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Research Article
8 March 2018

Self-Stigma and Age-Related Hearing Loss: A Qualitative Study of Stigma Formation and Dimensions

Publication: American Journal of Audiology
Volume 27, Number 1
Pages 126-136

Abstract

Purpose

This study explored experiences of self-stigma among older persons with age-related hearing loss (ARHL) using Corrigan's conceptualization of self-stigma process formation and the attribution model as its theoretical framework.

Method

In-depth semistructured interviews were conducted with 11 older persons (mean age = 81 years) with ARHL.

Results

Self-stigma was present in the lives of the participants. Analysis revealed the existence of 3 stages of self-stigma in which the 3 core dimensions of stigma (cognitive attributions: being old, stupid, and crippled; emotional reactions: shame, pity, and feeling ridiculed; and behavioral reactions: concealment, distancing, and adapting to hearing aids) were observed. Hearing devices emerged as having a significant influence on stigmatic experiences in all stages and dimensions of self-stigma.

Conclusion

The study contributes to the theoretical and practical understanding of self-stigma regarding ARHL as well as to the understanding of the role of hearing devices in the development of this stigma.

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References

Agrawal, Y., Platz, E. A., & Niparko, J. K. (2008). Prevalence of hearing loss and differences by demographic characteristics among US adults. Archives of Internal Medicine, 168(14), 1522–1530.
Ali, A., Hassiotis, A., Strydom, A., & King, M. (2012). Self-stigma in people with intellectual disabilities and courtesy stigma in family carers: A systematic review. Research in Developmental Disabilities, 33(6), 2122–2140.
American Speech-Language-Hearing Association. (2017). Overview of hearing aids. Retrieved from http://www.asha.org/public/hearing/Hearing-Aids-Overview/
Atcherson, S. R. (2002). Stigma and misconceptions of hearing loss: Implications for healthcare professionals with hearing loss. Journal of the Association of Medical Professionals with Hearing Losses, 1, 1–3.
Boyle, M. P. (2013). Assessment of stigma associated with stuttering: Development and evaluation of the self-stigma of stuttering scale (4S). Journal of Speech, Language, and Hearing Research, 56(5), 1517–1529.
Braun, V., & Clarke, V. (2012). Thematic analysis. In Cooper, H., Camic, P. M., Long, D. L., Panter, A. T., Rindskopf, D., & Sher, K. J. (Eds.), APA handbook of research methods in psychology, Vol. 2: Research designs: Quantitative, qualitative, neuropsychological, and biological (pp. 57–71). Washington, DC: American Psychological Association.
Bry, L. J., Mustanski, B., Garofalo, R., & Burns, M. N. (2016). Management of a concealable stigmatized identity: A qualitative study of concealment, disclosure, and role flexing among young, resilient sexual and gender minority individuals. Journal of Homosexuality, 64, 745–769.
Butler, R. N. (1969). Age-ism: Another form of bigotry. Gerontologist, 9, 243–246.
Chrisler, J. C., Barney, A., & Palatino, B. (2016). Ageism can be hazardous to women's health: Ageism, sexism, and stereotypes of older women in the healthcare system. Journal of Social Issues, 72(1), 86–104.
Corrigan, P. W. (2000). Mental health stigma as social attribution: Implications for research methods and attitude change. Clinical Psychology: Science and Practice, 7(1), 48–67.
Corrigan, P. W. (2016). Lessons learned from unintended consequences about erasing the stigma of mental illness. World Psychiatry, 15(1), 67–73.
Corrigan, P. W., Edwards, A. B., Green, A., Diwan, S. L., & Penn, D. L. (2001). Prejudice, social distance, and familiarity with mental illness. Schizophrenia Bulletin, 27(2), 219–225.
Corrigan, P. W., Rafacz, J., & Rüsch, N. (2011). Examining a progressive model of self-stigma and its impact on people with serious mental illness. Psychiatry Research, 189(3), 339–343.
Corrigan, P. W., & Watson, A. C. (2002). The paradox of self-stigma and mental illness. Clinical Psychology: Science and Practice, 9(1), 35–53.
Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self-stigma of mental illness: Implications for self-esteem and self-efficacy. Journal of Social and Clinical Psychology, 25(8), 875–884.
Dalton, D. S., Cruickshanks, K. J., Klein, R., Wiley, T. L., & Nondahl, D. M. (2003). The impact of hearing loss on quality of life in older adults. The Gerontologist, 43(5), 661–668.
David, D., & Werner, P. (2015). Stigma regarding hearing loss and hearing aids: A scoping review. Stigma and Health, 1(2), 59–71.
Espmark, A. K., & Scherman, M. H. (2003). Hearing confirms existence and identity—experiences from persons with presbyacusis. International Journal of Audiology, 42(2), 106–115.
Etikan, I., Musa, S.A., & Alkassim, R.S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4.
Fominaya, A. W., Corrigan, P. W., & Rüsch, N. (2016). The effects of pity on self-and other-perceptions of mental illness. Psychiatry Research, 241, 159–164.
Fulton, S., & Krainovich-Miller, B. (2010). Gathering and appraising the literature. In LoBiondo-Wood, G. & Haber, J. (Eds.), Nursing research: Methods, critical appraisal and utilization (pp. 56–80). St. Louis, MO: Mosby Elsevier.
Fung, K. M., Tsang, H. W., Corrigan, P. W., Lam, C. S., & Cheung, W. M. (2007). Measuring self-stigma of mental illness in China and its implications for recovery. The International Journal of Social Psychiatry, 53(5), 408–418.
Goffman, E. (1963). Stigma: Notes on a spoiled identity. Englewood Cliffs, NJ: Prentice-Hall.
Goldstein, A. L., Vilhena-Churchill, N., Munroe, M., Stewart, S. H., Flett, G. L., & Hoaken, P. N. (2017). Understanding the effects of social desirability on gambling self-reports. International Journal of Mental Health and Addiction, 15, 1342–1359.
Granberg, S., Swanepoel, D. W., Englund, U., Möller, C., & Danermark, B. (2014). The ICF core sets for hearing loss project: International expert survey on functioning and disability of adults with hearing loss using the international classification of functioning, disability, and health (ICF). International Journal of Audiology, 53(8), 497–506.
Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112.
Heffernan, E., Coulson, N. S., Henshaw, H., Barry, J. G., & Ferguson, M. A. (2016). Understanding the psychosocial experiences of adults with mild-moderate hearing loss: An application of Leventhal's self-regulatory model. International Journal of Audiology, 55, S3–S12.
Hinshaw, S., & Cicchetti, D. (2000). Stigma and mental disorder: Conceptions of illness, public attitudes, personal disclosure, and social policy. Development and Psychopathology, 12, 555–598.
Jacoby, A., Snape, D., & Baker, G. A. (2005). Epilepsy and social identity: The stigma of a chronic neurological disorder. The Lancet Neurology, 4(3), 171–178.
Jones, E. E. (1984). Social stigma: The psychology of marked relationships. London, England: W. H. Freeman.
Kochkin, S. (2007). MarkeTrak VII: Obstacles to adult non-user adoption of hearing aids. The Hearing Journal, 60(4), 24–51.
Mak, W. W., Cheung, R. Y., Law, R. W., Woo, J., Li, P. C., & Chung, R. W. (2007). Examining attribution model of self-stigma on social support and psychological well-being among people with HIV /AIDS. Social Science & Medicine, 64(8), 1549–1559.
Mak, W. W., Wu, C. F., & Eng, B. (2006). Cognitive insight and causal attribution in the development of self-stigma among individuals with schizophrenia. Psychiatric Services, 57(12), 1800–1802.
Manchaiah, V., Danermark, B., Vinay, T. A., Tomé, D., Krishna, R., & Germundsson, P. (2015). Social representation of hearing aids: Cross-cultural study in India, Iran, Portugal, and the United Kingdom. Clinical Interventions in Aging, 10, 1601–1615.
McCormack, A., & Fortnum, H. (2013). Why do people fitted with hearing aids not wear them? International Journal of Audiology, 52(5), 360–368.
McMahon, C. M. (2016). Hearing loss in older age and its effect on the individuals, their families and the community. Genetics of Deafness, 20, 9–18.
Mestdagh, A., & Hansen, B. (2014). Stigma in patients with schizophrenia receiving community mental health care: A review of qualitative studies. Social Psychiatry and Psychiatric Epidemiology, 49, 79–87.
Mittal, D., Sullivan, G., Chekuri, L., Allee, E., & Corrigan, P. W. (2012). Empirical studies of self-stigma reduction strategies: A critical review of the literature. Psychiatric Services, 63(10), 974–981.
Morse, J. M. (2008). Confusing categories and themes. Qualitative Health Research, 18(6), 727–728.
Noble, W. (2009). Preventing the psychosocial risks of hearing loss. Australian Family Physician, 38(8), 591.
Palmore, E. (2015). Ageism comes of age. Journals of Gerontology: Social Sciences, 70(6), 873–875.
Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd ed.) . Thousand Oaks, CA: Sage Publications.
Ritchie, J., & Lewis, J. (2003). Qualitative research practice. London, England: Sage Publications.
Schomerus, G., Lucht, M., Holzinger, A., Matschinger, H., Carta, M. G., & Angermeyer, M. C. (2011). The stigma of alcohol dependence compared with other mental disorders: A review of population studies. Alcohol and Alcoholism, 46(2), 105–112.
Shkedi, A. (2005). Multiple case narrative: A qualitative approach to studying multiple populations. Amsterdam, the Netherlands: John Benjamins Publishing.
Solheim, J., Kværner, K. J., & Falkenberg, E. (2011). Daily life consequences of hearing loss in the elderly. Disability and Rehabilitation, 33(22–23), 2179–2185.
Southall, K., Gagné, J., & Jennings, M. B. (2010). Stigma: A negative and a positive influence on help-seeking for adults with acquired hearing loss. International Journal of Audiology, 49(11), 804–814.
Vestergaard-Knudsen, L., Oberg, M., Nielsen, C., Naylor, G., & Kramer, S. E. (2010). Factors influencing help seeking, hearing aid uptake, hearing aid use and satisfaction with hearing aids: A review of the literature. Trends in Amplification, 14, 127–154.
Wallhagen, M. I. (2010). The stigma of hearing loss. The Gerontologist, 50(1), 66–75.
Watson, A. C., Corrigan, P., Larson, J. E., & Sells, M. (2007). Self-stigma in people with mental illness. Schizophrenia Bulletin, 33(6), 1312–1318.
West, J. S., Low, J. C., & Stankovic, K. M. (2016). Revealing hearing loss: A survey of how people verbally disclose their hearing loss. Ear and Hearing, 37(2), 194–205.
World Health Organization. (2015). Prevention of blindness and deafness. Grades of hearing impairment. Retrieved from http://www.who.int/pbd/deafness/hearing_impairment_grades/en

Information & Authors

Information

Published In

American Journal of Audiology
Volume 27Number 1March 2018
Pages: 126-136
PubMed: 29379957

History

  • Received: May 11, 2017
  • Revised: Aug 2, 2017
  • Accepted: Oct 11, 2017
  • Published in issue: Mar 8, 2018

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Authors

Affiliations

Dana David
Department of Community Mental Health, University of Haifa, Israel
Gil Zoizner
Kaplan Medical Center, Rehovot, Israel
Perla Werner
Department of Community Mental Health, University of Haifa, Israel

Notes

Disclosure: The authors have declared that no competing interests existed at the time of publication.
Correspondence to Perla Werner: [email protected]
Editor-in-Chief: Sumitrajit Dhar
Editor: Ann Eddins

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  • Social Predictors of Hearing Aid Purchase: Do Stigma, Social Network Composition, Social Support, and Loneliness Matter?, Ear & Hearing, 10.1097/AUD.0000000000001656, (2025).
  • Exploring Liminal Spaces in Older Age: Navigating the Enduring State of Dual Sensory Impairment (DSI), Sage Open, 10.1177/21582440241312464, 15, 1, (2025).
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  • Educational and Collaborative Model for Early Detection and Intervention of Age-Related Hearing Loss to Enhance Health and Well-Being of the Aged, Gerontology as an Interdisciplinary Science, 10.1007/978-981-97-2712-4_14, (191-213), (2024).
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