title: Stigma by association and family burden among family members of people with mental illness: the mediating role of coping.
abstract: When someone has a mental illness, family members may share the experience of stigma. Past research has established that family members' experiences of stigma by association predict psychological distress and lower quality-of-life.
  
  
  
  The present study, conducted with 503 family members of people with mental illness examined the prevalence of 14 different coping strategies. Of greater importance, we examined the role of these coping strategies as mediators of the relationships between stigma by association and family burden, on the one hand, and outcomes, such as psychological distress and quality-of-life, on the other.
  
  
  
  The results showed that both perceived stigma by association and family burden are associated with greater psychological distress and lower quality-of-life, and that most coping strategies mediate these relationships.
  
  
  
  Adaptive coping strategies were related to reduced negative outcomes, while most maladaptive coping strategies were related to enhanced negative outcomes. Implications for intervention development are discussed.
authors.affiliation: Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands. remco.vandersanden@maastrichtuniversity.nl.
authors.forename: Remko L M
authors.initials: RL
authors.lastname: van der Sanden
authors.affiliation: Department of Psychology, Illinois State University, Normal, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: Pryor
authors.affiliation: Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Stutterheim
authors.affiliation: Department of Work and Social Psychology, Faculty of Psychology and Neuroscience, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands.
authors.forename: Gerjo
authors.initials: G
authors.lastname: Kok
authors.affiliation: Faculty of Psychology and Educational Sciences, Open University, Heerlen, The Netherlands.
authors.forename: Arjan E R
authors.initials: AE
authors.lastname: Bos
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D002648:Child; D016241:Child of Impaired Parents / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005190:Family / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life / Q000523:psychology; D057545:Social Stigma; D013315:Stress, Psychological / Q000523:psychology*; D055815:Young Adult
keywords: Coping; Family burden; Mental illness; Psychological distress; Quality-of-life; Stigma by association