Resilience as a Mediator of the Association Between Perceived Stigma and Quality of Life Among People With Inflammatory Bowel Disease

Background: Improving Quality of Life (QOL) is an essential objective in the management of inflammatory bowel disease. An accumulating body of research has been conducted to explore the association between perceived stigma and QOL among patients with chronic illness. Still, underlying mechanisms behind this pathway have not been thoroughly examined. Objective: To investigate (a) the effect of perceived stigma on QOL among patients with inflammatory bowel disease; and (b) the mediating role of resilience in the association between perceived stigma and QOL. Methods: This cross-sectional study included a convenient sample of patients diagnosed with inflammatory bowel disease from four tertiary hospitals in Jiangsu Province, China. Patients completed the Perceived Stigma Scale in Inflammatory Bowel Disease (PSS-IBD), the Resilience Scale for Patients with Inflammatory Bowel Disease (RS-IBD), and the Inflammatory Bowel Disease Questionnaire (IBDQ). A bootstrapping analysis was implemented using the SPSS macro PROCESS. Results: A total of 311 patients with Cohn's disease and ulcerative colitis participated in this study, and 57.6% were men. The mean disease duration was 3.51 ± 1.04 years. Approximately 40% of the sample exceeded the criterion score for moderate stigma. Patients who perceived moderate or severe stigma reported lower QOL compared with those with mild stigma. After controlling for sociodemographic and clinical variables, we observed that perceived stigma was negatively associated with resilience. Moreover, resilience was found to mediate the relationship between perceived stigma and all aspects of QOL. Conclusions: These findings suggested that QOL of patients with inflammatory bowel disease was associated with perceived stigma and resilience and identified the mediating effects of resilience in the relationship between perceived stigma and QOL. Furthermore, this suggests that integrating intervention techniques to target resilience into the QOL improvement program of individuals with perceived stigma is possible.

Culture-related grief beliefs and social support influence depressive symptoms of Shidu parents in rural China

BACKGROUND

Parents who have lost their only child are known as Shidu parents in China. Losing an only child is an enormous tragedy for parents that can trigger severe depressive symptoms. Few studies have explored the influence of cultural beliefs and social support on depressive symptoms.

OBJECTIVE

This study aimed to explore the relationship between culture-related grief beliefs, social support and depressive symptoms among Shidu parents in rural China.

METHOD

This cross-sectional study was conducted in Sujiatun district of Shenyang, China. Data were collected from November 2019 to February 2020 from 228 rural Shidu parents. Questionnaires consisted of the Center for Epidemiologic Studies Depression Scales (CES-D), the Culture-related Grief Beliefs of Shidu Parents Questionnaire (CBSQ), the Social Support Rating Scale (SSRS), and demographic and bereavement-related information. Hierarchical multiple linear regression analysis was conducted to examine the associations among culture-related grief beliefs, social support and depressive symptoms.

RESULTS

Of the 228 Shidu parents, 87.0% reported depressive symptoms (CES-D ≥ 16). The mean age of the participants was 62.91 years, ranging from 50 to 86. Regression analysis indicated that parents' younger age, lower education level and debts were prominent risk factors for depressive symptoms. Perceived stigma (a subscale of CBSQ) was positively associated with depressive symptoms. Social support was negatively associated with depressive symptoms.

CONCLUSIONS

Given the high prevalence of depressive symptoms in rural Shidu parents, there is a critical need to reduce perceived stigma and increase social support to alleviate depressive symptoms among Shidu parents in rural China.

Gender Differences in Perceived Stigma and Coping Strategies Among People Living with HIV/AIDS at Jugal Hospital, Harar, Ethiopia

Background

HIV/AIDS is among the most devastating diseases, having multiple effects on the health and well-being of people living with HIV/AIDS (PLWHA). There is a paucity of studies that examined the gender differences in perceived stigma among PLWHA and the different coping strategies that they use in Ethiopia.

Objective

To assess the gender differences in perceived stigma and coping strategies among PLWHA.

Methods

A comparative cross-sectional study was conducted at Jugal Hospital, Harar, eastern Ethiopia from May 01 to July 30, 2018. A total of 412 (206 females and 206 males) PLWHA were included. Face-to-face interviewer-administered data were collected. Perceived HIV stigma was assessed using the Berger HIV stigma scale. Similarly, the coping strategies were assessed using the Brief Coping Orientation to Problems Experienced (Brief COPE) scale. The data were analyzed using STATA version 13.

Results

The mean Berger stigma scale score was 65.3±11.3. The overall perceived stigma mean score was not statistically different between males and females (64.8±10.8 vs 65.8±11.7, p=0.407). Among the four subscales, women reported a higher level of disclosure stigma than men (21.1±5.5 vs 20.3±5.5; p=0.006). Regarding maladaptive coping strategies, men often used substances compared to women (2.8±1.5 vs 2.1±0.4; p<0.001). However, women use behavioral disengagement (4.6±1.1 vs 4.2±1.1; p=0.002) and self-distraction (5.9±1.5 vs 5.5±1.7; p=0.019) more often than men. Females used a higher level of adaptive coping strategies compared to males (42.5±4.9 vs 40.9±6.3, p=0.005). Furthermore, females were found to use more emotional-focused coping than males (27.6±3.2 vs 26.4±4.0; p<0.001).

Conclusion

Women reported a higher level of disclosure stigma than men and the types of coping strategies used vary between male and female. Thus, interventions to support PLWHA must take into account the gender differences in terms of perceived stigma.

Older people living with human immunodeficiency virus/acquired immune deficiency syndrome in Chinese rural areas: perceived stigma and associated factors

BACKGROUND

Perceived stigma is a common problem among people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) (PLWHA). In recent years, the number of older adults with HIV/AIDS has rapidly increased in China. However, HIV/AIDS-related perceived stigma and associated factors in older PLWHA remain unknown.

METHODS

A cross-sectional study was conducted in Yongzhou. Participants were recruited via the Hunan HIV/AIDS Registry system. All participants were ≥50 y of age at the time of their HIV diagnosis. Sowell's HIV Stigma Scale was used to measure perceived stigma.

RESULTS

A total of 193 participants were interviewed, of which 132 (68.4%) were male. The ages of the participants ranged from 50 to 82 y and the average age was 61.1±5.95 y. Eighteen (9.3%) subjects were ethnic minorities. Older PLWHA reported a relatively high level of perceived stigma, especially individuals of Han ethnicity having high annual incomes. The individuals who had disclosed their HIV-positive status to all their family had higher scores on the dimension related to blame. Regression analysis showed that ethnicity, annual income, living arrangement and disclosure patterns were the main associated factors of perceived stigma.

CONCLUSIONS

Perceived stigma is common in older Chinese PLWHA. Individuals of ethnic minorities or with higher economic status have higher levels of stigma. Family relationships have a deep influence on perceived stigma.

In-Clinic Adolescent Peer Group Support for Engagement in Sub-Saharan Africa: A Feasibility and Acceptability Trial

Holding support groups with the same cohort of adolescents during clinic visits promises to increase engagement in care. Participants (N = 35 patients, aged 12-18, 50% female, from an adolescent HIV clinic in Kumasi, Ghana, were divided into 5 teams. Clinic visits were coordinated for members of each team. Team members participated in group discussions and activities while waiting to meet with their medical team. Teams met quarterly for 1 year. Participants reported benefits from talking with peers about the challenges of managing HIV. Clinic attendance improved from the preceding year (54% versus 84%). There were reductions in perceived internal stigma, perceived external stigma, worries about unintended disclosure from taking antiretroviral therapy (ART), and reduced ART concerns. The program demonstrated the feasibility, safety, and acceptability of facilitating increased interaction among adolescents living with HIV during clinic visits. Improvements in clinic attendance, perceived stigma, and concern about medications suggest that the intervention is a promising candidate for additional study.

Perceived stigma and school attendance among children and adolescents with epilepsy in South Western Uganda

Background

Epilepsy is a neurological disorder that has a high worldwide prevalence with eighty percent of the global burden being in low and middle-income countries. There is a high level of perceived stigma among children and adolescents with epilepsy, which has severe debilitating effects and affects school attendance.

Objective

To assess the effect of perceived stigma on school attendance patterns among children and adolescents with epilepsy.

Methods

We conducted a cross sectional study among 191 children and adolescents aged from 6–18 years with epilepsy at one large semi-urban hospital and a small rural health center in SouthWestern Uganda. Epilepsy-related perceived stigma was measured using the adapted Kilifi Stigma Scale of Epilepsy and school attendance patterns were assessed using a piloted investigator-designed questionnaire.

Results

Children with high-perceived stigma were more likely to have never attended school (13.8%) or started school late (average age 5.7 years) compared to those with low-perceived stigma (average age 4.9 years). Additionally, those with high epilepsy-related perceived stigma repeated classes 2.5 times more compared to those with low-perceived stigma.

Conclusion

These preliminary findings suggest correlation between high-perceived stigma and disrupted school attendance patterns among children and adolescents with epilepsy, hence the need to address this social challenge.

Perceived threat of Alzheimer's disease and related dementias in Chinese older adults: The role of knowledge and perceived stigma

OBJECTIVES

This study focused on perceived threat of Alzheimer's disease and related dementias (ADRD) in Chinese older adults and investigated its associations with their perceived stigma and knowledge of ADRD.

METHODS

We examined Chinese older adults' perceived threat of ADRD and its associations with perceived stigma, knowledge of ADRD, family variables and health variables. Data for this cross-sectional study were collected by student interviewers in 2016. The participants (N = 754) were recruited from two urban communities in mainland China and their ages ranged from 60 to 89 (M = 69.54, SD = 7.35).

RESULTS

Hierarchical regression analyses indicated that those who are younger, have more depressive symptoms and lower levels of family cohesion are more likely to worry about ADRD. More ADRD knowledge and higher levels of perceived stigma are significantly associated with perceived threat of ADRD. Community site moderated the relationship between stigma and perceived threat of ADRD.

CONCLUSIONS

Intervention or service programs need to promote ADRD knowledge and awareness in a culturally sensitive way as well as address stigma and fear toward ADRD in the older population. Future studies are needed to incorporate more cultural and environmental factors to fully understand Chinese older adults' attitudes toward and literacy of ADRD.

Therapeutic Songwriting for Perceived Stigma and Perceived Social Support in Adults with Substance Use Disorder: A Cluster-Randomized Effectiveness Study

Background: Due to negative societal stereotypes associated with substance use disorder (SUD), many people with addictions experience perceived stigma and lack perceived social support. Perceived stigma can prevent people with SUD from seeking treatment while perceived social support can facilitate recovery. Objective: The purpose of this study was to determine the effects of a single music therapy songwriting intervention on perceived stigma and perceived social support in adults with SUD on a detoxification unit. Method: Participants (N = 132) were cluster-randomized to a therapeutic songwriting or control condition in a single-session design. The experimental condition received a highly structured group-based blues songwriting intervention wherein participants composed lyrics describing stigma against addiction as an inappropriate and false social construct in the first verse and coping with stigma by using social supports in the second verse. Results: Analyses of variance indicated no significant between-group difference in perceived stigma or perceived social support. Conclusions: Due to its non-threatening medium, therapeutic songwriting concerning perceived stigma and perceived social support may be clinically relevant way to target these sensitive yet essential topics. Implications for clinical practice, limitations, and suggestions for future research are included.

Impact of Perceived Stigma in People Newly Diagnosed With Lung Cancer: A Cross-Sectional Analysis

OBJECTIVES

To investigate perceived stigma and its possible associations with treatment expectations and preferences in newly diagnosed patients with lung cancer.

SAMPLE & SETTING

274 patients with lung cancer diagnosed in the previous four months at oncology and respiratory outpatient clinics in Australia.

METHODS & VARIABLES

Participants completed a self-report survey about perceived lung cancer stigma and treatment expectations and preferences.

RESULTS

A mean perceived stigma score of 52 of a possible 124 was reported, which is lower than scores reported in other studies using the same measure; the current study determined that perceived lung cancer stigma was observed less frequently. Significantly higher scores were observed in participants who were younger or who had a history of smoking. Perceived lung cancer stigma was significantly related to treatment expectations. No relationship was found between perceived lung cancer stigma and treatment preferences.

IMPLICATIONS FOR NURSING

Healthcare providers are in a key position to provide support and communicate empathetically with patients to minimize potential stigma experiences.

Depression, Anxiety and Their Correlates Among Patients With HIV in South Ethiopia: An Institution-Based Cross-Sectional Study

Background: Depressive and anxious symptoms are more regularly seen in HIV-infected people than in the general population. This investigation planned to evaluate the magnitude and factors related to depressive and anxiety symptoms among HIV patients in South Ethiopia, 2018. Methods: This was an institution-based cross-sectional study directed among 363 HIV-infected individuals who had a customary visit at Hawassa University Comprehensive Specialized Hospital and Yirgalem Hospital, Ethiopia, who were incorporated into the study through systematic sampling techniques. The hospital anxiety and depression scale (HADS) was utilized to take a look at anxious and depressive symptoms. Results: The mean age of the respondents was 37.66 years (SD ±10.03). The prevalence of depression and anxiety were 32.0% and 34.4%, respectively. Patients who were living alone [AOR = 1.94, (95% CI: 1.06, 3.56)], had poor social support [AOR = 5.57, (95% CI: 1.20, 10.84)] or had HIV-related perceived stigma [AOR = 2.35, (95% CI: 1.44, 3.84)] were more likely to have depression as compared to their counterparts. Those with a previous history of mental illness [AOR = 3.36, (95% CI: 1.31, 8.61)] and poor social support [AOR = 6.67, (95% CI: 1.47, 10.33)] were more likely to have anxiety symptoms. Conclusion: The prevalence of anxiety and depression in the current study was high. Concerned health departments of the country should create guidelines to screen and treat depression and anxiety among HIV patients. Further research on hazard factors of depression and anxiety ought to be examined to strengthen and expand these findings.

Quality of Life and its Relationship with Perceived Stigma among Opioid Use Disorder Patients: An Exploratory Study

BACKGROUND

In view of recent global opioid epidemic and scarcity of literature assessing the quality of life (QoL) and stigma among opioid use disorder (OUD) patients, this study aimed to assess the overall QoL and examine its relationship with perceived stigma among them.

MATERIALS AND METHODS

This cross-sectional study assessed patients with OUD at a tertiary care centre. QoL was assessed using the World Health Organization Quality of Life-brief version, whereas perceived stigma was measured using the Perceived Stigma of Substance Abuse Scale (PSAS).

RESULTS

Among 168 patients with OUD, all the four domain-wise scores of physical health (r = 0.79, P < 0.01), psychological health (r = 0.87, P < 0.01), social relationships (r = 0.78, P < 0.01) and environment (r = 0.80, P < 0.01) QoL correlated significantly with average score, with maximum impairment noted in the social domain. The mean PSAS score was 21.19 ± 2.99, with perceived stigma found to be significantly associated with impairments in the physical (β = -0.28, P < 0.01), psychological (β = -0.27, P < 0.01) and environment (β = -0.21, P < 0.01) domains of QoL. Furthermore, being employed was significantly associated with impairment in the social domain of QoL (β = -0.17, P = 0.02).

CONCLUSION

OUD similarly affects all the four domains of QoL, with a higher level of perceived stigma associated with significantly poorer QoL in the physical, psychological and environment domains. However, future studies assessing different forms of stigma and QoL among patients with OUD are needed to confirm and better characterise the findings of this study.

Perceived HIV-related stigma among university students in South Africa: implications for HIV testing

HIV-related stigma, and particularly perceived stigma, has a negative impact across the HIV care continuum. This study adds to our understanding of stigma by assessing how perceived stigma varies from one context to another and how such differences are associated with the location where individuals would prefer an HIV test. We used self-administered questionnaire data (n = 378) obtained from a convenience sample of students (18 years and older) attending a tertiary education institution in Durban, South Africa. Perceived stigma in the university environment was compared to perceived stigma in the home community environment. Multiple logistic regression analysis tested whether a higher level of perceived stigma in one setting was associated with a preference for HIV testing in the other setting. While levels of symbolic stigma and discrimination were low, a large proportion of the sample perceived that people living with HIV experience some form of stigmatisation in the home community and university environments (47% vs 41%, p = 0.09). A total of 31% reported less perceived stigma in the university environment. Students who perceived less stigma in the university environment were significantly more likely to report a preference for HIV testing at the university clinic rather than at a clinic in their community (aOR: 2.03; p < 0.01). Perceptions common across settings that people living with HIV experience stigmatisation are of great concern, especially for efforts to increase demand for HIV testing among young people. Results suggest that HIV-testing services in environments perceived to be less stigmatising than home communities could provide preferred alternatives for HIV testing.

Relationship between physicians' perceived stigma toward depression and physician referral to psycho-oncology services on an oncology/hematology ward

OBJECTIVE

This study was performed to identify relationships between physicians' perceived stigma toward depression and psycho-oncology service utilization on an oncology/hematology ward.

METHODS

The study participants were 235 patients in an oncology/hematology ward and 14 physicians undergoing an internal medicine residency training program in Inha University Hospital (Incheon, South Korea). Patients completed the Patient Health Questionnaire-9 (PHQ-9), and residents completed the Perceived Devaluation-Discrimination scale that evaluates perceived stigma toward depression. A total PHQ-9 score of ≥5 was defined as clinically significant depression. Physicians decided on referral on the basis of their opinions and those of their patients. The correlates of physicians' recommendation for referral to psycho-oncology services and real referrals psycho-oncology services were examined.

RESULTS

Of the 235 patients, 143 had PHQ-9 determined depression, and of these 143 patients, 61 received psycho-oncology services. Physicians recommended that 87 patients consult psycho-oncology services. Multivariate analyses showed that lower physicians' perceived stigma regarding depression was significantly associated with physicians' recommendation for referral, and that real referral to psycho-oncology services was significantly associated with presence of a hematologic malignancy and lower physicians' perceived stigma toward depression.

CONCLUSION

Physicians' perceived stigma toward depression was found to be associated with real referral to psycho-oncology services and with physician recommendation for referral to psycho-oncology services. Further investigations will be needed to examine how to reduce physicians' perceived stigma toward depression.

Perceived stigma of HIV patients receiving task-shifted primary care service and its relation to satisfaction with health service

INTRODUCTION

HIV stigma is the remaining challenge to end the global epidemics of HIV. Whether stigma may form a barrier to the provision of ART within the community-based, primary care setting was not studied yet. Therefore, this study intended (1) to compare the levels of 'perceived stigma' in PLHIV attending district hospital and primary care units (PCUs), and (2) to measure the relation between HIV stigma and the satisfaction of patients with their health service.

METHODOLOGY

In this cross-sectional study, two matched PLHIV attending district hospitals were recruited for every PLHIV attending a PCU, within a pilot project, until the end of 2014. 198 informed and consented participants were recruited. We used validated Thai version instruments to measure the levels of 'perceived stigma' and 'internal shame' and the Patient Satisfaction Questionnaire 18 (PSQ18) to measure patients' satisfaction with the health service. Analysis applied MANOVA and multivariate robust regression.

RESULTS

The level of 'perceived stigma' and 'internal shame' levels were not significantly different between district hospitals attendants and PCU attendants (P>0.05 MANOVA). Moreover, the more patients were satisfied with the health service, the less likely to have 'perceived stigma' (β -5.9, 95% confidence interval -7.7 to -4.1) and 'internal shame' (β -5.7, 95% CI -8.3 to -3.2), P<0.001).

CONCLUSIONS

HIV associated stigma would be minimized through the attempt to promote PLHIV's satisfaction with ART service. There is ample role of health professional education and training to improve patients' satisfaction. It may contribute to the aim of zero discrimination.

Stigma perceptions in patients with eosinophilic gastrointestinal disorders

This study aims to evaluate the presence of perceived stigma in people diagnosed (self-reported) with an eosinophilic gastrointestinal disorder and examine the relationship to the patient's health-related quality of life and additional psychosocial patient-reported outcomes. One hundred forty-nine patients diagnosed for a minimum of 6 months participated in the study. Eligible participants completed questionnaires to assess perceived stigma, psychological functioning, and health-related quality of life. Perceived stigma was moderately associated with a decrease in total health-related quality of life and perceived treatment efficacy. Additionally, greater perceived stigma was positively correlated with an increase in anxiety, depression, and healthcare utilization. The study demonstrates the influence of perceived stigma on several aspects of health-related quality of life in patients with these illnesses. As such, it is important for health professionals to be aware of stigma in patients diagnosed with an eosinophilic gastrointestinal disorder.

Internalized Homophobia and Perceived Stigma: A Validation Study of Stigma Measures in a Sample of Young Men who Have Sex with Men

Young men who have sex with men (YMSM) experience minority stressors that impact their mental health, substance use, and sexual risk behaviors. Internalized homophobia (IH) and perceived stigma represent two of these minority stressors, and there has been limited research empirically validating measures of these constructs. We validated measures of IH and perceived stigma with a sample of 450 YMSM (mean age=18.9) and a sample of 370 YMSM (mean age=22.9). Results from exploratory and confirmatory factor analyses supported modifications to the IH and perceived stigma scales, ultimately revealing a three factor and one factor structure, respectively. Convergent and discriminant validity were examined utilizing correlations between IH, perceived stigma, and other variables related to minority stress (e.g., victimization). We evaluated predictive validity by examining relations with mental health, substance use, and risky sexual behaviors measured 12-months from baseline. There were mixed findings for IH, with subscales varying in their relations to mental health, drinking, and sexual risk variables. Perceived stigma was not related to mental health or substance use, but was associated with greater prevalence of STIs. Findings supported the use of these modified scales with YMSM and highlight the need for further measurement studies.

Development of Japanese version of King's Stigma Scale and its short version: Psychometric properties of a self-stigma measure

AIM

The study aimed to develop two Japanese versions of King's Stigma Scale, a full version (KSS-J-1) and a short version (KSS-J-2), through psychometric property testing.

METHODS

The sample included 112 people with mental illness. We tested the constructs of the scales using both confirmatory and exploratory factor analyses. Internal consistency and test-retest reliability were tested. We examined convergent validity with self-esteem or perceived stigma, and different group validity, using the Kessler Psychological Distress Scale (K6).

RESULTS

Whereas a relatively weak model fit (comparative fit index = 0.66, Tucker-Lewis index = 0.63, root mean square error of approximation = 0.097) of KSS-J-1 (full version: 28 items) was found, KSS-J-2 (short version: 17 items), produced by exploratory factor analysis, had a moderate model fit (comparative fit index = 0.90, Tucker-Lewis index = 0.89, root mean square error of approximation = 0.063). High internal consistency (KSS-J-1, ω = 0.82-0.89; KSS-J-2, ω = 0.86-0.89) and moderate test-retest reliability (KSS-J-1, interclass correlation = 0.56-0.88; KSS-J-2, interclass correlation = 0.45-0.85) were reported. Some subscales and the entire scale of KSS-J-1 were significantly correlated with self-esteem and perceived stigma. Conversely, only two subscales in KSS-J-2 were significantly correlated with self-esteem. The scores of each subscale and the entire score for both KSS-J-1 and KSS-J-2 in the high psychological distress group were higher than the low group (KSS-J-1, d = 0.61-0.83; KSS-J-2, d = 0.47-0.70), except for the Discrimination subscale in KSS-J-2.

CONCLUSION

Both Japanese versions of King's Stigma Scale can be utilized depending on their intended use.

Perceived stigma of mental illness: A comparison between two metropolitan cities in India

PURPOSE

An increasing number of comparative studies are conducted on the stigmatization of persons with mental illness, in particular with regard to regional and diachronic variation. So far, there have been no studies comparing stigmatization of persons with mental illness in two different regions of India. Therefore, we examined the differences in perception of stigma attached to mental illnesses in Kolkata and Chennai, with regard to cultural and geographical differences to better understand the roots and origins of this issue.

MATERIALS AND METHODS

Explorative surveys in the context of public attitudes toward people with mental disorders were conducted among conveniently selected members of the general population in Chennai (n = 166) and Kolkata (n = 158) with identical methodology. Link's perceived devaluation-discrimination measure was used. The samples were matched for age, gender, and education.

RESULTS

The calculated sum score indicated that respondents from Kolkata had a higher level of perceived discrimination toward persons with mental illness than respondents from Chennai (P = 0.043). Furthermore, regression analysis revealed that lower perceived stigma was associated with stronger religious devotion (P = 0.049) and higher educational attainment (P = 0.001) in both cities.

DISCUSSION

The results showed that perceived stigma was higher in Kolkata than in Chennai. The correlation of higher stigma with lower education was in line with the previous research, and interestingly, it was found that higher stigma correlated with weaker religious devotion. Further studies exploring a wider variety of factors may provide us with a better understanding of the roots of perceived stigma in India.

The Perceived Stigma in Patients with Alopecia and Mental Disorder: A Comparative Study

Aim:

We aimed to measure the perceived stigma, especially in patients with alopecia areata (AA) and to compare the results with patients with mental disorder (MD).

Materials and Methods:

This study included forty patients with AA who were consecutively recruited from dermatology outpatient clinic and 42 patients with MD who were consecutively recruited from psychiatric outpatient clinic. The presence of a MD was assessed by the Diagnostic and Statistical Manual of Mental Disorder Fourth Edition. All participants were asked to complete the 28 items modified stigmatization questionnaire.

Results:

Total and all subscale scores of stigmatization questionnaire scale were higher in the group of patients with AA than in the patients with MD.

Conclusion:

AA is a condition that leads to more self-stigmatization than MD.

Perceived Stigma among Recipients of Mental Health Care in the General Canadian Population

OBJECTIVES

The Mental Health Experiences Scale is a measure of perceived stigma, the perception of negative attitudes and behaviours by people with mental disorders. A recent Canadian survey (Canadian Community Health Survey-Mental Health) included this scale, providing an opportunity to describe perceived stigma in relation to diagnosis for the first time in the Canadian general population.

METHODS

The survey interview began with an assessment of whether respondents had utilised services for an "emotional or mental health problem" in the preceding 12 months. The subset reporting service utilisation were asked whether others "held negative opinions" about them or "treated them unfairly" for reasons related to their mental health. The analysis reported here used frequencies, means, cross-tabulation, and logistic regression, all incorporating recommended replicate sampling weights and bootstrap variance estimation procedures.

RESULTS

Stigma was perceived by 24.4% of respondents accessing mental health services. The frequency was higher among younger respondents (<55 years), those who were not working, those reporting only fair or poor mental health, and the subset who reported having received a diagnosis of a mental disorder. Sex and education level were not associated with perceived stigma. People with schizophrenia reported stigmatization only slightly more frequently than those with mood and anxiety disorders.

CONCLUSIONS

Stigmatization is a common, but not universal, experience among Canadians using services for mental health reasons. Stigmatization was a problem for a sizeable minority of respondents with mood, anxiety, and substance use disorders as well as bipolar and psychotic disorders.

Perceived stigma and associated factors among people with epilepsy at Gondar University Hospital, Northwest Ethiopia: a cross-sectional institution based study

BACKGROUND

Epilepsy is the world's most common neurological disorder, affecting approximately 69 million people worldwide. Perceived stigma affects many domains of the lives of people with epilepsy. However, in Ethiopia there is dearth of study on perceived stigma specifically among people with epilepsy.

OBJECTIVE

To assess the prevalence of perceived stigma and associated factors among people with epilepsy (PWE) attending the outpatient department of the University of Gondar hospital, Northwest Ethiopia, 2014.

METHODS

Institution based quantitative cross - sectional study was employed among 408 individuals people with epilepsy. Single population proportion formula was used utilized to calculate sample size. The participants were selected using systematic random sampling technique. Perceived stigma was measured using by the modified Family Interview Schedule (FIS) tool. Binary logistic regression analysis and adjusted odds ratio with 95% confidence interval were used to identify the associated factors with perceived stigma..

RESULTS

Overall, the prevalence of perceived stigma was found to be 71.6%. Marital status [single (AOR = 0.23, CI: 0.25, 0.90), widowed ( AOR = 0.37, CI: 0.15, 0.90) duration of illness [2-5 years (AOR = 4.38, CI:1.98,9.62, 6-10 years (AOR =4.29, CI:1.90,9.64, ≥11 years (AOR = 4.31,CI:1.84,10.00) and seizure frequency of [1-11per year (AOR=2.34, CI:2.21,3.56), ≥1per month (AOR = 5.63, CI:3.42,10.32)] were factors associated with perceived stigma.

CONCLUSION

Overall, the prevalence of perceived stigma was found to be high. Marital status, long duration of illness and seizure frequency were factors associated with perceived stigma.

Understanding internalized HIV/AIDS-related stigmas in the Dominican Republic: a short report

HIV/AIDS-related stigmas can become internalized, resulting in declines in physical and mental health. Pathways to internalized HIV-related stigma (IS), characterized by persistently negative, self-abasing thoughts, are not well established among women living with HIV/AIDS (WLWHA) in the Dominican Republic (DR). Identifying factors involved in self-directed shaming and blaming is important, given the high HIV prevalence in the DR's most vulnerable populations. The present study sheds light on factors involved in negative and self-abasing thoughts in WLWHA in the DR by examining the relationship between depression, perceived HIV-related stigma from the community (PSC), perceived HIV-related stigma from family (PSF), and IS. The Internalized AIDS-Related Stigma Scale (IA-RSS), the Center for Epidemiologic Studies Short Depression Scale (CES-D 10), and an instrument designed to measure perceived HIV-related stigma from the community and family was administered to 233 WLWHA in Puerto Plata, DR. Data were analyzed using descriptive statistics and ordered multiple logistic regression. Results showed that depression (OR = 1.60; p < .05), PSC (OR = 3.68; p < .001), and PSF (OR = 1.60; p < .01) were positively associated with IS. These findings indicate that IS-reducing interventions should address HIV-related depression. Additionally, HIV-related treatment and care services should work with WLWHA to adopt healthier attitudes about how community members view people living with HIV/AIDS in the DR.

Stigma, sex work, and substance use: a comparative analysis

Stigma is a widely used concept in social science research and an extensive literature claims that stigmatisation contributes to numerous negative health outcomes. However, few studies compare groups that vary in the extent to which they are stigmatised and even fewer studies examine stigma's independent and mediating effects. This article addresses these gaps in a comparative study of perceived stigma and drug use among three low-income feminised service occupations: sex work, food and alcoholic beverage serving, and barbering and hairstyling. An analysis of longitudinal data shows positive associations between sex work, perceived stigma, and socially less acceptable drug use (for example, heroin and cocaine), and that stigma mediates part of the link between sex work and the use of these drugs. Our overall findings suggest that perceived stigma is pronounced among those who work in the sex industry and negatively affects health independently of sex work involvement.

Stigma resistance among people with schizophrenia at Amanuel Mental Specialized Hospital Addis Ababa, Ethiopia: a cross-sectional institution based study

BACKGROUND

Schizophrenia is one of the most disabling and severely stigmatized mental disorders. Together with social stigma, internalized stigma and perceived stigma can trigger a vicious cycle and diminishes the stigma resistance abilities of individual. Helping patients to cope up with perceived and internalized stigma play crucial role in fighting stigma. This study aimed to assess the prevalence and associated factors of stigma resistance among people with schizophrenia attending the outpatient department of Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia.

METHODS

Institution based cross-sectional study design was employed. Single population proportion formula was used to calculate sample size. Subjects were selected by systematic sampling techniques. Bivariate and multivariate logistic regressions were performed to identify the presence and strength of association. Odds ratios with 95% confidence interval were computed to determine the level of significance.

RESULTS

A total of 411 subjects participated in the study giving a response rate of 97.4%. The prevalence of low stigma resistance was found to be 51.6%. Rural residence (AOR = 0.29 (95% CI: 0.142, 0.594), difficulties of adherence to antipsychotic medication (AOR = AOR = 0.3, 95% CI: 0.155, 0.542), internalized stigma (AOR = 0.24, 95% CI: (0.111, 0.530), alienation (AOR = 0.5, 95% CI: (0.270, 0.927), stereotype endorsement (AOR = 0.37(95% CI: 0.312, 0.463) and social withdrawal (AOR = 0.27, 95% CI: (0.156, 0.468) were factors statistically associated with low stigma resistance.

CONCLUSION

In this study, overall more than half of the study participants had low stigma resistance. Rural residence, difficulties of adherence to antipsychotic medication, high internalized stigma, alienation and social withdrawal were factors statistically associated with low stigma resistance. Encouraging participations in different social relationships such as befriending programs, family and peer support groups are recommended.

Moving beyond perceptions: internalized stigma in the irritable bowel syndrome

BACKGROUND

Internalized stigma (IS) is an important construct in the chronic illness literature with implications for several patient reported outcomes. To date, no study exists evaluating IS in patients with the irritable bowel syndrome (IBS).

METHODS

Two hundred and forty three online and clinical participants completed the following questionnaires: the IS scale for mental illness (ISMI; modified for IBS), perceived stigma scale for IBS, NIH-PROMIS Anxiety and Depression Scales, IBS quality of life scale, and the Perceived Health Competence Scale. Demographical and clinical data were also collected.

KEY RESULTS

The modified ISMI was reliable and valid in this population. Participants reported both perceived and IS. Alienation was most reported, followed by social withdrawal and discrimination experiences. IS predicted 25-40% of the variance in psychological functioning, quality of life, healthcare utilization, and health competence when controlling for stigma perception and disease variables. IBS patients perceived more stigma from personal relations than healthcare providers. Hispanic participants reported more perceived stigma, indicating there may be cultural differences in IBS-related stigma experience. Symptom severity, disruptiveness, and treatment choices are also implicated in stigma perception and internalization.

CONCLUSIONS & INFERENCES

Patients with IBS report both perceived and IS with alienation most reported. However, IS significantly predicts several patient outcomes when controlling for PS. Cultural and illness traits may influence how stigma is perceived and internalized. Future research is warranted.