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Zeng Y, Pan T, Sun M. The influencing factors of stigma towards people with mental illness among nursing students: a mixed-method systematic review. MEDICAL EDUCATION ONLINE 2024; 29:2376802. [PMID: 38970824 PMCID: PMC11229721 DOI: 10.1080/10872981.2024.2376802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
The stigma of nursing students towards people with mental illness (PMI) creates significant barriers to diagnosis, treatment, and recovery for those with PMI. It can also have a significant impact on the future career choices of nursing students in the field of psychiatry. Current research has found various influencing factors, including personal characteristics and educational influences. However, a comprehensive analysis that encompasses all aspects is lacking. The aim of the study was to conduct a convergent mixed-method systematic review to synthesize the influencing factors of the stigma of nursing students towards PMI according to Framework Integrating Normative Influences on Stigma (FINIS) at micro, meso, and macro levels. PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and PsycINFO were searched from 1990 to 31 December 2023. The reference lists of the included literature were further checked to identify potentially relevant articles. Two authors independently screened all titles, abstracts, and full-text articles and extracted data. Study quality was assessed by two authors using the Mixed Method Appraisal Tool (MMAT). A total of 4865 articles were initially retrieved, and 73 of these articles were included. The results suggested that the stigma towards PMI by nursing students was influenced by micro, meso and macro levels. At each FINIS level, the most frequent influencing factors are personal characteristics, the treatment system and media images. Numerous interconnected factors exert an influence on the stigma towards PMI among nursing students. Our research can be used to identify barriers and facilitators to nursing students' stigma towards PMI and to provide supporting information for interventions designed to reduce this stigma.
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Affiliation(s)
- Yi Zeng
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing, Changsha Medical University, Changsha, China
| | - Ting Pan
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Nursing, Xinjiang Medical University, Urumqi City, China
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Hu M, Wu X, Qiu S. Examining the impact of self-stigma on workplace well-being: an empirical investigation of medical students with physical disabilities in China and the moderating role of trait mindfulness. BMC MEDICAL EDUCATION 2024; 24:741. [PMID: 38982417 PMCID: PMC11234788 DOI: 10.1186/s12909-024-05554-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 05/13/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND As societal evolution unfolds in China, individuals with physical disabilities are increasingly provided opportunities in higher education, particularly in the field of medicine. However, these medical students often encounter bias in their work environments, including during internships, which fosters self-stigma and impedes their experience for workplace well-being (WWB). Such a decrease in WWB detrimentally affects not only their mental health in the workplace but also hinders their sense of personal worth and assimilation into broader society. This study aims to examine the challenges faced by medical students with physical disabilities in China as they aspire to achieve WWB, and to explore potential intervention strategies. METHODS Leveraging cognitive consistency theory (CCT), we introduces a conceptual framework to examine the relationships among self-stigma, perceived discrimination, and WWB. It also investigates the role of trait mindfulness as a potential mitigating factor in this dynamic. We employed the Internalized Stigma of Mental Illness Scale (ISMIS), Discrimination Perception Questionnaire (DPQ), Workplace Well-being Subscale (WWBS), and Mindful Attention Awareness Scale (MAAS) to survey 316 medical students with physical disabilities. Statistical analyses, including correlation, regression, and moderated mediation effect assessments, were conducted using SPSS 22.0 and AMOS 24.0. RESULTS A notable negative correlation exists between self-stigma and WWB (r = -0.56, p < 0.01). Perceived discrimination partially mediates the relationship between self-stigma and WWB. The direct effect of self-stigma and its mediating effect through perceived discrimination account for 60.71% and 21.43% of the total effect, respectively. Trait mindfulness moderates the latter part of this mediating pathway. Moderation models indicate that trait mindfulness has a significant negative moderating effect on the impact of perceived discrimination on WWB (β = -0.10, p < 0.001). CONCLUSIONS Self-stigma adversely affects the positive work experiences of medical students with physical disabilities by eliciting a heightened sensitivity to discriminatory cues, thereby undermining their WWB. Trait mindfulness can effectively counter the detrimental effects of perceived discrimination on WWB. Consequently, this study advocates for the systematic incorporation of mindfulness training into educational services and workplace enhancement programs for medical students with disabilities, aiming to foster an inclusive and supportive external environment.
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Affiliation(s)
- Minqiao Hu
- Business School, Sichuan University, Chengdu, China
| | - Xiongfu Wu
- Business School, Sichuan University, Chengdu, China
| | - Shuang Qiu
- School of Foreign Languages, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
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Vélez-Botero H, Agudelo-Hernández F, Moreno-Mayorga B, Plata-Casas LI. Psychometric characteristics of a questionnaire to assess perceived disability in people with epilepsy. Epilepsy Behav 2024; 158:109915. [PMID: 38941952 DOI: 10.1016/j.yebeh.2024.109915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/08/2024] [Accepted: 06/19/2024] [Indexed: 06/30/2024]
Abstract
It has been determined that quality of life in epilepsy is closely related to the perceived disability experienced by individuals with the diagnosis. However, this measure is seldom considered in healthcare processes. The objective of the present study is to establish the psychometric properties of the Perceived Disability Questionnaire in individuals diagnosed with epilepsy within a Latin American context. A cross-sectional, analytical study was conducted involving 325 participants, aged 12 years and older (M 40.42 years), individuals diagnosed with epilepsy in Colombia. The main psychometric properties of the instrument were explored to account for its factorial validity and reliability. The Perceived Disability Questionnaire exhibits high reliability (α = 0.878) and the three subscales comprising the final version of the questionnaire (Dissatisfaction, Pessimism, and Self-Disdain) explain 45.393 % of the total variance in relation to beliefs of disability associated with the diagnosis of epilepsy; the questionnaire significantly correlates with the Quality of Life in Epilepsy Inventory (QOLIE-10). Adequate psychometric properties of the instrument are found, which allows for its proposal as a tool in epilepsy care processes within the Colombian context.
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Alqahtani R, Pringle A. The general impact of self-stigma of mental illness on adult patients with depressive disorders: a systematic review. BMC Nurs 2024; 23:432. [PMID: 38918754 PMCID: PMC11200989 DOI: 10.1186/s12912-024-02047-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Mental illness stigma is often common among mentally ill patients. This stigma can come from others or the patients themselves, which is called 'self-stigma'. The present study explored the widespread impacts of self-stigma on adult patients with depression. Additionally, this review compared the severity of self-stigma levels among psychiatric disorders and to review and update thoughts about self-stigma of depression. METHODS An etiology and risk systematic review was conducted using the Joanna Briggs Institute (JBI) approach as a guideline. The search process was performed via research databases including MEDLINE, EMBASE and CINAHL. The inclusion criteria are studies include participants diagnosed with depressive disorders, both genders, participants' exposure to mental illness self-stigma, participants' experience of self-stigma consequences and any geographical site or clinical settings are included, the type of the included studies must be observational studies. The included studies were limited to the English language studies that were published from 2016 and onwards. Patients with depression under the age of eighteen and patients diagnosed with multiple mental illnesses were excluded. The JBI critical appraisal checklist were adopted to assess the risk of bias. RESULTS In December 2022, a comprehensive search yielded eight cross-sectional studies that were included in this systematic review, involving a total of 783 patients diagnosed with depression, and 28 studies were excluded for not fulfilling the inclusion criteria of the review. The findings were extracted and synthesized through textual narrative synthesis into three main categories negatively affected by self-stigma of depression. These are: (1) the impact on the quality of life, (2) the impact on self-esteem and (3) the impact on self-worth. Moreover, in regard to the comparison of self-stigma levels among psychiatric disorders, self-stigma for people with schizophrenia was higher than self-stigma of depression. CONCLUSION Self-stigma of depression has negatively impacted multiple aspects of the patient's life. Thus, the review brings the following recommendations: increase community awareness, educate the healthcare providers, include the topic of mental illness stigma in academic curriculums. The main limitation of the review is the limited number of included studies. TRIAL REGISTRATION The research proposal for this review has been registered to Prospero (ID number: CRD42022366555).
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Affiliation(s)
- Refah Alqahtani
- Faculty of Nursing and Applied Medical Sciences, College of Applied Medical Science in Jubail, Imam Abdulrahman Bin Faisal University (IAU), Jubail Industrial City, Saudi Arabia.
| | - Alan Pringle
- Faculty of Medicine & Health Sciences, School of Health Sciences, Nottingham University, Nottingham City, UK
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Lork K, Danielsson L, Larsson MEH, Holmgren K. Experiences of rehabilitation coordination among people on sick leave with mental health problems. Scand J Prim Health Care 2024:1-14. [PMID: 38833374 DOI: 10.1080/02813432.2024.2361242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/24/2024] [Indexed: 06/06/2024] Open
Abstract
PURPOSE Return to work often requires collaboration between different stakeholders. Rehabilitation coordination is a resource in coordinating efforts during sick leave to facilitate return to work. The purpose of the present study was to describe how people at risk for sick leave or on sick leave with mental health problems experienced rehabilitation coordination. MATERIALS AND METHOD The study had a qualitative approach using qualitative content analysis as described by Graneheim and Lundman. Eleven semi-structured interviews were conducted with persons at risk for sick leave or on sick leave due to mental health problems and with experience of rehabilitation coordination. RESULTS The participants experience of rehabilitation coordination were described by the overarching theme Building a bridge with many bricks between the person and society. The theme was formed by four categories and eleven subcategories reflecting the complex context of rehabilitation coordination. The categories were Collaboration in a new setting, Unburdened within certain limits, The way back to work is a joint project and Recognising challenges beyond the person. CONCLUSIONS People with mental health problems experienced rehabilitation coordination as a meaningful link between healthcare and work. However, rehabilitation coordination needs to be more recognised within healthcare to increase accessibility. It seems important that interventions are directed not only towards the person, but also include the workplace for a sustainable return to work.
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Affiliation(s)
- Kristin Lork
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Louise Danielsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Maria E H Larsson
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristina Holmgren
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Henderson MSG, Andersen JA, Dinh JM, Ziegenfuss JY, Canterbury M, JaKa MM. In Their Own Words: Content Analysis of Open-Ended Survey Responses for a More Nuanced, Local Understanding of Mental Illness Stigma. Issues Ment Health Nurs 2024; 45:498-505. [PMID: 38564780 DOI: 10.1080/01612840.2024.2318603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
This content analysis seeks to extend what is already known in nursing and public health about the stigma attached to mental illness, and further understand the following evaluation question: How do members of communities targeted by Make It OK, a community initiative to reduce mental illness stigma, describe that stigma? The analysis of responses to open-ended questions included in a community-based survey followed deductive and inductive coding based on published frameworks and survey responses. The domains of stigma were categorized as actions toward people living with mental illness, beliefs about mental illness, and beliefs about people living with mental illness. These identified constructs build on the existing literature base of mental illness stigma in nursing and public health, illuminate the nuance of stigma, and can help tailor anti-stigma efforts.
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Affiliation(s)
- Maren S G Henderson
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA
| | - Julia A Andersen
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA
| | - Jennifer M Dinh
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA
| | - Jeanette Y Ziegenfuss
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA
| | | | - Meghan M JaKa
- Center for Evaluation & Survey Research, HealthPartners Institute, Bloomington, MN, USA
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O'Loughlin CM, McClure K, Ammerman BA. Development and validation of the self-injury stigma scale. J Psychiatr Res 2024; 173:48-57. [PMID: 38484618 DOI: 10.1016/j.jpsychires.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/27/2023] [Accepted: 02/07/2024] [Indexed: 04/17/2024]
Abstract
Non-suicidal self-injury is a prevalent and concerning behavior. Negative beliefs and stereotypes about NSSI are associated with negative outcomes, and negative, self-referential beliefs (e.g., self-stigmatizing beliefs) related to engagement in NSSI may be particularly harmful. Despite this, there is no validated measure specifically designed to assess for NSSI self-stigma. As this significantly hinders the ability to understand and quantify the effect of NSSI self-stigma, this study sought to validate the newly developed Self-Injury Stigma Scale (SISS). It was hypothesized the SISS would follow a four-factor structure that parallels a widely cited theoretical model of stigma. It was also hypothesized measures of shame and help-seeking self-stigma would be moderately, negatively, correlated with the SISS subscales, supporting the measure's validity. Participants from Study 1 were college students (n = 264, 65.8% female) with at least one lifetime NSSI act. A series of factor analytic models revealed a one-factor structure for the Application of Stigma subscale (i.e., third step of the four-step model). As this was the only SISS subscale to achieve an appropriate model fit, this scale alone was retained as the final SISS. The factor structure was tested via confirmatory factor analysis on a second sample (i.e., community participants with at least one past month of NSSI act; n = 240, 41.3% female). An acceptable fit on most, but not all, indices was reached. Convergent and discriminant validity were supported. The SISS retrospectively predicted past 3 month NSSI frequency and method versatility, and lifetime NSSI versatility, but not lifetime NSSI frequency or disclosure. Thus, the clinical utility of the SISS was partially supported. Findings offering evidence in favor of the SISS's appropriateness and utility as a measure of self-stigma of NSSI. Future work using this measure has the potential to clarify the risk associated with NSSI self-stigma and inform behavioral interventions.
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Affiliation(s)
- Caitlin M O'Loughlin
- University of Notre Dame, Department of Psychology, 339 Corbett Family Hall, Notre Dame, IN, 46617, USA.
| | - Kenneth McClure
- University of Notre Dame, Department of Psychology, 339 Corbett Family Hall, Notre Dame, IN, 46617, USA
| | - Brooke A Ammerman
- University of Notre Dame, Department of Psychology, 339 Corbett Family Hall, Notre Dame, IN, 46617, USA
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Li ACM, Mak WWS, Chan KKY, Corrigan PW, Larson J, Chan AFC, Chan CLF. Honest, Open, Proud (HOP) for people with mental illness in Hong Kong: a randomized controlled trial. Soc Psychiatry Psychiatr Epidemiol 2024; 59:769-780. [PMID: 37582863 DOI: 10.1007/s00127-023-02545-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/30/2023] [Indexed: 08/17/2023]
Abstract
BACKGROUND Self-stigma among people with mental illness is negatively associated with personal and clinical recovery. Due to the concealable nature of mental illness, people with mental illness experience constant struggles between concealment and disclosure. Disclosure of mental health challenges can potentially minimize negative impacts of self-stigma and enhance self-esteem and sense of empowerment. Honest, Open, Proud (HOP) is a peer-led intervention that promotes autonomous and dignified decisions about disclosure. PURPOSE This study examined the effectiveness of HOP on concealment motivation, empowerment, self-stigma, stigma stress, and recovery among people with lived experience of mental illness in Hong Kong. METHODOLOGY A total of 162 participants with a mean age of 45.38 were recruited and randomized into intervention group and waitlist control group. Participants in the intervention group were invited to attend a 6-session HOP group intervention. RESULTS Significant improvement in optimism score from the empowerment scale was found in the intervention group compared to the waitlist control group and the effect was sustained at 1-month follow-up. However, significant changes were not found in other outcome variables. CONCLUSION Only improvement in optimism was observed in the current study. Future study needs to examine the effects of HOP with further modification to maximize the benefit for people with lived experience of mental illness in the local context.
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Affiliation(s)
- Amanda C M Li
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China.
| | - Kelly K Y Chan
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Jon Larson
- Illinois Institute of Technology, Chicago, IL, USA
| | - Alice F C Chan
- Vocational Rehabilitation Services, New Life Psychiatric Rehabilitation Association, Hong Kong, China
| | - Christopher L F Chan
- Community Services, New Life Psychiatric Rehabilitation Association, Hong Kong, China
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Chentsova VO, Bravo AJ, Hetelekides E, Gutierrez D, Prince MA. Exploring perceptions of self-stigma of substance use and current alcohol and marijuana use patterns among college students. PLoS One 2024; 19:e0301535. [PMID: 38578784 PMCID: PMC10997109 DOI: 10.1371/journal.pone.0301535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 03/18/2024] [Indexed: 04/07/2024] Open
Abstract
BACKGROUND While research has examined the effect of stigma from others towards individuals with substance use disorders, few studies have examined the relationship between perceived self-stigma and engagement in substance use more broadly, especially among non-clinical samples. AIMS The present study examined the relationships between perceptions of self-stigma if one were to develop a substance use disorder, consisting of negative self-esteem and negative self-efficacy, and alcohol or marijuana use behaviors and outcomes. METHOD Participants (n = 2,243; 71.5% female) were college students within the U.S. recruited to participate in an online survey on substance use with a special focus on alcohol and marijuana. RESULTS Results indicated no significant differences in stigma scores across individuals with different lifetime alcohol and marijuana use. Stigma ratings did differ between individuals with different profiles of last 30-day alcohol and marijuana use where, generally, individuals with lifetime use but no use in the last 30-day reported higher levels of self-stigma. Correlation analyses indicated that perceived impact of substance use disorder on sense of self-efficacy and self-esteem related negatively to nearly all observed factors of alcohol and marijuana use. CONCLUSIONS Though self-stigma, and stigma more broadly, has been shown to have negative implications for people with substance use disorders, the present study suggests that for non-clinical populations there may be some protective association between perceived self-stigma and alcohol or marijuana use engagement. This is not to say that self-stigma is a positive clinical intervention. Rather, we interpret these findings to indicate that negative perceptions of substance use disorder on the sense of self may be associated with distinct alcohol and marijuana use behaviors among young adults.
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Affiliation(s)
- Victoria O. Chentsova
- Department of Psychological Sciences, William & Mary, Williamsburg, Virginia, United States of America
| | - Adrian J. Bravo
- Department of Psychological Sciences, William & Mary, Williamsburg, Virginia, United States of America
| | - Eleftherios Hetelekides
- Department of Psychology, Colorado State University, Fort Collins, Colorado, United States of America
| | - Daniel Gutierrez
- Counseling and Special Education, School of Education, Virginia Commonwealth University, Richmond, Virginia, United States of America
| | - Mark A. Prince
- Department of Psychology, Colorado State University, Fort Collins, Colorado, United States of America
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Kim SY, Song DY, Bottema-Beutel K, Gillespie-Lynch K. Time to level up: A systematic review of interventions aiming to reduce stigma toward autistic people. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:798-815. [PMID: 37886792 DOI: 10.1177/13623613231205915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
LAY ABSTRACT How non-autistic people think about autistic people impacts autistic people negatively. Many studies developed trainings to reduce autism stigma. The existing trainings vary a lot in terms of study design, content, and reported effectiveness. This means that a review studying how the studies have been conducted is needed. We also looked at the quality of these studies. We collected and studied 26 studies that tried to reduce stigma toward autistic people. The studies often targeted White K-12 students and college students. Most trainings were implemented once. Trainings frequently used video or computer. Especially, recent studies tended to use online platforms. The study quality was poor for most studies. Some studies made inaccurate claims about the intervention effectiveness. Studies did not sufficiently address study limitations. Future trainings should aim to figure out why and how interventions work. How intervention changes people's behavior and thoughts should be studied. Researchers should study whether the training can change the societal stigma. Also, researchers should use a better study design.
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Affiliation(s)
| | - Da-Yea Song
- Seoul National University Bundang Hospital, South Korea
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11
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Beukema L, de Winter AF, Korevaar EL, Hofstra J, Reijneveld SA. Investigating the use of support in secondary school: the role of self-reliance and stigma towards help-seeking. J Ment Health 2024; 33:227-235. [PMID: 35502838 PMCID: PMC11147454 DOI: 10.1080/09638237.2022.2069720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/29/2022] [Accepted: 04/19/2022] [Indexed: 10/18/2022]
Abstract
Purpose: Adolescents are the least likely to seek help for their mental health problems. School may be an important route to improve early recognition of adolescents with mental health problems in need for support, but little is known about the barriers to school support.Materials and methods: Data were collected in a longitudinal cohort study of Dutch adolescents (age 12-16) in secondary school (n = 956). We assessed the relation between level of psychosocial problems at the beginning of the school year (T1) and the support used in school at the end of that school year (T2), whether the willingness to talk to others (measured at T1) mediates this relation, and whether stigma towards help-seeking (T1) moderates this mediation.Results: Adolescents with more psychosocial problems were more likely to use support in school and were less willing to talk to others about their problems, but the willingness to talk to others was not a mediator. Stigma moderated the relationship between psychosocial problems and willingness to talk to others.Conclusions: Most adolescents with psychosocial problems get support in Dutch secondary school regardless of their willingness to talk to others about their problems. However, perceiving stigma towards help-seeking makes it less likely for someone to talk about their problems.
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Affiliation(s)
- L. Beukema
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A. F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - E. L. Korevaar
- Department of Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - J. Hofstra
- Department of Rehabilitation, Hanze University of Applied Sciences, Groningen, The Netherlands
| | - S. A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Khalafalla HE, Albasheer O, Alfaifi BAH, Abudayah AHK, Almasary MH, Alsulami ES, Alshuqayhi DS, Kremers SP. Diabetes-related social stigma among university students in Saudi Arabia: A cross-sectional study. Medicine (Baltimore) 2024; 103:e36863. [PMID: 38215124 PMCID: PMC10783391 DOI: 10.1097/md.0000000000036863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 12/14/2023] [Indexed: 01/14/2024] Open
Abstract
Diabetes-related stigma encompasses stereotypes, discrimination, and blame, significantly influencing diabetes management and overall well-being. Despite high diabetes-related stigma prevalence in various contexts, there is limited research in Saudi Arabia, especially that perceived/enacted by non-diabetics, the so-called social stigma. This cross-sectional study aimed to assess diabetes-related social stigma (DRSS) and to identify correlates among university students in Jazan, Saudi Arabia. A convenience sampling was employed to collect responses from 536 Jazan University students using an online questionnaire. After excluding participants with diabetes mellitus (n = 17), data from 519 individuals were analyzed. The DRSS questionnaire comprised 2 scales: social distancing and negative attitudes and stereotyping. The study found mixed results regarding the student population's attitude toward diabetic patients. Most students displayed favorable answers on social distancing scale statements, with the majority of statements showing willingness to engage in different social aspects with diabetics getting a positive response from at least 96% of respondents. The study identified various types of negative attitudes and stereotyping, for example, 46% of the sample agreed that dealing with a diabetic is upsetting or tiring. Correlates of social distancing included academic year, rural residence, and nonmedical field of specialty, while predictors of negative attitude and stereotyping included female gender and higher family income. The findings indicate a need to improve attitudes related to diabetics among university students in Saudi Arabia, with a particular focus on negative attitude stereotyping. Raising awareness about DRSS, especially among future healthcare professionals, is essential. Further refinement of the DRSS measurement scales is recommended through broader testing among the general population to enhance our understanding of this important issue.
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Affiliation(s)
- Husameldin Elsawi Khalafalla
- Department of Health Education and Promotion, School of Nutrition and Translational Research in Metabolism Maastricht University, Maastricht, The Netherlands
| | - Osama Albasheer
- Family and Community Medicine Department, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | | | | | - Manal Hassan Almasary
- College of Medicine, Al-Qunfudah Medical College, Umm Al-Qura University, Mecca, Saudi Arabia
| | | | | | - Stef P.J. Kremers
- Department of Health Education and Promotion, School of Nutrition and Translational Research in Metabolism Maastricht University, Maastricht, The Netherlands
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Lavi-Rotenberg A, Frishman N, Igra L, Gilboa-Schechtman E, Hasson-Ohayon I. Beyond One's Attitude Toward the Self: The Role of Social Anxiety in Self-Stigma Among Individuals With Schizophrenia. J Nerv Ment Dis 2024; 212:28-32. [PMID: 37846987 DOI: 10.1097/nmd.0000000000001724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
ABSTRACT Self-stigma is associated with a variety of negative self-perceptions among people coping with schizophrenia, as well as with different aspects of social behaviors. We explored the associations between self-compassion, self-esteem, social anxiety, and self-stigma among people coping with schizophrenia. The baseline data of 56 adults with schizophrenia who were enrolled in a Metacognitive Reflection and Insight Therapy trial were used. Participants filled out self-report questionnaires measuring self-compassion, self-esteem, social anxiety, and self-stigma. Self-esteem and self-compassion were negatively correlated with self-stigma and social anxiety. Self-compassion was not found to contribute beyond self-esteem to the prediction of self-stigma. Importantly, self-esteem and social anxiety were found to mediate the effects of self-compassion on self-stigma. Thus, it seems that social variables, in addition to self-variables, may lead to the formation of self-stigma among people with schizophrenia. Therefore, alongside addressing self-esteem and self-compassion, integrating therapeutic elements related to coping with social anxiety into interventions would seem to be an important factor in reducing self-stigma among people with serious mental illness.
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Iimura D, Ishida O. Comparing the beliefs regarding biological or psychological causalities toward stereotyped perception of people who stutter. Front Psychol 2023; 14:1279169. [PMID: 38034304 PMCID: PMC10687552 DOI: 10.3389/fpsyg.2023.1279169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Purpose Developmental stuttering is a fluency disorder that may be caused by neurological, genetic, or familial factors. However, a general perception that stuttering is caused by psychological problems could lead to negative attitudes toward stuttering, causing prejudice or discrimination against people who stutter (PWS). Thus, our study aimed to investigate whether certain beliefs in etiology of stuttering are related to the negative perception of stuttering. Methods A web-based survey of 413 native Japanese adults, aged 20-69, who did not suffer from stuttering, schizophrenia, or depression, was conducted in August 2021. The participants were recruited through the Web monitor panel. Participants were divided into three uniform groups based on their response to a 27-item questionnaire about their implicit belief regarding the etiology of stuttering: belief in the biological model (stuttering-biological group), belief in the psychological model (stuttering-psychological group), and the control group (those who responded to perception of healthy adult males). Participants were also asked to respond to 25 items of semantic differential scales about perception of stuttering or healthy adult males. Responses were summarized into several factors by factor analysis, and factor scores were compared among the three groups. The stuttering-biological group had the fewest participants, comprising 80 individuals. Overall, a total of 240 participants, 80 from each group, were included in the analysis. Results Some pairs of stereotypes included in semantic differential scales revealed differences between the groups; PWS, irrespective of the participants of the biological or psychological group, were considered as having negative stereotyping properties such as being "tense," "anxious," or "afraid." Additionally, three concepts from the factor analysis of these 25 items were analyzed using an analysis of variance, and significant differences were found; the mean factor score of the "danger" stereotype was lower in the stuttering-biological group compared to the stuttering-psychological group. Conclusion Although the simplification of the biological model is not recommended, anti-stigma campaigns to educate people that stuttering is caused by multidimensional factors, not just psychological ones, could change the general public's negative perceptions of stuttering.
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Affiliation(s)
- Daichi Iimura
- Institute of Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Osamu Ishida
- College of Education, Ibaraki University, Ibaraki, Japan
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15
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Singh S, Melendez K, Sezginis N. Examining the effect of discrimination and stigma on utilization of mental health services among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2398-2405. [PMID: 34519631 DOI: 10.1080/07448481.2021.1970561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 06/30/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Even though onset of three-quarters of mental disorders occurs by age 25, few young adults seek help for their mental health needs. The objectives of this study are to examine the relationship of discrimination and stigma of mental illness on the help-seeking behavior for mental health among college students. METHOD Undergraduate students (N = 557) at a Midwestern university were surveyed online. Descriptive and logistic regression analysis was conducted using STATA15. RESULTS College students reporting higher discrimination were more likely to seek help for mental health services (OR = 1.04, CI = 1.01-1.06), after controlling for all covariates. Students with higher personal stigma reported lower odds of help-seeking behavior (OR = 89, CI = .80-.97). Students with higher perceived public stigma did not have an independent significant association on help-seeking behavior initially, but full model revealed a significantly association (OR = 1.02, CI = .99-1.05). CONCLUSION Developing targeted interventions addressing discrimination and stigma of mental illness is critical among college students.
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Affiliation(s)
- Shipra Singh
- School of Population Health, University of Toledo, Toledo, Ohio, USA
| | - Krizia Melendez
- School of Population Health, University of Toledo, Toledo, Ohio, USA
| | - Nilgun Sezginis
- School of Population Health, University of Toledo, Toledo, Ohio, USA
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Wallhed Finn S, Mejldal A, Baskaran R, Nielsen AS. Effects of media campaign videos on stigma and attitudes towards treatment seeking for alcohol use disorder: a randomized controlled study. BMC Public Health 2023; 23:1919. [PMID: 37794390 PMCID: PMC10552234 DOI: 10.1186/s12889-023-16811-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/21/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Alcohol Use Disorder (AUD) is one of the most stigmatized diagnosis, and stigma imposes a major barrier to treatment seeking. There is a need to develop interventions that can reduce stigma and increase treatment seeking. Little is known about the effects of video materials. The aim of this study was to investigate effects of different videos. The primary outcome was public stigma, and secondary outcomes were: self-stigma, and motivation to change own alcohol use; talking to someone else about their alcohol use; seeking information about AUD treatment or seeking AUD treatment. METHODS This is a three-armed double blind randomized controlled study. The study included 655 Danish adults. Data was collected at a study webpage, and the survey could be completed anywhere with Internet access. After informed consent and completing baseline measures, participants were randomized, 1:1:1 ratio, to a video (video 1 n = 228; video 2 n = 198; video 3 n = 229). Video 1 and 2 have been used in a national mass media campaign and video 3 was recorded for use in the present study. Immediately after exposure, follow-up measures were completed. Outcomes were analyzed with mixed effects linear regression. RESULTS In total n = 616 completed follow-up (video 1 n = 215; video 2 n = 192; video 3 n = 209). Randomization to video 1 and 3 decreased public stigma measured with "Difference, Disdain & Blame Scales", while video 2 increased stigma. Video 2 compared to 1: 2.262 (95% CI 1.155; 3.369) p < 0.001. Video 3 compared to 1: -0.082 (95% CI -1.170; 1.006) p = 0.882. Video 3 compared to 2: -2.344 (95% CI -3.455; -1.233) p = 0.882. All videos reduced motivation to change own alcohol use. Participants with hazardous alcohol use, were more sensitive to the different videos, compared to low-risk alcohol use. Video 2 decreased motivation to seek information about treatment. No effects were seen on motivation to seek treatment, motivation to talk to someone else or self-stigma. CONCLUSIONS Videos can have an immediate effect on level of public stigma. Other types of interventions are needed to increase motivation and reduce self-stigma. To avoid adverse effects in future interventions, the use of theoretical frameworks and stakeholder involvement is emphasized.
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Affiliation(s)
- Sara Wallhed Finn
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark.
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Anna Mejldal
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark
| | - Ruben Baskaran
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark
- SDU Health informatics and technology, Faculty of engineering, The Maersk Mc-Kinney Moller institute, University of Southern Denmark, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, Odense, 5000, Denmark
- Psychiatric Hospital, University Function, Region of Southern, Odense, Denmark
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Oldham C, Guffey K, Link K, Sampson S, McQueen T, Stanton A. Measuring Gatekeeper Instructor Comfort to Inform Suicide Prevention Train-The-Trainer Recruitment & Training in Agricultural Communities. J Agromedicine 2023; 28:689-702. [PMID: 37222378 DOI: 10.1080/1059924x.2023.2215249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Farmers experience psychological distress and suicide at consistently higher rates than workers in other industries. A gatekeeper is an individual who has been trained to recognize warning symptoms of possible suicidal ideations in others. Gatekeeper programs are recognized by the federal Substance Abuse and Mental Health Services Administration as a best practice for suicide prevention. While gatekeeper programs offer promise to addressing the increasing worldwide suicide rate, how to develop these networks in communities with largely ingrained stigma and taboo related to mental health and suicide remains unanswered. Three of this study's researchers were part of the development and pilot of an agricultural community gatekeeper program and questioned how gatekeeper instructor psychological comfort could be conceptualized and operationalized for the purpose of informing gatekeeper instructor recruitment and training. After a thorough review of the literature, the researchers constructed a conceptual developmental model of gatekeeper instructor comfort and created a Gatekeeper Instructor Comfort Measure instrument which was then piloted with Kentucky K-12 and university agricultural educators. The researchers of this study employed the Rasch model to determine whether the developmental model of gatekeeper instructor comfort held together empirically. Infit and outfit mean squares (0.73 to 1.33) indicate that the items measure one construct, or are unidimensional, while person reliability and separation statistics indicate that the Gatekeeper Instructor Comfort Measure is composed of enough items to differentiate respondents into almost four strata of gatekeeper comfort. The Gatekeeper Instructor Comfort Measure's fit to the Rasch model indicates that the instrument meets the requirements of invariant measurement and should serve as a useful measure for other researchers. The instrument's item difficulty hierarchy also serves as a guide for those training gatekeepers on how to target different gatekeeper outcomes sequentially or developmentally. Researchers recommend restructuring item responses to enable greater discrimination between categories and then piloting the instrument again with a more diverse sample. The revised measure could be used pre- and post-gatekeeper instructor training to determine the impact of training on gatekeeper comfort.
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Affiliation(s)
- Carolyn Oldham
- College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, USA
| | - Kristie Guffey
- Hutson School of Agriculture, Murray State University, Murray, KY, USA
| | - Kim Link
- School of Nursing and Allied Health, Western Kentucky University, Bowling Green, KY, USA
| | - Shannon Sampson
- College of Education, University of Kentucky, Lexington, KY, USA
| | - Tyler McQueen
- Department of Psychology, Eastern Kentucky University, Richmond, KY, USA
| | - Anna Stanton
- Department of Psychology, Eastern Kentucky University, Richmond, KY, USA
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Vaishnav M, Javed A, Gupta S, Kumar V, Vaishnav P, Kumar A, Salih H, levounis P, NG B, Alkhoori S, Luguercho C, Soghoyan A, Moore E, Lakra V, Aigner M, Wancata J, Ismayilova J, Islam MA, Da Silva AG, Chaimowitz G, Xiaoping W, Okasha T, Meyer-Lindenberg A, Schulze T, NG R, Chiu SN, (Sherry) CKW, Tanra AJ, Park YC, Panteleeva L, Taveras M, Mazaliauskiene R, Sulaiman AHB, Sanchez T, Sedain CP, Sheikh TL, Lien L, Rasool G, Buenaventura R, Gambheera HC, Ranasinghe K, Sartorius N, Charnsil C, Larnaout A, Nakku J, Ashurov Z. Stigma towards mental illness in Asian nations and low-and-middle-income countries, and comparison with high-income countries: A literature review and practice implications. Indian J Psychiatry 2023; 65:995-1011. [PMID: 38108051 PMCID: PMC10725213 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_667_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/23/2023] [Accepted: 09/23/2023] [Indexed: 12/19/2023] Open
Abstract
Background Stigma related to mental illness (and its treatment) is prevalent worldwide. This stigma could be at the structural or organizational level, societal level (interpersonal stigma), and the individual level (internalized stigma). Vulnerable populations, for example, gender minorities, children, adolescents, and geriatric populations, are more prone to stigma. The magnitude of stigma and its negative influence is determined by socio-cultural factors and macro (mental health policies, programs) or micro-level factors (societal views, health sectors, or individuals' attitudes towards mentally ill persons). Mental health stigma is associated with more serious psychological problems among the victims, reduced access to mental health care, poor adherence to treatment, and unfavorable outcomes. Although various nationwide and well-established anti-stigma interventions/campaigns exist in high-income countries (HICs) with favorable outcomes, a comprehensive synthesis of literature from the Low- and Middle-Income Countries (LMICs), more so from the Asian continent is lacking. The lack of such literature impedes growth in stigma-related research, including developing anti-stigma interventions. Aim To synthesize the available mental health stigma literature from Asia and LMICs and compare them on the mental health stigma, anti-stigma interventions, and the effectiveness of such interventions from HICs. Materials and Methods PubMed and Google Scholar databases were screened using the following search terms: stigma, prejudice, discrimination, stereotype, perceived stigma, associate stigma (for Stigma), mental health, mental illness, mental disorder psychiatric* (for mental health), and low-and-middle-income countries, LMICs, High-income countries, and Asia, South Asian Association for Regional Cooperation/SAARC (for countries of interest). Bibliographic and grey literature were also performed to obtain the relevant records. Results The anti-stigma interventions in Asia nations and LMICs are generalized (vs. disorder specific), population-based (vs. specific groups, such as patients, caregivers, and health professionals), mostly educative (vs. contact-based or attitude and behavioral-based programs), and lacking in long-term effectiveness data. Government, international/national bodies, professional organizations, and mental health professionals can play a crucial in addressing mental health stigma. Conclusion There is a need for a multi-modal intervention and multi-sectoral coordination to mitigate the mental health stigma. Greater research (nationwide surveys, cultural determinants of stigma, culture-specific anti-stigma interventions) in this area is required.
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Affiliation(s)
- Mrugesh Vaishnav
- Samvedana Group of Hospital and Research Centre, Institute of Psychological and Sexual Research-Samvedana Foundation, Ahmedabad, Gujarat, India
| | - Afzal Javed
- World Psychiatric Association (WPA), Geneva, Switzerland
| | - Snehil Gupta
- Associate Professor, Dept. of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Vinay Kumar
- President, Indian Psychiatric Society, Ahmedabad, Gujarat, India
| | | | - Akash Kumar
- Department of Psychiatry, All India Institute of Medical Sciences (AIIMS), Bhopal, India
| | - Hakimullah Salih
- President, Afghanistan National Psychiatrists Association, San Diego, USA
| | | | - Bernardo NG
- Clinical Assistant Professor, Department of Psychiatry, University of California, San Diego, USA
| | - Samia Alkhoori
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | - Cora Luguercho
- President, Association of Argentine Psychiatrists (APSA), Australia
| | | | - Elizabeth Moore
- President of the Royal Australian and New Zealand College of Psychiatrists (RANZCP), Australia
| | - Vinay Lakra
- Divisional Director, Mental Health, Northern Health, Australia
| | - Martin Aigner
- President, Austrian Society for Psychiatry, Psychotherapy and Psychosomatics
| | - Johannes Wancata
- Professor and Chair for Social Psychiatry, Medical University of Vienna, University Campus
| | - Jamila Ismayilova
- The National Mental Health Center of the Ministry of Health of Azerbaijan
| | - Md. Azizul Islam
- President, Bangladesh Association of Psychiatrist, Principal, US-Bangla Medical College
| | | | - Gary Chaimowitz
- Head of Service, Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton
| | | | - Tarek Okasha
- Professor of Psychiatry, Okasha Institute of Psychiatry, Faculty of Medicine Ain Shams University in Cairo, Egypt
| | | | - Thomas Schulze
- Director of the Institute of Psychiatric Phenomics and Genomics (www.ippg.eu) at the University Hospital of LMU, Munich, Germany
| | | | - SN Chiu
- President, Hong Kong College of Psychiatrists
| | - Chan Kit Wa (Sherry)
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR
| | | | - Yong Chon Park
- Emeritus Professor, Department of Psychiatry, Han Yang University, Seoul, Korea
| | | | - Marisol Taveras
- Department of Mental Health, Dr. Ney Arias Lora Traumatology Hospital, Santo Domingo Norte
| | - Ramune Mazaliauskiene
- Lithuanian Health Sciences University; Lithuanian Health Sciences University Kaunas Hospital
| | | | | | | | | | - Lars Lien
- Department of Health and Social Science, Innlandet University of Applied Science, Elverum, Norway
| | | | - Robert Buenaventura
- Associate Professor II, La Consolacion University Philippines College of Medicine
| | | | | | - Norman Sartorius
- President, Association for the Improvement of Mental Health Programmes (AMH), Geneva, Switzerland
| | - Chawanun Charnsil
- Professor of Psychiatry: Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Amine Larnaout
- Razi Hospital, Faculty of Medicine of Tunis, Tunis El Manar University, Tunisia
| | - Juliet Nakku
- Butabika Hospital and Makerere University, Kampala, Uganda
| | - Zarif Ashurov
- Head of the Psychiatry and Narcology, Department of the Tashkent Medical Academy
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McAllister A, Dickson K, Rangi M, Griffiths L, Dimov S, Reavley N, Knaak S. Embedding interpersonal stigma resistance into the medical curriculum: a focus group study of medical students. BMC MEDICAL EDUCATION 2023; 23:686. [PMID: 37735393 PMCID: PMC10515016 DOI: 10.1186/s12909-023-04512-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 07/14/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Mental-health-related stigma among physicians towards people with mental illnesses remains a barrier to quality care, yet few curricula provide training with a proactive focus to reduce the potential negative impacts of stigma. The aim of our study was to explore medical students' perspectives on what areas of learning should be targeted (where stigma presents) and how they could be supported to prevent the formation of negative attitudes. METHODS Six focus group discussions were conducted with second, third, and fourth-year postgraduate medical students (n = 34) enrolled at The University of Melbourne Medical School in September - October 2021. Transcripts were analysed using inductive thematic analysis. RESULTS In terms of where stigma presents, three main themes emerged - (1) through unpreparedness in dealing with patients with mental health conditions, (2) noticing mentors expressing stigma and (3) through the culture of medicine. The primary theme related to 'how best to support students to prevent negative attitudes from forming' was building stigma resistance to reduce the likelihood of perpetuating stigma towards patients with mental health conditions and therefore enhance patient care. The participants suggest six primary techniques to build stigma resistance, including (1) reflection, (2) skills building, (3) patient experiences, (4) examples and exemplars, (5) clinical application and (6) transforming structural barriers. We suggest these techniques combine to form the ReSPECT model for stigma resistance in the curriculum. CONCLUSIONS The ReSPECT model derived from our research could provide a blueprint for medical educators to integrate stigma resistance throughout the curriculum from year one to better equip medical students with the potential to reduce interpersonal stigma and perhaps self-stigma. Ultimately, building stigma resistance could enhance care towards patients with mental health conditions and hopefully improve patient outcomes.
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Affiliation(s)
- Ashley McAllister
- School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, VIC, 3053, Australia.
| | - Kara Dickson
- School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Mediya Rangi
- School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Leonie Griffiths
- Melbourne Medical School, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Stefanie Dimov
- School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Nicola Reavley
- School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Carlton, VIC, 3053, Australia
| | - Stephanie Knaak
- Faculty of Nursing and Department of Psychiatry, University of Calgary, 2500 University Drive NW, Calgary, Alberta, T2N 1N4, Canada
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Duan W, Wang J, Wang Z. A Network Analysis of Brief Measure of Perceived Courtesy and Affiliate Stigma During COVID-19 in Hubei China. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2023; 20:623-636. [PMID: 37461302 DOI: 10.1080/26408066.2023.2192716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
PURPOSE The current study aims to test perceived affiliate and courtesy stigma in Hubei province China during the early periods of COVID-19 by using network analysis. METHOD In this study, 4,591 participants (3,034 female, mean age = 26.64) from the Hubei Province of China were recruited to conduct network analysis. RESULTS The network analysis found network connections between Estranged - Blamed, Shamed - No Strong Point, and Rejected - Plague were the strongest. The most important stigma features (nodes) of COVID-19 (i.e. Plague, No Strong Point, Discriminated, and Disgusting). DISCUSSION AND CONCLUSIONS This study uncovered the most central features of perceived affiliate and courtesy stigma on COVID-19, proposing these features (and associations between features) could be prioritized for anti-stigma interventions for the COVID-19 pandemic.
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Affiliation(s)
- Wenjie Duan
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, P. R. China
| | - Jingying Wang
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, P. R. China
| | - Zichuan Wang
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, P. R. China
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21
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Wallhed Finn S, Mejldal A, Nielsen AS. The associations between public stigma and support for others' help-seeking for alcohol use disorder: a cross sectional study in the general Danish population. Addict Sci Clin Pract 2023; 18:46. [PMID: 37542352 PMCID: PMC10403820 DOI: 10.1186/s13722-023-00400-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/25/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND A minority of all individuals with alcohol use disorders (AUD) seek treatment, where stigma is one prominent barrier. Social support is important to facilitate health and increase treatment-seeking. Whether there is an association between stigma and attitudes towards others' help-seeking for AUD is unknown. The aim of this study was to investigate the associations between stigma and support towards others' help-seeking for AUD, also to explore possible gender differences. METHOD Cross-sectional study, n = 2895, including Danish adults aged 30-65 in the general population. Year 2020, an online questionnaire was administrated, which covered demographics, attitudes towards others' help-seeking for AUD, and stigma measured with the Difference, Disdain & Blame Scales. Analyses were performed with Restricted Cubic Spline models, and odds ratios were calculated. RESULTS Lower level of stigma was associated with a higher probability for endorsing an "active support strategy". Level of stigma was not associated with "not knowing what to say or do" or "sharing my concern with others". There were few gender differences: among men, higher level of stigma was associated with a higher probability of "avoidance". Among women, lower level of stigma was associated with a lower probability of "avoidance". CONCLUSION There is a clear association between stigma and attitudes towards supporting others' help-seeking for AUD. The results highlight the need to reduce stigma and promote engagement towards others' treatment-seeking.
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Affiliation(s)
- Sara Wallhed Finn
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, 5000, Odense, Denmark.
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Anna Mejldal
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, 5000, Odense, Denmark
| | - Anette Søgaard Nielsen
- Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, entrance. 220 B, 5000, Odense, Denmark
- Psychiatric Hospital, University Function, Region of Southern Denmark, Odense, Denmark
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Richards SJ, O'Connell KA, Dickinson JK. Acknowledging Stigma: Levels of Prejudice among Undergraduate Nursing Students toward People Living with a Mental Illness-A Quasi-Experimental Single-Group Study. Issues Ment Health Nurs 2023; 44:778-786. [PMID: 37459622 DOI: 10.1080/01612840.2023.2229438] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
INTRODUCTION The undergraduate mental health nursing course may be an optimal time to cultivate students' positive attitudes toward people living with a mental illness. AIM To determine the impact of an undergraduate mental health nursing course on students' attitudes toward people living with a mental illness, depression, and schizophrenia. METHOD A quasi-experimental single-group pretest posttest study was conducted using a sample of undergraduate nursing students in New York City (N = 44). Self-reported measures of prejudice toward those living with a mental illness were collected at the beginning of a mental health nursing course and again at its conclusion. RESULTS A statistically significant decrease in prejudice scores was found concerning mental illness (p = .03, d = 0.23), depression (p = .01, d = 0.31), and schizophrenia (p = .013, d = 0.34). Subscale analysis revealed significant decreases in the fear/avoidance and unpredictability subscales. Yet no significant change was found in the subscales of authoritarianism and malevolence for any of the three conditions. DISCUSSION A mental health course led to a modest decrease in prejudice. However, certain facets of prejudice remain unchanged. IMPLICATIONS FOR PRACTICE Major curricular reform is needed to optimize the impact of undergraduate nursing education.
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Affiliation(s)
| | | | - Jane K Dickinson
- Teachers College Columbia University, New York City, New York, USA
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23
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Velten J, Margraf J. Exploring barriers and facilitators to women's intention and behavior to seek treatment for distressing sexual problems. PLoS One 2023; 18:e0288205. [PMID: 37463132 DOI: 10.1371/journal.pone.0288205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/21/2023] [Indexed: 07/20/2023] Open
Abstract
Many women experience distressing problems with sexual functioning, most commonly in the form of low sexual desire or arousal, difficulties reaching orgasm, or genito-pelvic pain with sexual activity. Although effective treatments are available, more than half of the women who experience distressing sexual problems do not seek professional help. Understanding help-seeking patterns, experiences with treatment providers, and barriers to treatment is crucial to address this underutilization. Examining the role of personal characteristics, sexual problem symptoms, and cognitive factors in explaining the intention to seek treatment can help identify individuals who are most reluctant to seek help. Psychological online interventions are a promising resource to increase the availability of effective treatments. Knowledge about the predictors of women's intention to use internet-delivered treatments, as well as information about personal preferences regarding their scope, can help tailor them to women's needs. To address these research questions, cross-sectional data of 800 women (Mage = 30.49, range = 18-73) were analyzed. While many women considered clinical psychologists to be the most qualified treatment providers, gynecologists were cited as the most likely first point of contact. Among women not utilizing any treatments, many reported a preference for dealing with a sexual problem on their own as a reason not to seek help. Higher help-seeking intention was related to living in a larger city, experiencing higher sexual distress, experiencing pain or difficulties with vaginal penetration, higher self-stigma. and lower sexual assertiveness. Women who were convinced of the effectiveness of psychological online interventions and who appreciated the benefits of anonymity indicated that they were more likely to use them. Understanding what factors influence women's decisions about whether or not to seek professional help for distressing sexual problems is key to reducing the underutilization of available resources and developing treatments that meet their needs and preferences.
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Affiliation(s)
- Julia Velten
- Mental Health Research and Treatment Center, Ruhr University Bochum, Germany
| | - Jürgen Margraf
- Mental Health Research and Treatment Center, Ruhr University Bochum, Germany
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Leung DKY, Wong FHC, Yau JHY, Zhang AY, Au WSH, Liu T, Wong GHY, Lum TYS. Dimensionality and risk factors of the personal stigma of depression in adults aged 50 years and older at risk of depression. Aging Ment Health 2023; 27:1644-1651. [PMID: 36809116 DOI: 10.1080/13607863.2023.2179973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/05/2023] [Indexed: 02/23/2023]
Abstract
Objectives: Knowledge about the mechanism of the personal stigma of depression may inform strategies to reduce stigma and promote help-seeking. We examined the dimensionality and risk factors of the personal stigma of depression in older adults at risk of depression.Methods: Seven-hundred and one Hong Kong adults aged 50 years and older at risk of depression completed the personal stigma subscale of the depression Stigma Scale (DSS-personal) at two-time points. We used exploratory factor analysis (EFA) to explore the factor structure of DSS personal and confirmatory factor analysis to examine the model fit of the EFA-informed factor structure and structures proposed in previous studies. Regression analyses examined the relationships between risk factors and personal stigma dimensions.Results: Factor analyses identified a 3-factor structure of DSS-personal resembling the social-cognitive model consistent over time and included stereotype, prejudice, and discrimination (CFI = 0.95, TLI = 0.92, RMSEA = 0.05). Regression analyses indicated all stigma dimensions were associated with older age, less education, and no personal history of depression (B = -0.44 to 0.06); discrimination was also associated with more depressive symptoms (B = 0.10 to 0.12).Conclusion: Findings illustrated the potential theoretical underpinning of DSS-personal. Stigma reduction interventions could target and tailor to older adults with risk factors to enhance effectiveness and promote help-seeking.
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Affiliation(s)
- Dara Kiu Yi Leung
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Frankie Ho Chun Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Philip Merrill College of Journalism, University of Maryland, College Park, USA
| | - Jessie Ho-Yin Yau
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Anna Yan Zhang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Walker Siu Hong Au
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Tianyin Liu
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Gloria Hoi Yan Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Terry Yat Sang Lum
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong
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Roberts-West L, Gravatt A, Guest N, Hunt A, Siddique L, Serbic D. A Comparison of Social Exclusion Towards People with Depression or Chronic Back Pain. Br J Pain 2023; 17:267-280. [PMID: 37342396 PMCID: PMC10278445 DOI: 10.1177/20494637221148337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Objectives Research comparing mental and physical health stigma is scarce. The aim of this study was to compare social exclusion towards hypothetical males and females with depression or chronic back pain. Furthermore, the study investigated whether social exclusion is associated with participant's empathy and personality traits, while controlling for their sex, age and personal exposure to mental/physical chronic health conditions. Design This study employed a cross-sectional questionnaire design. Methods Participants (N = 253) completed an online vignette-based questionnaire and were randomly allocated to either a depression or chronic back pain study condition. Measures of social exclusion through respondents' willingness to interact with hypothetical individuals, empathy and the Big Five personality traits were completed. Results Willingness to interact scores did not significantly differ depending on the diagnosis or sex of the hypothetical person in the vignette. For depression, higher levels of conscientiousness significantly predicted less willingness to interact. Whilst being a female participant and having higher empathy significantly predicted greater willingness to interact. For chronic back pain, higher empathy significantly predicted greater willingness to interact, with no significant predictors found from the Big Five personality traits. Conclusion Findings indicate that females and males with depression or chronic back pain face similar levels of social exclusion, with empathy being a core variable driving social exclusion behaviours. These findings enhance our understanding of potential variables driving social exclusion, in-turn informing campaign development to reduce public stigma towards depression and chronic back pain.
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Affiliation(s)
- Lucy Roberts-West
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Amy Gravatt
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Natasha Guest
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Ashley Hunt
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Laraib Siddique
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
| | - Danijela Serbic
- Department of Psychology, Royal Holloway University of London, Egham, SRY, UK
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Ramírez-Vielma R, Vaccari P, Cova F, Saldivia S, Vielma-Aguilera A, Grandón P. Interventions to reduce the stigma of mental health at work: a narrative review. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:14. [PMID: 37213032 DOI: 10.1186/s41155-023-00255-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/07/2023] [Indexed: 05/23/2023] Open
Abstract
BACKGROUND While there are reviews of the literature on mental health stigma reduction programs, very few have focused on the workplace. OBJECTIVE We sought to identify, describe and compare the main characteristics of the interventions to reduce the stigma towards mental health at work. METHOD The search of original articles (2007 to 2022) was carried out in the Web of Science Core Collection and Scopus databases, selecting 25 articles from the key terms: 1. Stigma, 2. Workplace, 3. Anti-stigma intervention/program, 4. Mental health. RESULTS These interventions can be effective in changing the knowledge, attitudes, and behaviors of workers towards people with mental health problems, although further verification of these results is needed as they are limited to date. DISCUSSION AND CONCLUSION Interventions to reduce stigma in the workplace could create more supportive work environments by reducing negative attitudes and discrimination and improving awareness of mental disorders.
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Affiliation(s)
- Raúl Ramírez-Vielma
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Barrio Universitario S/N, Concepción, Chile
| | - Pamela Vaccari
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Barrio Universitario S/N, Concepción, Chile
| | - Félix Cova
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Barrio Universitario S/N, Concepción, Chile
| | - Sandra Saldivia
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Alexis Vielma-Aguilera
- Departamento de Psiquiatría y Salud Mental, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Pamela Grandón
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Concepción, Barrio Universitario S/N, Concepción, Chile.
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Napoli G, Autuori S, Ephraim KS. Attitudes of Italian mental health nurses towards mental illness and recovery: a cross-sectional study. AIMS Public Health 2023; 10:333-347. [PMID: 37304595 PMCID: PMC10251057 DOI: 10.3934/publichealth.2023025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/22/2023] [Accepted: 04/23/2023] [Indexed: 06/13/2023] Open
Abstract
Background Mental health nurses' (MHNs) stigma and discrimination against people with mental illnesses are obstacles to recovery and the development of effective care and treatment. Although many authors have been interested in exploring stigma among general health professionals, paradoxically, less and non-generalizable evidence is available on this phenomenon among MHNs. Understanding the factors associated with stigma and its relationship to recovery attitudes among MHNs could allow for more accurate interventions and improve patient care outcomes. Objective This study conducted on a sample of Italian psychiatric nurses had the objective of analyzing the aptitude for recovery and the tendency towards stigma of these professionals towards mental illness. Methodology A cross-sectional web survey was conducted on a sample of Italian MHNs, who were administered two validated tools, the RAQ-7 (assessment of recovery aptitude) and the WHO-HC-15 (assessment of stigma) respectively. Results A total of 204 MHNs were interviewed. The analysis showed positive overall scores (high recovery aptitude and low stigma levels) among participating MHNs. The attitude to recovery appeared to be directly related to a lower tendency to stigma towards mental illness. It has been observed that MHNs with advanced levels of education appear to be more predisposed to recovery, as well as generally less stigmatizing. There is evidence that the setting in which care is provided, marital status and age can play a significant role in the tendency to stigmatization. Conclusion Our manuscript could assist nursing executives, leaders or educators in making decisions about managing and preventing stigma among MHNs.
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Affiliation(s)
- Giovanni Napoli
- Dipartimento di Salute Mentale, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy
| | - Simone Autuori
- UOC Psichiatria 2, Azienda Ospedale-Università Padova (AOUP), Padova, Italy
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Arboleya-Faedo T, González-Menéndez A, González-Pando D, Paino M, Alonso-Pérez F. Experiences of Self-Stigma in People with Chronic Psychosis: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095688. [PMID: 37174206 PMCID: PMC10178090 DOI: 10.3390/ijerph20095688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
We present the results of a phenomenological study understanding the personal meaning of self-stigma in people with chronic psychosis. Self-stigma is a frequent phenomenon in the lives of people with psychosis and their families and it functions as a barrier to recovery. Semi-structured in-depth interviews were conducted with fourteen outpatients that suffer from chronic psychosis during January 2020. Data analysis was carried out using an inductive approach as described by Graneheim and Lundman through the MAXQDA 2022 program. The themes observed were: "Contextual Stigma", "Components of Self-Stigma", "Skills Loss" and "Coping with Self-Stigma". The main categories and subcategories were avoidance and escape behaviours from their social environment, labelling, loss of social relationships, negative impact and self-concealment of the diagnosis. Our results revealed influence on each other, forming a looping effect that explains and amplifies the lived experience of self-stigma. These findings highlight the need to implement strategies in nursing practice aimed at training the acceptance and distancing necessary to minimize the impact of self-stigma on people with chronic psychosis. This study adheres to the EQUATOR guidelines for the Consolidated Criteria for Reporting Qualitative Research (COREQ).
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Affiliation(s)
| | | | - David González-Pando
- ISPA-Health Research Institute of the Principality of Asturias, 33011 Oviedo, Spain
- Faculty of Nursing, University of Oviedo, 33394 Gijón, Spain
| | - Mercedes Paino
- Department of Psychology, University of Oviedo, 33003 Oviedo, Spain
| | - Fernando Alonso-Pérez
- ISPA-Health Research Institute of the Principality of Asturias, 33011 Oviedo, Spain
- Faculty of Nursing, University of Oviedo, 33394 Gijón, Spain
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Owusu AFS, Abdullah A, Pinto GH, Bentum H, Moo JTN, Ayim M, Mbamba CR, Cudjoe E. Where Do We Go After Surviving the Virus? Cross-Country Documentary Analysis of the Social Consequences Faced by COVID-19 Survivors. COMMUNITY HEALTH EQUITY RESEARCH & POLICY 2023; 43:329-338. [PMID: 34102924 PMCID: PMC9996079 DOI: 10.1177/0272684x211022176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
In this study, we attempted to move beyond the skewed discussions on stigma to unravel other social consequences that are experienced by persons who have recovered from COVID-19. We conducted a documentary review of published news reports from 14 highly ranked news portals in Ghana and Malaysia (published between 1st January 2020 and 30th August 2020) that contained personal accounts from the recovered patients about their lived experiences with the virus and social consequences encountered after recovery. Narratives from the recovered patients were extracted and analyzed following the narrative thematic analysis procedure. Common themes identified from the narratives included: 1) Stigma impacting mental health, 2) Assault and abuse 3) Experiences of treatment. The findings show the need for interprofessional collaboration between social and health care professionals such as social workers, community health workers, medical practitioners and psychologists to prevent and address issues of abuse and other social consequences experienced by COVID-19 survivors.
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Affiliation(s)
- Alfred F S Owusu
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Alhassan Abdullah
- Department of Social Work and Social Administration, the University of Hong Kong, HKU Centennial Campus, Hong Kong
| | - Godfred H Pinto
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Hajara Bentum
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Janet Tein Ni Moo
- Department of Social Work and Social Administration, the University of Hong Kong, HKU Centennial Campus, Hong Kong
| | - Mary Ayim
- Department of Social Work and Social Care, University of Birmingham, UK
| | - Crispin R Mbamba
- School of Governance and International Affairs, Durham Global Security Institute, UK
| | - Ebenezer Cudjoe
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
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30
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Chan KKS, Tsui JKC. Longitudinal impact of experienced discrimination on mental health among people with mental disorders. Psychiatry Res 2023; 322:115099. [PMID: 36848709 DOI: 10.1016/j.psychres.2023.115099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/29/2023] [Accepted: 02/05/2023] [Indexed: 02/09/2023]
Abstract
The present study examined the longitudinal impact of stigma on mental health among people with mental disorders. Specifically, this study tested whether higher levels of experienced discrimination would be longitudinally associated with lower levels of symptomatic remission, functional restoration, well-being, and life satisfaction and whether these associations would be mediated by higher levels of self-stigma content and process. A total of 202 people with mental disorders completed questionnaires at three time points (i.e., T1, T2, and T3) over two years. Path analyses showed that experienced discrimination at T1 was positively associated with self-stigma content and process at T2, which were, in turn, negatively associated with symptomatic remission, functional restoration, well-being, and life satisfaction at T3. Bootstrap analyses further revealed that experienced discrimination at T1 had indirect effects on symptomatic remission, functional restoration, well-being, and life satisfaction at T3 through self-stigma content and process at T2. This study shows that experienced discrimination may exacerbate self-stigma content and process and, in turn, impede recovery and wellness among people with mental disorders. Our findings highlight the importance of designing and implementing stigma and self-stigma reduction programs in order to enable people with mental disorders to attain mental illness recovery and positive mental health.
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Affiliation(s)
- Kevin Ka Shing Chan
- Department of Psychology, The Education University of Hong Kong, Hong Kong; Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong.
| | - Jack Ka Chun Tsui
- Department of Psychology, The Education University of Hong Kong, Hong Kong
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31
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ORDU F. Evaluation of Stigma of Mental Illnesses: A Review. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2023. [DOI: 10.18863/pgy.1079332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Stigma is the society's development of prejudiced attitudes and behaviors against the individual due to the diagnosis and treatment associated with mental illnesses, and the individual's exposure to discrimination within the social group. Stigma can be observed as social and internalized. Social stigma can limit people's opportunities, options and competitive conditions. Internalized stigma is the internalization of beliefs related to the prejudiced and discriminatory approach of the environment by the individual. Social and internalized stigmatization processes are related to self-esteem. It has been stated that patient relatives are also exposed to stigmatization along with individuals who have mental illness, and stigmatization reduces the possibility of recovery in mental illnesses. Considering the relevant research findings, it is understood that there is a need to struggle individually and socially against stigma in order to prevent the increase in the negative consequences of mental illness and the development of comorbidities, to strengthen functional behaviors during the treatment process and to increase social support. Informing patients, patient's family, mental health workers and the society, encouraging social change and new research on the subject can be considered as methods of struggle with stigma. In this review, the stigmatization process, social and internalized stigma, the relationship between psychopathology and self-esteem with internalized stigma, stigma and the patient's family, status of stigma over time, status of stigma according to societies, and the relationship of stigma with mental health services were evaluated. In this review, the stigmatization process, social and internalized stigma, the relationship between psychopathology and self-esteem with internalized stigma, stigma and the patient's family, status of stigma over time, status of stigma according to societies, and the relationship of stigma with mental health services were evaluated.
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32
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Lee JE, Goh ML, Yeo SF. Mental health awareness of secondary schools students: Mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health. Heliyon 2023; 9:e14512. [PMID: 36950622 PMCID: PMC10025912 DOI: 10.1016/j.heliyon.2023.e14512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 02/27/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
Purpose The mental health situation among adolescents in Malaysia has reached a worrying state with the rising number of cases. Despite a significant increase in the literature on mental health, there is a lack of studies that focused on mental health awareness. Therefore, this study aimed to investigate the factors affecting Malaysian youth's mental health awareness as well as the mediating roles of knowledge on mental health, knowledge on professional help, and attitude towards mental health. Methods Self-administered questionnaires were distributed to 450 secondary school students aged 15-19 years old in Kuala Lumpur and Melaka who were recruited via purposive sampling. Data analysis was performed using SPSS and SmartPLS to obtain the descriptive analysis, measurement model, and structural model. Results The results indicated that mental health awareness was influenced by knowledge on mental health and attitude towards mental health. The findings also revealed that familiarity and media exposure were important determinants of knowledge on mental health, knowledge on professional help, and attitude towards mental health. Moreover, the results indicated that knowledge on mental health positively mediated the relationship between media exposure and mental health awareness. Besides, attitude towards mental health also found to play mediating roles between familiarity and mental health awareness, as well as between media exposure and mental health awareness. Conclusion This study contributed important knowledge to the limited literature in this contemporary domain. An effective public mental health campaign is needed to reduce the burden of disease and the cost of mental illness.
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Affiliation(s)
- Jia En Lee
- Faculty of Business, Multimedia University, Melaka, Malaysiax
| | - Mei Ling Goh
- Faculty of Business, Multimedia University, Melaka, Malaysiax
- Corresponding author.
| | - Sook Fern Yeo
- Faculty of Business, Multimedia University, Melaka, Malaysiax
- Department of Business Administration, Daffodil International University,Dhaka, Bangladesh
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Winiker AK, White S, Candelario J, Takahashi LM, Tobin KE. "Through the Things That Have Happened to Me, They've Made Me Stronger": Individual and Interpersonal Sources of Violence and Resilience Among a Diverse Sample of Transgender Women in Los Angeles. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:5019-5043. [PMID: 36062750 DOI: 10.1177/08862605221120896] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Within the United States, transgender women face a disproportionate burden of violence, experiencing increased rates of multiple forms of violence compared with cisgender women and other sexual/gender minority groups. Among transgender women, further racial/ethnic disparities in experiences of violence exist. Resilience has been shown to be protective against the adverse impacts of violence on mental and physical health outcomes, yet little is known about unique sources of resilience, coping, and strength among transgender women. Sixteen in-depth interviews were conducted with a racially diverse sample of transgender women between May and July, 2020 in Los Angeles. Participants were between the ages of 23 and 67 years. Four participants identified as African American/Black, four as Latina, four as White, two as Asian, and two as Native American. Participants were recruited from a local social service organization. Interview questions assessed social network characteristics, experiences of violence, coping mechanisms, and sources of resilience in response to violence. Deductive and inductive coding schemes were used to identify common themes, and data analysis focused upon experiences of violence and sources of resilience/coping. Violence was common among members of the sample, with every participant reporting a history of multiple forms of violence. Violence perpetration came from many sources, including cisgender male strangers, family members, intimate partners, and other transgender women. Women also reported multiple sources of strength and coping, including engaging in self-care and leisure activities, behavioral adaptations, mentorship/support from other transgender women, and striving to "pass" as cisgender. Despite having faced extensive violence, the participants in this sample were resilient, demonstrating many internal and external coping mechanisms and sources of strength. These findings can inform programs and services that target transgender women, providing participants with opportunities to build resilience and other coping mechanisms to buffer the harmful mental and physical health impacts of exposure to violence.
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Affiliation(s)
| | - Sydney White
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Lois M Takahashi
- Sol Price School of Public Policy - University of Southern California, Sacramento, CA, USA
| | - Karin E Tobin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Kim SY, Song DY, Bottema-Beutel K, Gillespie-Lynch K, Cage E. A systematic review and meta-analysis of associations between primarily non-autistic people's characteristics and attitudes toward autistic people. Autism Res 2023; 16:441-457. [PMID: 36508161 DOI: 10.1002/aur.2867] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 11/25/2022] [Indexed: 12/14/2022]
Abstract
This systematic review includes a narrative synthesis and meta-analysis of research on the associations between primarily non-autistic people's characteristics and their attitudes toward autistic people. Of 47 studies included in the narrative synthesis, White undergraduate students were surveyed most frequently. Demographic characteristics were the factors most frequently tested for associations with attitudes, followed by contact-related factors (i.e., quantity and quality), knowledge about autism, trait and personality factors, and other factors that did not fit into a single category. Internal consistency was not reported for some instruments assessing raters' characteristics; some instruments had alpha levels lower than 0.70, and many characteristics of raters were measured using one-item measures. Moreover, theoretical motivations for investigating the raters' characteristics were rarely provided. A total of 36 studies were included in the meta-analysis, which showed that attitudes toward autistic people were significantly associated with participants' gender, knowledge about autism, and quality and quantity of their previous contact with autistic people, but not with their age or autistic traits. These findings indicate a need for more studies that focus on context-related characteristics (e.g., institutional variables such as support/commitment to inclusion), use reliable instruments to measure non-autistic people's characteristics, and situate their investigation in a theoretical framework.
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Affiliation(s)
- So Yoon Kim
- Department of Teacher Education, Duksung Women's University, Seoul, South Korea
| | - Da-Yea Song
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam-si, South Korea
| | - Kristen Bottema-Beutel
- Teaching, Curriculum, and Society department, Lynch School of Education and Human Development, Boston College, Chestnut Hill, Massachusetts, USA
| | | | - Eilidh Cage
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, Scotland, UK
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Finn SW, Mejldal A, Nielsen AS. Public stigma and treatment preferences for alcohol use disorders. BMC Health Serv Res 2023; 23:76. [PMID: 36694198 PMCID: PMC9872434 DOI: 10.1186/s12913-023-09037-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/04/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Alcohol use disorders (AUD) are among the most highly stigmatized medical conditions. Only a minority of individuals with AUD seek treatment, and stigma is one of the most prominent barriers to treatment-seeking. However, there is a lack of knowledge about the associations between stigma and preferences for help-seeking, and the associations between stigma and preferences for treatment seeking. AIM to investigate the associations between stigma and preferences for where to seek help and treatment for AUD. As sub-analyses, associations between stigma, level of alcohol use and preferences for help-seeking and treatment preferences will be analyzed. METHOD Cross-sectional design, including n = 3037 participants aged 30 - 65 years, living in Denmark. DATA In 2020, an online questionnaire was administered by a market research company. The questionnaire covered demographics, preferences for help-seeking and treatment for AUD, stigma measured with the Difference, Disdain & Blame Scales for Public Stigma, and alcohol use measured with the Alcohol Use Disorder Test (AUDIT). ANALYSES restricted cubic spline models were applied to model outcomes. Odds ratios were calculated. RESULTS A lower level of stigma was associated with a higher probability of preferring formal and informal help-seeking for AUD. Both high and low levels of stigma were associated with a higher probability of preferring to consult general practitioners. Stigma was not associated with other preferences for treatment-seeking, nor trying to change oneself or a passive strategy. The sub-analyses, grouped by level of alcohol use, showed similar results. CONCLUSION Stigma is associated with lower preferences for formal and informal help-seeking, however not type of treatment preferred. Future studies should address stigma in relation to other factors of the treatment-seeking process.
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Affiliation(s)
- Sara Wallhed Finn
- grid.10825.3e0000 0001 0728 0170Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, Entrance. 220 B, 5000 Odense, Denmark ,grid.4714.60000 0004 1937 0626Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Mejldal
- grid.10825.3e0000 0001 0728 0170Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, Entrance. 220 B, 5000 Odense, Denmark
| | - Anette Søgaard Nielsen
- grid.10825.3e0000 0001 0728 0170Unit of Clinical Alcohol Research, Institute of Clinical Research, University of Southern Denmark, J.B. Winsløws Vej 20, Entrance. 220 B, 5000 Odense, Denmark ,grid.425874.80000 0004 0639 1911Psychiatric Hospital, University Function, Region of Southern Denmark, Odense, Denmark
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Baek CH, Kim HJ, Park HY, Seo HY, Yoo H, Park JE. Influence of Biogenetic Explanations of Mental Disorders on Stigma and Help-Seeking Behavior: A Systematic Review and Meta-Analysis. J Korean Med Sci 2023; 38:e25. [PMID: 36647220 PMCID: PMC9842491 DOI: 10.3346/jkms.2023.38.e25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 10/20/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Biogenetic causal explanations of mental disorders are commonly used for public education and campaigns. However, the influence of biogenetic explanations on the ideas about and attitudes toward mental illness is unclear. We examined the influence of biogenetic explanations on attitudes toward mental disorders using a meta-analytic method accompanied by subgroup analyses. METHODS The protocol for this meta-analysis was registered in PROSPERO (CRD42020158656) in March 2020. Experimental and correlational studies were analyzed separately. Five outcome measures related to attitudes toward mental disorders were included: 'attitude toward help-seeking,' 'blame,' 'perceived dangerousness,' 'prognostic pessimism,' and 'social distance.' Subgroup analyses were performed for the type of mental disorder, population, and geographic region for which a biogenetic explanation was provided. RESULTS A total of 44 studies were included, of which 24 were experimental and 20 were correlational. A positive attitude toward help-seeking was associated with having a biogenetic concept (d = 0.43; 95% confidence interval [CI], 0.18 to 0.67; P < 0.001) in general population and in Eastern countries in particular. Although a biogenetic explanation was associated with a decreased level of blame (d = -0.20; 95% CI, -0.38 to -0.02; P = 0.029) in the general population, it was also associated with significantly higher levels of perceived dangerousness (d = 0.13; 95% CI, 0.03 to 0.23; P = 0.008). A tendency toward a higher level of prognostic pessimism and social distance was associated with a biogenetic concept of mental disorders although there was no statistical significance. CONCLUSION Having a biogenetic concept of the cause of mental disorders was related with a positive attitude toward help-seeking, particularly in the general population and individuals living in Eastern countries. Providing a biogenetic explanation decreased blame toward individuals with mental illness but was associated with increased perceived dangerousness and prognostic pessimism. Therefore, although a biogenetic explanation promotes public use of mental health services, it should be carefully applied to avoid an increase in negative thoughts, such as that mental illness is biologically irreversible and untreatable.
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Affiliation(s)
- Chang Hyeon Baek
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Hee Jung Kim
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Hye Yoon Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Hwo Yeon Seo
- Public Health Service, Seoul National University Hospital, Seoul, Korea
| | - Heejeong Yoo
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jee Eun Park
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea.
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What Are Parents' Experiences With Their Child's Hearing Aid Use in the First 5 Years? Ear Hear 2023:00003446-990000000-00108. [PMID: 36706068 DOI: 10.1097/aud.0000000000001332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
OBJECTIVES Parents are required to make informed choices for their children regarding the use of hearing amplification after hearing loss has been diagnosed. If parents choose a listening and spoken language approach for their child where the development of age appropriate spoken language is the parents' goal, then the early fitting and frequent use of hearing aids is crucial. Within the framework of family centered care, parents have the ultimate responsibility for supporting their child's hearing aid use. However, few studies have focused on parents' insights regarding the aspects that shape hearing aid use in the early years. Thus the aim of this study was to explore parents' firsthand experiences with their child's hearing aid use in the first 5 years. Understanding parents' insights will help improve service provision to optimize outcomes for children with hearing loss. DESIGN The study utilized a prospective qualitative design to explore parents' firsthand experiences with their child's hearing aid use. Purposive sampling was used to recruit 12 parents who participated in semi-structured interviews. Parents' responses were analyzed using thematic analysis. RESULTS Three overarching themes were conceptualized, namely: (a) towards hearing aids - journey into the wilderness; (b) adjusting to hearing aids - it's the journey, not the destination; and (c) support for my child's hearing aid use - it's not where you are going, it's who you have beside you. Each theme was further divided into categories and subcategories. CONCLUSIONS This study identified that parents have much to contribute to service providers' understanding regarding the aspects that shape consistent hearing aid use in young children. Parents shared many insights such as the emotionally daunting nature of the first few months post hearing loss confirmation, the influence of family support, and the importance of building connections and understanding about hearing loss and hearing aid use within their social networks. Based on these insights, the authors provide recommendations for clinical best practice that draw upon key principles of family centered care. They consist of practical suggestions including strategic support to overcome less optimal hearing aid use and ways to facilitate parent support within their familial and communal networks.
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Clapp JD, Sowers AF, Freng SA, Elmi LM, Kaya RA, Bachtel AR. Public beliefs about trauma and its consequences: Profiles and correlates of stigma. Front Psychol 2023; 13:992574. [PMID: 36687984 PMCID: PMC9846146 DOI: 10.3389/fpsyg.2022.992574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
Public stereotypes about trauma exposure and its likely consequences have the potential to influence levels of support extended to survivors in the larger community. The current project sought to examine unique profiles of stereotype endorsement both within and across participants sampled from distinct populations. Trauma-related stereotypes involving symptom course, dangerousness, employability, social functioning, predictability, character, and treatment need were examined in undergraduate (N 1 = 404; N 2 = 502) and MTurk (N 3 = 364) samples. Sympathizing [low overall endorsement], Fearful [high overall endorsement], Pejorative [high endorsement + moralizing beliefs], Safety-Focused [intermediate endorsement + dangerousness], and Performance-Focused [intermediate endorsement + employability] groups were replicated in latent profile models across all samples. Stereotype profiles demonstrated hypothesized associations with general perspectives of mental illness although support for consistent relations with respondent characteristics (e.g., sex; personal exposure to trauma; reported exposure in friends/family) was limited. Data suggest that trauma stereotypes are endorsed at high frequencies in the general community and conform to systematic patterns of prejudice that may be overlooked in more global assessments of stigma.
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Jankowski SE, Yanos P, Dixon LB, Amsalem D. Reducing Public Stigma Towards Psychosis: A Conceptual Framework for Understanding the Effects of Social Contact Based Brief Video Interventions. Schizophr Bull 2023; 49:99-107. [PMID: 36190348 PMCID: PMC9810007 DOI: 10.1093/schbul/sbac143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND HYPOTHESIS Public stigma reduces treatment-seeking and increases the duration of untreated psychosis among young people with psychosis. Social contact-based video interventions have been shown to be effective at reducing stigma; however, more research is needed regarding very brief interventions less than 2 minutes long, which are suitable for social media platforms and particularly relevant for young adults. We recently conducted three randomized control trials and demonstrated the efficacy of such videos to reduce stigma toward individuals with psychosis among young adults of the general public. However, it is unclear what elements contributed to the effectiveness of these very brief interventions. STUDY DESIGN The present article proposes a conceptual framework to discern what elements contributed to the efficacy of these interventions. We first review the existing literature describing social contact-based interventions and how they impact the cognitions, emotions, and behaviors of participants. STUDY RESULTS Then, using this lens, we suggest an alternate observation of the data from our studies by examining changes in stigmatizing views across time, rather than utilizing mean scores and conceptualizing how key characteristics of our interventions helped reduce stigma. We also highlight future research directions, including the need to look at mediators and moderators of change and the need to examine behavioral outcomes. STUDY CONCLUSIONS By hypothesizing how these interventions are proposed to work, this framework is intended to provide a roadmap for further development of brief video-based interventions to reduce stigma.
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Affiliation(s)
- Samantha E Jankowski
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Philip Yanos
- Department of Psychology, John Jay College Of Criminal Justice, City University of New York, New York, NY, USA
| | - Lisa B Dixon
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
| | - Doron Amsalem
- New York State Psychiatric Institute and Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA
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40
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Yip CCH, Fung WTW, Leung DCK, Chan KKS. The impact of stigma on engaged living and life satisfaction among people with mental illness in Hong Kong. Qual Life Res 2023; 32:161-170. [PMID: 36056192 DOI: 10.1007/s11136-022-03218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE The present study aimed to investigate how the interpersonal (experienced discrimination) and intrapersonal (anticipated stigma and internalized stigma) manifestations of psychiatric stigma may affect engaged living and life satisfaction among people with mental illness. In this study, we developed and evaluated a conceptual model to clarify how experienced discrimination may lead to anticipated stigma and internalized stigma and thereby impede engaged living and reduce life satisfaction. METHODS A total of 205 Hong Kong Chinese people with mental illness completed standardized questionnaire measures of experienced discrimination, anticipated stigma, internalized stigma, engaged living, and life satisfaction. The associations among these variables were analyzed using path analyses and bootstrap analyses. RESULTS Path analyses showed that experienced discrimination was related to higher levels of anticipated stigma and internalized stigma, which were, in turn, linked to lesser engaged living and consequently lower life satisfaction. Bootstrap analyses further revealed that experienced discrimination had significant indirect effects on life satisfaction via anticipated stigma and engaged living and via internalized stigma and engaged living. CONCLUSIONS Theoretically, our study uncovers how the interpersonal and intrapersonal manifestations of psychiatric stigma may adversely affect engaged living and life satisfaction among people with mental illness. Practically, our study points to the importance of developing and implementing stigma-related interventions at societal and individual levels in order to enable people with mental illness to live fulfilling and satisfying lives.
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Affiliation(s)
| | - Winnie Tsz Wa Fung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Donald Chi Kin Leung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Kevin Ka Shing Chan
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong. .,Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, Hong Kong.
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Cross-cultural comparison of mental illness stigma and help-seeking attitudes: a multinational population-based study from 16 Arab countries and 10,036 individuals. Soc Psychiatry Psychiatr Epidemiol 2022; 58:641-656. [PMID: 36583767 DOI: 10.1007/s00127-022-02403-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 12/12/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND There is evidence that culture deeply affects beliefs about mental illnesses' causes, treatment, and help-seeking. We aimed to explore and compare knowledge, attitudes toward mental illness and help-seeking, causal attributions, and help-seeking recommendations for mental illnesses across various Arab countries and investigate factors related to attitudes toward help-seeking. METHODS We carried out a multinational cross-sectional study using online self-administered surveys in the Arabic language from June to November 2021 across 16 Arab countries among participants from the general public. RESULTS More than one in four individuals exhibited stigmatizing attitudes towards mental illness (26.5%), had poor knowledge (31.7%), and hold negative attitudes toward help-seeking (28.0%). ANOVA tests revealed a significant difference between countries regarding attitudes (F = 194.8, p < .001), knowledge (F = 88.7, p < .001), and help-seeking attitudes (F = 32.4, p < .001). Three multivariate regression analysis models were performed for overall sample, as well as Palestinian and Sudanese samples that displayed the lowest and highest ATSPPH-SF scores, respectively. In the overall sample, being female, older, having higher knowledge and more positive attitudes toward mental illness, and endorsing biomedical and psychosocial causations were associated with more favorable help-seeking attitudes; whereas having a family psychiatric history and endorsing religious/supernatural causations were associated with more negative help-seeking attitudes. The same results have been found in the Palestinian sample, while only stigma dimensions helped predict help-seeking attitudes in Sudanese participants. CONCLUSION Interventions aiming at improving help-seeking attitudes and behaviors and promoting early access to care need to be culturally tailored, and congruent with public beliefs about mental illnesses and their causations.
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Rodríguez-Ferrer JM, Manzano-León A, Fernández-Jiménez C, Aguilar-Parra JM, Cangas AJ, Luque de la Rosa A. The use of digital escape rooms in nursing education. BMC MEDICAL EDUCATION 2022; 22:901. [PMID: 36581837 PMCID: PMC9798354 DOI: 10.1186/s12909-022-03879-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/09/2022] [Indexed: 06/17/2023]
Abstract
Negative attitudes and prejudices towards people with a mental disorder are common across cultures and societies. The stigma associated with mental illness leads to a lower quality of life, given the discrimination and social exclusion suffered by people with this type of disorder. In the field of health, research has shown that doctors and nurses also manifest these types of stigmatizing behaviors and attitudes. The present study aims to create and apply an educational escape room for the purpose of training nursing students in mental health, promoting positive attitudes towards people who have a mental disorder. To do so, a pre-post study was conducted with an experimental group and a control group to determine whether the escape room was effective for the modification of stigmatizing behaviors compared to transmissive lecture class, and a third measurement was made at 6 months only to the experimental group to evaluate whether the changes produced by the escape room were maintained in the long term. The results indicate that the students participating in the study obtained better scores in sensitization and these remain better over time. It is concluded that the escape room used is suitable for the training and sensitization of future nursing professionals in the field of mental health, facilitating the learning of knowledge and positive attitudes towards severe mental disorder.
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Affiliation(s)
- J M Rodríguez-Ferrer
- Department of Psychology, Health Care Center, University of Almería, Almería, Spain
| | - A Manzano-León
- Department of Psychology, Health Care Center, University of Almería, Almería, Spain.
| | | | - J M Aguilar-Parra
- Department of Psychology, Health Care Center, University of Almería, Almería, Spain
| | - A J Cangas
- Department of Psychology, Health Care Center, University of Almería, Almería, Spain
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Arthur YA, Boardman GH, Morgan AJ, McCann TV. Cluster randomised controlled trial of a problem-solving, Story-bridge mental health literacy programme for improving Ghanaian community leaders' knowledge of depression. J Ment Health 2022; 31:748-756. [PMID: 32755441 DOI: 10.1080/09638237.2020.1793122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Low levels of mental health literacy about depression in the community impact negatively on attitudes towards people with the disorder and their help-seeking. AIMS The aim of this study was to assess the effectiveness of a problem-solving, Story-bridge mental health literacy programme, in improving community leaders' knowledge about helpful interventions for, and recognition of, depression. METHODS A cluster randomised controlled trial involving 140 assembly members, intervention (n = 70) and control (n = 70) groups. The intervention group received a three-hour mental health literacy programme. The control group received a plain language basic brochure about mental health issues. Data were collected at baseline and 12-week follow-up. RESULTS The intervention group demonstrated greater improvement in knowledge about helpful interventions for, and recognition of, depression compared to the control group at follow-up; however, the differences in both measures were small and not statistically significant. CONCLUSION The programme has the potential to improve participants' knowledge about helpful interventions for, and recognition of, depression. Positive outcomes have public mental health implications as they might enhance early help-seeking and contribute to better outcomes for individuals with mental health problems. TRIAL REGISTRATION ACTRN12617000033347. Date of registration - 9 January 2017.
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Affiliation(s)
- Yaw Amankwa Arthur
- Discipline of Nursing and Midwifery, Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Gayelene H Boardman
- Discipline of Nursing and Midwifery, Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Amy J Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
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Tsukuda M, Kayano T, Ito Y. Experiences of COVID-19-Related Stigma: A Qualitative Study on Nurses Caring for Patients With COVID-19. J Nurs Res 2022; 30:e241. [PMID: 36302148 DOI: 10.1097/jnr.0000000000000528] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Healthcare workers caring for patients with Coronavirus Disease 2019 (COVID-19) have been a primary target of stigmatization and discrimination during the COVID-19 outbreak. Thus, there is an urgent need to develop a support system for Asian healthcare workers who care for patients with COVID-19. PURPOSE This study was designed to understand the characteristics of COVID-19-related stigma experienced by nurses caring for patients with COVID-19. METHODS A qualitative content analysis methodology was used. This study was conducted between April 2020 and March 2021. The participants were 10 female registered nurses working at three medical facilities that accepted patients with COVID-19. The data included specific narratives on the instances of stigma experienced when caring for patients with COVID-19, including connected situations and ideas. The data were collected using focus group interviews with three or four participants in each group. Data analysis was conducted based on the inductive qualitative analysis approach of Krippendorff. RESULTS The content analysis identified two categories and seven subcategories of stigma experienced by clinical nurses. The category "directly experienced prejudice and discrimination" included the subcategories "being avoided," "being treated as dirty," "discrimination toward family members," and "others prying." The category "self-imposed coping behavior" included the subcategories "keeping oneself apart," "feeling guilty," and "nondisclosure." CONCLUSIONS/IMPLICATIONS FOR PRACTICE The participants internalized their experiences of stigma, as Japanese culture emphasizes keeping such things to oneself. Therefore, there is an urgent need to strengthen the support system for nurses who care for patients with COVID-19. This study addressed the problem of the stigmatization of these nurses and their families by others as well as their colleagues. The main findings were that stigma was directly experienced as discrimination and prejudice and often resulted in self-imposed coping behavior. The major implication of these findings is the need to establish systematic, active, and ongoing organizational support programs for nurses who are discriminated against because of COVID-19-related stigma.
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Affiliation(s)
- Makoto Tsukuda
- PhD, RN, Lecturer, College of Nursing Art and Science, University of Hyogo, Akashi, Japan
| | - Tomonori Kayano
- MSN, RN, Lecturer, Department of Human Nursing, Sonoda Women's University, Amagasaki, Japan
| | - Yoshiyasu Ito
- MSN, RN, Assistant Professor, College of Nursing Art and Science, University of Hyogo, Akashi, Japan
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Rasset P, Mange J, Montalan B, Stutterheim SE. Towards a better understanding of the social stigma of facial difference. Body Image 2022; 43:450-462. [PMID: 36345083 DOI: 10.1016/j.bodyim.2022.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 10/10/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022]
Abstract
Facial difference (FD) is not only an individual experience; it is inherently social, reflecting interactions between social norms and individual attitudes. Often FD is stigmatized. In this paper, we employ a widely used stigma framework, namely the social stigma framework put forth by Pryor and Reeder (2011), to unpack the stigma of FD. This framework posits that there are four forms of stigma: public stigma, self-stigma, stigma by association, and structural stigma. We first discuss the social and psychological literature on FD as it pertains to these various forms of stigma. We then describe coping approaches for FD stigma. Lastly, we delineate evidence-based methods for addressing the various forms of FD stigma, such that future efforts can more effectively tackle the stigma of facial difference.
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Affiliation(s)
- Pauline Rasset
- Laboratoire de Psychologie de Caen Normandie (LPCN EA 7452), Université de Caen Normandie, France.
| | - Jessica Mange
- Laboratoire de Psychologie de Caen Normandie (LPCN EA 7452), Université de Caen Normandie, France
| | - Benoît Montalan
- Centre de Recherche sur les Fonctionnements et Dysfonctionnements Psychologiques (CRFDP EA 7475), Université de Rouen Normandie, France
| | - Sarah E Stutterheim
- Department of Health Promotion, Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
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Hegazi O, Alalalmeh S, Alfaresi A, Dashtinezhad S, Bahada A, Shahwan M, Jairoun AA, Babalola TK, Yasin H. Development, Validation, and Utilization of a Social Media Use and Mental Health Questionnaire among Middle Eastern and Western Adults: A Pilot Study from the UAE. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16063. [PMID: 36498139 PMCID: PMC9736958 DOI: 10.3390/ijerph192316063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/20/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES We aimed to develop and validate a mental health stigma measurement tool for use within the social media context, utilizing the tool to assess whether the stigma shown in face-to-face interactions translates to social media, coupled with comparing whether social media use can cause the stigma among a sample of Middle Eastern and Western populations. METHODS The development and validation phase comprised a systematic process that was used to develop an assessment tool that could be used within the social media context and establish its validity and reliability. A 5-point Likert-type scale (1 = strongly disagree to 5 = strongly agree) was developed to assess mental health stigma. The anonymous questionnaire was distributed from June 2022 to August 2022 on various social media platforms and groups predominated by the two demographics of interest, enrolling 1328 participants (with only 1001 responses deemed valid). The utilization phase consisted of bivariate and multivariable analysis of the data. The cutoff points for low, medium, and high scores were the 25th, 50th, and 75th percentil, respectively. RESULTS The instrument comprised three dimensions: acceptance, intolerance, and digital care sentiment. In the Middle Eastern subset of participants, a higher score of intolerance (more stigma) toward mental illness was found in 72.4% of the participants, with a higher score of acceptance being 35.1% and of digital care sentiment being 46.4%. The mean scores for all the scales were as follows: intolerance (3.08 ± 0.64), acceptance (3.87 ± 0.71), and digital care sentiment (3.18 ± 0.69). For Westerners, a higher score of intolerance toward mental illness was found in 24.0% of the participants, with a higher score of acceptance being 56.8% and of digital care sentiment being 38.2%. The mean scores for all the scales were as follows: intolerance (2.28 ± 0.73), acceptance (4.21 ± 0.61), and digital care sentiment (3.08 ± 0.62). Various results were obtained regarding the effect of individual social media platforms on the different subscales. CONCLUSIONS Stigma does follow people on social media, whether they are Middle Easterners or Westerners, although to varying degrees. The results of social media interaction and activity varied based on the group that used them, with some having an impact on one group but not the other. For these reasons, proper guidance is advised when utilizing and interacting with social media platforms.
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Affiliation(s)
- Omar Hegazi
- College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
| | - Samer Alalalmeh
- College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
| | - Ahmad Alfaresi
- College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
| | - Soheil Dashtinezhad
- College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
| | - Ahmed Bahada
- College of Engineering, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Moyad Shahwan
- College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
| | | | - Tesleem K. Babalola
- Program in Public Health, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY 11794, USA
| | - Haya Yasin
- College of Pharmacy and Health Sciences, Ajman University, Ajman 346, United Arab Emirates
- Centre of Medical and Bio-allied Health Sciences Research, Ajman University, Ajman 346, United Arab Emirates
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Chan KKS, Fung WTW, Leung DCK, Tsui JKC. The impact of perceived and internalised stigma on clinical and functional recovery among people with mental illness. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6102-e6111. [PMID: 36254881 DOI: 10.1111/hsc.14047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/16/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to develop and validate a conceptual model linking public and internalised stigma to recovery attitudes, processes and outcomes among people with mental illness. Specifically, we sought to examine whether perceptions of public stigma (i.e., perceived stigma) would affect experiences of internalised stigma (i.e., self-stigma) and thereby influence recovery attitudes (i.e., recovery orientation), recovery processes (i.e., service engagement) and recovery outcomes (i.e., clinical recovery and functional recovery). A total of 205 people with mental illness from Hong Kong, China, completed questionnaire measures on perceived stigma, self-stigma, recovery orientation, service engagement, clinical recovery and functional recovery. The associations among these variables were analysed using path analyses and bootstrap analyses. Path analyses showed that perceived stigma was related to greater self-stigma, which was, in turn, linked to lower recovery orientation and then lesser service engagement and ultimately poorer clinical recovery and functional recovery. Bootstrap analyses further demonstrated that perceived stigma had significant indirect effects on recovery orientation via self-stigma, on service engagement via self-stigma and recovery orientation and on clinical recovery and functional recovery via self-stigma, recovery orientation and service engagement. Theoretically, our findings reveal how public and internalised stigma may adversely affect recovery attitudes, processes and outcomes among people with mental illness. Practically, our findings point to the vital and urgent need to develop effective interventions to mitigate stigma and self-stigma at community and individual levels in order to reduce the deleterious impact of stigma on recovery.
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Affiliation(s)
- Kevin Ka Shing Chan
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
- Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Winnie Tsz Wa Fung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Donald Chi Kin Leung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Jack Ka Chun Tsui
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
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Bizumic B, Gunningham B, Christensen BK. Prejudice towards people with mental illness, schizophrenia, and depression among mental health professionals and the general population. Psychiatry Res 2022; 317:114817. [PMID: 36122536 DOI: 10.1016/j.psychres.2022.114817] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/29/2022] [Accepted: 08/30/2022] [Indexed: 11/27/2022]
Abstract
The aim of the study was to measure and compare prejudice towards people with specific mental illnesses between mental health professionals and the general population, and examine personality, ideological, and attitudinal antecedents of prejudice. To do so, we also aimed to validate three shortened scales of prejudice. A sample of mental health professionals (N = 299) and a sample from the general population (N = 427) completed shortened versions of the Prejudice towards People with Mental Illness, Prejudice towards People with Schizophrenia, and Prejudice towards People with Depression scales. They also completed measures of validity criteria and demographics. The scales demonstrated construct validity in both samples. Although prejudice was highest towards people with schizophrenia and lowest towards people with depression, mental health professionals demonstrated significantly less prejudice overall than the general population. Prejudice was associated with higher social dominance orientation, right wing authoritarianism, ethnocentrism, conservatism, and generalized prejudice, and lower agreeableness, openness to experience, and contact. These antecedents of prejudice were better predictors than any demographic or profession-related variables examined. This study contributes increased knowledge of the structure and correlates of prejudice towards people with mental disorders. This knowledge should inform more nuanced and effective interventions, therapy, and training.
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Affiliation(s)
- Boris Bizumic
- Research School of Psychology, the Australian National University, Canberra, ACT 2601, Australia.
| | - Beth Gunningham
- Research School of Psychology, the Australian National University, Canberra, ACT 2601, Australia
| | - Bruce K Christensen
- Research School of Psychology, the Australian National University, Canberra, ACT 2601, Australia
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How threatening are people with mental disability? it depends on the type of threat and the disability. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03655-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AbstractThere is clear evidence that people with mental disability suffer from discrimination at school, at work, and in society. Less is known about the psychological processes and perceptions that guide such behaviors and even less if these perceptions vary according to the type of disability. Our objective was to build on well-established social psychological models and investigate the perceptions (i.e., stereotypes, perceived threats, and emotions) of people towards different types of mental disability. Participants from two francophone countries completed a questionnaire measuring their perceptions towards 18 mental disabilities and their familiarity with disability (N = 560). As expected, results revealed heterogeneous perceptions across groups. Moreover, perceived threats mediated the link between the stereotype of warmth and emotions. Surprisingly, greater familiarity with mental disability went along with greater derogation. This research nuances the overly generalized perceptions often associated with mental disability. We discuss implications for the reduction of discrimination against people with mental disability.
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Poulgrain JW, Bremner NM, Zimmerman H, Jao CW, Winter T, Riordan BC, Bizumic B, Hunter J, Scarf D. Why So Serious? An Attempt to Mitigate the Short-Term Harmful Effects of the Film Joker on Prejudice toward People with Mental Illness. Behav Sci (Basel) 2022; 12:bs12100384. [PMID: 36285953 PMCID: PMC9598699 DOI: 10.3390/bs12100384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/04/2022] [Accepted: 10/04/2022] [Indexed: 11/16/2022] Open
Abstract
The media perpetuates many harmful stereotypes about people with mental illness. In two studies, we demonstrate the impact of negative media portrayals of mental illness on prejudice and attempt to mitigate these negative effects. Specifically, in Study 1, participants watched the movie Joker, a recent film which associates mental illness with violent behavior, or a control film (Terminator). Participants completed the Prejudice towards People with Mental Illness (PPMI) scale before and after viewing their respective films. The PPMI consists of four dimensions: fear/avoidance (i.e., wanting to avoid people with mental illness), malevolence (i.e., viewing people with mental illness as inferior), authoritarianism (i.e., preference for control over people with mental illness), and unpredictability (i.e., the behavior of people with mental illness is unreliable). We hypothesized that participants who watched the film Joker would display an increase in their fear/avoidance of people with mental illness and their support for authoritarian approaches to their treatment. Consistent with these hypotheses, participants who viewed Joker displayed a significant increase in the fear/avoidance and authoritarian subscales of the PPMI, relative to participants that watched Terminator. In Study 2, in an attempt to mitigate the impact of Joker on prejudice towards people with mental illness, directly after the film we displayed educational and counter-stereotypical statements on-screen that challenged the view that people with mental illness are violent. A control group viewed Joker without these statements. Identical to Study 1, all participants completed the PPMI scale before and after viewing the film. We hypothesized that participants who viewed Joker with the statements would display lower prejudice relative to the control condition. Unfortunately, participants in the experimental and control conditions displayed a comparable increase in prejudice. Together, these studies confirm the negative effect of media portrayals of mental illness (as depicted in Joker) and demonstrate that these effects are not easily mitigated.
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Affiliation(s)
| | | | - Hannah Zimmerman
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
| | - Chia-Wei Jao
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
| | - Taylor Winter
- Department of Psychology, Victoria University of Wellington, Wellington 6140, New Zealand
| | | | - Boris Bizumic
- Research School of Psychology, Australian National University, Canberra 2601, Australia
| | - John Hunter
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
| | - Damian Scarf
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand
- Correspondence:
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