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Title: Dilemmas of stigma, support seeking, and identity performance in physical disability : a social identity approach
Author: Read, Stuart Allen
ISNI:       0000 0004 5372 8820
Awarding Body: University of Exeter
Current Institution: University of Exeter
Date of Award: 2015
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Physically disabled people belong to a stigmatised group that is subject to negative societal stereotypes of incompetence and dependency on others. In order to maintain a positive sense of self, as well as receive needed support from others, physically disabled people need to continually navigate the stigma associated with disability. In so doing, they may face a number of dilemmas about how to express their disabled identity to others. The core argument of this thesis is that managing these identity dilemmas can have implications for support-seeking behaviour, as well as individual health and well-being. To develop this argument, this thesis aimed: first, to investigate the way in which physically disabled people experience their identity; second, to explore the role of stigma in shaping the experience and expression of identity among disabled individuals; and third, to elaborate a model of identity performance to describe how physically disabled people enact their identities in ways that navigate the twin concerns of stigma and accessing needed support. Before presenting a series of studies designed to address these aims, Chapters 1 through 3 explore the existing literature and develop the rationale for the present work. Chapter 1 presents a substantive review of previous research into stigma and physical disability. This review includes studies of general attitudes about disability and toward disabled individuals from the perspective of the non-disabled, and studies documenting the experience of stigmatisation from the perspective of disabled individuals themselves. Chapter 2 presents the social identity approach as a general framework for understanding identity in the context of stigma, and for theorising links between these processes and individual outcomes in terms of health and well-being. This chapter extends the basic social identity approach by incorporating recent thinking about identity performance, and considers the applicability of this to the disability context. Chapters 4 through 6 present the empirical work undertaken as part of this thesis. Chapter 4 provides a qualitative investigation of the ways in which people with cerebral palsy experience stigmatisation when accessing support. These experiences demonstrate individual awareness of stigma in support-seeking contexts and that this awareness is associated with felt pressures to perform one’s disabled identity in specific ways. In particular, respondents reported a tension between needing to be seen as sufficiently disabled in order to qualify for others’ support, but also the need to downplay feelings of difference from non-disabled people when accessing this support. Chapter 5 explores this tension further via a series of three connected quantitative studies. Using self-report data, these studies assessed how the salience of stigma as an issue (Study 2), and the salience of specific stigmatising audiences (healthcare providers, the general public, educators and employers; Studies 3 and 4) might promote changes in how physically disabled people enact their selves, and the implications of this for subjective feelings of health and well-being, and willingness to engage in support-seeking behaviour. The key finding from these studies is that the salience of specific audiences (but not the issues to which these connect) can activate expectations of stigma in the form of negative meta-stereotypes, and that these activated stereotypes shape the form and consequences of individual identity expressions. Healthcare providers were associated with especially negative stereotypes about disabled people, and these stereotypes undermined individual health and well-being as well as willingness to engage with support. Consistent with our identity-based analysis of these processes, individual differences in identification were found to play a role in modifying responses to these salient audiences and the meta-stereotypes these audiences activated in Studies 3 and 4. Finally, Chapter 6 presents a further qualitative investigation designed to build on the insights of the previous four studies. Specifically, Study 5 delves deeper into physically disabled people’s experiences of stigma when interacting with healthcare providers, educators and employers, the behavioural pressures they felt when doing so, and the strategies they engaged to deal with those pressures. When interacting with healthcare providers, participants discussed concerns about their deservingness for care potentially being questioned, and so sought to perform their identity in ways that demonstrated their legitimacy or need for support. When interacting with educators and employers, participants were instead concerned about being devalued in terms of their competence, and so sought to demonstrate their identity in ways that amplified their capabilities. However, in enacting these performances, participants noted the possible negative implications these behaviours had for how they personally viewed themselves (and wanted to be viewed by others). In this sense, Study 5 demonstrated that disabled people face dilemmas in negotiating demands from their audience, while also attempting to maintain a positive view of their self. In the concluding Chapter 7, a final discussion is completed in which the results from the five studies are reviewed and integrated, and the theoretical and practical contributions this work are noted.
Supervisor: Morton, Thomas ; Ryan, Michelle Sponsor: ESRC
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available