Stigma Regarding Dissociative Disorders.

Abstract

Clinicians and researchers who work in the dissociative disorders field, as well as individuals diagnosed with a dissociative disorder (DD), seem well aware that there continues to be much skepticism about the class of disorders, and dissociative identity disorder (DID) in particular. Professional skepticism has been documented in the scientific literature going back several decades (e.g., Dell, 1988), and subsequently, such skepticism from within the clinical community has been found to lead to missed diagnoses of DID (Brand et al., 2016). Why such professional skepticism persists may relate to several factors, perhaps most importantly what professionals in training are taught (or not taught) about the DDs (Gleaves, 2007). A topic closely related to skepticism is stigma, which generally refers to a “negative social attitude attached to a characteristic of an individual that may be regarded as a mental, physical, or social deficiency” (American Psychological Association, n.d..). Although stigma may be associated with all sorts of personal characteristics (e.g., physical or racial features), there is a wealth of research related to mental/psychological disorders (see Levy et al., 2014 for a review). In the literature on this topic, several types of stigma have often been identified, including self-stigma (also referred to as internalized stigma and which refers to negative attitudes of individuals regarding their own mental/ psychological disorder), social stigma (also referred to as public stigma which refers to negative attitudes held by individuals or groups within the general population), professional stigma (negative attitudes held by health-care professionals, researchers and academics), and institutional stigma (an organization’s policies or culture which perpetuate negative attitudes and beliefs toward stigmatized individuals) (Subu et al., 2021). In general, high levels of stigma against psychological disorders have been found since at least the 1950s (Levy et al., 2014), although it varies somewhat depending on the disorder. Much of the stigma research seems to focus on mental health (or “mental illness”) in general, or it has focussed on “severe mental illness” (e.g., Morgan et al., 2018), which typically refers to schizophrenia or bipolar disorders, or has focussed on what are typically referred to as common but less severe disorders such as depressive and anxiety disorders (e.g., Anderson et al., 2015). However, as is often the case regarding research on mental/ psychological disorders, the DDs seem to be frequently ignored or left out. To illustrate this, we recently conducted a PsychInfo search and, although there were thousands of results for search terms related to stigma OR dissociation/ dissociative, we only found one study that actually related to stigma associated JOURNAL OF TRAUMA & DISSOCIATION 2023, VOL. 24, NO. 3, 317–320 https://doi.org/10.1080/15299732.2023.2191240