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Zedan SA, Zahid A, Best MW. Examining the effects of diagnostic awareness, positive symptoms, and negative symptoms on stigmatizing attitudes and social exclusion towards schizophrenia. Schizophr Res 2024; 264:482-490. [PMID: 38277738 DOI: 10.1016/j.schres.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Social exclusion towards schizophrenia can occur as a response to symptom presentations and/or diagnostic knowledge. The present study examined stigma towards schizophrenia as a function of diagnostic awareness, positive symptoms, and negative symptoms. METHODS 559 participants were presented with one of eight vignettes depicting an individual in a social situation based on a 2 (label: present, absent) x 2 (positive symptoms: present, absent) x 2 (negative symptoms: present, absent) design. Participants then completed various measures of social exclusion and stigmatizing attitudes. RESULTS A significant three-way interaction between positive symptoms, negative symptoms, and a diagnostic label was found for stigmatizing attitudes such that knowledge of diagnosis was associated with less stigma when symptoms were present but resulted in more stigma when symptoms were absent. A significant interaction between diagnostic label and negative symptoms was found on social distance such that knowledge of diagnosis increased desire for social distance when negative symptoms were present. CONCLUSION Diagnostic awareness increases stigmatizing attitudes and social distance when symptoms are not present. However, when contextualized with the presence of symptoms, diagnostic awareness may reduce exclusion by providing an explanation for those symptoms. Determining when and to whom to disclose one's diagnosis may be helpful to improve social functioning in schizophrenia.
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Affiliation(s)
- Saleena A Zedan
- Department of Psychology, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Aqsa Zahid
- Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Michael W Best
- Department of Psychology, University of Toronto Scarborough, Scarborough, Ontario, Canada; Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Scarborough, Ontario, Canada; Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada.
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Adhikari T, Aggarwal S, Nair S, Joshi A, Diwan V, Stephen A, Devi KR, Kumar Mishra B, Yadav GK, Bangar SD, Sahu D, Yadav J, Ovung S, Gulati BK, Sharma S, Singh C, Duggal C, Sharma M, Ujagare D, Padmakar Chinchore S, Rebecca PB, Rani S, Selvaraj P, Xavier GG, Peter V, Watson B, Kannan T, Asmathulla KSM, Bhattacharya D, Turuk J, Palo SK, Kanungo S, Kumar Behera A, Pandey AK, Zaman K, Misra BR, Kumar N, Behera SP, Singh R, Narain K, Kant R, Sahay S, Tiwari RR, Thomas BE, Rao MVV. Factors associated with COVID-19 stigma during the onset of the global pandemic in India: A cross-sectional study. Front Public Health 2022; 10:992046. [PMID: 36311615 PMCID: PMC9615248 DOI: 10.3389/fpubh.2022.992046] [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: 07/12/2022] [Accepted: 09/27/2022] [Indexed: 01/26/2023] Open
Abstract
Objective To assess factors associated with COVID-19 stigmatizing attitudes in the community and stigma experiences of COVID-19 recovered individuals during first wave of COVID-19 pandemic in India. Methods A cross-sectional study was conducted in 18 districts located in 7 States in India during September 2020 to January 2021 among adults > 18 years of age selected through systematic random sampling. Data on socio demographic and COVID-19 knowledge were collected from 303 COVID-19 recovered and 1,976 non-COVID-19 infected individuals from community using a survey questionnaire. Stigma was assessed using COVID-19 Stigma Scale and Community COVID-19 Stigma Scale developed for the study. Informed consent was sought from the participants. Univariate and multivariate binary logistic regression analysis were conducted. Results Half of the participants (51.3%) from the community reported prevalence of severe stigmatizing attitudes toward COVID-19 infected while 38.6% of COVID-19 recovered participants reported experiencing severe stigma. Participants from the community were more likely to report stigmatizing attitudes toward COVID-19 infected if they were residents of high prevalent COVID-19 zone (AOR: 1.5; CI: 1.2-1.9), staying in rural areas (AOR: 1.5; CI:1.1-1.9), belonged to the age group of 18-30 years (AOR: 1.6; CI 1.2-2.0), were male (AOR: 1.6; CI: 1.3-1.9), illiterate (AOR: 2.7; CI: 1.8-4.2), or living in Maharashtra (AOR: 7.4; CI: 4.8-11.3). COVID-19 recovered participants had higher odds of experiencing stigma if they had poor knowledge about COVID-19 transmission (AOR: 2.8; CI: 1.3-6.3), were staying for 6-15 years (AOR: 3.24; CI: 1.1-9.4) in the current place of residence or belonged to Delhi (AOR: 5.3; CI: 1.04-26.7). Conclusion Findings indicated presence of stigmatizing attitudes in the community as well as experienced stigma among COVID-19 recovered across selected study sites in India during the first wave of COVID-19 pandemic. Study recommends timely dissemination of factual information to populations vulnerable to misinformation and psychosocial interventions for individuals affected by stigma.
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Affiliation(s)
- Tulsi Adhikari
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Sumit Aggarwal
- Division of Epidemiology and Communicable Diseases (ECD), Indian Council of Medical Research, New Delhi, India
| | - Saritha Nair
- ICMR-National Institute of Medical Statistics, New Delhi, India,*Correspondence: Saritha Nair
| | - Aparna Joshi
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Vishal Diwan
- Division of Environmental Monitoring and Exposure Assessment (Water and Soil), ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - A. Stephen
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - K. Rekha Devi
- Enteric Disease Division, ICMR-Regional Medical Research Center, NE Region, Dibrugarh, Assam, India
| | - Bijaya Kumar Mishra
- Medical Department, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | | | - Sampada Dipak Bangar
- Division of Epidemiology and Biostatistics, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Damodar Sahu
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Jeetendra Yadav
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Senthanro Ovung
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | | | - Saurabh Sharma
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Charan Singh
- ICMR-National Institute of Medical Statistics, New Delhi, India
| | - Chetna Duggal
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Moina Sharma
- Department of Environmental Health and Epidemiology, ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Dhammasagar Ujagare
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Sneha Padmakar Chinchore
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Pricilla B. Rebecca
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - S. Rani
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - Pradeep Selvaraj
- Office of District Non-Communicable Disease, Directorate of Public Health and Preventive Medicine, Chennai, Tamil Nadu, India
| | | | - Vanessa Peter
- Information and Resource Center for the Deprived Urban Communities, Chennai, Tamil Nadu, India
| | - Basilea Watson
- Electronic Data Processing Unit (EDP), ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | - T. Kannan
- Epidemiology Statistics Unit, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
| | | | - Debdutta Bhattacharya
- Department of Microbiology, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Jyotirmayee Turuk
- Department of Microbiology, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Subrata Kumar Palo
- Department of Epidemiology, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Srikanta Kanungo
- Department of Epidemiology, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | - Ajit Kumar Behera
- Clinical Department, ICMR-Regional Medical Research Center, Bhubaneswar, Odisha, India
| | | | - Kamran Zaman
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India
| | - Brij Ranjan Misra
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India
| | - Niraj Kumar
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India
| | | | - Rajeev Singh
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India
| | - Kanwar Narain
- ICMR-Regional Medical Research Center, NE Region, Dibrugarh, Assam, India
| | - Rajni Kant
- ICMR-Regional Medical Research Center, Gorakhpur, Uttar Pradesh, India,Research Management, Policy, Planning and Coordination Cell, Indian Council of Medical Research, New Delhi, India
| | - Seema Sahay
- Division of Social and Behavioral Research, ICMR-National AIDS Research Institute, Pune, Maharashtra, India
| | - Rajnarayan R. Tiwari
- ICMR-National Institute for Research in Environmental Health, Bhopal, Madhya Pradesh, India
| | - Beena Elizabeth Thomas
- Department of Social and Behavioral Research, ICMR-National Institute for Research in Tuberculosis, Chennai, Tamil Nadu, India
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