Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Dr. Paul B. Perrin


As rates of Parkinson’s disease (PD) increase, so does the need to examine some of the negative social consequences experienced by people with PD. Symptoms of PD have been linked to greater experiences of stigma, and the more visible symptoms of PD increase an individual’s likelihood for experiencing stigmatization and social rejection. Individuals who experience high levels of stigma generally have poorer mental health outcomes. While these relationships are well documented, little is known about whether stigma mediates the relationship between PD symptoms and mental health outcomes. Additionally, some past research suggests that the personal strengths of social support and spirituality may moderate the relationship between stigma and mental health in other populations; however, no research has examined the potential moderating effects of these variables in individuals with PD. This study sought to examine the connections among PD symptoms, stigma, and mental health, as well as examine social support and spirituality as potential buffers. This study represents a secondary data analysis of clinical data reflecting these constructs collected from 392 individuals with PD being seen at a PD specialty clinic affiliated with an academic medical center. Results showed stigma partially mediated the relationship between both motor and non-motor symptoms and mental health problems. There was also a moderating effect of social support on the relationships among motor/non-motor symptoms, stigma, and mental health problems, with stronger indirect effects at low levels of social support, suggesting that this mediational model held only for individuals with low social support. Spirituality moderated the relationships among motor/non-motor symptoms, stigma, and mental health problems, with stronger indirect effects at lower levels of spirituality, again suggesting that this mediational model held only for those with low or mid-levels of spirituality. Implications of these results are that health professionals working with individuals with PD may wish to consider stigma and discrimination in how they present and design treatment options for PD patients. Interventions designed to increase and foster social support among individuals with PD, such as helping individuals maintain a number of positive close relationships, may have beneficial mental health effects. Also, including an assessment of spiritual practice and beliefs into patient assessments may help health care providers better understand an individual with PD’s worldview, and subsequently view of chronic illness, if there is a spiritual community of support, and if spiritual interventions and coping mechanisms may be appropriate and helpful for the individual.


© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission