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Labelling theory matters because it explains how the label 'mentally ill' can itself change a person's behaviour and identity, not just describe an existing problem. Labelling theory proposes that deviance, behaviour that breaks social norms, is not an inherent quality of an act but something conferred by how society reacts to it. For example, imagine two teenagers who both shoplift once: one is quietly cautioned by a shopkeeper, while the other is formally arrested and labelled a 'young offender' by the system. In practice, the labelled teenager is more likely to be treated differently by others and to start seeing himself through that same label, which can shape his future behaviour.

Lemert distinguished primary deviance, an initial rule-breaking act that has little effect on a person's self-concept, from secondary deviance, further deviance that occurs after a person accepts a deviant label as part of their identity. Once secondary deviance sets in, the label can become a self-fulfilling prophecy, since being treated as 'deviant' pushes the person toward further deviant behaviour, reinforcing the very label that was applied. Scheff applied this idea to psychiatry, arguing that being formally diagnosed and treated as 'mentally ill' can itself shape a person's long-term identity and behaviour, beyond the effect of the underlying symptoms. Say a patient is discharged after a first psychiatric admission and is then excluded from a job because of their diagnosis: that social exclusion can worsen their functioning independently of their original illness. In practice, clinicians should be alert that diagnosis and hospitalisation carry a social cost, the label itself, on top of any direct clinical effect.

• Lemert distinguished two stages of deviance. Which term describes the initial rule-breaking act, before any label has been applied by others?
• Scheff argued that psychiatric symptoms often begin as breaches of unnamed social conventions for which no specific rule exists. What term did he use for these breaches?
• Rosenhan's 1973 study sent healthy volunteers to psychiatric hospitals reporting a single symptom. Which finding is most often cited as supporting labelling theory?
• A sociologist describes a characteristic that overwhelms all others in how a person is seen, so that everything about them is read through it. What is this called?

• Stigma, the negative attitude or discrimination attached to a label, unlike labelling theory's broader account of the labelling process itself.
• Anti-psychiatry movement, argues mental illness is largely a social construct, whereas labelling theory accepts the illness is real but adds a social-reaction layer.
• Primary deviance, an initial act with little effect on self-concept, unlike secondary deviance, which follows from accepting a deviant label.
• Self-fulfilling prophecy, the general mechanism by which an expectation shapes behaviour, rather than labelling theory's specific application to deviance and diagnosis.

• That is not part of the original two-stage distinction.
• That broader term does not capture the unnamed quality he emphasised.
• That term describes behaviour that follows the label being applied.
• That term describes breaking unnamed social conventions.
• That describes an expectation bringing about its own fulfilment.

• Name the learning, social or research principle being tested before reading the options.
• Identify the antecedent, behaviour, consequence or cognitive process in the vignette.
• Compare the direction of effect with the nearest competing principle.
• Apply the same rule to a new example to confirm that the answer transfers.