STIGMA AND SELF-STIGMA IN ADOLESCENTS WITH EPILEPSY PSYCHO-SEMANTIC APPROACH

Abstract

Over 50 million people worldwide have epilepsy and 80% of them live in develop- ing countries. [7]. According to the international statistics, although the complete seizure control is  achieved in considerable part of the patients, the majority of them are suffering the enormous influ- ence of social stigma and self –stigmatization [1]. Level of stigma awareness in patients with epilepsy  is relatively high. It turns out that, 50% of them consider themselves stigmatized, while 15% has  strong feeling of being an object of stigmatization. Furthermore, young people face stigma more often  than the old ones. [5]. Considering psychological issues of adolescence, stigma-related problems of  chronic disease should be of biggest importance for this age group among population with epilepsy.  Problems of stigmatization in adolescents with epilepsy are less explored nowadays though. Researches about adolescents with epilepsy involve youngsters between the ages 11-21. It  should be noted, that researches are mostly based on data obtained from questionnaires and scales  [8], [6], [4], [3]. One of the limitations associated with the study of stigma is, that it is difficult to  narrow it down to specific variables. Because of that, most of the studies about stigma are cor- relative and quantitative. Although recently in a scientific study of the stigmatization of people  with epilepsy, qualitative, phenomenological approaches have become more common 11]. On the  one hand, the reason is that quantitative researches do not provide enough data about the subject,  because individuals might not be conscious of some of the components of self-stigmatization and  these components may unconsciously affect their important attitudes. On the other hand, qualitative  approaches are far more relevant for studying phenomena, such as stigma and stigma perception.  Psycho-social aspects of epilepsy has not been studied on Georgian population until recently, there- fore the number of researches is few. The most part of the studies involve only adult patients and  comprises general information about the quality of their life and public awareness [13].  Stigma, either in a form of social discrimination or any other kind of action, expressed in  behavior towards the group of people with epilepsy is obvious, observable, exteriorized and con- scious. It’s far more difficult to study the phenomena of stigma perception and self-stigmatization.  The patient’s values and attitudes to self-perception and self-stigmatization are not obvious, observ- able and very often are unconscious. It should be noticed that less conscious attitudes and beliefs  are very hard to reveal and assess because of psychological defense mechanisms (denial, regression,  rationalization etc.) affecting such types of phenomenon. Therefore attitudes and values of patients  with chronic disease, related to self-perception and self-stigmatization are hard to reveal and require specific approach. The best way to accomplish this is to use a procedure that would allow phenome- nological analysis of the issues of self-perception, self-stigmatization and help to unveil true values and believes of patients with epilepsy, while avoiding the defense mechanisms mentioned above.