Abstract
Self-stigma detracts from the wellbeing, self-esteem, and social connectedness of adults with mental health disorders. Although emerging research has indicated that self-stigma may have similar consequences for parents of children with mental health disorders, currently we lack a comprehensive description of how parents experience self-stigma. To address this, we investigated parents’ lived experiences of self-stigma using a descriptive qualitative approach. Directed by interview questions informed by a parent-based participatory action research group (n = 4), we conducted individual semi-structured interviews with 12 parents of children (aged 5–13) diagnosed with emotional and/or behavioural disorders. Data obtained from interviews with 11 mothers was coded and thematically analysed. Five themes were found: (1) the ‘good parent’ ideal, (2) awareness of external stigma, (3) outcomes of external stigma (social avoidance and self-doubt), (4) self-stigma (believing self-doubt and external stigma), and (5) refuting self-stigma. Our findings show that parents of children with mental health disorders experience self-stigma. However, because it leads to a diminished sense of being a good parent, the self-stigma is of a different type to that which has been described for adults with mental illness. This has important implications for the conceptualisation and assessment of parent self-stigma as research in this area moves forward.
Similar content being viewed by others
References
Arcia, E., Fernández, M. C., & Jáquez, M. (2005). Latina mothers’ characterizations of their young children with disruptive behaviors. Journal of Child and Family Studies, 14(1), 111–125. doi:10.1007/s10826-005-1126-8.
Arditti, J. A., Gryzwacz, J. G., & Gallimore, S. W. (2013). A demedicalized view of maternal distress: Conceptualisation and instrument development. Psychological Services, 10(4), 386–394. doi:10.1017/a0029954.
Blum, L. M. (2007). Mother-blame in the Prozac nation: Raising kids with invisible disabilities. Gender and Society, 21(2), 202–226. doi:10.1177/0891243206298178.
Bos, A. R., Pryor, J. B., Reeder, G. D., & Stutterheim, S. E. (2013). Stigma: Advances in theory and research. Basic and Applied Social Psychology, 35(1), 1–9. doi:10.1080/01973533.2012.746147.
Brohan, E., Elgie, R., Sartorius, N., & Thornicroft, G. (2010). Self-stigma, empowerment and perceived discrimination among people with schizophrenia in 14 European countries: The GAMIAN-Europe study. Schizophrenia Research, 122(1–3), 232–238. doi:10.1016/j.schres.2010.02.1065.
Campbell, J. L., Quincy, C., Osserman, J., & Pedersen, O. K. (2013). Coding in-depth semistructured interviews: Problems of unitization and intercoder reliability and agreement. Sociological Methods and Research, 42(3), 294–320. doi:10.1177/0049124113500475.
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. London: Sage.
Chevalier, J. M., & Buckles, D. J. (2013). Participatory action research: Theory and methods for engaged inquiry. UK: Routledge.
Coleman, P. K., & Hilderbrandt-Karraker, K. (2003). Maternal self-efficacy beliefs, competence in parenting, and toddlers’ behaviour and developmental status. Infant Mental Health Journal, 24(2), 126–148. doi:10.1002/imhj.10048.
Corrigan, P. W., & Miller, F. E. (2004). Shame, blame, and contamination: A review of the impact of mental illness stigma on family members. Journal of Mental Health, 13(6), 537–548. doi:10.1080/09638230400017004.
Corrigan, P. W., & Rao, D. (2012). On the self-stigma of mental illness: Stages, disclosure, and strategies for change. Canadian Journal of Psychiatry, 57(8), 464–469. doi:10.1177/070674371205700804.
Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35–53. doi:10.1093/clipsy.9.1.35.
Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social and Clinical Psychology, 25(8), 875–884. doi:10.1521/jscp.2006.25.8.875.
Corrigan, P. W., Larson, J. E., & Rüsch, N. (2009). Self-stigma and the “why try” effect: Impact on life goals and evidence-based practices. World Psychiatry, 8(2), 75–81. doi:10.1002/j.2051-5545.2009.tb00218.x.
Corrigan, P. W., Rafacz, J., & Rüsch, N. (2011). Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Research, 189(3), 339–343. doi:10.1016/j.psychres.2011.05.024.
Corrigan, P. W., Michaels, P. J., Vega, E., Gause, M., Watson, A. C., & Rüsch, N. (2012). Self-stigma of mental illness scale-short form: Reliability and validity. Psychiatric Research, 199(1), 65–69. doi:10.1016/j.psychres.2012.04.009.
Corrigan, P. W., Pickett, S., Kraus, D., Burks, R., & Schmidt, A. (2015). Community-based participatory research examining health care needs of African Americans who are homeless with mental illness. Journal of Health Care for the Poor and Undeserved, 26(1), 119–133. doi:10.1353/hpu.2015.0018.
Corrigan, P. W., Bink, A. B., Schmidt, A., Jones, N., & Rüsch, N. (2016). What is the impact of self-stigma? Loss of self-respect and the “why try” effect. Journal of Mental Health, 25(1), 10–15. doi:10.3109/09638237.2015.1021902.
Crotty, M. (1998). The foundations of social research: Meaning and perspective in the research process. London: Sage Publications.
Ditrano, C. J., & Silverstein-Bordeaux, L. (2006). Listening to parents’ voices: Participatory action research in the schools. Professional Psychology: Research and Practice, 37(4), 359–366. doi:10.1037/0735-7028.37.4.359.
Fernández, M. C., & Arcia, E. (2004). Disruptive behaviours and maternal responsibility: A complex portrait of stigma, self-blame, and other reactions. Hispanic Journal of Behavioural Science, 26(3), 356–372. doi:10.1177/0739986304267208.
Ferriter, M., Huband, N., & Ferriter, N. (2003). Experiences of parents with a son or daughter suffering from schizophrenia. Journal of Psychiatric and Mental Health Nursing, 10(5), 552–560. doi:10.1046/j.1365-2850.2003.00624.x.
Francis, A. (2012). Stigma in an era of medicalisation and anxious parenting: how proximity and culpability shape middle-class parents’ experiences of disgrace. Sociology of Health & Illness, 34(6), 927–942. doi:10.1111/j.1467-9566-2011.01445.x.
Frigerio, A., & Montali, L. (2015). An ethnographic-discursive approach to parental self-help groups: The case of ADHD. Qualitative Health Research, 26(7), 935–950. doi:10.1177/1049732315586553.
Garrison, D. R., Cleveland-Innes, M., Koole, M., & Kappelman, J. (2006). Revisiting methodological issues in transcript analysis: Negotiated coding and reliability. Internet and Higher Education, 9(1), 1–8. doi:10.1016/j.jheduc.2005.11.001.
Giorgi, A. (2009). The descriptive phenomenological method in psychology. Pittsburgh, PA: Duquesne University Press.
Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. New York, NY: Simon and Schuster.
Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18(1), 59–82. doi:10.1605/01.301-0006629869.2009.
Halcomb, E., & Davidson, P. M. (2006). Is verbatim transcription of interview data always necessary? Applied Nursing Research, 19(1), 38–42. doi:10.1016/j.apnr.2005.06.001.
Harden, J. (2005). Parenting a young person with mental health problems: Temporal disruption and reconstruction. Sociology of Health & Illness, 27(3), 351–371. doi:10.1111/j.1467-9566.2005.0046.x.
Hasson-Ohayon, I., Levy, I., Kravetz, S., Vollanski-Narkis, A., & Roe, D. (2011). Insight into mental illness, self-stigma, and the family burden of parents of persons with a severe mental illness. Comprehensive Psychiatry, 52(1), 75–80. doi:10.1016/j.comppsych.2010.04.008.
Hinshaw, S. P. (2004). Parental mental disorder and children’s functioning: Silence and communication, stigma and resilience. Journal of Clinical Child & Adolescent Psychology, 33(2), 400–441. doi:10.1207/s15374424jccp3302_22.
Hinshaw, S. P., Scheffler, R. M., Fulton, B. D., Aase, H., Banaschewski, T., Cheng, W., & Weiss, M. D. (2011). International variation in treatment procedures for ADHD: Social context and recent trends. Psychiatric Services, 62(5), 459–464. doi:10.1176/appi.ps.62.5.459.
Ilic, M., Reinecke, J., Bohner, G., Röttgers, H., Beblo, T., Driessen, M., & Corrigan, P. W. (2011). Protecting self-esteem from stigma: A test of different strategies for coping with the stigma of mental illness. International Journal of Social Psychiatry, 58(3), 246–257. doi:10.1177/0020764010392058.
Kaiser, K. (2009). Protecting respondent confidentiality in qualitative research. Qualitative Health Research, 19(11), 1632–1641. doi:10.1177/1049732309350879.
Koch, T. (2006). Establishing rigour in qualitative research: The decision trail. Journal of Advanced Nursing, 53(1), 91–100. doi:10.1111/j.1365-2648.2006.03681.x.
Koro-Ljungberg, M., & Bussing, R. (2009). The management of courtesy stigma in the lives of families with teenagers with ADHD. Journal of Family Issues, 30(9), 1175–1200. doi:10.1177/0192513X09333707.
Lindseth, A., & Norberg, A. (2004). A phenomenological hermeneutical method for researching lived experience. Scandinavian Journal of Caring Sciences, 18(2), 145–153. doi:10.1111/j.1471-6712.2004.00258.x.
Mak, W. W. S., & Cheung, R. Y. M. (2008). Affiliate stigma among caregivers of people with intellectual disability of mental illness. Journal of Applied Research in Intellectual Disabilities, 21(6), 532–545. doi:10.1111/j.1468-3148.2008.00426.x.
Mak, W. W. S., & Cheung, R. Y. M. (2012). Psychological distress and subjective burden of caregivers of people with mental illness: The role of affiliate stigma and face concern. Community Mental Health Journal, 48(3), 270–274. doi:10.1007/s10597-011-9422-9.
Mak, W. W. S., & Kwok, Y. T. Y. (2010). Internalisation of stigma for parents of children with autism spectrum disorder in Hong Kong. Social Science and Medicine, 70(12), 2045–2051. doi:10.1016/j.socscimed.2010.02.023.
Malterud, K. (2012). Systematic text condensation: A strategy for qualitative analysis. Scandinavian Journal of Public Health, 40(8), 795–805. doi:10.1177/1403494812465030.
Masten, A. S. (2014). Ordinary magic: Resilience in development. New York: Guilford Publications.
McNall, M. A., & Foster-Fishman, P. G. (2007). Methods of rapid evaluation, assessment, and appraisal. American Journal of Evaluation, 28(2), 151–168. doi:10.1177/1098214007300895.
Mehta, S. I., & Farina, A. (1988). Associative stigma: Perceptions of the difficulties of college-aged children of stigmatized fathers. Journal of Social and Clinical Psychology, 7(2), 192–202. doi:10.1521/jscp.1988.7.2-3.192.
Milliken, J. P. (2001). Disenfranchised mothers: Caring for an adult child with schizophrenia. Health Care for Women International, 22(1–2), 149–166. doi:10.1080/073993301300003135.
Milliken, J. P., & Northcott, H. C. (2003). Redefining parental identity: Caregiving and schizophrenia. Qualitative Health Research, 13(1), 100–113. doi:10.1177/1049732302239413.
Mittal, D., Sullivan, G., Chekuri, L., Allee, E., & Corrigan, P. W. (2012). Empirical studies of self-stigma reduction strategies: A critical review of the literature. Psychiatric Services, 63(10), 974–981. doi:10.1176/appi.ps.201100459.
Moses, T. (2010). Exploring parents’ self-blame in relation to adolescent’s mental disorders. Family Relations: An Interdisciplinary Journal of Applied Family Studies, 59(2), 103–120. doi:10.1111/j.1741-3729.2010.00589.x.
Moses, T. (2014). Stigma and family. In P. W. Corrigan (Ed.), The stigma of disease and disability (pp. 247–268). Washington DC: American Psychological Association.
Mukolo, A., Heflinger, C. A., & Wallston, K. A. (2010). The stigma of childhood mental disorders: A conceptual framework. Journal of the American Academy of Child and Adolescent Psychiatry, 49(2), 92–103. doi:10.1016/j.jaac.2009.12.003.
Neuberg, S. L., Smith, D. M., Hoffman, J. C., & Russell, F. J. (1994). When we observe stigmatised and ‘normal’ individuals interacting: Stigma by association. Personality and Social Psychology Bulletin, 20(2), 196–209. doi:10.1177/0146167294292007.
Ohan, J. L., Leung, D. W., & Johnston, C. (2000). The parenting sense of competence scale: Evidence of a stable factor structure and validity. Canadian Journal of Behavioural Science, 32(4), 251–261. doi:10.1037/h0087122.
Ohan, J. L., Visser, T. A. W., Moss, R. G., & Allen, N. B. (2013). Parents’ stigmatising attitudes toward psychiatric labels for ADHD and depression. Psychiatric Services, 64(12), 1270–1273. doi:10.1176/appi.ps.201200578.
Perlick, D. A., Rosenheck, R., Clarkin, J., Sirey, J., Salahi, J., Struening, E., & Link, B. (2001). Stigma as a barrier to recovery: Adverse effects of perceived stigma on social adaption of persons diagnosed with bipolar affective disorder. Psychiatric Services, 52(12), 1627–1632. doi:10.1176/appi.ps.52.12.1627.
Perlick, D. A., Kalvin, C., Huntington, B., Holman, C. S., Nelson, A. H., Mattias, K., & Corrigan, P. W. (2011). In our own voice-family companion: Reducing self-stigma of family members of persons with serious mental illness. Psychiatric Services, 62(12), 1456–1462. doi:10.1176/appi.ps.001222011.
Pescosolido, B. A., Fettes, D. L., Martin, J. K., McLeod, J. D., & Monahan, J. (2007). Perceived dangerousness of children with mental health problems and support for coerced treatment. Psychiatric Services, 58(5), 619–625. doi:10.1176/appi.ps.58.5.619.
Phelan, J. C., Bromet, E. J., & Link, B. G. (1998). Psychiatric illness and family stigma. Schizophrenia Bulletin, 24(1), 115–126. doi:10.1093/oxfordjournals.schbul.a033304.
Polanczyk, G. V., De Lima, M. S., Horta, B. L., Biederman, J., & Rohde, L. A. (2007). The worldwide prevalence of ADHD: A systematic review and metaregression analysis. The American Journal of Psychiatry, 164(6), 942–948. doi:10.1176/appi.ajp.164.6.942.
Polanczyk, G. V., Salum, G. A., Sugaya, L. S., Caye, A., & Rohde, L. A. (2015). Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. Journal of Child Psychology and Psychiatry and Allied Disciplines, 56(3), 345–365. doi:10.1111/jcpp.12381.
Saltzburg, S. (2009). Parents’ experience of feeling socially supported as adolescents come out as lesbian and gay: A phenomenological study. Journal of Family Social Work, 12(4), 340–358. doi:10.1080/10522150903261932.
Shaw, R. (2010). Embedding reflexivity within experiential qualitative psychology. Qualitative Research in Psychology, 7(3), 233–243. doi:10.1080/14780880802699092.
Singh, I. (2004). Doing their jobs: Mothering with Ritalin in a culture of mother-blame. Social Science and Medicine, 59(6), 1193–1205. doi:10.1016/j.socscimed.2004.01.011.
Snell, P., Miguel, N., & East, J. (2009). Changing directions: Participatory action research as a parent involvement strategy. Educational Action Research, 17(2), 239–258. doi:10.1080/09650790902914225.
Tobin, G. A., & Begley, C. M. (2004). Methodological rigour within a qualitative framework. Journal of Advanced Nursing, 48(4), 388–396. doi:10.1111/j.1365-2648.2004.03207.x.
Todd, S., & Jones, S. (2003). ‘Mum’s the word!’: Maternal accounts of dealings with the professional world. Journal of Applied Research in Intellectual Disabilities, 16(3), 229–244. doi:10.1046/j.1468-3148.2003.00163.x.
Walker, J. S., Coleman, D., Lee, J., Squire, P. N., & Friesen, B. J. (2008). Children’s stigmatization of childhood depression and ADHD: Magnitude and demographic variation in a national sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 912–920. doi:10.1097/CHI.0b013e318179961a.
Watson, A. C., Corrigan, P., Larson, J. E., & Sells, M. (2007). Self-stigma in people with mental illness. Schizophrenia Bulletin, 33(6), 1312–1318. doi:10.1093/schbul/sbl076.
Zisman-Ilani, Y., Levy-Frank, I., Hasson-Ohayon, I., Kravetz, S., Mashiach-Eizenberg, M., & Roe, D. (2013). Measuring the internalised stigma of parents of persons with a serious mental illness. The Journal of Nervous and Mental Disease, 201(3), 186–187. doi:10.1097/NMD.0b013e3182845d00.
Acknowledgments
The authors would like to extend their sincerest gratitude to the parents who contributed to this research. The insight into your experiences is valued greatly.
Funding
This research was funded by the University of Western Australia.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Western Australia Human Research Ethics Office.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Eaton, K., Ohan, J.L., Stritzke, W.G.K. et al. Failing to Meet the Good Parent Ideal: Self-Stigma in Parents of Children with Mental Health Disorders. J Child Fam Stud 25, 3109–3123 (2016). https://doi.org/10.1007/s10826-016-0459-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-016-0459-9