Home Page Forums General Discussion Stigma and effective anti-stigma campaigns

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  • #211711
    Anonymous
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    This is mostly about mental illness, but is relevant to real and perceived stigma related to P&M, unbelief, sexual orientation, and gender identity in the Church (as well as mental illness, of course):

    http://www.apa.org/monitor/2009/06/stigma.aspx

    Quote:


    Quinn and her colleagues asked college students to take a portion of the GRE Analytic Test, a difficult test of logic and reasoning. At the top of the test were several demographic questions, and, for half of the participants, a question about whether they had any history of mental illness.

    Simply answering “yes” to that question caused some students’ performance to plummet. Of the students who had a history of mental illness, those who had to disclose it before taking the test did about half as well as those who were allowed to keep quiet.

    “It’s really surprising that something as subtle as answering a question can effect people’s performance,” says Quinn.

    The result, she notes, is similar to one that’s found when students are asked to identify their race or gender before a test. Identifying oneself as part of a stigmatized group activates a fear of being stereotyped, and students must devote brainpower to pushing that out of their minds, which results in poorer test performance.

    In addition to test performance, stigma can harm the physical health of people with mental illness, finds a study by Quinn, in press in the Journal of Personality and Social Psychology. In it, she surveyed 235 people who kept some parts of their identities secret to avoid stigma, including people with mental illness, rape victims and people with criminal histories. The more stigmatized their secret identities, the more likely people were to report symptoms of physical illness, Quinn found.

    “Stigma is a day-to-day stressor, she says. “Little things happen every day to make people feel devalued, and that can add up and affect people’s health.”

    The paper on the physical effects of stigma is here:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4511710/

    A relevant lesson from anti-stigma campaigns:

    Quote:


    A lesson of the Scotland campaign, says study co-author Lee Knifton, is that anti-stigma campaigns can’t just focus on eradicating negative depictions of people with mental illness. They need to tell positive stories as well, he says.

    #324708
    Anonymous
    Guest

    I may be misinterpreting here but perhaps another way of explaining the phenomenon is that if talk about things making people “unworthy” the very real danger is that they will internalize the label and begin to believe it.

    #324709
    Anonymous
    Guest

    nibbler wrote:


    I may be misinterpreting here but perhaps another way of explaining the phenomenon is that if talk about things making people “unworthy” the very real danger is that they will internalize the label and begin to believe it.

    I think that’s also likely. To me, the greatest weakness in the study I linked to is that it considers only the person’s perceived devaluation in others’ eyes if his or her secret were made public, and not the effects of the person internalizing the cultural stigma surrounding the secret. I think the effect of internalizing showed up in Study 2, where cultural stigma had a curious direct negative effect on physical health, apparently without being mediated by psychological distress.

    In my case, internalizing doesn’t apply at all. All of my distress arises from expected devaluation.

    Quoting the discussion at the end of the paper:

    Quote:


    In the current research, we proposed, and found support for, a conceptual framework that can be used to examine how both intraindividual factors (i.e., anticipated stigma, centrality [importance to identity], and salience [frequency in thoughts]) and an external factor (i.e., level of cultural stigma) are related to psychological distress and illness symptoms for people who live with a concealable stigmatized identity.

    Study 1 demonstrated that anticipated stigma, centrality, salience, and cultural stigma each independently relate to greater psychological distress among people who live with concealable stigmatized identities. Study 1 also showed that the effect of anticipated stigma on distress occurred through its impact on centrality and salience. Thus, the intraindividual experience of stigma had both direct and indirect effects on psychological well-being.

    In particular, anticipated stigma makes the concealed identity a more important part of overall identity and thoughts. According to their statistical modeling, it’s more likely that the cause works in this direction than the other (i.e. that higher importance causes higher anticipated stigma).

    One thing the authors point out in the body of the paper is the magnitude of the effect of concealing a stigmatized identity on psychological distress:

    Quote:


    The mean on the depression scale was 20.63. A frequency analysis showed that 59% of the sample fell at or over a score of 16, which is used as the clinical cutoff point for depression diagnosis (Radloff, 1977). Surveys of the general population have found mean CES-D scores around 9 (Weissman, Sholomskas, Pottenger, Prusoff, & Locke, 1977), although surveys of young adults have sometimes shown a mean closer to 15 (Radloff, 1991).

    They mention young adults because that’s their study population. Still, adding at least 6 points to a depression scale where 16 is the clinical cutoff is a huge effect.

    I find this interesting from the perspective of personal introspection:

    Quote:


    Although participants’ reported levels of anticipated stigma were relatively low (they did not think it was highly likely that others would discriminate against them if they revealed the identity), they were a strong predictor of psychological distress and directly predicted poorer health functioning.

    In other words, like stereotype threat, it affects you more than your mental model of your peers might suggest.

    One more finding before I go on to how this information might apply to us:

    Quote:


    In addition to developing new measures of anticipated and cultural stigma, we sought to address a theoretical quandary about centrality. We found that centrality is positively related to distress, signifying that the more central the identity is to the self, the more distress is reported. Although people with visible stigmas may reap psychological benefits from identity centrality because they can utilize mechanisms that provide group-based social support and attributional processes (e.g., Crocker & Major, 1989), according to our data identity centrality seems to render people who live with a concealed identity more vulnerable to distress.

    #324710
    Anonymous
    Guest

    Between P&M, mental illness, unbelief, sexual orientation, gender identity, and everything else we might be made to feel ashamed of (e.g. not paying tithing, not doing home teaching, etc., etc., etc.) there are probably very few people in the Church who aren’t hiding something.

    Between worthiness interviews, being expected to pray in SM, and a myriad of other tests of varying publicity, the Church drives that salience variable (frequency of thought) right up into the stratosphere.

    Because of anticipated stigma driving up centrality (importance to identity), social support is key. (Remember, centrality is good with sufficient support, and is otherwise bad.) This might be a big contributing factor in why ARP helps break P&M’s distress-indulgence feedback cycle. In almost all other respects, Church culture and policy isolates and quarantines members, which is toxic and bad. Online forums can be a psychological lifeline. For all their negativity, even ex-Mormon sites save lives. Sites like this are a godsend. Family support can be critical.

    If at all possible, reduce both centrality and salience. The causal direction may be against you, but it doesn’t always have to run that way. This tracks well with advice given here: take a break every once in a while, reduce activity to a comfortable level, attend another church occasionally, expand your social circle to include people from other faiths or no faith at all, and don’t “other” other members of the Church or its leaders.

    Regarding any personal anti-stigma campaigns: tell a story or two about an apostate doing something good. :D

    #324711
    Anonymous
    Guest

    Reuben wrote:


    Regarding any personal anti-stigma campaigns: tell a story or two about an apostate doing something good. :D

    I once tried to update the parable of the good Samaritan. It should be remembered that Samaritans taught a version of Judaism that was considered heretical and apostate. Furthermore, the road from Jericho to Jerusalem does not travel through Samaria. The Samaritan was trespassing. He was a hated and despised heretic traveling on foreign soil.

    I thought of the Tanners. They are career apostates from the LDS church yet they seem to be lovely people in every other capacity.

    #324712
    Anonymous
    Guest

    I thought of the good Samaritan as well. Also the tax collector at the temple, and Jacob’s anti-polygamy sermon that contrasts Nephite polygamy with Lamanite families.

    Jesus is always hanging out with the stigmatized.

    I told my ward SS that my brother has grown in ways I don’t think he could have grown in the Church.

    IIRC, in the Ensign article “When He Stopped Believing,” the author has good things to say about her husband.

    #324713
    Anonymous
    Guest

    Reuben wrote:


    One thing the authors point out in the body of the paper is the magnitude of the effect of concealing a stigmatized identity on psychological distress:

    Quote:


    The mean on the depression scale was 20.63. A frequency analysis showed that 59% of the sample fell at or over a score of 16, which is used as the clinical cutoff point for depression diagnosis (Radloff, 1977). Surveys of the general population have found mean CES-D scores around 9 (Weissman, Sholomskas, Pottenger, Prusoff, & Locke, 1977), although surveys of young adults have sometimes shown a mean closer to 15 (Radloff, 1991).

    They mention young adults because that’s their study population. Still, adding at least 6 points to a depression scale where 16 is the clinical cutoff is a huge effect.

    I wanted to calibrate my intuition on how big this effect is, so I went poking around. Here’s a study on the effects of full-time caregiving for parents with dementia:

    http://www.nejm.org/doi/full/10.1056/NEJMsa035373?viewType=Print&viewClass=Print&#iid=t01

    It suggests that caring full-time for a parent with dementia raises CES-D scores by about 4 points, and that the parent’s subsequent death tends to raise CES-D scores by about 6 points. Some time after death, caregivers’ CED-D scores drop to general population scores.

    The drop-off brings up an important idea: some stressors are continuous, and others are discrete events. The effect of discrete events (with no aftermath) drops over time. Continuous stressors are rightly seen as more significant.

    This paper contains a table of percentages of populations whose members score higher than 16 (the clinical depression cutoff) on the CES-D:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1404896/pdf/amjph00224-0094.pdf

    Comparing those percentages to 59% (the percentage of stigmatized-identity-concealing young adults who scored above 16) can give a rough idea of how distressing concealing a stigmatized identity can be. Here it is with percentages from a few other populations:

    Homeless – inner-city LA – male: 71%

    Psychiatric inpatient: 70%

    Alcoholic: 62%

    Concealing stigmatized identity – young adult: 59%

    Drug addict: 52%

    Death of a spouse – past year: 52%

    Marital separation – past year: 49%

    Unemployed – LA – multi-ethnic: 47%

    General population: 19%

    This suggests that concealing a stigmatized identity is a little less distressing than being homeless, about as distressing as being an alcoholic, and a little more distressing than having lost a spouse in the past year.

    (It might actually be closer to homelessness. The studies on it don’t or can’t distinguish the effects of homelessness from the effects of pre-existing mental illness, which is known to be more prevelant in homeless populations. Further, the CES-D contains questions about reduced appetite and sleep that might be answered affirmatively because of environmental conditions.)

    One thing to be careful of is overgeneralizing these results. Not everyone is affected the same way by stigma, and it’s reasonable to hypothesize that younger adults are affected more than middle-aged and older adults.

    #324714
    Anonymous
    Guest

    I think it would be interesting to drill down a little further, try to see the effects of concealing specific identities. That would be hard to do because which identities one felt necessary to conceal would depend largely on the identities and values of the dominant culture.

    E.g. if you were a Mormon living in Helsinki you might not be as concerned with drinking a cup of coffee at work when compared to a Mormon that wants to drink a cup of coffee at work in Provo, UT. Or another example, the pressures of concealing coffee drinking might or might not produce the same levels of stress as concealing P&M, unbelief, sexual orientation, gender identity, etc. (speaking entirely within the confines where the Mormon culture is the dominant culture).

    #324715
    Anonymous
    Guest

    Last lecture-style post.

    What’s my point, here? First, what’s not? I’m not trying to convince anybody to leave the Church or even to come out of the closet. I also don’t intend to make the Church look bad… though I think the bright light this research shines on the effects of Church culture, discourse and policies does that perfectly well. (I do keep in mind that the Church is changing for the better in many respects.)

    I started looking into this because I wanted to understand why it felt so much better to attend a different church. I expected to feel better, and for the effect to persist somewhat through the week, but I didn’t expect that magnitude of change. Also, I recently found myself unable to explain exactly what was so bad about having to conceal my thoughts among other members. It occurred to me that research on staying in the closet might help explain both of these things. The research was good, so I thought I’d share.

    Here’s my less research-y take on it: the negative effects of staying closeted come down to dread. I’ve heard “dread” defined as “the fear of possibilities.” All of the possible monsters that might be under the bed are in sum scarier than the one monster that actually is. Even if you have a well-calibrated idea of how people will react negatively to your new beliefs, all the possible ways they might react badly are worse in total.

    In almost all respects, the research I’ve found supports the accumulated wisdom on this site.

    I would add a couple of things.

    First, I think we should be more sensitive to how staying closeted can compound mental illness. It can make an otherwise well-adjusted person clinically depressed, send someone in depression or anxiety remission into a fresh downward spiral, or make someone who is deeply depressed suicidal. One good question to ask when deciding whether to come out to a family member or priesthood leader might be “How was my mental health just before my faith crisis?”

    Second, when folks are considering coming out, we ask why. That’s a good question that we should keep asking. We should also keep encouraging them to weigh the pros and cons. But I think we should give more weight to the significant continued distress that comes from dreading others’ devaluation, which everyone tends to underestimate.

    #324716
    Anonymous
    Guest

    nibbler wrote:


    I think it would be interesting to drill down a little further, try to see the effects of concealing specific identities. That would be hard to do because which identities one felt necessary to conceal would depend largely on the identities and values of the dominant culture.

    I agree. And if you wanted the results to generalize, you’d have to classify the identities into general categories, and then justify the classes and classifications. That sounds much harder than studying any specific identity. Does it make sense to distinguish identities that make others fear for their exaltation from identities that make them fear for their safety, or is it all the same?

    One fascinating thing that complicates everything is the fact that stigmas are socially constructed, but the expectation of being stigmatized is deeply personal. What one person feels necessary to conceal, another person might not. How one person reacts to expected devaluation can be very different from how another person does. What personality traits mediate these differences? How do these traits interact?

    #324717
    Anonymous
    Guest

    Good Thoughts – thank you!

    In my case, I want to tell my husband, but I don’t know what to say.

    “Honey I don’t believe the way I used to” just doesn’t work for me. “What’s changed?” he would ask. And I would tell him “I don’t know yet.” Because I don’t know yet where I stand on a lot of stuff, or what (if anything) I am going to do about it.

    We talk about some of the items that came off the shelf in generalities – he shares the same opinion I have on polygamy, but doesn’t realize that means not every word out of a prophet’s mouth is prophesy. I think he believes in the BoM more literally than I do, but he has no problem with it being viewed more non-literally as well.

    And even if I was able to have a solid series of conversations about where I stand – what would that do for my Pathways education? While my membership has been in good standing (recently renewed my temple recommend), and I have a history of good membership (mostly attending church, served a mission) – I don’t need to play leadership roulette right now.

    I thought long and hard about whether my “unbelief” would disqualify me from the Pathways program – and so far I believe I still qualify.

    LESSONS FROM THE SITE:

    1. Go slow – nothing needs to be rushed, and rushing things usually leads to disaster.

    2. Leadership roulette is real – and even if you are likely to have good leaders (very hands-off supportive branch president, inspiring stake leadership who stick to the TR interview questions), they are likely to take your unorthodox views more seriously and in random unintended ways.

    3. Re-building your faith house is a growth process – and you can’t “miracle-grow” it.

    4. There are ways you can be authentic in your unorthodox views and still be in the fold. Mostly be ultra-respectful and speak their language.

    #324718
    Anonymous
    Guest

    One thing I’d like follow-up research on is the effect of coming out to family or friends. For me, coming out to my kids was significant, and about the same as my de facto coming out by attending a different church.

    AmyJ, do you have real-life friends you could talk to about it? That might relieve some of the dread.

    Also, I wonder whether a little anti-stigma campaigning at home could help.

    I personally wouldn’t risk my education if I didn’t have alternatives, but that’s just how I weigh my own pros and cons.

    #324719
    Anonymous
    Guest

    Reuben,

    This group is it :wave:

    Since I am undecided about a lot of things, and rocking the boat for potentially nothing is not something I am interested in, I figure it is easier to just follow the guidelines of “StayLDS”. On some levels, church culture things are nothing new. Because I am already unorthodox in how I live life in general (probably due to being an Aspie), and am used to hiding part of who I am to appear to fit in – this is nothing new, and is easier at church on some levels.

    My husband and I talk about more religious things now, and we are easing into the idea that we can have and respect differing views. This is nothing new really – I have always been unorthodox in everything, and that is one of the reasons he loves me. I recognize that when we talk about the majority of my sore points, he feels the same way I do. I also know that to bring it up as unorthodox potentially heretical and point out he agrees with me would be potentially inducing a faith transition on his side, and I am not interested in doing that. He is truly changing and becoming a better person now that he wants to become a better disciple of Christ as well. We have apparently orthodox friends in the branch – which is a balm for his social-anxiety ridden soul. Since it has taken us the better part of 8 years to be in a place church-wise where he made friends and wanted to theoretically socialize on any level – this is huge. I don’t have the resources to make serious non-LDS friends or church hop right now.

    So far, the takeaway I have about my Faith Transition is I want to focus on being a better Christian – and I have plenty of work to do in this area. I am also focused on thinking about and living the 2 great commandments – Love God and love your neighbor. Those are the planks of my new faith house so far.

    For my 7.75 year old, she has had the same Primary teacher who loves her for the last 2 years – and I am hopeful that we will be able to keep her or transition successfully. Consistency is HUGE for her. My daughter doesn’t tune onto the nuances of culture anyways (everything has to be blatantly obvious and direct for her to get it). She is good at making friends with adults, but not so much kids. I don’t see how going to another church would help her in this area – and take away what stability she has.

    My 14 month old baby girl will be just fine in the nursery in a few months. Until then, we can manage by running around in the halls or going to the nursery early – we have a very small nursery.

    #324720
    Anonymous
    Guest

    AmyJ wrote:


    3. Re-building your faith house is a growth process – and you can’t “miracle-grow” it.


    This is something I have come to realize myself. In my recent talk about the three pigs (see the thread on talks and lessons), I was comparing testimonies and what they’re built from to the houses. A FC is when your house gets blown down by the big bad wolf… But it also gives you the opportunity to build your house out of better materials.

    That same week, the high council speaker was making some gospel analogy with roofing and having to rip out shingles if they don’t line up correctly. I don’t remember what he compared it to exactly, but I remember I wasn’t totally on board with it. However, as I’ve thought about it more personally, I’ve come to realize that my recent faith deconstruction is just that- though leaving the first layer intact (my foundations on Christ and God’s mercy). I was realizing that the shingles of my faith weren’t lining up and I had to rip them out. And it all started with these issues regarding stigmas… or close enough at least.

    AmyJ wrote:


    4. There are ways you can be authentic in your unorthodox views and still be in the fold. Mostly be ultra-respectful and speak their language.


    I’m still figuring this out, though I definitely have been “probing” my ideas to see what others think of them.

    In the lesson I gave last Sunday, (it was on eternal families) I at one point asked how we can show love for family members who have left the church. There was good discussion on it, though mostly the same people who were participating for the rest of the lesson. One girl shared her experience with one of her brothers converting to Islam though. That was pretty cool.

    #324721
    Anonymous
    Guest

    I’m always a fan of some good psych research. Thanks for sharing, Reuben. Not too long ago, I saw a similar study with regards to having the students answer basic questions on demographics (gender, race, parent’s eduation) before taking a math test.

    I do think it’s very dangerous territory to frame this in terms of “stigma”. Stigmas are very dependant on one’s perspective, and most are VERY deep rooted. And while there are some qualities in each of us we should learn to accept, others are in deep need of change. For example, in the US there are extreme stigmas against:

    -White Supremacists

    -Furries

    -Ex-convicts

    The prejudice against white supremacy is well founded. People should be accepting of all races, and each should be treated with equal respect. But you’re not going to change a white supremacists mind by belittling them. Furries have a fetish that I find a bit weird, but I personally need to be more accepting, and take a stand against the bullying of my “furry friends”. Ex-convicts are those who are trying to change, and yet too often the stigma prevents them from making those changes. Shame on us.

    There are also a few traits which we should want to change, but shouldn’t get us down if we can’t in the short term. Addictions including P&M, smoking, fried foods, sugar, and alcoholism are among them. Your life will honestly be better in all areas if you can stay away from them. But the levels of addiction, and their root in the mind have all sorts of factors, from genetics, to duration, to personal circumastance. In my home ward, one of our youth leaders was a smoker. He tried everything within his power to quit; he gave up coffee and drinking with little effort, but he could not kick the smoking habit. And I know he wants to more than anything. On the other hand, I’ve known plenty of people who quit smoking cold turkey on a dime. Same problem, different situations, different perspectives, different people, different results.

    I can honestly say you’ll be better off giving up certain life behaviors. I am more than willing to do anything I can to help. But if you can’t kick the habit, I can’t judge you. And for the most part, I won’t hold it against you (though please smoke outside).

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