Stigma and Relationships-Brandon

After an interesting tangent last week on the relationship between mania and creativity, I decided to go back to our list of topics and find a case study that addressed one of them. Lily focused on how bipolar disorder affects familial relationships last week so I decided to find a case study that was  centered around social relationships. After clicking through pages and pages of articles on Google Scholar, ProQuest, and Jstor without finding anything relevant I was ready to give up. 

I slammed my laptop shut and went out into the hall to play a few games of pool. When my win steak was snapped, I was ready to come back to my research with a clear mind. Instead of trying to find an article about social relationships, I moved onto the next topic on my list which was stigma.  A search of “bipolar and stigma” proved to be fruitful as I found a relevant case study within the first three results. Interestingly enough, the article, Internalized stigma and intimate relations in bipolar and schizophrenic patients: A comparative study covered both stigmas and social relationships.

My parents divorced when I was three years old and although by Dad dated off and on, he never had a serious relationship. I don’t know if his divorce or lack of a long-term relationship thereafter was an effect of his bipolar disorder however, this article provided me a general picture of how people suffering from bipolar disorder navigate romantic relationships.

The study analyzed how self-perceived stigma affected the interpersonal relationships of those suffering from bipolar disorder and schizophrenia.  I usually think of stigma coming from external sources so I thought that the spotlight on internal stigma brought a unique perspective. A total of 119 bipolar patients and 109 schizophrenia patients were studied.


The patients were given The Internalized Stigma of Mental Illness Scale (ISMI) survey which was developed by Risher et al. Risher’s test asked the subjects to rate their levels of Alienation, Stereotype Endorsement, Discrimination Experience, Social Withdrawal, and Stigma Resistance. The total ISMI score can range from 29 to 116. High ISMI scores show that the individual has high levels of self-perceived stigma.

After being given the ISMI test, the patients were given the Multidimensional Relationship Questionnaire (MRQ) created by Snell et al. The survey focused on Relational Extremely, Satisfaction, Anxiety, Monitoring, Esteem, External Relational Control, Assertiveness, and Internal Relational Control. The subjects responded to the the set of question on a scale of 1 to 5 with 1 being “this does not apply to me at all” and 5 being “this applies to me very strongly”.

The results of the study were as I expected. 18.5 percent of bipolar patients had internalized stigma compared to the 19.4 percent of patients with schizophrenia. A possible reason for this is that schizophrenia is more widely known than bipolar disorder which weakens the schizophrenic patients’ resistance to stigma as they are subjected to greater discrimination.

Unsurprisingly, the patients with higher levels of internalized stigma were less satisfied with their interpersonal relationships compared to their counterparts with lower levels of internalized stigma. The finding is true for both bipolar and schizophrenic patients however the latter group’s relationships suffered more from internalized stigma.

The authors of the study suggested that clinicians should focus more on internalized stigma because of its link with interpersonal relationships. They advise that relationships should be included in psycho-therapeutic procedures. I agree with both of their suggestions hope that more is done to reduce internalized stigma in bipolar and schizophrenic patients. Although the week started out with some challenges, I am glad I worked through them and was able to find this article.

Photograph Used:

Falcone, Paul M. “Consumed: Mental Illness Through Photography.” Dear Hope., n.d. Web. 11 Oct. 2015.

2 thoughts on “Stigma and Relationships-Brandon

  1. lmagliente

    Hey Brandon. When we talked about this the other day, you didn’t mention how it related to you and your family. I think it’s really cool that you have this personal connection. Lets see what other articles we can find for the upcoming weeks and discover how they might relate to your personal experience. 🙂

  2. cleokelleher

    I think that this is such an important way to look at any mental disorder in order to accurately understand it. I’m left wondering what the cause of these internalized stigmas are (beyond just having bipolar disorder) but where these stigmas arise and what differs between different responses from case to case.


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