Illness stigmatization among inflammatory bowel diseases (IBDs) is poorly understood. We aim to characterize internalized stigma and stigma resistance in IBD patients, and evaluate their relationships to outcomes. A total of 191 IBD patients reported internalized stigma, resistance, demographic and clinical information, and several outcomes: health-related quality of life (HRQOL), psychological distress, self-esteem, and self-efficacy. Overall 36% experienced internalized stigma and 88% moderate to high stigma resistance behaviors. Internalized stigma strongly related to poorer outcomes while resistance demonstrated a weaker, opposite effect. Internalized stigma and stigma resistance are important considerations for IBD outcomes. Interventions to reduce internalized stigma and leverage resistance are warranted.
CasatiJTonerBBDe RooyECDrossmanDAMaunderRG (2000) REVIEW: Concerns of patients with inflammatory bowel disease. Digestive Diseases and Sciences45(1): 26–31.
5.
CorriganPWLarsonJERuschN (2009) Self-stigma and the ‘why try’ effect: Impact on life goals and evidence-based practices. World Psychiatry8(2): 75–81.
6.
DerogatisLRMelisaratosN (1983) The Brief Symptom Inventory: An introductory report. Psychological Medicine13(3): 595–605.
7.
De RooyECTonerBBMaunderRG. (2001) Concerns of patients with inflammatory bowel disease: Results from a clinical population. American Journal of Gastroenterology96(6): 1816–1821.
8.
DrossmanDALesermanJLiZMMitchellCMZagamiEAPatrickDL (1991) The rating form of IBD patient concerns: A new measure of health status. Psychosomatic Medicine53(6): 701–712.
9.
FarrellDSavageE (2010) Symptom burden in inflammatory bowel disease: Rethinking conceptual and theoretical underpinnings. International Journal of Nursing Practice16(5): 437–442.
10.
FryMBatesG (2011) The tasks of self-managing hepatitis C: The significance of disclosure. Psychology and Health. Epub ahead of print 7July2011. DOI: 10.1080/08870446.2011.592982.
11.
GoudgeJNgomaBMandersonLSchneiderH (2009) Stigma, identity and resistance among people living with HIV in South Africa. Social Aspects of HIV/AIDS Research Alliance6(3): 94–104.
12.
GuyattGMitchellAIrvineEJ. (1989) A new measure of health status for clinical trials in inflammatory bowel disease. Gastroenterology96(3): 804–810.
13.
HaldingAGHeggdalKWahlA (2011) Experiences of self-blame and stigmatisation for self-infliction among individuals living with COPD. Scandinavian Journal of Caring Science25(1): 100–107.
14.
JeneretteCMBrewerC (2010) Health-related stigma in young adults with sickle cell disease. Journal of the National Medical Association102(11): 1050–1055.
15.
JonesMPBrattenJKeeferL (2007) Quality of life in patients with inflammatory bowel disease and irritable bowel syndrome differs between subjects recruited from clinic or the internet. American Journal of Gastroenterology102(10): 2232–2237.
16.
JuniartiNEvansD (2010) A qualitative review: The stigma of tuberculosis. Journal of Clinical Nursing20(13–14): 1961–1970.
17.
KeeferLKieblesJLTaftTH (2011) The role of self-efficacy in inflammatory bowel disease management: Preliminary validation of a disease-specific measure. Inflammatory Bowel Diseases17(2): 614–620.
18.
KotruljaLTadinacMJoki-BegiNAGregurekR (2010) A multivariate analysis of clinical severity, psychological distress and psychopathological traits in psoriatic patients. Acta Dermato-Venereologica90(3): 251–256.
19.
KozuchPLHanauerSB (2008) Treatment of inflammatory bowel disease: A review of medical therapy. World Journal of Gastroenterology14(3): 354–377.
20.
LillisJLevinMEHayesSC (2011) Exploring the relationship between body mass index and health-related quality of life: A pilot study of the impact of weight self-stigma and experiential avoidance. Journal of Health Psychology16(5): 722–727.
21.
LindfredHSaalmanRNilssonSReichenbergK (2008) Inflammatory bowel disease and self-esteem in adolescence. [Comparative Study Research Support, Non-U.S. Gov’t.]Acta Paediatrica97(2): 201–205.
LivingstonJDBoydJE (2010) Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Social Science and Medicine71(12): 2150–2161.
24.
MerinAPachankisJE (2011) The psychological impact of genital herpes stigma. Journal of Health Psychology16(1): 80–90.
25.
MolodeckyNASoonISRabiDM. (2011) Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology142(1): 46–54.
NahonSLahmekPDuranceC. (2012) Risk factors of anxiety and depression in inflammatory bowel disease. Inflammatory Bowel Diseases. Epub ahead of print 31January2012. DOI: 10.1002/ibd.22888.
28.
PallisAGMouzasIAVlachonikolisIG (2004) The inflammatory bowel disease questionnaire: A review of its national validation studies. Inflammatory Bowel Diseases10(3): 261–269.
29.
PodolskyDK (1991) Inflammatory bowel disease (1). New England Journal of Medicine325(13): 928–937.
30.
PuhlRBrownellKD (2003) Ways of coping with obesity stigma: Review and conceptual analysis. Eating Behaviors4(1): 53–78.
31.
RitsherJBPhelanJC (2004) Internalized stigma predicts erosion of morale among psychiatric outpatients. Psychiatry Research129(3): 257–265.
32.
RitsherJBOtilingamPGGrajalesM (2003) Internalized stigma of mental illness: Psychometric properties of a new measure. [Research Support, US Gov’t, Non-PHS.]Psychiatry Research121(1): 31–49.
33.
RosenbergM (1965) Society and the Adolescent Self-Image. Princeton, NJ: Princeton University Press.
34.
SaylesJNHaysRDSarkisianCAMahajanAPSpritzerKLCunninghamWE (2008) Development and psychometric assessment of a multidimensional measure of internalized HIV stigma in a sample of HIV-positive adults. AIDS and Behavior12(5): 748–758.
35.
SaylesJNRyanGWSilverJSSarkisianCACunninghamWE (2007) Experiences of social stigma and implications for healthcare among a diverse population of HIV positive adults. Journal of Urban Health84(6): 814–828.
36.
ShepanskiMAHurdLBCultonKMarkowitzJEMamulaPBaldassanoRN (2005) Health-related quality of life improves in children and adolescents with inflammatory bowel disease after attending a camp sponsored by the Crohn’s and Colitis Foundation of America. Inflammatory Bowel Diseases11(2): 164–170.
37.
SibitzIUngerAWoppmannAZidekTAmeringM (2011) Stigma resistance in patients with schizophrenia. Schizophrenia Bulletin37(2): 316–323.
38.
SorsdahlKRMallSSteinDJJoskaJA (2011) The prevalence and predictors of stigma amongst people living with HIV/AIDS in the western province. AIDS Care23(6): 680–685.
39.
StevelinkSAVan BrakelWHAugustineV (2011) Stigma and social participation in Southern India: Differences and commonalities among persons affected by leprosy and persons living with HIV/AIDS. Psychology, Health and Medicine16(6): 695–707.
40.
TaftTHKeeferLLeonhardCNealon-WoodsM (2009) Impact of perceived stigma on inflammatory bowel disease patient outcomes. Inflammatory Bowel Diseases15(8): 1224–1232.
41.
TsangHWFungKMChungRC (2010) Self-stigma and stages of change as predictors of treatment adherence of individuals with schizophrenia. Psychiatry Research180(1): 10–15.
42.
Van BrakelWH (2006) Measuring health-related stigma: A literature review. Psychology, Health and Medicine11(3): 307–334.
43.
VyavaharkarMMoneyhamLMurdaughCTavakoliA (2010) Factors associated with quality of life among rural women with HIV disease. AIDS and Behavior16(2): 295–303.
44.
WeissMGRamakrishnaJSommaD (2006) Health-related stigma: Rethinking concepts and interventions. Psychology, Health and Medicine11(3): 277–287.
45.
WestMLYanosPTSmithSMRoeDLysakerPH (2011) Prevalence of internalized stigma among persons with severe mental illness. Stigma Research and Action1(1): 3–10.
46.
WottCBCarelsRA (2010) Overt weight stigma, psychological distress, and weight loss treatment outcomes. Journal of Health Psychology15(4): 608–614.
