Abstract

Background It is well understood that stigma varies across cultures, but only recently a theoretical framework was developed with the purpose of identifying and understanding these variations (Yang et al., 2014). Exploring culture-specific aspects of stigma is important because of its profound impact on recovery and treatment seeking behaviors. Particularly in Latin America, cultural factors such as gender differences stemming from religious traditions and cultural influences of machismo are thought to strongly influence stigma. This study explores the cultural aspects in Chile and Argentina to reveal specific characteristics of stigma, and how it affects those diagnosed with psychosis. Methods. 9 Chilean consumers (7 users and 2 caregivers) were interviewed from a psychiatric hospital in Santiago, Chile, and 4 Argentinians (3 users and 1 caregiver) are being interviewed now from a mental health center in Cordoba, Argentina. The process used for the interviews consisted of semi-structured in-depth interviews being derived from the Scale of Perceived Discrimination and Devaluation (PDD). The analyses incorporate theoretical framework of WMM (Yang, et al., 2007) to identify core interactions which: 1) shaped the culturallyspecific expression of stigma, and 2) protected against stigma within the cultural context. To supplement this process and validate our findings, we also conducted a literature review consisting of key cultural or anthropological texts about characteristics unique to Chilean society and Argentinian society. Bilingual Spanish-English coders are analyzing the content of the interviews and coding according to the What Matters Most framework. Results Results from Chile, and preliminary results from Argentina have so far supported What matters most model. Preliminary results show that the machismo culture expects men to be strong and breadwinners of the family increasing stigma towards those who cannot fulfill these expectations due to mental illness. Stigma also further affects men´s capacity to fulfill these roles. Similarly, women perceived less stigma and felt more socially integrated when they were able to fulfill marital and family responsibilities. Familismo high value of family ties, has been identified as a protective factor against stigma, as relatives tend to encourage and support the mentally ill to recover. Differences between countries are expected, for instance, being able to work was stressed by Chilean users as a motivation to recover, but also as a source of perceived stigma, while capacity to socialize was found to be a salient code in Argentinian interviews. Discussion Stigma was found to be rooted in social characteristics and shared meanings of what is most at stake in Chilean and Argentinian culture. Particularly, preliminary results support the influence of gender roles and family shaping and protecting users from stigma. Thus, increasing capacities that matter most among consumers provides a target to reduce stigma in these cultures (Yang et al., 2014). However, local differences have to be observed regarding what matters most for each community. Culturally-appropriate anti-stigma interventions can shield stigmatized individuals from internalizing stereotypes by helping them fulfill their responsibilities and maintain a respected status in their communities.