A call to action: Managing the neural pathway of disgust, bias, prejudice, and discrimination that fuels stigma

Little Evidence for the Role of Disgust Sensitivity in Implicit Disgust to Images of White People Engaged in Injecting Drug Use (IDU)

Background: Previous research has shown that People Who Inject Drugs (PWID) are subject to public stigma, which affects access to, and provision and quality of, treatment and support services. Less is known about the socio-cognitive processes that support the development and maintenance of public stigma toward PWID. The present study investigated the role of disgust sensitivity in implicit disgust to injecting drug use. Methods: 126 participants took part in an online Implicit Association Task (IAT) measuring implicit disgust to pictorial stimuli of injecting drug use or medical injecting. Participants also completed The Disgust Scale Revised, Injecting Phobia Scale (Short Form), Attitudes to People Who Use Drugs (PWUD) scale and a substance use inventory. Results: Average IAT score was negative indicating significantly higher implicit disgust to injecting drug use. Hierarchical linear regression found that injecting phobia predicted implicit disgust to injecting drug use. Questionnaire measures of disgust did not predict implicit disgust. While animal reminder disgust and injecting phobia were significantly correlated with each other, animal reminder disgust did not predict implicit disgust scores. Conclusions: On the basis of our findings, stigma toward PWID may not be a result of feelings of disgust toward injecting drug use. We discuss findings in the context of the underlying cortical processes supporting implicit and explicit representations of disgust. Future research should seek to investigate neurophysiological evidence for disgust to and stigmatization of injecting drug use and the potential role of domains of disgust in this.

Comparisons Between COVID-19 Stigma and Other Stigmas: Distinct in Explicit Attitudes and Similar in Implicit Process

Since the outbreak of COVID-19, the public stigma associated with COVID-19 has emerged. To better understand the COVID-19 stigma, the present research conducted three studies on 1,493 Chinese participants from the outbreak to the recovery period of the COVID-19 pandemic to examine the psychological mechanisms of COVID-19 stigma by comparing it with other disease-related stigmas in terms of their explicit and implicit processes. Study 1 and Study 2 jointly demonstrated that the public endorsed more stigma toward the COVID-19 related people (i.e., the COVID-19 patients) relative to the other disease-related people (i.e., the SARS patients, people with flu) in multiple explicit aspects, including emotional, motivational, cognitive, and social processing. Using the implicit association test (IAT), Study 3 found no significant difference in the implicit measures of the COVID-19 vs. the SARS groups, which further revealed that the pandemic stigmas (i.e., COVID-19 and SARS) were similar at the implicit level. These findings suggest common (implicit level) but distinct (explicit level) psychological processes of the pandemic-related stigmas, which provide reference to policymakers in formulating suitable interventions to deal with COVID-19 stigma and a newly generated potential stigma and provide psychological support for the public in the future.

Exploring Clinical Practice and Developing Clinician Self-Reflection Through Cross Self-Confrontation Methodology: An Application Within an Addiction Medicine Unit

Use of the methodology of cross self-confrontation (CSC) is limited in the field of healthcare and in the context of clinical practice. We applied this methodology within an addiction medicine unit of a university hospital, as part of an exploration of addiction-related clinical difficulties. Cross self-confrontation was used according to a 3-phase design based on video recorded clinical interviews with pairs of nurses and medical doctors. The article reports and discusses the application of CSC in a specific clinical context and illustrates the methodological process through one result. Findings suggest two major strengths of CSC in the context of clinical practice research and education: (1) the capacity to elicit tacit knowledge from daily clinical practice and (2) the ability to enhance self-reflection by questioning professionals both individually and collectively. Further use of CSC in nursing surroundings and clinical settings should be encouraged.

A Contagious Other? Exploring the Public's Appraisals of Contact with 'Mental Illness'

Mental illness has recurrently been found to be Othered by the lay public, although few researchers have examined the affective and implicit processes involved. To explore this, we triangulated facial electromyography (EMG), self-reports, and individual interview data, finding participants to Other mental illness, a process that involved disgust, fear and pity. Furthermore, mental illness was considered to have the potential to permeate, posing a contagious threat. This research highlights the need to fully explore the forms of understanding, which maintain mental-health related stigma, including beliefs about contamination, and the implications this may have for the design of anti-stigma campaigns.

Challenges and new horizons in substance use and addictions: Overview of the 2019 conference of the Association of Multidisciplinary Education and Research in Substance use and Addiction (AMERSA)

The morbidity and mortality associated with opioids, alcohol and other substances challenges clinicians, educators, researchers and policy makers to address these preventable health problems. Interventions are needed to address the many and complex factors that are needed for access to and receipt of life-saving treatment and resources for those who are at risk because of substance use and those with substance use disorders. This article provides an overview of the 43rd annual conference of the Association of Multidisciplinary Education and Research in Substance use and Addiction (AMERSA) held in Boston, MA on November 7-9, 2019. With more than 500 attendees from the nursing, social work, behavioral health, psychiatry, medicine, pharmacy, research and policy among others, the conference provided a platform to address challenges and new horizons in substance and addiction prevention, treatment and research, as well as opportunities for collegial discussion and networking.

Nursing: Addressing substance use in the 21st century

Over the past two decades, there has shift from focusing on the most severe end of the substance use continuum to earlier detection of persons who are at risk given the consequences associated with alcohol and other drug use. In 2017, the Association for Multidisciplinary Education and Research in Substance Use and Addiction (AMERSA) undertook the development of core competencies for specific disciplines addressing substance use in the 21st century. This article presents the core competencies for nursing in accord with the 16 standards of practice and performance for nursing. The competencies for the registered nurse and the advanced practice nurse are intended to inform and guide nursing practice with a focus on prevention, intervention, treatment, and recovery supports for persons who are affected by substance.

Experiences and outcomes of nurses referred to a peer health assistance program: Recommendations for nursing management

AIM

To provide recommendations for nursing management based on the experiences of current and former nurses who were served by a peer health assistance program (PHAP).

BACKGROUND

Providing help for nurses with impaired practice is critical to their health and well-being, assuring patient safety and public trust, as well as returning competent nurses to the healthcare workforce.

METHODS

Nurses (n = 268) who were current clients or former clients of a PHAP were surveyed about their experiences.

RESULTS

Nearly half of nurses were referred by the board of nursing with 69% reporting the referral was due to substance use, alcohol being the most common. Most (62%) did not believe that their substance use affected their practice yet relayed that recognition of their emotional or physical condition could have led to earlier identification. Key barriers to seeking assistance were fear and embarrassment, along with concerns about losing their nursing license.

CONCLUSIONS

Nurses in management are in key roles to identify and intervene with nurses who are at risk for impaired practice.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurses in management and nurse colleagues would benefit from workplace education on the warning signs of impaired nursing practice and how to address it.