Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care. Stigma yields 2 kinds of harm that may impede treatment participation: It diminishes self-esteem and robs people of social opportunities. Given the existing literature in this area, recommendations are reviewed for ongoing research that will more comprehensively expand understanding of the stigma-care seeking link. Implications for the development of antistigma programs that might promote care seeking and participation are also reviewed.

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How stigma interferes with mental health care.

This 1966 paperback edition of a publication which first appeared in 1963 has by now been widely reviewed as a worthy contribution to the sociological study of deviant behavior. Its current appearance as a paperback is a testimonial both to the quality of the work and to the prominence of deviant behavior in this generation. In general the author places deviance in perspective, identifies types of deviant behavior, considers the role of rule makers and enforcers, and some of the problems in studying deviance. In addition, he develops a sequential model of deviance relying on the concept of career, a concept originally developed in studies of occupations. In his study of a particular kind of deviance, the use of marihuana, the author posits and tests systematically an hypothesis about the genesis of marihuana use for pleasure. The hypothesis traces the sequence of changes in individual attitude

Outsiders Studies in the Sociology of Deviance.

In this study, we build on previous work by developing and estimating a model of the relationships between causal attributions (e.g., controllability, responsibility), familiarity with mental illness, dangerousness, emotional responses (e.g., pity, anger, fear), and helping and rejecting responses. Using survey data containing responses to hypothetical vignettes, we examine these relationships in a sample of 518 community college students. Consistent with attribution theory, causal attributions affect beliefs about persons' responsibility for causing their condition, beliefs which in turn lead to affective reactions, resulting in rejecting responses such as avoidance, coercion, segregation, and withholding help. However, consistent with a danger appraisal hypothesis, the effects of perceptions of dangerousness on helping and rejecting responses are unmediated by responsibility beliefs. Much of the dangerousness effects operate by increasing fear, a particularly strong predictor of support for coercive treatment. The results from this study also suggest that familiarity with mental illness reduces discriminatory responses.

An attribution model of public discrimination towards persons with mental illness

This study examines whether structural properties of friendship networks condition the association between friends' delinquency and an individual's own delinquent behavior. Data from the Add Health allows a more accurate conceptualization of the peer network and a more rigorous measurement of peer delinquency than previous research. Findings from this study indicate that friends' delinquency is associated with an adolescent's own delinquency involvement. However, characteristics of adolescents' friendship networks, such as its density and adolescents' centrality and popularity, condition the delinquency‐peer association. Network density, in particular, emerges as an important component of the delinquency‐peer association, with very cohesive networks containing stronger delinquency‐peer associations than those that are less cohesive. These findings suggest that it is necessary to consider the underlying structural properties of friendship networks in order to understand the impact of peer influence on adol...

https://www.jstor.org/stable/10.1086/320298

Delinquent Peers Revisited: Does Network Structure Matter?1

The course and outcomes of mental illness are hampered by stigma and discrimination. Research on controllability attributions has mapped the relationships between signaling events, mediating stigma, emotional reactions, and discriminating behavior. In this article, I describe how an attribution model advances research questions related to mental health stigma in three areas. (1) Stigma research needs to examine signaling events related to psychiatric stigma including the label of mental illness, behaviors associated with psychiatric symptoms, and physical appearance. (2) Research into mediating knowledge structures needs to bridge information about controllability attributions with public attitudes about dangerousness and self-care. (3) Ways in which these knowledge structures lead to emotional reactions (pity, anger, and fear) as well as behavioral responses (helping and punishing behaviors) need to be examined. The attribution model has significant implications for social change strategies that seek to decrease mental illness stigma and discrimination.

Mental health stigma as social attribution: Implications for research methods and attitude change.

This paper examines how journalists and graphic artists in the national print media used statistical results from annual surveys of student drug use to construct quantified claims about a cocaine epidemic and other drug problems in 1986 and in subsequent years. Editorial and creative decisions entailed in transforming modest yearly changes in time-series data into a dramatic graphic image of “a coke plague” early in 1986 are reconstructed. The changing character of quantified images in the print media during the summer and fall of 1986 provides additional insights into how the rise and decline of a media “feeding frenzy” altered the claims-making activity of media workers. Finally, a recent case of the construction of a “new” drug problem on the eroding foundation of the cocaine epidemic is presented. The paper concludes with a discussion of how competitive conditions in the journalistic arena affect the production and distortion of quantified images of drug problems.

Shocking Numbers and Graphic Accounts: Quantified Images of Drug Problems in the Print Media

Despite its prominence among common sense explanations of alcohol use and drinking problems, the phenomenon of boredom has received remarkably little attention among alcohol researchers. This study...

Contrasting Effects of Two Kinds of Boredom on Alcohol Use

Based on Sutherland's differential association theory and Becker's early research on marijuana use, a contingency model estimating the exact probability of getting high on marijuana under various associational and motivational conditions is specified and tested. Data from surveys at two universities fit this model closely. Predicted first-order interactions and nonlinear effects of motivational balance and peer association are statistically significant and generate highly precise estimates of the probability of getting high. These results suggest that linear main-effects models employed in previous research on differential association processes do not adequately reject the complex casual structure of Sutherland's theory. In addition, this study raises serious questions about claims that differential association theory is untestable and has been made outdated by social learning theory.

Differential association and marijuana use: a closer look at sutherland (with a little help from becker)*

This article demonstrates the potential of small group laboratory research for attacking some of the theoretical and methodological problems currently confronting the societal-reaction perspective in the field of deviance. The results of small group research by Schachter, and Sampson and Brandon are reinterpreted within a conceptual framework derived from the societal-reaction literature. These two studies suggest that inclusive reactions to deviance attempt to control deviation through intense interactional pressure, accompanied by relatively low attitudinal hostility toward the deviant. Exclusive reactions to deviance reject the deviant as an outsider and are characterized by low levels of interaction, but high levels of covert hostility. Inclusive reactions tend to occur when deviance is attributed to a particular situation, whereas deviance attributed to the character of the deviant tends to result in exclusive reactions. While labeling theorists have contributed a number of insights as to the social processes involved in deviance, they have not been much concerned with developing a clear and rigorous formulation of their theoretical position (Gibbs, 1966, 1972; Schur, 1969); or with adequate empirical evaluation of it (Davis, 1972; Gove, 1970; Mankoff, 1971; Ward, 1971). Until we overcome these deficiencies, the ideas of the societal-reaction perspective are not likely to generate a soLind cumulative tradition of theoretically oriented research. This article will argue that small group laboratory research is a potentially valuable tool for sharpening the attack on certain theoretical issues raised by the societal-reaction perspective. Small group research has been used effectively to stLidy a variety of social differentiation processes, such as status structure development and role differentiation (cf. Cartwright and Zander, 1968; Hare et al., 1965). This methodological strategy seems no less applicable to processes of societal reaction, particularly because of the emphasis placed by labeling theorists on the analysis of deviance as an interactional product. The small group laboratory enables more detailed and reliable observation of interactional processes than is achieved by the impressionistic and loosely structured research techniques typically used by those favoring the societal-reaction perspective (Davis,

Societal Reaction and the Response to Deviation in Small Groups

This article examines the relationship between sex-role attitude change and female victims' reports of rape incidents to police in an analysis of time-series data from national attitude surveys of college freshmen and adults, and from annual victimization surveys. Declining support for traditional sex-role attitudes among both college women and men is strongly related to an increase in the proportion of rapes by nonstranger assailants that were reported to police from 1973 to 1985. However, victims' reports of rapes by strangers are more closely related to offenders' use of weapons during sexual assaults. These findings and other evidence against alternative explanations suggest that the cultural bases for “rape myths” have eroded during the 1970s and 1980s, and that broader definitions of rape have contributed to increased reporting of certain forms of sexual assault to police.

James D. Orcutt

Papers

Shocking Numbers and Graphic Accounts: Quantified Images of Drug Problems in the Print Media

Contrasting Effects of Two Kinds of Boredom on Alcohol Use

Differential association and marijuana use: a closer look at sutherland (with a little help from becker)*

Societal Reaction and the Response to Deviation in Small Groups

Sex-Role Attitude Change and Reporting of Rape Victimization, 1973–1985