Social Perceptions: Biological vs. Behavioral Diseases

Decades after behavioral disorders such as alcohol and drug addictions have been recognized by the medical community as diseases instead of simply a series of bad choices, social stigmas still play a role with these health issues. Negative associations cause people to fear, reject, and discriminate against a person with a behavior-related disease, according to research by Shaffer done in 1987. In a recent edition of Addiction and Humanities, the author examined the work of Shaffer alongside a more recent study by Room in 2005. Room reviewed the literature on stigma and rejection involved with psychoactive substance abuse. Shaffer analyzed the responses of 96 individuals to determine whether those participants perceived addiction-related behaviors to be the same kinds of diseases as biologically-based diseases. Shaffer used 80 words or phrases and had each participant indicate whether the word or phrase represented a disease. Shaffer’s study showed that participants clearly and subjectively distinguished words or phrases that indicated a biological disease versus those that were behavior-related. Room’s findings in 2005 were consistent with Shaffer’s study. Room found that attitudes about behavioral versus biological diseases resulted in disapproval and stigmatizing of behavior-related diseases. Room also established three elements of addiction that result in marginalization of the sufferer. Unpredictability (losing inhibitions), losing control (negativity associated with loss of will power), and cultural context (for example a Muslim drinking alcohol) are the elements that cause the stigma and marginalization. Room also analyzed and established three processes of social control that enhance stigma and marginalization. The first is related to friends and family members, who serve as a powerful social control and may isolate the person dealing with an addiction. Additionally, some public and private treatment methods seeking to assist those with substance addictions may increase their social problems by not effectively integrating them back in to society. Third, some policies make it difficult for sufferers of behavior-related diseases to maintain a social circle. For example, a federal U.S. law requires eviction from public housing if any member of the family is found to be associated with drug dealing. These findings call into question whether the line between behavior-related and biological diseases may become more blurred over time. As researchers find that cancer rates increase in those with more stress, less exercise and poor eating habits, the social stigmas that follow with substance abuse may weaken. All people make health choices inherent in their lifestyles and the medical community may need to do further research on whether it may be beneficial to establish a more multi-dimensional method of how diseases are classified.

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