Link B G, Mirotznik J, Cullen F T
Columbia University, New York State Psychiatric Institute.
J Health Soc Behav. 1991 Sep;32(3):302-20.
Recent research has assigned a prominent role to labeling and stigma as factors that impair the social and psychological functioning of people officially labeled mentally ill. But can the effects of labeling and stigma be overcome by adopting a few simple approaches to coping with these problems? If so, the stigma-induced problems of social awkwardness, demoralization and unemployment emphasized by recent research may not be as severe as claimed. Using a sample of psychiatric patients, we examine this issue by assessing whether patients can ameliorate labeling effects by keeping their history of treatment a secret, educating others about their situation, or avoiding situations in which rejection might occur. None of these coping orientations were effective in diminishing negative labeling effects on unemployment or on psychological distress/demoralization. In fact, the three coping strategies show consistent effects in the direction of producing more harm than good, and with respect to withdrawal-avoidance this effect is significant. Based on these results we argue that stigma is powerfully reinforced by culture and that its effects are not easily overcome by the coping actions of individuals. Using C. Wright Mills's (1967) distinction we conclude that labeling and stigma are "social problems" not "individual troubles."
最近的研究已将标签化和污名视为损害被官方认定为患有精神疾病者社会和心理功能的因素。但能否通过采取一些简单方法应对这些问题来克服标签化和污名的影响呢？如果可以，那么近期研究所强调的由污名引发的社交尴尬、士气低落和失业等问题可能并不像所宣称的那么严重。我们以精神科患者为样本，通过评估患者是否能通过隐瞒治疗史、向他人说明自身情况或避免可能遭遇拒绝的场合来减轻标签化影响，从而研究这一问题。这些应对方式均未能有效减少对失业或心理困扰/士气低落的负面标签化影响。事实上，这三种应对策略均呈现出一致的效果，即弊大于利，而就回避退缩而言，这种影响尤为显著。基于这些结果，我们认为文化有力地强化了污名，且个人的应对行为不易克服其影响。运用C. 赖特·米尔斯（1967）的区分方法，我们得出结论，标签化和污名是“社会问题”而非“个人困扰”。
