What mom thinks matters when it comes to mental illness

A new study led by a Northern Illinois University sociologist shows that while family members often provide critical support, they also can sometimes be the source of stigmatizing attitudes that impede the recovery of mentally ill relatives.

"Negative attitudes of family members have the potential to affect the ways that mentally ill persons view themselves, adversely influencing the likelihood of recovery from the illness," said lead researcher Fred Markowitz, an NIU professor of sociology.

Markowitz and his colleagues, Beth Angell from Rutgers, and Jan Greenberg from the University of Wisconsin-Madison, published their findings in the June issue of Social Psychology Quarterly, a peer-reviewed journal of the American Sociological Association.

Over an 18-month period, the researchers studied 129 mothers of adult children with schizophrenia.

"In short, what mom thinks matters," Markowitz said. "It's a chain of effects that unfolds.

"We found that when those with mental illness exhibited greater levels of initial symptoms, lower self-confidence and quality of life, their mothers tended to view them in more stigmatized terms—for example, seeing them as 'incompetent,' 'unpredictable,' and 'unreliable,'" Markowitz continued. "When mothers held these views, their sons and daughters with mental illness were more likely to come to see themselves in similar terms—what social psychologists call 'the reflected appraisals process.' Importantly, when the individuals with mental illness took on these stigmatizing views of themselves, their symptoms became somewhat greater and levels of self-confidence and quality of life lower."

A long line of research has shown that the stigma associated with mental illness can be a major impediment to recovery, affecting self-esteem and even job prospects. But research has not historically examined the links between stigma, reflected appraisals, identity formation, and recovery, Markowitz said.

"Our study is part of research that is starting to more fully examine how stigma affects the self-concept and identity of those with mental illness," he said.

Markowitz and his colleagues believe it is important to acknowledge that many of the sentiments conveyed toward ill relatives grow out of positive intentions and reflect attempts to cope with the difficulties of having a relative with serious mental illness. Yet, stigmatizing attitudes are of concern because of their potential adverse effects.

"This study highlights the notion that recovery from mental illness is not simply a matter of controlling symptoms as indicated by a strictly 'psychiatric' perspective," Markowitz said. "It is, to a certain extent, a social-psychological process.

"The ways in which people, including family members and service providers, think about persons with mental illness affect the beliefs and actions of the individuals with mental illness, in turn shaping the trajectory of recovery."