ABSTRACTATTRIBUTION THEORYMETHODMeasuresRESULTSDISCUSSIONACKNOWLEDGEMTNSREFERENCESHealth Communication, 29: 516–526, 2014Copyright © Taylor & Francis Group, LLCISSN: 1041-0236 print / 1532-7027 onlineDOI: 10.1080/10410236.2013.777685Negative Public Perceptions of Juvenile Diabetics: ApplyingAttribution Theory to Understand the Public’s Stigmatizing ViewsArun VishwanathDepartment of CommunicationSUNY at BuffaloDespite a rise in the incidence of juvenile diabetes globally, little research has focused onpublic perceptions regarding its patients. The need to evaluate whether the public holds stig-matizing views is pressing when one considers the relatively young age of the patients ofthe disease. The current study extends the attribution theoretic framework to evaluate publicstigma regarding juvenile diabetes. The findings suggest that a large percentage of individualsmisattribute the causes of the disease and believe it is relatively rare and that its patients arepersonally responsible for contracting it. Individuals often utilize pejorative terms describingjuvenile diabetes as a disease afflicting children who are lazy, unhealthy, fat, obese, lackingexercise, and having eating disorders.Type 1 diabetes is an autoimmune disorder in which thebody’s immune system attempts to destroy the cells in thepancreas that produce insulin. The disease is also calledjuvenile diabetes because most individuals develop it dur-ing puberty and early adulthood, although it is not restrictedto these life stages and many adults also develop Type 1 dia-betes (Centers for Disease Control [CDC], 2012). Accordingto the American Diabetes Association, the risk of developingType 1 diabetes is higher than virtually any other chronicchildhood disease. Unlike Type 2 or adult-onset diabetes,which is linked to obesity and weight gain (CDC, 2012;Rubin, 2011), Type 1 diabetes has no known cause and thereare no preventative measures that can be taken to ward offthe onset of the disease. There is also no cure for it, and oncediagnosed, the disease affects all aspects of a child’s life.Patients suffering from Type 1 diabetes have to followa lifelong regimen of regular blood glucose testing, urinetesting, and insulin therapy, in addition to constantly mon-itoring their diet and maintaining a healthy lifestyle. Theseactions are difficult for most adults, let alone young children,to enact. Support provided by the immediate family andcaregivers helps overcome the many challenges faced bypatients as they cope with the disease (Hanson, Henggeler,& Burghen, 1987). The perceptions of peers, teachers,Correspondence should be addressed to Arun Vishwanath, Departmentof Communication, 333 Baldy Hall, SUNY at Buffalo, Buffalo, NY 14260-1060. E-mail: [email protected], and society at large may also play an importantrole in empowering patients and helping them create socialsupport networks throughout their lives (Dunst, Carol, &Cross, 1986).While positive public perceptions could help foster asense of normalcy among patients, negative perceptionsof the disease may result in patients feeling stigmatized(Weiner, Perry, & Magnusson, 1985). Stigma is definedas the devaluation of a person in a particular socialcontext based on the perceived presence of a negativeattribute or social identity (Crocker, Major, & Steele, 1998).Stigmatizing beliefs held by the public or public stigmacreates a s ense of isolation and withdrawal among patients(Puhl & Brownell, 2003). Left unchecked, these perceptionsmay overtime result in major public health issues such aslowered reporting of the disease or a lack of investment ininstitutional mechanisms that care for and support patients.Societal devaluation could be internalized by patients,resulting in self-stigma and reduced self-esteem that couldheighten people’s sense of alienation and lead to reducedhealth care utilization, reduced compliance with treatment,and other negative outcomes (Boysen & Vogel, 2008).Hence, it is imperative to study public stigma of juvenilediabetes because so little is known about it and few scholarshave addressed this important issue (Gollust & Lantz, 2009).Besides this, the patient population of this disease tends tobe younger, making the need for understanding and creatingpositive public perceptions particularly important. JuvenileNEGATIVE PUBLIC PERCEPTIONS 517diabetes’s incidence is also on the rise globally (Gale, 2002),making the need to study issues related to it both urgent andtimely.In this article we extend the attribution theoreticframework—a framework that is often applied to the under-standing of public perceptions, stereotypes, and stigma invarious domains (Armesto & Weisman, 2001; Cobb & deCh-abert, 2002; Corrigan, 2000; Crandall & Schiffhauer, 1998;Zucker & Weiner, 1993)—to the understanding of publicstigma toward juvenile diabetes. We begin the next sectionwith an overview of attribution theory, followed by researchquestions and hypotheses.ATTRIBUTION THEORYAttribution theory focuses on the inferential process of when,how, and why individuals assign blame to a general, specific,or individual event or source (Weiner, 2000). Attribution the-ory explains the phenomenon of stigma as a sociocognitiveprocess stemming from the need to make sense and infera cause for events, a process that is in turn shaped by theindividuals’ knowledge and thoughts about the phenomenon(Corrigan, 2000). Understanding stigma, therefore, requiresan understanding of the underlying cognitive and affectivestructures in individuals’ minds that create attributions andresult in their stigmatizing views.There are three dimensions or types of attributions indi-viduals invoke that are of interest to researchers examiningstigma (Weiner et al., 1988). One of the most importantattributions from a public stigma perspective is the locusof causal responsibility (Hunt, Domzal, & Kernan, 1982).Generally, people attempt to ascertain who exactly is respon-sible for a particular behavior or disease. Behaviors thatare thought to be within the volitional control of indi-viduals are more prone to being stigmatized than thosethat are accidental and beyond a person’s control. Suchexpectations within individualist cultures s uch as that ofthe United States are thought to be founded on tradi-tional conservative values of self-determination, individ-ualism, internal control, and self-discipline (Crandall &Martinez, 1996; Crandall & Schiffhauer, 1998). Related tothe locus of