From social curse to social cure: A self‐help group community intervention for people affected by leprosy in Nepal

Social Identity and Online Support Groups: A Qualitative Study with Family Caregivers

BACKGROUND

The purpose of this study was to explore whether a sense of collective or shared group identity was developed in one established online social support group for family caregivers and, if so, what did group identification mean for the group members and how was this cultivated in the group.

METHODS

Eighteen semi-structured interviews were carried out with members of a family caregiver online support group in Ireland. Inductive and deductive reflexive thematic analysis drawing on the social identity approach (SIA) generated four main themes and several related subthemes.

RESULTS

The first main theme generated was The group are a Tribe and the Tribe gets it, with subthemes: Invisibility as a common experience, my Tribe understands I am more than just a carer and Just being part of the Tribe can be enough. The second main theme generated was the Tribe is a lifeline and life-changing, with related subthemes: Our connection relieves experiences of loneliness and social isolation and Sharing knowledge, experience and support made me feel visible. The third and fourth main themes generated were The leadership of group moderators helped create the Tribe identity and Lessons that can be learnt. These findings are discussed in relation to the social identity approach, social isolation and loneliness.

CONCLUSIONS

We concluded that group identity can be cultivated through considered, active and balanced moderation, creating a safe, welcoming and supportive space where family caregivers are able to have fun and seek information, advice and emotional support, which helps relieve loneliness and social isolation.

The link between anticipated and internalized stigma and depression: A systematic review

Stigmatized groups may experience psychological distress. Yet, some studies show no significant relation between stigma and mental health outcomes. This systematic review investigates the link between anticipated and internalized stigma, and one mental health outcome, depression. We aimed to (1) determine whether anticipated and internalized stigma predict levels of depression, and (2) review the quality of evidence for this link. We searched PsycInfo, PubMed and EMBASE databases. Eighty-three studies (N = 34,705) met our inclusion criteria, across five stigma categories: Sexual and gender minorities; HIV/AIDS; Illness or disability-related (non-HIV); Weight, and Other. We reviewed evidence within each category and study design and developed a narrative synthesis. Sixty studies (72.3%) supported the proposed link, which varied across categories from 53.6% to 100%. Using the NIH quality assessment tool, most studies were of fair quality. Most cross-sectional studies (76.7%) straightforwardly supported the positive relation between internalized and/or anticipated stigma and depression, while only 40% of longitudinal studies did. Implications for the study of stigma and mental health outcomes are discussed.

Disclosing an autism diagnosis: A social identity approach

Autistic people face a difficult dilemma around whether or not to disclose their diagnosis because autistic people are a stigmatized social group. The central aim of this study was to examine if a social identity approach could be useful in understanding the factors that predict the likelihood of autistic adults disclosing their autism diagnosis in social settings, in the workplace, in educational settings and in the family. The social identity approach predicts that autistic people may cope with this dilemma by using an individualistic strategy to distance themselves from their autistic social identity. Alternatively, they may embrace their autistic social identity and use a collective strategy to resist stigma and advocate for autistic people. We present a survey based cross-sectional study (n = 175) with autistic adults living in Ireland. Participants completed a series of measures; autism social identification, stigma consciousness, and individualistic and collective strategy use to assess disclosing in the four settings. The overall models in each of the four regressions were significant. Autism social identification positively predicted disclosure in social, workplace and educational settings, while stigma consciousness negatively predicted disclosure in the family and in the workplace. Interestingly, over and above these predictors individualistic strategy use negatively predicted disclosure in each of the four settings, while collective strategy use positively predicted disclosure in social, educational and family settings. Our novel social identity approach was useful for explaining autistic adults' strategies to cope with the complex disclosure dilemma. Strengths, limitations, and directions for future research are discussed.

Health literacy among self-help leprosy group members reduces stereotype endorsement and stigma-related harm in rural Nepal

There is increasing appreciation that group memberships can have both beneficial and damaging impacts on health. In collaboration with Nepal Leprosy Trust (NLT), this longitudinal study explores a group-based approach to stigma reduction among people affected by leprosy in rural Nepal (N = 71)-a hard to reach and underrepresented non-WEIRD population. Informed by the 'social cure' literature, and the progressive model of self-stigma, we use a longitudinal design. We found that a sense of belonging to a self-help group can facilitate education in terms of health literacy, and over time these two factors also have impacts on participants stigma. Specifically, self-help group belonging predicted improvements in health literacy, leading to reduced endorsement of negative stereotypes and thus less stigma-related harm among people affected by leprosy. The study offers promising evidence that group-based interventions, which support health education, can reduce the harmful impact of stigma in very challenging contexts.