CCSR - Stigma and Behavioral Health in Urban Employers from China and the United States

Stigma and Behavioral Health in Urban Employers from China and the United States

Abstract & Stages
Theoretical Review and Models
1. Behaviorally-Driven Health Conditions and Causal Attribution
2. Behaviorally-driven Health Conditions and Dangerousness
3. Cross-Cultural Differences
4. References
Researchers & Acknowledgements

Behaviorally-driven Health Conditions and Dangerousness

In addition to responsibility attributions, an equally important central stereotype is the belief that people with some behaviorally-driven health conditions (especially mental illnesses like psychotic disorder and alcohol abuse) need to be segregated from society because they are dangerous (Brockington et al., 1993; Cohen & Struening, 1962; Link et al., 1999; Pescosolido et al., 1999; Taylor & Dear, 1981). A recently examined model showing the influence of emotional and behavioral consequences of danger attributions is summarized in Figure 2 (Corrigan, Markowitz et al., 2003; Corrigan, Rowan et al., 2002). According to the model, attributing dangerousness to personal control leads to anger that subsequently yields punishing behavior. Alternatively, perceptions of dangerousness might directly lead to fear; most people respond to violent threats of any kind with apprehension (Johnson-Dalzine, Dalzine, & Martin-Stanley, 1996). Fear about dangerousness, in turn, yields avoidant behaviors; for example, studies have shown that fearful reactions to media representations of mental illness or substance abuse led to greater social distance from individuals with mental illness (Angermeyer & Matschinger, 1996; Levey & Howells, 1995; Madianos et al., 1987). This kind of avoidance behavior manifests itself as lost opportunities. Employers fail to hire persons with these conditions to keep their distance. Similar prominent concerns about dangerousness and behaviorally-driven health conditions have been found in Chinese samples (Tam, Tsang & Chan, in press; Tsang, Tam, et. al., 2003).

This model is a variation of what Weiner (1985) called primary appraisal; an emotional response like fear yields a behavioral outcome (avoidance or punishment) without a mediating attribution. Blascovich and colleagues (2000, 2001) have construed a similar model; they examined perception of a stigma directly followed by threat and psychophysiological reactivity (fear). In fact, one recent study offered partial support concerning violence in mental illness and attributions about the locus of causality (Boisvert & Faust, 1999). Clearly, research suggests dangerousness concerns are key to the stigma of mental illness and alcohol abuse (Link, Phelan et al., 1999). Less clear is its relevance to people with HIV/AIDS. On one hand, this difference may represent the group distinctions that explain stigma differences within the category of behaviorally-driven-health conditions (i.e., being labeled mentally ill versus HIV/AIDS). This kind of theoretical difference may explain some of the mediated effects of stigma in behaviorally-driven health conditions.