**2. What is stigma?**

Stigma is defined as a characteristic or disorder that separates the individual from "normal" people in society and marks them as "unacceptable." Stigma is defined by the World Health Organization [WHO] as "a sign of embarrassment, embarrassment, or rejection that has been excluded from rejection, discrimination and participation in different areas of the society." [16]. The stigmatization process involves the identification of the separating state and then the step of disqualification of the individual [17]. The purpose of the stamp is to separate and exclude the individual from society [18]. Stigma means "scar, trail, sign," but today, it is mostly used as "black spot." The stamp is considered a symptom of a situation that is to be embarrassed for a person or a group or an unusual, unacceptable sign [18]. Stigmatizing is the individual's mental or physical disability, his race, drug addiction, or any illness that is considered bad by the society. The individual is stained, flawed, and reduced to the eye of others. This causes the stigmatized individuals to fear the society and isolate itself from society [19] (**Figure 1**).

#### **2.1. Historical development of stigma**

Stigma was originally used by the Ancient Greeks and symbolizes the physical signs that one has unusual and negative qualities in social or moral status. These signs are made by

**Figure 1.** Problematic stigma cycle.

quality of life [8–10]. In addition, it is suggested that the stigmatization not only affects the lives of the members of the family and their immediate surroundings but also the quality of life [11, 12]. One of the psychiatric disorders that are exposed to such stigmatizing attitudes and behaviors is obsessive compulsive disorder (OCD) although the stigmatization effect on the individuals who have received the diagnosis of schizophrenic disorder in the first and most recent years is discussed. OCD is a chronic mental disorder that negatively affects the quality of life and social, academic, and occupational functioning of individuals and families with this disorder [13]. Obsessions and compulsions experienced by an individual with OCD diagnosis, especially the distress experienced by them, cause the individual to be more isolated from the society. Moreover, it is stated that the quality of life is affected at a similar level to the diagnosis of schizophrenic disorder in OCD diagnosis [14]. In this chapter, it was aimed to explain the effect of the stigmatization in OCD.

The problems brought by individual and familial problems with a psychiatric diagnosis already have a very negative effect. In addition, individuals with mental disorders are exclusively excluded from society because of the reactions they are likely to exhibit and possibly display, as well as other people's feelings, thoughts, and behaviors, with causal attributions, as seen in people with certain characteristics; rather than seeking treatment, they can choose to hide their problems at home and live a relatively isolated life. This, in turn, reduces the likelihood that many people with a diagnosis of being diagnosed have the potential to get treatment and solve their problems; this situation leads to many types of loss in terms of individual and society. For this reason, reducing the stigmatizing attitudes and behaviors in the society is at least as important as the treatment. In recent years, it appears that the number and nature of initiatives undertaken to reduce the stigmatization of mental disorders has increased significantly [15].

Stigma is defined as a characteristic or disorder that separates the individual from "normal" people in society and marks them as "unacceptable." Stigma is defined by the World Health Organization [WHO] as "a sign of embarrassment, embarrassment, or rejection that has been excluded from rejection, discrimination and participation in different areas of the society." [16]. The stigmatization process involves the identification of the separating state and then the step of disqualification of the individual [17]. The purpose of the stamp is to separate and exclude the individual from society [18]. Stigma means "scar, trail, sign," but today, it is mostly used as "black spot." The stamp is considered a symptom of a situation that is to be embarrassed for a person or a group or an unusual, unacceptable sign [18]. Stigmatizing is the individual's mental or physical disability, his race, drug addiction, or any illness that is considered bad by the society. The individual is stained, flawed, and reduced to the eye of others. This causes the

stigmatized individuals to fear the society and isolate itself from society [19] (**Figure 1**).

Stigma was originally used by the Ancient Greeks and symbolizes the physical signs that one has unusual and negative qualities in social or moral status. These signs are made by

**2. What is stigma?**

88 Anxiety Disorders - From Childhood to Adulthood

**2.1. Historical development of stigma**

excavating the body or by tattooing, and evidence that a person carrying such a sign is a slave, a person who must be kept away like a criminal or a traitor. With the spread of Christianity, the term stigma is added. This ironic version refers to signs believed to have manifested itself in the form of bud-like sores on the skin, believed to be the physical signs of God's mercy, as it is in the prophet Jesus, and thus believed to be sacred. The first person to take this issue in scientific terms is Goffman [20]. Goffman describes three distinct types of content that are quite different in content: (a) differences in personality (mental disorders, homosexuality, alcoholism, addiction, imprisonment, depersonalization, etc.), (b) various physical deformations (weak wills, extreme passions, perverted and rigid beliefs and immorality, stay, unemployment, suicide attempts) and (c) ethnological stamps (race, nation and religion). Stigmatization is defined as the perception of the individual as imperfect or obtrusive rather than normal; the stigmatized individual is less valued and these people are almost not perceived as human [20]. Stigmatizing is not a new phenomenon, but the traces are based on a rather old history. Many diseases arising from the existence of mankind have been perceived as catastrophic in the society and have caused the sufferers to suffer persecution. The plague that emerged in the 1300s was regarded as a punishment sent by God to sinful people, and people with plague were declared criminals. Individuals caught up in syphilis, which is quite common in Europe during the 15th century, have been cursed for centuries. Although such specimens now seem very out of date and old, similar misconceptions and beliefs still exist today. AIDS, previously known as homosexual disease, has been considered a divine punishment given to sinful people by God [21]. As a result, stigmatization has a history as old as human history, and many diseases have been subjected to stigmatization; it continues to stay.
