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Walsh D, Foster J. Understanding the public stigma of mental illness: a mixed-methods, multi-level, exploratory triangulation study. BMC Psychol 2024; 12:403. [PMID: 39033289 PMCID: PMC11265057 DOI: 10.1186/s40359-024-01887-3] [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: 01/22/2024] [Accepted: 07/05/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND This study examines the role of themata in understanding mental health-related stigma. It is motivated by the need for alternative theoretical-methodological approaches beyond the dominant frameworks in education and contact-based anti-stigma public health efforts, which have shown mixed effects. Specifically, it addresses the need for a more nuanced framework in stigma research, one that is sensitive to the dialogues through which people relate themselves to mental health and stigma in context. METHODS The research employs an exploratory mixed-methods approach, including the analysis of 529 news reports, 20 focus group discussions, and 19 one-to-one interviews, all concerning representations of shared living arrangements with someone perceived to have experiences of mental illness. Thematic analysis and natural language processing are used within a convergent triangulation design to analyze the data. RESULTS We found that mental health and illness were communicated through an overarching Self/Other thema and five subordinate themata: normal/abnormal, harm/non-harm, bounded/non-bounded, and moral/immoral. Despite familiarity with psychological distress and 'modern' explanations of mental illness, concerns about social identity motivated representations of mental illness as a predominantly permanent, negative form of personhood marked by abnormality, harm, distance, and immorality. Additionally, concerns about personal vulnerability, including historically rooted fears of contagion, motivated distancing representations of mental illness, rather than neutral portrayals. CONCLUSIONS Themata have under-developed theoretical and methodological potential for addressing mental health-related stigma, particularly in their ability to describe the dynamic ways in which culture motivates people to both resist and reproduce stigma, partly through ambivalences, absences, tensions, and ambiguities in representation. A critical discussion is provided on how themata may support ecological strategies in mental health campaigns over generic models, emphasizing the need to understand group knowledge and contact dynamics to mitigate adverse effects. Themata Public Health Unintended Consequences Mixed Methods Behaviour Change Natural Language Processing.
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Affiliation(s)
- Daniel Walsh
- Grenoble Alpes University, Bureau 49 Sciences Po/ Pacte, Grenoble, 38040, France.
| | - Juliet Foster
- King's College London, 16 De Crespigny Park, London, SE5 8AB, UK
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Hultqvist J, Hensing G, Björk L, Bertilsson M. Managers' attitudes to depression and the association with their rating of how work capacity is affected in employees with common mental disorders. BMC Res Notes 2024; 17:144. [PMID: 38773610 PMCID: PMC11110306 DOI: 10.1186/s13104-024-06750-7] [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: 08/31/2023] [Accepted: 03/18/2024] [Indexed: 05/24/2024] Open
Abstract
OBJECTIVE This explorative, cross-sectional study assessed the association between managers' attitudes to employee depression and their rating of how common mental disorders (CMDs) affect employee work capacity. RESULTS A principal component analysis was performed for the nine variables concerning managers' rating of how CMDs can affect work capacity among employees. The analysis resulted in two factors: task-oriented- and relational work capacity. The result of the multivariate analysis of covariance showed a p value of 0.014 (Pillai's trace) indicating a statistically significant association between managers' attitudes towards employee depression and managers' rating of how CMDs affect work capacity. The association was significant for both factors as indicated by the p value of 0.024 for task-oriented work capacity and the p value of 0.007 for relational work capacity. The R2 value was 0.022 for task-oriented work capacity and 0.017 for relational work capacity. We assumed that negative attitudes towards employee depression would be associated with a perception of decreased work capacity among employees with CMDs. The results showed a significant association; however, the effect (~ 2%) was small. Further studies of manager's attitudes and other possible determinants of managers' rating of CMD-related work capacity are needed to better understand these factors.
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Affiliation(s)
- Jenny Hultqvist
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, 405 30, Gothenburg, Sweden.
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30, Gothenburg, Sweden
| | - Lisa Björk
- Region Västra Götaland, The Institute of Stress Medicine, 413 19, Gothenburg, Sweden
- Department of Sociology and Work Science, University of Gothenburg, 405 30, Gothenburg, Sweden
| | - Monica Bertilsson
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, 405 30, Gothenburg, Sweden
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Staland-Nyman C, Nurul Basar KM, Hultqvist J, Bertilsson M. The significance of managers' knowledge of common mental disorders on managerial stigma towards employee depression: a cross-sectional study in Sweden. BMC Public Health 2024; 24:378. [PMID: 38317109 PMCID: PMC10840239 DOI: 10.1186/s12889-023-17577-5] [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: 04/23/2023] [Accepted: 12/24/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Common mental disorders (CMD) such as depression, anxiety and stress-related disorders have increased in the working-age population in many countries but are still often associated with social stigma in workplaces. Managers have a key role in supporting employees with impaired health. Identifying factors that can improve stigmatizing attitudes among managers towards CMD is crucial. The aim of this study was to investigate managers' knowledge of CMD on managerial stigma; more specifically knowledge aquired through training and education and through occupational and personal experience of CMD on low managerial stigma towards employee depression. METHODS Data from a web-based survey conducted in 2017 among 3038 managers in Sweden were used. Managers' attitudes towards employee depression were measured using the Swedish version of the Managerial Stigma towards Employee Depression questionnaire. Binary logistic regression analysis, with adjustments for work setting and managerial experience, was conducted for associations between sources of knowledge of CMD and low managerial stigma. RESULTS With regard to knowledge acquired through training, medical training on CMD was significantly associated with a higher probability for low managerial stigma towards employee depression after adjustments (odds ratio [OR], 1.95; 95% confidence interval [CI], 1.26-3.01), whereas no significant associations were found between knowledge acquired through managerial training on CMD or level of formal education and low managerial stigma. With regard to knowledge acquired through professional and personal experience, occupational experience of treating people with CMD was significantly associated with a higher probability for low managerial stigma (OR, 2.03; 95% CI, 1.40-2.94) as was occupational experience of employees with CMD (1 employee: OR, 1.31; 95% CI, 1.04-1.66); >1 employee, OR 1.35 (CI 1.05-1.73). Personal experience of CMD was significantly associated with low managerial stigma (OR, 1.98; 95% CI, 1.60-2.46). CONCLUSIONS Managers' knowledge and understanding of CMD may increase the probability of a low level of managerial stigma towards employees with depression. Managers' professional and/or personal experiences of CMD were important sources of knowledge in relation to a low level of stigmatizing attitudes. Organizations should encourage the use of managers' experience-based knowledge of CMD in addition to training on CMD to reduce managerial stigma.
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Affiliation(s)
- Carin Staland-Nyman
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Box 100, S-405 30, Sweden.
- School of Health and Welfare, Halmstad University, Box 823, S-301 18, Halmstad, Sweden.
| | - Kazi Mohammad Nurul Basar
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Box 100, S-405 30, Sweden
| | - Jenny Hultqvist
- Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Box 100, S-405 30, Gothenburg, Sweden
| | - Monica Bertilsson
- School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Box 100, S-405 30, Sweden
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Hensing G, Blom S, Björkman I, Bertilsson M, Martinsson J, Wängnerud L, Löve J. Differences in how women and men in a Swedish population-based sample think about sick leave: A cross-sectional vignette study. Work 2024; 77:827-838. [PMID: 37781846 DOI: 10.3233/wor-230119] [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: 10/03/2023] Open
Abstract
BACKGROUND Gender differences in attitudes towards depression gives reason to believe that sociocultural gender norms play a role in other areas. OBJECTIVE The aim was to test (i) if the likelihood to think that sick leave with depression symptoms is not reasonable varies between women and men, and (ii) if the likelihood to think sick leave is not reasonable varies depending on the gender of the individual with depression symptoms. METHODS A study population of 3147 participants responded to a web-survey with a written case briefly describing a man or woman with symptoms of depression. Respondents were asked if they thought it is reasonable that the person was sick listed for two weeks. Logistic regression was used to analyse the data. RESULTS After controlling for age, education, self-rated health, and respondent's own experience of sickness absence the adjusted OR was 1.45 (95% CI 1.25-1.67) for men being less likely to think sick-leave was reasonable. Gender difference decreased when adjusting for negative attitudes towards depression (adjusted OR 1.24, 95% CI 1.06-1.44). No difference was found between how women and men thought about sick leave in relation to the gender of the case described in the vignette. CONCLUSION Men were more likely to think that sick leave was not reasonable with decreased OR after adjustment for negative attitudes towards depression. Gender norms might be part of the explanation for differences but are challenging to test. This study contributes to a bourgeoning research field on gendered attitudes and sick leave, in terms of theoretical reasoning and methodological choice.
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Affiliation(s)
- Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sara Blom
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ida Björkman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Monica Bertilsson
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Johan Martinsson
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Lena Wängnerud
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Jesper Löve
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Hultqvist J, Zhang P, Staland-Nyman C, Bertilsson M. Managers' Influence on the Prevention of Common Mental Disorders in the Workplace: A Cross-Sectional Study Among Swedish Managers. J Occup Environ Med 2023; 65:1008-1016. [PMID: 37621038 DOI: 10.1097/jom.0000000000002950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To investigate the association among managers' attitudes toward subordinates with common mental disorders (CMDs), self-confidence in supporting these subordinates, and managerial preventive actions (MPAs). METHODS A cross-sectional study was conducted among Swedish managers (n = 2988) and two types of MPAs: reviewing assignments and work situation (MPA-review), and talking about CMD at the workplace (MPA-talk). Binary logistic regression models were applied and adjusted for individual and organizational covariates. RESULTS Managers with negative attitudes toward subordinates with CMD were less likely to have done both MPAs. Managers with higher self-confidence in supporting these subordinates were more likely to have done both MPAs compared with managers with lower self-confidence. CONCLUSIONS Managerial negative attitudes toward CMD and self-confidence in supporting subordinates with CMD have a role in MPAs and should be addressed in manager training programs to encourage preventive actions.
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Affiliation(s)
- Jenny Hultqvist
- From the Department of Health and Rehabilitation, Sahlgrenska Academy, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden (J.H.); School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (P.Z., C.S.-N., M.B.); and School of Health and Welfare, Halmstad University, Halmstad, Sweden (C.S.-N.)
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González Sanguino C, Santos-Olmo AB, Zamorano S, Sánchez-Iglesias I, Muñoz López M. The stigma of mental health problems: A cross-sectional study in a representative sample of Spain. Int J Soc Psychiatry 2023; 69:1928-1937. [PMID: 37300414 DOI: 10.1177/00207640231180124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Mental health stigma is a relevant phenomenon with implications for the people who suffer from it. Despite its importance, no studies have been carried out in Spain at national level with a representative sample of the population. AIMS The aim of this research is to analyze the stigma associated with MHPs in a representative sample of the Spanish population for the first time. METHOD A cross-sectional quantitative descriptive study was carried out with a representative sample of the population (N = 2746). Descriptive analyses and regressions are carried out on the different dimensions of stigma such as attitude, attribution and intention of social distance. RESULTS Medium levels of stigma are obtained in stigmatizing attitudes and attributions, and medium-low levels in the intention of social distance. The best predictors of stigma in its different dimensions are attitudes, attributions and intention of social distance themselves. Progressive political ideology is related to less stigma in all dimensions. Knowing someone with mental health problems and talking openly about it together with higher education are also relevant protectors. Mixed results are obtained regarding age, gender and help-seeking. CONCLUSION National programs and campaigns focused on attitudes, attributions and behavioral intentions are necessary to reduce the stigma still present in Spanish society.
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Affiliation(s)
- Clara González Sanguino
- Department of Psychology, School of Education and Social Work, University of Valladolid, Spain
- Chair Against Stigma Grupo 5-Complutense University of Madrid, Spain
| | - Ana Belén Santos-Olmo
- Chair Against Stigma Grupo 5-Complutense University of Madrid, Spain
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Complutense University of Madrid, Spain
| | - Sara Zamorano
- Chair Against Stigma Grupo 5-Complutense University of Madrid, Spain
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Complutense University of Madrid, Spain
| | - Iván Sánchez-Iglesias
- Chair Against Stigma Grupo 5-Complutense University of Madrid, Spain
- Department of Psychobiology and Behavioral Sciences Methods, School of Psychology, Complutense University of Madrid, Spain
| | - Manuel Muñoz López
- Chair Against Stigma Grupo 5-Complutense University of Madrid, Spain
- Department of Personality, Assessment and Clinical Psychology, School of Psychology, Complutense University of Madrid, Spain
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Sánchez-Iglesias I. The "Why" in Mental Health, Stigma, and Addictive Behaviors: Causal Inferences in Applied Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6915. [PMID: 37887653 PMCID: PMC10606211 DOI: 10.3390/ijerph20206915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 10/12/2023] [Indexed: 10/28/2023]
Abstract
Mental health problems, broadly understood, are highly prevalent [...].
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Affiliation(s)
- Iván Sánchez-Iglesias
- Department of Psychobiology & Behavioral Sciences Methods, Complutense University of Madrid, 28223 Madrid, Spain
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Congia P, De Fabritiis D, Arca M, Farris D, Sarigu D, Virdis M. Effects of Affective Proximity and Treatment on Emotional Response toward People with Substance Use. Subst Use Misuse 2023; 58:1505-1518. [PMID: 37415338 DOI: 10.1080/10826084.2023.2227701] [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] [Indexed: 07/08/2023]
Abstract
BACKGROUND Emotions act as mediators of the relationship between stereotypes and inclinations to discriminate against and isolate individuals with substance use disorders (SUD). Emotional responses toward people with SUD are more negative than toward those people with non-drug-related mental disorders. This study explored the effects of affective bonds with substance users and treatment on the type and frequency of emotions, valence, and interpersonal distance. METHODS A convenience sample of 1,195 individuals was included in this survey-based study. Participants responded to questions regarding their knowledge of psychoactive drugs and beliefs about substance use disorders and were requested to report the emotions they imagined having felt in four scenarios depicting a substance user whose characteristics varied according to two dimensions: the substance user was a relative or an unknown; the substance user was in treatment for SUD, or not. RESULTS Emotions toward relative drug users were more negative and expressed greater interpersonal distance. Treatment was associated with more positive valence and lower interpersonal distance, but emotions toward relatives in treatment were more negative than those not. CONCLUSION Specific interventions for relatives of people with SUD may be necessary because of the emotional burden caused by the courtesy stigma.
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Affiliation(s)
- Pierpaolo Congia
- Department of Mental Health and Addiction, SER.D.2, ASSL Cagliari, Cagliari, Italy
| | - Daniela De Fabritiis
- Department of Mental Health and Addiction, SER.D.2, ASSL Cagliari, Cagliari, Italy
| | - Manuela Arca
- Department of Mental Health and Addiction, SER.D.2, ASSL Cagliari, Cagliari, Italy
| | - Daniela Farris
- Department of Mental Health and Addiction, SER.D.2, ASSL Cagliari, Cagliari, Italy
| | - Davide Sarigu
- Department of Mental Health and Addiction, SER.D.2, ASSL Cagliari, Cagliari, Italy
| | - Mariella Virdis
- Ministry of Public Education High School Euclide, Cagliari, Italy
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Robling K, Cosby C, Parent G, Gajjar S, Chesher T, Baxter M, Hartwell M. Person-centered language and pediatric ADHD research: a cross-sectional examination of stigmatizing language within medical literature. J Osteopath Med 2023; 123:215-222. [PMID: 36762442 DOI: 10.1515/jom-2022-0126] [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: 06/21/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023]
Abstract
CONTEXT Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children and often goes untreated. A major barrier to treatment is the stigma surrounding the disorder, including from the educational and scientific community. Person-centered language (PCL) is associated with positive health outcomes, and its implementation is recommended by multiple professional groups, but its use has not been quantified for ADHD. OBJECTIVES The goal of this study is to quantify the adherence to PCL among ADHD-related journal publications utilizing a cross-sectional study design. METHODS We conducted a cross-sectional examination including a systematic search of PubMed, which encompasses MEDLINE, for ADHD-related articles from January 2014 to March 2021. All journals with at least 20 ADHD-related search returns, human research, and in the English language were included, totaling 5,308 articles from 88 journals. Articles were randomized, and the first 500 were screened for inclusion of prespecified, non-PCL terminology. After exclusion, 311 articles were retained. RESULTS Of the 311 retained articles, 131 (42.1%) adhered to PCL guidelines. Among articles with non-PCL, stigmatizing language such as "problem(s) with [the/a] child or problem child" and "suffers from" was found most frequently- occurring in 47.6% (148/311) and 5.8% (18/311) of the articles, respectively. We found no significant association between PCL adherence and study characteristics. CONCLUSIONS Our findings revealed that over half of the current ADHD literature did not adhere to PCL guidelines. Adherence to PCL by the scientific and medical community will increase the overall efforts to mitigate stigma and increase support for individuals with ADHD.
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Affiliation(s)
- Kristyn Robling
- Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Caitlin Cosby
- Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Gunner Parent
- Oklahoma State University College of Osteopathic Medicine at the Cherokee Nation, Tahlequah, OK, USA
| | - Swapnil Gajjar
- Department of Industrial Engineering & Management, Oklahoma State University, Stillwater, OK, USA
| | - Tessa Chesher
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
| | - Michael Baxter
- Department of Pediatrics, University of Oklahoma School of Community Medicine, Tulsa, OK, USA
| | - Micah Hartwell
- Department of Psychiatry and Behavioral Sciences, Oklahoma State University Center for Health Sciences, Tulsa, OK, USA
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Huggard L, Murphy R, O'Connor C, Nearchou F. The Social Determinants of Mental Illness: A Rapid Review of Systematic Reviews. Issues Ment Health Nurs 2023; 44:302-312. [PMID: 36972547 DOI: 10.1080/01612840.2023.2186124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Previous research agendas have prioritised the role of biological determinants in mental illness aetiology. This is of particular concern, as endorsing biological determinants has been shown to promote negative attitudes towards people with mental illness. The aim of this review was to provide an overview of high-quality evidence of the social determinants of mental illness. A rapid review of systematic reviews was conducted. Five databases were searched: Embase, Medline, Academic Search Complete, CINAHL Plus, and PsycINFO. Systematic reviews or meta-analyses that described any social determinant of mental illness, were published in peer-review journals in English, and focussed on human participants were included. The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were applied for the selection procedure. Thirty-seven systematic reviews were deemed eligible for review and narrative synthesis. Determinants identified included conflict, violence and maltreatment, life events and experiences, racism and discrimination, culture and migration, social interaction and support, structural policies and inequality, financial factors, employment factors, housing and living conditions, and demographic factors. We recommend that mental health nurses ensure adequate support be provided to those affected by the evidenced social determinants of mental illness.
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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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Kallai D, März V, de Timary P, De Mol J. Mental Health Nurses' Social Representations of People Who Experience Mental Illness: A Story of Paradoxes. Glob Qual Nurs Res 2023; 10:23333936231203818. [PMID: 37899770 PMCID: PMC10605669 DOI: 10.1177/23333936231203818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 10/31/2023] Open
Abstract
Public representations of people who experience mental illness (PEMI) have been well documented within the stigma literature. However, studies about mental health nurses' representations of PEMI are still scarce and characterized by contradictions. Using the theoretical concept of social representation instead of stigma, the current study aims to explore and understand mental health nurses' social representations of PEMI. Qualitative research was conducted based on 13 semi-structured interviews with nurses from two psychiatric units in general hospitals. Data were analyzed using interpretative phenomenological analysis. Results showed that nurses' social representations were characterized by paradoxes. They explicitly displayed positive social representations, while nuancing them from an implicit point of view. The nurses wanted to work toward a destigmatizing voice for PEMI while nuancing their assertions to sound honest and accurate, which led them to a state of cognitive dissonance.
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Affiliation(s)
| | - Virginie März
- UCLouvain, Louvain-la-Neuve, Walloon Brabant, Belgium
| | - Philippe de Timary
- UCLouvain, Louvain-la-Neuve, Walloon Brabant, Belgium
- UCLouvain, Woluwé-Saint-Lambert, Belgium
| | - Jan De Mol
- UCLouvain, Louvain-la-Neuve, Walloon Brabant, Belgium
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Schomerus G, Schindler S, Sander C, Baumann E, Angermeyer MC. Changes in mental illness stigma over 30 years - Improvement, persistence, or deterioration? Eur Psychiatry 2022; 65:e78. [PMID: 36328960 PMCID: PMC9724218 DOI: 10.1192/j.eurpsy.2022.2337] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 10/05/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Large efforts have been made to erase the stigma of mental illness, but it is unclear whether they have succeeded on a population level. We examine how attitudes toward people with depression or schizophrenia have evolved in Germany since 1990, and whether there are different developments for both disorders. METHODS Using data from the three decades, four wave repeated cross-sectional representative population study in the "old" (western) states in Germany with surveys in 1990 (n = 2,044), 2001 (n = 4,005), 2011 (n = 1,984), and 2020 (n = 2,449), we calculate time-trends for social distance and emotional reactions toward someone with major depression or acute schizophrenia. RESULTS Social distance worsened in six out of seven situations for schizophrenia, whereas improving in two out of seven situations for depression. Emotions related to fear and uneasiness increased for schizophrenia, whereas tending to decrease for depression. Pro-social reactions like the desire to help increased for depression, but decreased for schizophrenia. Initially observed differences, favoring depression over schizophrenia, widened over the 30-year study period. For schizophrenia, the biggest negative changes occurred between 1990 and 2001, whereas some improvements with regard to depression occurred more recently. CONCLUSION Contrary to expectations, stigma has become more severe regarding acute schizophrenia in Germany over the last 30 years, whereas only slightly improving for depression. The apparent normalization of mental health problems seems not to directly translate into improving attitudes toward people with severe mental illness. Re-focusing of anti-stigma efforts on people with severe mental illness seems necessary.
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Affiliation(s)
- Georg Schomerus
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Stephanie Schindler
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Christian Sander
- Department of Psychiatry, University of Leipzig Medical Center, Leipzig, Germany
| | - Eva Baumann
- Department of Journalism and Communication Research, Hannover University of Music, Drama, and Media, Hannover, Germany
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Hazell CM, Berry C, Bogen-Johnston L, Banerjee M. Creating a hierarchy of mental health stigma: testing the effect of psychiatric diagnosis on stigma. BJPsych Open 2022; 8:e174. [PMID: 36156196 PMCID: PMC9534883 DOI: 10.1192/bjo.2022.578] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Levels of mental health stigma experienced can vary as a function of the presenting mental health problem (e.g. diagnosis and symptoms). However, these studies are limited because they exclusively use pairwise comparisons. A more comprehensive examination of diagnosis-specific stigma is needed. AIMS The aim of our study was to determine how levels of mental health stigma vary in relation to a number of psychiatric diagnoses, and identify what attributions predict levels of diagnosis-specific stigma. METHOD We conducted an online survey with members of the public. Participants were assessed in terms of how much stigma they had, and their attributions toward, nine different case vignettes, each describing a different mental health diagnosis. RESULTS We recruited 665 participants. After controlling for social desirability bias and key demographic variables, we found that mental health stigma varied in relation to psychiatric diagnosis. Schizophrenia and antisocial personality disorder were the most stigmatised diagnoses, and depression, generalised anxiety disorder and obsessive-compulsive disorder were the least stigmatised diagnoses. No single attribution predicted stigma across diagnoses, but fear was the most consistent predictor. CONCLUSIONS Assessing mental health stigma as a single concept masks significant between-diagnosis variability. Anti-stigma campaigns are likely to be most successful if they target fearful attributions.
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Affiliation(s)
| | - Clio Berry
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Sussex and University of Brighton, UK; and School of Psychology, University of Sussex, UK
| | - Leanne Bogen-Johnston
- Research & Development Department, Sussex Partnership NHS Foundation Trust, UK; and School of Psychology, University of Sussex, UK
| | - Moitree Banerjee
- Institute of Education, Social and Life Sciences, University of Chichester, UK
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Walsh D, Foster J. Charting an Alternative Course for Mental Health-Related Anti-Stigma Social and Behaviour Change Programmes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10618. [PMID: 36078334 PMCID: PMC9518073 DOI: 10.3390/ijerph191710618] [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: 07/09/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
Mental health-related anti-stigma strategies are premised on the assumption that stigma is sustained by the public's deficiencies in abstract professional knowledge. In this paper, we critically assess this proposition and suggest new directions for research. Our analysis draws on three data sets: news reports (N = 529); focus groups (N = 20); interviews (N = 19). In each social context, we explored representations of mental health and illness in relation to students' shared living arrangements, a key group indicated for mental health-related anti-stigma efforts. We analysed the data using term-frequency inverse-document frequency (TF-IDF) models. Possible meanings indicated by TF-IDF modelling were interpreted using deep qualitative readings of verbatim quotations, as is standard in corpus-based research approaches to health and illness. These results evidence the flawed basis of dominant mental health-related anti-stigma campaigns. In contrast to deficiency models, we found that the public made sense of mental health and illness using dynamic and static epistemologies and often referenced professionalised understandings. Furthermore, rather than holding knowledge in the abstract, we also found public understanding to be functional to the social context. In addition, rather than being agnostic about mental health-related knowledge, we found public understandings are motivated by group-based identity-related concerns. We will argue that we need to develop alternative anti-stigma strategies rooted in the public's multiple contextualised sense-making strategies and highlight the potential of engaging with ecological approaches to stigma.
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Affiliation(s)
- Daniel Walsh
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8AB, UK
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Public attitudes towards protecting the human rights of people with mental illness: a scoping review and data from a population trend study in Germany. Int Rev Psychiatry 2022; 35:167-179. [PMID: 37105152 DOI: 10.1080/09540261.2022.2087494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The human rights of people with mental illness are constantly threatened. We conduct a scoping review showing how public attitudes towards protecting human rights have so far been examined and providing an overview of our present knowledge of these attitudes, and present novel findings from a trend study in Germany over nine years, reporting attitudes elicited in 2020 and examining whether these attitudes have changed since 2011. Few studies address attitudes towards human rights explicitly, but several studies contain single items on either first generation human rights, mainly concerning involuntary admission, or civil liberties like the right to vote, or second generation human rights, mainly with regard to funding for healthcare, but also for example regarding career choice. Recent data from Germany showed little improvement in attitudes towards protecting human rights over the last decade and particularly high support for restricting job opportunities for people with mental illness. Although generally, most restrictions were supported by a minority of respondents only, both our data and our scoping review indicate substantial support for several restrictions in several countries, showing that public attitudes pose a challenge to the human rights of persons with mental illness. We discuss possible lines of future research.
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Bertilsson M, Löve J, Martinsson J, Wängnerud L, Hensing G. Association of stigmatizing attitudes with people’s opinion of depression as a valid reason for sickness absence: A Swedish vignette study. Work 2022; 73:495-504. [DOI: 10.3233/wor-205181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Depression is a common cause of sickness absence (SA) and also highly associated with stigma. Few studies have addressed the role of stigma in relation to SA. OBJECTIVE: To investigate if attitudes to depression were associated with the public’s opinion of depression as a valid reason of SA. METHODS: The study population (n = 2413) originated from a web-based panel of citizens. The survey included a short vignette describing a person with symptoms of depression and the person’s work tasks, followed by a question on recommendation of SA. Negative attitudes were measured by the Depression Stigma Scale. Logistic regressions were used to estimate the odds ratios (OR) for the likelihood of not recommending SA, controlling for individual and work-related co-variates. RESULTS: The crude association between negative attitudes and not recommending SA was OR 2.15 (95% CI, 1.76–2.62). In the fully adjusted model the OR was 1.76 (95% CI, 1.40 –2.21) for not recommending SA. CONCLUSIONS: Participants with negative attitudes to depression were more likely to not consider depression as a valid reason of sickness absence. The study supports theories on layered stigma; attitudes from one arena are related to other arenas. Future studies are needed to confirm our findings.
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Affiliation(s)
- Monica Bertilsson
- Department of Public Health and Community Medicine, the Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Jesper Löve
- Department of Public Health and Community Medicine, the Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Johan Martinsson
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Lena Wängnerud
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- Department of Public Health and Community Medicine, the Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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18
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Nikolaou E, Petkari E. Stigma towards schizophrenia in Cyprus: Does studying a mental health related programme make a difference? Int J Soc Psychiatry 2022; 68:891-897. [PMID: 33845608 DOI: 10.1177/00207640211010208] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Students from mental health related programmes may display stigmatising attitudes towards people of schizophrenia, however there are no data available on this population in Cyprus. The purpose of the present study was (a) to examine the levels of contact and stigma towards schizophrenia in Cypriot students of programmes related to mental health and students of other programmes and (b) to examine whether the successful recognition of a person with schizophrenia through a vignette and the estimation of severity levels was related to stigmatising attitudes. METHODS The participants were undergraduate students purposively selected across Cypriot universities (N = 152). A vignette depicting a person with schizophrenia, followed by the OMI to examine stigma and the BAE to examine contact with mental illness were used to collect the data. RESULTS The results showed that studying a mental health related programme and being a man was associated with more positive views related to social integration. No further stigma dimensions were predicted by the included variables. Similarly, level of contact and being able to identify the mental condition and estimate its severity was not related to stigma. CONCLUSION The results emphasise the need to develop educational interventions to tackle stigma across students independently of their study programme and enhance mental health related programmes with opportunities for structured contact with patients with mental illness.
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Affiliation(s)
| | - Eleni Petkari
- European University of Cyprus, Nicosia, Cyprus.,Universidad Internacional de la Rioja, Logroño, Spain
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19
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Hazell CM, Fielding-Smith S, Koc Y, Hayward M. Pilot evaluation of a brief training video aimed at reducing mental health stigma amongst emergency first responders (the ENHANcE II study). J Ment Health 2022:1-9. [PMID: 35532043 DOI: 10.1080/09638237.2022.2069707] [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: 06/22/2021] [Revised: 11/12/2021] [Accepted: 01/18/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND First responders (i.e. police and ambulance staff) have increasingly become part of the mental health care system, often being the first port of call for those experiencing a crisis. Despite their frequent involvement in supporting those with mental health problems, there is evidence that mental health stigma is high amongst first responders. AIMS The aim of the present study was to evaluate a brief training video aimed at reducing mental health stigma amongst first responders. METHODS First responders watched a training video based on the cognitive behavioural model of mental health stigma, and involved contributions from people with lived experience, and first responders. Measures of mental health stigma were collected before and after viewing the training. RESULTS The training video produced small but significant improvements in mental health stigma, and these effects did not differ between police and ambulance staff. We were unable to determine what psychological constructs mediated this change in stigma. The feedback on the training video was generally positive, but also indicated some key areas for future development. CONCLUSIONS The present study provides encouraging evidence that levels of mental health stigma can be improved using a resource-light training intervention.
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Affiliation(s)
- Cassie M Hazell
- School of Social Sciences, University of Westminster, London, UK
| | - Sarah Fielding-Smith
- Department of Experimental Psychology, University of Oxford, Radcliffe Observatory, Oxford, UK
| | - Yasin Koc
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
| | - Mark Hayward
- R&D Department, Sussex Partnership NHS Foundation Trust, Sussex Education Centre, Hove, UK
- School of Psychology, University of Sussex, Brighton, UK
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20
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Renaming Schizophrenia and Stigma Reduction: A Cross-Sectional Study of Nursing Students in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063563. [PMID: 35329254 PMCID: PMC8954196 DOI: 10.3390/ijerph19063563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/04/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022]
Abstract
Schizophrenia is one of the most stigmatized mental disorders. In 2014, schizophrenia was renamed in Mandarin in Taiwan, from the old name of “mind-splitting disease” to new name “disorder with dysfunction of thought and perception”, in an attempt to reduce the stigmatization of schizophrenia. This cross-sectional study aimed to investigate the effects of renaming schizophrenia on its stigma in nursing students. We examined the public stigma, self-stigma, and social distance associated with schizophrenia and compared them before and after the renaming. Basic demographic data and previous contact experience were collected, and participants completed a modified Attribution Questionnaire, the Perceived Psychiatric Stigma Scale, and modified Social Distance Scale. The final sample comprised 99 participants. Assessment revealed that the renaming significantly reduced public stigma, self-stigma, and social distance. Regarding the old and new names for schizophrenia, the fourth-year nursing students scored significantly higher on public stigma and self-stigma than did the first-year students. Personal exposure to individuals diagnosed with mental disorders reduced public stigma toward schizophrenia. The study findings suggest that the renaming of schizophrenia reduced its associated stigma. Providing accurate information, instruction by qualified tutors, as well as exposure to patients in acute exacerbation in hospital settings and recovered patients in the community are important. Further studies with longitudinal design, participants from diverse backgrounds, and larger sample sizes to investigate the effect of renaming on the stigma toward schizophrenia are warranted.
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Herrman H, Patel V, Kieling C, Berk M, Buchweitz C, Cuijpers P, Furukawa TA, Kessler RC, Kohrt BA, Maj M, McGorry P, Reynolds CF, Weissman MM, Chibanda D, Dowrick C, Howard LM, Hoven CW, Knapp M, Mayberg HS, Penninx BWJH, Xiao S, Trivedi M, Uher R, Vijayakumar L, Wolpert M. Time for united action on depression: a Lancet-World Psychiatric Association Commission. Lancet 2022; 399:957-1022. [PMID: 35180424 DOI: 10.1016/s0140-6736(21)02141-3] [Citation(s) in RCA: 318] [Impact Index Per Article: 159.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Sangath, Goa, India; Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Christian Kieling
- Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil; Child & Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Michael Berk
- Deakin University, IMPACT Institute, Geelong, VIC, Australia
| | - Claudia Buchweitz
- Graduate Program in Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania L Vanvitelli, Naples, Italy
| | - Patrick McGorry
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia; Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Charles F Reynolds
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Myrna M Weissman
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Dixon Chibanda
- Department of Psychiatry, University of Zimbabwe, Harare, Zimbabwe; Centre for Global Mental Health, The London School of Hygiene and Tropical Medicine, London, UK
| | - Christopher Dowrick
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Louise M Howard
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Christina W Hoven
- Columbia University Mailman School of Public Health, New York, NY, USA; Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA; New York State Psychiatric Institute, New York, NY, USA
| | - Martin Knapp
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | - Helen S Mayberg
- Departments of Neurology, Neurosurgery, Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Shuiyuan Xiao
- Central South University Xiangya School of Public Health, Changsha, China
| | - Madhukar Trivedi
- Peter O'Donnell Jr Brain Institute and the Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Lakshmi Vijayakumar
- Sneha, Suicide Prevention Centre and Voluntary Health Services, Chennai, India
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22
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Walsh D, Foster J. Where does research design fall short? Mental health related‐stigma as example. JOURNAL FOR THE THEORY OF SOCIAL BEHAVIOUR 2022. [DOI: 10.1111/jtsb.12337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Walsh
- Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Juliet Foster
- Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
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23
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Makowski AC, von dem Knesebeck O. Public depression stigma does not vary by symptom severity. J Ment Health 2022; 32:434-442. [PMID: 35014921 DOI: 10.1080/09638237.2021.2022626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Previous studies on public depression stigma did not include different severity levels and thus, did not adequately consider the continuum notion of depressive disorders. AIMS We address the following research questions: 1. Are there differences in public depression stigma according to different severity levels? 2. Is stigma associated with sociodemographic characteristics, experience with depressive symptoms, and symptom severity? METHODS Computer-assisted telephone interviews were conducted in winter 2019/2020 in Germany (N = 1009). Three vignettes representing mild, moderate, and severe depressive symptoms were used. Three indicators of stigma were assessed: negative stereotypes, anger reactions, and desire for social distance. Age, sex, education, and experience with depression (own affliction, contact) were additionally introduced into multiple linear regression analyses. RESULTS Overall, negative stereotypes, anger reactions, and desire for social distance do not significantly vary by depression symptom severity. All components of depression stigma showed positive associations with age, while anger was negatively associated with experiences. CONCLUSIONS Our results do not indicate that public depression stigma is more pronounced when symptoms are more severe. Conclusion is ambivalent: Persons with severe depression do not seem to be additionally burdened by increased stigma, but the German public holds stigmatizing attitudes even towards individuals with mild depressive symptoms.
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Affiliation(s)
- Anna C Makowski
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Peitz D, Kersjes C, Thom J, Hoelling H, Mauz E. Indicators for Public Mental Health: A Scoping Review. Front Public Health 2021; 9:714497. [PMID: 34646802 PMCID: PMC8502920 DOI: 10.3389/fpubh.2021.714497] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/17/2021] [Indexed: 12/11/2022] Open
Abstract
Background: To monitor population mental health, the identification of relevant indicators is pivotal. This scoping review provides a comprehensive overview of current indicators representing the various fields of public mental health core topics. It was conducted as a first step to build up a Mental Health Surveillance for Germany. Methods: We conducted a systematic MEDLINE search via PubMed. This search was supplemented by an extensive examination of the websites of relevant national as well as international institutions in the context of public mental health and an additional internet search via Google. To structure the data, an expert-based focus group identified superordinate topics most relevant to public mental health to which the identified indicators could be assigned to. Finally, the indicator set was screened for duplicates and appropriate content to arrive at a final set. Results: Within the various search strategies, we identified 13.811 records. Of these records, a total of 365 records were processed for indicator extraction. The extracted indicators were then assigned to 14 topics most relevant to public mental health as identified by the expert-based focus group. After the exclusion of duplicates and those indicators not meeting criteria of specificity and target group, the final set consisted of 192 indicators. Conclusion: The presented indicator set provides guidance in the field of current concepts in public mental health monitoring. As a comprehensive compilation, it may serve as basis for future surveillance efforts, which can be adjusted and condensed depending on the particular monitoring focus. Our work provides insights into established indicators included in former surveillance work as well as recent, not yet included indicators reflecting current developments in the field. Since our compilation mainly concludes indicators related to mental health in adults, it should be complemented with indicators specific to children and adolescents. Furthermore, our review revealed that indicators on mental health promotion and prevention are underrepresented in current literature of public mental health and should hence be focused on within future research and surveillance.
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Affiliation(s)
- Diana Peitz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Christina Kersjes
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Julia Thom
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Heike Hoelling
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Elvira Mauz
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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Chiu YH, Kao MY, Goh KK, Lu CY, Lu ML. Effects of Renaming Schizophrenia on Destigmatization among Medical Students in One Taiwan University. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179347. [PMID: 34501941 PMCID: PMC8431284 DOI: 10.3390/ijerph18179347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/09/2021] [Accepted: 09/02/2021] [Indexed: 11/24/2022]
Abstract
The stigma associated with serious mental illnesses causes a huge burden on patients, their families, and society. In October 2012, in Taiwan, schizophrenia was renamed to reduce the stigma associated with this disease. The aim of this study was to compare the differences of public stigma, self-stigma, and social distance associated with schizophrenia between old and new name of schizophrenia in medical students. A cross-sectional survey was administered to 180 medical students of Taipei Medical University from October 2014 to February 2015. In total, 123 complete questionnaires were included in this study. Participants completed the modified attribution questionnaire, the perceived psychiatric stigma scale, and modified social distance scale to assess public stigma, self-stigma, and social distance, respectively. We also collected basic demographic data and previous experience of contact with people with mental illness. In total, 52 and 71 of the first- and fourth-year medical students, respectively, participated in the study. Among them, there were 51 females and 72 males. A significant difference in age was observed between the first- and fourth-year groups (20.2 ± 1.7 years vs. 22.7 ± 0.9 years, p < 0.001). After renaming schizophrenia, we noted significant differences in the scores in the modified attribution questionnaire, the perceived psychiatric stigma scale, and the modified social distance scale in all participants and the fourth-year students, respectively. Female gender (Beta = 0.230, p = 0.018) was significantly associated with the difference in the score of the modified attribution questionnaire after name change. The difference in the score of the perceived psychiatric stigma scale after the name change (Beta = 0.277, p = 0.004) and age (Beta = −0.186, p = 0.049) were significantly associated with the difference in the score of the modified social distance scale after name change. In conclusion, renaming was associated with the changes in the scores of the modified attribution questionnaire, the perceived psychiatric stigma scale, and the modified social distance scale toward individuals with schizophrenia in medical students of one Taiwan university. Further studies with large sample sizes, diverse participant backgrounds, and that monitor the subsequent behavioral changes are warranted.
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Affiliation(s)
- Yi-Hang Chiu
- Department of Psychiatry and Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; (Y.-H.C.); (K.K.G.)
| | - Meei-Ying Kao
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei 110, Taiwan;
| | - Kah Kheng Goh
- Department of Psychiatry and Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; (Y.-H.C.); (K.K.G.)
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
| | - Cheng-Yu Lu
- Psychology of Mental Health Programme, School of Health in Social Science, College of Arts, Humanities and Social Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK;
| | - Mong-Liang Lu
- Department of Psychiatry and Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan; (Y.-H.C.); (K.K.G.)
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Correspondence:
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Trusty WT, Swift JK, Rasmussen EB. A Behavioral Economic Model of Help-Seeking for Depression. Perspect Behav Sci 2021; 44:541-560. [DOI: 10.1007/s40614-021-00308-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 11/28/2022] Open
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Beutel ME, Krakau L, Schmutzer G, Brähler E. Somatic symptoms in the Eastern and Western states of Germany 30 years after unification: Population-based survey analyses. J Psychosom Res 2021; 147:110535. [PMID: 34062335 DOI: 10.1016/j.jpsychores.2021.110535] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 05/17/2021] [Accepted: 05/24/2021] [Indexed: 11/26/2022]
Abstract
Background Following German reunification, physical health indicators in the formerly separated states (German Democratic Republic- East/ Federal Republic of Germany-West) have converged. However, it remains unclear how these societal changes have impacted somatic complaints, a major indicator of physical and mental health. Therefore, we investigated how somatic symptom reporting in men and women evolved regarding residency. Methods We administered cross-sectional surveys representative of the German population with comparable sample size in 1994 (N = 3047), 2001 (N = 2050), 2013 (N = 2508) and 2019 (N = 2531) following random route procedure. Men and women aged 14-99 reported demographics and filled the Gießen Complaint List, a standardized questionnaire, to assess major physical symptoms. Results Residency in the Eastern states was a determinant of higher symptom load in 2001 (β = 0.11, SE = 0.02, [95% CI = 0.07 to 0.15], p < .001) where symptom reporting has been consistently higher compared to the West from 1994 through 2013. However, in 2019, the pattern reversed and residency in the East was associated with lower symptom load (β = -0.15, SE =0.02, [95% CI = -0.19 to -0.11], p < .001). Predictors of high symptom load among all surveys were higher age, female sex, and low household income. Conclusions Symptom reporting did not converge, but reversed in 2019, with a higher symptom load in the Western states. This finding is particularly intriguing since other determinants, e.g., socioeconomic factors have converged, but have remained unfavorable in the East.
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Affiliation(s)
- Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany
| | - Lina Krakau
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany.
| | - Gabriele Schmutzer
- Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Untere Zahlbacher Str. 8, 55131 Mainz, Germany; Integrated Research and Treatment Center Adiposity Diseases, Behavioral Medicine Research Unit, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Germany
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Sander C, Rieckhof S, Peter LJ, Horsfield P, Speerforck S, Angermeyer MC, Schomerus G. [Psychometric Evaluation of a Long and Short German Version of the Prejudice Towards People with Mental Illness Scale (PPMI-D)]. PSYCHIATRISCHE PRAXIS 2021; 49:144-151. [PMID: 34015852 DOI: 10.1055/a-1481-1026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE We present a German version of the Prejudice towards People with Mental Illness Scale in long (PPMI-DL) and short form (PPMI-DK) and provide a psychometric evaluation in a German population sample. METHODS After German translation (including back-translation), an online survey (N = 1004) was conducted. RESULTS Item difficulty and selectivity are in the desirable medium range. Internal consistencies are high to excellent (PPMI-DL: α = 0.919; PPMI-DK: α = 0.872) in the overall scale. Confirmatory factor analyses confirm the 4 subscales of the original scale. Medium correlations are found with authoritarian attitudes (KSA-3) and low negative correlations with social desirability (KSE-G). Norm values for the PPMI subscales are reported. CONCLUSION The PPMI-D can be used in German-speaking countries to survey prejudice towards people with mental illness.
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Affiliation(s)
- Christian Sander
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
| | - Sophia Rieckhof
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
| | - Lina-Jolien Peter
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
| | - Philipp Horsfield
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
| | - Sven Speerforck
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
| | | | - Georg Schomerus
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Leipzig, Deutschland
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O'Connor C, Brassil M, O'Sullivan S, Seery C, Nearchou F. How does diagnostic labelling affect social responses to people with mental illness? A systematic review of experimental studies using vignette-based designs. J Ment Health 2021; 31:115-130. [PMID: 34008456 DOI: 10.1080/09638237.2021.1922653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND An outstanding question in the stigma literature is the extent to which negative responses are provoked by diagnostic labels, rather than observable symptoms of mental illness. Experimental studies frequently use vignettes to identify the unique effects of diagnostic labels on social responses to people with mental illness, independent of their behaviour or socio-demographic characteristics. AIMS The current article identifies, evaluates, and synthesises the body of experimental vignette studies of labelling effects. METHODS A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were subjected to quality evaluation and narrative synthesis. RESULTS Of 1511 articles screened, 22 met inclusion criteria. Most studies focused on the diagnostic categories of attention deficit hyperactivity disorder, schizophrenia spectrum disorders, and autism spectrum disorder. The literature reported diverse effects, with diagnostic disclosure either exacerbating, mitigating, or not affecting stigma. The quality of studies was generally acceptable but the review identified an over-reliance on convenience sampling and unvalidated measures. CONCLUSIONS Results highlight the complexity of labelling effects, which diverge across diagnostic categories and social contexts. The review emphasises the need for expansion of diagnostic labels and contexts studied, standardisation of validated attitude scales, incorporation of behavioural outcomes, and diversification of samples.
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Affiliation(s)
| | - Maryanne Brassil
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Sadhbh O'Sullivan
- School of Medicine, Royal College of Surgeons of Ireland, Dublin, Ireland
| | - Christina Seery
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Finiki Nearchou
- School of Psychology, University College Dublin, Dublin, Ireland
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O'Connor C. Has the COVID-19 Pandemic Affected Lay Beliefs about the Cause and Course of Mental Illness? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4912. [PMID: 34063004 PMCID: PMC8124589 DOI: 10.3390/ijerph18094912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/22/2021] [Accepted: 05/02/2021] [Indexed: 11/23/2022]
Abstract
COVID-19 and its countermeasures have negatively impacted the mental health of populations worldwide. The current paper considers whether the rising incidence of psychiatric symptoms during the pandemic may affect lay beliefs about the cause and course of mental illness. Laypeople's causal attributions and expectations regarding the trajectory of mental illness have important implications for societal stigma and therapeutic orientations. Two online experimental studies investigated whether reading about fictional cases of mental illness that were explicitly situated during the COVID-19 pandemic, compared with reading about the same cases without any pandemic-related contextualisation, affected attributions and expectations about Generalised Anxiety Disorder (Study 1) and Major Depressive Disorder (Study 2). Study 1 (n = 137) results showed that highlighting the onset of anxiety symptoms during the COVID-19 pandemic weakened attributions to biological causes and reduced the anticipated duration of symptoms. However, Study 2 (n = 129) revealed no effects of COVID-19 contextualisation on beliefs about the cause or course of depression. The research provides preliminary evidence that the increased incidence of mental illness during the pandemic may reshape public beliefs about certain mental illnesses. Given the importance of public understandings for the lived experience of mentally unwell persons in society, further evidence of the range and extent of the pandemic's effects on lay beliefs is important to inform clinical, public health and stigma-reduction initiatives.
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Speerforck S, Hertel J, Stolzenburg S, Grabe HJ, Carta MG, Angermeyer MC, Schomerus G. Attention Deficit Hyperactivity Disorder in Children and Adults: A Population Survey on Public Beliefs. J Atten Disord 2021; 25:783-793. [PMID: 31271090 PMCID: PMC7897776 DOI: 10.1177/1087054719855691] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Objective: To investigate beliefs and attitudes of the public toward attention deficit hyperactivity disorder (ADHD) in children and adults. Method: In a representative population survey in Germany (N = 1,008) using computer-assisted telephone interviews, we asked participants about causal beliefs, illness recognition, treatment recommendations, and beliefs about ADHD, presenting an unlabelled vignette of a child or an adult with ADHD. Results: The most frequently endorsed causal beliefs for the depicted child with ADHD were "TV or Internet," "lack of parental affection," and "broken home." In comparison with the child vignette, biological causal beliefs were endorsed more often after the adult vignette. In the child vignette, 66% advised against a treatment with stimulant medication. About 90% of respondents had heard of ADHD. Of those, 20% said they believed ADHD to be not a real disease. Conclusion: Beliefs of the German public partly contradict evidence and should be considered in therapeutical and public contexts.
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Affiliation(s)
- Sven Speerforck
- University Medicine Greifswald, Germany,Sven Speerforck, Department of Psychiatry, University of Greifswald, Ellernholzstraße 1-2, 17475 Greifswald, Germany.
| | | | | | | | - Mauro G. Carta
- Center for Public Mental Health, Gösing am Wagram, Austria
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O'Connor C, Vaughan S. Does selectively endorsing different approaches to treating mental illness affect lay beliefs about the cause and course of mental illness? Psychiatry Res 2021; 297:113726. [PMID: 33486271 DOI: 10.1016/j.psychres.2021.113726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/11/2021] [Indexed: 02/01/2023]
Abstract
The current paper reports three experimental studies that investigate how selectively emphasising different treatment approaches (biological, psychological or social) for mental health difficulties affects lay beliefs about those illnesses. Online experimental vignettes exposed participants to different treatment narratives for a clinical case of Major Depressive Disorder (Study 1; n=164), Generalized Anxiety Disorder (Study 2; n=173) and Schizophrenia (Study 3, n=170). Measures of causal attributions and illness perceptions assessed effects on beliefs about the causes and course of the illness. Emphasising psychological treatment of Major Depressive Disorder promoted more causal attributions to personal weakness, while endorsing biological treatment weakened confidence in individual control over the course of the illness. For Generalized Anxiety Disorder, stressing social treatment encouraged more causal attributions to personal weakness and lifestyle factors. Causal attributions for Schizophrenia did not shift according to treatment modality, but highlighting biological treatment made the symptoms appear more treatable, while emphasising psychological treatment made the illness seem more personally controllable. As lay understandings of the causes and course of mental illness have implications for help-seeking, treatment engagement and stigma, effects on illness beliefs may be an important consideration when endorsing a particular treatment approach in public discourse or clinical communication.
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Affiliation(s)
| | - Sarah Vaughan
- School of Psychology, University College Dublin, Dublin, Ireland
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Walsh DAB, Foster JLH. A Call to Action. A Critical Review of Mental Health Related Anti-stigma Campaigns. Front Public Health 2021; 8:569539. [PMID: 33490010 PMCID: PMC7820374 DOI: 10.3389/fpubh.2020.569539] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/04/2020] [Indexed: 12/17/2022] Open
Abstract
Using a knowledge-attitudes-behavior practice (KABP) paradigm, professionals have focused on educating the public in biomedical explanations of mental illness. Especially in high-income countries, it is now common for education-based campaigns to also include some form of social contact and to be tailored to key groups. However, and despite over 20 years of high-profile national campaigns (e.g., Time to Change in England; Beyond Blue in Australia), examinations suggest that the public continue to Other those with experiences of mental ill-health. Furthermore, evaluations of anti-stigma programs are found to have weak- to no significant long-term effects, and serious concerns have been raised over their possible unintended consequences. Accordingly, this article critically re-engages with the literature. We evidence that there have been systematic issues in problem conceptualization. Namely, the KABP paradigm does not respond to the multiple forms of knowledge embodied in every life, often outside conscious awareness. Furthermore, we highlight how a singular focus on addressing the public's perceived deficits in professionalized forms of knowledge has sustained public practices which divide between "us" and "them." In addition, we show that practitioners have not fully appreciated the social processes which Other individuals with experiences of mental illness, nor how these processes motivate the public to maintain distance from those perceived to embody this devalued form of social identity. Lastly, we suggest methodological tools which would allow public health professionals to fully explore these identity-related social processes. Whilst some readers may be frustrated by the lack of clear solutions provided in this paper, given the serious unintended consequences of anti-stigma campaigns, we caution against making simplified statements on how to correct public health campaigns. Instead, this review should be seen as a call to action. We hope that by fully exploring these processes, we can develop new interventions rooted in the ways the public make sense of mental health and illness.
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Mangerini I, Bertilsson M, de Rijk A, Hensing G. Gender differences in managers' attitudes towards employees with depression: a cross-sectional study in Sweden. BMC Public Health 2020; 20:1744. [PMID: 33213425 PMCID: PMC7678207 DOI: 10.1186/s12889-020-09848-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 11/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Depression is prevalent among employees and a major reason for sickness absence. First-line managers' attitudes towards employees with depression might influence return to work and the scant literature indicates gender differences in attitudes. The objective of this study was to investigate gender differences in managers' attitudes to employees with depression. METHODS A cross-sectional study was conducted among 4737 Swedish managers in 2017 (response rate 71%, n = 3358). Attitudes towards depression were measured with the instrument "Managerial stigma towards employees with depression" (12 items). The response patterns of women and men, the level of stigma and the direction of the gender differences were investigated with independent t tests and binary logistic regression analyses with covariates. RESULTS The likelihood of reporting high negative attitudes (score ≥ 36) was lower among women than men (odds ratio, 1.64; 95% confidence interval, 1.28-2.10) after adjusting for age, level of education, work sector, distribution of women and men among the staff, current workplace experience in management, lifetime experience in management, managerial position and presence of staff members at the current workplace who had depression and/or anxiety disorders. CONCLUSIONS Based on these findings, a gender-sensitive approach is suggested for future interventions to improve managers' attitudes towards employees with depression and other mental disorders.
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Affiliation(s)
- Ilaria Mangerini
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Monica Bertilsson
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Angelique de Rijk
- Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Dey M, Paz Castro R, Jorm AF, Marti L, Schaub MP, Mackinnon A. Stigmatizing attitudes of Swiss youth towards peers with mental disorders. PLoS One 2020; 15:e0235034. [PMID: 32706786 PMCID: PMC7380889 DOI: 10.1371/journal.pone.0235034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 06/08/2020] [Indexed: 11/19/2022] Open
Abstract
Background Previous research on public stigma towards people with mental disorders has mostly targeted adult samples and focused on depression, schizophrenia or mental disorders in general. Hence, the present study aimed to investigate predictors of stigmatizing attitudes towards different mental disorders (including less researched ones) in a representative sample of adolescents and young adults. Methods Data from the Swiss Youth Mental Health Literacy and Stigma Survey were used (analytical sample: n = 4,932). Each participant was randomly presented with one of five vignettes (depression; alcohol abuse; depression and alcohol abuse combined; schizophrenia; social anxiety). The structure of stigmatizing attitudes was assessed using confirmatory factor analysis. Regression models, implemented within a structural equation framework, were used to study predictors for the identified latent variables. Results A three-factor model for stigmatizing attitudes–consisting of ‘dangerous/unpredictable’, ‘weak-no-sick’, and ‘social distance’ factors–best fitted the data. Female gender was associated with less stigmatizing attitudes. Associations in opposite directions with different latent factors were found for educational and migration background. Exposure to mental disorders (being personally affected, personally having received professional help or knowing someone close who has received treatment for a mental disorder) was either not or was negatively associated with stigmatizing attitudes. In contrast, current mental health symptoms (heightened levels of psychological distress, problematic alcohol use) were generally not or were positively associated with stigmatizing attitudes. Even though the included predictors had some predictive value, the variance explained by the models was rather small (the adjusted R2 varied between 0.03 and 0.26). Conclusions The current study indicates that contact with someone who has received treatment for a mental disorder might be an important component of programs aiming to decrease stigmatizing attitudes towards people with mental disorders, since this exposure variable predicted lower levels of stigmatizing attitudes. Furthermore, the findings suggest that target-group interventions for specific subgroups need to be considered, as the process leading to stigmatizing attitudes towards people with mental disorders appears to differ between specific sociodemographic subgroups.
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Affiliation(s)
- Michelle Dey
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
- * E-mail:
| | - Raquel Paz Castro
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Anthony Francis Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Laurent Marti
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, Scotland, United Kingdom
| | - Michael Patrick Schaub
- Swiss Research Institute for Public Health and Addiction, University of Zurich, Zurich, Switzerland
| | - Andrew Mackinnon
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Black Dog Institute, University of New South Wales, Sydney, Australia
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Ludwig J, Liebherz S, Dreier M, Härter M, von dem Knesebeck O. Public Stigma Toward Persons with Suicidal Thoughts-Do Age, Sex, and Medical Condition of Affected Persons Matter? Suicide Life Threat Behav 2020; 50:631-642. [PMID: 32115757 DOI: 10.1111/sltb.12629] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Suicidal persons often face public stigmatization which affects help-seeking behavior and may lead to an additional suicide risk. There is not much known about differences in stigmatizing attitudes concerning characteristics of affected persons. The present study investigates public stigma toward suicidal persons in Germany by focussing on differences concerning sex, age, and medical condition of the affected person. METHOD A national telephone survey (N = 2,002) was conducted using case vignettes presenting a person with suicidal thoughts. Vignettes systematically varied in sex, age, and medical condition (depressive symptoms vs. cancer). Several components of stigma were assessed ("weakness of will" as a cause, separation, negative emotional reactions, and desire for social distance). RESULTS About 44% of the respondents agreed that a cause of suicidal thoughts is "weakness of will," and two thirds disagreed that they would feel and think the same as the described person. In terms of emotional reactions, fear was more pronounced than anger. Stigmatizing attitudes were particularly pronounced when the described person was female and depressive symptoms were presented. CONCLUSIONS Magnitude of public suicide stigma varies depending on the characteristics of the described person. Groups that are at special risk of being stigmatized should be considered in antistigma programs.
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Affiliation(s)
- Julia Ludwig
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Liebherz
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mareike Dreier
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Härter
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Almhdawi KA, Alazrai A, Kanaan S, Shyyab AA, Oteir AO, Mansour ZM, Jaber H. Post-stroke depression, anxiety, and stress symptoms and their associated factors: A cross-sectional study. Neuropsychol Rehabil 2020; 31:1091-1104. [PMID: 32419606 DOI: 10.1080/09602011.2020.1760893] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Individuals post-stroke are subject to increased levels of mental health symptoms. This is a cross-sectional study explored levels of depression, anxiety, and stress symptoms and identified their predictors among Jordanian individuals with stroke. Outcome measures included Depression Anxiety Stress Scale, Fugl-Meyer assessment, goniometry, hand-held dynamometry, nine-hole peg test, Ashworth scale, Motor Activity Log, ten-meter walk test, and 12-item Short-Form health survey (SF-12). Descriptive analyses were used to describe prevalence of mental health symptoms and multiple variable linear regression models were used to identify their predictors. A total of 153 individuals participated in the study. Proportions of participants with mental health symptoms were 74.5% for depression, 52.9% for anxiety, and 68% for stress. Significant predictors of post-stroke mental health symptoms were SF-12 Mental Composite Score and grip strength for depression, anxiety, and stress. Depression and stress symptoms were significantly associated with discontinuation of rehabilitation services. Furthermore, self-reports of fewer sleep hours was significantly associated with anxiety and stress. Finally, Gender and self-reported physical diseases other than stroke were significantly associated with depression symptoms. We conclude that high proportions of Jordanian individuals' post-stroke have suffered mental health symptoms. Future studies are required to design effective interventions to improve post-stroke mental health.
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Affiliation(s)
- Khader A Almhdawi
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alza Alazrai
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Saddam Kanaan
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Awni A Shyyab
- Division of Neurology, King Hussein Centre, Amman, Jordan
| | - Alaa O Oteir
- Department of Allied Health Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Zaid Modhi Mansour
- Department of Physical and Occupational Therapy, Hashemite University, Zarqa, Jordan
| | - Hanan Jaber
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Beutel ME, Klein EM, Henning M, Werner AM, Burghardt J, Tibubos AN, Schmutzer G, Brähler E. Somatic Symptoms in the German General Population from 1975 to 2013. Sci Rep 2020; 10:1595. [PMID: 32005895 PMCID: PMC6994459 DOI: 10.1038/s41598-020-58602-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 01/14/2020] [Indexed: 11/23/2022] Open
Abstract
The study determines how burden and patterns of somatic symptom reporting developed over almost four decades in the general German population. Additionally, we studied how socio-demographic factors affected the degree of somatic symptoms. Population-based samples representative for West Germany between 18 and 60 years of age were analyzed comparing three cross-sectional samples of 1975 (N = 1601), 1994 (N = 1416), and 2013 (N = 1290) by conducting a three-way analysis of variance (sex, age, survey). The prevalence rates for somatic symptoms in men and women were lower in the more recent surveys; this affected women most strongly. Exhaustion and musculoskeletal complaints remained leading symptoms (affecting 25%, resp. 11% of the men and 30%, resp. 19% of the women). There was a slight increase in women’s prevalence of exhaustion from 1994 (15%) to 2013 (19%). As determined by stepwise multiple regression, somatic symptoms were consistently associated with female sex and higher age. In the 2013 survey, education became an additional negative predictor of somatic symptom load, while the impact of age and sex on somatic symptoms reporting decreased. Somatic symptoms remain a major burden in the general population. Findings are interpreted with regard to improved living and health care conditions, different cohort experiences, and more public health information.
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Affiliation(s)
- Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva M Klein
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michaela Henning
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.,Department of Psychosomatics and Psychotherapy, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Antonia M Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.
| | - Juliane Burghardt
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ana Nanette Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gabriele Schmutzer
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, University of Leipzig, Leipzig, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.,Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, University of Leipzig, Leipzig, Germany
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Speerforck S, Stolzenburg S, Hertel J, Grabe HJ, Strauß M, Carta MG, Angermeyer MC, Schomerus G. ADHD, stigma and continuum beliefs: A population survey on public attitudes towards children and adults with attention deficit hyperactivity disorder. Psychiatry Res 2019; 282:112570. [PMID: 31558401 DOI: 10.1016/j.psychres.2019.112570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 12/20/2022]
Abstract
ADHD is a mental illness of high epidemiological and clinical importance, embedded in a complex socio-cultural context. We estimated the prevalence of attitudes related to ADHD in a representative population survey in Germany (n = 1008) after presenting an unlabelled vignette of a child or an adult with ADHD. Relations of personal experience, interpersonal contact and continuum beliefs with emotions and social distance were calculated using path models. About two-thirds of the German public indicated they believe in a continuum of ADHD symptoms, and half stated that they know somebody among family or close friends with a comparable problem. About one-quarter of respondents felt annoyed by the depicted person. While an adult with ADHD was most frequently accepted as a work colleague or neighbor, about one-quarter of the German general population rejected renting a room or giving a job recommendation. Personal Experience (both vignettes) and contact (adult vignette) were related to a higher belief in a continuum of symptoms, while explanation of variance was low. A belief in a continuum of symptoms was related to more pro-social reactions and less social distance. This study indicates that emphasizing aspects of a continuum of symptoms should be considered within the disorder model of ADHD.
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Affiliation(s)
- Sven Speerforck
- Department of Psychiatry, Medical Faculty, University of Leipzig, Germany; Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany.
| | - Susanne Stolzenburg
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany
| | - Johannes Hertel
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany
| | - Hans J Grabe
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany
| | - Maria Strauß
- Department of Psychiatry, Medical Faculty, University of Leipzig, Germany
| | - Mauro G Carta
- Department of Public Health, Clinical and Molecular Psychiatry, University of Cagliari, Cagliari, Italy
| | | | - Georg Schomerus
- Department of Psychiatry, Medical Faculty, University of Leipzig, Germany
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Tattoos in der deutschen Bevölkerung – Prävalenzen, Soziodemografie und Gesundheitsorientierung. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1077-1082. [DOI: 10.1007/s00103-019-02999-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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41
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Gilmore L, Hughes B. Perceptions of schizophrenia in the Australian community: 2005–2017. J Ment Health 2019; 30:440-446. [DOI: 10.1080/09638237.2019.1630720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Linda Gilmore
- Faculty of Education, Queensland University of Technology, Brisbane, Australia
| | - Brenda Hughes
- Faculty of Education, Queensland University of Technology, Brisbane, Australia
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Löve J, Bertilsson M, Martinsson J, Wängnerud L, Hensing G. Political Ideology and Stigmatizing Attitudes Toward Depression: The Swedish Case. Int J Health Policy Manag 2019; 8:365-374. [PMID: 31256568 PMCID: PMC6600024 DOI: 10.15171/ijhpm.2019.15] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 03/02/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Stigmatizing attitudes toward persons with mental disorders is a well-established and global phenomenon often leading to discrimination and social exclusion. Although previous research in the United States showed that conservative ideology has been related to stigmatizing attitudes toward mental disorders, there is reason to believe that this mechanism plays a different role in the context of a universal welfare state with a multi-party system such as Sweden. Furthermore, "mental disorders" may signify severe psychotic disorders, which may evoke more negative attitudes. This suggests the importance of specific studies focusing on the more common phenomenon of depression. This paper investigates the relationship between political ideology and stigmatizing attitudes toward depression in Sweden. METHODS This study is part of the New Ways research program. Data were collected by the Laboratory of Opinion Research (LORE) at the University of Gothenburg in 2014 (N = 3246). Independent variables were political ideology and party affiliation. The dependent variable was the Depression Stigma Scale (DSS). Data were analyzed with linear regression analyses and analyses of variance. RESULTS More conservative ideology (B = 0.68, standard error [SE] = 0.04, P<.001) and more conservative party affiliation (F(8 2920) = 38.45, P<.001) showed more stigmatizing attitudes toward depression. Item-level analyses revealed a difference where the supporters of the conservative party differed (P<.05) from supporters of the liberal party, with a higher proportion agreeing that "people could snap out of " depression if they wanted to; the populist right-wing party differed from the conservative party with a higher proportion agreeing on items displaying people with depression as "dangerous" and "unpredictable." Even self-stigma was highest among the populist right-wing party with 22.3% agreeing that "if I had depression I wouldn't tell…." CONCLUSION Political ideology was associated with stigmatizing attitudes toward depression in Sweden. The results also confirm the need to distinguish between different forms of conservatism by observing social distance as being a more important driver among voters for the populist right-wing party compared with personal agency and responsibility among voters for the more traditional conservative party.
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Affiliation(s)
- Jesper Löve
- Department of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Monica Bertilsson
- Department of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Johan Martinsson
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Lena Wängnerud
- Department of Political Science, University of Gothenburg, Gothenburg, Sweden
| | - Gunnel Hensing
- Department of Public Health and Community Medicine at Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Interventions to Reduce Internalized Stigma in individuals with Mental Illness: A Systematic Review. SPANISH JOURNAL OF PSYCHOLOGY 2019; 22:E27. [PMID: 31084665 DOI: 10.1017/sjp.2019.9] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Internalized stigma has a high prevalence in people with mental health problems and is associated with negative consequences in different areas: work, social, personal, etc. Therefore, it is relevant to systematically study the characteristics and effectiveness of the different psychological and psychosocial interventions aimed at reducing it. Through the databases MEDLINE and PsycINFO, among others, controlled studies on specific interventions to reduce internalized stigma in people with severe mental disorders published between 2008 and 2018 were selected and reviewed. Results showed that the interventions can be grouped into four blocks: (a) psychoeducational interventions about stigma; (b) cognitive-behavioral interventions, mainly aimed at modifying self-stigmatizing beliefs; (c) interventions focused on the revelation of mental illness; and (d) multicomponent interventions that combine several of the above. The interventions had an average of 10 sessions and were predominantly applied in group format. In 9 of the 14 studies reviewed, significant results were obtained in the reduction of internalized stigma with small or moderate effect sizes. There were also significant improvements in other variables, such as subjective recovery or coping. The main methodological limitation of the studies reviewed was the absence of information on the rejection rate. We conclude that there are effective interventions aimed at reducing internalized stigma, with psychoeducational interventions on stigma and multicomponent interventions showing the best results. Cognitive-behavioral interventions and interventions based on disclosure have been studied to a lesser extent and their results are inconclusive. Future research should focus on establishing optimal interventions according to characteristics and objectives of individuals.
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Von Lersner U, Gerb J, Hizli S, Waldhuber D, Wallerand AF, Bajbouj M, Schomerus G, Angermeyer MC, Hahn E. Stigma of Mental Illness in Germans and Turkish Immigrants in Germany: The Effect of Causal Beliefs. Front Psychiatry 2019; 10:46. [PMID: 30814959 PMCID: PMC6381049 DOI: 10.3389/fpsyt.2019.00046] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 01/23/2019] [Indexed: 12/22/2022] Open
Abstract
Background: Stigma poses an additional burden for people suffering from mental illness, one that often impairs their social participation and can prevent them from seeking adequate help. It is therefore crucial to understand how stigma develops in order to counteract it by setting up effective evidence-based anti-stigma interventions. The present study examines the effect of causal beliefs on stigmatizing behavioral intentions, namely people's desire to distance themselves from persons with mental illness. In addition, we draw cross-cultural comparisons between native Germans and Turkish immigrants to investigate the influence of culture on stigma and causal beliefs and to broaden knowledge on the biggest immigrant group in Germany and on immigrants in Western countries in general. Methods: n = 302 native Germans and n = 173 Turkish immigrants were presented either a depression or a schizophrenia vignette. Then, causal beliefs, emotional reaction and desire for social distance were assessed with questionnaires. Path analyses were carried out to investigate the influence of causal beliefs on the desire for social distance and their mediation by emotional reactions for Germans and Turkish immigrants, respectively. Results: We found an influence of causal beliefs on the desire for social distance. Emotional reactions partly mediated this relationship. Causal attribution patterns as well as the relationship between causal attributions and stigma varied across both subsamples and mental illnesses. In the German subsample, the ascription of unfavorable personal traits resulted in more stigma. In the Turkish immigrant subsample, supernatural causal beliefs increased stigma while attribution to current stress reduced stigma. Conclusion: Our study has implications for future anti-stigma interventions that intend to reduce stigmatization of mentally ill people. Targeting the ascription of unfavorable personal traits and supernatural causal attributions as well as promoting current stress as the cause for mental illness appears to be of particular importance. Also, the mediating influence of emotional responses to causal beliefs needs to be addressed. Furthermore, differential interventions across cultural groups and specific mental illnesses may be appropriate.
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Affiliation(s)
- Ulrike Von Lersner
- Department of Clinical Psychology, Humboldt University of Berlin, Berlin, Germany
| | - Julia Gerb
- Department of Clinical Psychology, Humboldt University of Berlin, Berlin, Germany
| | - Serdar Hizli
- Friedrich von Bodelschwingh-Klinik, Berlin, Germany
| | - Daniel Waldhuber
- Department of Clinical Psychology, Humboldt University of Berlin, Berlin, Germany
| | | | - Malek Bajbouj
- Charité Medical University of Berlin, Berlin, Germany
| | - Georg Schomerus
- Department of Psychiatry and Psychotherapy, University of Greifswald, Greifswald, Germany
| | | | - Eric Hahn
- Charité Medical University of Berlin, Berlin, Germany
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Mukaetova-Ladinska EB, Cosker G, Chan M, Coppock M, Scully A, Kim SY, Kim SW, McNally RJQ, Teodorczuk A. Delirium Stigma Among Healthcare Staff. Geriatrics (Basel) 2018; 4:E6. [PMID: 31023974 PMCID: PMC6473673 DOI: 10.3390/geriatrics4010006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/20/2018] [Accepted: 12/23/2018] [Indexed: 11/16/2022] Open
Abstract
Older people with delirium occupy more than one third of acute medical beds and require increased medical attention, as care at present is suboptimal. In addition, since delirium is undetected, it should form a target for teaching in wards. Moreover, as people with delirium are largely dependent on daily interactions and care by inpatients professional staff, it is important to address stigmatisation of these vulnerable patients. This is especially important as previous studies have shown that negative staff attitudes towards these patients undermine good care. This single center cross-sectional study was designed to determine the extent of institutional stigma among health professionals involved in the care of people with delirium. For this, professional staff working on medical wards and in communities were approached to fill in a questionnaire containing the adapted Delirium Stigma Scale and the EuroQol five dimensions (EQ-5D-5L) questionnaire. Additional demographic information concerning their education and professional and personal experience with delirium was also collected. The characteristics associated with stigma were determined from the sample. The findings of our study provide an insight into the high level of stigmatisation of delirium patients among professionals (mean 11.66/18 points). This was not related to professionals' own experiences of delirium, their educational and professional backgrounds, or them having received formal delirium education. However, working closely with people with delirium seems to have a positive impact on the de-stigmatisation of this population among health professionals. Our findings that attitudes are not influenced by formal delirium teaching need to be incorporated into the design of interprofessional educational interventions. Accordingly, we advocate more direct patient-oriented and care delivered teaching interventions.
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Affiliation(s)
- Elizabeta B Mukaetova-Ladinska
- Institute of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester LE1 7RH, UK.
- The Evington Centre, Leicestershire Partnership NHS Trust, Leicester General Hospital, Gwendolen Rd, Leicester LE5 4QG, UK.
| | - Glynis Cosker
- Northumberland, Tyne and Wear NHS Foundation Trust, Richardson Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4PL, UK.
| | - Mahathir Chan
- Northumberland, Tyne and Wear NHS Foundation Trust, Richardson Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4PL, UK.
| | - Michael Coppock
- Northumberland, Tyne and Wear NHS Foundation Trust, Richardson Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4PL, UK.
| | - Ann Scully
- Northumberland, Tyne and Wear NHS Foundation Trust, Richardson Unit, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4PL, UK.
| | - Seon-Young Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
| | - Sung-Wan Kim
- Departments of Psychiatry, Chonnam National University Medical School, Gwangju 61469, Korea.
| | - Richard J Q McNally
- Institute of Health & Society, Newcastle University, Sir James Spence Institute, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP, UK.
| | - Andrew Teodorczuk
- School of Medicine and Health Institute for the Development of Education and Scholarship (Health IDEAS), Griffith University, Queensland 4122, Australia.
- The Prince Charles Hospital, Metro North, Brisbane, Queensland 4032, Australia.
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Almhdawi KA, Kanaan SF, Khader Y, Al-Hourani Z, Almomani F, Nazzal M. Study-related mental health symptoms and their correlates among allied health professions students. Work 2018; 61:391-401. [DOI: 10.3233/wor-182815] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Khader A. Almhdawi
- Department of Rehabilitation Sciences-Occupational Therapy, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Saddam F. Kanaan
- Department of Rehabilitation Sciences-Physical Therapy, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef Khader
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Zeid Al-Hourani
- Department of Applied Dental Science-Dental Technology, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Fidaa Almomani
- Department of Rehabilitation Sciences-Occupational Therapy, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Nazzal
- Department of Rehabilitation Sciences-Occupational Therapy, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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von dem Knesebeck O, Lehmann M, Löwe B, Makowski AC. Public stigma towards individuals with somatic symptom disorders - Survey results from Germany. J Psychosom Res 2018; 115:71-75. [PMID: 30470321 DOI: 10.1016/j.jpsychores.2018.10.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/12/2018] [Accepted: 10/24/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE The study aims to investigate (1) the magnitude of public stigma towards individuals with somatic symptom disorder (SSD), (2) differences in public stigma between SSD and depression, and (3) predictors of social distance towards individuals with SSD. METHODS Analyses are based on a national telephone survey in Germany (N = 1004). Two vignettes with symptoms of SSD were used. Vignettes differed regarding main type of symptom (pain vs. fatigue) and existence of an earlier somatic disease (yes vs. no). Stigma was measured by stereotypes, negative emotional reactions, and desire for social distance. RESULTS There were no significant differences in public stigma regarding type of symptom and existence of an earlier somatic disease. Two of three components of public stigma under study (stereotypes and desire for social distance) showed higher values in case of depression compared to SSD (both vignettes pooled). Age and negative emotional reactions were positively associated with desire for social distance in case of both SSD vignettes, whereas associations with stereotypes and experience (own affliction and contact to persons afflicted) were inconsistent. Education was not associated with social distance towards people with SSD. CONCLUSIONS Results indicated public stigma towards people affected by SSD in Germany. Compared with depression, SSD stigma was lower in most components. Magnitude of SSD stigma was similar, irrespective of main type of symptom (pain vs. fatigue) and existence of an earlier somatic disease (yes vs. no). Reducing SSD stigma could help to improve illness behaviour and prevent chronification.
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Affiliation(s)
- Olaf von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr 52, Hamburg 20146, Germany.
| | - Marco Lehmann
- Institute and Outpatients Clinic for Psychosomatic Medicine and Psychotherapy, Martinistr 52, Hamburg 20146, Germany
| | - Bernd Löwe
- Institute and Outpatients Clinic for Psychosomatic Medicine and Psychotherapy, Martinistr 52, Hamburg 20146, Germany
| | - Anna C Makowski
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistr 52, Hamburg 20146, Germany
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Makowski AC, von dem Knesebeck O. Depression stigma and migration - results of a survey from Germany. BMC Psychiatry 2017; 17:381. [PMID: 29187164 PMCID: PMC5707908 DOI: 10.1186/s12888-017-1549-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 11/20/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There are barely any studies focusing on migration in relation to mental illness stigma. We explore present attitudes regarding depression among migrants (either born in Germany or born abroad) and non-migrants in Germany, drawing upon three components of public stigma: stereotypes, emotional reactions and desire for social distance. Furthermore, differences in self-stigma of depression between the two groups are analyzed. METHODS Analyses are based on a representative telephone survey (N = 2013) in Germany. Respondents were presented with a vignette depicting either someone from Turkey or from Germany affected by depression, followed by questions on stereotypes, emotional reactions and desire for social distance. The (anticipated) self-stigma of depression was also assessed. Analyses of variance tested for differences between migrant and non-migrant respondents, stratified by migrant status in the vignette. RESULTS Regarding the depression vignette depicting a non-migrant, there were only few differences between subgroups. However, when presented with a vignette describing someone from Turkey, respondents with migrant background who were foreign-born expressed greater stigmatizing attitudes, e.g. when it comes to stereotypes or desire for social distance. Furthermore, this subsample displayed higher levels of self-stigma of depression, especially regarding the ascription of own responsibility. CONCLUSIONS The results underline the need to incorporate migration status/ethnicity in stigma research. Differences in attitudes as well as in (anticipated) self-stigma of depression identify foreign-born migrants in Germany as important target groups for tailored anti-stigma interventions, which need to consider diverse cultural backgrounds.
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Affiliation(s)
- Anna C. Makowski
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20146 Hamburg, Germany
| | - Olaf von dem Knesebeck
- Department of Medical Sociology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20146 Hamburg, Germany
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Schomerus G, Stolzenburg S, Bauch A, Speerforck S, Janowitz D, Angermeyer MC. Shifting blame? Impact of reports of violence and mental illness in the context of terrorism on population attitudes towards persons with mental illness in Germany. Psychiatry Res 2017; 252:164-168. [PMID: 28282533 DOI: 10.1016/j.psychres.2017.02.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/22/2017] [Accepted: 02/22/2017] [Indexed: 01/18/2023]
Abstract
We examine whether reporting on violent and terrorist acts committed in July 2016 by persons who, among other characteristics, were suspected to have mental health issues did impact on mental illness stigma, and whether any changes added to changes observed after the Germanwings plane crash in 2015. Three identical online surveys (in 2014, 2015 and 2016) were conducted among persons >15 years old from an established market research panel in Germany (N=2195). Participants answered questions about a woman ("Anne") with either depression or schizophrenia as described in an unlabeled vignette. In the 2016 survey (<4 weeks after the attacks), we also elicited perceived causes of the violent incidents. Compared to 2014, the predicted probability to rate Anne as dangerous increased from 7% to 11%. Perceived unpredictability increased from 17% to 23%. Other stigma measures did not change significantly. No significant changes were visible between 2015 and 2016. Mental illness ranked third among the most important perceived causes for the attacks in 2016, after 'religious beliefs' and 'being manipulated by others'. Overall, the observed attitude changes were small. We discuss how the context of the attacks may have prevented further attitude change regarding persons with mental illness.
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Affiliation(s)
- Georg Schomerus
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany.
| | - Susanne Stolzenburg
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany; Helios Hanseklinikum Stralsund, Stralsund, Germany
| | - Alexandra Bauch
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany
| | - Sven Speerforck
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany
| | - Deborah Janowitz
- Department of Psychiatry, University Medicine Greifswald, Greifswald, Germany
| | - Matthias C Angermeyer
- Center for Public Mental Health, Gösing am Wagram, Austria; Department of Public Health, Clinical and Molecular Medicine, Cagliari, Italy
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