Understanding explanatory mechanisms for racial and ethnic differences in mental health stigma: the role of vertical individualism and right-wing authoritarianism

Mental Illness and Racial Disparities in Correctional Staff-Involved Violence: An Analysis of Jails in the United States

In this study, we draw on theories of opportunity and focal concerns to examine how mental illness and race correspond to correctional staff-involved violence, particularly within the transient and diverse context of jails. Using a sample of 3,936 people incarcerated in jails from the 2011 to 2012 National Inmate Survey (NIS-3), we analyze how an individual's mental health status (number of mental illness diagnoses) and race relates to the risk of staff-inflicted victimization. Using a series of Firth's logistic regression models, we find that Black and Hispanic individuals are much more likely to be victims of correctional staff assault than their White counterparts. Those with one and two or more mental illness diagnoses are also at greater risk for staff-involved violence, respectively. Supplementary models show that those who suffer from serious mental illness are at particularly high risk for staff victimization. In a subsequent moderation analysis, we find that race does not condition the influence of mental health diagnoses on risk for staff-involved violence. Our findings reinforce the need for more research on correctional staff-involved violence and the implications of this research support calls for enhanced training of correctional staff regarding mental illness and racial bias.

Gambling Disorder and Stigma: Opportunities for Treatment and Prevention

Purpose of Review

Gambling disorder is among the most stigmatized mental health problems. More research is needed to understand the mechanisms that underlie this stigma and the effects of stigma-reduction interventions. This paper reviews extant literature on the stigma of gambling disorder and highlights evidence from this research and the broader mental illness stigma literature to help advance research on the prevention and reduction of gambling-related stigma.

Recent Finding

The public stigma of gambling disorder includes stereotypes of affected individuals as “greedy” and “irresponsible,” beliefs that affected individuals are to blame for their problems, and desire to avoid social contact with affected individuals. Stigmatizing attitudes held by the public are often internalized by individuals with gambling disorder, which leads to problem concealment, reduced treatment-seeking, and decreased self-esteem. Women with gambling disorder, as well as those with more severe gambling problems and who perceive greater stigma by the public, are most vulnerable to self-stigma. There is evidence that certain beliefs may underlie the stigmatization of gambling disorder, including beliefs about its causes. Contact- and education-based interventions show efficacy for the reduction of mental illness-related stigma more broadly; additional research is needed to determine the efficacy of various stigma reduction strategies for gambling disorder specifically.

Summary

Gambling disorder is highly stigmatized relative to other mental health problems, in part because it is viewed as more likely to be caused by controllable factors. Interventions that emphasize the biopsychosocial etiology of gambling disorder may help to prevent and reduce the blame and stigmatization of affected individuals. Structural stigma within domains such as legislation, healthcare, and the gambling industry, interventions to reduce self-stigma, stigma among mental health professionals, and the influence of culture on stigma and its reduction are critical issues for future research.

The Depression Anxiety Stress Scale 8-Items Expresses Robust Psychometric Properties as an Ideal Shorter Version of the Depression Anxiety Stress Scale 21 Among Healthy Respondents From Three Continents

To examine the cultural limitations and implications in the applicability of the Depression Anxiety Stress Scale 8-items (DASS-8)—a shortened version of the DASS-21 recently introduced in an Arab sample—this study evaluated its psychometric properties, including measurement invariance, among healthy subjects from the United States, Australia, and Ghana. Confirmatory factor analysis revealed good fit of the DASS-8 relative to a 12-item version (DASS-12). Both the DASS-8 and the DASS-12 were invariant at all levels across genders, employment status, and students vs. non-students. The DASS-8/DASS-12 also expressed invariance at the configural and metric levels across all countries, albeit scalar invariance was not maintained due to misspecification of the factor loadings in the Ghanian sample. Mann–Whitney U test revealed significantly lower levels of mental symptomatology on the DASS measures among Ghanian students than in English-speaking respondents (both students and non-students). The DASS-8 expressed excellent internal consistency (coefficient alpha = 0.89), good convergent validity—noted by high values of item-total correlations (r = 0.87 to 0.88), good predictive validity—indicated by significantly strong correlation with the DASS-21 and its subscales (r = 0.95 to 0.80), and adequate discriminant validity—indicated by heterotrait–monotrait ratio of correlations <0.85. The DASS-8 correlated with the Internet Gaming Disorder-9, the Adult attention-deficit/hyperactivity disorder Self-Report Scale, and the Individualism and Collectivism Scale/Culture Orientation Scale at the same level as the DASS-21 and the DASS-12, denoting its adequate criterion validity. The DASS-8 can be used as a brief alternative to the DASS-21 to screen for mental symptomatology in English-speaking and African cultures. However, the same scores on the DASS-8 and the DASS-12 may not always indicate the same level of symptom severity in subjects from different countries. Further inter-cultural evaluations of the DASS-8 are needed.

Microaggression and the adult stuttering experience

BACKGROUND

Microaggressions are subtle insults, invalidations, or slights that target people due to their association with a marginalized group. Microaggressive experiences have been shown to degrade quality of life and corroborate negative stereotypes towards persons with disabilities. To date, minimal research has been dedicated to exploring microaggressions within adults who stutter.

METHODS

Seven adults who stutter participated in semi-structured focus group interviews similar to Keller and Galgay's (2010) qualitative investigation of microaggressions experienced by adults with a disability. Group interviews were transcribed and analyzed using QSR NVivo software to develop themes and subthemes.

RESULTS

Eight major themes were identified within two supraordinate themes: Microaggressive Behavior (patronization, second-class status, perceived helplessness, workplace microaggression, clinical microaggression, denial of privacy) and Perception of Microaggressive Behavior (exoneration of listener, no or minimal microaggressive experience). Although patronization, second-class status, and helplessness were mentioned frequently by multiple participants, exoneration of the listener was the most frequently recurring theme.

DISCUSSION

Based on these preliminary focus group interviews, stuttering-based microaggressions broadly resemble ableist microaggressions reported by Keller and Galgay (2010). Interviewees also expressed a reluctance to identify slights related to stuttering as microaggression and often characterized these incidents as unavoidable.

A Cross-National Study of Dementia Stigma Among the General Public in Israel and Australia

BACKGROUND

Despite the increasing amount of research on dementia stigma, there is a dearth of cross-national studies conducted on this subject. This is surprising since the experience of stigma is closely associated to socio-cultural aspects.

OBJECTIVE

The present study intended to expand knowledge about the impact of culture on dementia stigma by comparing the level and correlates of stigmatic beliefs about dementia among the general public in Israel and Australia.

METHODS

A cross-sectional study using an online survey was conducted with two age-matched samples: 447 adults in Israel and 290 adults in Australia.

RESULTS

Overall, dementia stigma was moderate in both countries. However, the level of dementia stigma was significantly higher in Australia than in Israel. Lower levels of subjective knowledge and higher levels of ageism were associated with increased levels of stigmatic beliefs in both countries. Gender was a significant correlate of dementia stigma, with male participants reporting higher levels of public stigma than women, although this gender difference was mainly driven by the Australian sample.

CONCLUSION

Our findings indicate that providing knowledge and decreasing ageist attitudes should be key considerations in dementia awareness and stigma reduction campaigns despite the cultural context. In addition, developing gender-specific messages should be considered as a way of improving the effects of such campaigns.

Internalization process of stigma of people with mental illness across cultures: A meta-analytic structural equation modeling approach

This meta-analytic study synthesized findings from 108 independent data sets across 22 cultures to investigate whether the stigma internalization model (the internalization of experienced stigma and perceived stigma to self-stigma) is associated with well-being and recovery of people with mental illness. We also examined the moderating role of collectivism in the internalization process. Results of the meta-analytic structural equation modeling suggested that self-stigma is a significant mediator in the relationships between experienced stigma and perceived stigma with well-being and recovery variables (indirect effects = 0.02 to -0.16). Experienced and perceived stigma had significant direct effects on well-being and recovery variables (Bs = 0.07 to -0.21, p < 0.05), suggesting that both external (e.g., public stigma) and internal (i.e., self-stigma) influences of stigma work concurrently to affect recovery and well-being of people with mental illness. The results of the mixed effect three-level meta-analytic models showed that collectivism significantly moderated the relationship between experienced and perceived stigma with self-stigma (Bs = 0.06 to 0.11, p < 0.05). This implied that the more collectivistic a culture is, the stronger the correlation between experienced and perceived stigma with self-stigma. Implications to stigma reduction approaches were discussed.