The Impact of Stigma and Visible Difference on Children & Adolescents Living with Physical Health Conditions

Aims & Background: There is an increased prevalence of psychological distress and poorer long-term outcomes for Children and Young People (CYP) living with physical health conditions. To better understand the psychological processes of living with a physical health condition, this study aimed to explore the impact of stigma and visible or less visible differences on concealment, illness attitudes and emotional and peer difficulties in CYP with physical health conditions. Method: 61 CYP were recruited from a specialist national hospital and completed three validated questionnaires to investigate self-reported self-stigma, concealment beliefs and illness attitudes. Measures of visibility, psychosocial difficulties and relevant demographic and medical information were obtained from caregivers. Results: CYP with visible physical health conditions reported significantly poorer illness attitudes and more emotional and peer difficulties with large and moderate effect sizes respectively. Higher reported self-stigma significantly predicted greater concealment, poorer illness attitudes and more emotional and peer difficulties in CYP. Conclusions: The findings suggest that condition-specific factors such as visibility can affect the attitudes CYP have towards their physical health condition, their emotional wellbeing and peer relationships. The visibility of a condition and stigma perceptions should be taken into account when supporting CYP with physical health conditions and their families