Stigma towards Peers with Mental Health Disorders in Childhood & Adolescence: An Investigation into Explicit & Implicit Stigma & Social Reasoning about Exclusion
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Children and adolescents with mental health disorders are widely reported to have problems with peer relationships; however, few studies have explored the way in which their peers regard these young people. The literature that exists exclusively focuses on explicit measures to evaluate stigma and provides an incomplete assessment of the many aspects of stigma. The aim of this body of research was to provide a comprehensive insight into mental health disorder stigma in childhood and adolescence by exploring how young people perceive peers with mental health problems. Specifically, this research assessed all known dimensions of stigma (stereotypes, prejudice, discrimination, power and social status) and implicit attitudes towards peers with disorders. In addition, it also investigated how young people reason about the exclusion of peers with disorders. In doing so, this research programme consisted of two studies. In the first study, patterns of explicit and implicit stigmatisation of peers with depression and attention deficit hyperactivity disorder (ADHD) were explored. The sample was 385 children (M = 10.21 years) and adolescents (M = 15.36 years). Questionnaire data indicated that the peer with ADHD was perceived more negatively than the peer with depression on all dimensions of stigma, except perceived dangerousness and fear. In contrast, the implicit data, detected by the Implicit Association Test (IAT), suggested that some participants had more negative views of the peer with depression than the peer with ADHD. Specifically, the findings demonstrated that adolescent males exhibited significantly stronger negative implicit evaluations of depression compared to younger males and adolescent females. Overall, the findings of Study One demonstrated that the nature and extent of stigmatising responses depends on the type of clinical disorder, the type of measure used and also the perceivers¿ age and gender. In Study Two, group interviews with 150 children (M = 10.76 years) and adolescents (M = 15.5 years) were conducted to investigate evaluations of dyadic and group exclusion scenarios involving peers with ADHD and depression. Explanations for why the target peers were rejected were also explored. Thematic analysis of the data showed that evaluations of peer exclusion were often multi-faceted, with participants frequently explaining that legitimacy of exclusion hinged on many factors. In general, young people believed that such peers were rejected because their disordered behaviour violated the expectations that they apply to their friendships. Overall, Study Two provided an insight into the reasons why young people with mental health problems are likely to be excluded by their peers. The findings from this body of research provide a valuable insight into how children and adolescents with mental health disorders are perceived by their peers. This information can be used in the development of anti-stigma interventions.