Advertisement

Journal of Child and Family Studies

, Volume 26, Issue 11, pp 2949–2959 | Cite as

Stigma towards Mental Health Problems during Childhood and Adolescence: Theory, Research and Intervention Approaches

  • Caroline Heary
  • Eilis Hennessy
  • Lorraine Swords
  • Patrick Corrigan
Original Paper

Abstract

Many children and teenagers living with mental health problems experience stigma from within their peer group, yet this remains an under-researched topic in developmental science and the broader mental health literature. This paper highlights the limitations of adopting measures, concepts and theories that have exclusively emanated from the adult mental health literature. We argue that the social context of children and adolescents is critical in understanding the development and maintenance of stigma towards those with mental health problems, alongside the changing developmental needs and abilities of children and adolescents. In this article we argue that a theory proposed to explain the development of stereotypes and prejudice in childhood has potential as a framework for integrating existing research findings on mental health stigma in childhood and adolescence and providing direction for further research. The need for interventions that are grounded within the developmental science literature and that explicitly state their theory of change are identified as key research priorities for reducing stigma during childhood and adolescence.

Keywords

Stigma Children Adolescence Mental health disorders Developmental Inter-Group Theory 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

References

  1. Aboud, F. E., Tredoux, C., Tropp, L. R., Brown, C. S., Niens, U., & Noor, N. M. (2012). Interventions to reduce prejudice and enhance inclusion and respect for ethnic differences in early childhood: A systematic review. Developmental Review, 32, 307–336.CrossRefGoogle Scholar
  2. Adlaf, E. M., Hamilton, H. A., Wu, F., & Noh, S. (2009). Adolescent stigma towards drug addiction: Effects of age and drug use behaviour. Addictive Behaviors, 3, 360–364.CrossRefGoogle Scholar
  3. Beelmann, A., & Heinemann, K. S. (2014). Preventing prejudice and improving intergroup attitudes: A meta-analysis of child and adolescent training programs. Journal of Applied Developmental Psychology, 35, 10–24.CrossRefGoogle Scholar
  4. Bellanca, F. F., & Pote, H. (2013). Children’s attitudes towards ADHD, depression and learning disabilities. Journal of Research in Special Educational Needs, 13, 234–241. doi: 10.1111/j.1471-3802.2012.01263.x.CrossRefGoogle Scholar
  5. Bem, S. L. (1981). Gender schema theory: A cognitive account of sex typing. Psychological Review, 88(4), 354–364.CrossRefGoogle Scholar
  6. Bigler, R. S., & Liben, L. S. (2006). A developmental intergroup theory of social stereotypes and prejudice. Advances in Child Development and Behavior, 34, 39–89.CrossRefPubMedGoogle Scholar
  7. Bigler, R. S., & Liben, L. S. (2007). Developmental inter-group theory: Explaining and reducing children’s social stereotyping and prejudice. Current Directions in Psychological Science, 16, 162–166.CrossRefGoogle Scholar
  8. Bulanda, J. J., Bruhn, C., Byro-Johnson, T., & Zentmyer, J. (2014). Addressing mental health stigma among young adolescents: Evaluation of a youth-led approach. Health & Social Work, 39(2), 73–80.CrossRefGoogle Scholar
  9. Chandra, A., & Minkovitz, C. S. (2007). Factors that influence mental health stigma among 8th grade adolescents. Journal of Youth and Adolescents, 36, 763–774.CrossRefGoogle Scholar
  10. Chisholm, K. E., Patterson, P., Torgerson, C., Turner, E., & Birchwood, M. (2012). A randomized controlled feasibility trial for an educational school-based mental health intervention: Study protocol. BMC Psychiatry, 12, doi: 10.1186/1471-244X-12-23.
  11. Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rusch, N., Brown, S. J. L., & Thornicroft, G. (2015). What is the impact of mental health-related stigma on help seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45, 11–27. doi: 10.1017/S0033291714000129.CrossRefPubMedGoogle Scholar
  12. Corrigan, P. W., & Kosyluk, K. A. (2014). Mental illness stigma: Types, constructs and vehicles for change. In P. Corrigan (Ed.), The stigma of disease and disability: Understanding causes and overcoming injustices (pp. 35–56). Washington, DC: American Psychological Association. xi, 319 p.CrossRefGoogle Scholar
  13. Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D. & Rüsch, N. (2012). Challenging the public stigma of mental illness: A meta-analysis of outcome studies. Psychiatric Services. doi: 10.1176/appi.ps.201100529.
  14. Corrigan, P. W., & Rao, D. (2012). On the self-stigma of mental illness: Stages, disclosure, and strategies for change. The Canadian Journal of Psychiatry, 57(8), 464–469.CrossRefPubMedGoogle Scholar
  15. Corrigan, P. W., & Shapiro, J. R. (2010). Measuring the impact of programs that challenge the public stigma of mental illness. Clinical Psychology Review, 30, 907–922.CrossRefPubMedPubMedCentralGoogle Scholar
  16. Corrigan, P. W., Watson, A., & Barr, L. (2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social & Clinical Psychology, 25(9), 875–884.CrossRefGoogle Scholar
  17. Degner, J. & Dalege, J. (2013). The apple does not fall far from the tree, or does it? A meta-analysis of parent–child similarity in intergroup attitudes. Psychological Bulletin, 139, 1270–1304.Google Scholar
  18. Dolphin, L., & Hennessy, E. (2014). Adolescents’ perceptions of peers with depression: An attributional analysis. Psychiatry Research, 218, 295–302.CrossRefPubMedGoogle Scholar
  19. Farrelly, S., Clement, S., Gabbidon, J., Jeffery, D., Dockery, L., & Lassman, F., et al. (2014). Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: A cross sectional study. BMC psychiatry, 14(1), 157.CrossRefPubMedPubMedCentralGoogle Scholar
  20. Faulkner, G., Irving, H., Paglia-Boak, A., & Adlaf, E. (2010). Adolescent knowledge of schizophrenia and social distancing: A province-wide survey. Journal of Community Psychology, 38, 933–942.CrossRefGoogle Scholar
  21. Gelman, S. A. (2003). The essential child: Origins of essentialism in everyday thought. New York, NY: Oxford University Press. New York, NY.CrossRefGoogle Scholar
  22. Gelman., S. A., Heyman, G. D., & Legare, C. H. (2007). Developmental changes in the coherence of essentialist beliefs about psychological characteristics. Child Development, 78, 757–774.CrossRefPubMedGoogle Scholar
  23. Gifford-Smith, M. E., & Brownell, C. A. (2003). Childhood peer relationships: Social acceptance, friendships, and peer networks. Journal of School Psychology, 41, 235–284.CrossRefGoogle Scholar
  24. Giles, J. W., & Heyman, G. D. (2003). Preschooler’s beliefs about the stability of antisocial behaviour: Implications for navigating social challenges. Social Development, 12(2), 182–197.CrossRefGoogle Scholar
  25. Goffman, E. (1963). Stigma: Notes on the management of spoiled identity. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  26. Harnum, M., Duffy, J., & Ferguson, D. A. (2007). Adults’ versus children’s perceptions of a child with autism or attention deficit hyperactivity disorder. Journal of Autism and Developmental Disorders, 37, 1337–1343.CrossRefPubMedGoogle Scholar
  27. Harris, M. J., Milich, R., Corbitt, E. M., Hoover, D. W., & Brady, M. (1992). Self fulfilling effects of stigmatizing information on children’s social interactions. Journal of Personality and Social Psychology, 63, 41–50.CrossRefPubMedGoogle Scholar
  28. Hinshaw, S. P. (2005). The stigmatization of mental illness in children and parents: Developmental issues, family concerns, and research needs. Journal of Child Psychology and Psychiatry, 46, 714–734.CrossRefPubMedGoogle Scholar
  29. Howell, A. J., Ulan, J. A., & Powell, R. A. (2014). Essentialist beliefs, stigmatizing attitudes, and low empathy predict greater endorsement of noun labels applied to people with mental disorders. Personality and Individual Differences, 66, 33–38.CrossRefGoogle Scholar
  30. Hoza, B., Mrug, S., Gerdes, A. C., Bukowski, W. M., Kraemer, H. C., & Wigal, T., et al. (2005). What aspects of peer relationships are impaired in children with attention-deficit/hyperactivity disorder? Journal of Consulting and Clinical Psychology, 73, 411–423.CrossRefPubMedGoogle Scholar
  31. Jones, N., & Corrigan, P. W. (2014). Understanding stigma. In P. W. Corrigan (Ed.), The stigma of disease and disability: Understanding causes and overcoming injustices (pp. 9–34). Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  32. Jorm, A. F., & Wright, A. (2008). Influences on young people’s stigmatizing attitudes towards peers with mental disorders: National survey of young Australians and their parents. British Journal of Psychiatry, 192, 144–149.CrossRefPubMedGoogle Scholar
  33. Juvonen, J. (1991). Deviance, perceived responsibility, and negative peer reactions. Developmental Psychology, 27(4), 672–681.CrossRefGoogle Scholar
  34. Kaushik, K., Kostaki, E., & Kyriakopoulos, M. (2016). The stigma of mental illness in children and adolescents: A systematic review. Psychiatry Research, 243, 469–494.CrossRefPubMedGoogle Scholar
  35. Koller, M., & Stuart, H. (2016). Reducing stigma in high school youth. Acta Psychiatr Scand, 134(Suppl. 446), 63–70.Google Scholar
  36. Kranke, D., Floersch, J., Townsend, L., & Munson, M. (2010). Stigma experience among adolescents taking psychiatric medication. Children and Youth Services Review, 32, 496–505.CrossRefGoogle Scholar
  37. Kroger, J. (2007). Identity development: Adolescence through adulthood. London: Sage.Google Scholar
  38. Ladd, G. W. (1999). Peer relationships and social competence during early and middle childhood. Annual Review of Psychology, 50, 333–359.CrossRefPubMedGoogle Scholar
  39. Law, G. U., Sinclair, S., & Fraser, N. (2007). Children’s attitudes and behavioural intentions towards a peer with ADHD: Does the addition of a diagnostic label make a difference? Journal of Children’s Health Care, 11, 98–111.CrossRefGoogle Scholar
  40. Lawson, A., & Fouts, G. (2004). Mental illness in Disney animated films. The Canadian Journal of Psychiatry / La Revue Canadienne De Psychiatrie, 49, 310–314.CrossRefGoogle Scholar
  41. Liben, L. S., & Signorella, M. L. (1980). Gender-related schemata and constructive memory in children. Child Development, 51, 11–18.CrossRefGoogle Scholar
  42. MacLean, A., Hunt, K., & Sweeting, H. (2013). Symptoms of mental health problems: Children’s and adolescents’ understandings and implications for gender differences in help seeking. Children and Society, 27, 161–173.CrossRefPubMedPubMedCentralGoogle Scholar
  43. Martin, C. L., & Halverson, Jr., C. F. (1981). A schematic processing model of sex typing and stereotyping in children. Child Development, 52, 1119–1134.CrossRefGoogle Scholar
  44. McKeague, L., Hennessy, E., O’Driscoll, C., & Heary, C. (2015). Retrospective accounts of self-stigma experienced by young people with attention deficit hyperactivity disorder (ADHD) ordepression. Psychiatric Rehabilitation, 38, 158–163.CrossRefGoogle Scholar
  45. McNulty, C. P., & Roseboro, D. L. (2009). “I’m not really that bad”: alternative school students, stigma, and identity politics. Equity & Excellence in Education, 42, 412–427.CrossRefGoogle Scholar
  46. Moses, T. (2010). Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders. Social Science & Medicine, 70, 985–993.CrossRefGoogle Scholar
  47. Moses, T. (2014). Determinants of mental illness stigma for adolescents discharged from psychiatric hospitalization. Social Science & Medicine, 109, 26–34.CrossRefGoogle Scholar
  48. Mrug, S., Hoza, B., Pelham, W. E., Gnagy, E. M., & Greiner, A. R. (2007). Behavior and peer status in children with ADHD: Continuity and change. Journal of Attention Disorders, 10, 359–371.CrossRefPubMedGoogle Scholar
  49. Mueller, J., Callanan, M. M., & Greenwood, K. (2014). Parents’ communication to primary school-aged children about mental health and ill-health: A grounded theory study. Journal of Public Mental Health, 13, 13–19.CrossRefGoogle Scholar
  50. Mueller, J., Callanan, M. M., & Greenwood, K. (2016). Communications to children about mental illness and their role in stigma development: An integrative review. Journal of Mental Health, 25, 62–70. doi: 10.3109/09638237.2015.1021899.CrossRefPubMedGoogle Scholar
  51. 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 & Adolescent Psychiatry, 49, 92–103.Google Scholar
  52. Murman, N. M., Buckingham, K. C. E., Fontilea, P., Villanueva, R., Leventhal, B., & Hinshaw, S. P. (2014). Let’s erase the stigma (LETS): A quasi-experimental evaluation of adolescent-led school groups intended to reduce mental illness stigma. Child Youth Care Forum, 43, 621–637.CrossRefGoogle Scholar
  53. O’Driscoll, C., Heary, C., Hennessy, E., & McKeague, L. (2012). Explicit and implicit stigma towards peers with mental health problems in childhood and adolescence. Journal of Child Psychology and Psychiatry, 53, 1054–1062.CrossRefPubMedGoogle Scholar
  54. O’Driscoll, C., Heary, C., Hennessy, E., & McKeague, L. (2015). Adolescents’ explanations for the exclusion of peers with mental health problems: An insight into stigma. Journal of Adolescent Research, 30, 710–728.CrossRefGoogle Scholar
  55. Parker, J., Rubin, K., Price, J., & De Rosier, M. (1995). Peer relationships, child development, and adjustment. In D. Cicchetti & D. Cohen (Eds.), Developmental psychopathology: Vol 2. Risk, disorder, and adaptation (pp. 96–161). New York: Wiley.Google Scholar
  56. Pauker, K., Ambady, N., & Apfelbaum, E. P. (2010). Race salience and essentialist thinking in racial stereotype development. Child Development, 81, 1799–1813. doi: 10.1111/j.1467-8624.2010.01511.x.CrossRefPubMedPubMedCentralGoogle Scholar
  57. Pauker, K., William, A., & Steele, J. R. (2016). Children’s racial categorization in context. Child Development Perspectives, 10, 33–38.CrossRefPubMedGoogle Scholar
  58. Perry, Y., Petrie, K., & Buckley, H., et al. (2014). Effects of a classroom-based educational resource on adolescent mental health literacy: A cluster randomised controlled trial. Journal of Adolescent Health, 37, 1143–1151.CrossRefGoogle Scholar
  59. Phelan, J. C., Link, B. G., & Dovidio, J. F. (2008). Stigma and prejudice: One animal or two? Social Science & Medicine, 67(3), 358–367.CrossRefGoogle Scholar
  60. Pinfold, V., Toulmin, H., Thornicroft, G., Huxley, P., Farmer, P., & Graham, T. (2003). Reducing psychiatric stigma and discrimination: Evaluation of educational interventions in UK secondary schools. British Journal of Psychiatry, 182, 342–346.CrossRefPubMedGoogle Scholar
  61. Pinto-Foltz, M. D., Logsdon, M. C., & Myers, J. A. (2011). Feasibility, acceptability, and initial efficacy of a knowledge-contact program to reduce mental illness stigma and improve mental health literacy in adolescents. Social Science & Medicine, 72, 2011e–2019e.CrossRefGoogle Scholar
  62. Reavley, N., & Jorm, A. (2011). Depression stigma in Australian high school students. Youth Studies Australia, 30, 33–40.Google Scholar
  63. Rubin, K. H., Bukowski, W. M., & Bowker, J. (2015). Children in Peer Groups. In R. M. Lerner, M. H. Bornstein & T. Leventhal(Eds.), Handbook of Child Psychology and Developmental Science (Vol. 4, pp. 175–222). New Jersey: Wiley. Ecological Settings and Processes.Google Scholar
  64. Sakellari, E., Leino‐Kilpi, H., & Kalokerinou‐Anagnostopoulou, A. (2011). Educational interventions in secondary education aiming to affect pupils’ attitudes towards mental illness: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 18, 166–176.CrossRefPubMedGoogle Scholar
  65. Schachter, H. M., Girardi, A., Ly, M., Lacroix, D., Lumb, A. B., van Berkom, J., & Gill, R. (2008). Effects of school-based interventions on mental health stigmatization: A systematic review. Child and Adolescent Psychiatry and Mental Health, 2, 18–31.CrossRefPubMedPubMedCentralGoogle Scholar
  66. Shutts, K., Pemberton Roben, C. K., & Spelke, E. S. (2013). Children’s use of social categories in thinking about people and social relationships. Journalof Cognition and Development, 14, 35–62. doi: 10.1080/15248372.2011.638686.CrossRefGoogle Scholar
  67. Stuart, H., Arboleda-Florez, J., & Sartiorius, N. (2012). Paradigms Lost: Fighting Stigma and the Lessons Learned. Oxford University Press, Oxford.Google Scholar
  68. Swords, L., Heary, C., & Hennessy, E. (2011). Factors associated with acceptance of peers with mental health problems in childhood and adolescence. Journal of Child Psychology and Psychiatry, 52, 933–941.CrossRefPubMedGoogle Scholar
  69. Wahl, O. F. (2002). Children’s views of mental illness: A review of the literature. Psychiatric Rehabilitation Skills, 6, 134–158.CrossRefGoogle Scholar
  70. Wahl, O. F. (2003). Depictions of mental illnesses in children’s media. Journal of Mental Health, 12, 249–258.CrossRefGoogle Scholar
  71. Wahl, O. F., Hanrahan, E., Karl, K., Lasher, E., & Swaye, J. (2007). The depiction of mental illness in children’s television programs. Journal of Community Psychology, 35(1), 121–133.CrossRefGoogle Scholar
  72. 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, 912–920.CrossRefPubMedGoogle Scholar
  73. Wei, Y., Hayden, J. A., Kutcher, S., Zygmunt, A., & McGrath, P. (2013). The effectiveness of school mental health literacy programs to address knowledge, attitudes and help seeking among youth. Early Intervention in Psychiatry, 7(2), 109–121.Google Scholar
  74. Whalen, C. K., Henker, B., Dotemoto, S., & Hinshaw, S. P. (1983). Child and adolescent perceptions of normal and atypical peers. Child Development, 54, 1588–1598.CrossRefPubMedGoogle Scholar
  75. Yap, M. B., & Jorm, A. F. (2011). The influence of stigma on first aid actions taken by young people for mental health problems in a close friend or family member: Findings from an Australian national survey of youth. Journal of Affective Disorders, 134, 473–477.CrossRefPubMedGoogle Scholar
  76. Yap, M. B. H., Reavley, N., MacKinnon, A. J., & Jorm, A. F. (2013). Psychiatric labels and other influences on young people’s stigmatizing attitudes. Findings from an Australian national survey. Journal of Affective Disorders, 148, 299–309.Google Scholar
  77. Younger, A. J., & Boyko, K. A. (1987). Aggression and withdrawal as social schemas underlying children’s peer perceptions. Child Development, 58, 1094–1100.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Caroline Heary
    • 1
  • Eilis Hennessy
    • 2
  • Lorraine Swords
    • 3
  • Patrick Corrigan
    • 4
  1. 1.School of PsychologyNational University of IrelandGalwayIreland
  2. 2.School of PsychologyUniversity College DublinDublin 4Ireland
  3. 3.School of Psychology & Children’s Research CentreTrinity College DublinDublin 2Ireland
  4. 4.Lewis College of Human SciencesIllinois Institute of TechnologyChicagoUSA

Personalised recommendations