O IMPACTO DAS EXPERIÊNCIAS ESTIGMATIZADORAS E AUTOESTIGMA NA SAÚDE MENTAL E NO COMPORTAMENTO SUICIDA: UM ESTUDO EM PAÍSES DE LÍNGUA PORTUGUESA

Abstract

Introduction: Stigma was first described as an attribute that discredits an individual from society, diminishing the person. People who have self-stigma endorse negative stereotypes about themselves, which leads to negative reactions and feelings of shame. Self-stigma affects the overall health, mainly mental health, quality of life and can lead to poor self-esteem and poor self-efficacy, and has been found to be a major barrier when it comes to seeking help from mental health professionals. There are several studies addressing the effects of self-stigma on people with mental illness and studies addressing how self-stigma affects treatment seeking in people with mental illness. That being said, there is a large gap in demonstrating the relationship between experiences of stigmatization and the impact on mental health. Moreover, self-stigma can be seen as a risk factor for suicide, whose consequences (shame, hopelessness, social isolation and low self-esteem) are also risk factors for suicide. Objectives: The majority of the studies conducted about self-stigma and stigmatizing experiences in Portugal, Brazil and African Countries are focused on the mental health stigma and HIV/AIDS related stigma. Thus, this study aims to address the lack of studies of the impact of stigmatizing experiences in the normative populations in this countries and to explore the impact of self-stigma and stigmatizing experiences on the mental health and suicidal behavior by 1) evaluating the stigmatizing experiences, self-stigma, mental health and suicidal behavior, comparing differences between countries of residence; 2) evaluating the correlations between self-stigma, stigmatizing experiences, mental health variables and suicidal behavior; 3) determining the effect of self-stigma, number of stigmatizing experiences and sociodemographic variables in predicting mental health and suicidal behavior. Methods: 1006 participants from Portugal, Brazil and African Countries with Portuguese as an Official Language (ACPOL), 424 men and 576 women, between the ages of 18 and 80 years old (mean=41.76; SD=14.19) responded to the survey. 53.7% reported having had stigmatizing experiences, in which 15.9% reported experiences about skin colour, 10.7% regarding cultural or ethnic origin, 13.5% regarding gender identity, 9.5% regarding sexual orientation, 17.6% regarding physical attributes, 8.3% regarding age, 15.4% regarding weight, 1.5% regarding physical illness, 3.3% regarding mental illness, 1.3% regarding physical disabilities, 9.5% regarding poverty and 8.1% regarding place of residence. Measurement instruments included a sociodemographic questionnaire, the Brief Symptom Inventory-18, the Portuguese version of the Suicidal Behaviours Questionnaire- Revised (SBQ-R) and the Paradox of Self‑Stigma scale (PaSS‑24). Results: The results showed participants with higher levels of self-stigma and stigmatizing experiences presented significantly higher mental health issues and suicidal behavior. Correlational analyses showed significant correlations among mental health and suicidal variables and self-stigma variables. Regression analyses showed that sociodemographic variables, number of stigmatizing experiences and self-stigma explained 25.3% of mental health issues and sociodemographic variables, number of stigmatizing experiences and self-stigma explained 13.5% of suicidal behavior. Conclusions: Self-stigmatization has a negative impact on mental health and suicidal behavior, and countries should initiate mental health promotion campaigns and suicide prevention campaigns whose central goal should be to optimize people's quality of life