Para el desahogo de los asuntos del condominio, existirán las

It is necessary to understand what comprises self-esteem in order to see how it might be damaged by courtesy stigma.

A frequently cited definition of self-esteem from Rosenberg (1965) describes it as a ‘favourable or unfavourable attitude towards the self’. However ‘attitude’ to oneself is not based upon our objective assessment of ourselves, but upon the judgments others make of us (Emler, 2001). Who we understand ourselves to be is determined by our interactions with others. Furthermore, we derive self-esteem not only on the basis of how others treat us, but from how we imagine others will treat us (Emler, 2001). It is not difficult to see, therefore, how courtesy stigma can have a negative impact upon self-esteem. This does not necessarily have to consist of direct discriminatory experiences. Perceived or self-stigma (Wahl and Harman, 1989;

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Corrigan et al., 2006), - i.e. how we imagine others think of us – presents a significant threat.

There is also a broader point to consider. While individuals make personal appraisals of themselves based upon how they believe others think of them, they also derive self- worth on the basis of the group to which they belong (Tajfel, 1978). The worth or status of the group effects assessment of self-worth. As such, our social identities are sources of self-esteem. For those who are associated with a discredited, stigmatised, group in society, self-esteem derived from group belonging can be poor.

However, Festinger (1954) argues that the status of the groups to which we belong can only be determined relatively – by comparison with other groups in society. Such comparisons are made on a lateral (others perceived as holding the same attributes as our group); downward (those considered to hold less favourable attributes) or upward basis (others viewed in a more favourable position) (Finlay and Lyons, 2000). In order to protect self-esteem, people will avoid upward comparisons (Festinger, 1954), yet this may not be easy for the children of parents with learning disabilities.

Where their parents may be able to make lateral or downward comparison to people with learning disabilities generally, children may find it more difficult to seek out a sense of group belonging, particularly if not learning disabled themselves. Indeed, avoiding identification with others in the same position has been seen as a coping strategy in order to protect a sense of a ‘normal round of life’ (Birenbaum, 1970). Risks to self-esteem are of concern, as it plays an important role in competent functioning across a range of abilities and behaviours. For example, children with good self-esteem are more likely to possess effective social skills (Riggio,

Throckmorton and De Paola, 1990; Burhmester, Furman, Wittenberg and Reis, 1988), enabling them to better develop friendship networks (Dolgin, Meyer and Schwartz, 1991).

Conversely, low self-esteem appears to predict a number of negative emotional, behavioural and social problems, in childhood and later life. It has been found to increase the likelihood of suicide attempts and suicidal thoughts (Reynolds, 1991),

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risky sexual behaviour and teenage pregnancy (California Task Force to Promote Self-esteem and Personal and Social Responsibility, 1990), eating disorders (Veron- Guidry, Williamson and Netemeyer, 1997) and lower educational expectations (McFarlin and Blaskovich, 1981). It has also been shown to predict periods of extended unemployment (Feinstein, 2000).

It appears that if courtesy stigma presents a risk to self-esteem, there may be a number of potential negative consequences to the child.

Summary

Despite Goffman’s (1963) early work on the social aspects of stigma, the influence of the normalisation movement (Wolfensberger, 1972) and the weight of legislation (Disability Discrimination Act: Office of Public Sector Information, 1995), it seems people with learning disabilities remain a stigmatised group in society (Beart et al., 2005). Those who go on to have children may have to contend with an even greater degree of discrimination; their learning disability leads to a particular risk of

prejudicial treatment when the support of statutory services is needed (Booth, 2000). As such, their children may be vulnerable to stigma by association (Perkins et al., 2002).

There is only a small body of literature which has investigated courtesy stigma

(Angermeyer et al., 2003; Birenbaum, 1970; Corrigan et al., 2006; Green et al., 2005; Meta and Farina, 1988; Norvilitis et al., 2002; Ostman and Kjellin, 2002; Wahl and Harman, 1989) and only three report on this issue for the children of parents with learning disabilities (Booth and Booth, 1997; Perkins et al., 2002; Ronai, 1997). Collectively, these studies investigated courtesy stigma using a range of different methods. Some used a focus group to draw out salient themes on the subject (Angermeyer et al., 2003; Corrigan et al., 2006), others interviewed people

individually (Birenbaum, 1970; Davis et al.,2005), and others designed questionnaires with items drawn from the literature (Corrigan et al., 2006; Norvilitis et al., 2002; Wahl and Harman, 1989; Perkins et al., 2002), or from clinical experience (Ostman

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and Kjellin, 2002). Two studies used case vignettes to explore courtesy stigma from the perspective of non-stigmatised college students, to evaluate their perceptions of children whose parents had stigmatising conditions (Burk and Sher, 1990; Mehta and Farina, 1988). There were no standardised measures used and only one of the

questionnaires was devised directly from a qualitative exploration of the subject (Corrigan et al., 2006). The measurement of courtesy stigma, such that findings can be generalised, is still in its very early stages.

Although outcomes to date must therefore be viewed cautiously, the literature seems to suggest courtesy stigma is characterised by three different core issues:

 A distinction is made between perceived and actual courtesy stigma; it appears courtesy stigma does not simply arise as a consequence of actual

discriminatory experiences at the hands of others. It is characterised by a self- stigma, where the discredited social identity of the stigmatised family member is internalised by relatives (Corrigan et al., 2006; Norvilitis et al., 2002; Wahl and Harman, 1989).

 It may impact on social relationships (Angermeyer et al., 2003; Burk and Sher, 1990; Mehta and Farina, 1988; Ostman and Kjellin, 2002), even leading to feelings of social exclusion (Green et al., 2005).

 There is tentative suggestion that courtesy stigma may also effect mental health (Green et al., 2005; Norvilitis et al., 2002; Ostman and Kjellen, 2002), and impact negatively upon self-esteem (Corrigan et al., 2006; Perkins et al., 2002; Wahl and Harman, 1989).

What we know about the relationship between courtesy stigma and self-esteem was gleaned from studies on the adult population (Corrigan et al., 2006; Wahl and Harman, 1989). Based on these findings, the current research hypothesised courtesy stigma may present a risk to child self-esteem.

If this hypothesis is correct, factors which promote resilience to courtesy stigma are a sensible focus for investigation.

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Only one study to date has considered resilience at all in the children of parents with learning disabilities (Booth and Booth, 1997). The next section therefore reviews Booth and Booth’s (1997) research and considers resilience for children faced with adversity, focusing upon several additional factors that may be pertinent to the children of parents with learning disabilities.

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2.3 Exploring possible resilience factors

The previous section reviewed literature on courtesy stigma, drawing attention to its likely existence in the lives of children whose parents have learning disabilities. This section therefore examines what factors might protect children in such

circumstances. The literature on resilience in the children of parents with learning disabilities was reviewed. One study was identified and, although it did not

specifically address courtesy stigma, it did highlight the role of parental bonds and a supportive relationship with another adult (for both parent and child) in promoting good outcomes for these children (Booth and Booth, 1997).

No other studies were found which considered resilience in this population. The wider research was also reviewed. This identified a large body of evidence, which reports adaptive functioning to be promoted by a number of personal, relational and external support-system based variables; found to universally promote children’s resilience, across a range of unfavourable risks to development (Masten, 2001; Masten and Coatsworth, 1998).

Drawing on Booth and Booth’s (1997) research, as well as the wider literature, two main resilience variables were considered: a child’s attachment relationship with their mother (henceforth referred to as attachment) and friendships with peers and adults (henceforth referred to as social support). To give the investigation a broader perspective, literature on three further protective variables was also reviewed: child age, gender and cognitive ability. These were chosen as they were considered to be state rather than trait variables; components of a child’s life not dependant on other people or systems and therefore less vulnerable to the effects of other variables. However, in the current study, these resilience factors were given a secondary focus to attachment and social support.

Research into resilience has been extensive and the literature search identified a large number of studies. These were then analysed for their relevance to the circumstances of the children of parents with learning disabilities. Twelve studies were considered

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appropriate for review (Bolger and Patterson, 2001a; Bolger, Patterson and

Kupersmidt, 1988; Collishaw et al., 2007; Cicchetti and Rogosch, 1997; Fergusson and Horwood, 2007; Flores, Cicchetti and Rogosch, 2005; Herrenkohl, Herrenkohl and Egolf, 1994; Kim and Cicchetti, 2004; Owens and Shaw, 2007; Perkins and Jones, 2004; Schwartz, Dodge, Pettit and Bates, 2000; Szalacha et al., 2003). Resilience research differs significantly from that carried out with the children of parents with learning disabilities. The populations involved are significantly larger, as well as easier to access. The findings are therefore more reliable than seen in much of the research reviewed so far. Studies tend to combine qualitative and quantitative methods within single investigations, consider multiple variables, use substantial sample sizes and often report outcomes assessed over many years (some from

childhood to middle-age), in order to examine the nature of adaptive functioning over time. This review has drawn out salient points from each study identified. An overall critique of the methodologies is left until the end, so the investigations can be

considered as a whole.

This section first defines resilience and then reviews Booth and Booth’s (1997) study on the children of parents with learning disabilities. Subsequently it considers findings of the twelve resilience studies, with respect to attachment, social support, child age, gender and intellectual functioning.