Public stigma and the perception of rights: Differences between intellectual and physical disabilities

Highlights

• More stereotypes, social distance and withdrawal were found toward people with ID.

• Lower support of rights was found toward people with ID.

• Lower degree of acceptance was associated with greater social distance.

• Higher perception of dangerousness were associated with greater social distance.

• Greater social distance was related to lower perception of rights.

Abstract

Stigma may have detrimental effects on the rights of individuals with disabilities. This study examined the association between stigma and the perception of rights of people with intellectual disabilities and people with physical disabilities. Telephone interviews using vignette methodology were conducted with a nationally representative sample of 605 adults. Items included stereotypes, prejudice, behavioral reactions and the perception of rights of these individuals. More negative stereotypes, greater social distance and greater withdrawal behaviors were found toward people with intellectual disabilities as compared to people with physical disabilities. Lower support of rights was found toward people with intellectual disabilities as compared to people with physical disabilities. Lower degree of acceptance and higher perception of dangerousness were associated with greater social distance, which was related to lower perception of rights. Programs should aim at decreasing social distance to improve support to exercise rights, especially among people with intellectual disabilities.

Introduction

To promote the full realization of rights and fundamental freedoms of people with disabilities, the Convention on the Rights of Persons with Disabilities calls for adopting a human rights perspective (Stuart, 2012, UN, 2007). The social model of disability, on which the Convention is based, recognizes that social inequalities stem from social structures (Jongbloed, 2003). For example, public stigma, which refers to the attitudes of the general population toward stigmatized individuals (Phelan, Bromet, & Link, 1998), can negatively impact participation and inclusion in community life (World Health Organization, WHO, 2001), including a decreased realization of rights (Ditchman et al., 2013).

Although stigma may have a detrimental effect on the lives of people with disabilities, to date there is a paucity of research in the field of intellectual disability (ID) stigma. Recently researchers (Author, in press) have attempted to conceptualize stigma in the ID field based on the conceptual framework from the mental illness field. According to this conceptualization, stigma is a process consisting of stereotypes, prejudice, and discrimination. Stereotypes refer to knowledge structures or attitudes about a larger group of people that can be either positive or negative (Wagemans, van Schrojenstein Lantman-de-Valk, Tuffrey-Wijne, Widdershoven, & Curfs, 2010). Prejudice occurs when individuals endorse negative stereotypes and consequently generate negative emotional reactions (Fisher, Orkin, Green, Chinchilli, & Bhattacharya, 2009). Finally, discrimination relates to behavior that includes avoidant behavior, increased social distance, and hostile behavior (Corrigan, Markowitz, Watson, Rowan, & Kubiak, 2003). The results of the above study supported this conceptual framework for the ID field, although several unique aspects of ID were also recognized. Specifically, stereotypes regarding ID stigma were found to include positive cognitions of acceptance and negative cognitions of low-ability and dangerousness. Prejudice was found to consist of two factors: negative affect and calm affect, which relate to feelings of serenity and peace. Finally, behavioral aspects included notions of discrimination, specifically withdrawal behaviors and social distance; as well as positive behaviors of helping (Author, in press).

Although, to the best of our knowledge, the above study was the first to examine public stigma regarding ID within a theoretical stigma process model, one of its main limitations was the lack of a comparison group. Comparing stigma toward people with ID to other disability groups is of importance because it may provide a more complete understanding of the similarities and dissimilarities of the stigma process in different groups (Ouellette-Kuntz, Burge, Brown, & Arsenault, 2010). Further, past research has found a hierarchy of acceptance among disability groups, with people having ID frequently being the least socially accepted, whereas people with physical disabilities (PD) were usually more accepted (e.g., Miller et al., 2009, Thomas, 2000, Wang et al., 2003). However, research in this area was not based on a theoretical conceptualization of stigma (Scior, 2011). Thus, the first aim of the current study was to compare stigma toward people with ID to that attached to people with PD among a representative sample of the Israeli public.

Beyond stigma, differences between disability groups may also have an impact on the way that the rights of these individuals are perceived. Rights discourse begun with the recognition that social structures and policies were systematically depriving individuals with disabilities of their human rights. During the 1970s people with disabilities were beginning to be recognized as having drives, needs, and wishes similar to others. Most recently, the Convention on the Rights of Persons with Disabilities (CRPD, UN General Assembly, 2007) has attempted to protect internationally the rights of all individuals with disabilities. The ratification of the Convention established a framework for states to work toward the progressive realization of rights of persons with disabilities; specifically the “full realization of all human rights and fundamental freedoms of all persons with disabilities without discrimination of any kind on the basis of disability” (Article 4).

Among different fields, the CRPD (UN General Assembly, 2007) wishes to protect equality of political rights, including the right to vote (Article 29); the right to marry and found a family (Article 23); the right to the highest standard of healthcare on the basis of free and informed consent (Article 25); and the right to participate in cultural life, recreation, leisure, and sports activities on an equal basis to others (Article 30). Although in recent years there has been an increased focus on rights discourse, an open question is how does the public view the basic human rights of people with disabilities in general, and people with ID in particular. Thus, the second aim of this study was to examine the public's perception of the rights of people with ID by comparing them to people with PD among a nationally representative sample.

The CRPD (UN General Assembly, 2007) has recognized that disability is an evolving concept resulting from the interaction between individuals with impairments and attitudinal and environmental barriers that hinder their full and effective participation in society on an equal basis with others. Among attitudinal barriers, one detrimental consequence of stigma is seen in its impact on the rights of people with disabilities. Thus, the third aim of the current study was to examine the association between public stigma and the perception of the rights of people with ID and people with PD.

Few studies have focused on the perception of the rights of people with ID. One recent study, conducted among a representative sample of the public in Quebec, showed that people in the public were generally positive regarding the rights of people with ID, but had more reservation regarding the rights to drink alcohol and to have children (Morin, Rivard, Crocker, Boursier, & Caron, 2013). A different review has shown that the rights of individuals with ID to autonomous decision making in various domains of their lives is still often restricted (Werner, 2012). This may be result from “paternalistic control” whereby parents, siblings, and other caregivers feel that they know what is best for individuals with ID (Khan, 1985) and are motivated to protect them (Glick & Fiske, 1996). The damaging consequences of this response are the low expectations that follow: even adults with ID are viewed as incapable of making decisions for themselves. Such diminished expectations may frequently lead to discrimination and diminished rights of people with ID because they are perceived as being incapable of handling decisions, managing their lives, or participating in a full range of social activities (Ditchman et al., 2013). Thus, stigma and discrimination may lead to diminishing the rights of people with disabilities. However, to the best of our knowledge, no research has examined the association between public stigma and people's perception of rights.

In sum, this study had three main aims. First, to examine public stigma toward people with ID by comparing them to people with PD. Second, to compare the perceptions of the rights of people with ID and people with PD. Third, to examine the association between public stigma and the public's perception of the rights of people with ID by comparing them to people with PD. The following hypotheses were tested: (1) Greater negative stereotypes, prejudice, and discrimination will be reported toward people with ID as compared with people with PD. (2) Lower support of rights will be found toward people with ID as compared with people with PD. (3) A greater degree of stigma will be associated with a lower endorsement of the rights of people with ID and people with PD.