From the Freak Show to the Living Room: Cultural Representations of Dwarfism and Obesity1

This article examines how cultural representations of deviant bodies vary based on historically informed narratives of bodily stigma. Using content analysis of 40 episodes of reality television programming, I contrast cultural representations of dwarfism and obesity. Over time, dwarfism became constructed as an identity project with the aim of bodily acceptance, whereas obesity became regarded as a body project with the goal of body transformation through weight loss. The mostly positive historical characterizations of dwarfs allowed them to easily adopt the tenets of the disability rights movement as they evolved from freak show performances to television as an educational platform. They have adopted a social model of disability, positive social identity, self‐acceptance, and full social participation. By contrast, the past and contemporary representations of obesity have been overwhelmingly negative. Obese freak show performers were openly mocked, and classifying obesity as a disability has not yet gained traction as a civil rights movement. Instead, obesity is viewed through the lens of individual responsibility and limits of social participation are emphasized. Body modification through weight loss constructs an identity based on self‐change. Generally, this article suggests that cultural representations as de‐stigmatization projects are enabled or constrained by historical factors and the nature of the bodily stigma.     

Body mass index, academic achievement, and school context: examining the educational experiences of adolescents at risk of obesity

Reflected self-appraisal suggests that individual functioning is related to the fit between individual characteristics and the norms of their primary contexts. To apply this social psychological concept to the study of obesity, we hypothesized that adolescents at risk of obesity would have lower academic achievement overall than other students, especially in schools in which their weight status was most likely to elicit negative evaluations. Multi-level modeling of nationally representative data revealed that the negative longitudinal association between risk of obesity and achievement was stronger in schools with higher rates of romantic activity and lower average body size among students, two school contexts in which obesity was likely to be stigmatized, but weaker in schools with higher rates of athletic participation, a school context in which such stigmatization was also likely. Additional analyses suggested that this last, unexpected finding reflected a process of niche-picking.     

Two distinct mediated pathways to disordered eating in response to weight stigmatization and their application to prevention programs

ABSTRACT

Objective: Disordered eating behaviors among undergraduate women are common and, thus, are an important public health concern. Weight stigmatization, stress, and social withdrawal are often associated with disordered eating behaviors; however, it is unclear whether stress and social withdrawal act as mediators between weight stigmatization and disordered eating. By testing specific pathways to disordered eating, theory-driven prevention programs can be implemented. Methods: Self-reported surveys were administered to 217 undergraduate women during the Fall 2014 semester. Results: There were 2 distinct mediational pathways in response to weight stigmatization. Stress partially mediated the path between weight stigmatization and emotional eating (38%), whereas social withdrawal partially mediated the path between weight stigmatization and dietary restraint (44%). Conclusions: Stress and social withdrawal mediate the relationship between weight stigmatization and disordered eating. The results of this study identified potentially critical risk factors that, if addressed, may improve outcomes of campus-based disordered eating programs for women.     

Group Dieting,the Stigma of Obesity,and Overweight Adolescents

Natalie Allon was one of the pioneers in the sociological analysis of obesity and dieting, and a consistent voice on the topic in the 1970s. Her contributions to the study of the obese are reviewed in this paper. As an ethnographer who used participant observation and unstructured interviewing to examine organized dieting groups, she provided insight into the structure and function of these groups. She showed how group dieting was a form of religious ritual for the participants, as well as performing the latent function of providing social support. Her analysis of the stigma of obesity examined stigmatization of fatness in four areas: as sin, as disease, as crime, and as ugliness. Work on overweight adolescents showed that they had problems in social interaction. Because obesity often served as the exclusive focus of interaction, it overwhelmed others with mixed emotions, it clashed with positive attributes of a person, and it was an uncertain predictor of joint activity. Negative self image and a mixture of self responsibility for fatness and the negation of responsibility were related to actual weight loss. Allon's analyses provide us with a basis for further sociological analysis of obesity and dieting.     

The stigmatization of smokers: an empirical investigation

This study examines the social stigmatization of tobacco smokers, i.e., the extent to which smokers are seen as discredited persons. A representative sample of residents of a major Canadian city was interviewed. Clear evidence of an unfavorable stereotype of smokers was found. The ex-smoker enjoys a positive image, but one which is slightly less favorable than that of someone who has never smoked. A majority of non-smoking respondents preferred non-smokers in roles in which the role incumbents were likely to be in close proximity. Friendship networks and marital relationships tended to be segregated along lines of smoking behavior. Sociodemographic and attitudinal correlates of anti-smoker attitudes are explored. The implications of stigmatization for changing smokers' behavior are examined.     

Perspectives of elementary school educators in Japan,South Korea,Taiwan and the US on disability,stigmatization and children's developing self Part 1: Defining the problem in cultural context

The stigmatization of individuals with disabilities is a widespread social justice issue. This paper introduces a study of disability, stigmatization and self for children with disabilities and their typically-developing peers. It is the first of two companion papers. It examines the problem of stigmatization from the perspectives of experienced elementary school educators practicing in diverse cultural contexts. We conducted cross-cultural analyses of individual, audio recorded interviews with 26 Japanese, 43 Korean, 16 Taiwanese and 18 US educators, including school social workers. Educators from all four cultural groups described disability and stigma as challenging children's development of self: children with disabilities may experience the self as isolated and inadequate, and typically-developing peers may experience the self as lacking culturally expected values of empathy and respect. Educators' understandings of children's experiences also were culturally nuanced. Educators variously described children with disabilities as experiencing a sense of not belonging [Japan], loss of motivation [South Korea], too much shame [Taiwan], and low self-esteem [US]. They variously described typically-developing children as challenged to show empathy [Japan], include children with disabilities in their peer group [South Korea], develop benevolence [Taiwan], and show respect for individual differences [US]. We contextualize educators' perceptions within their specific sociocultural-historical contexts. Our second paper will focus on solutions; specifically, educators' perspectives on how to minimize stigmatization and support the development of self for children with disabilities and their typically-developing peers. Together, these companion papers provide social workers with valuable perspectives for eliminating the stigmatization of children with disabilities in future generations.     

Effects of sociodemographic factors,stage of illness,and perceived stigma on the identification of a support person among women with HIV infection

Addressing the lack of research on the social distribution of social support and research on the social experience of women with HIV infection, this article examines how sociodemographic factors, stage of illness, and perceived stigma affected the identification of a supportive social relationship among HIV‐infected women. Data were collected from women with HIV disease living in the state of Georgia. Logistic regression analysis indicates that after taking account of other factors, marital status, rural‐urban residency, stage of illness, and stigmatization were significant predictors of whether the women identified a support person. Single status and rural residency had negative effects on the outcome. Those who were at the advanced stage of illness were less likely than those at the asymptomatic stage to identify a supportive relationship. Contrary to our expectation, stigmatization had positive effects on the outcome. Implications and limitations of the analysis are discussed, followed by directions for future research.     

Perspectives of elementary school educators in Japan,South Korea,Taiwan and the US on disability,stigmatization and children's developing self: Part 2: Solutions

The stigmatization of children with disabilities at school is a culturally widespread social justice challenge. The paper is the second of a two-part series. In the first paper (Haight, Kayama, Ku, Cho, & Lee, 2016), we described the problem of stigmatization from the perspectives of experienced elementary school educators in Japan, South Korea, Taiwan and the US. In this paper, we focus on the solutions provided by these same educators; specifically, their perspectives on socialization practices to minimize stigmatization and support the development of self for children with disabilities and their typically-developing peers. We conducted cross-cultural analyses of individual, semi-structured, audio recorded interviews with 26 Japanese, 43 South Korean, 16 Taiwanese and 18 US educators, including school social workers. Educators from all research sites described socialization practices to support children with disabilities and their typically-developing peers. For children with disabilities, US educators focused on individualized support provided in private to minimize stigmatization. East Asian educators intentionally involved peers in supporting children with disabilities. For typically-developing peers, educators described cultivating empathy (Japan), providing formal disability awareness programs (South Korea), teaching moral values (Taiwan) and respecting individual differences (US). We discuss these socialization practices within educators' sociocultural-historical contexts. Educators' perspectives can be used to develop culture- and stigma-sensitive intervention programs for children with disabilities and their peers.     

Development of children's understandings of physical disabilities and stigmatization in a Japanese cultural context: Reflections of children in second through sixth grades

Stigmatization associated with disability is a culturally widespread social justice issue. Elementary school age is an important period for children to develop positive attitudes toward people with disabilities. This study examines Japanese elementary school-aged children's developing perceptions of disability and stigmatization. Following interactions and discussion about disabilities with the author, a guest teacher who uses a wheelchair, 118 typically-developing Japanese children in second through sixth grades provided written reflections on physical disability and stigmatization. Children in all grade levels described both positive and negative aspects of disability. Younger children's responses, however, were relatively positive, focusing on concrete examples of life in a wheelchair. Older children's responses focused more on challenges, and articulated their feelings and thoughts about disability in greater detail. Some older children also used the author's disability narratives to describe how they had overcome their own challenges that were not necessarily related to disability. Such differences in children's responses by grade levels are discussed in the context of Japanese socialization practices that emphasize sensitivity to stigmatization as well as empathy to maintain interpersonal relationships. Implications of Japanese cultural cases to professionals in Western countries also are discussed.     

Prostitution Stigma and Its Effect on the Working Conditions,Personal Lives,and Health of Sex Workers

Researchers have shown that stigma is a fundamental determinant of behavior, well-being, and health for many marginalized groups, but sex workers are notably absent from their analyses. This article aims to fill the empirical research gap on sex workers by reviewing the mounting evidence of stigmatization attached to sex workers’ occupation, often referred to as “prostitution” or “whore” stigma. We give special attention to its negative effect on the working conditions, personal lives, and health of sex workers. The article first draws attention to the problem of terminology related to the subject area and makes the case for consideration of prostitution stigmatization as a fundamental cause of social inequality. We then examined the sources of prostitution stigma at macro, meso, and micro levels. The third section focuses on tactics sex workers employ to manage, reframe, or resist occupational stigma. We conclude with a call for more comparative studies of stigma related to sex work to contribute to the general stigma literature, as well as social policy and law reform.     

Ageing, status politics and sociological theory

As a feature of social change and as an aspect of social stratification, ageing and age groups have been seriously neglected by sociological theory. This article attempts to conceptualize age groups in a multi-dimensional model of stratification which considers ageing in relation to economic class, political entitlement, or citizenship, and cultural life-styles. This multi-dimensional model provides an analytical basis for rejecting functionalist theories of ageing, which emphasize the positive functions of social disengagement, activity theories, which show that self-esteem in ageing is an effect of continuing social involvement, and Marxist social gerontology, which argues that retirement is determined by labour-market requirements in capitalism. The article concludes by developing a reciprocity-maturation curve of ageing which explains age stigmatization through exchange theory as an effect of declining social reciprocity. Both young and elderly social groups in a period of economic recession are perceived to be socially dependent, and become the targets of 'the politics of resentment'. The processes of social ageing can be located in the core of sociological theory, because they are connected fundamentally to the conditions of social solidarity.     

Assessment & treatment of persons with pedophilia

1. Like any other form of major mental disorders, pedophilia is an AXIS-I diagnosis that warrants psychiatric treatment. 2. The combination of anti-androgenic medications and individual/group psychotherapy are common treatments for pedophilia. 3. The social stigmatization of pedophilia brands mental health professionals who provide treatment for pedophiles as supporters of illegal sexual acts against children rather than as professionals treating a psychiatric disorder.     

Doin’ Meth or Doin’ Math: What Client Constructions of Social Class Mean for Social Work Practice

The voices of people experiencing poverty are underrepresented in social work research, public policy development, and practice interventions. This study explored the social class attributions of clients receiving poverty-related services through qualitative interviews. Findings reveal dynamic contributions of individual, environmental, and structural factors of social class positioning and significant stress and stigmatization associated with experiencing economic hardship. Participants indicate a sense of lived contradiction, viewing social class to be the result of fate while simultaneously endorsing individualistic attributions of poverty. Results have implications for social work research and practice, as well as poverty-related policy and program development.     

Stigma Management Among Gay/Bisexual Men with HIV/AIDS

People with HIV infection are subjected to prejudice, discrimination and hostility related to the stigmatization of AIDS. To manage the stigma of their disease, they mount complex coping strategies. This paper reports results from a qualitative study that examined gay/bisexual men's experiences of living with HIV infection. Unstructured interviews from a diverse sample of 139 men were analyzed to examine how men coped with AIDS-related stigma. We discerned a variety of stigma management strategies that could be arranged along a continuum from reactive to proactive based on the extent to which they implicitly accepted or challenged the social norms and values that underlie the stigmatization of HIV/AIDS. Reactive strategies to cope with stigma involve defensive attempts to avoid or mitigate the impact of stigma, but imply acceptance of the underlying social norms and values that construct the stigma. Examples of reactive strategies include hiding one's HIV status, presenting one's illness as a less stigmatizing one (e.g., cancer), or distancing one's self from more damaging aspects of AIDS-stigma (e.g., attributing infection to blood transfusion). Proactive strategies challenge the validity of the stigma and imply disavowal and resistance of the social norms and values that underlie the stigma. Examples of proactive strategies include engaging in public educational efforts that address misperceptions about HIV transmission and social activism to change the social and political conditions that affect PWA/HIV.     

East Asian and US educators' reflections on how stigmatization affects their relationships with parents whose children have disabilities: Challenges and solutions

Stigmatization is a culturally widespread social justice challenge with broad implications for the development of children. This study examines the reflections of elementary school educators in Japan, South Korea, Taiwan and the US on how stigma affects their relationships with parents whose children have disabilities and how they respond to these challenges. We conducted cross-cultural analyses of individual, audio recorded interviews with 26 Japanese, 43 Korean, 16 Taiwanese and 18 US educators, including school social workers. Educators from all four cultural groups characterized the development of collaborative relationships with parents as critical to supporting the school success of children with disabilities. They also described challenges posed by stigmatization to those relationships, and solutions to those challenges. Japanese educators watched over, carefully guided, and expressed empathy to parents responding to stigmatization. South Korean educators avoided openly indicating children's struggles to parents, but provided them with education about disabilities to counter misperceptions. Taiwanese educators exercised patience with parents who expressed distress due to stigmatization, and concealed their own negative emotional responses to such displays. US educators engaged parents through fact-oriented, solution-focused responses to children's struggles. The perspectives of educators from diverse contexts can be used to identify cultural blind spots, and develop effective culture- and stigma-sensitive strategies to build relationships with parents to better support children with disabilities.     

‘Hidden identities’: perceptions of sexual identity in Beijing

This article draws upon responses given by volunteers who work in the Beijing LGBT Centre regarding perceptions of sexual identity, and how Chinese culture affects hidden or open sexual identities of Chinese lesbian and gay people in this region. The insights gained from those working carefully to create social change offers an important and original contribution to the field of gay and lesbian studies in China. The findings indicate the volunteers at the Beijing LGBT Centre are frustrated by the lack of acceptance of non‐heterosexual relationships among Chinese culture and society, and by the disregard of lesbian gay and bisexual (LGB) people by the Chinese government. The findings also illustrate stigmatization of homosexuality in China is enacted in structural terms (such as in the lack of policy, legislation and positive endorsement by governmental and socio‐political organizations), public expression (such as negative attitudes, beliefs or reactions towards LGB people) and internalized repression (through fear of stigmatization, and subsequent abuse due to negative societal attitudes and discrimination). Influenced by the Chinese tradition of conforming to group values, the findings from this study show that volunteers at the Beijing LGBT Centre believe LGB people in China are generally hesitant to disclose their sexual identities, and reject the idea that there had been a collective shift in Chinese culture regarding increased acceptance of LGB people. It also finds volunteers at the LGBT Centre in Beijing blame Chinese culture for its lack of acceptance of non‐heterosexual relationships, and state stigmatization of homosexuality in China is due to deep‐rooted cultural homophobia.     

Inequality as an Explanation for Obesity in the United States

Over the past several decades, there has been a sharp increase in obesity across all population groups in the United States. In fact, the United States has one of the highest rates of obesity compared to other countries throughout the world. Obesity has become a national public health concern because it is related to a number of negative health, social, psychological, and economic outcomes. It is particularly concerning because racial/ethnic minorities and populations with the least education and highest poverty rates bear the largest burden of obesity. In addition, disparities in obesity tend to be gendered, with women experiencing the largest disparities in obesity by income, education, and race/ethnicity. In this review, I describe how social inequality is linked to obesity in the United States. I highlight elements of disadvantage at the individual‐, family‐, school‐, and neighborhood‐level that are linked to energy intake and expenditure, which are directly related to obesity, and draw from evidence and theories from multiple fields of the social and medical sciences. I also highlight the important role stress may play in linking disadvantage to obesity, particularly for women. I argue that understanding the complex mechanisms and processes that link social inequality to obesity requires multidisciplinary and multilevel frameworks.     

A review of the empirical status of tranditional modes of interpersonal helping: Implications for social work practice

The empirical status of traditional modes of interpersonal helping are reviewed in terms of client deterioration, spontaneous remission, and immediate and long-term effects. Necessary therapeutic conditions for client change, such as genuineness, nonpossessive warmth, and accurate empathic understanding, are discussed. Variables contributing to the ineffectiveness of traditional modes of interpersonal helping are elaborated in terms of the following: the medical model of mental disease, behavior as symptoms, diagnosis and treatment, labeling and stigmatization, the training of clinical social workers, conflict models of human behavior, academic achievement and fieldwork practice, criteria for the selection of theories of human behavior and induced change, and the relationship between academic performance and effectiveness in the field of clinical practice. The rationale is presented for a new type of social worker, the behavioral social worker, whose profile is reviewed in terms of knowledge base, behavioral skills, and value base.