowed participants to avoid stigmatised identities and was used in two contradictory ways. On the one hand, participants drew on a ‘‘childfree-by-choice script,’’ which enabled them to hold a positive identity of themselves as autonomous, rational, and responsible decision makers. On the other hand, they mobilised a ‘‘disavowal of choice script’’ that allowed a person who is unable to choose childlessness (for various reasons) to hold a blameless identity regarding deviation from the norm of parenthood. We demonstrate how choice rhetoric allowed participants to resist stigma and challenge pronatalism to some extent; we discuss the political potential of these scripts for reproductive freedom.

In many societies there is a stigma surrounding menstruation. It is often perpetuated through representations in advertisements as well as lack of open discussions. This thesis investigates ways that people are presenting menstruation on the social media platform Instagram and concludes that this is a space which allows the normative menstruation discourse to be challenged. Instagram is a widely used app that allows users to interact with others through sharing photos and has the potential to be a space for empowerment and challenging dominant ideologies. Publicly accessible photos were collected from the app using hashtags related to menstruation and menstrual activism, as well as menstrual activist accounts and menstrual product accounts. The results of a qualitative content analysis reveal numerous themes which challenge or reinforce the stigmas: Empowerment, Solidarity, Resistance, Normalizing Periods, Women’s Health, Standard/Normative, Eco-Friendly and Marketing.

The financial crisis was accompanied by widespread media stigmatisation of investment bankers. This research integrates literature on occupational stigma, subject positioning and rhetoric to examine the development of tainted subject positions in media coverage and individual bankers' responses to such positioning. It draws on two influential media sources - opinion columns from The Sun and BBC correspondent Robert Peston's blog - and interviews with nine investment bankers at three time points. The empirical material covers the development of the crisis between April 2008 and October 2009. The analysis identifies two specific sites of contest: the morality of bankers’ pay and responsibility for the financial crisis. The media construct vividly stigmatising subject positions for all bankers which become increasingly physically tainted as the crisis develops. Interviewees resist these, differentiating between themselves and the occupational group. They concede the accuracy of taint regarding pay for some bankers but not for themselves, claiming instead self-positioning as normal, hard workers. The media stigmatisation regarding responsibility appears less compelling and interviewees focus on the contributory roles of other players rather than discussing personal or occupational culpability. In claiming credibility of voice, the media either emphasise similarity and identification with readers (The Sun) or superior knowledge (Peston). Interviewees accuse the media of over-simplification and scaremongering and position themselves as informed insiders and voices of reason. The analysis highlights that stigmatisation is a contest over the validity of what and who are tainted and the authority to make such pronouncements. It reinforces existing findings on the link between taint and dirt in constructing stigma. It also suggests the weakness of occupational identity as a resource for investment bankers. The findings could suggest that while construction of a simple, tainted identity for bankers was effective, using this to establish blame was more complex.

In this thesis I examine the ways in which residents of France's so-called 'banlieues' respond to everyday life in stigmatised neighbourhoods. Through a description of the processes at work in two housing estate neighbourhoods of the southern French city of Nîmes - Pissevin and Valdegour - and drawing upon an analysis of intensive interviews, I question the popular belief that residents of French banlieue-spaces come to internalise the stigmatic representations that are produced outside their place of residence. The overarching argument of the thesis is that, while it is clear that territorial stigmatisation has long-lasting and pervasive consequences for banlieue residents, affecting their sense of self and their capacity for collective action, there are a number of ways in which the 'blemish of place' is challenged and the marks of neighbourhood stigma resisted. It is important to recognise the attempts that are made within French housing estates to displace or negotiate stigmatising gazes and to confront the labels that affix themselves to place. This thesis argues that there are a variety of counter-discursive attempts to reframe and to reclaim the representations of France's housing estates that leads to the affirmation of banlieue-identities. Within the banlieues, there are solid links between residents and place, as well as between the residents themselves. Strong efforts are deployed by associations, neighbourhood committees and grassroots organisations to actively challenge the stigmatic scripts that are imposed upon stigmatised neighbourhoods. However, this thesis also draws attention to the everyday tactics that residents enact in order to cope with territorial stigmatisation and its effects. These everyday practices allow for some to cope with the heavy burden of stigma while taking control of the 'neighbourhood space'. All of these tactics challenge and 'speak back' to the labels, the stereotypes and the stigmatising language that is produced at the level of urban planning. This leads to the vital rethinking of policies that aim to displace and disperse residents in the name of social mixing, as well as urban policy initiatives that equate renovation to the demolition of housing estates within French banlieues.

This research explores areas of contention in the mental heath field in Australia through a qualitative analysis of voices and practices that can broadly be seen as talking with and talking back to psychiatry. The thesis is informed by key shifts in thinking that underpin postpsychiatry and analyses a set of materials through an interpretive lens of reading psychiatry against the grain (Bracken & Thomas, 2005; Lewis, 2006). In particular, it examines a failed ethics application to conduct research with people diagnosed with a mental illness, an anti-stigma campaign, the practices of some prominent mental health organisations in Australia, a conversation with two members of an emerging consumer/survivor network in Australia, and a television documentary and online discussion forum about an antidepressant medication. The research draws from discourse analytic methods and concepts from social movement framing research to identify factors shaping conformity and resistance to psychiatric doxa in the Australian mental health field. The research identifies the discursive repertoires that characterise the mental health field as a "game" in which competing perspectives vie for recognition. In relation to research ethics committees, the thesis argues that deference to clinical expertise is a potential barrier to cultural studies of psychiatry and a more inclusive agenda in mental heath research and practice. Some practices for ethics committees to consider when reviewing research that involves people who may have been diagnosed with a mental illness are proposed. The research also identifies problematic features of anti-stigma campaigns that direct their efforts toward protecting and promoting the discourse of biomedical psychiatry. A critique of this type of campaign is offered in relation to perspectives from postpsychiatry and social constructionism. On the basis of this research, it is argued that organisations that champion "mental health literacy" are limited in their ability to give voice to the goals and priorities of those who are calling for a more open, reflexive and democratic debate in mental health. The central argument of this thesis is that elevating first-person and postpsychiatry perspectives is necessary in order to interrogate and address the dominance of the medical model in psychiatry and its consequences.

With the ascendency of neoliberal ideology, mega-events have been increasingly used by ruling elites as part of a narrative of competitive progress in order to attract investment capital. Unfortunately, the dark side of mega-events has not received enough attention in existing literature, especially the critically important question of displacement and forced eviction because of such events. This thesis contributes to the literature by debunking the myths of mega-events and examining the domicide effects through an in-depth case study of the Shanghai World Expo. Theoretically, the thesis develops the notion of domicide by incorporating the literature on domination and subordination. It attempts to negotiate the tension between the subjective experience of victimhood and the objective process of victimisation in domcide. In analysing the domicide experiences, this thesis proposes to look into both the temporalities and spatialities of domicide, and to examine the variegated ways the displaced appropriate them. It questions how the morally, legally and politically problematic act of domicide is committed without effective forms of resistance. Empirically, this thesis offers a post hoc impact assessment of the ‘best ever’ World Expo and voices the suppressed outcries from those on the receiving end. It supplies a detailed account of the social production of domicide with a case from the Global South, and in doing so; it explores ‘actually existing neoliberalism’ in the Chinese context, expanding the geographical horizon in existing literature and enhancing our understanding of the articulation of neoliberalism in different localities. Although contextualised through the lens of mega-events, the conditions, mechanisms, process and tactics that provide the fertile soil for domicide as identified in this thesis can teach us a great deal about urban spatial practices elsewhere. The thesis draws upon the data collected through site-intensive ethnographic fieldwork, mixing the use of interviews, (non-)participatory observation, survey, unorthodox focus groups and media content. It argues that the exceptionality of the World Expo revokes political, moral and legal boundaries in causing pain to affected citizens in order to facilitate the accumulation of capital. Such exceptionality is constructed through various normative discourses. Those discourses and values naturalise and legitimatise the process of domicide, produce symbolic violence, and undermine the solidarity of the powerlessness. The submission of the displaced to the dominant power enables the production and reproduction of a repressive social and spatial structure. These are vitally important questions given the international focus on China’s economic growth and urbanisation.

碩士
國立臺灣大學
公共衛生碩士學位學程
101
Objective: Research has revealed that many patients with mental illness such as schizophrenia experience elevated internalized stigma (IS), which affects many recovery-related outcomes. Recently, attention moved to stigma resistance (SR), an individual’s capacity to battle against the stigma of mental illness. This study aimed to investigate the extent of internalized stigma (IS) and stigma resistance (SR) in patients with schizophrenia and other mental illness and to examine the relationship among IS, SR, and psychiatric variables in Han Chinese population. Method: A total of 160 outpatients with (n = 103) and without (n = 57) psychotic disorders were recruited and administrated with the Chinese version of the Internalized Stigma of Mental Illness Scale (ISMIS-C), which is one of the few instruments available to measure IS and SR simultaneously, and measures of perceived stigma, self-esteem, self-efficacy, depressive symptoms, and hopelessness. Results: Our factor analysis supported the concept distinction between IS and SR. The results also provided the evidence for the use of IS four subscales. IS and SR subscale scores were significantly associated with each other and with other psychiatric measures. Our data also demonstrated that the scale was ultimately found to be able to differentiate between psychotic and non-psychotic samples with different degrees of IS, but not with SR. Conclusions: Assessment of IS and SR using an appropriate instrument is a crucial aspect in the context of mental health. Our findings provided evidence supporting that the ISMIS-C is a reliable and valid measure for the assessment of IS and SR among individuals with mental illness.

Indiana University-Purdue University Indianapolis (IUPUI)
STUDY 1: Objective: Stigma resistance is consistently linked with key recovery outcomes, yet theoretical work is limited. This study explored stigma resistance from the perspective of individuals with serious mental illness (SMI). Methods: Twenty-four individuals with SMI who were either peer-service-providers (those with lived experience providing services; n = 14) or consumers of mental health services (n = 10) engaged in semi-structured interviews regarding experiences with stigma, self-stigma, and stigma resistance, including key elements of this process and examples of situations in which they resisted stigma. Results: Stigma resistance is an ongoing, active process that involves using one’s experiences, knowledge, and sets of skills at the 1) personal, 2) peer, and 3) public levels. Stigma resistance at the personal level involves a) not believing stigma or catching and challenging stigmatizing thoughts, b) empowering oneself by learning about mental health and recovery, c) maintaining one’s recovery and proving stigma wrong, and d) developing a meaningful identity beyond mental illness. Stigma resistance at the peer level involves using one’s experiences to help others fight stigma and at the public level, resistance involved a) education, b) challenging stigma, c) disclosing one’s lived experience, and d) advocacy work. Discussion: Findings present a more nuanced conceptualization of resisting stigma, grounded in the experiences of people with SMI. Interventions should consider focusing on personal stigma resistance early on and increasing the incorporation of peers into services. STUDY 2: Background: Despite strong links between stigma resistance and recovery outcomes, limitations of existing measures of stigma resistance have contributed to this construct remaining largely under-studied. This study sought to develop and validate an improved measure of mental illness stigma resistance, grounded in the perspectives of people with lived experience. Method: An item pool was developed from qualitative interviews (Study 1) and items were piloted in an online MTurk sample with people self-reporting a mental illness diagnosis (n=489). Best performing items were selected and preliminary factor structure was examined using exploratory factor analysis in a subset of the sample (30%, n=161). The new measure was then administered to individuals at two state mental health consumer recovery conferences (n=202) and confirmatory factor analyses were conducted to assess factor structure and refine the measure. Validity of the new scale was then examined through correlations with theoretically relevant measures. Results: The EFA suggested possible models of either 1, 3, or 5 factors. CFA demonstrated that the 5-factor model best fit the remaining MTurk data (n=328) and this was replicated in the conference sample; these samples were then combined to refine the measure across a heterogeneous sample (n=530). The final 20-item measure demonstrated good internal consistency for the total score (.93) and each of the 5 subscales (.71 - .88), good test-retest reliability (.74), and strong construct validity. Discussion: This study produced an improved measure of stigma resistance with strong psychometric properties and construct validity. Use of this new measure will allow for a more nuanced assessment of stigma resistance across important domains of recovery.

The discovery that it is possible to identify an individual before the onset of first episode psychosis and that treatment may prevent or delay onset have led to a proliferation of early intervention clinics designed to intervene before symptoms of psychosis have fully appeared. Early intervention has generated considerable debate, given the risks associated with intervening and that the majority of those identified will never develop full-blown psychosis. Despite potential stigmatizing effects, little is known about young people’s views regarding the favourable and/or adverse consequences of early intervention. This research examines the experiences and meaning of illness in young people identified as being at ultra high risk for psychosis and participating in a psychological intervention program. Specifically, the study uses photo elicitation to explore how participants construct and interpret their experiences, and the impact an at risk label has on their sense of self, identity, and social relationships. Five young people were invited to photograph their daily experiences at home, at school, and in the community. The participants and I then analyzed the photographs together in a photo elicitation interview. I further analyzed the visual and textual data from an interactionist perspective, exploring the concept of stigma and its relationship to young people’s experiences. Visual and narrative data revealed that young people reject their at risk status and redefine their experiences to fit with more acceptable and familiar notions of health. Participants are conscious of the stigma associated with psychosis and actively undertake strategies of resistance to avoid stigmatization and uphold a normal self conception and social impression. Photo elicitation provided insight and understanding into the experiences of young people at risk for psychosis that were not available through more traditional methods. The results from this study support the call for a reconsideration of the psychosis risk paradigm. There is a need to increase awareness about the power of diagnostic information and the labeling process. Non-specialized settings such as schools and community health centres may offer more appropriate environments for mental health monitoring and intervention.

This thesis examines the labour market experiences of a purposive sample of legally blind people in a medium-sized Canadian city. Relevant literature on disability, employment and stigma is reviewed, providing context for the thesis. Thematic analysis of qualitative data gathered from 18 in-depth face-to-face interviews of legally blind working-age participants provide rich narratives of their experiences in the labour market and society at large. The participants’ current and past employment situations are described and barriers to acceptance of their disability in the workforce are identified. Findings suggest that while perceived, enacted, and felt stigma constitute significant barriers to meaningful employment for the participants, many employ effective strategies to adapt to or resist stigmatizing treatment by others. Policy suggestions are provided to mitigate the impact of stigma on the lives of legally blind Canadians. The thesis concludes with suggestions for future directions of research in the area.
Graduate
0629
0630
0626
martha.jansenberger@gmail.com

碩士
國立臺北護理健康大學
護理研究所
105
Background: Tuberculosis (TB) is a major cause of death worldwide and Swaziland is one of the countries with highest rates of TB. Patients with Drug-resistant are feared by nurses because of the infectiousness nature of the diseases and its resistance to drugs. This fear is thought to lead to poor nurse caring behaviors which patients perceive as stigma. Purpose: To examine (1) the relationship between patients’ perceptions of nurse caring and tuberculosis related stigma (2) the predictors of tuberculosis related stigma among patients with drug-resistant TB in Swaziland. Methods: In this descriptive cross-sectional study, 84 patients with drug-resistant TB completed a demographic data sheet, Lee-Hsieh at el., (2004) Caring behavior measurement and Van Rie at el., (2008) Tuberculosis related stigma scale. Results: The patients reported a poor perception of nurse caring behaviors frequency (x̅ =2.52±.41), and a high level of perceived TB related stigma (x̅ = 30.20±9.31). Only the “gender” and “monthly income” variables had a significant mean difference in nurse caring behaviors (p< .05). There were no demographic factors associated with TB related stigma. There was a significant correlation between the perception of nurse caring behaviors and TB stigma among patients with drug resistant TB (r= -.709, p< 0.01). Hierarchical Multiple Regression revealed that “Sincerity, Empathy & Respect” and “Professional caring behavior” can predict TB related stigma (F= 42.24, p< 0.01), explained variance of 52.8% with “Sincerity, Empathy & Respect” being the strongest (β = -.599). Conclusion: Nurse caring behaviors can predict how patients perceive stigma, thus emphasis on caring behaviors education on nurses is needed to reduce TB stigma among patients with drug-resistant TB. Once patients have a lower perception of stigma, they have a higher possibility of adhering to TB treatment.

Les ‘Panama papers’ (2016) représentent une fuite de 11,2 millions de documents issus de la firme panaméenne Mossack Fonseca. Les révélations exposent des conduites fiscales compromettantes relevant de la finance offshore, soulignant par le fait même l’implication d’acteurs sociaux, parmi lesquels des banques, politiciens, chefs d’entreprises, responsables politiques et économiques, fortunes familiales, etc. D’une envergure internationale, les ‘Panama papers’ ont marqué l’univers médiatique de façon importante, toutefois en référence au jeu d’interprétation entourant les conduites exposées, il est possible de souligner le pluralisme des réactions sociales. S’intéressant particulièrement aux figures politiques et économiques listées, le mémoire se présente sous la forme de trois études de cas : Sigmundur David Gunnlaugsson, premier ministre de l’Islande (de 2013 à 2016), David Cameron, premier ministre du Royaume-Uni (de 2010 à 2016) et Malcom Turnbull, premier ministre de l’Australie (de 2015 à 2018). Le mémoire vise à dégager deux niveaux d’analyse. D’une part, détailler la couverture médiatique respective des cas, cela dans le but de saisir les réactions sociales suscitées, en particulier lors de la production et l’évolution des discours publics. D’autre part, il s’agit d’objectiver et discerner les prises de positions et de défenses à l’utilisation de comptes offshores, ce mémoire s’inscrivant dans le prolongement des études portant sur la résistance au stigmate. Afin de mener à terme la recherche, un corpus incluant treize références de la presse écrite a été constitué, représentant une analyse approfondie du contenu de plus de 671 documents écrits parus entre le 3 avril et le 30 septembre 2016. En s’appuyant sur les prémisses théoriques de la sociologie du scandale, la recherche illustre, dans les cas présents, différentes finalités possibles à l’épisode des ‘Panama papers’ : scandale, affaire ou non-scandale.
The Panama Papers (2016) represent a leak of 11,2 million documents from the Panamanian firm Mossack Fonseca. The revelations exposed compromising tax practices relating to offshore finance, and highlights by the same token, the involvement of the players : banks, politicians, business leaders, political and economic leaders, family fortunes, etc. Of an international scope, the 'Panama papers' have marked the media world in an important way. In reference to the interpretation game surrounding the exposed behaviors, it is possible to emphasize the pluralism of social reactions. Focusing on the listed political and economic figures, the document is presented in the form of three case studies : Sigmundur David Gunnlaugsson, Iceland’ prime minister (2013-2016), David Cameron, UK’ prime minister (2010-2016) and Malcom Turnbull, Australia’ prime minister (2015-2018). The thesis aims to identify two levels of analysis. The first level of analysis details the respective media coverage of the cases. The goal is to collect the social reactions, the production and the evolution of the discourse. The second level of analysis objectifies and discerns positions and defenses used with offshore accounts, whereas the writings of the dissertation are an extension of studies on the resistance of the stigma. In order to complete the research, a corpus including thirteen references of the written press was gathered, representing a thorough analysis of the contents of more than 671 written documents published between April 3 and September 30, 2016. Based on the theoretical premises of the sociology of scandal, the research illustrates, in the present cases, different possible outcomes to the episode of the 'Panama papers' : scandal, affair, or non-scandal.

Migrant workers in the Deciduous Fruit Industry are part of the marginalised communities in South Africa. They are often voiceless in the communities they find themselves. They are historically displaced, often prone to xenophobia and very vulnerable in terms of HIV. Not only do they have a high infection rate but they also struggle in isolation to carry the burden of HIV and AIDS affection or infection. They will face double jeopardy when a partner becomes ill, in the homeland and they have to continue with employment. The main aim of this research was to reach a holistic understanding through interdisciplinary investigation. The important question that I aim to answer is; “What is the experience of God in the lives of persons affected or infected by HIV and AIDS.” I have looked at Postfoundationalism and the Seven Movements as proposed by Muller to present the research undertaken among migrant workers with HIV and AIDS. The Practical Theology, which I explore, develops out of a very specific praxis, HIV and AIDS. I have also made used of Transversal Rationality as a practical way of doing interdisciplinary work with the stories of my co-researchers affected with HIV AIDS as a case study. I understand that Christian belief has its own integrity, which is exclusive, but if valid, is vital to be able to incorporate the different dimensions of our modern practise to give it the maximum level of meaning and significance. I hope to demonstrate this possibility through my thesis.
Thesis (PhD)--University of Pretoria, 2010.
Practical Theology
unrestricted

As a social worker practising in long-term residential care for people living with dementia, I am alarmed by discourses in the media and health policy that construct persons living with dementia and their health care needs as a threatening “rising tide” or crisis. I am particularly concerned about the material effects such dominant discourses, and the values they uphold, might have on the collective provision of care and support for our elderly citizens in the present neoliberal economic and political context of health care. To better understand how dominant discourses about dementia work at this time when Canada’s population is aging and the number of persons living with dementia is anticipated to increase, I have rooted my thesis in poststructural methodology. My research method is a discourse analysis, which draws on Foucault’s archaeological and genealogical concepts, to examine two contemporary health policy documents related to dementia care – one national and one provincial. I also incorporate some poetic representation – or found poetry – to write up my findings. While deconstructing and disrupting taken for granted dominant crisis discourses on dementia in health policy, my research also makes space for alternative constructions to support discursive and health policy possibilities in solidarity with persons living with dementia so that they may thrive.
Graduate
0452
0680
0351
macsuz@shaw.ca