The Effects of Diagnostic Labeling and Behavioral Attribution on Dementia-Related Stigmatization
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Authors
Chong, Adrienne
Issue Date
2022
Type
Dissertation
Language
Keywords
Alternative Title
Abstract
Neurocognitive disorders (NCD) such as Alzheimer’s disease are leading causes of disability and dependence for older adults worldwide. As our population ages, it is increasingly important to investigate the impact of age-related NCDs on individuals’ experiences, including how individuals are perceived and treated. Research has investigated the impact of diagnostic labeling and the observed behavior of persons living with dementia on the risk of stigmatization, with mixed results. Additionally, a growing body of research has investigated whether exposure to disease-related information such as symptom severity and disease prognosis increase the risk of the stigmatization of an individual. Attributional analysis of the behavior of an individual may also impact perceptions of an individual. A contextual model of the functioning of persons living with an NCD explains behavior as being influenced by a variety of factors including current environmental conditions, an individual’s prior life experience and their current health and emotional status. In contrast, pathology-oriented accounts of the behavior of persons living with dementia attribute behavior to neuropathology. The current study enrolled 202 participants and employed a 2x2 experimental design to investigate the impact of diagnostic labeling (Alzheimer’s disease diagnosis vs. no diagnosis) and behavioral attributional accounts (contextual description vs pathology-oriented description) on participants’ perceptions of an older individual. Participants in the no diagnosis conditions scored significantly higher on perceptions of the target’s competence than their counterparts in the Alzheimer’s disease diagnosis conditions, but only when they were exposed to a contextual behavioral attribution. There was also a main effect of behavioral attribution on ratings of the social appeal of the target, suggesting the potentially positive impact of non-pathologizing behavioral attribution regardless of diagnostic label. With regard to dementia stigma, there was also a significant main effect such that participants in the pathology model conditions scored higher on a measure of dementia stigma than did their contextual model condition counterparts. No significant differences were found across conditions for dementia mindset. The findings from the current study suggest that both behavioral attribution and the presence or absence of an Alzheimer’s disease diagnosis impact perceptions of competence, ratings of social appeal, and dementia stigma. While the use of diagnostic labels such as Alzheimer’s disease will continue, promoting a contextual understanding of dementia may be a useful and important intervention focus.