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      Understanding the Role of Stigma and Misconceptions in the Experience of Epilepsy in India: Findings From a Mixed-Methods Study

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          Abstract

          It is surprising that although 12 million people in India suffer from epilepsy this remains a thoroughly under-researched area in the sociology of health and practice. We address this intellectual and policy neglect by reviewing the social, psychological and legal challenges governing the lives of people living with epilepsy (PWE) by paying particular attention to negotiations in arranged marriages and employment. Drawing on the analytical frameworks of the sociological study of stigma, critical race theory and paying attention to the cultural models of health and suffering, this study utilized a combination of (online) survey data ( N = 100) and in-depth qualitative interviews ( N = 10) with PWE and their families. The online survey was administered to map the level of awareness about epilepsy and its clinical management among the general population, whereas the in-depth interviews were conducted to understand the experience, self-perception and everyday struggles of those diagnosed with the condition. Findings from the survey on non-PWE suggest a general lack of awareness and fearful misconceptions around epilepsy related seizures. In-depth interviews with PWEs revealed concealment (of the illness) as a dominant coping strategy to attenuate the social alienation and rejection associated with epilepsy. Further, PWE participants reported persistent discrimination, harassment and prejudiced understanding of diminished cognitive capacities at workplaces as a result of cultural myths and popular representations of epilepsy-related seizures. The study also demonstrated the significance of institutional support groups in assisting PWE to cope with symbolic violence and forge solidarities. We conclude with reflections on the ethical dilemmas faced by medical practitioners while dealing with social-medical interventions of epilepsy treatment. Overall, results from this study undergird the significance to revisit the social-moral as well as legal frameworks that persistently restrict opportunities for PWE in India. In an attempt to reimagine inclusive futures regardless of disease, disability and affliction, we attempt to move beyond the biomedical gaze and instead privilege stories of individual personhood, struggles and aspirations.

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          Using thematic analysis in psychology

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            Stigma as a fundamental cause of population health inequalities.

            Bodies of research pertaining to specific stigmatized statuses have typically developed in separate domains and have focused on single outcomes at 1 level of analysis, thereby obscuring the full significance of stigma as a fundamental driver of population health. Here we provide illustrative evidence on the health consequences of stigma and present a conceptual framework describing the psychological and structural pathways through which stigma influences health. Because of its pervasiveness, its disruption of multiple life domains (e.g., resources, social relationships, and coping behaviors), and its corrosive impact on the health of populations, stigma should be considered alongside the other major organizing concepts for research on social determinants of population health.
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                Author and article information

                Contributors
                Journal
                Front Sociol
                Front Sociol
                Front. Sociol.
                Frontiers in Sociology
                Frontiers Media S.A.
                2297-7775
                13 May 2022
                2022
                : 7
                : 790145
                Affiliations
                [1] 1Department of Humanities and Social Sciences, Indian Institute of Technology Gandhinagar , Gandhinagar, India
                [2] 2Department of Sociology, Flame University , Pune, India
                Author notes

                Edited by: Rachana Bhangaokar, Maharaja Sayajirao University of Baroda, India

                Reviewed by: Harish Naraindas, Jawaharlal Nehru University, India; Giovanni Assenza, Campus Bio-Medico University, Italy

                *Correspondence: Tannistha Samanta tannistha.samanta@ 123456flame.edu.in

                This article was submitted to Medical Sociology, a section of the journal Frontiers in Sociology

                Article
                10.3389/fsoc.2022.790145
                9136008
                35633838
                c4c4a9b8-a997-4eb9-8ffd-139a313acf51
                Copyright © 2022 Gosain and Samanta.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 06 October 2021
                : 11 April 2022
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 65, Pages: 13, Words: 11432
                Categories
                Sociology
                Original Research

                epilepsy,stigma,misconception,india,marriage,cultural models of health and illness,employment

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