There is widespread conviction among health care professionals that coping affects emotion. Yet theory and research have traditionally emphasized the effects of emotion on coping. The present research addresses this imbalance by evaluating the extent to which coping mediated emotions during stressful encounters in two Caucasian, community-residing samples. Subjects' recently experienced stressful encounters, the ways they coped with the demands of those encounters, and the emotions they experienced during two stages of those encounters were assessed repeatedly. The extent to which eight forms of coping mediated each of four sets of emotions was evaluated with a series of hierarchical regression analyses (of residuals). Coping was associated with changes in all four sets of emotions, with some forms of coping associated with increases in positive emotions and other forms associated with increases in negative emotions.

Coping as a mediator of emotion.

Critics of labeling theory vigorously dispute Scheff's (1966) provocative etiological hypothesis and downplay the importance of factors such as stigma and stereotyping. We propose a modified labeling perspective which claims that even if labeling does not directly produce mental disorder, it can lead to negative outcomes. Our approach asserts that socialization leads individuals to develop a set of beliefs about how most people treat mental patients. When individuals enter treatment, these beliefs take on new meaning. The more patients believe that they will be devalued and discriminated against, the more they feel threatened by interacting with others. They may keep their treatment a secret, try to educate others about their situation, or withdraw from social contacts that they perceive as potentially rejecting. Such strategies can lead to negative consequences for social support networks, jobs, and self-esteem. We test this modified labeling perspective using samples of patients and untreated community residents, and find that both believe that "most people" will reject mental patients. Additionally, patients endorse strategies of secrecy, withdrawal, and education to cope with the threat they perceive. Finally, patients' social support networks are affected by the extent to which they fear rejection and by the coping responses they adopt to deal with their stigmatized status.

https://www.jstor.org/stable/pdfplus/2095613.pdf

A modified labeling theory approach to mental disorders : an empirical assessment

This paper hypothesizes that official labeling gives personal relevance to an individual's beliefs about how others respond to mental patients. According to this view, people develop conceptions of what others think of mental patients long before they become patients. These conceptions include the belief that others devalue and discriminate against mental patients. When people enter psychiatric treatment and are labeled, these beliefs become personally applicable and lead to self-devaluation and/or the fear of rejection by others. Such reactions may have negative effects on both psychological and socialfunctioning. This hypothesis was tested by comparing samples of community residents and psychiatric patients from the Washington Heights section of New York city. Five groups were formed (1) first-treatment contact patients, (2) repeat-treatment contact patients, (3) formerly treated community residents, (4) untreated community cases, and (5) community residents with no evidence of severe psychopathology. These groups were administered a scale that measured beliefs that mental patients would be devalued and discriminated against by most people. Scores on this scale were associated with demoralization, income loss, and unemployment in labeled groups but not in unlabeled groups. The results suggest that labeling may produce negative outcomes like those specified by the classic concept of secondary deviance.

Understanding labeling effects in the area of mental disorders : An assessment of the effects of expectations of rejection

Recent research shows that the crucial factor determining the rejection of former mental patients is their behavior rather than their stigmantized status. The study reported here, based on a vignette experiment (with a design that varies patient status with the nature of behavior), challenges this conclusion. Like previous research, it indicates that a simple assessment of labelings shows little effect on a social distance scale. However, when a measure of perceived dangerousness of mental patients is introduced, strong labeling effects emerge. Specifically, the data reveal that the lable of "previous hospitalization" fosters high social distance among those who perceive mental patients to be dangerous and low social distance among those who do not see patients as a threat. It appears that past investigators have missed these effects because they have averaged excessively lenient responses with excessively rejecting ones. This suggests that labels play an important role in how former mental patients are p...

The Social Rejection of Former Mental Patients: Understanding Why Labels Matter'

Advocacy, government, and public-service groups rely on a variety of strategies to diminish the impact of stigma on persons with severe mental illness. These strategies include protest, education, and promoting contact between the general public and persons with these disorders. The authors argue that social psychological research on ethnic minority and other group stereotypes should be considered when implementing these strategies. Such research indicates that (a) attempts to suppress stereotypes through protest can result in a rebound effect; (b) education programs may be limited because many stereotypes are resilient to change; and (c) contact is enhanced by a variety of factors, including equal status, cooperative interaction, and institutional support. Future directions for research and practice to reduce stigma toward persons with severe mental illness are discussed.

Lessons from social psychology on discrediting psychiatric stigma.

This study assesses the impact of mental illness on occupational careers. Thirty-six married men who first entered mental hospitals in the 1950s were followed up in 1972 and eighteen men who were first hospitalized in 1973-74 were interviewed. Their histories reveal the importance of the development of competence in the work role prior to the onset of mental illness. Those who were able to develop competence were likely to retain their jobs through the initial episode of illness and to remain occupationally stable in the ensuing years even in the face of persistent symptomatology. The data are interpreted as evidence that the label, "mental patient," does not constitute a master status and in and of itself does not significantly affect occupational careers.

Madness and Work: Short- and Long-Term Effects of Mental Illness on Occupational Careers

Data are presented on a) the relationship between psychoactive substance use and personal characteristics, b) the relationship between psychoactive substance use and appraisal of and coping with stressful situations, and c) the use of psychoactive substances specifically to cope with stress among older people. Data were provided by 141 65-to-74-year-old retired Caucasians who were assessed repeatedly over 6 months. Compared to national samples, subjects were relatively heavy users of alcohol and average users of psychoactive drugs. Use of alcohol increased with income, and drug use was associated with several psychosocial characteristics as well as with psychological and somatic health. Psychoactive substance use did not relate to the ways subjects appraised and coped with stressful encounters. Further, only a small number of subjects used drugs or alcohol specifically to help them cope in these encounters. The findings about psychoactive drug users are compared with other findings about misusers of drugs...

Psychoactive Drugs, Alcohol, and Stress and Coping Processes in Older Adults

MENTAL1 disorder is manifest in thoLght processes and in behavior. Such behavior may be constricted or extravagant, self-demeaning or flagrantly offensive, but it must deviate from social norms or situational proprieties in order to be labeled as mental disorder. Once behavior is so labeled, responses to it may reflect the label as much as the behavior. But before labeling takes place, whatever set of criteria may be entailed, we do not know whether or not the behaviors in question are to be regarded as manifestations of' mental disorder. Social response to the manifestations of mental disorder rests, then, upon the interpretation of' particuLlar behaviors in varied social contexts, upon the general stereotypes and criteria used as bases for labeling, and upon the beliefs that exist with reference to the categories employed. Thei'e are many facets to social response to mental disorder. One that has received a good deal of attention pertains to the labeling of partictuflar behaviors as instances of' mental disor'der and to the consequences of such labeling. Another' pertains to the treatment accoi'ded to people who have been designated as having a mental disorder-the influence of' such labeling upon their rights and privileges and upon their conceptions of themselves. Still another' hicet of'the pi'oblem relates to the institutional For'ms and the social processes that are elaborated as modes f'or dealing with mental disoi'dei' in ai given society.

Sociocultural and social-psychological factors affecting social responses to mental disorder.

Data are presented on a) the relationship between psychoactive substance use and personal characteristics, b) the relationship between psychoactive substance use and appraisal of and coping with stressful situations, and c) the use of psychoactive substances specifically to cope with stress among older people. Data were provided by 141 65-to-74year-old retired Caucasians who were assessed repeatedly over 6 months. Compared to national samples, subjects were relatively heavy users of alcohol and average users of psychoactive drugs. Use of alcohol increased with income, and drug use was associated with several psychosocial characteristics as well as with psychological and somatic health. Psychoactive substance use did not relate to the ways subjects appraised and coped with stressful encounters. Further, only a small number of subjects used drugs or alcohol specifically to help them cope in these encounters. The findings about psychoactive drug users are compared with other findings about misusers of drugs, and the risks associated with each type of drug use are discussed.

Carol L. Huffine

Papers

Madness and Work: Short- and Long-Term Effects of Mental Illness on Occupational Careers

Psychoactive Drugs, Alcohol, and Stress and Coping Processes in Older Adults

Sociocultural and social-psychological factors affecting social responses to mental disorder.

Psychoactive Drugs, Alcohol, and Stress and Coping Processes in 01 der Ad u I t s