Preferred Name
Brandy Hollins
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
ORCID
https://orcid.org/0000-0001-7886-9679
Date of Graduation
5-14-2026
Semester of Graduation
Spring
Degree Name
Doctor of Philosophy (PhD)
Department
Department of Communication Sciences and Disorders
First Advisor
Erin Piker
Abstract
Many vestibular disorders are “invisible”, not widely recognized, and challenging for patients to describe. However, its impact is visible and leads to significant challenges. Research has shown that stigma associated with other chronic health conditions can detrimentally affect patient outcomes, suggesting a greater need in this area. The World Health Organization’s (WHO) International Classification of Functioning, Disability, and Health (ICF) elucidates the role of physical, social, and cultural factors in the manifestation of health conditions within a universal framework. A critical aspect of the ICF’s contextual factors for individuals with vestibular loss is societal perception. Few studies have reported stigmatization among individuals with chronic vestibulopathy and its impact on participation remains to be accomplished. This was a cross-sectional, explanatory mixed-methods study. This study recruited 57 participants from the Vestibular Disorders Association’s (VeDA) online support group and, among them, interviewed 10 for a follow-up component. In the Phase I (quantitative), we mapped questionnaires to WHO ICF domains: the Vertigo symptom scale-short form (body systems and structures), the Activities Balance Confidence scale (activity), the Impact on Participation and Autonomy questionnaire (participation and autonomy), the Stigma Scale for Chronic Illness-8 item form (environmental), and demographic questions (personal factors). Variables showed a significant association with the participation and autonomy domain; stigma was the only significant predictor of this outcome. In Phase II (qualitative), we performed semi-structured interviews to explain quantitative results. Four themes emerged from Phase II: Disease profile, Social, Healthcare experiences, and Agency and meaning-making. Mixed methods integration via cross-case comparison joint display tables found that higher stigma groups more frequently reported healthcare system challenges, isolation, unsupportive friends/family and acquaintances, and legitimacy denial, whereas lower stigma participants showed higher frequencies of timely intervention, progress toward symptom management, and internalized perspectives such as acceptance. Our findings suggest that stigma plays a critical role in overall health should be assessed in the care and management of those with vestibular disorders.
