Gelotophobia, attitudes to illness and self-stigmatisation in patients with non-psychotic mental disorders and brain injuries


brain injuries
non-psychotic mental disorders.
attitudes to illness

How to Cite

Shunenkov, D., Vorontsova, V., & Ivanova, A. (2021). Gelotophobia, attitudes to illness and self-stigmatisation in patients with non-psychotic mental disorders and brain injuries. The European Journal of Humour Research, 9(2), 141–153.


Gelotophobia, or the fear of being laughed at, has been described as an inability to enjoy humour and laughter in social interaction. A number of studies have shown its increased levels under various mental disorders. Gelotophobia in psychiatric patients may appear either as a primary syndrome, or as a secondary disorder connected to the patient’s reaction to their social position (self-stigmatization). In turn, self-stigmatization is closely related to the personality of the patient and, in particular, to their attitudes to illness. Since the fear of being laughed at has been studied within both the clinical concept and the continual model of individual differences, the question of differentiation between normal and pathological fear of being laughed at is topical, while borderline groups are of particular interest. The aim of the present study was to examine the relationship between gelotophobia, attitudes to illness, and self-stigmatization in patients with minor, non-psychotic mental disorders, as well as those with brain injuries, who also had mild mental disorders, without having the status of psychiatric patients. The sample consisted of 73 patients with non-psychotic mental disorders, and 30 patients with brain injuries. The methods used included PhoPhiKat-30, ISMI-9 (Internalized Stigma of Mental Illness Inventory), and TOBOL (Types of the Attitudes to Disease). The results revealed at least a slight level of gelotophobia in 31% patients with non-psychotic mental disorders, and 20% in those with brain injuries. Gelotophobia correlated with certain types of attitude to illness in each group. Subjects displaying high levels of gelotophobia were in general characterized by disadvantageous attitudes to illness. In the group of psychiatric patients, gelotophobia was associated with self-stigmatization, whereas in the group of neurological patients it was not. Thus, in this study gelotophobia was examined for the first time in patients with non-psychotic mental disorders, as well as in those with brain injuries. Different mechanisms of gelotophobia development were suggested for the two groups.


Babaylova, O. M., Panova, I. E. & Klevakina, Yu. S. (2014).‘Vnutrennyaya kartina bolezni kak osnova adaptatsii k zabolevaniyu u patsientov s glaukomoy’ [Internal picture of the disease as the basis of adaptation to the disease in patients with glaucoma]. Vostok – Zapad. Tochka zreniya. 1. Retrieved June 13, 2019 from

Boyd, J. E. et al. (2014). ‘Internalized Stigma of Mental Illness (ISMI) scale: A multinational review’. Comprehensive Psychiatry 55, pp. 221-231.

Brazevich, S. S. & Sidorova, A. Yu. (2013) ‘Invalidnost’: problemy preodoleniya stigmatizatsii i stanovleniya tolerantnogo soznaniya’ [Disability: problems of overcoming stigma and becoming tolerant consciousness]. Modern problems of science and education 1. Retrieved May 10, 2019 from

Brück, C., Derstroff, S. & Wildgruber, D. (2018). ‘Fear of being laughed at in borderline personality disorder’. Frontiers in Psychology 9: 4, pp. 1-5.

Chugunov, V. V., Grigoryan, A. Z. & Gorodokin, A. D. (2014). ‘Osobennosti vnutrennego otnosheniya k bolezni sredi kontingenta patsientov, stradayushchikh affektivnymi rasstroystvami v strukture addiktsiy’ [Features of dynamic change of inner disease-relation type in cohort of patients suffering from addictions]. Zaporozhye Medical Journal 6, pp. 61-65.

Corrigan, P. W. & Rao, D. (2012). ‘On the self-stigma of mental illness: stages, disclosure, and strategies for change’. The Canadian Journal of Psychiatry 57 (8), pp. 464-469.

Corrigan, P. W. & Watson, A. C. (2002). ‘Understanding the impact of stigma on people with mental illness’. World Psychiatry: Official Journal of the World Psychiatric Association (WPA) 1 (1) pp. 16-20.

Dmitrieva, T. B. et al. (eds.) (2015). Psikhiatriya. Natsional’noe Rrukovodstvo. Kratkoe Iizdanie [Psychiatry. National guideline. The short edition]. Executive editor is Aleksandrovskiy, Yu. A. M.: GEOTAR – Media publ.

Dobrokhotova, T. A. (2016). Neyropsikhiatriya. Izdanie 2-e, ispravlennoe [Neuropsychiatry. Second Edition, corrected]. M.: BINOM publ.

Famin, A. V., Kirpinhenka, A. A. & Famin, F. A. (2014). ‘The types of attitude towards disease and quality of life in patients with acute pancreatitis’. Novosti Khirurgii 22, pp. 306-312.

Forabosco, G., Ruch, W. & Nucera, P. (2009). ‘The fear of being laughed at among psychiatric patients’. Humor: International Journal of Humor Research 22, pp. 233-251.

Hammer, J. H. & Toland, M. D. (2016). ‘Internal structure and reliability of the internalized stigma of mental illness scale (ISMI-29) and brief versions (ISMI-10, ISMI-9) among Americans with depression’. Stigma and Health. Advance online publication. Retrieved April 03, 2019 from

Havranek, M. M., et al. (2017). ‘The fear of being laughed at as additional diagnostic criterion in social anxiety disorder and avoidant personality disorder?’ PLoS ONE 12 (11), pp. 1-11.

Hedman, E. et al. (2015). ‘Optimal cut-off points on the Health Anxiety Inventory, Illness Attitude Scales and Whiteley Index to Identify Severe Health Anxiety’. PLoS ONE 10 (4), pp. 1-12.

Ivanova A. et al. (2012) ‘The fear of being laughed at in healthy people and psychiatric patients. Assessing gelotophobia in Russia’. Bridging Eastern and Western Psychiatry 8 (1), pp. 10-17.

Ivanova, E. M. et al. (2016). ‘Russkoyazychnaya adaptatsiya oprosnika gelotofobii, gelotofilii i katagelastitsizma PhoPhiKat’ [Russian-language adaptation of the questionnaire of a gelotophobia, gelotophilia and katagelasticism PhoPhiKat]. Voprosy psikhologii 2, pp. 162-171.

Ivashchenko, N. E. (2012). ‘Issledovanie vnutrenney kartiny bolezni pri shizofrenii’ [A study of an internal picture of the disease under schizophrenia]. Psychiatry, Psychotherapy and Clinical Psychology 2, pp. 37-45.

Judit, B. & Séra, L. (2016). ‘The relationship between gelotophobia, shame, and humiliation’. The European Journal of Humour Research 4, pp. 93-101.

Kanter, J. W., Rusch, L. C. & Brondino, M. J. (2008). ‘Depression self-stigma’. The Journal of Nervous and Mental Disease 196 (9), pp. 663-670.

Link, B. G. et al. (1997). ‘On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse’. Journal of Health and Social Behaviour 38, pp. 177-190.

Lysaker, P. H., Roe, D., & Yanos, P. T. (2007). ‘Toward understanding the insight paradox: Internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders’. Schizophrenia Bulletin 33, pp. 192-199.

Lyubavskaya, A. A., Oleychik, I. V. & Ivanova, E. M. (2018). ‘Osobennosti gelotofobii, gelotofilii i katagelastitsizma u patsientov s depressivnym sindromom’ [Features of a gelotophobia, gelotophilia and katagelasticism in patients with a depressive syndrome]. Clinical Psychology and Special Education 3 (27), pp. 119-134.

Moya-Garófano, A., Torres-Marín, J. & Carretero-Dios, H. (2019). ‘Beyond the Big Five: the fear of being laughed at as a predictor of body shame and appearance control beliefs’. Personality and Individual Differences 138, pp. 219-224.

Nikolaeva, E. & Elnikova, O. (2014). ‘Attitude to the diseases of the people with different health levels’. Procedia - Social and Behavioral Sciences 159, pp. 96-100.

Odynets, T., Briskin, Y. & Sydorko, O. (2018). ‘Psycho-emotional state and quality of life characteristics in women with post-mastectomy syndrome with different types of attitude to the disease’. Physiotherapy Quarterly 26 (1), pp. 9-12.

Petrova, N. N. (2015). ‘Kliniko-psikhologicheskaya kharakteristika rasstroystv nastroeniya u patsientov obshchemeditsinskoy praktiki’ [Clinical psychological characteristic of mood disorders in patients of general medicine]. Klinicheskaya i meditsinskaya psikhologiya: issledovaniya, obuchenie, praktika: elektron. nauch. zhurn. 3 (9). Retrieved July 24, 2019 from

Platt, T. (2008). ‘Emotional responses to ridicule and teasing: Should gelotophobes react differently?’ Humor: International Journal of Humor Research 21 (2), pp. 105-128.

Platt, T. (2019). ‘Extreme gelotophobia: Affective and physical responses to ridicule and teasing’. Current Psychology, pp. 1-9.

Proyer, R. T. & Ruch, W. (2009). ‘Intelligence and gelotophobia: The relations of self-estimated and psychometrically measured intelligence to the fear of being laughed at’. Humor: International Journal of Humor Research 22 (1/2), pp. 165-182.

Ruch, W. & Proyer, R. T. (2009a). ‘Extending the study of gelotophobia: On gelotophiles and katagelasticists’. Humor: International Journal of Humor Research 22 (1-2), pp. 183-212.

Ruch W. & Proyer R. T. (2009b). ‘Who fears being laughed at? The location of gelotophobia in the Eysenckian PEN-model of personality’. Personality and Individual Differences 46 (5-6) pp. 627-630.

Ruch W., Beermann U. & Proyer R. T. (2009). ‘Investigating the humor of gelotophobes: Does feeling ridiculous equal being humorless?’ Humor: International Journal of Humor Research 22 (1/2), pp. 111-144.

Ruch W. et al. (2014). ‘The state-of-the art in gelotophobia research: A review and some theoretical extensions’. Humor: International Journal of Humor Research 27 (1) pp. 23-45.

Ruch, W. & Proyer, R. T. (2008). ‘Who is gelotophobic? Assessment criteria for the fear of being laughed at’. Swiss J. Psychol. 67, pp. 19-27.

Samson, A., Huber, O. & Ruch, W. (2011). ‘Teasing, ridiculing and the relation to the fear of being laughed at in individuals with Asperger’s syndrome’. J. Autism. Dev. Disord. 41, pp. 475-483.

Stefanenko, E. A. (2014). Psikhologicheskie Osobennosti gelotofobii pri shizofrenii i affektivnykh rasstroystvakh: dis. kand. psikhol. nauk [Psychological features of a gelotophobia underat schizophrenia and affective disorders: Ph.D. thesis in Psychological Science].

Stefanenko, E. A. et al. (2011). ‘Diagnostika strakha vyglyadet’ smeshnym: russkoyazychnaya adaptatsiya oprosnika gelotofobii’ [The Fear of Being Laughed at Diagnostics: Russian Adaptation of Gelotophobia Questionnaire]. Psikhologicheskii zhurnal 32 (2), pp. 94-108.

Stefanenko, E. A. et al. (2014). ‘Osobennosti otnosheniya k yumoru i smekhu u bol’nykh shizofreniey’ [Features of attitude to humour and laughter in patients with schizophrenia]. S.S. Korsakov Journal of Neurology and Psychiatry = Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova 1. pp. 26-29.

Stewart, S. H. & Watt, M. S. (2000). ‘Illness Attitudes Scale dimensions and their associations with anxiety-related constructs in a nonclinical sample’. Behaviour Research and Therapy 38 (1), pp. 83-99.

Titze, M. (1996). ‘The Pinocchio Complex: Overcoming the fear of laughter’. Humor and Health Journal 5, pp. 1-11.

Vasilieva, I. A. (2005). ‘Otnoshenie k bolezni patsientov na khronicheskom gemodialize’ [Attitudes to the diseases in patients with chronic hemodialysis]. Nephrology 9 (2), pp. 53-60.

Vasserman, L. I. et al. (2005). ‘Psikhologicheskaya diagnostika otnosheniya k bolezni: posobie dlya vrachey’ [Psychological diagnostics of the relation to a disease: guideline for physicians]. SPb.: NIPNI of V.M. Bekhtereva publ.

Vorontsova, V. S. et al. (2019). ‘Russkoyazychnaya adaptatsiya oprosnika internalizovannoy stigmy psikhicheskogo sostoyaniya (samostigmatizatsii)’ [Russian-language adaptation of the Internalized Stigma of Mental Illness Inventory]. Neurological Bulletin LI (4), pp. 29-33.

Watson, A. C. et al. (2006). ‘Self-stigma in people with mental illness’. Schizophrenia Bulletin 33(6), pp. 1312-1318.

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