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Johnson CA, Gerwin KL, Tichenor SE, Boyle MP, Walsh B. Evaluating Stuttering Self-Stigma and Its Relationship to Adverse Impact in Children and Adolescents With the Child Stuttering Self-Stigma Scale. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024:1-15. [PMID: 39141882 DOI: 10.1044/2024_jslhr-24-00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
PURPOSE Self-stigma occurs when a person internalizes and applies stereotypes, prejudice, and discrimination to themselves. For adults who stutter, self-stigma is linked to negative outcomes and reduced quality of life. The development of self-stigma in people who stutter is not well understood. The aim of this study is to evaluate stuttering self-stigma in school-age children and adolescents and explore potential relationships to stuttering's overall adverse impact. METHOD One hundred one children and adolescents who stutter, aged 10-18 years, completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), a measure of adverse impact related to stuttering, and the Childhood Self-Stigma of Stuttering Scale (Child 4S), our novel adapted version of the Self-Stigma of Stuttering Scale (4S) created for this study. The Child 4S comprises three subscales measuring three stages of self-stigma: Awareness, Agreement, and Application. Each stage was evaluated for relationships with child age and the adverse impact of stuttering. RESULTS We found a range of self-stigma scores among children and adolescents who stutter. Child age did not correlate with Awareness and Agreement; however, older children and adolescents reported greater Application. All stages of self-stigma strongly predicted adverse impact as measured by the OASES, and latter stages of the model were stronger predictors than earlier stages. CONCLUSIONS Children as young as 10 years old may experience stuttering self-stigma, and the application of self-stigma increases in adolescence, a critical period in the development of personal identity. Importantly, all stages of self-stigma predicted adverse impact related to stuttering, with latter stages being stronger predictors than earlier ones consistent with the progressive model of self-stigma being tested. The findings highlight the need for targeted, early intervention to mitigate downstream effects of stuttering self-stigma. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.26352556.
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Affiliation(s)
- Chelsea A Johnson
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Katelyn L Gerwin
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Seth E Tichenor
- Department of Speech-Language Pathology, Duquesne University, Pittsburgh, PA
| | - Michael P Boyle
- Department of Communication Sciences and Disorders, Montclair State University, Bloomfield, NJ
| | - Bridget Walsh
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
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Han E, Scior K, Grace K, Heath E, Dufresne S, Crane L. 'Who, When, How to Share': Pilot study of a new disclosure decision-making programme for autistic adults. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024; 28:2090-2104. [PMID: 38339979 PMCID: PMC11301964 DOI: 10.1177/13623613231221685] [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] [Indexed: 02/12/2024]
Abstract
LAY ABSTRACT 'Who, When, How to Share' is a new programme that aims to support autistic adults in making decisions around sharing their autistic identity with others. The programme involves working through a self-help guide independently over 3 weeks with optional peer support. We wanted to find out if autistic adults would join the programme and find it useful. Thirty-two autistic adults took part in the programme and 19 of them completed it. Most participants who completed the programme liked the programme and found it helpful, but some felt that they needed more time and support to complete it. They suggested that the programme would be more accessible if it was more interactive, such as including videos and other ways to gain feedback on their progress. Surveys filled in by participants before and after the programme suggested that they became more confident and less stressed about sharing their autistic identity with others, but some felt they still needed to build more confidence in order to handle negative attitudes from others. More work is needed to improve and test the programme further.
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Affiliation(s)
- Emeline Han
- Centre for Research in Autism and Education (CRAE), IOE, UCL’s Faculty of Education and Society, UK
| | - Katrina Scior
- UCL Research Department of Clinical, Educational and Health Psychology, UK
| | - Kana Grace
- Centre for Research in Autism and Education (CRAE), IOE, UCL’s Faculty of Education and Society, UK
| | | | - Simone Dufresne
- Eliot-Pearson Department of Child Study & Human Development, Tufts University, USA
| | - Laura Crane
- Centre for Research in Autism and Education (CRAE), IOE, UCL’s Faculty of Education and Society, UK
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Akif A, Qusar MMAS, Islam MR. The Impact of Chronic Diseases on Mental Health: An Overview and Recommendations for Care Programs. Curr Psychiatry Rep 2024; 26:394-404. [PMID: 38767815 DOI: 10.1007/s11920-024-01510-7] [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] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
PURPOSE OF REVIEW The current achievement of medical advancement is noteworthy; however, the occurrence of chronic diseases is increasing day by day, with a significant percentage of affected people are suffering from a mental health crisis. This article aims to present a thorough yet brief review of methods that can be employed to build the emotional wellness of chronic patients. RECENT FINDINGS The mental health care strategies include resilience-building, coping skills training, professional counseling, and lifestyle adaptations. Additionally, the article highlights the efficacy of several modern interventions, such as mindfulness-based therapies, cognitive behavioral therapy, eye movement desensitization, and recovery from stress therapy. The global burden of chronic illness emphasizes the pressing need to mitigate mental health problems among chronic patients. By providing actionable insights, our study clears the path for targeted interventions and holistic approaches for chronic disease patients. Moreover, the article suggests to policymakers and clinicians the need for collaboration and multifaceted interventions.
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Affiliation(s)
- Adnan Akif
- University of Houston College of Pharmacy, 4349 Martin Luther King Boulevard, Houston, TX, 77204-5000, USA
| | - M M A Shalahuddin Qusar
- Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University, Shahabagh, 1000, Dhaka, Bangladesh
| | - Md Rabiul Islam
- School of Pharmacy, BRAC University, Kha 224 Bir Uttam Rafiqul Islam Avenue, Merul Badda, Dhaka, 1212, Bangladesh.
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Klauber DG, Christensen SH, Fink-Jensen A, Pagsberg AK. I Didn't Want the Psychotic Thing to Get Out to Anyone at All: Adolescents with Early Onset Psychosis Managing Stigma. Cult Med Psychiatry 2024:10.1007/s11013-024-09859-3. [PMID: 38869653 DOI: 10.1007/s11013-024-09859-3] [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] [Accepted: 05/01/2024] [Indexed: 06/14/2024]
Abstract
The impact of stigmatisation on adults with mental illnesses has been thoroughly demonstrated. However, little is known about experiences of stigmatisation among adolescents with mental illness. Through semi-structured interviews with 34 Danish adolescents (14-19 years) diagnosed with psychosis, this study explores adolescents' experiences of psychosis stigma. On the basis of phenomenological analysis, we find that stigmatisation is widely experienced, and psychosis is generally regarded as more stigmatising than co-morbid mental illnesses. The participants engage in different strategies to manage possible stigma, especially strategies of (non-)disclosure. Disclosure is experienced as both therapeutic and normative, but also bears the risk of stigmatisation, and is therefore associated with numerous considerations. Being understood when disclosing is central to the participants, and lack of understanding from others is a continuous challenge. Nevertheless, participants experience benefits when feeling understood by people they confide in and can to a degree create the grounds for this through centralising aspects of their experiences of psychosis and mental illness. We argue that disclosure is both a stigma management strategy and a normative imperative, and that being understood or not is a challenge transcending stigma definitions.Clinical trial registration: Danish Health and Medicines Authority: 2612-4168. The Ethics Committee of Capital Region: H-3-2009-123. ClinicalTrials.gov: NCT01119014. Danish Data Protection Agency: 2009-41-3991.
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Affiliation(s)
- Dea Gowers Klauber
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Sofie Heidenheim Christensen
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
| | - Anders Fink-Jensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
- Laboratory of Neuropsychiatry, Department of Neuroscience and Pharmacology, University of Copenhagen, Nordre Ringvej 26-67, 2600, Glostrup, Denmark
- Psychiatric Center Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Denmark
| | - Anne Katrine Pagsberg
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark
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Amsalem D, Jankowski SE, Pagdon S, Markowitz JC, Martin A, Dixon LB. Stigma Reduction Via Brief Video Interventions: Comparing Presentations by an Actor Versus a Person With Lived Experience. Psychiatr Serv 2024; 75:485-488. [PMID: 38088037 DOI: 10.1176/appi.ps.20230215] [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: 05/02/2024]
Abstract
OBJECTIVE This study aimed to compare the efficacy of two brief video interventions in reducing mental health-related stigma: one featuring a person with lived experience of mental illness, the other featuring an actor guided by focus groups of individuals with lived experience. METHODS Participants (N=1,216) ages 18-30 were randomly assigned to an intervention group or a control group. The intervention groups viewed one of two 2-minute videos in which a young Black protagonist describes symptoms, struggles, and personal recovery related to schizophrenia. Five domains of stigma were assessed at baseline, postintervention, and a 30-day follow-up. RESULTS Stigma scores were lower across all five domains in both intervention groups (vs. control), and noninferiority analyses found no difference between the two videos (all p<0.001). CONCLUSIONS This study enhanced prior findings showing similar efficacy of the two videos and illustrated opportunities for people with mental illness to share their personal stories without public exposure.
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Samantha E Jankowski
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Shannon Pagdon
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - John C Markowitz
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Andrés Martin
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
| | - Lisa B Dixon
- New York State Psychiatric Institute, New York City (Amsalem, Jankowski, Pagdon, Markowitz); Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York City (Amsalem, Jankowski, Pagdon, Markowitz, Dixon); Child Study Center and Teaching and Learning Center, Yale School of Medicine, New Haven, Connecticut (Martin)
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Earnshaw VA, Sepucha KR, Laurenceau JP, Subramanian SV, Hill EC, Wallace J, Brousseau NM, Henderson C, Brohan E, Morrison LM, Kelly JF. Disclosing Recovery: A pilot randomized controlled trial of a patient decision aid to improve disclosure processes for people in treatment for opioid use disorder. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 160:209291. [PMID: 38272118 PMCID: PMC11060902 DOI: 10.1016/j.josat.2024.209291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 12/19/2023] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
INTRODUCTION People engaged in treatment for opioid use disorder (OUD) report struggling with whether and how to disclose, or share information about their OUD history and/or treatment with others. Yet, disclosure can act as a gateway to re-establishing social connection and support during recovery. The current study describes a pilot randomized controlled trial of Disclosing Recovery: A Decision Aid and Toolkit, a patient decision aid designed to facilitate disclosure decisions and build disclosure skills. METHODS Participants (n = 50) were recruited from a community-based behavioral health organization in 2021-2022 and randomized to receive the Disclosing Recovery intervention versus an attention-control comparator. They responded to surveys immediately after receiving the intervention as well as one month following the intervention at a follow-up appointment. Primary outcome analyses examined indicators of implementation of the intervention to inform a future efficacy trial. Secondary outcome analyses explored impacts of the intervention on the decision-making process, disclosure rates, and relationships. RESULTS Participants were successfully recruited, randomized, and retained, increasing confidence in the feasibility of future efficacy trials to test the Disclosing Recovery intervention. Moreover, participants in the Disclosing Recovery intervention agreed that the intervention is acceptable, feasible, and appropriate. They additionally reported a higher quality of their decision-making process and decisions than participants in the comparator condition. At their follow-up appointment, participants with illicit opioid use who received the Disclosing Recovery intervention were less likely to disclose than those who received the comparator condition. Moreover, significant interactions between illicit opioid use and the intervention condition indicated that participants without illicit opioid use who received the Disclosing Recovery intervention reported greater closeness to and social support from their planned disclosure recipient than those who received the comparator condition. CONCLUSIONS The Disclosing Recovery intervention appears to be an acceptable, feasible, and appropriate patient decision aid for addressing disclosure processes among people in treatment for OUD. Moreover, preliminary results suggest that it shows promise in improving relationship closeness and social support in patients without illicit opioid use. More testing is merited to determine the intervention's efficacy and effectiveness in improving relationship and treatment outcomes for people in treatment for OUD.
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Affiliation(s)
- Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE 19716, USA.
| | - Karen R Sepucha
- Health Decision Sciences Center, Massachusetts General Hospital, 100 Cambridge St, Suite 1600, Boston, MA 02114, USA; Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
| | - Jean-Philippe Laurenceau
- Department of Psychological and Brain Sciences, University of Delaware, 231 Wolf Hall, Newark, DE 19716, USA.
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Cambridge, MA, USA; Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
| | - E Carly Hill
- Department of Human Development and Family Sciences, University of Delaware, 111 Alison Hall West, Newark, DE 19716, USA; Center for Research on Education and Social Policy, University of Delaware, 125 Academy Street, Newark, DE 19716, USA.
| | - James Wallace
- Center for Research on Education and Social Policy, University of Delaware, 125 Academy Street, Newark, DE 19716, USA; Department of Epidemiology, University of Delaware, 100 Discovery Blvd, Newark, DE 19716, USA.
| | - Natalie M Brousseau
- Graduate School of Applied and Professional Psychology, Rutgers University, 152 Frelinghuysen Rd, Piscataway, NJ 08854-8020, USA.
| | - Claire Henderson
- Health Services and Population Research Department, King's College London Institute of Psychiatry, Psychology and Neuroscience, United Kingdom of Great Britain and Northern Ireland.
| | - Elaine Brohan
- Health Services and Population Research Department, King's College London Institute of Psychiatry, Psychology and Neuroscience, United Kingdom of Great Britain and Northern Ireland.
| | - Lynn M Morrison
- Brandywine Counseling and Community Services, 2713 Lancaster Avenue, Wilmington, DE 19805, USA.
| | - John F Kelly
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Recovery Research Institute, Massachusetts General Hospital, 151 Merrimac St, 6th Floor, Boston, MA 02114, USA.
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von Peter S, Ponew A, Strelen A, Lust C, Speerforck S, Stützle S. [Disclosure of Own Crisis And Treatment Experiences By Staff Of Psychiatric Institutions In BerLin And Brandenburg - An Underused Resource For Reducing Stigma?]. PSYCHIATRISCHE PRAXIS 2024. [PMID: 38670117 DOI: 10.1055/a-2296-7173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/28/2024]
Abstract
AIM This article is part of the EKB-study which explores lived crisis and treatment experiences of mental health professionals in Berlin and Brandenburg. It addresses the disclosure of mental health workers' lived experiences in their workplace. METHOD An online survey was conducted among 182 mental health professionals, containing questions on disclosure of lived experiences. Data were analyzed descriptively and analytically. RESULTS Participants reported disclosure mainly to supervisors and affiliated colleagues. Experiences were mostly positive, with severe negative exceptions. Central motives against disclosure were fear of vulnerability, fear of compromising professional identity, and shame. CONCLUSIONS Disclosure of lived crisis experiences is not always the proper strategy for mental health professionals. Disclosure may be a means of reducing public and internalized stigma.
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Affiliation(s)
- Sebastian von Peter
- Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg, Neuruppin
| | - Angel Ponew
- Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg, Neuruppin
| | - Anna Strelen
- Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg, Neuruppin
| | - Christian Lust
- Psychiatrie und Psychotherapie, Medizinische Hochschule Brandenburg, Neuruppin
| | - Sven Speerforck
- Klinik und Poliklinik fur Psychiatrie und Psychotherapie, Universität Leipzig
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Kaneko N, Hill AO, Shiono S. Factors associated with help-seeking regarding sexual orientation concerns among Japanese gay and bisexual men: results from a cross-sectional survey. BMC Res Notes 2024; 17:117. [PMID: 38654279 DOI: 10.1186/s13104-024-06776-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVE This study investigates Japanese gay and bisexual men's experiences of seeking help for emotional support from others regarding their sexual orientation concerns. It examines the relationship between their help-seeking and presence of gay and bisexual peers, duration between questioning their sexual orientation and accepting it, and experience of coming out to family members by multiple logistic regression analysis. RESULTS We conducted a cross-sectional survey using a self-reported paper questionnaire. There were 360 valid responses. Eighty-two respondents (22.8%) had experience of help-seeking for emotional support, and this was associated with age, occupation, presence of gay/bisexual friends, and experience of coming out to family members about their sexual orientation. Respondents sought the most help from their male friends (70.0%), followed by female friends (25.0%), mothers (17.5%), and the Internet (16.3%). Even after controlling for age and occupation, experience of help-seeking for emotional support was higher among participants who had gay/bisexual friends when they were aware of their sexual orientation, took < 1 year from questioning to realizing their sexual orientation, and had come out to their family about their sexual orientation.
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Affiliation(s)
- Noriyo Kaneko
- Department of Global and Community Health, Graduate School of Nursing, Nagoya City University, 1-4-7, Aoi, Higashi-ku, Nagoya, Aichi, Japan.
| | - Adam Orlando Hill
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Satoshi Shiono
- Faculty of Health Science, Osaka Aoyama University, Osaka, Japan
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Zedan SA, Zahid A, Best MW. Examining the effects of diagnostic awareness, positive symptoms, and negative symptoms on stigmatizing attitudes and social exclusion towards schizophrenia. Schizophr Res 2024; 264:482-490. [PMID: 38277738 DOI: 10.1016/j.schres.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Social exclusion towards schizophrenia can occur as a response to symptom presentations and/or diagnostic knowledge. The present study examined stigma towards schizophrenia as a function of diagnostic awareness, positive symptoms, and negative symptoms. METHODS 559 participants were presented with one of eight vignettes depicting an individual in a social situation based on a 2 (label: present, absent) x 2 (positive symptoms: present, absent) x 2 (negative symptoms: present, absent) design. Participants then completed various measures of social exclusion and stigmatizing attitudes. RESULTS A significant three-way interaction between positive symptoms, negative symptoms, and a diagnostic label was found for stigmatizing attitudes such that knowledge of diagnosis was associated with less stigma when symptoms were present but resulted in more stigma when symptoms were absent. A significant interaction between diagnostic label and negative symptoms was found on social distance such that knowledge of diagnosis increased desire for social distance when negative symptoms were present. CONCLUSION Diagnostic awareness increases stigmatizing attitudes and social distance when symptoms are not present. However, when contextualized with the presence of symptoms, diagnostic awareness may reduce exclusion by providing an explanation for those symptoms. Determining when and to whom to disclose one's diagnosis may be helpful to improve social functioning in schizophrenia.
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Affiliation(s)
- Saleena A Zedan
- Department of Psychology, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Aqsa Zahid
- Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Scarborough, Ontario, Canada
| | - Michael W Best
- Department of Psychology, University of Toronto Scarborough, Scarborough, Ontario, Canada; Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Scarborough, Ontario, Canada; Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada.
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Klein T, Kösters M, Corrigan PW, Mak WWS, Sheehan L, Conley CS, Oexle N, Rüsch N. Does the peer-led Honest, Open, Proud program reduce stigma's impact for everyone? An individual participant data meta-regression analysis. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1675-1685. [PMID: 37160437 PMCID: PMC10562308 DOI: 10.1007/s00127-023-02491-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/30/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE Many people with mental illness experience self-stigma and stigma-related stress and struggle with decisions whether to disclose their condition to others. The peer-led Honest, Open, Proud (HOP) group program supports them in their disclosure decisions. In randomized controlled trials, HOP has shown positive effects on self-stigma and stigma stress on average. This study examined individual predictors of HOP outcomes and tested the hypothesis that stigma stress reduction at the end of HOP mediates positive HOP effects at follow-up. METHODS Six RCTs were included with data at baseline, post (after the HOP program) and at 3- or 4-week follow-up. Baseline variables were entered in meta-regression models to predict change in self-stigma, stigma stress, depressive symptoms and quality of life among HOP participants. Mediation models examined change in stigma stress (post) as a mediator of HOP effects on self-stigma, depressive symptoms, and quality of life at follow-up. RESULTS More shame at baseline, and for some outcomes reduced empowerment, predicted reduced HOP effects on stigma stress, self-stigma, depressive symptoms, and quality of life. Younger age was related to greater improvements in stigma stress after the HOP program. Stigma stress reductions at the end of HOP mediated positive effects on self-stigma, depressive symptoms and quality of life at follow-up. CONCLUSION Participants who are initially less burdened by shame may benefit more from HOP. Stigma stress reduction could be a key mechanism of change that mediates effects on more distal outcomes. Implications for the further development of HOP are discussed.
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Affiliation(s)
- Thomas Klein
- Section Public Mental Health, Department of Psychiatry II, Ulm University and BKH Günzburg, Parkstraße 11, 89073, Ulm, Germany
| | - Markus Kösters
- Center for Evidence-Based Healthcare, Medical Faculty Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Patrick W Corrigan
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Winnie W S Mak
- Department of Psychology, The Chinese University of Hong Kong Shatin , NT, Hong Kong SAR
| | - Lindsay Sheehan
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
| | - Colleen S Conley
- Department of Psychology, Loyola University Chicago, Chicago, IL, USA
| | - Nathalie Oexle
- Section Public Mental Health, Department of Psychiatry II, Ulm University and BKH Günzburg, Parkstraße 11, 89073, Ulm, Germany
| | - Nicolas Rüsch
- Section Public Mental Health, Department of Psychiatry II, Ulm University and BKH Günzburg, Parkstraße 11, 89073, Ulm, Germany.
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Mayer L, Puschner N, Votruba N, Rüsch N, Oexle N. Social Reactions After Disclosing Suicide Loss Among Women. CRISIS 2023; 44:451-457. [PMID: 35801538 PMCID: PMC10658635 DOI: 10.1027/0227-5910/a000871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 04/06/2022] [Accepted: 04/11/2022] [Indexed: 11/23/2022]
Abstract
Background: Suicide loss is often concealed. While initial evidence suggests that disclosure is important for healthy grieving, observed beneficial effects may depend on social reactions. Aim: The current study aimed to identify social reactions and associated consequences experienced by persons who lost a loved one to suicide (i.e., suicide loss survivors). Method: We conducted qualitative interviews with 22 female adult suicide loss survivors focusing on social reactions after suicide loss. Interviews were transcribed and analyzed using qualitative content analysis. Results: When talking about their loss with others, suicide loss survivors experienced a broad range of social reactions including compassionate and supportive responses, speechlessness and insecurity, curiosity and gossip, stigmatization, and grieving expectations. Depending on these social reactions, disclosing suicide loss was associated with both negative and positive long-term effects. Limitations: The findings are limited to the current female sample. Conclusion: Interventions that help suicide loss survivors in finding supportive confidants, combined with public interventions to decrease public suicide stigma and improve the public's readiness to provide helpful support to suicide loss survivors, could improve grieving outcomes among this group.
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Affiliation(s)
- Lea Mayer
- Department of Psychiatry and Psychotherapy II, University of Ulm and BKH Günzburg, Germany
| | - Nadja Puschner
- Department of Psychiatry and Psychotherapy II, University of Ulm and BKH Günzburg, Germany
| | - Nicole Votruba
- Centre for Implementation Science and Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
- The George Institute for Global Health, London, UK
| | - Nicolas Rüsch
- Department of Psychiatry and Psychotherapy II, University of Ulm and BKH Günzburg, Germany
| | - Nathalie Oexle
- Department of Psychiatry and Psychotherapy II, University of Ulm and BKH Günzburg, Germany
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Richa S, Khairallah C, Khoury E, Kassab A, Haddad F, Kerbage H, Richa N, Benmassoud D, Oussedik A, Gernay MM, El Hage W, Mercier M. Social representations of intellectual disability; a comparison between cultures. L'ENCEPHALE 2023; 49:466-473. [PMID: 35970643 DOI: 10.1016/j.encep.2022.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 05/04/2022] [Accepted: 05/12/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES People with Intellectual disability consistently appear to be one of the most looked-down upon and repressed subgroups of society in many cultures. The main aim of this study was to compare social representations of intellectual disability in its various aspects between different cultures. MATERIALS AND METHODS The study was conducted in four different sites: Beirut-Lebanon, Algiers-Algeria, Tours-France and Namur-Belgium. Participants were asked to complete a questionnaire evaluating social representations of intellectual disability. RESULTS A total of 755 participants consented to take part in the study. Gender only affected social representations in the Lebanese population. Overall, Algerians appeared to have the least positive social representations and Lebanon to have more positive attitudes, while France and Belgium tended to have the most favourable representations. DISCUSSION AND CONCLUSIONS Findings highlight the imbalance between a European and a non-European country showing the importance of developing tailored interventions to improve general attitudes towards intellectual disability.
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Affiliation(s)
- S Richa
- Facuty of Medicine, Saint-Joseph University, Lebanon
| | - C Khairallah
- Facuty of Medicine, Saint-Joseph University, Lebanon
| | - E Khoury
- Facuty of Medicine, Saint-Joseph University, Lebanon
| | - A Kassab
- Facuty of Medicine, Saint-Joseph University, Lebanon.
| | - F Haddad
- Facuty of Medicine, Saint-Joseph University, Lebanon
| | - H Kerbage
- Facuty of Medicine, Saint-Joseph University, Lebanon
| | - N Richa
- Facuty of Medicine, Saint-Joseph University, Lebanon
| | | | - A Oussedik
- Faculty of Medicine, Alger University, Algeria
| | - M-M Gernay
- Faculty of Psychology, Namur University, Namur, Belgium
| | - W El Hage
- Faculty of Medicine, Tours University, France
| | - M Mercier
- Faculty of Psychology, Namur University, Namur, Belgium
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13
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Amsalem D, Rogers RT, Stroup TS, Dixon L, Pope LG. Self-stigma among people with serious mental illnesses: The use of focus groups to inform the development of a brief video intervention. Psychiatr Rehabil J 2023; 46:243-249. [PMID: 37227841 PMCID: PMC10643101 DOI: 10.1037/prj0000570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE People with mental illnesses may avoid or delay treatment due to a fear of labeling and discrimination, a phenomenon known as self-stigma. Self-stigma is a major barrier to care and creates obstacles to pursuing employment, independent living, and a fulfilling social life. We aimed to gather input from people with lived experience of mental illness to develop a social-contact-based, brief video-based intervention to reduce self-stigma. METHOD Two (n = 12) focus groups were conducted to inform video content and led to the creation of a script and brief video using a professional actor, who described a story of living with schizophrenia while focusing on symptoms, personal struggles, and recovery. Two (n = 9) additional focus groups were held after video development to gather feedback and suggested edits. Focus group transcripts were analyzed using thematic content analysis. RESULTS Themes emerging in prevideo development included the negative effects of being diagnosed with severe mental illnesses, being stereotyped, the value of relatable recovery stories and seeing the person as a whole, and the utility of focusing on symptoms and experiences rather than diagnosis-specific language. Feedback in the postvideo focus groups was mainly favorable and resulted in edits related to language about "responsibility" and a disclaimer about using a professional actor. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE While participants' experiences of stigma are consistent with extant literature, this is the first study to elicit the perspectives of people living with mental illnesses in developing a video intervention to reduce self-stigma. Studies are needed to examine the efficacy of these videos in reducing self/public stigma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Doron Amsalem
- Department of Psychiatry, Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons
| | - R Tyler Rogers
- Department of Psychiatry, Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons
| | - T Scott Stroup
- Department of Psychiatry, Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons
| | - Lisa Dixon
- Department of Psychiatry, Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons
| | - Leah G Pope
- Department of Psychiatry, Division of Behavioral Health Services and Policy Research, New York State Psychiatric Institute, Columbia University Vagelos College of Physicians and Surgeons
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Bogart KR, Bryson BA, Harcourt D. Disclosing the obvious: Psychosocial implications of (not) explaining facial differences. Body Image 2023; 46:91-102. [PMID: 37247489 DOI: 10.1016/j.bodyim.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/22/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023]
Abstract
Although the disclosure of invisible stigmatized identities has been frequently researched, little work has examined disclosure of facial differences (FD), in which stigma is often highly visible. People with FD are frequently expected by others to disclose or explain their condition. Qualitative work indicates that people with FD have a range of disclosure approaches from agentic disclosure (feeling obliged to disclose), autonomous nondisclosure (choosing not to disclose or to disclose only to certain people), and autonomous disclosure (choosing to openly disclose). The purpose of the present study was to validate these disclosure approaches in a large international sample, examine their frequency of use, and test their relationship to psychosocial outcomes using validated measures. English-speaking participants (n = 288) with 33 different types of FD completed an online survey of disclosure approaches and psychosocial outcomes (i.e. anxiety, depression, self-esteem, stigma, job satisfaction, and relationship self-concept). Participants disclosed to 59 % of the people they knew. Selective and indiscriminate disclosure were the most frequently used and recommended approaches. As predicted, autonomous disclosure was associated with more positive psychosocial outcomes than agentic (non)disclosure and autonomous nondisclosure. Findings from this study can support disclosure autonomy, and thus positive psychosocial outcomes, among people with FD.
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Affiliation(s)
- Kathleen R Bogart
- School of Psychological Science, Oregon State University, Corvallis, OR 97331, USA.
| | - Brooke A Bryson
- Department of Psychology, Texas State University, San Marcos, TX 78666, USA
| | - Diana Harcourt
- Centre for Appearance Research, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK
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Howe E. White Noise and Questions Regarding Death Anxiety, Forgiveness, and Patient Self-disclosure. INNOVATIONS IN CLINICAL NEUROSCIENCE 2023; 20:27-29. [PMID: 37817812 PMCID: PMC10561986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
This commentary examines three critical therapeutic questions that arise for all patients, particularly for patients with psychiatric illness. These questions involve fearing death, forgiving oneself for past acts, and disclosing medical and psychiatric conditions to others. These questions, which can be critical to providing optimal medical care in some contexts, are prompted by the movie White Noise, as it might provoke questions regarding death and self-disclosure in patients. Specific responses that might be helpful to patients are offered.
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Affiliation(s)
- Edmund Howe
- Dr. Howe is Professor of Psychiatry, Uniformed Services University of the Health Sciences in Bethesda, Maryland
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Lipsett M, Wyant-Stein K, Mendes S, Berger E, Berkman ET, Terplan M, Cioffi CC. Addressing stigma within the dissemination of research products to improve quality of care for pregnant and parenting people affected by substance use disorder. Front Psychiatry 2023; 14:1199661. [PMID: 37351006 PMCID: PMC10282149 DOI: 10.3389/fpsyt.2023.1199661] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 05/15/2023] [Indexed: 06/24/2023] Open
Abstract
Substance use disorders are a common and treatable condition among pregnant and parenting people. Social, self, and structural stigma experienced by this group represent a barrier to harm reduction, treatment utilization, and quality of care. We examine features of research dissemination that may generate or uphold stigmatization at every level for pregnant and parenting individuals affected by substance use disorder and their children. We explore stigma reduction practices within the research community that can increase uptake of evidence-based treatment programs and prevent potential harm related to substance use in pregnant and parenting people. The strategies we propose include: (1) address researcher stereotypes, prejudice, and misconceptions about pregnant and parenting people with substance use disorder; (2) engage in interdisciplinary and transdisciplinary collaborations that engage with researchers who have lived experience in substance use; (3) use community-based approaches and engage community partners, (4) address stigmatizing language in science communication; (5) provide contextualizing information about the social and environmental factors that influence substance use among pregnant and parenting people; and (6) advocate for stigma-reducing policies in research articles and other scholarly products.
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Affiliation(s)
- Megan Lipsett
- Department of Psychology, Center for Translational Neuroscience, University of Oregon, Eugene, OR, United States
| | - Katie Wyant-Stein
- Diamond Lab, Department of Psychology, University of Utah, Salt Lake City, UT, United States
| | - Simone Mendes
- Department of Psychology, Center for Translational Neuroscience, University of Oregon, Eugene, OR, United States
| | - Estelle Berger
- Department of Psychology, Center for Translational Neuroscience, University of Oregon, Eugene, OR, United States
| | - Elliot T. Berkman
- Department of Psychology, Center for Translational Neuroscience, University of Oregon, Eugene, OR, United States
| | - Mishka Terplan
- Friends Research Institute, Baltimore, MD, United States
| | - Camille C. Cioffi
- Department of Psychology, Center for Translational Neuroscience, University of Oregon, Eugene, OR, United States
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
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Adu J, Oudshoorn A, Anderson K, Marshall CA, Stuart H. Experiences of familial stigma among individuals living with mental illnesses: A meta-synthesis of qualitative literature from high-income countries. J Psychiatr Ment Health Nurs 2023; 30:208-233. [PMID: 36031879 DOI: 10.1111/jpm.12869] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 07/29/2022] [Accepted: 08/16/2022] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Mental illness stigma has been long acknowledged as a social problem that continues to persist and contribute to social exclusion of affected persons globally. Researchers have explored mental illness stigma in the general public and among health professionals, with little focus on stigma from family members and close relatives of persons with mental illnesses. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This study appears to be the first meta-synthesis of familial mental illness stigma in high-income countries. Family members or close relatives of persons with mental illnesses may be perpetrators of stigma. That is, the family may enact stigma of mental illness against their relative to "save face" or by avoiding or narrowing their social contacts. Familial stigma is harmful due to the likely disaffection it brings within one's home environment. Familial mental stigma from the existing literature seems to be a by-product of public stigma and stigma by association WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further research is necessary to look at the existence of familial mental illness stigma as well as available policies to reduce its impact on affected individuals in high-income countries. Researchers in high-income countries should endeavour to examine the relationship between familial, public and associative stigma to establish baseline metrics to inform future anti-stigma programs seeking to reduce familial mental illness stigma. ABSTRACT INTRODUCTION: Familial mental illness stigma is a pervasive issue but very subtle in high-income countries. Familial mental illness stigma implies persons living with mental illnesses are discriminated against by their family members or close relatives. AIM/QUESTION This meta-synthesis explored the experiences of familial stigma among individuals living with mental illnesses in high-income countries, focusing on empirical literature, to understand the breadth of current literature and ways to reduce this form of stigma. METHOD We conducted a meta-synthesis through a structured search of qualitative data from six electronic databases (Sociological Abstract, CINAHL, Medline, PsycINFO, Google Scholar and Embase). Inclusion criteria comprised: empirical primary research, primary technique for data collection is qualitative, studies published in a peer-reviewed journal in the English language between 2000 and 2020, studies reported on experiences of familial mental illness stigma, and studies conducted in high-income countries. The exclusion criteria were as follows: all grey literature, studies not written in English and non-peer-reviewed, studies not focused on familial mental illness stigma, quantitative peer-reviewed articles on the related concept and peer-reviewed articles on the related topic before the year 2000. RESULTS The study identified only 28 peer-reviewed articles on the topic within two decades. Concealment of familial stigma was found to be detrimental due to the potential for alienation within one's home environment. Disclosure and social contact within the family system were considered as critical interventions to provide some safety nets for individuals with mental illnesses. DISCUSSION AND IMPLICATIONS FOR PRACTICE The paucity of studies over the review period highlights the need for further attention to support optimal environments for persons living with mental illnesses. Families' understanding of the difficulties of mental illness stigma is vital to supporting the development of policies and interventions towards the avoidance of social exclusion within societies. Families should make concerted efforts to reduce stigma, and this includes within the family system. Education and training approaches around mental illness-related stigma should involve individuals with lived experience and their families, as well as service providers and the general public.
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Affiliation(s)
- Joseph Adu
- Department of Health and Rehabilitation Sciences, Elborn College, Western University, London, Ontario, Canada
| | - Abe Oudshoorn
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Kelly Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Carrie Anne Marshall
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Heather Stuart
- Department of Public Health Sciences, Department of Psychiatry and the School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada
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18
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Zhou N, Ren F, Shi G, Wang J. Understanding the Relationship Between Peer Support and Grief/Growth in Chinese Shidu Parents: The Roles of Internalized Stigma and Stigma Resistance. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231154844. [PMID: 36718655 DOI: 10.1177/00302228231154844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
In China, families who have lost their only child are called shidu families. Support from similar others, or peer support, can help bereaved individuals adapt by reducing negative consequences and promoting positive changes. However, no research has examined the mechanism that mediates the effect of peer support on postloss adaptation. This article investigates the mediating roles of internalized stigma and stigma resistance in the relationship between peer support and grief/growth among Chinese shidu parents. In total, 208 shidu parents completed the required measurements. Structural equation modeling was used to analyze the data. The results showed that peer support was negatively related to grief symptoms and positively linked with posttraumatic growth by reducing internalized stigma. The mediating effect existed only for informational support. The mediating role of stigma resistance was not significant. These findings provide valuable information for the mechanism of peer support and promote the development of interventions.
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Affiliation(s)
- Ningning Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Fei Ren
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Guangyuan Shi
- Center for Psychological Development, Tsinghua University, Beijing, China
| | - Jianping Wang
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
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19
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Plackowski EF, Bogart KR. "If not me, who?": Awareness- and Self-Advocacy-Related Experiences of Adults With Diverse Rare Disorders. QUALITATIVE HEALTH RESEARCH 2023; 33:63-80. [PMID: 36444970 DOI: 10.1177/10497323221135974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
In a two-study project, researchers used qualitative methods and inductive thematic analyses to investigate the lived awareness- and advocacy-related experiences of 27 adults with over 35 different rare diseases, disorders, or disabilities (RDs). In Study 1, participants in two focus groups described how a lack of RD awareness led to experiences with several types of stigma, complicated their expressions and disclosures of disability, and spurred them to work towards awareness. Participant priorities identified in Study 1 motivated researchers to design and conduct Study 2. In Study 2, researchers interviewed 18 RD self-advocates about their lived experiences with and ideas regarding advocacy. Their recommendations included increasing social and systemic support, education, and media and professional representation. Advocates in Study 2 also warned of potential roadblocks to self-advocacy and change, including systemic invalidation and bias, lack of access to activist spaces, and limited time and energy for advocacy. Overall, analyses exposed the complex and interwoven influences of RD awareness and advocacy.
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Affiliation(s)
- Emily F Plackowski
- School of Psychological Science, 2694Oregon State University, Corvallis, OR, USA
| | - Kathleen R Bogart
- School of Psychological Science, 2694Oregon State University, Corvallis, OR, USA
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20
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Sportel BE, van Enthoven M, van Donkersgoed RJM, Kuis DJ, van de Giessen T, Lysaker PH, Hasson-Ohayon I, de Jong S, Boonstra N, Pijnenborg GHM. Self-stigma and cognitive insight in individuals at ultra-high risk for psychosis. Front Psychiatry 2023; 14:1154284. [PMID: 37124265 PMCID: PMC10133542 DOI: 10.3389/fpsyt.2023.1154284] [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: 01/30/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Background Impaired cognitive insight and increased self-stigma have been consistently reported in individuals diagnosed with schizophrenia spectrum disorders, but little is known about its presence in individuals at ultra-high risk of developing a psychosis, although self-stigma is associated with transition.to psychosis. The current study examined whether self-stigma is already present in individuals at ultra-high risk of psychosis, and whether this is associated with impaired cognitive insight. Methods 184 participants were recruited divided over three groups, namely individuals diagnosed with a schizophrenia spectrum disorder (SSD; n = 92, 34% females), individuals at ultra-high risk for psychosis (UHR; n = 43, 59% females) and general population controls (GPC; n = 49, 27% females). All participants completed assessments on demographic information (gender, age, education), and cognitive insight. In addition, participants with SSD and individuals at UHR completed a questionnaire on self-stigma. Results The level of self-stigma did not differ between individuals at UHR and individuals diagnosed with SSD. Cognitive insight also did not differ significantly between the three groups, but the subscale self-reflection differed between the three groups [F(2,184) = 4.20, p = 0.02], with the UHR and SSD groups showing more self-reflection. Pearson's correlation analyses showed that in individuals at UHR total cognitive insight and its self-reflection subscale were significantly associated with the alienation subscale of self-stigma, and in individuals with SSD self-certainty subscale of cognitive insight was significantly associated with stereotype endorsement. Conclusion Findings show that self-stigma was already present in the UHR phase, to a similar degree as in individuals with a diagnosis of a SSD, and is thus not dependent of previous experience of having a label of SSD. Cognitive insight in individuals at UHR of psychosis appears to be intact, but individuals at UHR showed more self-reflectiveness, and individuals at risk with high cognitive insight also experience high levels of self-stigma. Overall findings from our study suggest that pre-emptive interventions targeting self-stigma, while considering cognitive insight, are needed early on in manifestation of psychotic illness, preferably already in the UHR phase.
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Affiliation(s)
- Bouwina Esther Sportel
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- *Correspondence: Bouwina Esther Sportel,
| | - Mirjam van Enthoven
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
| | - Rozanne J. M. van Donkersgoed
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Daan Jan Kuis
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
| | - Tara van de Giessen
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
| | - Paul H. Lysaker
- Department of Psychiatry, Richard L. Roudebush VA Medical Center, Indianapolis, IN, United States
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, United States
| | | | | | - Nynke Boonstra
- KieN Early Intervention Service, Leeuwarden, Netherlands
- Research Group Care and Innovation in Psychiatry, NHL Stenden University for Applied Sciences, Leeuwarden, Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands
| | - Gerdina H. M. Pijnenborg
- Department of Psychotic Disorders, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
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Skaggs P, Bell SB, Scutchfield FD, Robinson LE. Providers' Stigmas and the Effects on Patients with Opioid Use Disorder: A Scoping Review. JOURNAL OF APPALACHIAN HEALTH 2023; 4:87-102. [PMID: 38026051 PMCID: PMC10655729 DOI: 10.13023/jah.0403.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction One of the most prevalent, dangerous stigmas in health care is the complex bias toward patients with opioid use disorder (OUD). This stigma damages the vital patient-provider relationship, further perpetuating the opioid epidemic. Purpose Unfortunately, research on the relationship between OUD and provider stigma is greatly lacking. To fill this gap, the present in-depth study undertakes a scoping review of research on providers' stigma toward OUD in order to determine how enacted stigma affects treatment plans. Methods Four databases were used to identify articles published from 1999 to 2021. A comprehensive search strategy was developed through a collaborative process between the researchers and a medical librarian. The researchers used the methodological framework developed by Arksey and O'Malley (2005) and expanded upon by Levac et al.(2010) to chart study characteristics and themes. Results A total of 196 search items were retrieved. After de-duplication (n=31), remaining articles were screened based on the inclusion and exclusion criteria detailed in the protocol. After both a title/abstract review and full-text review, an additional 158 articles were removed. This yielded a total of seven articles. Three main themes were identified in the literature: (1) rural-urban differences in bias; (2) provider concern regarding legal implications and regulatory concerns; and (3) the belief that OUD is a moral failing rather than a medical diagnosis. Implications Additional research should further analyze prescribed treatment plans for patients with OUD and utilize this information to create future considerations aimed at reducing opioid-related stigma in healthcare in Appalachia.
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23
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Young MM, Byrd CT, Gabel R, White AZ. Self-Disclosure Experiences of Adults Who Stutter: An Interpretative Phenomenological Analysis. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2045-2060. [PMID: 35985338 DOI: 10.1044/2022_ajslp-22-00048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Self-disclosure describes the act of revealing personal information to another person. To date, researchers in the area of stuttering have primarily demonstrated the utility of self-disclosure through analysis of listener perceptions. This study explores the utility of informative self-disclosure use from the perspectives of adults who stutter with experience using this strategy over time and across contexts. METHOD Twelve adults who stutter discussed their self-disclosure experiences in semistructured interviews. Interview transcripts were analyzed using interpretative phenomenological analysis to produce themes reflecting the most salient aspects of self-disclosure experiences. Credibility was achieved through bracketing, investigator triangulation, and member checking. RESULTS Four superordinate themes reflecting experiences shared by all 12 participants were generated. Each superordinate theme contained two to three corresponding subthemes. The superordinate themes included cognitive relief, self-empowerment, social connection, and personalization. These findings reflect the positive impact of informative self-disclosure use on communication and quality of life. CONCLUSIONS Adults who stutter perceive informative self-disclosure to be an effective strategy that provides various benefits to the speaker, in addition to facilitating positive listener perceptions. Clinicians should encourage clients to self-disclose in an informative and personalized manner, provide opportunities for practice, and support clients in determining when and where it is most beneficial for them to implement this strategy.
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Affiliation(s)
- Megan M Young
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | - Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
| | - Rodney Gabel
- Division of Speech and Language Pathology, Binghamton University, NY
| | - Andrew Z White
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin
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Meadows A, Higgs S. Challenging oppression: A social identity model of stigma resistance in higher-weight individuals. Body Image 2022; 42:237-245. [PMID: 35816967 DOI: 10.1016/j.bodyim.2022.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/07/2022] [Accepted: 06/07/2022] [Indexed: 11/15/2022]
Abstract
Many higher-weight individuals have internalised societal weight stigma, devaluing themselves because of their weight. Rejecting and challenging societal devaluation is generally associated with superior outcomes compared with stigma internalisation or inaction; however, stigma resistance has not been studied in higher-weight individuals, despite ubiquitous weight stigma in daily life. Applying a social identity framework, we utilised decision tree analysis to explore predictors of responses to weight stigma in 931 self-classified higher-weight individuals. While ingroup identification with the group 'Fat' was the major predictor of stigma resistance (versus internalisation), perceived illegitimacy of societal weight stigma defined a subgroup of resisters even in the absence of group identity. Interventions focusing on the illegitimacy of unequal social status and treatment may be effective at reducing internalisation and fostering resistance in a population with characteristically low ingroup identity.
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Affiliation(s)
- Angela Meadows
- Department of Psychology, University of Essex, Colchester CO4 3SQ, UK.
| | - Suzanne Higgs
- School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
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25
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Yeatts PE, Abbott DM, Mollen D. Development and Evaluation of the Atheist Identity Concealment Scale (AICS). JOURNAL OF RELIGION AND HEALTH 2022; 61:3525-3541. [PMID: 34843010 DOI: 10.1007/s10943-021-01465-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 06/13/2023]
Abstract
The Atheist Identity Concealment Scale (AICS) was developed as a tool to assess the degree to which atheists conceal their atheist identity from others. Drawing on concealable stigmatized identity (CSI) theory, the aim of this study was to provide researchers with a valid means to effectively assess atheist identity concealment. Using three separate samples of more than 500 adults in the USA, exploratory and confirmatory factor analyses were conducted which ultimately resulted in a short, robust measure comprised of eight items. Additional validity evidence was provided by examining the relationship between the AICS and several previously validated tools (i.e., outness, nonreligiosity, depression, anxiety, stress, and self-esteem).
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26
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Adair C, Luna-Rose H. Insights from an online self-help forum for people with gaming problems. Curr Opin Behav Sci 2022. [DOI: 10.1016/j.cobeha.2022.101157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Sun J, Yin X, Li C, Liu W, Sun H. Stigma and Peer-Led Interventions: A Systematic Review and Meta-Analysis. Front Psychiatry 2022; 13:915617. [PMID: 35865307 PMCID: PMC9294224 DOI: 10.3389/fpsyt.2022.915617] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose The main purpose of our systematic review was to investigate the effect of peer-led intervention on self-stigma in individuals with mental health problems. Secondary purpose was investigating the impact of peer intervention on clinical symptoms, recovery-related outcomes, and disclosure-related outcomes. Methods Five electronic databases were searched from 1975 to 2021. Literature databases were searched for randomized controlled trials. From the perspective of key outcomes, a meta-analysis of the effects of peer-led interventions on changing stigma was conducted. Results A meta-analysis of randomized controlled trials targeting different target groups with mental health problems (e.g., adolescents, college students, family members of mentally ill persons, unemployed persons, etc.) was conducted. It was found that, at the end of the intervention, intervention had a positive effect on main outcomes such as self-stigma and stress from stigma. As for secondary outcomes, there was no significant influence on clinical symptoms. There was a positive effect on rehabilitation and empowerment, but without a statistical significance. There was a statistically significant effect on self-efficacy and professional help seeking. There was a statistically significant effect on confidentiality and disclosure-related distress in the Honest Open Proud (HOP) subgroup. There was no significant influence on confidentiality and withdrawal in the non-HOP subgroup. Conclusion Peer-led intervention can reduce self-stigma and stigma pressure and might improve recovery and empowerment. It increases self-efficacy and willingness to seek professional help, but has no significant effect on clinical symptoms and withdrawal. HOP intervention has positive effects on disclosure-related confidentiality and pain. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42021287584.
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Affiliation(s)
- Jing Sun
- School of Public Health, Weifang Medical University, Weifang, China
| | - Xunbao Yin
- School of Teacher Education, Weifang University, Weifang, China
| | - Changjiang Li
- School of Psychology, Weifang Medical University, Weifang, China
| | - Wuyi Liu
- School of Public Health, Weifang Medical University, Weifang, China
| | - Hongwei Sun
- School of Public Health, Weifang Medical University, Weifang, China
- School of Psychology, Weifang Medical University, Weifang, China
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A call for ACTion: A systematic review of empirical evidence for the use of Acceptance and Commitment Therapy (ACT) with LGBTQI+ individuals. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Victor SE, Schleider JL, Ammerman BA, Bradford DE, Devendorf AR, Gruber J, Gunaydin LA, Hallion LS, Kaufman EA, Lewis SP, Stage DL. Leveraging the Strengths of Psychologists With Lived Experience of Psychopathology. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 17:1624-1632. [PMID: 35748769 DOI: 10.1177/17456916211072826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Psychopathology is a common element of the human experience, and psychological scientists are not immune. Recent empirical data demonstrate that a significant proportion of clinical, counseling, and school psychology faculty and graduate students have lived experience, both past and present, of psychopathology. This commentary compliments these findings by leveraging the perspectives of the authors and signatories, who have personal lived experience of psychopathology, to improve professional inclusivity in these fields. By "coming out proud," the authors aim to foster discussion, research, and inclusion efforts as they relate to psychopathology experiences in psychological science. To that end, the authors describe considerations related to disclosure of lived experience, identify barriers to inclusion, and provide concrete recommendations for personal and systemic changes to improve recognition and acceptance of psychopathology lived experience among psychologists.
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Affiliation(s)
- Sarah E Victor
- Department of Psychological Sciences, Texas Tech University
| | | | | | | | | | - June Gruber
- Department of Psychology and Neuroscience, University of Colorado Boulder
| | - Lisa A Gunaydin
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco
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Best MW, Bowie CR. Social exclusion in psychotic disorders: An interactional processing model. Schizophr Res 2022; 244:91-100. [PMID: 35640357 DOI: 10.1016/j.schres.2022.05.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/11/2022] [Accepted: 05/18/2022] [Indexed: 11/28/2022]
Abstract
Psychotic disorders are among the most highly stigmatized mental disorders, and individuals with psychosis experience significant exclusion from the community. Stigma reduction programs have done little to reduce social exclusion of individuals with psychosis, and there are significant limitations to the traditional stigma model as it applies to social exclusion. Herein, we present the Interactional Processing Model (IPM) of social exclusion towards individuals with psychosis. The IPM considers social exclusion to be the result of two interacting pathways with additional consideration for a feedback loop through which social exclusion sets in motion natural behavioural responses of individuals with psychosis that inadvertently perpetuates exclusion. The IPM considers initial social exclusion to be the result of an interaction between these two pathways. The first path aligns with the traditional stigma model and consists of the community becoming aware that an individual is diagnosed with a psychotic disorder and then excluding the individual based on pre-existing, generalized knowledge about the disorder. The second path to exclusion involves the observation of atypical behaviours from the individual, and generation of an individualized exclusion response. We provide initial empirical support for the IPM of social exclusion, outline testable hypotheses stemming from the model, and discuss implications for novel ways to consider both societal stigma reduction and personalized intervention.
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Affiliation(s)
- Michael W Best
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada.
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31
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Gearing RE, Brewer KB, Leung P, Cheung M, Chen W, Carr LC, Bjugstad A, He X. Mental health help-seeking in China. J Ment Health 2022:1-8. [PMID: 35532046 DOI: 10.1080/09638237.2022.2069703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 01/21/2022] [Accepted: 02/07/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND In China, mental health disorders are considered the leading causes of disability, yet treatment-seeking behaviors among individuals with mental health problems are deficient. AIMS This study sought to examine attitudes and participant characteristics associated with help-seeking among adults residing in China's Shanghai metropolitan area. METHODS This study employed a convenience cross-sectional sampling strategy and recruited 500 participants in public places in Shanghai. The survey administered in Mandarin was comprised of two sections: a series of demographic questions and standardized instruments measuring stigma and help-seeking attitudes. RESULTS Findings indicate that beliefs about seeking professional help for mental health are influenced by knowing someone with a mental health problem. In addition, men who were older, had a child, and were married endorsed more openness to help-seeking for mental health needs, underscoring the importance of life experience as an essential variable when considering attitudes toward help-seeking. CONCLUSIONS Findings support future research identifying the mechanisms by which these life experiences impact individuals' help-seeking attitudes.
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Affiliation(s)
- Robin Edward Gearing
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Kathryne B Brewer
- University of New Hampshire Institute for Policy and Social Science Research, Durham, NH, USA
| | - Patrick Leung
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Monit Cheung
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Wanzhen Chen
- East China University of Science and Technology, Shanghai, China
| | - L Christian Carr
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Arlene Bjugstad
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MHRIT ES Center), Graduate College of Social Work, University of Houston, Houston, TX, USA
| | - Xuesong He
- East China University of Science and Technology, Shanghai, China
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Adu J, Oudshoorn A, Anderson K, Marshall CA, Stuart H. Social Contact: Next Steps in an Effective Strategy to Mitigate the Stigma of Mental Illness. Issues Ment Health Nurs 2022; 43:485-488. [PMID: 34652979 DOI: 10.1080/01612840.2021.1986757] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
People living with mental illnesses and their families may conceal their conditions to avoid prejudice and discrimination. Stigma often prevents people from receiving adequate health care and other social support services which could exacerbate social and health consequences such as unemployment, homelessness, substance use, and compulsory hospitalization. In this paper, we discuss social contact as a promising anti-stigma strategy for enhancing social interactions among people with mental illnesses, their families, and those without mental illnesses. In particularly, we consider next steps for an approach that works to reduce the stigma-related burden of mental illness. For social contact to be effective in reducing mental illness stigma, it requires broad social buy-in as well as implementation within care systems. Engagement with this approach can be driven through diverse contact-based education using collaborative efforts of society, academic institutions, policy-makers, health professionals, media, and governments. Ultimately, this work aims to consider the next steps in enacting social contact as an anti-stigma strategy through direct interventions and contact-based education. The success of this approach requires pragmatic public policies to support its implementation.
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Affiliation(s)
- Joseph Adu
- Department of Health and Rehabilitation Sciences, Elborn College, Western University, London, Ontario, Canada
| | - Abe Oudshoorn
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Kelly Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Carrie Anne Marshall
- School of Occupational Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Heather Stuart
- Department of Public Health Sciences, Queens University, Kingston, Ontario, Canada.,Department of Psychiatry and the School of Rehabilitation Therapy, Queens University, Kingston, Ontario, Canada
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Wall A, Lovheden T, Landgren K, Stjernswärd S. Experiences and Challenges in the Role as Peer Support Workers in a Swedish Mental Health Context - An Interview Study. Issues Ment Health Nurs 2022; 43:344-355. [PMID: 34569894 DOI: 10.1080/01612840.2021.1978596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The focus on recovery within psychiatric care is increasing, where peer support may play a pivotal role. Previous research shows both mixed and promising results in terms of beneficial outcomes for patients and peer support workers (PSW). The study's aim was to investigate PSW' experiences of their professional role and associated relationships with healthcare staff and patients. Semi-structured in-depth interviews were conducted with 10 PSW. Data was analyzed with content analysis. Three themes were constructed; "Experience of stigma", "Authenticity and balance in the patient relationship" and "Opportunities and setbacks in the team". Challenges included stigmatization, loyalty conflicts, lack of a clear job description and feelings of insecurity and disinterest among other staff. However, the peer support role was perceived as deeply meaningful. The peer support role comes with challenges and opportunities for the PSW, and potentially for the patients and the surrounding work team. Further research is needed to illuminate the value of peer support for patients, PSW and healthcare staff, and potential barriers and facilitators to the integration of peer support within psychiatric care.Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1978596 .
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Affiliation(s)
- Anna Wall
- Department of Psychosis Care, Region Skåne, Malmö, Sweden
| | | | - Kajsa Landgren
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Sigrid Stjernswärd
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
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Zamir A, Tickle A, Sabin-Farrell R. A systematic review of the evidence relating to disclosure of psychological distress by mental health professionals within the workplace. J Clin Psychol 2022; 78:1712-1738. [PMID: 35247268 PMCID: PMC9541467 DOI: 10.1002/jclp.23339] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 11/10/2021] [Accepted: 02/12/2022] [Indexed: 11/27/2022]
Abstract
Objective To systematically review evidence regarding prevalence and choices of disclosure of psychological distress, by mental health professionals within the workplace. Methods Six databases were searched in June 2020. Studies were included if they were published in English language and included empirical quantitative, qualitative or mixed‐methods data. Studies were excluded if they focused on general healthcare professionals or the general population, or on stress or physical health problems. Study quality was assessed using the Mixed Methods Quality Appraisal tool. Results Nine studies, with a total of 1891 participants, were included. Study quality varied, with studies generally reporting descriptive surveys using hypothetical disclosure scenarios. Distress was often conceptualized in psychiatric terms. These limitations mean conclusions should be treated with caution. Individuals were less likely to disclose in work and had negative experiences of doing so compared to social circles. Fear of stigma inhibited disclosure. There were differing levels of disclosure relating to recipient, trust, quality of supervision, how distress was conceptualized, and type of problem. Disclosure was experienced by some as valuable. Conclusion There is a need for further research, which addresses the nuanced complexities surrounding disclosure choices for mental health professionals.
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Affiliation(s)
- Aliya Zamir
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Jubilee Campus, Nottingham, UK.,Derbyshire Healthcare NHS Foundation Trust, Nottinghamshire, UK
| | - Anna Tickle
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Jubilee Campus, Nottingham, UK.,Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, England
| | - Rachel Sabin-Farrell
- Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Jubilee Campus, Nottingham, UK.,Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, England
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35
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Hogg LI, Smith LGE, Morrison AP, Prosser AMB, Kurz T. The nuances of “the social cure” for people who experience psychosis. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2022. [DOI: 10.1002/ejsp.2848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Lorna I. Hogg
- Department of Psychology University of Bath
- Oxford Health NHS Foundation Trust
- Harris Manchester College University of Oxford
| | | | | | | | - Tim Kurz
- Department of Psychology University of Bath
- School of Psychological Science University of Western Australia
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36
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Lewis C, Zammit S, Jones I, Bisson JI. Prevalence and correlates of self-stigma in Post-Traumatic Stress Disorder (PTSD). Eur J Psychotraumatol 2022; 13:2087967. [PMID: 35898808 PMCID: PMC9310800 DOI: 10.1080/20008198.2022.2087967] [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] [Indexed: 11/12/2022] Open
Abstract
Background Self-stigma refers to the internalisation of negative societal views and stereotypes. Self-stigma has been well-characterised in the context of mental disorders such as schizophrenia but has received little attention in relation to post-traumatic stress disorder (PTSD). Objective This work aimed to determine the prevalence of self-stigma in a sample of adults with PTSD and to establish factors associated with the internalisation of stigma in this population. Method Participants were 194 adults (mean age 46.07 (SD = 12.39); 64.4% female; 96.6% white Caucasian; residing in the UK), who self-reported a diagnosis of PTSD and currently screened positive for the disorder according to the PTSD Checklist for DSM-5 (PCL-5). Structured interviews and validated self-report questionnaires were used to ascertain clinical and sociodemographic information for analysis. Results The prevalence of self-stigma measured by the Internalized Stigma of Mental Illness Scale (ISMIS) was 41.2% (95% CI 34.24-48.22). There was no evidence of an association between self-stigma and gender (β = -2.975 (95% CI -7.046-1.097) p = .151), age (β = 0.007 (95% CI -0.152-0.165) p = .953), sexual trauma (β = 0.904 (95% CI -3.668-5.476) p = .697), military trauma (β = -0.571 (95% CI -4.027-7.287) p = .571). Self-stigma was associated with lower income and higher levels of anxiety (β = 5.722 (95% CI 2.922-8.522) p = <.001), depression (β = 6.937 (95% CI 4.287-9.588) p = <.000), and traumatic stress symptoms (β = 3.880 (95% CI 1.401-6.359) p = .002). Conclusions The results indicate that self-stigma may be a significant issue among people with a diagnosis of PTSD. Further work is needed to understand the long-term impact and to develop interventions to address the internalisation of stigma in this population. HIGHLIGHTS The prevalence of self-stigma among a sample of participants with PTSD was 41.2%.There was no evidence of an association between self-stigma and gender, age or sexual / military trauma.Self-stigma was associated with lower income and higher levels of anxiety, depression, and traumatic stress symptoms.
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Affiliation(s)
- Catrin Lewis
- National Centre for Mental Health (NCMH), Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Stan Zammit
- National Centre for Mental Health (NCMH), Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.,Centre for Academic Mental Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Ian Jones
- National Centre for Mental Health (NCMH), Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Jonathan I Bisson
- National Centre for Mental Health (NCMH), Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
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Sefi S, Shoval G, Lubbad N, Goldzweig G, Hasson-Ohayon I. Coping With Information Style, Self-Concealment, Internalized Stigma, and Family Burden Among Parents of Children With Psychiatric Disorders. FAMILY PROCESS 2021; 60:1523-1538. [PMID: 33521955 DOI: 10.1111/famp.12637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Parents of children with psychiatric disorders who are hospitalized in a psychiatric unit often experience family burden. Family burden has been found to be affected by many variables related to parents' personal traits and ways of reacting to the disorder. The current study examined the association between information coping styles (monitoring and blunting) and family burden, among parents of children who were hospitalized in a day care unit. The possible role of self-stigma as a mediator between coping style and family burden and the role of self-concealment as a moderator between coping style and self-stigma were examined. A total of 41 parents completed questionnaires assessing their levels of self-stigma, information coping style, self-concealment, and family burden. Self-stigma was found to mediate the positive association between the monitoring coping style and family burden. Moreover, a moderation effect of self-concealment was found, indicating that monitoring parents suffered from higher levels of self-stigma particularly if they had a high tendency toward self-concealment. Taking into account parents' information, coping style, self-stigma, and self-concealment can help professionals tailor family interventions according to parents' diverse needs. A monitoring coping style may not be beneficial especially when combined with concealment, suggesting the need to promote other coping styles.
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Affiliation(s)
- Shir Sefi
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Gal Shoval
- Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nesrin Lubbad
- Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel Aviv-Yaffo, Israel
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38
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Rothschild N, Aharony N. Self-disclosure in public and private groups of people with mental illnesses in Facebook. ONLINE INFORMATION REVIEW 2021. [DOI: 10.1108/oir-04-2021-0212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe Internet enables various voices and opinions that previously did not participate in the community discourse to express themselves. People with mental illnesses make use of social networks to advance their special needs in varied ways. The study aims to examine the nature of the discourse that takes place in public and private groups of people with mental illnesses.Design/methodology/approachThe research corpus consisted of the content of 615 messages taken from public and private groups of people with mental illnesses in Facebook. Linguistic parameters (the total number of words, the number of words in the first person) were examined for each message. Two skilled judges classified the messages on a self-disclosure scale to determine the degree of disclosure of personal information, thoughts and emotions.FindingsThe results of the study indicate that the messages published in public groups are longer than the messages in private groups; however, the level of personal disclosure in messages written in private groups is deeper than in messages written in public groups. In addition, the level of self-disclosure in opening posts was found to be greater than the level of self-disclosure in comments.Practical implicationsIn the study, the authors focus on the ways people in excluded populations make use of virtual tools to advance both their personal and social needs.Originality/valueThe study is innovative, as it explores the discourse of people with mental illnesses in public and private groups on Facebook.
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Disclosure processes as predictors of relationship outcomes among people in recovery from opioid use disorder: A longitudinal analysis. Drug Alcohol Depend 2021; 228:109093. [PMID: 34601276 DOI: 10.1016/j.drugalcdep.2021.109093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/15/2021] [Accepted: 09/15/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Personal disclosure of opioid use disorder (OUD) recovery can lead to relationship outcomes such as social support, which is associated with greater treatment retention, or stigma, which is associated with risk of treatment dropout. Although disclosure may have important impacts on the relationships and ensuing recovery trajectories of people with OUD, disclosure processes remain understudied in the context of OUD. METHODS Guided by the Disclosure Process Model, this longitudinal study explored the disclosure goals of people in treatment for OUD and examined associations between disclosure goals and relationship outcomes. Data were collected at baseline (N = 146) and three months later (n = 124) from participants who were in treatment for OUD and planning to disclose their OUD history and/or treatment to someone new. RESULTS Qualitative baseline data were analyzed to identify disclosure goals. Approach goals (i.e., reasons for disclosure) included support, honesty, amends, set an example, and logistics; avoidance goals (i.e., reasons against disclosure) included judgment, worry, and privacy. Quantitative data suggested that approach goals at baseline were associated with greater likelihood of disclosure within three months (OR=2.16, 95% CI=1.04-4.49) as well as with greater social support [B(SE)= 0.35(0.16), p = 0.03] and relationship closeness [B(SE)= 0.29(0.17), p = 0.01] following disclosures. In contrast, avoidance goals at baseline were associated with greater enacted stigma following disclosures [B(SE)= 0.30(0.14), p = 0.04]. CONCLUSIONS Findings draw attention to the potentially important role of disclosures in relationship outcomes among people in recovery from OUD. Disclosure may represent a promising intervention target to improve relationship outcomes and recovery trajectories of people in recovery from OUD.
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Serchuk MD, Corrigan PW, Reed S, Ohan JL. Vicarious Stigma and Self-Stigma Experienced by Parents of Children with Mental Health and/or Neurodevelopmental Disorders. Community Ment Health J 2021; 57:1537-1546. [PMID: 33475886 PMCID: PMC8531051 DOI: 10.1007/s10597-021-00774-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 01/05/2021] [Indexed: 02/08/2023]
Abstract
The stigma of young children with mental health and/or neurodevelopmental disorders is experienced by their parents in at least two ways: self-stigma and vicarious stigma. Secrecy may diminish stigma through impression management or strategic disclosure. The present study explores the relationship between vicarious stigma, self-stigma, secrecy coping, depression, and quality of life. Additionally, we examine the structure of a novel measure of vicarious stigma. Fifty parents of children with mental health and/or neurodevelopmental disorders completed measures. Self-stigma and sadness due to vicarious stigma were significantly associated with greater depression and diminished quality of life. Higher secrecy coping was also associated with higher depression and lower quality of life, supporting the benefits of disclosure. This research meaningfully adds to our understanding of stigma in general, and as experienced by parents of children with mental health and/or neurodevelopmental disorders. Implications for ongoing stigma change development and evaluation are discussed.
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Affiliation(s)
- Marisa D Serchuk
- Department of Psychology, Illinois Institute of Technology, 3424 South State Street, Chicago, IL, 60616, USA.
| | - Patrick W Corrigan
- Department of Psychology, Illinois Institute of Technology, 3424 South State Street, Chicago, IL, 60616, USA
| | - Sarah Reed
- Rogers Behavioral Health, 4555 W. Schroeder Drive, Suite 185, Brown Deer, WI, 53223, USA
| | - Jeneva L Ohan
- School of Psychological Science, University of Western Australia, M304, Perth, WA, 6009, Australia
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Croft RL, Byrd CT. Does the clinical utility of self-disclosure of stuttering transcend culturally and linguistically diverse populations? INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 23:548-558. [PMID: 33544005 DOI: 10.1080/17549507.2020.1861326] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Purpose: Research suggests that self-disclosure can improve listeners' perceptions of stuttering; however, it is unknown whether the effectiveness of self-disclosure transcends culture and language. This study examined the clinical utility of self-disclosure in a culturally and linguistically diverse population: Hebrew-speaking people who stutter in Israel.Method: The experimental protocol replicated Byrd, Croft et al. Participants (N = 92 adults in Israel) viewed a video of either a male or female Hebrew-speaking person who simulated stuttering and self-disclosed informatively, apologetically, or not at all. Participants then rated the speaker on ten traits (i.e. friendly, outgoing, intelligent, confident, engaging, distracting, unfriendly, shy, unintelligent, insecure) using a bipolar likert scale.Result: Results indicated that participants rated the speaker who self-disclosed in a neutral and informative manner as significantly more outgoing compared to the speaker who did not self-disclose at all, supporting the results from Byrd, Croft et al. Additionally, the male speaker was rated as significantly more friendly and outgoing than the female speaker.Conclusion: This study suggests that self-disclosing in a neutral and informative manner can improve listeners' perceptions of people who stutter similarly across culture and language.
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Affiliation(s)
- Robyn L Croft
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, USA
| | - Courtney T Byrd
- Department of Speech, Language, and Hearing Sciences, The University of Texas at Austin, Austin, USA
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Qualitative characterizations of misinformed disclosure reactions to medications for opioid use disorders and their consequences. J Subst Abuse Treat 2021; 132:108593. [PMID: 34507880 DOI: 10.1016/j.jsat.2021.108593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 07/15/2021] [Accepted: 08/05/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Methadone and buprenorphine/naloxone medications are among the most effective treatment options for opioid use disorders, yet many people remain misinformed about their benefits and hold negative perceptions about the use of medications to treat opioid use disorders. Such perceptions, especially negative perceptions based on misinformation, may be especially harmful or stigmatizing within the context of disclosure (i.e., telling another about one's opioid use disorder history or treatment), inhibiting important recovery outcomes and sources of social support. METHODS Therefore, using the Disclosure Process Model as a framework, the current study seeks to characterize and compare participants' perceptions of stigmatizing reactions to their disclosures of MOUD use that stem from misinformation about methadone or buprenorphine/naloxone. Participants included people who are actively receiving MOUD as treatment. RESULTS Results suggest that participants (N = 52) receiving both types of medications experienced similar stigmatizing reactions to disclosures. Participants also reported treatment consequences of misinformed reactions to their disclosure, such as dropping out of support groups (e.g., Narcotics Anonymous) or prematurely ending their medication use. Further, the paper provides participants' recommendations for avoiding or managing misinformed disclosure reactions. CONCLUSIONS Short-term intervention efforts may promote strategies to manage misinformation, equipping individuals to respond to misinformation surrounding their medication use. Long-term interventions may target misinformation about methadone and buprenorphine/naloxone medications to increase health literacy, reduce stigma, and combat cultural ambivalence within communities, as well as promote recovery among people receiving medications for opioid use disorder.
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Rüsch N, Kösters M. Honest, Open, Proud to support disclosure decisions and to decrease stigma's impact among people with mental illness: conceptual review and meta-analysis of program efficacy. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1513-1526. [PMID: 33893512 PMCID: PMC8429161 DOI: 10.1007/s00127-021-02076-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Honest, Open, Proud (HOP; formerly "Coming Out Proud"/COP) is a peer-led group program to support people with mental illness in their disclosure decisions and in their coping with stigma. The aims of this study were to provide (i) a conceptual review of HOP, including versions for different target groups and issues related to outcome measurement and implementation; and (ii) a meta-analysis of program efficacy. METHODS Conceptual and empirical literature on disclosure and the HOP program was reviewed. Controlled trials of HOP/COP were searched in literature databases. A meta-analysis of HOP efficacy in terms of key outcomes was conducted. RESULTS HOP program adaptations for different target groups (e.g. parents of children with mental illness; veterans or active soldiers with mental illness) exist and await evaluation. Recruitment for trials and program implementation may be challenging. A meta-analysis of five HOP RCTs for adults or adolescents with mental illness or adult survivors of suicide attempts found significant positive effects on stigma stress (smd = - 0.50) as well as smaller, statistically non-significant effects on self-stigma (smd = - 0.17) and depression (smd = - 0.11) at the end of the HOP program. At 3- to 4-week follow-up, there was a modest, not statistically significant effect on stigma stress (smd = - 0.40, 95%-CI -0.83 to 0.04), while effects for self-stigma were small and significant (smd = - 0.24). Long-term effects of the HOP program are unknown. CONCLUSION There is initial evidence that HOP effectively supports people with mental illness in their disclosure decisions and in their coping with stigma. Implementation issues, future developments and public health implications are discussed.
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Affiliation(s)
- Nicolas Rüsch
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm/Günzburg, Germany.
| | - Markus Kösters
- Department of Psychiatry II, Ulm University and BKH Günzburg, Ulm/Günzburg, Germany
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Cipollina R, Sanchez DT, Egert A, Dominick JK, Albuja AF, Maimon MR. Disclosure Style and Response Engagement During Disclosures of Concealable Stigmatized Identities. SOCIAL PSYCHOLOGICAL AND PERSONALITY SCIENCE 2021. [DOI: 10.1177/19485506211034390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Supportive disclosure experiences benefit the well-being of those with concealable stigmatized identities (CSIs). The present research examines relationships between discloser’s disclosure directness, recipient’s response engagement, feelings of identity support, and disclosure response satisfaction. Across several correlational and experimental studies, direct disclosures (i.e., those referencing the CSI more explicitly) were met with more engaged recipient responses (e.g., verbal discussion of CSIs). Moreover, more engaged recipient responses were evaluated by disclosers as more supportive/validating and satisfying. To isolate the effects of disclosure directness, we explored and controlled for other disclosure factors including closeness to recipient and discloser outness. This work fills a current literature gap regarding how disclosure and response styles may promote positive disclosure experiences for those with varied CSIs.
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Moore K, Camacho D, Spencer-Suarez KN. A mixed-methods study of social identities in mental health care among LGBTQ young adults of color. THE AMERICAN JOURNAL OF ORTHOPSYCHIATRY 2021; 91:724-737. [PMID: 34166057 PMCID: PMC10794050 DOI: 10.1037/ort0000570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Social identities have been shown to reflect normative beliefs and practices that can impact important health behaviors. A better understanding of how this process unfolds among young people with marginalized identities can help inform strategies to decrease mental health disparities and improve their overall health outcomes. A mixed method, convergent parallel design was used to examine identity centrality, mental health treatment history, and cultural experiences of a purposeful sample, consisting of 31 Black and Latinx young adults (Mage = 22.16) who identified as sexual and gender minorities in New York City. Data from validated measures and in-depth interviews were triangulated to strengthen and add context to findings. Participants with higher social identity centrality scores, particularly on community belonging and sexual identity, were more likely to continuously use mental health services. Seven social identities were prominent in qualitative data: Sexual, Ethnic-racial, Religious, Socioeconomic, Gender, Family, and Generational. These social identities were described as interconnected, and as both significant barriers and facilitators to participants' involvement in treatment. Results suggested that young lesbian, gay, bisexual, transgender, queer (LGBTQ) people of color seeking mental health care might need more support to navigate experiences related to intersecting identities. Interventions to improve services and maintain these youth in treatment should employ strategies to assess and support positive minority identity development, while also addressing self-stigma and discrimination experienced through culture, family, and mental health professionals. Considering social identity development is conceptually useful for adapting services for diverse youth because it is a major focus of transitioning to adulthood and calls attention to multiple minority identities impacting individual clients. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Kiara Moore
- Silver School of Social Work, New York University
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Zahid A, Best MW. Stigma towards individuals with schizophrenia: Examining the effects of negative symptoms and diagnosis awareness on preference for social distance. Psychiatry Res 2021; 297:113724. [PMID: 33486270 DOI: 10.1016/j.psychres.2021.113724] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 01/11/2021] [Indexed: 12/26/2022]
Abstract
Social exclusion towards individuals with schizophrenia can occur as a result of stigmatizing attitudes towards the diagnosis or as a response to observing atypical behaviours resulting from symptoms. The present study examined social exclusion towards schizophrenia as a function of diagnosis awareness and presence of negative symptoms. 64 healthy participants watched four different videos of confederates who were either labelled / not labelled with schizophrenia and displayed / did not display negative symptoms. Participants ranked their preference for social interaction with individuals in ten different activities and were told that they would complete the activities based on their rankings. A significant interaction between label and symptoms was found as knowledge of diagnosis increased desire for social distance if symptoms were absent and decreased desire for social distance if symptoms were present. A main effect of symptom presence was also found as participants displayed greater desire to complete activities with individuals not displaying symptoms than participants displaying symptoms but there was no effect of diagnostic label. Social exclusion appears to be dependent on both presence of negative symptoms and knowledge of diagnosis. It may be useful to focus on increasing public acceptance of specific symptom presentations in public mental health campaigns.
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Affiliation(s)
- Aqsa Zahid
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada; Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, ON, Canada M1C 1A4
| | - Michael W Best
- Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada; Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, Toronto, ON, Canada M1C 1A4.
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Golay P, Moga M, Devas C, Staecheli M, Poisat Y, Israël M, Suter C, Silva B, Morandi S, Ferrari P, Favrod J, Bonsack C. Measuring the paradox of self-stigma: psychometric properties of a brief scale. Ann Gen Psychiatry 2021; 20:5. [PMID: 33468180 PMCID: PMC7814463 DOI: 10.1186/s12991-021-00325-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 01/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exposure to public stigma can lead to stereotype endorsement and resignation, which are constructs related to self-stigma. This latter phenomenon has well-documented deleterious consequences for people living with mental illness. Paradoxically, it can also lead to the empowering reactions of righteous anger and coming out proud. AIM The aim of this study was to develop and validate a brief tool to measure stereotype endorsement, righteous anger, and non-disclosure across different groups of stigmatized persons. This process was conducted in collaboration with users. METHOD Using focus groups with mental health professionals and people living with mental illness, 72 items were developed to measure various aspects of self-stigma. The Paradox of Self-Stigma scale (PaSS-24) containing 24 items and three subscores (stereotype endorsement, non-disclosure, and righteous anger) resulted from a calibration phase using factor analysis. This structure was cross-validated on an independent sample. Internal consistency, test-retest reliability, and convergent validity were also evaluated. RESULTS 202 patients were assessed. The PaSS-24 demonstrated good internal validity. Internal consistency, test-retest reliability, and convergent validity estimates were also good. CONCLUSIONS The PaSS-24 is a short but psychometrically rigorous tool designed to measure self-stigma and related constructs in French language, developed in collaboration with users. The development and validation of the PaSS-24 represent a first step towards implementing and evaluating programs aimed at reducing negative consequences of self-stigma.
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Affiliation(s)
- Philippe Golay
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. .,General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. .,Institute of Psychology, Faculty of Social and Political Science, University of Lausanne, Lausanne, Switzerland.
| | - Mihaela Moga
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Celia Devas
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Mélissa Staecheli
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Yasmine Poisat
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Marie Israël
- Groupe d'accueil et d'action psychiatrique (GRAAP), Lausanne, Switzerland
| | - Caroline Suter
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Benedetta Silva
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Stéphane Morandi
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pascale Ferrari
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Jérôme Favrod
- La Source, School of Nursing Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Lausanne, Switzerland
| | - Charles Bonsack
- Community Psychiatry Service, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Bhatt J, Stoner CR, Scior K, Charlesworth G. Adaptation and preliminary psychometric properties of three self-stigma outcome measures for people living with dementia. BMC Geriatr 2021; 21:34. [PMID: 33422016 PMCID: PMC7796608 DOI: 10.1186/s12877-020-01983-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 12/22/2020] [Indexed: 11/29/2022] Open
Abstract
Background A diagnosis of dementia presents individuals with both social and psychological challenges but research on self-stigma in dementia has been largely confined to qualitative approaches due to a lack of robust outcome measures that assess change. The Stigma Impact Scale (SIS) is the most commonly used measure of self-stigma in dementia but its suitability as a tool to assess change in a UK population is unclear. Thus, the aim of this study was to identify, adapt and evaluate the acceptability and preliminary psychometric properties of self-stigma measures for people with dementia for use as measures of change. Method A 4-step sequential design of identifying, selecting, adapting and testing psychometric measures as follows: 1) identification of stigma outcome measures through reviewing anti-stigma intervention literature, 2) selection of candidate measures through quality assessment (Terwee criteria) and expert consultation, 3) adaptation for UK dementia population (Stewart and colleagues Modification Framework) 4) testing of adapted measures in people living with dementia (N=40) to establish acceptability and preliminary reproducibility (test retest), criterion (concurrent with SIS) and construct (negative convergence with Rosenberg self-esteem scale) validity. Results Seven measures were identified from the review, but most were poor quality (Terwee range: 0–4). Three measures were selected for modification: Stigma Stress Scale; Secrecy subscale of the Stigma Coping Orientation Scale; Disclosure Related Distress Scale. Internal consistency and test-retest reliability were acceptable (.866≤α≤ .938; ICC .721–.774), except for the Stigma Stress Scale (α= .643) for which the component subscales (perceived harm, ability to cope) had stronger psychometric properties. Concurrent validity with the SIS was not established (r<.7) although there were significant correlations between total SIS and perceived harm (r=.587) and between internalized shame and secrecy (r=.488). Relationships with self-esteem were in the hypothesized direction for all scales and subscales indicating convergent validity. Conclusion Stigma scales from mental health are not readily adapted for use with people with dementia. However there is preliminary evidence for the acceptability, reliability and validity of measures of perceived harm, secrecy and stigma impact. Further conceptual and psychometric development is required.
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Affiliation(s)
- Jem Bhatt
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.
| | - Charlotte R Stoner
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Katrina Scior
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Georgina Charlesworth
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK.,Research and Development, North East London Foundation Trust, Essex, UK
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Lockenvitz S, Tetnowski JA, Oxley J. The sociolinguistics of lisping: a review. CLINICAL LINGUISTICS & PHONETICS 2020; 34:1169-1184. [PMID: 32646249 DOI: 10.1080/02699206.2020.1788167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 06/11/2023]
Abstract
This article presents a review of the lisping research literature with the aim of providing a framework for the consideration of the sociolinguistics of lisping. We consider, in turn, the nature of lisping, the construction of identity through speech, the nature of stigma, and, in particular, stigma associated with communication disorders and especially lisping. Further, we examine two aspects of the literature on lisping in more detail: lisping as minor bodily stigma and lisping and the internet. We conclude that experiential research on identity construction at the level of the individual, and stigma theory at a collective speech community level, support the case for viewing the sociolinguistics of lisping as a legitimate field of study and establishing a framework for acknowledgment of and further investigation into the self-identified adult who lisps.
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Affiliation(s)
- Sarah Lockenvitz
- Communication Sciences and Disorders, Missouri State University , Springfield, USA
| | - John A Tetnowski
- Communication Sciences and Disorders, Oklahoma State University , Stillwater, USA
| | - Judith Oxley
- Communicative Disorders, University of Louisiana , Lafayette, USA
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Ong WJ, Shahwan S, Goh CMJ, Tan GTH, Chong SA, Subramaniam M. Daily Encounters of Mental Illness Stigma and Individual Strategies to Reduce Stigma - Perspectives of People With Mental Illness. Front Psychol 2020; 11:590844. [PMID: 33192931 PMCID: PMC7661547 DOI: 10.3389/fpsyg.2020.590844] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/06/2020] [Indexed: 01/21/2023] Open
Abstract
Introduction A qualitative evaluation of mental illness stigma experienced by people with mental illness (PMI) is currently lacking in Singapore. This study aims to employ qualitative methods to identify the common encounters of mental illness stigma experienced by PMI in Singapore and uncover their individual strategies and efforts to reduce mental illness stigma. Methods This study is part of a larger research project that explores the concept of mental illness stigma among different stakeholders in Singapore. Focus group discussions (FGDs) were conducted with 42 PMI to collect qualitative data on their experience with mental illness stigma, including encounters of stigma and individual strategies to reduce stigma. The inductive thematic analysis method was employed to analyze the data. Results The eight emergent themes associated with encountering stigma in PMI's everyday life were categorized into two over-arching themes, public stigma (i.e., negative beliefs and attitudes, subjected to contemptuous treatment, social exclusion, over-scrutinizing, and receiving excessive care and concern) and structural stigma (i.e., the requirement to declare psychiatric conditions during job interviews, excluded from consideration after the declaration, and requirement of medical endorsements for employment). Four themes regarding PMI's individual strategies to reduce stigma were also identified (i.e., non-disclosure of condition, standing up for themselves, individual efforts in raising awareness, improving themselves, and living life as per normal). Limitations Participants may be influenced by social desirability bias due to the presence of other participants in an FGD setting. Also, those who agreed to participate in the study may possess strong views or beliefs about mental illness stigma and may therefore be inherently different from those who refused to participate. Conclusion Our findings on instances of public and structural stigma encountered by PMI in Singapore can guide policymakers with the development of future policies and strategies to reduce mental illness stigma in the Singapore society. Furthermore, our study also identified individual strategies that PMI employed to reduce mental illness stigma. However, the effectiveness of these strategies was unclear and little is known of their effect on PMI themselves. Hence, there is a need for future studies to examine these strategies.
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Affiliation(s)
- Wei Jie Ong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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