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Stigma and attention-deficit/hyperactivity disorder: negative perceptions and anger emotional reactions mediate the link between active symptoms and social distance

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ADHD Attention Deficit and Hyperactivity Disorders

Abstract

This study aimed to understand the contributions of active ADHD symptoms and the diagnostic label of ADHD in yielding negative attitudes and social distance ratings. Using Amazon’s Mechanical Turk (n = 305), respondents were assigned to read a vignette about: (a) a typically developing child, (b) a child with active ADHD symptoms and (c) a child with active ADHD symptoms + diagnostic label. Participants were then asked to answer questions about their beliefs and feelings about the child in the vignette. The active ADHD symptom condition predicted higher levels of social distance, and this link was mediated by negative and animalistic adjective ratings, and by angry emotions felt by the participants after reading the vignettes. Our findings suggest that ADHD symptoms drive negative views and social distance and that an ADHD label may serve as a protective factor to help people overcome biases related to childhood ADHD. ADHD symptom literacy and contact with children with varying levels of ADHD symptoms may be an important target to help reduce negative attitudes.

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References

  • American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub, Philadelphia

  • Angermeyer MC, Matschinger H (2003) The stigma of mental illness: effects of labelling on public attitudes towards people with mental disorder. Acta Psychiatr Scand 108(4):304–309

    Article  CAS  PubMed  Google Scholar 

  • Bandura A (2002) Selective moral disengagement in the exercise of moral agency. J Moral Educ 31(2):101–119

    Article  Google Scholar 

  • Barkley RA, Fischer M, Smallish L, Fletcher K (2002) The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol 111(2):279

    Article  PubMed  Google Scholar 

  • Bharadwaj P, Pai MM, Suziedelyte A (2017) Mental health stigma. Econ Lett 159:57–60

    Article  Google Scholar 

  • Biederman J, Kwon A, Aleardi M, Chouinard VA, Marino T, Cole H, Mick E, Faraone SV (2005) Absence of gender effects on attention deficit hyperactivity disorder: findings in nonreferred subjects. Am J Psychiatry 162(6):1083–1089

    Article  PubMed  Google Scholar 

  • Bussing R, Mehta AS (2013) Stigmatization and self-perception of youth with attention deficit/hyperactivity disorder. Patient Intell 5:15–27

    Article  Google Scholar 

  • Canu WH, Carlson GL (2003) Differences in heterosocial behavior and outcomes of ADHD-symptomatic subtypes in a college sample. J Atten Disord 6(3):123–133

    Article  CAS  PubMed  Google Scholar 

  • Canu WH, Newman ML, Morrow TL, Pope DL (2008) Social appraisal of adult ADHD: stigma and influences of the beholder’s Big Five personality traits. J Atten Disord 11(6):700–710

    Article  PubMed  Google Scholar 

  • Castano E, Giner-Sorolla R (2006) Not quite human: infrahumanization in response to collective responsibility for intergroup killing. J Pers Soc Psychol 90(5):804

    Article  PubMed  Google Scholar 

  • Charbonnier E, Caparos S, Trémolière B (2018) The role of mothers’ affiliate stigma and child’s symptoms on the distress of mothers with ADHD children. J Ment Health. https://doi.org/10.1080/09638237.2018.1521944

    Article  PubMed  Google Scholar 

  • Corrigan PW, Watson AC (2002) Understanding the impact of stigma on people with mental illness. World Psychiatry 1(1):16

    PubMed  PubMed Central  Google Scholar 

  • Corrigan PW, Kerr A, Knudsen L (2005) The stigma of mental illness: explanatory models and methods for change. Appl Prev Psychol 11(3):179–190

    Article  Google Scholar 

  • Crisp A, Gelder M, Goddard E, Meltzer H (2005) Stigmatization of people with mental illnesses: a follow-up study within the changing minds campaign of the royal college of psychiatrists. World Psychiatry 4(2):106

    PubMed  PubMed Central  Google Scholar 

  • Crocker J (2003) Social stigma and the self: Meanings, situations, and self-esteem. In: Heatherton TF, Kleck RE, Hebl MR, Hull JG (eds) The social psychology of stigma. Guilford Press, New York, pp 153–183

    Google Scholar 

  • Eisenberg D, Schneider H (2007) Perceptions of academic skills of children diagnosed with ADHD. J Atten Disord 10:390–397

    Article  PubMed  Google Scholar 

  • Faraone SV, Biederman J, Mick E (2006) The age-dependent decline of attention deficit hyperactivity disorder: a meta-analysis of follow-up studies. Psychol Med 36(2):159–165

    Article  PubMed  Google Scholar 

  • Fiske ST, Cuddy AJ, Glick P, Xu J (2002) A model of (often mixed) stereotype content: competence and warmth respectively follow from perceived status and competition. J Pers Soc Psychol 82(6):878

    Article  PubMed  Google Scholar 

  • Fiske ST, Cuddy AJ, Glick P (2007) Universal dimensions of social cognition: warmth and competence. Trends Cognit Sci 11(2):77–83

    Article  Google Scholar 

  • Goffman E (1963) Stigma: Notes on the management of spoiled identity. Prentice-Hall, Englewood Cliffs

    Google Scholar 

  • Green DE, McCormick IA, Walkey FH, Taylor AJ (1987) Community attitudes to mental illness in New Zealand twenty-two years on. Soc Sci Med 24:417–422

    Article  CAS  PubMed  Google Scholar 

  • Gureje O, Lasebikan V, Ephraim-Oluwanuga O, Olley B, Kola L (2005) Community study of knowledge of and attitude to mental illness in Nigeria. Br J Psychiatry 186:436–441

    Article  PubMed  Google Scholar 

  • Harpur RA, Thompson M, Daley D, Abikoff H, Sonuga-Barke EJS (2008) The attention-deficit/hyperactivity disorder medication-related attitudes of patients and their parents. J Child Adolesc Psychopharmacol 18:461–473

    Article  PubMed  Google Scholar 

  • Harris LT, Fiske ST (2006) Dehumanizing the lowest of the low: neuroimaging responses to extreme out-groups. Psychol Sci 17:847–853

    Article  PubMed  Google Scholar 

  • Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford, New York

    Google Scholar 

  • Hinshaw SP (2002) Preadolescent girls with attention-deficit hyperactivity disorder: background characteristics, comorbidity, cognitive and social functioning, and parenting practices. J Consult Clin Psychol 70(5):1086–1098

    Article  PubMed  Google Scholar 

  • Hinshaw SP (2007) The mark of shame: stigma of mental illness and an agenda for change. Oxford University Press, New York

    Google Scholar 

  • Hinshaw SP, Cicchetti D (2000) Stigma and mental disorder: conceptions of illness, public attitudes, personal disclosure, and social policy. Dev Psychopathol 12:555–598

    Article  CAS  PubMed  Google Scholar 

  • Hinshaw SP, Owens EB, Sami N, Fargeon S (2006) Prospective follow-up of girls with attention-deficit/hyperactivity disorder into adolescence: evidence for continuing cross- domain impairment. J Consult Clin Psychol 74(3):489–499

    Article  PubMed  Google Scholar 

  • Hinshaw SP, Owens EB, Zalecki C, Huggins SP, Montenegro-Nevado AJ, Schrodek E, Swanson EN (2012) Prospective follow-up of girls with attention deficit/hyperactivity disorder into early adulthood: continuing impairment includes elevated risk for suicide attempts and self-injury. J Consult Clin Psychol 80(6):1041–1051

    Article  PubMed  PubMed Central  Google Scholar 

  • IBM Corp (2016) IBM SPSS statistics for Windows, version 24.0. IBM Corp., Armonk

  • Impett EA, Kogan A, English T, John O, Oveis C, Gordon AM, Keltner D (2012) Suppression sours sacrifice: emotional and relational costs of suppressing emotions in romantic relationships. Pers Soc Psychol Bull 38(6):707–720

    Article  PubMed  Google Scholar 

  • Koro-Ljungberg M, Bussing R (2009) The management of courtesy stigma in the lives of families with teenagers with ADHD. J Fam Issues 30(9):1175–1200

    Article  Google Scholar 

  • Law GU, Sinclair S, Fraser N (2007) Children’s attitudes and behavioral intentions towards a peer with symptoms of ADHD: does the addition of a diagnostic label make a difference? J Child Health Care 11:98–111

    Article  PubMed  Google Scholar 

  • Lebowitz MS (2016) Stigmatization of ADHD a developmental review. J Atten Disord 20(3):199–205

    Article  PubMed  Google Scholar 

  • Martin JK, Pescosolido BA, Olafsdottir S, McLeod JD (2007) The construction of fear: Americans’ preferences for social distance from children and adolescents with mental health problems. J Health Soc Behav 48(1):50–67

    Article  PubMed  Google Scholar 

  • Martinez AG, Piff PK, Mendoza-Denton R, Hinshaw SP (2011) The power of a label: mental illness diagnoses, ascribed humanity, and social rejection. J Soc Clin Psychol 30(1):1–23

    Article  Google Scholar 

  • Masuch TV, Bea M, Alm B, Deibler P, Sobanski E (2018) Internalized stigma, anticipated discrimination and perceived public stigma in adults with ADHD. In: ADHD attention deficit and hyperactivity disorders, pp 1–10

    Article  PubMed  Google Scholar 

  • Mendoza-Denton R (1999) Lay contextualism in stereotyping: situational qualifiers of stereotypes in intuitive theories of dispositions (Doctoral dissertation, ProQuest Information and Learning)

  • Millenet S, Laucht M, Hohm E, Jennen-Steinmetz C, Hohmann S, Schmidt MH, Esser G, Banaschewski T, Brandeis D, Zohsel K (2018) Sex-specific trajectories of ADHD symptoms from adolescence to young adulthood. Eur Child Adolesc Psychiatry 27(8):1067–1075

    Article  PubMed  Google Scholar 

  • Mueller B, Nordt C, Lauber C, Rueesch P, Meyer PC, Roessler W (2006) Social support modifies perceived stigmatization in the first years of mental illness: a longitudinal approach. Soc Sci Med 62(1):39–49

    Article  PubMed  Google Scholar 

  • Mueller AK, Fuermaier ABM, Koerts J, Tucha L (2012) Stigma in attention deficit hyperactivity disorder. Attent Deficit Hyperact Disorders 4(3):101–114

    Article  Google Scholar 

  • O’Driscoll C, Heary C, Hennessy E, McKeague L (2012) Explicit and implicit stigma towards peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry 53(10):1054–1062

    Article  PubMed  Google Scholar 

  • Ohan JL, Visser TA, Moss RG, Allen NB (2013) Parents’ stigmatizing attitudes toward psychiatric labels for ADHD and depression. Psychiatr Serv 64(12):1270–1273

    Article  PubMed  Google Scholar 

  • Okonofua JA, Eberhardt JL (2015) Two strikes: race and the disciplining of young students. Psychol Sci 26(5):617–624

    Article  PubMed  Google Scholar 

  • Phelan JE, Basow SA (2007) College students’ attitudes toward mental illness: an examination of the stigma process. J Appl Soc Psychol 37(12):2877–2902

    Article  Google Scholar 

  • Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40(3):879–891

    Article  PubMed  Google Scholar 

  • Sartorius N (1998) Stigma: what can psychiatrists do about it? Lancet 352(9133):1058–1059

    Article  CAS  PubMed  Google Scholar 

  • Schomerus G, Schwahn C, Holzinger A, Corrigan PW, Grabe HJ, Carta MG, Angermeyer MC (2012) Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatr Scand 125(6):440–452

    Article  CAS  PubMed  Google Scholar 

  • Shrout PE, Bolger N (2002) Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychol Methods 7(4):422–445

    Article  PubMed  Google Scholar 

  • Singh I, Kendall T, Taylor C, Mears A, Hollis C, Batty M, Keenan S (2010) Young people’s experience of ADHD and stimulant medication: a qualitative study for the NICE guideline. Child Adolesc Mental Health 15:186–192

    Article  Google Scholar 

  • Sirey JA, Bruce ML, Alexopoulos GS, Perlick DA, Raue P, Friedman SJ et al (2001) Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. Am J Psychiatry 158:479–481

    Article  CAS  PubMed  Google Scholar 

  • Srivastava S, Tamir M, McGonigal KM, John OP, Gross JJ (2009) The social costs of emotional suppression: a prospective study of the transition to college. J Pers Soc Psychol 96(4):883

    Article  PubMed  PubMed Central  Google Scholar 

  • Stroes AD, Alberts ED, der Meere JJV (2003) Boys with ADHD in social interaction with a nonfamiliar adult: an observational study. J Am Acad Child Adolesc Psychiatry 42(3):295–302

    Article  PubMed  Google Scholar 

  • Thomas R, Sanders S, Doust J, Beller E, Glasziou P (2015) Prevalence of attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Pediatrics 135(4):995–1001

    Article  Google Scholar 

  • Thompson AC, Lefler EK (2016) ADHD stigma among college students. ADHD Attent Deficit Hyperact Disord 8(1):45–52

    Article  Google Scholar 

  • Viki GT, Winchester L, Titshall L, Chisango T, Pina A, Russell R (2006) Beyond secondary emotions: the infrahumanization of outgroups using human–related and animal–related words. Soc Cognit 24(6):753–775

    Article  Google Scholar 

  • Walker JS, Coleman D, Lee J, Squire PN, Friesen BJ (2008) Children’s stigmatization of childhood depression and ADHD: magnitude and demographic variation in a national sample. J Am Acad Child Adolesc Psychiatry 47(8):912–920

    Article  PubMed  Google Scholar 

  • Wark C, Galliher JF (2007) Emory Bogardus and the origins of the social distance scale. Am Sociol 38(4):383–395

    Article  Google Scholar 

  • Weiss MF (1994) Children’s attitudes toward the mentally ill: an eight-year longitudinal follow-up. Psychol Rep 74:51–56

    Article  CAS  PubMed  Google Scholar 

  • Wiener J, Malone M, Varma A, Markel C, Biondic D, Tannock R, Humphries T (2012) Children’s perceptions of their ADHD symptoms: positive illusions, attributions, and stigma. Canad J Sch Psychol 27(3):217–242

    Article  Google Scholar 

  • Williamson D, Johnston C (2015) Gender differences in adults with attention-deficit/hyperactivity disorder: a narrative review. Clin Psychol Rev 40:15–27

    Article  PubMed  Google Scholar 

  • World Psychiatric Association (2001) The WPA global programme to reduce the stigma and discrimination because of schizophrenia—an interim report 2001. World Psychiatric Association, Geneva

    Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, University of California, 2121 Berkeley Way West, Berkeley, CA, 94720-1650, USA

    Jocelyn I. Meza, Maria Monroy & Rodolfo Mendoza-Denton

  2. Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada

    Ruofan Ma

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  1. Jocelyn I. Meza
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  2. Maria Monroy
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  3. Ruofan Ma
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  4. Rodolfo Mendoza-Denton
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Correspondence to Jocelyn I. Meza.

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Meza, J.I., Monroy, M., Ma, R. et al. Stigma and attention-deficit/hyperactivity disorder: negative perceptions and anger emotional reactions mediate the link between active symptoms and social distance. ADHD Atten Def Hyp Disord 11, 373–382 (2019). https://doi.org/10.1007/s12402-019-00302-x

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