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Protecting self-esteem from stigma: A test of different strategies for coping with the stigma of mental illness

Background: To date, there has been little research into effective strategies for preventing the detrimental effects of stigma on the well-being of people with mental illness. Aim: The present research set out to identify adaptive strategies for dealing with the stigma of mental illness. Methods: On the basis of the responses of 355 people with mental illness (PWMI) a standardized questionnaire assessing 10 identity management strategies was developed. Participants also reported their personal experiences with stigma, depression and self-esteem. Results: Hierarchical regression analyses showed that after controlling for depression and stigmatizing experiences, the strategies of community involvement, humour and positive ingroup stereotyping were related to higher self-esteem. Secrecy, selective disclosure and attempts at overcompensation or disproving stereotypes were related to lower self-esteem. The following strategies were unrelated to self-esteem: comparing the present social position of PWMI with that in the past, normalization of the illness within a medical model, information seeking and selective withdrawal. Conclusions: PWMI should be encouraged to seek support within their community and to develop a positive image of their ingroup.