title: The internalized stigma experienced by members of a mental health advocacy group in South Africa.
abstract: BACKGROUND
  Although there is a growing literature on internalized stigma from the developed world, very little research has been conducted in developing countries such as South Africa. Therefore, the purpose of this study was to describe the internalized stigma experienced by members of a mental health advocacy group in South Africa and relationships between self-stigma and other constructs, namely, empowerment, perceived devaluation and discrimination.
  
  
  METHODS
  Self-administered questionnaires measuring respondents reported levels of internalized stigma, empowerment and perceived devaluation and discrimination were distributed to all the members of the South African Depression & Anxiety Group (SADAG) by post and via email. Of the 850 members invited to participate, 142 members of SADAG completed the questionnaire. Pearson correlations were computed and multiple regression analyses were carried out to analyse the data.
  
  
  RESULTS
  The highest reports of stigma were for stigma resistance (mean = 2.9), alienation (mean = 2.47) and perceived discrimination (mean = 2.24). Low levels of stereotype endorsement (mean = 1.77) and social withdrawal (mean = 1.22) were reported. Although respondents often felt that the public held negative attitudes towards individuals suffering with a mental illness (perceived devaluation and discrimination scale (PDD), mean = 2.95), a majority of respondents reported high levels of empowerment (mean = 3.0) and self-efficacy (mean = 2.47). After controlling for socio-demographic factors, higher scores on the PDD were associated with social withdrawal and having experienced discrimination.
  
  
  CONCLUSIONS
  Internalization of stigma, disempowerment and loss of self-esteem are not inevitable consequences for all individuals with a mental illness. Nevertheless, perceived stigma is significantly associated with social withdrawal and experienced discrimination.
authors.affiliation: Department of Psychiatry & Mental Health, University of Cape Town, South Africa. katherine.sorsdahl@uct.ac.za
authors.forename: Katherine R
authors.initials: KR
authors.lastname: Sorsdahl
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Kakuma
authors.forename: Zane
authors.initials: Z
authors.lastname: Wilson
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010344:Patient Advocacy; D012044:Regression Analysis; D012649:Self Concept; D013019:South Africa; D013240:Stereotyping; D011795:Surveys and Questionnaires