This study was conducted to determine how mothers’ evaluation of their mentally ill children affects reflected and self-appraisals and how appraisals affect the outcomes of recovery. The results showed that a mother’s positive appraisal of her mentally ill child has a significant positive effect on the child’s self-appraisal which supports the recovery process. However, stigmatized appraisal of the mother exerts a negative influence on the recovery process. Self-appraisals were seen to have a greater impact on outcomes compared to reflected appraisals.
Mentally ill people are often viewed by others as dangerous, incapable, and unpredictable. Recovery from mental illness is a continuous process and includes the ability of the person to deal with the difficulties, manage symptoms which interfere with functioning, regain a positive sense of self, and lead a satisfying life. The stigma associated with mental illness is a major obstacle to the recovery process. Many of the social-psychological aspects of recovery, such as stigma and identity, remain unexplored. This study focuses on the relationships between stigma, self-concept, and recovery and the impact of mothers’ appraisals, self-appraisals and reflected appraisals on the outcomes.
- The study was conducted over a period of 18 months on 129 mothers (55 years or older) of adult children with schizophrenia. Mothers completed an in-home interview and a questionnaire. Their children, who agreed to participate, also answered the questionnaire.
- Three appraisal parameters were included – self-appraisal (how the mentally ill person perceives himself), mother’s appraisal (how a mother perceives her mentally ill child) and reflected appraisal (how a mentally ill person thinks about how his mother perceives him). 22 items (for each of the 3 parameters) were recorded on a 7-point scale, with higher numbers indicating more stigmatized appraisals. The recovery outcomes based on different appraisals were isolated and the influence of the parameters on each other was studied by regression analysis.
- Life satisfaction was assessed using 22 items on a 7-point scale (1- terrible to 7 – delighted). The participants rated their perceptions about living arrangements, social relationships, leisure activities, finances, employment, safety, and health.
- Self-efficacy score was measured by the average score on an 8-item scale. The items were coded on a 1 to 4 scale with higher numbers indicating a greater degree of self-efficacy.
- Increased symptoms were associated with increased stigmatized mothers’ appraisals (beta coefficient (β) =0.32) and stigmatized reflected appraisals (β = 0.16). Self-appraisals had a small but significant effect on symptoms (β= 0.10).
- Increased life satisfaction levels were noted with less stigmatized mothers’ appraisals (β = -0.36) and less stigmatized reflected appraisals (β = -0.22).
- Life satisfaction levels had a significant effect on the self-appraisals (β=-0.44).
- Higher self-efficacy was seen with less stigmatized mothers’ appraisals and less stigmatized reflected appraisals (both, β = -0.25). The effect of self-efficacy on stigmatized self-appraisals was significant (β= -0.32).
Data was collected at an 18-month interval which is only a part of the long-term process. The effects of reflected appraisals prior to the study were not taken into account. Future studies need to be taken up on larger sample sizes. There is a need for more frequent administration of appraisal items, and inclusion of appraisals of other family members and caregivers.
Less stigmatized mothers’ and reflected appraisals results in diminished symptoms, higher self-satisfaction and a better quality of life in mentally ill persons. Self-efficacy and life satisfaction levels are influenced by stigmatized self-appraisals. Stigmatized self-conceptions lead to a sense of lack of control, and social exclusion which leads to diminished life quality. These results suggest that the recovery process is a social-psychological process and stigmatized appraisals slow recovery from mental illness. What other people think about mentally ill persons affect the beliefs and actions of the mentally ill, which in turn shapes the outcome of the recovery process.
For More Information:
Stigma, Reflected Appraisals, and Recovery Outcomes in Mental Illness
Publication Journal: Social Psychology Quarterly, 2011
By Fred E Markowitz; Beth Angell
From the Northern Illinois University, Illinois and Rutgers University, New Jersey
*FYI Living Lab Reports Are Summaries of the Original Research.