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Safiri S, Mousavi SE, Nejadghaderi SA, Noori M, Sullman MJM, Kolahi AA, Shekarriz-Foumani R. The burden of major depressive disorder in the Middle East and North Africa region, 1990-2019. Acta Neuropsychiatr 2024; 36:139-152. [PMID: 37690795 DOI: 10.1017/neu.2023.42] [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: 09/12/2023]
Abstract
BACKGROUND Major depressive disorder (MDD) is one of the leading causes of disability. We aimed to report the MDD-attributable prevalence, incidence and years lived with disability (YLDs) in the Middle East and North Africa (MENA) region from 1990 to 2019 by age, sex and socio-demographic index (SDI). METHODS Publicly available data on the burden of MDD were retrieved from the Global Burden of Disease (GBD) study 2019 for the 21 countries in MENA. The counts and age-standardised rates (per 100,000) were presented, along with their corresponding 95% uncertainty intervals. RESULTS In 2019, MDD had an age-standardised point prevalence of 3322.1 and an incidence rate of 4921.7 per 100,000 population in MENA. Furthermore, there were 4.1 million YLDs in 2019. However, there were no substantial changes in the MDD burden over the period 1990-2019. In 2019, Palestine had the highest burden of MDD. The highest prevalence, incidence and YLDs attributable to MDD were found in the 35-39 age group. In 2019, the YLD rate in MENA was higher than the global rate for almost all age groups. Furthermore, there was a broadly negative association between the YLD rate and SDI. CONCLUSION The study highlights the need to prevent the disorder using a multidisciplinary approach and for the provision of cost-effective treatments for those affected, in order to increase their quality of life.
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Affiliation(s)
- Saeid Safiri
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Ehsan Mousavi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Aria Nejadghaderi
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Shekarriz-Foumani
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Yin M, Li Z, Li X. Family influence on stigma internalisation in people with severe mental illness: A grounded theory study. Int J Ment Health Nurs 2024. [PMID: 38767116 DOI: 10.1111/inm.13346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/22/2024]
Abstract
The internalisation of stigma has adverse effects on the recovery and quality of life of people with severe mental illnesses. Studies have shown that life experiences in one's close environment are highly relevant in explaining the onset and development of self-stigma. Families play a critical role in the daily care of people with severe mental illness and have a profound impact on patient recovery. This qualitative study explored the influence of family on stigma internalisation among people with severe mental illness in the context of Chinese culture. A grounded theory design was used. Semi-structured interviews were conducted with 20 patients with severe mental illness and 10 family members, and observations were carried out among five of the families. The data analysis followed three steps (open, axial and selective coding) and involved the use of a constant comparative method and memo writing. The COREQ reporting checklist was used to report the results. Our findings revealed that families can facilitate and impede stigma internalisation in people with severe mental illness via negative or positive daily interactions. A theoretical framework was developed to present the potential effects of the identified family factors on stigma internalisation. Three major family factors influencing patients' internalised stigma were identified, namely, "beliefs of family members" at the individual level, "responses within the family" at the intrafamilial level and "differentiated family environment" at the level of the whole family system, in which "biased beliefs of family members" could bring about "negative responses within the family" and further result in patients' internalised stigma. Our findings suggested that mental health stigma internalised by ill people should be viewed within the broad context of the family. Family-based programs aimed at improving positive interactions and support within the family need to be developed and launched, with particular attention given to interventions for affiliate stigma, coping with stigma and families' negative responses towards people with severe mental illness to prevent the internalisation of stigma by patients.
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Affiliation(s)
- Min Yin
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Zheng Li
- School of Nursing, Peking Union Medical College, Beijing, China
| | - Xiaoxue Li
- School of Nursing, Peking Union Medical College, Beijing, China
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Ramos N, McNally RJ. What variables predict stigmatizing attitudes toward people with mental disorders and their treatment in Filipinos and Americans? Transcult Psychiatry 2024:13634615241245872. [PMID: 38766870 DOI: 10.1177/13634615241245872] [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: 05/22/2024]
Abstract
In the United States, Asian Americans express greater stigma toward those with mental disorders and report lower rates of seeking mental health treatment than do White Americans. However, research on these topics in Filipino cultural groups, especially Filipinos living in the Philippines (i.e., Filipino nationals), is sparse. To support the design of interventions to decrease stigma and improve rates of seeking treatment, we assessed attitudes toward mental disorders and help-seeking in Filipinos. U.S. national (i.e., American) and Filipino national participants completed an online survey containing the Mental Illness Stigma Scale, a Theory of Planned Behavior questionnaire measuring attitudes toward seeking treatment, and queries regarding demographic and psychosocial factors. Filipinos expressed significantly more stigma regarding relationship disruption, interpersonal anxiety, and poor hygiene, alongside increased perceived subjective norms opposing seeking treatment and decreased perceived behavioral control over getting treatment if necessary. We ran a linear mixed effects regression on each nationality separately to identify relationships between stigma and psychosocial factors. For Filipinos, increased parental education predicted decreased perceived relationship disruption and interpersonal anxiety; urbanization was associated with greater trust in mental health professionals, and having a close relative with a disorder led to decreased belief in patient recoverability. For Americans, increased participant education predicted decreased interpersonal anxiety, increased perceived recoverability, and improved perceived behavioral control over getting treatment if necessary, and having a close relative with a disorder predicted improved perceived treatability. The results guide programs for decreasing stigma and increasing treatment-seeking behavior. Limitations, future research directions, and possible interventions are discussed.
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Affiliation(s)
- Noah Ramos
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Du N, Wang Y, Huang YT. Parental Depression and Self-Stigma Among Chinese Young People Living With Depression: A Qualitative Study. QUALITATIVE HEALTH RESEARCH 2024:10497323241232351. [PMID: 38462846 DOI: 10.1177/10497323241232351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
Self-stigma is detrimental to psychosocial well-being and the recovery journey among people living with depression. However, there has been limited research exploring the experience of stigma internalization when depression runs in families. This study aims to address this gap by (1) characterizing the manifestations of self-stigma among individuals living with depression whose parent(s) also have depression and (2) exploring the potential mechanisms underlying the impact of parental depression on self-stigma. Essential principles of the constructivist grounded theory approach were adopted to collect data through in-depth interviews with 27 participants aged 15-30, living in Mainland China. Many participants perceived depression running in their family as an endless disaster and an incurable illness. These beliefs further led to stigmatizing emotions (such as suppression, anger, and guilt) and behaviors (such as concealment and social withdrawal). Participants also highlighted ambivalent intergenerational relationships, tense family atmospheres, lower parental emotional involvement and support, and a lack of family flexibility due to parental depression. Furthermore, parental depression impacted participants' self-stigma by interfering with family relationships, family functioning, and parenting styles. It also shaped their perceptions of family, illness attribution, and public stigma. Additionally, parental depression had an impact on participants' social functioning, self-esteem, and personality, making them more susceptible to self-stigma. This study emphasizes the crucial role that the family plays in the internalization of stigma among individuals living with depression. It suggests that family dynamics, rather than family structure or economic backgrounds alone, shape this process.
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Affiliation(s)
- Nan Du
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Yihang Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Yu-Te Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
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Singh S, Melendez K, Sezginis N. Examining the effect of discrimination and stigma on utilization of mental health services among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:2398-2405. [PMID: 34519631 DOI: 10.1080/07448481.2021.1970561] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 06/30/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Even though onset of three-quarters of mental disorders occurs by age 25, few young adults seek help for their mental health needs. The objectives of this study are to examine the relationship of discrimination and stigma of mental illness on the help-seeking behavior for mental health among college students. METHOD Undergraduate students (N = 557) at a Midwestern university were surveyed online. Descriptive and logistic regression analysis was conducted using STATA15. RESULTS College students reporting higher discrimination were more likely to seek help for mental health services (OR = 1.04, CI = 1.01-1.06), after controlling for all covariates. Students with higher personal stigma reported lower odds of help-seeking behavior (OR = 89, CI = .80-.97). Students with higher perceived public stigma did not have an independent significant association on help-seeking behavior initially, but full model revealed a significantly association (OR = 1.02, CI = .99-1.05). CONCLUSION Developing targeted interventions addressing discrimination and stigma of mental illness is critical among college students.
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Affiliation(s)
- Shipra Singh
- School of Population Health, University of Toledo, Toledo, Ohio, USA
| | - Krizia Melendez
- School of Population Health, University of Toledo, Toledo, Ohio, USA
| | - Nilgun Sezginis
- School of Population Health, University of Toledo, Toledo, Ohio, USA
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Sugisawa H, Shimizu Y, Kumagai T, Shishido K, Koda Y, Shinoda T. Influence of dialysis-related stigma on health-related indicators in Japanese patients undergoing hemodialysis. Ther Apher Dial 2023; 27:855-865. [PMID: 37052040 DOI: 10.1111/1744-9987.13992] [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: 02/01/2023] [Revised: 03/06/2023] [Accepted: 04/02/2023] [Indexed: 04/14/2023]
Abstract
INTRODUCTION Focusing on impacts to health-related indicators in older Japanese patients, this study analyzed both the direct influence of dialysis-related stigma and influences of its intersectionality with other stigmatized characteristics. METHODS Data were collected through a cross-sectional survey of 7461 outpatients in dialysis facilities. Other stigmatized characteristics include lower income, lower education, disabled activities of daily living, and diabetic end-stage renal disease (ESRD) as a cause for starting dialysis treatment. RESULTS The average rate of an "agree" response on dialysis-related stigma items was 18.2%. Dialysis-related stigma significantly influenced all three health-related indicators, including suspected depression, informal networks, and compliance with dietary therapy. In addition, each interaction between dialysis-related stigma and educational attainment, gender, and diabetic ESRD significantly influence one health-related indicator. CONCLUSION These results suggest that dialysis-related stigma has both a significant direct and synergic influence with other stigmatized characteristics on health-related indicators.
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Affiliation(s)
- Hidehiro Sugisawa
- Gerontology Program, J. F. Oberlin University Graduate School of International Studies, Tokyo, Japan
| | | | - Tamaki Kumagai
- School of Health Sciences, International University of Health and Welfare, Odawara, Kanagawa, Japan
| | | | - Yutaka Koda
- Koda Medical and Dialysis Clinic, Niigata, Japan
| | - Toshio Shinoda
- Advanced Course for Clinical Engineering, Teikyo University Junior College, Tokyo, Japan
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Faruk MO, Khan AH, Chowdhury KUA, Jahan S, Sarker DC, Colucci E, Hasan MT. Mental illness stigma in Bangladesh: Findings from a cross-sectional survey. Glob Ment Health (Camb) 2023; 10:e59. [PMID: 37854431 PMCID: PMC10579681 DOI: 10.1017/gmh.2023.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 08/12/2023] [Accepted: 09/11/2023] [Indexed: 10/20/2023] Open
Abstract
Background Mental illness stigma is universally prevalent and a significant barrier to achieving global mental health goals. Mental illness stigma in Bangladesh has gained little attention despite its widespread impact on seeking mental health care in rural and urban areas. This study aimed to investigate mental illness stigma and the associated factors in rural and urban areas of Bangladesh. Methods The study areas were divided into several clusters from which 325 participants (≥18 years) were recruited with systematic random sampling. The Bangla version of the Days' Mental Illness Stigma Scale was used to collect data. Independent-samples t-test, ANOVA, and multiple regression were performed. Results Results suggest that gender, age, geographical location, socioeconomic status, and occupation significantly differed across subscales of stigma. Age, gender, seeking treatment of mental illness, having knowledge on mental health, and socioeconomic status were predictive factors of mental illness stigma. The results also showed a high treatment gap in both rural and urban areas. Conclusion This study supports that mental illness stigma is prevalent in Bangladesh, requiring coordinated efforts. Results can inform the development of contextually tailored mental health strategies to reduce stigma and contribute to the promotion of mental health of individuals and communities across Bangladesh.
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Affiliation(s)
- Md Omar Faruk
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Abid Hasan Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Kamal Uddin Ahmed Chowdhury
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
- Nasirullah Psychotherapy Unit, Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Sabiha Jahan
- Department of Clinical Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Depon Chandra Sarker
- Child Development Center, Department of Pediatrics, Satkhira Medical College and Hospital, Satkhira, Bangladesh
| | | | - M. Tasdik Hasan
- Action Lab, Department of Human Centred Computing, Faculty of Information Technology, Monash University, Melbourne, VIC, Australia
- Department of Public Health, State University of Bangladesh, Dhaka, Bangladesh
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8
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Nan D, Chong ESK, Dannuo W, Zewei L, Zexuan M, Shuyu D, Huang YT. Prevalence, risk, and protective factors of self-stigma for people living with depression: A systematic review and meta-analysis. J Affect Disord 2023; 332:327-340. [PMID: 37060952 DOI: 10.1016/j.jad.2023.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 03/27/2023] [Accepted: 04/07/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND People living with depression are subjected to widespread stigmatization worldwide. Self-stigma may negatively affect patients' treatment, recovery, and psychological well-being. This review aims to summarize and synthesize the evidence on the prevalence, risk, and protective factors of depression self-stigma. METHODS Four online databases, PubMed, PsycINFO, Web of Science, and Embase, were searched to identify eligible studies. Fifty-six studies involving a total of 11,549 samples were included in the final analysis. Four reviewers independently screened the literature, extracted data, and assessed the risk of bias in eligible studies. Pearson's r was chosen as the effect size metric of risk and protective factors. RESULTS The results showed that the global prevalence of depression self-stigma was 29 %. Levels of self-stigma varied across regions, but this difference was not significant. Two demographic factors were identified: ethnicity (r = 0.10, p < 0.05) and having a partner/married (r = -0.22, p < 0.001). Five risk factors were identified: depression severity (r = 0.33, p < 0.01), public stigma (r = 0.44, p < 0.001), treatment stigma (r = 0.46, p < 0.001), perceived stigma (r = 0.37, p < 0.001), and enacted stigma (r = 0.71, p < 0.001). Five protective factors were identified: quality of life (r = -0.38, p < 0.001), social relationship (r = -0.26, p < 0.05), self-esteem (r = -0.46, p < 0.001), extroversion (r = -0.32, p < 0.001), and social functioning (r = -0.49, p < 0.001). LIMITATIONS Heterogeneity was observed in some of the results. Causality cannot be inferred due to the predominance of cross-sectional designs among the included literature. CONCLUSIONS Risk and protective factors of depression self-stigma exist across many dimensions. Future research should examine the inner mechanisms and effectiveness of interventions to reduce stigma.
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Affiliation(s)
- Du Nan
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Eddie S K Chong
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Wei Dannuo
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Liu Zewei
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong, China
| | - Mu Zexuan
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Deng Shuyu
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China
| | - Yu-Te Huang
- Department of Social Work and Social Administration, the University of Hong Kong, Hong Kong, China.
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Wang Y, An S, Yang X, Zhang Z, Li S, Yao J, Chen Y, Deng H. Disease information disclosure among patients with mental illness and their family members in China. Front Psychiatry 2023; 13:1036568. [PMID: 36683996 PMCID: PMC9846142 DOI: 10.3389/fpsyt.2022.1036568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 12/08/2022] [Indexed: 01/05/2023] Open
Abstract
Objective The disclosure of mental illness is a first and crucial step in alleviating stigma and promoting mental recovery. However, at present, there is a lack of research on this subject in the Chinese context. Therefore, we conducted this survey among patients with mental illness and their family members and analyzed the influencing factors. Methods Questionnaires were distributed to qualified patients with mental illness and their family members, who were enrolled from the inpatient departments of two major mental health centers in China. Hierarchical linear regression analysis was used to evaluate the factors affecting the disclosure of disease information by patients with mental illness and their family members. Results A total of 153 patients and 159 family members were included. The percentages of patients and family members who intended to disclose disease information were 34.6 and 18.2%, respectively. Regarding the benefits of being out (BBO), marital status and the number of hospitalizations explained 13.1% of the variance, and stigma explained 4.3% of the variance. Regarding the reasons for staying in (RSI), marital status and family history of mental illness explained 14.4% of the variance, and stigma explained 14.8% of the variance. In the model predicting the influencing factors of family member disclosure, stigma was a predictor of both BBO and RSI, explaining 8.1 and 8.7% of the variance, respectively. Conclusion Both patients and their families were more reluctant than willing to disclose. Marital status, number of hospitalizations and family history of mental illness were all influencing factors of patients' intentions to disclose disease information. Stigma is closely related to disclosure intention and plays an important role in the disclosure intentions of patients and their families. This suggests that the disclosure of disease information is complex, and many factors need to be considered. Disclosure guidelines should be tailored to individuals.
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Affiliation(s)
- Yi Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Sleep Medicine Center, The Third People’s Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Siyao An
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing, China
| | - Zhuoqiu Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Shuiying Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Jing Yao
- Sleep Medicine Center, The Third People’s Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, China
| | - Ying Chen
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
- Hope Recovery and Rehabilitation Center, Chengdu, China
| | - Hong Deng
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
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Yip CCH, Fung WTW, Leung DCK, Chan KKS. The impact of stigma on engaged living and life satisfaction among people with mental illness in Hong Kong. Qual Life Res 2023; 32:161-170. [PMID: 36056192 DOI: 10.1007/s11136-022-03218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2022] [Indexed: 01/12/2023]
Abstract
PURPOSE The present study aimed to investigate how the interpersonal (experienced discrimination) and intrapersonal (anticipated stigma and internalized stigma) manifestations of psychiatric stigma may affect engaged living and life satisfaction among people with mental illness. In this study, we developed and evaluated a conceptual model to clarify how experienced discrimination may lead to anticipated stigma and internalized stigma and thereby impede engaged living and reduce life satisfaction. METHODS A total of 205 Hong Kong Chinese people with mental illness completed standardized questionnaire measures of experienced discrimination, anticipated stigma, internalized stigma, engaged living, and life satisfaction. The associations among these variables were analyzed using path analyses and bootstrap analyses. RESULTS Path analyses showed that experienced discrimination was related to higher levels of anticipated stigma and internalized stigma, which were, in turn, linked to lesser engaged living and consequently lower life satisfaction. Bootstrap analyses further revealed that experienced discrimination had significant indirect effects on life satisfaction via anticipated stigma and engaged living and via internalized stigma and engaged living. CONCLUSIONS Theoretically, our study uncovers how the interpersonal and intrapersonal manifestations of psychiatric stigma may adversely affect engaged living and life satisfaction among people with mental illness. Practically, our study points to the importance of developing and implementing stigma-related interventions at societal and individual levels in order to enable people with mental illness to live fulfilling and satisfying lives.
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Affiliation(s)
| | - Winnie Tsz Wa Fung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Donald Chi Kin Leung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Kevin Ka Shing Chan
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong. .,Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, Hong Kong.
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11
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A qualitative study on the experience of stigma for Chinese parents of children with autism spectrum disorder. Sci Rep 2022; 12:19550. [PMID: 36379973 PMCID: PMC9666461 DOI: 10.1038/s41598-022-23978-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 11/08/2022] [Indexed: 11/16/2022] Open
Abstract
Experiencing stigma related to having a child with autism spectrum disorder (ASD) can be difficult and is detrimental to parent well-being. Since the research on stigmatized experiences among parents of children with ASD in non-Western communities is limited, this qualitative study examined the experiences, reactions and impacts of stigma on parents of children with ASD in Hong Kong. In-depth interviews were conducted with 54 Chinese parents/caregivers of children with ASD aged between 35 and 73 years old. Data were analyzed using an inductive approach. The participants reported stigma which stemmed from negative labelling of their children by schools and healthcare professionals, bullying by peers, stereotypes of ASD and stigma linked to autistic children's behavior in the community. The reactions of participants towards stigmatization were classified into internalizing reactions including apologizing, ignoring and concealing ASD and externalizing reactions such as fighting back. The participants also reported impacts of stigma on both personal and emotional levels. The results point to the urgent need for the government to allocate resources and make concerted efforts to reduce stigma by educating the community to foster more positive attitudes towards individuals with ASD and offer support and counselling services to parents.
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12
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Wong NE, Hagan MJ, Holley SR, Paik JH, Duh S. Traumatic Stress, Mental Health Stigma, and Treatment-Seeking Attitudes among Chinese College Students. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2022. [DOI: 10.1080/87568225.2022.2145253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Natalie E. Wong
- Department of Psychology, San Francisco State University, San Francisco, CA, USA
| | - Melissa J. Hagan
- Department of Psychology, San Francisco State University, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Sarah R. Holley
- Department of Psychology, San Francisco State University, San Francisco, CA, USA
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Jae H. Paik
- Department of Psychology, San Francisco State University, San Francisco, CA, USA
| | - Shinchieh Duh
- Department of Psychology, San José State University, San Francisco, CA, USA
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Chan KKS, Fung WTW, Leung DCK, Tsui JKC. The impact of perceived and internalised stigma on clinical and functional recovery among people with mental illness. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6102-e6111. [PMID: 36254881 DOI: 10.1111/hsc.14047] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/16/2022] [Accepted: 08/21/2022] [Indexed: 06/16/2023]
Abstract
The present study aimed to develop and validate a conceptual model linking public and internalised stigma to recovery attitudes, processes and outcomes among people with mental illness. Specifically, we sought to examine whether perceptions of public stigma (i.e., perceived stigma) would affect experiences of internalised stigma (i.e., self-stigma) and thereby influence recovery attitudes (i.e., recovery orientation), recovery processes (i.e., service engagement) and recovery outcomes (i.e., clinical recovery and functional recovery). A total of 205 people with mental illness from Hong Kong, China, completed questionnaire measures on perceived stigma, self-stigma, recovery orientation, service engagement, clinical recovery and functional recovery. The associations among these variables were analysed using path analyses and bootstrap analyses. Path analyses showed that perceived stigma was related to greater self-stigma, which was, in turn, linked to lower recovery orientation and then lesser service engagement and ultimately poorer clinical recovery and functional recovery. Bootstrap analyses further demonstrated that perceived stigma had significant indirect effects on recovery orientation via self-stigma, on service engagement via self-stigma and recovery orientation and on clinical recovery and functional recovery via self-stigma, recovery orientation and service engagement. Theoretically, our findings reveal how public and internalised stigma may adversely affect recovery attitudes, processes and outcomes among people with mental illness. Practically, our findings point to the vital and urgent need to develop effective interventions to mitigate stigma and self-stigma at community and individual levels in order to reduce the deleterious impact of stigma on recovery.
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Affiliation(s)
- Kevin Ka Shing Chan
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
- Centre for Psychosocial Health, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Winnie Tsz Wa Fung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Donald Chi Kin Leung
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Jack Ka Chun Tsui
- Department of Psychology, The Education University of Hong Kong, Tai Po, Hong Kong
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Dahiru T, Iliyasu Z, Aliyu MH. Social participation restriction among persons with leprosy discharged from a multidrug therapy clinic in northern Nigeria. Trans R Soc Trop Med Hyg 2022; 116:694-703. [DOI: 10.1093/trstmh/trac056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/10/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The burden of leprosy-related disability, stigma and social participation after completing treatment is not well documented in Nigeria. We assessed the extent of disability, level of stigma and predictors of activity limitation and social participation restriction after completing multidrug therapy (MDT) for leprosy in Kano, Nigeria.
Methods
A consecutively recruited cross-section of 354 persons discharged from MDT and 360 community members were interviewed. The Eyes, Hands and Feet sum score, Screening of Activity Limitation and Safety Awareness scale, Participation scale and Jacoby Stigma scale were used for affected persons. The Exploratory Model Interview Catalogue scale was used to assess community-perceived stigma. Levels of disability, activity limitation, participation restriction and stigma were scored. Adjusted ORs for predictors were generated from logistic regression models.
Results
Most (91.5%, n=324) respondents had a disability; (8.2%, n=29) and (83.3%, n=295) were WHO grades 1 and 2, respectively. Similarly, 321 participants (90.7%) had activity limitation and 316 respondents (89.3%) experienced participation restriction. Further, 88.7% of participants (n=314) anticipated stigma. Activity limitation was higher among unemployed participants, men, persons with disability and those who anticipated stigma. Participation restriction was higher among low income earners (≤1000 Nigerian Naira per month (equivalent to US$2.50 per month)) and persons with disability, limited activity and anticipated stigma.
Conclusion
Leprosy-related disability, stigma, activity limitation and social participation restriction are high after treatment. We recommend community-based rehabilitation to sustain self-care, reduce stigma and ensure social inclusion.
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Affiliation(s)
- Tahir Dahiru
- Leprosy and Tuberculosis Relief Initiative , Jos, Nigeria
- Texila American University , Georgetown, Guyana
| | - Zubairu Iliyasu
- Department of Community Medicine, Bayero University , Kano, Nigeria
| | - Muktar H Aliyu
- Department of Health Policy and Vanderbilt Institute for Global Health, Vanderbilt University Medical Center , Tennessee 37203, USA
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15
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Latifeh Y, Jaredh MW, Nasri L, Shriedy D, Al-Mahdi A, Murtada MW. Knowledge, stigma, and beliefs toward mental illnesses among schoolteachers in Damascus. Int J Soc Psychiatry 2022; 68:1054-1062. [PMID: 33969746 PMCID: PMC9310142 DOI: 10.1177/00207640211015701] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Teachers have an important role in promoting the mental wellbeing of their students, hence their knowledge and attitudes toward mental health disorders should be assessed. A very few studies regarding this topic were conducted in Syria, but due to the recent events which have had occurred the country, it is essential to deal with students who suffer from mental illnesses professionally especially that such disorders may be stigmatized by the society. AIMS This paper aims to investigate knowledge, beliefs, and attitudes toward mental disorders in a sample of Syrian schoolteachers. METHOD A cross-sectional study using self-administered questionnaire was conducted in Damascus and Refdimashq, involving 400 teachers from 16 schools. RESULTS The results showed that the prevalence of stigmatizing positions toward psychiatric illnesses was low among teachers. The contributors did not state a correlation between spiritual beliefs and psychological disorders. It was also found that teachers were neutral in their knowledge about mental illnesses and psychiatric treatment or interventions along with their mental health resources. However, 42.5% of the participants use the internet for such purposes. CONCLUSION In general, teachers of Damascus and its Refdimashq had a reasonable degree of awareness about mental disorders and treatments. Furthermore, neither stigma nor the relation between religious thoughts and mental disorders had been ascertained.
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Affiliation(s)
- Youssef Latifeh
- Syrian Private University, Syria.,Faculty of Medicine, Damascus University, Damascus, Syria, Syrian Arab Republic
| | - Mhd Wael Jaredh
- Faculty of Medicine, Damascus University, Damascus, Syria, Syrian Arab Republic
| | - Lulia Nasri
- Faculty of Medicine, Damascus University, Damascus, Syria, Syrian Arab Republic
| | - Duaa Shriedy
- Faculty of Medicine, Damascus University, Damascus, Syria, Syrian Arab Republic
| | - Ayat Al-Mahdi
- Faculty of Medicine, Damascus University, Damascus, Syria, Syrian Arab Republic
| | - Mhd Wasim Murtada
- Faculty of Medicine, Damascus University, Damascus, Syria, Syrian Arab Republic
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16
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Sory CI, Cissé K, Millogo T, Dahourou DL, Ouedraogo HG, Kouanda S. Prevalence and factors associated with stigma among people with disabilities in Niger in 2018: a multi-level analysis. AIDS Care 2022; 34:65-70. [PMID: 35531861 DOI: 10.1080/09540121.2022.2038365] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
People with disability face stigmatization in most of African countries. The objective of this study was to determine the prevalence and the factors associated with stigma among people living with a disability in Niger. This is a secondary analysis of data from a cross sectional study on disability and HIV conducted in Niger from June to November 2018. People with disabilities in grades 3 and 4 identify with Washington Group Short Set of Questions, aged 15-60, were included. Factors associated with stigma were identified by a binary multilevel regression model. A total of 820 participants were included. The prevalence of stigma was 18%. People with intellectual (adjusted odds ratio [aOR]: 1.89; 95% Confidence interval [95%CI] [1.58-5.03]) and cognitive (aOR:2.82; 95%CI 1, 14-3.13]were more likely to experience stigma than other types of disabilities. People with disabilities over the age of 20 were 57% to 71% less likely to be stigmatized than people with disabilities aged 15-19. Living in the same accommodation with other people with disabilities was also a protective factor against the experience. There is a need to implement interventions to reduce the stigmatization of people with disabilities in Niger.
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Affiliation(s)
| | - Kadari Cissé
- African Institute of Public Health (IASP), Ouagadougou, Burkina Faso.,Institute for Research in Health Sciences (IRSS / CNRST), Ouagadougou, Burkina Faso
| | - Tieba Millogo
- African Institute of Public Health (IASP), Ouagadougou, Burkina Faso
| | | | - Henri Gautier Ouedraogo
- African Institute of Public Health (IASP), Ouagadougou, Burkina Faso.,Institute for Research in Health Sciences (IRSS / CNRST), Ouagadougou, Burkina Faso
| | - Seni Kouanda
- African Institute of Public Health (IASP), Ouagadougou, Burkina Faso.,Institute for Research in Health Sciences (IRSS / CNRST), Ouagadougou, Burkina Faso
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17
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Hernandez Fernandes RH, Carrara B, Andrade Vidigal BA, Barbosa Martins AL, Bobbili SJ, Arena Ventura CA. Stigma experienced by people with mental illness in South America: an integrative review. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction: People with mental illness are highly stigmatized by populations around the world and are perceived to be a burden on society. As a result of stigma, many people with mental illness are discriminated against, which leads to limited life opportunities. Given that beliefs about mental illness can vary based on culture, religion, nationality and ethnicity, it is important to understand the different types of mental illness-related stigma experienced around the world. Materials and Methods: Whittemore and Knafl’s (2005) methodology for integrative reviews was used to analyze 18 studies about lived experiences of mental illness-related stigma in South America. Results: Findings suggest that certain types of stigma in South America are based on gender and social norms, such as the social position of men and women in society. This leads to discrimination, isolation and violence from family, intimate partners, friends, society and health professionals. Employment is also limited for South Americans with mental illness. Other consequences, such a self-stigma, also impact the lives of people with mental illness in many South American contexts. Discussion: Family, friendship and social relationships, including health professionals, can involve processes that lead to the stigma experienced by people with mental illness. Conclusion: This integrative review highlights how mental illness related-stigma impacts
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18
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Psychological interventions for personal stigma of patients with schizophrenia: A systematic review and network meta-analysis. J Psychiatr Res 2022; 148:348-356. [PMID: 35202995 DOI: 10.1016/j.jpsychires.2022.02.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND & OBJECTIVES Trials to assess the efficacy of psychological interventions for personal stigma in patients with schizophrenia are controversial, inconclusive, and limited. Using a systematic review and network meta-analysis, this study aimed to compare the effect of different psychological interventions for reducing personal stigma in patients with schizophrenia both direct and indirect. METHODS Relevant randomized controlled trials (RCTs) were obtained from Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, PsycINFO, Embase, Ovid Medline, CNKI, Wanfang, CBM, and Weipu. The focus of this network meta-analysis was on comparing the effects of various psychological interventions for reducing personal stigma in patients with schizophrenia. Standardized mean differences (SMDs) of personal stigma outcomes and 95% confidence intervals (CIs) were used to determine the efficacy. Inconsistency test, network map, surface under the cumulative rankings curve (SUCRA), comparison-adjusted funnel plot, and sensitivity analysis was performed. RESULTS Twenty-one RCTs involving 1,749 participants and nine psychological interventions were included. In terms of short-term efficacy, group self-assertiveness training ranked as most likely to reduce personal stigma (SUCRA: 97.0%, SMD: 2.15, 95% CI: 1.07 to 3.23), followed by group psychoeducation programs (SUCRA: 60.1%, SMD: 0.90, 95% CI: 0.24 to 1.55). These two interventions were significantly more effective than the treatment as usual. CONCLUSIONS Group self-assertiveness training and psychoeducation programs with higher ranks in short-term efficacy might be favorable to reduce personal stigma in patients with schizophrenia. However, the quality of evidence for pairwise comparison was rated as "very low" to "low" according to the Confidence in Network Meta-Analysis (CINeMA) approach. Further longitudinal studies with larger well-designed multicentric RCTs are needed to verify the efficacy of long-term outcomes.
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19
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Zhou M, Sun X, Huang L. Does Social Pension Expansion Relieve Depression and Decrease Medical Costs? Evidence From the Rural Elderly in China. Int J Public Health 2022; 67:1604296. [PMID: 35370536 PMCID: PMC8966648 DOI: 10.3389/ijph.2022.1604296] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: This study was designed to explore the effect of the New Rural Pension Scheme on depressive symptoms or medical costs induced by depression.Methods: We used the Logit, OLS and 2SLS models to explore the impact of the pension on depression and medical costs. We also adopt the method of quantile regression and discontinuity regression to verify the causal relationship between the New Rural Pension Scheme and depression or medical costs induced by depression of the rural elderly.Results: We have found that the New Rural Pension Scheme decreases depressive symptoms of elderly in rural China (OR = 0.90), and the medical costs induced by depressive symptoms by 4.6%. Regression discontinuity results showed that pension significantly reduced the depressive symptoms (depression) and the medical expenditure caused by depressive symptoms (depression) by using parametric and non-parametric methods, and performing a placebo test. The mediating effect results showed that pension may improve mental health by increasing confidence about the future.Conclusion: We demonstrate that the pension significantly decreased both mental health problems and the medical expenses due to depressive symptoms and depression of elderly in rural China. Therefore, our results suggest that the Chinese government should perfect the New Rural Pension Scheme to eliminate barriers to mental health resources, especially for the rural elderly.
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20
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Patra BN, Patil V, Balhara YPS, Khandelwal SK. Self-stigma in patients with major depressive disorder: An exploratory study from India. Int J Soc Psychiatry 2022; 68:147-154. [PMID: 33243067 DOI: 10.1177/0020764020975811] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND One of the barriers to effective care in patients with depression is stigma associated with having a mental disorder, which also acts as a barrier to recovery and increases the disability. AIMS To study the stigma and disabilities experienced by the patients with depressive disorders seeking treatment in a tertiary care hospital. METHODOLOGY Fifty patients diagnosed to have depressive disorder as per ICD-10 were recruited by convenient sampling. To measure the stigma, the Discrimination and Stigma Scale -12 was applied. The severity of depression was determined by applying Hamilton Depression Rating Scale (HAMD). The disability was calculated by using WHO Disability Assessment Schedule 2.0. RESULTS Fifty percentages of the participants reported unfair treatment and they experienced discrimination in at least one life domain. There was significant positive correlation between unfair treatment subscale of stigma and disability. Around one fourth of the participants reported to be treated unfairly by their own families. Seventy percent reported to have concealed their mental health problems, 54% have stopped themselves from having a close personal relationship and 32% didn't apply for work in anticipating discrimination. Experienced and anticipated discrimination were significantly associated with concealing the mental health problem. CONCLUSION Stigma due to having depression acts as a barrier to vocational & social integration and functional recovery. Concealment of the diagnosis of depression is itself barrier for help seeking and to receiving appropriate treatment. Small sample size and adopting the purposive sampling method are the limitations of the study.
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Affiliation(s)
- Bichitra Nanda Patra
- Department of Psychiatry & NDDTC, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Vaibhav Patil
- Department of Psychiatry & NDDTC, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Yatan Pal Singh Balhara
- Department of Psychiatry & NDDTC, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Sudhir K Khandelwal
- Department of Psychiatry & NDDTC, All India Institute of Medical Sciences (AIIMS), New Delhi, India.,Presently at Holy Family Hospital, Okhla, New Delhi
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21
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Chung EYH, Tse TTO. Effect of human library intervention on mental health literacy: a multigroup pretest-posttest study. BMC Psychiatry 2022; 22:73. [PMID: 35090412 PMCID: PMC8800197 DOI: 10.1186/s12888-022-03725-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/21/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Mental health literacy (MHL) is an evolving concept encompassing knowledge of mental illness, help-seeking options, perceived stigma, and discrimination. This study aimed to test the effectiveness of a human library intervention at enhancing MHL. A human library intervention was adopted to enhance MHL in this study. The human library intervention aims to establish a positive framework and safe space for dialogue between readers and a 'human book'. It works to promote dialogue, reduce prejudice, and encourage understanding of people who are regarded as disadvantaged or in a minority group. METHODS An experimental approach with a multigroup pretest-posttest design was adopted. Forty-five participants aged between 18 and 23 years were recruited and randomly assigned to the experimental group (human library intervention), comparison group (didactic teaching session), or control group (no intervention). Adapted vignette-based MHL scale scores were used as the outcome measures. The overall and subscale scores were included in the analysis. RESULTS The human library intervention group showed a significant improvement in overall MHL compared with the other two groups. In a multivariate analysis of the variance in subscale scores, the intervention was shown to significantly reduce stigma and preferred social distance, but had no significant effect on knowledge acquisition. CONCLUSIONS The human library intervention is effective at enhancing overall MHL and reducing stigma and preferred social distance. Further studies are suggested to further develop the MHL construct, human library interventions, and the MHL scales for consolidating evidence-based practice.
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Affiliation(s)
- Eva Yin-han Chung
- grid.419993.f0000 0004 1799 6254Department of Special Education and Counseling, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories Hong Kong ,grid.419993.f0000 0004 1799 6254Centre for Special Educational Needs and Inclusive Education, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Tasha Tin-oi Tse
- grid.419993.f0000 0004 1799 6254Department of Special Education and Counseling, The Education University of Hong Kong, 10 Lo Ping Road, Tai Po, New Territories Hong Kong
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22
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Lai KYC, Hung SF, Lee HWS, Leung PWL. School-Based Mental Health Initiative: Potentials and Challenges for Child and Adolescent Mental Health. Front Psychiatry 2022; 13:866323. [PMID: 35757210 PMCID: PMC9226981 DOI: 10.3389/fpsyt.2022.866323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/17/2022] [Indexed: 11/13/2022] Open
Abstract
School-based mental health support services allow children and adolescents easy access to services without requirement of traveling to clinics and hospitals. We describe a School Mental Health Support Scheme (SMHSS) piloted in Hong Kong and discuss the challenges and learnings from the experience. This conceptual paper argues that accessibility is not the only advantage of such services. Teachers are significant others in child development, alongside with families. They play a central role in impacting the children's/adolescents' needs for competence and adult attachment, while schools provide an expanded social network of peers for one's social relationship. The fulfillment of these needs has powerful implications in the mental health of the children/adolescents. Teachers can help students to develop a sense of competence with self-worth and self-identity via providing guidance and feedback, whether they be on one's strengths or weaknesses, with acceptance, tolerance and unconditional positive regard. Particularly, the latter define a form of teacher-student relationship or adult attachment that offers the children/adolescents emotional security and nourishment, protecting them from failings and adversities. Teachers can also supervise and guide their students' social development with peers at schools. A recent meta-analysis has found preliminary evidence that those school-based mental health services integrated into the teachers' routine teaching activities are more effective. Teachers, who are overworked and stressed by the schools' overemphasis on academics and grades, have yet to fully grasp their unique roles in supporting students with mental health needs. This paper ends by advocating a paradigm shift in which both the healthcare professionals and educators should forge a mutually beneficial collaboration in jointly enhancing the mental health of children/adolescents at schools.
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Affiliation(s)
- Kelly Y C Lai
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Se-Fong Hung
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hannah W S Lee
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Patrick W L Leung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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23
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Wu C, Chen M, Rong J, Liu C. Developing an assessment tool for geropsychiatric mental healthcare knowledge and attitude evaluations in clinical practice for nursing students. Nurs Open 2021; 8:1678-1687. [PMID: 33606917 PMCID: PMC8186687 DOI: 10.1002/nop2.802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 12/14/2020] [Accepted: 01/29/2021] [Indexed: 11/07/2022] Open
Abstract
AIM To develop an instrument to investigate geropsychiatric psychological symptoms, health problem nursing knowledge (GPN-K), geropsychiatric psychological symptoms and health problem nursing attitude scale (GPN-A) in clinical practice for nursing students. DESIGN Instrument development and cross-sectional study for psychometric testing. METHODS Construct validity was evaluated using confirmatory factor analysis (CFA) and exploratory factor analysis (EFA), and internal consistency was calculated using Cronbach's α. RESULTS A total of 300 students have completed the questionnaires (85.71% response rate). The CFA of GPN-K showed good fitness and validity. The Kuder-Richardson 20 (KR-20) value of the internal consistency reliability is 0.64. The GPN-A overall content validity index is 0.95. A three-factor structure was shown by exploratory factor analysis. The three factors are communication and care, helping others improve and problem evaluation tendency. The total variance explained is 59.01%. Cronbach's alpha of GPN-A equals 0.84, which represents good internal consistency.
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Affiliation(s)
- Chia‐Shan Wu
- Department of NursingNational Tainan Junior College of NursingTainan CityTaiwan, R.O.C.
| | - Mei‐Fang Chen
- Department of NursingNational Tainan Junior College of NursingTainan CityTaiwan, R.O.C.
| | - Jiin‐Ru Rong
- School of NursingNational Taipei University of Nursing and Health SciencesTaipei CityTaiwan, R.O.C.
| | - Chieh‐Yu Liu
- Biostatistical Consultant Lab.Department of Language Pathology and AudiologyNational Taipei University of Nursing and Health SciencesTaipei CityTaiwan, R.O.C.
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24
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Abo-Rass F, Werner P, Shinan-Altman S. Self-stigma formation process among younger and older Israeli Arabs diagnosed with depression. Aging Ment Health 2021; 25:1071-1076. [PMID: 32347106 DOI: 10.1080/13607863.2020.1758901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Self-stigma is common among persons with depression. Still, studies that examined the process of self-stigma concentrated mostly on younger adults (ages 18-65) with mental illness in general, with a limited number of studies examining older adults with depression. This study was aimed to examine and compare the self-stigma formation process and its relation to self-esteem among younger (ages 18-64) and older Israeli Arabs (age 65+) diagnosed with depression. The study was based on a self-stigma model which defines the self-stigma formation process as composed of three stages: stereotypes awareness, stereotype agreement, and self-concurrence. METHOD A total of 160 younger and older Israeli Arabs with depression completed measures of self-stigma formation process, self-esteem, and socio-demographic and health characteristics. RESULTS The self-stigma formation process was found as a multi-level and progressive model for both younger and older adults, despite that older adults reported significantly higher levels of self-stigma in all stages of the process. Low self-esteem was significantly associated with higher levels of stereotype agreement and self-concurrence in both age groups. CONCLUSION The self-stigma formation process provides an adequate model for understanding depression self-stigma in both younger and older adults. Appropriate intervention programs aiming to reduce self-stigma should be developed, focusing on reducing the three stages of self-stigma.
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Affiliation(s)
- Fareeda Abo-Rass
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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25
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van Netten WJ, van Dorst M, Waltz M, Pandey B, Aley D, Choudhary R, van Brakel W. Mental wellbeing among people affected by leprosy in the Terai region, Nepal. LEPROSY REV 2021. [DOI: 10.47276/lr.92.1.59] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Lyon AS, Mortimer-Jones SM. The Relationship between Terminology Preferences, Empowerment and Internalised Stigma in Mental Health. Issues Ment Health Nurs 2021; 42:183-195. [PMID: 32605415 DOI: 10.1080/01612840.2020.1756013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. However, people who are empowered may actively challenge stigma by engaging in meaningful opportunities, furthering their self-worth as they achieve control within their lives. People who are empowered through active treatment participation are more likely to reach recovery goals and experience the benefits of evidence-based practices. Hence, empowerment can be viewed as essential to the recovery and well-being of people with a mental illness. Participants in this quantitative study (N = 173) were diagnosed with a mental illness and were recruited via convenience sampling from mental health support groups in Australia. Internalised stigma was less common and empowerment more prevalent in this study than was found in previous studies. However high internalised stigma and low empowerment were present. The terms 'individual' and 'person with lived experience' which have been identified as the preferred terms in a previous study were highlighted as both empowering and recovery focussed.
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Affiliation(s)
- Andrea Sam Lyon
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia
| | - Sheila Mary Mortimer-Jones
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Australia.,School of Nursing & Midwifery, Edith Cowan University, Joondalup, Australia
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27
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Yu HZ, Fu T, Zhou JN, Ke P, Wang YX. More Depression-Related Public Concern After the Suicide of a Pop Star in China: Evidence From the Online Big Data Platform. Front Psychiatry 2021; 12:629904. [PMID: 33889095 PMCID: PMC8055860 DOI: 10.3389/fpsyt.2021.629904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/03/2021] [Indexed: 12/14/2022] Open
Abstract
Background: In China, we have seen dramatic increases in public concern over depression and mental health after the suicide of some famous persons. The objective of this study is to investigate the changes of search-engine query patterns to monitor this phenomenon based on the tragic suicide of a young Chinese pop star, Kimi Qiao. Methods: The daily search volume for depression was retrieved from both the Baidu Index (BDI) and the Sina MicroBlog Index (SMI). Besides, the daily BDI for suicide, schizophrenia, obsessive-compulsive disorder, common cold, stomach cancer, and liver cancer were collected for comparison. According to the time of Qiao's suicide, all data were divided into two periods (i.e., Period One from 1 September 2015 to 31 August 2016 while Period Two ranged from 1 October 2016 to 30 September 2017). The paired t-test was used to compare the differences in search volumes between two periods. The Pearson correlation analysis was used to estimate correlations between the BDI and SMI for depression. Results: The average BDI for depression, BDI for suicide, and SMI for depression in Period Two were significantly higher than in Period One (p < 0.05). There was a strong positive correlation between the BDI and SMI for depression (r = 0.97, p < 0.001). And no significant difference in BDI for other diseases between the two periods was found. Conclusions: The changes of search-engine query patterns indicated that the celebrity's suicide might be able to improve the netizens' concern about depression in China. The study suggests publishing more practical knowledge and advice on depression through the Internet and social media, to improve the public's mental health literacy and help people to cope with their depressive symptoms appropriately.
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Affiliation(s)
- Hong-Zhang Yu
- Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Tian Fu
- Third Xiangya Hospital of Central South University, Changsha, China
| | - Jia-Nan Zhou
- Faculty of Psychology, Naval Medical University, Shanghai, China
| | - Ping Ke
- Air Force Hangzhou Special Service Recuperation Center Sanatorium Area 3, Hangzhou, China
| | - Yun-Xia Wang
- Faculty of Psychology, Naval Medical University, Shanghai, China
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28
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Manor-Binyamini I. Internalized Stigma among Bedouin and Jews with Mental Illness: Comparing Self-Esteem, Hope, and Quality of Life. Psychiatr Q 2020; 91:1381-1393. [PMID: 32418139 DOI: 10.1007/s11126-020-09758-x] [Citation(s) in RCA: 4] [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: 11/29/2022]
Abstract
The aim of this study was to assess the differences in internalized-stigma, self-esteem, hope, and quality of life in individuals with mental illness from two diverse cultures (Bedouins and Jews) and to examine the relationships between self-stigma and self-esteem, hope, and quality of life in participants from both cultures. Two hundred participants with mental illness in Israel were assessed on the Internalized Stigma of Mental Illness (ISMI) scale. The Arab Bedouin participants tended to internalize stigma to a greater extent than the Jewish participants. Overall, there was a significant negative correlation between self-stigma, self-esteem, and hope and between alienation and quality of life in both groups although the correlation was stronger among the Arab Bedouin participants. By contrast, the associations between self-stigma and quality of life were only significant for two of the self-stigma dimensions (alienation and discrimination) among the Jewish participants. These results contribute to a better understanding of the role internalized stigma may play in the life of people with mental illness from diverse cultures. They may help design culturally appropriate intervention programs for people with mental illness.
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Affiliation(s)
- Iris Manor-Binyamini
- Department of Special Education, University of Haifa, 199 Aba Khoushy Ave. Mount Carmel, 3498838, Haifa, Israel.
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Ng SM, Fung MHY, Gao S. High level of expressed emotions in the family of people with schizophrenia: has a covert abrasive behaviours component been overlooked? Heliyon 2020; 6:e05441. [PMID: 33210009 PMCID: PMC7658711 DOI: 10.1016/j.heliyon.2020.e05441] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/23/2020] [Accepted: 11/04/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND High expressed emotion (EE) in a patient's family is a known risk factor of relapse in schizophrenia. The three components of high EE - criticism, hostility and emotional over-involvement - were developed through a data-driven approach and a focus on overt abrasive behaviours. The influence of covert abrasive behaviours has not been explored. AIMS AND METHODS This study aims to explore both overt and covert abrasive behaviours through semi-structured interviews conducted with 22 people with schizophrenia, who were recruited through iterative purposive sampling. RESULTS Thematic analysis suggests that participants' experiences of overt abrasive behaviours resonate with the three-factor structure of high EE, except "emotional over-involvement" is renamed to "over-involvement" to focus on behaviours and embrace different levels or types of emotional reactions. Regarding covert abrasive behaviours, two domains are proposed: disassociation and apathy, which focus on family members' disengaging actions and indifferent attitudes respectively. While both overt and covert abrasive behaviours cause psychological distresses and behavioural reactions on the participants, their precise impacts are not entirely the same. CONCLUSION People with schizophrenia experience both overt and covert abrasive behaviours with family members. The findings of this study may expand the conceptualization of high EE, enhance its content validity, and provide an extended conceptual framework for developing more comprehensive measures.
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Affiliation(s)
- Siu-Man Ng
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - Melody Hiu-Ying Fung
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
| | - Siyu Gao
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong
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Initial validation of the help-seeker stereotype scale in a Chinese cultural context: A bifactor model. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-00703-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tesfaye E, Worku B, Girma E, Agenagnew L. Internalized stigma among patients with mood disorders in Ethiopia: a cross-sectional facility-based study. Int J Ment Health Syst 2020; 14:32. [PMID: 32399059 PMCID: PMC7204044 DOI: 10.1186/s13033-020-00365-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/29/2020] [Indexed: 11/22/2022] Open
Abstract
Background Information on the degree of internalized stigma experienced by patients with mood disorders in Ethiopia is limited. This study attempted to assess the levels of internalized stigma and factors associated with it in patients with mood disorders who were on follow-up as an outpatient in a Psychiatry clinic at Saint Paul’s Hospital, Addis Ababa, Ethiopia. Methods A facility-based cross-sectional study employed, and a consecutive sampling technique was used to get study participants (235 cases with mood disorders). Internalized stigma of mental illness scale used to assess stigma of study subjects. The collected data were cleaned, checked for completeness, coded and entered into Epi-data version 3.1 data entry software and exported to SPSS version 20 statistical software for analysis. Univariate linear regression analysis was done to see the association between dependent and independent variables at P-value < 0.25 and multivariate linear regression analysis was done to identify predictor variables at P-value < 0.05. Results Nearly one-third (31.5%) of the patients had moderate or high levels of internalized stigma, and more than half (54.9%) of the respondents had moderate or high stigma resistance and self-esteem score of (67.2%). About a quarter (27.7%) had moderate to high levels of discrimination experience and a similar proportion (26.4%) had moderate to severe or extreme disability. Females had significantly higher internalized stigma (std. β = .169 with P < 0.01) than men. Adherence to medication was significantly correlated with lower internalized stigma (std. β = − .212 with P < 0.01). Conclusions These findings suggested that moderate to high internalized stigma occurred among approximately 1 in 3 people with a mood disorder in the urban city of Ethiopia. So, working on adherence to medication, self-esteem of patients and psycho-education about stigma is crucial to reducing the internalized stigma of people with a mood disorder and special attention should give to female patients.
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Affiliation(s)
- Elias Tesfaye
- 1Department of Psychiatry, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Benyam Worku
- 2Department of Psychiatry, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Eshetu Girma
- 3Department of Preventive Medicine, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
| | - Liyew Agenagnew
- 1Department of Psychiatry, Faculty of Medical Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
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Chen Y, Thissen D, Anand D, Chen LH, Liang H, Daughters SB. Evaluating Differential Item Functioning (DIF) of the Chinese Version of the Behavioral Activation for Depression Scale (C-BADS). EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2020. [DOI: 10.1027/1015-5759/a000525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Depression is prevalent in both China and Taiwan, and Behavioral Activation (BA), an Evidence-Based Treatment (EBT) for depression, is ideally suited for cross cultural implementation. As a first step, the current study examined cross cultural differences in the understanding of BA constructs, by investigating item level differences in functioning between the English and Chinese versions of Behavioral Activation for Depression Scale (BADS and C-BADS; Kanter, Mulick, Busch, Berlin, & Martell, 2007 ; Li, Ding, Kanter, Zeng, & Yang, 2014) . 752 college students were recruited from China, Taiwan, and the United States. Factorial invariance-based Differential Item Functioning (DIF) analysis was used to study item level differences in functioning for the BADS and C-BADS. Results. DIF was observed in the majority of BADS items, with items in the avoidance and impairment factors showing the greatest DIF. The constructs of avoidance and impairment demonstrate less cross-cultural generalizability compared to the activation construct. Suggestions for the implementation of DIF analysis for future cross cultural psychometric studies, and further modification of the C-BADS as a clinical assessment tool in China and Taiwan, are discussed.
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Affiliation(s)
- Yun Chen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, USA
| | - David Thissen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, USA
| | - Deepika Anand
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, USA
| | - Lung Hung Chen
- Department of Positive Sport & Leisure Psychology, National Taiwan Sport University, Taiwan
| | - Hong Liang
- Department of Political Science, Huazhong University of Science and Technology, Wuhan, PR China
| | - Stacey B. Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, NC, USA
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González-Domínguez S, González-Sanguino C, Muñoz M. Efficacy of a combined intervention program for the reduction of internalized stigma in people with severe mental illness. Schizophr Res 2019; 211:56-62. [PMID: 31351829 DOI: 10.1016/j.schres.2019.07.010] [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: 03/26/2019] [Revised: 06/13/2019] [Accepted: 07/07/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Internalized stigma (IS) is a key factor in the recovery, quality of life and functioning of people with severe mental illness (SMI), and effective intervention programs are needed to reduce IS in all its dimensions. The aim of this report was to design and evaluate the effectiveness of a new psychological intervention group program for the reduction of IS in people with SMI. METHODS A 9-session hands-on intervention program was designed with a group format in which different therapeutic techniques were combined. To evaluate the effectiveness of the program, 80 people with SMI and high levels of IS were selected and randomly assigned to one of two groups: program (n = 41, experimental group) or conventional treatment (n = 39, control group). RESULTS Mixed analysis of variance showed improvements in total IS and all of its dimensions (cognitive, emotional and behavioral) (p ≤ 0.01) and in depressive symptomatology (p = 0.01) in the experimental group after the treatment phase. CONCLUSION The results indicate that the program effectively reduces IS and its dimensions as well as other relevant associated variables in a sample of people with SMI.
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Affiliation(s)
- Sara González-Domínguez
- School of Psychology, Department of Personality, Evaluation and Clinical Psychology, University Complutense of Madrid
| | - Clara González-Sanguino
- School of Psychology, Department of Personality, Evaluation and Clinical Psychology, University Complutense of Madrid.
| | - Manuel Muñoz
- School of Psychology, Department of Personality, Evaluation and Clinical Psychology, University Complutense of Madrid
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Ebrahimi H, Movaghari MR, Bazghaleh M, Shirmohammadi N, Mohammadpourhodki R. Parental attitude toward children's mental disorders and its relationship with help seeking behaviors. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2019; 16:/j/jcim.ahead-of-print/jcim-2018-0244/jcim-2018-0244.xml. [PMID: 31433784 DOI: 10.1515/jcim-2018-0244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 03/09/2019] [Indexed: 02/05/2023]
Abstract
Background The purpose of the study was to assess parent's attitudes toward mental illness in children and its relationship with help seeking behaviors. Method This cross-sectional study was conducted in a pediatric psychiatric clinic of under affiliation of Tehran University of Medical Sciences in 2016-2017. All children's parents or guardians who referred for the first time to the clinics were the study population. Convenient sampling was applied and 400 subjects were included by survey method. The data collection tool for this study included a form for demographic data, a questionnaire for assessing parents' attitude toward the causes, behavioral demonstrations and treatment of mental disorders in children, and finally a checklist to determine help seeking behaviors. Descriptive and inferential statistics was applied with SPSS software version 16 for data analysis. Results Of the parents, 93.7% had a good attitude toward mental illness in the three studied realms. Of the parents, 56.25% referred to official sources of help. The results of this research showed that there was a significant difference between the mean scores of parents' attitude (sum of the three areas) in terms of child's gender, parents' marital status, father's job, father's education, and mother's education and there was a significant relationship between help seeking behavior of parents just with fathers' education level (p<0.05). Conclusions The results showed that parents had a good attitude toward their children's mental disorders. However, it should not be overlooked that nearly half of the parents were still referring to unofficial sources of assistance.
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Affiliation(s)
- Hossein Ebrahimi
- Center for Health Related social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Reza Movaghari
- Department of Nursing, School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Bazghaleh
- Department of Nursing, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Nasim Shirmohammadi
- Department of Nursing, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Mohammadpourhodki
- Department of Nursing, School of Nursing & Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Patra S, Kumar Patro B. Affiliate stigma among parents of children with autism in eastern India. Asian J Psychiatr 2019; 44:45-47. [PMID: 31315059 DOI: 10.1016/j.ajp.2019.07.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 07/08/2019] [Accepted: 07/08/2019] [Indexed: 12/17/2022]
Abstract
Parents of children with autism experience high levels of stigma. They often internalize stigma which results in high psychological distress and has negative impact on seeking and providing care. Qualitative methodology has been used to study stigma in Indian population while quantitative studies have not been reported. The authors report affiliate stigma perception among parents of children with autism in a tertiary care medical centre using Affiliate Stigma Scale. Thirty-eight parents participated in this cross- sectional study. We discuss predictors of stigma in terms of caregiver characteristics and symptom profile. Identification of predictors of stigma perception can help in identifying populations at risk.
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Moore KE, Stein MD, Kurth ME, Stevens L, Hailemariam M, Schonbrun YC, Johnson JE. Risk Factors for Self-stigma among Incarcerated Women with Alcohol Use Disorder. STIGMA AND HEALTH 2019; 5:158-167. [PMID: 33102697 DOI: 10.1037/sah0000182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Alcohol use disorder (AUD) is a highly stigmatized condition, often associated with negative stereotypes such as being morally weak, incompetent, unpredictable, and aggressive. People with AUD are at risk of experiencing self-stigma, a social-cognitive experience in which people think others hold negative stereotypes about them, expect to be treated unfairly, and/or believe that negative stereotypes are personally accurate. Women in the criminal justice system with AUD in particular are at risk of experiencing self-stigma due to intersecting sources of disadvantage. Given that self-stigma can lead to treatment avoidance and dropout, it is important to understand risk factors for self-stigma to inform prevention and intervention efforts in the justice system. Incarcerated women with AUD (n=185) completed measures of alcohol self-stigma as well as a variety of theoretically relevant risk factors including sociodemographics, baseline levels of stress and depression, and alcohol-related factors (i.e., length of drinking history, frequency/amount of use, consequences of use, physician advice to stop, belief that legal involvement is related to alcohol use, alcohol-related charges, self-efficacy to quit, readiness for treatment, pressures to enter treatment, factors that influence treatment) and other stigmatized conditions (drug use, exchanging sex, and homelessness). Results showed that experiencing more consequences of alcohol use, pressures to enter treatment, and perceived stress were associated with internalized stigma and anticipated/enacted stigma. This study begins to identify which incarcerated women with AUD are most at risk of experiencing self-stigma that may interfere with alcohol treatment.
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Affiliation(s)
- Kelly E Moore
- East Tennessee State University, Department of Psychology, 420 Rogers-Stout Hall P.O. 70649, Johnson City, TN 37614
| | - Michael D Stein
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
- Boston University School of Public Health, Department of Health Law, Policy & Management, 715 Albany Street, Boston, MA 02118
| | - Megan E Kurth
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
| | - Lindsey Stevens
- Brown University Medical School, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906
| | - Maji Hailemariam
- Michigan State University, Division of Public Health, College of Human Medicine, 200 East 1st St., Flint, MI 48502
| | - Yael C Schonbrun
- Butler Hospital, Behavioral Medicine and Addictions Research, 345 Blackstone Blvd. Providence, RI 02906
- Brown University Medical School, Department of Psychiatry and Human Behavior, 345 Blackstone Boulevard, Providence, RI 02906
| | - Jennifer E Johnson
- Michigan State University, Division of Public Health, College of Human Medicine, 200 East 1st St., Flint, MI 48502
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Chan KKS, Fung WTW. The impact of experienced discrimination and self-stigma on sleep and health-related quality of life among individuals with mental disorders in Hong Kong. Qual Life Res 2019; 28:2171-2182. [DOI: 10.1007/s11136-019-02181-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2019] [Indexed: 01/12/2023]
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Cheng CM, Chang CC, Wang JD, Chang KC, Ting SY, Lin CY. Negative Impacts of Self-Stigma on the Quality of Life of Patients in Methadone Maintenance Treatment: The Mediated Roles of Psychological Distress and Social Functioning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16071299. [PMID: 30978986 PMCID: PMC6480473 DOI: 10.3390/ijerph16071299] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 04/01/2019] [Accepted: 04/06/2019] [Indexed: 12/11/2022]
Abstract
A sample of heroin users (n = 250) in methadone maintenance treatment (MMT) was used in this cross-sectional study to clarify the mechanisms of the effects of stigma on quality of life (QoL) through psychological distress and social functioning. All the participants had their self-stigma, psychological distress, social functioning, and QoL measured. Psychological distress and social functioning were proposed to be mediators between self-stigma and QoL. Several linear models using structural equation modeling were conducted to examine the mediated effects. The negative effects of self-stigma on QoL were significantly mediated by psychological distress, as self-stigma directly and significantly influenced psychological distress, but not social functioning. This study demonstrated a linear model describing the effects of self-stigma on QoL for opioid-dependent individuals; psychological distress was also an important mediator between self-stigma and their QoL. Clinicians were able to notice the importance of reducing self-stigma for opioid-dependent individuals according to the following results: higher levels of self-stigma were associated with high psychological distress, decreased social functioning, and impaired QoL. Our mediation findings suggest that treating psychological distress is better than treating social functioning if we want to eliminate the effects of self-stigma on QoL for heroin users.
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Affiliation(s)
- Ching-Ming Cheng
- Jianan Psychiatric Center, Ministry of Health and Welfare, No. 80, Ln. 870, Zhongshan Rd., Rende Dist., Tainan 71742, Taiwan.
- Department of Natural Biotechnology, College of Science and Technology, Nanhua University, Chiayi 62249, Taiwan.
| | - Chih-Cheng Chang
- Department of Psychiatry, Chi Mei Medical Center, Tainan 70246, Taiwan.
- Department of Health Psychology, Chang Jung Christian University, Tainan 71101, Taiwan.
- Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
| | - Jung-Der Wang
- Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan.
| | - Kun-Chia Chang
- Jianan Psychiatric Center, Ministry of Health and Welfare, No. 80, Ln. 870, Zhongshan Rd., Rende Dist., Tainan 71742, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan.
| | - Shuo-Yen Ting
- Chang-Hua Hospital, Ministry of Health and Welfare, Puxin Township, Changhua County, Puhsin 51341, Taiwan.
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
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Karaffa KM, Hancock TS. Mental Health Stigma and Veterinary Medical Students' Attitudes Toward Seeking Professional Psychological Help. JOURNAL OF VETERINARY MEDICAL EDUCATION 2019; 46:459-469. [PMID: 30920943 DOI: 10.3138/jvme.1217-185r] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Veterinary medical students may be at increased risk for a variety of mental health problems. However, research with student samples suggests that students in distress may not seek professional help, even when mental health services are available. The purpose of this study was to explore veterinary students' willingness to seek mental health services for several common presenting concerns, as well as their perceptions of their peers' willingness to seek help for the same concerns. We also sought to explore the roles of public stigma, self-stigma, and attitudes toward seeking professional psychological help in explaining students' willingness to seek services using a serial mediation analysis. Study participants were 573 veterinary medical students currently enrolled in accredited programs in the United States. Participants reported being most willing to seek mental health services for issues regarding substance abuse, traumatic experiences, and anxiety. They also tended to perceive other students were less willing to seek mental health services for most presenting issues than they actually were. As expected, self-stigma and attitudes toward seeking professional psychological help serially mediated the relationship between public stigma and willingness to seek mental health services. Public stigma was positively related to self-stigma, self-stigma was negatively related to attitudes toward seeking professional psychological help, and attitudes toward seeking help were positively related to willingness to seek mental health services. Implications for outreach, research, and education are discussed.
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Au CH, Wong CSM, Law CW, Wong MC, Chung KF. Self-stigma, stigma coping and functioning in remitted bipolar disorder. Gen Hosp Psychiatry 2019; 57:7-12. [PMID: 30654294 DOI: 10.1016/j.genhosppsych.2018.12.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/13/2018] [Accepted: 12/18/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Stigma has a deleterious effect on functioning in individuals with bipolar disorder (BD). However, there has been no research investigating how stigma coping predicts self-stigma and functioning in BD. Furthermore, how different stages of self-stigma might affect functioning is unclear. The following hypotheses were examined: (1) Stigma coping by withdrawal and secrecy was associated with more self-stigma; (2) Stigma coping by withdrawal and secrecy was associated with worse social functioning; and (3) Later stages of self-stigma were associated with worse social functioning. METHODS A random sample of remitted BD in a regional psychiatric clinic was examined using a cross-sectional design (n = 115). Self-stigma was measured using the Chinese versions of Self-Stigma of Mental Illness Scale (C-SSMIS). Social functioning was assessed using the Functional Assessment Short Test (FAST). Stigma coping was evaluated using the Stigma Coping Orientation Scale (SCOS). RESULTS Multiple regression analysis revealed that coping by secrecy was associated with the stereotype agreement subscale of C-SSMIS, while coping by withdrawal was associated with the C-SSMIS self-concurrence and self-esteem decrement subscales. Another regression analysis showed that FAST total score was associated with the self-esteem decrement subscale of C-SSMIS and the severity of depressive and manic symptoms. CONCLUSION We showed that self-esteem decrement, the final stage of self-stigma, was the most crucial stage in determining psychosocial functioning. Our findings suggested that stigma-reduction intervention should be arranged during the early stage of BD and targeted at various dysfunctional stigma coping.
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Affiliation(s)
- Chi-Hung Au
- Department of Psychiatry, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Corine Sau-Man Wong
- Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region
| | - Chi-Wing Law
- Department of Psychiatry, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Ming-Cheuk Wong
- Department of Psychiatry, Queen Mary Hospital, Hong Kong Special Administrative Region
| | - Ka-Fai Chung
- Department of Psychiatry, Queen Mary Hospital, Hong Kong Special Administrative Region; Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region; Centre on Behavioral Health, University of Hong Kong, Hong Kong Special Administrative Region.
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Yang LH, Grivel MM, Anderson B, Bailey GL, Opler M, Wong LY, Stein MD. A new brief opioid stigma scale to assess perceived public attitudes and internalized stigma: Evidence for construct validity. J Subst Abuse Treat 2019; 99:44-51. [PMID: 30797393 DOI: 10.1016/j.jsat.2019.01.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/03/2019] [Accepted: 01/03/2019] [Indexed: 01/23/2023]
Abstract
One key strategy to improve treatment access for persons with opioid use disorder (OUD) is overcoming stigma that is internalized by such individuals. Because few theoretically-derived, multidimensional measures of substance abuse stigma exist, we contribute a brief, theoretically-based measure of opioid-related stigma (adapted from Corrigan's Self-Stigma of Mental Illness Scale) to assess perceived stigma and internalized stigma among individuals with OUD. This study presents initial validation of the newly-developed Brief Opioid Stigma Scale among 387 adults who entered an inpatient opioid managed-withdrawal program. The scale assesses: (1) Stereotype awareness ("Aware"), or the extent to which individuals who use opioids perceive community members to believe OUD-related stereotypes; (2) Stereotype agreement ("Agree"), or the endorsement of stigmatizing beliefs by individuals who use opioids; (3) Self-esteem decrement ("Harm"), or the diminution of self-esteem due to these negative stereotypes' impacts on self-worth. Psychosocial measures including self-esteem, depressive symptoms, mental and physical functioning, and desire for aftercare OUD medication treatment, were administered to assess construct validity. Results showed that greater endorsement of the "harm" stigma subscale was associated with greater depressive symptoms, lower self-esteem, and poorer mental and physical functioning. The "aware" stigma subscale displayed similar overall patterns of associations with self-esteem and depression but to a lesser magnitude. The "aware" stigma subscale was positively associated with desire for aftercare methadone and naltrexone treatment, and the "harm" subscale was positively associated with desire for aftercare buprenorphine treatment. Results indicated good initial construct validity. Tailored stigma interventions are recommended for specific aftercare OUD medication treatments.
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Affiliation(s)
- Lawrence H Yang
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, NY, USA.
| | - Margaux M Grivel
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, NY, USA
| | | | - Genie L Bailey
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Stanley Street Treatment & Resources, Inc., Fall River, MA, USA
| | | | | | - Michael D Stein
- Butler Hospital, Providence, RI, USA; Boston University School of Public Health, Boston, MA, USA
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Chen X, Wang T, Busch SH. Does money relieve depression? Evidence from social pension expansions in China. Soc Sci Med 2018; 220:411-420. [PMID: 30530234 DOI: 10.1016/j.socscimed.2018.12.004] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 10/22/2018] [Accepted: 12/03/2018] [Indexed: 11/29/2022]
Abstract
We estimate the impact of pension enrollment on mental well-being using China's New Rural Pension Scheme (NRPS), the largest existing pension program in the world. Since its launch in 2009, more than 400 million Chinese have enrolled in the NRPS. We first describe plausible pathways through which pension may affect mental health. We then use the national sample of China Family Panel Studies (CFPS) to examine the effect of pension enrollment on mental health, as measured by CES-D and self-reported depressive symptoms. To overcome the endogeneity of pension enrollment or of income change on mental health, we exploit geographic variation in pension program implementation. Results indicate modest to large reductions in depressive symptoms due to pension enrollment; this effect is more pronounced among individuals eligible to claim pension income, among populations with more financial constraints, and among those with worse baseline mental health. Our findings hold for a rich set of robustness checks and falsification tests.
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Affiliation(s)
- Xi Chen
- Department of Health Policy and Management, Yale School of Public Health, USA; Department of Economics, Yale University, USA.
| | - Tianyu Wang
- School of Labor and Human Resources, Renmin University of China, China.
| | - Susan H Busch
- Department of Health Policy and Management, Yale School of Public Health, USA; Institution for Social and Policy Studies, Yale University, USA.
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Lovell B, A Wetherell M. Caregivers' characteristics and family constellation variables as predictors of affiliate stigma in caregivers of children with ASD. Psychiatry Res 2018; 270:426-429. [PMID: 30316169 DOI: 10.1016/j.psychres.2018.09.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 09/14/2018] [Accepted: 09/22/2018] [Indexed: 10/28/2022]
Abstract
Affiliate stigma is one risk factor for psychological distress in familial caregivers. Few studies however, and none involving caregivers in the UK and US, have explored caregivers' characteristics and family constellation variables as risk and protective factors for affiliate stigma. This study aimed to fill this gap. Moreover, we believe this study is only second to explore these relationships among caregivers of children with autism spectrum disorder (ASD), a group particularly vulnerable to affiliate stigma. A sample of n = 192 caregivers of children with ASD completed an online survey assessing caregivers' characteristics and family factors, and affiliate stigma. Non-partnered caregivers were more likely to report affiliate stigma, as were caregivers with shorter sleep duration. These findings might help clinicians and other health professionals identify caregivers at risk for affiliate stigma and concomitant psychological distress.
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Affiliation(s)
- Brian Lovell
- Northumbria University, Northumberland Road Newcastle upon Tyne NE1 8ST, United Kingdom.
| | - Mark A Wetherell
- Northumbria University, Northumberland Road Newcastle upon Tyne NE1 8ST, United Kingdom.
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44
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Shen Y, Chan BSM, Liu J, Meng F, Yang T, He Y, Lu J, Luo X, Zhang XY. Estimated prevalence and associated risk factors of attention deficit hyperactivity disorder (ADHD) among medical college students in a Chinese population. J Affect Disord 2018; 241:291-296. [PMID: 30142587 DOI: 10.1016/j.jad.2018.08.038] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND To investigate the prevalence of attention deficit hyperactivity disorder (ADHD) among medical college students in a Chinese population. METHODS A cross-sectional design was used to collect demographic data on participants and their symptoms of ADHD, anxiety, and depression. Data were collected through questionnaires filled out on a computer or through WeChat, a widely used social media app. RESULTS The prevalence of ADHD among 5693 college students was 3.5% (3.02∼3.98%). Individuals with ADHD showed higher scores on scales of anxiety and depression symptoms (both p < 0.05) than the general population. There was a significant difference in the prevalence of ADHD grouped by smoking, drinking, suicidal ideation, suicidal plans, suicidal attempt, anxiety and depression (p < 0.05). The odds ratio (OR) of ADHD was high for suicidal ideation, suicide plans, suicide attempts, anxiety and depression, with ORs of 5.901, 5.46, 6.011, 8.037 and 7.88, respectively. The ORs of suicidal behaviors for ADHD were decreased after adjusting for covariates such as drinking, smoking and depression. LIMITATIONS The sample was exclusively selected from three medical-related colleges, which might not be best representation of college students in China. Furthermore, majority of the participants were females. CONCLUSIONS ADHD remains a common disorder among Chinese medical college students and is significantly associated with suicidal behaviors, anxiety and depression. It is important to increase awareness and promote effective interventions to this particular population.
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Affiliation(s)
- Yanmei Shen
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Bella Siu Man Chan
- The Department of Educational and Counselling Psychology, and Special Education, The University of British Columbia, Vancouver, Canada
| | - Jianbo Liu
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Fanchao Meng
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Tingyu Yang
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Yuqiong He
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China
| | - Jianping Lu
- Department of Child and Adolescent Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen, China
| | - Xuerong Luo
- Department of Psychiatry, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China; Mental Health Institute of Central South University, China National Clinical Research Center on Mental Disorders (Xiangya), China National Technology Institute on Mental Disorders, Hunan Technology Institute of Psychiatry, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan 410011, China.
| | - Xiang Yang Zhang
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, UT Houston Medical School, Houston, Texas, USA; Institute of Psychology, Chinese Academy of Sciences, Beijing, China.
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45
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Ren Z, Zhang P, Wang H, Wang H. Qualitative research investigating the mental health care service gap in Chinese burn injury patients. BMC Health Serv Res 2018; 18:902. [PMID: 30486854 PMCID: PMC6263539 DOI: 10.1186/s12913-018-3724-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 11/16/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Psychological disturbances are prevalent in people with burn injuries; however, psychological services are rarely accessiblepost-burn injury in China. The objective of this qualitative study was to explore and conceptualize the obstacles to delivering mental health care in burn injury patients. METHODS The researchers used a grounded theory research approach to interview sixteen burn injury patients, five nurses, four rehabilitation therapists, five medical doctors, and eight caregivers regarding their experiences with current health care services and barriers. RESULTS An explorative model was generated from the data, and the relationships among the categories were identified. People's beliefs, knowledge, socioeconomic status, cultural understanding of mental health, and social stigma appear to play key roles in the public health approach to post-burn health promotion and post-burn psychosocial interventions. CONCLUSION The model proposed in our research highlights the need to focus on the underlying social, economic, and cultural determinants of mental health care. The underlying social determinants of the mental health care gap that is responsible for the ill-prepared health care must be addressed.
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Affiliation(s)
- Zhengjia Ren
- Department of Clinical Psychology, The First Affiliated Hospital to Army Medical University (Third Military Medical University), Chongqing, China
| | - PeiChao Zhang
- Research Center for Modern Psychology, Wuhan University, Wuhan, China
| | - HongTao Wang
- Department of Burn and Cutaneous Surgery, Burn Centre of the People Liberation Army, The First Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Hongyan Wang
- Department of Cadre Ward, Navy General Hospital, Beijing, 100048 China
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46
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Primary care patient beliefs and help-seeking preferences regarding depression in China. Psychiatry Res 2018; 269:1-8. [PMID: 30144669 DOI: 10.1016/j.psychres.2018.08.031] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 08/09/2018] [Accepted: 08/12/2018] [Indexed: 12/20/2022]
Abstract
Patient beliefs about depression and its treatment in primary care clinics in China influence the delivery of care. Our objective was to investigate primary care patients' beliefs about depression and its treatment as well as help-seeking preferences regarding depression in China to aid in the development and promotion of interventions that are acceptable to patients with depression. 100 primary care nurses used the Public Knowledge and Beliefs Survey Package (PKBSP) to assess patients in the primary care clinic waiting rooms. Of the 2639 patients, 15.5% were depressed. Patients with higher education level were less likely to be depressed. Differences in beliefs were significantly associated with age, education level and depression status, but no significant differences were found on gender. Help-seeking preferences were also significantly associated with age, education level and depression status. Patients screened with PHQ-9 positive depression were less willing to endorse "take antidepressants" and "consult a non-medical practitioner" than non-depressed patients. However, they were more willing to endorse "consult a psychotherapist". Patient beliefs about depression and its treatment highlight a need for modification of current paradigms, practices, and approaches to improve the acceptability of depression care provision. Efforts to increase collaboration between primary care physicians and mental health professionals are needed.
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47
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Fox AB, Earnshaw VA, Taverna EC, Vogt D. Conceptualizing and Measuring Mental Illness Stigma: The Mental Illness Stigma Framework and Critical Review of Measures. STIGMA AND HEALTH 2018; 3:348-376. [PMID: 30505939 PMCID: PMC6261312 DOI: 10.1037/sah0000104] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Although the last decade has seen a proliferation of research on mental illness stigma, lack of consistency and clarity in both the conceptualization and measurement of mental illness stigma has limited the accumulation of scientific knowledge about mental illness stigma and its consequences. In the present article, we bring together the different foci of mental illness stigma research with the Mental Illness Stigma Framework (MISF). The MISF provides a common framework and set of terminology for understanding mechanisms of mental illness stigma that are relevant to the study of both the stigmatized and the stigmatizer. We then apply this framework to systematically review and classify stigma measures used in the past decade according to their corresponding stigma mechanisms. We identified more than 400 measures of mental illness stigma, two thirds of which had not undergone any systematic psychometric evaluation. Stereotypes and discrimination received the most research attention, while mechanisms that focus on the perspective of individuals with mental illness (e.g., experienced, anticipated, or internalized stigma) have been the least studied. Finally, we use the MISF to discuss the strengths and weaknesses of mental illness stigma measurement, identify gaps in the literature, and provide recommendations for future research.
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Affiliation(s)
- Annie B Fox
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System
| | - Valerie A Earnshaw
- Division of General Pediatrics, Department of Medicine, Boston Children's Hospital
- Department of Pediatrics, Harvard Medical School
| | - Emily C Taverna
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System
| | - Dawne Vogt
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System
- Department of Psychiatry, Boston University School of Medicine
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48
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Yıldız M, Kiras F, İncedere A, Abut FB. Development of self-stigma inventory for patients with schizophrenia (SSI-P): reliability and validity study. PSYCHIAT CLIN PSYCH 2018. [DOI: 10.1080/24750573.2018.1533189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Mustafa Yıldız
- Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Fatma Kiras
- Department of Psychiatry, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Aysel İncedere
- Department of Psychosocial Rehabilitation, Kocaeli University Institute of Health Science, Kocaeli, Turkey
| | - Fatma Betül Abut
- Department of Psychology, Kocaeli University Faculty of Art and Sciences, Kocaeli, Turkey
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49
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Jones LB, Thomas SDM. A pilot study exploring mental health consumers' experiences with the police. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2018; 26:235-251. [PMID: 31984075 PMCID: PMC6762131 DOI: 10.1080/13218719.2018.1504240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Accepted: 07/21/2018] [Indexed: 06/10/2023]
Abstract
Police encounters with people experiencing mental illness are both common and problematic. While there is an international body of literature on police officers' perceptions of mental-health-related incidents, few studies have sought to understand these encounters from the perspectives of people experiencing mental illness. This pilot study recruited 26 people through a state-wide Consumer Advisory Group who completed an online survey regarding their encounters with police. Results indicated that when people perceived procedurally just treatment from police they were more likely to co-operate with them and to evaluate the encounter positively. The nature of police involvement and levels of internalised stigma moderated the association between perceived procedural justice and their evaluation. Prior contacts were also important in shaping participants' overall attitudes towards police. Findings highlight the importance of officers treating people experiencing mental illness fairly and respectfully to facilitate peaceful encounters and help foster more positive perceptions of the police.
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Affiliation(s)
- Lily B. Jones
- School of Psychology, University of
Wollongong, Wollongong, New South Wales, Australia
| | - Stuart D. M. Thomas
- Social and Global Studies Centre, RMI
University, Melbourne, Victoria, Australia
- Legal Intersections Research Centre,
University of Wollongong, Wollongong, New South Wales,
Australia
- Southern Clinical School, Monash
University, Melbourne, Victoria, Australia
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50
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Fox AB, Smith BN, Vogt D. How and when does mental illness stigma impact treatment seeking? Longitudinal examination of relationships between anticipated and internalized stigma, symptom severity, and mental health service use. Psychiatry Res 2018; 268:15-20. [PMID: 29986172 DOI: 10.1016/j.psychres.2018.06.036] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 04/13/2018] [Accepted: 06/13/2018] [Indexed: 11/30/2022]
Abstract
Although mental illness stigma has been identified as an important barrier to mental health treatment, there is little consensus regarding how and when mental illness stigma negatively impacts treatment seeking. The relationship between mental illness stigma and treatment seeking may depend on the particular stigma mechanism under investigation, as well as an individual's symptom severity. In the present study, we examined relationships between anticipated and internalized stigma, depressive symptom severity, and mental health service use using data from a two-wave longitudinal survey study of U.S. post-9/11 veterans. Mediated and moderated relationships were tested using PROCESS. Mediation analyses revealed that higher anticipated stigma led to higher levels of internalized stigma, which was associated with decreased treatment seeking. Moderation analyses revealed that anticipated stigma was only associated with treatment seeking when depressive symptoms were severe. The central role observed for internalized stigma highlights the value of stigma reduction efforts that focus on this stigma mechanism, whereas the finding that only those individuals with more severe symptoms are vulnerable to the negative effects of anticipated stigma underscores the importance of more targeted anti-stigma interventions.
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Affiliation(s)
- Annie B Fox
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, MA, USA; MGH Institute of Health Professions, 36 First Avenue, Boston, MA 02129, USA.
| | - Brian N Smith
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Dawne Vogt
- Women's Health Sciences Division, National Center for Posttraumatic Stress Disorder, VA Boston Healthcare System, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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