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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

  • Jocelyn I. MezaEmail author
  • Maria Monroy
  • Ruofan Ma
  • Rodolfo Mendoza-Denton
Original Article
  • 39 Downloads

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.

Keywords

ADHD Stigma Social distance 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study. Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.

References

  1. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub, PhiladelphiaGoogle Scholar
  2. 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):304–309Google Scholar
  3. Bandura A (2002) Selective moral disengagement in the exercise of moral agency. J Moral Educ 31(2):101–119Google Scholar
  4. 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):279Google Scholar
  5. Bharadwaj P, Pai MM, Suziedelyte A (2017) Mental health stigma. Econ Lett 159:57–60Google Scholar
  6. 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):1083–1089Google Scholar
  7. Bussing R, Mehta AS (2013) Stigmatization and self-perception of youth with attention deficit/hyperactivity disorder. Patient Intell 5:15–27Google Scholar
  8. Canu WH, Carlson GL (2003) Differences in heterosocial behavior and outcomes of ADHD-symptomatic subtypes in a college sample. J Atten Disord 6(3):123–133Google Scholar
  9. 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):700–710Google Scholar
  10. Castano E, Giner-Sorolla R (2006) Not quite human: infrahumanization in response to collective responsibility for intergroup killing. J Pers Soc Psychol 90(5):804Google Scholar
  11. 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 Google Scholar
  12. Corrigan PW, Watson AC (2002) Understanding the impact of stigma on people with mental illness. World Psychiatry 1(1):16Google Scholar
  13. Corrigan PW, Kerr A, Knudsen L (2005) The stigma of mental illness: explanatory models and methods for change. Appl Prev Psychol 11(3):179–190Google Scholar
  14. 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):106Google Scholar
  15. 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 153–183Google Scholar
  16. Eisenberg D, Schneider H (2007) Perceptions of academic skills of children diagnosed with ADHD. J Atten Disord 10:390–397Google Scholar
  17. 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):159–165Google Scholar
  18. 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):878Google Scholar
  19. Fiske ST, Cuddy AJ, Glick P (2007) Universal dimensions of social cognition: warmth and competence. Trends Cognit Sci 11(2):77–83Google Scholar
  20. Goffman E (1963) Stigma: Notes on the management of spoiled identity. Prentice-Hall, Englewood CliffsGoogle Scholar
  21. Green DE, McCormick IA, Walkey FH, Taylor AJ (1987) Community attitudes to mental illness in New Zealand twenty-two years on. Soc Sci Med 24:417–422Google Scholar
  22. 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 186:436–441Google Scholar
  23. 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 18:461–473Google Scholar
  24. Harris LT, Fiske ST (2006) Dehumanizing the lowest of the low: neuroimaging responses to extreme out-groups. Psychol Sci 17:847–853Google Scholar
  25. Hayes AF (2013) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford, New YorkGoogle Scholar
  26. 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):1086–1098Google Scholar
  27. Hinshaw SP (2007) The mark of shame: stigma of mental illness and an agenda for change. Oxford University Press, New YorkGoogle Scholar
  28. Hinshaw SP, Cicchetti D (2000) Stigma and mental disorder: conceptions of illness, public attitudes, personal disclosure, and social policy. Dev Psychopathol 12:555–598Google Scholar
  29. 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):489–499Google Scholar
  30. 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):1041–1051Google Scholar
  31. IBM Corp (2016) IBM SPSS statistics for Windows, version 24.0. IBM Corp., ArmonkGoogle Scholar
  32. 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):707–720Google Scholar
  33. 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):1175–1200Google Scholar
  34. 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 11:98–111Google Scholar
  35. Lebowitz MS (2016) Stigmatization of ADHD a developmental review. J Atten Disord 20(3):199–205Google Scholar
  36. 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):50–67Google Scholar
  37. 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):1–23Google Scholar
  38. 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 1–10Google Scholar
  39. Mendoza-Denton R (1999) Lay contextualism in stereotyping: situational qualifiers of stereotypes in intuitive theories of dispositions (Doctoral dissertation, ProQuest Information and Learning)Google Scholar
  40. 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):1067–1075Google Scholar
  41. 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):39–49Google Scholar
  42. Mueller AK, Fuermaier ABM, Koerts J, Tucha L (2012) Stigma in attention deficit hyperactivity disorder. Attent Deficit Hyperact Disorders 4(3):101–114Google Scholar
  43. 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):1054–1062Google Scholar
  44. Ohan JL, Visser TA, Moss RG, Allen NB (2013) Parents’ stigmatizing attitudes toward psychiatric labels for ADHD and depression. Psychiatr Serv 64(12):1270–1273Google Scholar
  45. Okonofua JA, Eberhardt JL (2015) Two strikes: race and the disciplining of young students. Psychol Sci 26(5):617–624Google Scholar
  46. Phelan JE, Basow SA (2007) College students’ attitudes toward mental illness: an examination of the stigma process. J Appl Soc Psychol 37(12):2877–2902Google Scholar
  47. Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40(3):879–891Google Scholar
  48. Sartorius N (1998) Stigma: what can psychiatrists do about it? Lancet 352(9133):1058–1059Google Scholar
  49. 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):440–452Google Scholar
  50. Shrout PE, Bolger N (2002) Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychol Methods 7(4):422–445Google Scholar
  51. 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 15:186–192Google Scholar
  52. 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 158:479–481Google Scholar
  53. 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):883Google Scholar
  54. 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):295–302Google Scholar
  55. 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):995–1001Google Scholar
  56. Thompson AC, Lefler EK (2016) ADHD stigma among college students. ADHD Attent Deficit Hyperact Disord 8(1):45–52Google Scholar
  57. 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):753–775Google Scholar
  58. 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):912–920Google Scholar
  59. Wark C, Galliher JF (2007) Emory Bogardus and the origins of the social distance scale. Am Sociol 38(4):383–395Google Scholar
  60. Weiss MF (1994) Children’s attitudes toward the mentally ill: an eight-year longitudinal follow-up. Psychol Rep 74:51–56Google Scholar
  61. 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):217–242Google Scholar
  62. Williamson D, Johnston C (2015) Gender differences in adults with attention-deficit/hyperactivity disorder: a narrative review. Clin Psychol Rev 40:15–27Google Scholar
  63. World Psychiatric Association (2001) The WPA global programme to reduce the stigma and discrimination because of schizophrenia—an interim report 2001. World Psychiatric Association, GenevaGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Jocelyn I. Meza
    • 1
    Email author
  • Maria Monroy
    • 1
  • Ruofan Ma
    • 2
  • Rodolfo Mendoza-Denton
    • 1
  1. 1.Department of PsychologyUniversity of CaliforniaBerkeleyUSA
  2. 2.Department of PsychologyUniversity of WaterlooWaterlooCanada

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