Anti-stigma Interventions Research Articles

Unveiling the silent struggle: navigating the labyrinth of mental health for parents of children with life-threatening illnesses in Pakistan.

Dear Editor, We write this letter to highlight the scarcely recognised complexity associated with the unrecognised mental health needs of parents of children diagnosed with life-threatening or life-limiting illnesses. It has been widely established that parents of children with disabilities are at an increased risk of developing variants of mental diseases when compared to parents of children without such disabilities. Parents tend to alter their lives socially to acclimatize themselves as caregivers for their children, therefore adopting a role that becomes far more labyrinthine as both parent and caregiver. (1) Mental health in general, is a subject that is insufficiently addressed in societal and scholarly contexts, specifically in Pakistan, particularly among parents. Within the scope of parents acting as sole caregivers, stress is a prominent determinant contributing to their mental health. Stress can attenuate parents’ and children’s abilities to navigate these circumstances and diminish their capacity for problem-solving and coping. (2) There are a myriad of factors that contribute to the reported prevalence of mental health-related disorders among parents of children with disabilities. Mental health remains a stigmatised entity. Such disregard impedes the delivery of healthcare towards patients suffering from mental health illnesses. There is a noteworthy hindrance in individuals facing such factors when amalgamatinge into society. When considering parental figures of diseased children, this facet serves to isolate further and reinforce such mental health illnesses. The lack of quantifiable data on anti-stigma interventions in Low and Middle-Income Countries, including Pakistan, underscores the urgent need for research. (3) Parents of children admitted to the ICU have a near-pervasive struggle with mental health and an innate inability to disclose their requirements for support. Factors barricading such disclosure should be identified and broken down through interventions, facilitating access to vital mental health support. (4) Caregivers must establish coping strategies, and remain a steady pillar of support and comfort to their child. The Keeping Hope Alive Toolkit intervention was established, which worked on fostering emotional experiences, living in the moment, remembering self and supporting social preferences, this intervention provided a template for emotional support. (5) We hope this letter can underscore how important supporting parental disclosure of unmet mental health needs is – a rampant and insufficiently reported plight in Pakistan. The ability to recognise these emotions and rectify them is not highlighted in this region but is imperative to implement, to improve the provision of healthcare to diseased children and their parents alike.

Correlates of public stigma towards prolonged grief disorder

BackgroundPublic stigma for grief may reduce the social support provided to bereaved persons and increase bereavement-related distress. The general public reports more stigmatizing responses towards bereaved persons with prolonged grief disorder (PGD) than towards persons experiencing non-clinical grief. No studies to date have investigated whether personal characteristics of the general public relate to public stigma towards PGD. The present study examined whether participants’ socio-demographic characteristics and personal bereavement experiences are associated with stigmatizing responses towards PGD. MethodWe combined data of three previously published vignette experiments to conduct a secondary analysis. All studies presented members of the general public (N = 452) with a description of a male bereaved person with PGD symptoms and a PGD diagnosis. Participants rated three indicators of public stigma - negative attributes (competence, warmth), emotional reactions (fear, anger), and preferred social distance. First, we examined whether gender, age, and educational level related to public stigma towards PGD. Second, we examined the association of participants’ personal bereavement experiences with public stigma. ResultsRegression analyses demonstrated that participants’ socio-demographic characteristics explained a significant amount of variance for warmth (ΔR² = .03; p < .05) and anger (ΔR² = .05; p < .01): Male participants rated the person in the vignette as less warm (β = -.13, p < .05). Being older related to lower ratings of warmth (β = -.12, p < .05) and higher ratings of anger (β = .18, p < .01). Participants’ educational level was not associated with stigma. Participants’ bereavement experiences explained a significant amount of variance for preferred social distance (ΔR² = .11; p <. 05): Participants reporting higher personal grief severity preferred less social distance from a person with PGD (β = -.29, p < .05). A higher number of experienced losses, the recency of the bereavement, and the cause of death (natural vs. unnatural) did not relate to public stigma. ConclusionsMale and older persons are more likely to demonstrate public stigma towards PGD. Experiencing severe grief oneself is associated with less preferred social distance from a person with PGD. Anti-stigma interventions may advance the public's knowledge about grief and PGD and address specific target groups (men and older persons).

Irrational parenthood cognition and infertility stigma among infertile women: A cross-sectional study in Changsha, China

BackgroundStigma is among the most prevalent and disturbing consequences of being infertile among women, yet it remains unknown whether fertility stigma is affected by irrational parenthood cognitions (IPC). The current study aimed to assess IPC, infertility stigma, and their interrelationship among a group of Chinese women referred to an infertility center in Changsha, Hunan, China. MethodsA cross-sectional study was conducted among 376 women seeking treatment for infertility in Changsha City, China. Pearson correlation test was used to explore the association between IPC and infertility stigma, while multivariate linear regression was used to explore the independent influencing factors of infertility stigma. ResultsParticipants had a mean score of 42.41 ± 13.03 for IPC and 62.89 ± 24.50 for ISS. IPC was highly correlated with infertility stigma with a large effect size (r = 0.55, p < 0.001). Multivariate linear regression showed that patients' infertility stigma was positively associated with IPC (β = 1.06, p < 0.001) while negatively associated with education (β = −5.4, p = 0.036) and disclosure of infertility (β = −8.39, p = 0.001) (R2 = 36 %). In addition, various influencing factors were identified for the four dimensions of infertility stigma. ConclusionThis study is the first to identify a positive association between irrational parenthood cognitions and infertility stigma among infertile women in China. Our findings provide useful guidance for the future development of effective anti-stigma intervention programs among infertile women.

Adapting the Opening Minds Stigma Scale for Healthcare Providers to Measure Opioid-Related Stigma.

The opioid crisis in Canada continues to cause a devastating number of deaths. Community-based naloxone programs have been identified as one of the solutions for combatting this crisis; however, there are disparities in which pharmacies stock and offer naloxone. Opioid-related stigma is a major barrier for limited naloxone distribution through pharmacies. Therefore, the development of anti-stigma interventions is crucial to improve naloxone distribution in Canada. However, there is no validated tool to specifically measure opioid-related stigma. The Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) is a validated scale used to measure mental illness-related stigma. This study will adapt the OMS-HC by using four different opioid-related terminologies to determine which is the most stigmatizing to use in an opioid-related anti-stigma intervention. Pharmacy students completed four versions of the adapted OMS-HC. The average OMS-HC scores and Cronbach's α co-efficient were calculated for each version. The term "opioid addiction" was found to be the most stigmatizing term among participants and will be used in the adapted version of the OMS-HC in a future anti-stigma interventions.

Examining recovery and mental health service satisfaction among young immigrant Muslim women with mental distress in Quebec

ObjectiveThe overall aim of this study was to understand the experiences and perspectives of immigrant Muslim women in Quebec living with mental illness, who have recently used formal mental health services such as an accredited therapist, psychologist, or clinician. Specific objectives included (i) eliciting and examining their self-identified barriers and facilitators to recovery; (ii) exploring links between religion and mental health; and (iii) self-reported satisfaction with mental health services received.MethodsWe adopted a qualitative approach, facilitating the prioritization of participant perspectives. This involved semi-structured interviews with 20 women who (i) identified as Muslim; (ii) had used mental health services in the last three years; and (iii) were 18 + years of age. Interviews were transcribed and analyzed using thematic analysis techniques.ResultsThree prominent themes emerged from the analysis. These themes were (i) stigma and misunderstandings in families (especially parents) and sometimes in the ethno-religious community, both acting as barriers to health service utilization and recovery; (ii) frustrating clinical experiences within formal mental health care settings, in particular a perceived lack of cultural and religious competence, which negatively affected service utilization and the development of a therapeutic alliance; and (iii) deeply-held religious beliefs, practices and trust in God imparting a rhythm, purpose and meaning, which were strong facilitators to recovery.Conclusions and implications for practiceThese findings suggest that recovery from mental illness can be advanced by a three-pronged approach in this population. First, anti-stigma mental health literacy interventions could be held in collaboration with Muslim community groups. Second, there is a need for further religious and cultural competence interventions, resources and trainings for mental health professionals working with Muslims. Third, self-care resources should be developed that harness aspects of religious practices that can give structure, meaning, purpose and hope. All this could ultimately foster recovery in this population.

Children of parents with a mental illness - stigma questionnaire: validation and revision.

Mental disorders are often stigmatized in society. The stigma of mental illness affects people with a mental illness themselves as well as their family members-a phenomenon called stigma by association (SBA). Children of parents with a mental illness (COPMI) are a particular vulnerable group for SBA. In our systematic review, experienced SBA, anticipated SBA, affiliate SBA, and structural discrimination were identified as relevant stigma dimensions for children of parents with a mental illness. To assess SBA in adolescents who grow up with a parent with a mental illness, the COPMI-SQ was developed. N = 930 adolescents completed the study. Of those, N = 380 adolescents (sample 1; 72.6% female, mean age 17.12 (SD = 2.01) years) reported growing up with at least one parent with a mental illness. Using confirmatory (CFA) and exploratory factor analyses (EFA) as well as standard item and reliability analyses, we analyzed and revised the COPMI-SQ in the first sample. To validate the factorial structure of the revised COPMI-SQ, CFA was also conducted in the independent sample of the other N = 550 adolescents (sample 2; 80.0% female, mean age 16.36 (SD = 1.98) years) who reported not growing up with a parent with a mental illness. To test four measurement invariance, a multiple-group CFA was conducted in the combined sample of adolescents who reported growing up with and without a parent with a mental illness (sample 1 and sample 2). CFA in sample 1 resulted in an inadequate model fit for the theoretically assumed four-factor structure (CFI = .687; RMSEA = .064 (90% CI = .062-.066); SRMR = .092; AIC = 229 155.63). Following EFA and item and reliability analyses in sample 1, the COPMI-SQ was reduced to four scales ("Experienced SBA," "Affiliate SBA," "Shame," and "Anticipated SBA") and two additional screening scales ("Healthcare" and "Social support"). To facilitate questionnaire use, only the three best items were retained in each scale, reducing the total item number to 12 plus five additional screener items. CFA in sample 2 also resulted in an inadequate model fit for the theoretically assumed four factor structure (CFI = .667; RMSEA = .065 (90% CI = .063-.066); SRMR = .101; AIC = 335 651.99). In comparison, the final version of the COPMI-SQ-r showed the best model fit (CFI = .945; RMSEA = .062 (90% CI = .052-.072); SRMR = .049; AIC = 60 008.05). In the multiple-group CFA (sample 1 and sample 2), metric invariance was established (χ2 (208) = 481.58, p < .001; CFI = .939; RMSEA = .053 (90% CI = .047-.059); SRMR = .056). In sample 2, internal consistency was found to be good for the total scale (α = .84) and almost acceptable to almost good for the subscales (α = .64 to.78). The revised version of the COPMI-SQ (COPMI-SQ-r) is a reliable and economic questionnaire to assess SBA in adolescents who grow up with a parent with a mental illness. The COPMI-SQ-r can be used to help develop and evaluate anti-stigma and general interventions for affected adolescents.

Borderline personality disorder subtypes and public stigma

Despite high public stigma towards individuals with borderline personality disorder (BPD), no research has examined whether stigma differs among the various proposed BPD subtypes. The primary purpose of this research was to examine two potential contributors to stigma towards individuals with BPD: 1) gender, and 2) BPD subtype of the individuals. The three subtypes utilized in this study were emotional, low anxiety, and inhibited (Sleuwaegen, 2018). A total of 415 participants read 1 of 6 randomly assigned vignettes about an individual and then completed the Attribution Questionnaire which encompasses 6 aspects of stigma. Male individuals (featured in a vignette) led to greater overall and 5 aspects of stigma than female individuals. Higher public stigma was also expressed towards individuals with the emotional subtype for overall and 4 aspects of stigma than the other subtypes. The aggression portrayed in the emotional subtype may be a particularly worthy area of investigation, given the potential for over-appraisal of threat to one's personal safety. The findings here suggest that accurate portrayals of BPD need to be infused in education or contact anti-stigma interventions.

Prevalence of HIV-related stigma manifestations and their contributing factors among people living with HIV in Sweden – a nationwide study

BackgroundWith access to antiretroviral therapy (ART) HIV infection is a chronic manageable condition and non-sexually transmissible. Yet, many people living with HIV still testify about experiencing HIV-related stigma and discrimination. It is well-documented that HIV-related stigma and discrimination continue to be critical barriers to prevention, treatment, care and quality of life. From an individual stigma-reduction intervention perspective, it is essential to identify individual and interpersonal factors associated with HIV-related stigma manifestations. To address this issue and to expand the literature, the aim of this study was to assess the prevalence of HIV-related stigma manifestations and their associated factors among a diverse sample of people living with HIV in Sweden.MethodData from 1 096 participants were derived from a nationally representative, anonymous cross-sectional survey ”Living with HIV in Sweden”. HIV-related stigma manifestations were assessed using the validated Swedish 12-item HIV Stigma Scale encompassing four HIV-related stigma manifestations: personalised stigma, concerns with public attitudes towards people living with HIV, concerns with sharing HIV status, and internalized stigma. Variables potentially associated with the HIV-related stigma manifestations were divided into four categories: demographic characteristics, clinical HIV factors, distress and ART adherence, and available emotional HIV-related support. Four multivariable hierarchical linear regression analyses were employed to explore the associations between multiple contributors and HIV-related stigma manifestations.ResultsThe most dominating stigma feature was anticipation of HIV-related stigma. It was manifested in high scores on concerns with sharing HIV status reported by 78% of the participants and high scores on concerns about public attitudes towards people living with HIV reported by 54% of the participants. High scores on personalised stigma and internalized stigma were reported by around one third of the participants respectively. Between 23 and 31% of the variance of the four reported HIV-related stigma manifestations were explained mainly by the same pattern of associated factors including female gender, shorter time since HIV diagnosis, feelings of hopelessness, non-sharing HIV status, and lack of available emotional HIV-related support.ConclusionThe most dominating stigma feature was anticipation of stigma. Female gender, shorter time since HIV diagnosis, feelings of hopelessness, non-sharing HIV status, and lack of available emotional HIV-related support constituted potential vulnerability factors of the four HIV-related stigma manifestations. Our findings highlight the vital necessity to support people living with HIV to increase their resilience to stigma in its different forms. Exploring associated factors of HIV-related stigma manifestations may give an indication of what circumstances may increase the risk of stigma burden and factors amenable to targeted interventions. As individual stigma-reductions interventions cannot be performed isolated from HIV-related stigma and discrimination in society, a key challenge is to intensify anti-stigma interventions also on the societal level.

‘It’s a delicate topic’: Stigma, capabilities and young people’s mental health in post-conflict Colombia

ABSTRACT Young people in Colombia present high rates of mental health problems, to which the country’s history of armed internal conflict contributes in complex ways. Mental health services in Colombia are fragmented, inadequate, and difficult to access for many. Young people’s help-seeking is often hindered by mental health stigma and/or poor experiences with services. This paper presents a thematic analysis of qualitative data from a mixed-methods study aimed at developing and testing a mental health intervention for Colombian youths. We draw upon theoretical lenses from scholarly work on stigma and Sen’s ‘capabilities approach’ to inform our analysis of interviews and group discussions with staff and young people involved in the state-funded human capital building programme ‘Jovenes en Acción’ (JeA). By illustrating how study participants talked about stigma, vulnerability, mental health services organisation, and the challenges of discussing mental health topics in a learning environment, we illuminate aspects of mental health support and anti-stigma interventions that might need enhancing. In particular, we suggest that more emphasis on ‘community competencies’ as complementary to and interrelated with individual competencies would strengthen young people’s individual and collective resources for mental wellbeing while being in line with the sociocritical principles of existing human capital-enhancing programmes.

Anti-stigma interventions in low-income and middle-income countries: a systematic review

Stigma exacerbates power imbalances and societal disparities, significantly impacting diverse identities and health conditions, particularly for low and middle-income countries (LMICs). Though crucial for dismantling harmful stereotypes, and enhancing healthcare utilisation, existing research on anti-stigma interventions is limited with its condition-focused approach. We aimed to thoroughly evaluate peer-reviewed and non-peer-reviewed literature for a comprehensive review of anti-stigma interventions for diverse identities and all health conditions in LMICs. This review systematically explored peer-reviewed and non-peer-reviewed literature, in ten electronic databases up to January 30, 2024, covering all anti-stigma interventions across various stigmatised identities and health conditions in LMICs. Quality assessment for this systematic review was conducted as per Cochrane Collaboration's suggested inclusions. The review was registered with PROSPERO (Registration: 2017 CRD42017064283). Systematic synthesis of the 192 included studies highlights regional imbalances, while providing valuable insights on robustness and reliability of anti-stigma research. Most studies used quasi-experimental design, and most centred on HIV/AIDS or mental health related stigma, with very little work on other issues. Certain high-population LMICs had no/little representation. The interventions targeted diverse segments of populations and consequently yielded a multitude of stigma-related outcomes. However, despite the heterogeneity of studies, most reported positive outcomes underscoring the effectiveness of existing interventions to reduce stigma. This study is supported by the UK Medical Research Council Indigo Partnership (MR/R023697/1) award.

The moderating role of stigma in the relationship between depression and resilience: results of a cross-sectional study in university students.

Depression is a growing concern in university students and resilience has shown to play a protective role. The impact of stigma is still under-explored, with reference to its moderating role between depression and resilience. The present study investigate such a relationship among Italian university students. A cross-sectional design was applied in a simple of 1,912 students to examine the interrelationships between depression (Patient Health Questionnaire-9), resilience (Nicholson McBride Resilience questionnaire), and stigma (Stigma-9). Correlation, predictor, and moderation analyses were applied in RStudio. A negative correlation was found between depressive symptoms and resilience (r = -0.455, p < 0.001). A positive correlation was found between depressive symptoms and stigma (r = 0.207, p < 0.001). Lower levels of resilience and higher levels of stigma were significant predictors of depressive symptoms [F(df, n) = 190.8(3, 1884), p < 0.001, R2 = 0.236]. The moderation analysis showed a weakening of resilience protective effect against depression as stigma levels increase [F(df,n) = 186.7(3,1908), p < 0.001, R2 = 0.226]. Stigma influences the relationship between depression and resilience. Anti-stigma interventions and programs empowering resilience, should be implemented in university settings to protect students from depression.

Affiliate stigma and its association with family burden among family members of people living with schizophrenia in China

PurposeUnderstanding affiliate stigma and its impact on family of people living with schizophrenia (PLS) in China is important for culturally informed intervention. This study aims to describe the pattern of affiliate stigma of family members of PLS in China and investigated the association between affiliate stigma and family burden. MethodsPLS and their family members dwelling in community were randomly recruited from four cities across China and completed measures of affiliate stigma and family burden. Linear regression analyses were used to determine the association between affiliate stigma and family burden. ResultsA total of 493 dyads of family member and PLS were include in this study. The mean affiliate stigma in family members was 2.21 (SD = 0.61). The vast majority of family members reported the feeling of inferiority, helpless and sad because of their family members' schizophrenia, but few family members refusing to communicate or contact with the PLS. The mean score of overall family burden was 22.25 (SD = 14.90), with 98 % of participants reported moderate or severe burden. A higher level of affiliate stigma was associated with more family burden (b = 7.837, 95CI: 5.240 to 8.747). Affiliate stigma was significantly associated with family daily activities, entertainment activities, family relationship, physical health and mental health of family members, but not family economic burden. ConclusionA higher level of affiliate stigma was associated with more family burden among family with PLS. Anti-stigma intervention of mental illness should be consider not only PLS but also their family members.

Mental health stigma and its relationship with mental health professionals - A narrative review and practice implications.

The extent and magnitude of the mental health stigma are enormous, with substantial clinical and social implications. There is a complex relationship between mental health stigma and mental health professionals (MHPs); MHPs can be anti-stigma crusaders, victims of stigma, and even a source of stigma. Unfortunately, literature is scarce talking about the relationship between stigma and MHPs. Hence, the current review aims to bridge the existing gap in the literature on various aspects of stigma and the role of MHPs. For the current review, we ran a search in PubMed and Google Scholar databases; we restricted our study to records focusing on the interplay of mental health stigma and the MHPs, published during 2012-2022, in English, and having a full text available. We found that MHPs (psychiatrists, psychologists, and psychiatric nurses) can also be the recipients of the stigma. The stigma faced by the MHPs is determined by the negative stereotypes set by the media, or medical students, or other health professionals; the marginal position of psychiatry in the health system; difficult-to-treat mental disorders; MHPs' own experience of stigma; and the attitude or beliefs of various caders of the MHPs, their professional experience, and expertise in managing various mental health conditions. Notably, MHPs can also be a source of stigma (stigmatizers). MHPs need to be sensitized concerning this, and the anti-stigma interventions must incorporate this aspect of stigma. Novel interventions, such as digital-based programs, should be used instead of traditional anti-stigma programs in order to decrease stigma around mental health issues and make anti-stigma initiatives more appealing and scalable. To address the issues of stigma, there has to be more communication between MHPs, other health professionals, service users, and policymakers.

Active psychoeducational components of antistigma interventions for untreated depressive symptoms: Specific effects of continuum beliefs?

Active psychoeducational components of antistigma interventions for untreated depressive symptoms: Specific effects of continuum beliefs?

Individual stigma in people with severe mental illness: Associations with public stigma, psychological capital, cognitive appraisal and coping orientations

IntroductionThe reason why some people with severe mental illness (SMI) maintain positive self-identity, while some are affected by the stigmatized environment is unclear. AimsTo describe the status of individual stigma and explore the relationship between self-stigma, stigma resistance and related variables in people with SMI. MethodsA cross-sectional study was conducted from April 2021 to March 2022. The Chinese version of Internalized Stigma of Mental Illness Scale and Stigma Resistance Scale were used to assess individual stigma. Perceived public stigma, psychological capital, stigma stress appraisal and coping orientations were also measured by scales. Data was provided by 422 patients with schizophrenia or bipolar disorder, from one psychiatric hospital and four community healthcare centers in China. A structural equation model was applied for analysis. ResultsThe total mean scores of self-stigma and stigma resistance were (2.06 ± 0.65), and (3.95 ± 0.84). Perceived public stigma was the primary condition for constructing individual stigma, which indirectly affected self-stigma (β = 0.268) and stigma resistance (β = −0.145). Stigma stress appraisal mediated the transformation of public stigma into individual, which had direct and indirect effects on self-stigma (β = 0.417, 0.166), and an indirect effect on stigma resistance (β = −0.374). Secrecy positively affected self-stigma (β = 0.117), while positive coping positively affected stigma resistance (β = 0.380). Psychological capital significantly directly impacted individual stigma. ConclusionsFindings highlighted how public stigma determines the degree to which patients with SMI deal with stigma stress appraisal, and how this influences individuals. Anti-stigma programs and interventions to improve individuals' psychological capital and coping capabilities should be emphasized.

Cross-cultural variation in experiences of acceptance, camouflaging and mental health difficulties in autism: A registered report.

Recent findings suggest that stigma and camouflaging contribute to mental health difficulties for autistic individuals, however, this evidence is largely based on UK samples. While studies have shown cross-cultural differences in levels of autism-related stigma, it is unclear whether camouflaging and mental health difficulties vary across cultures. Hence, the current study had two aims: (1) to determine whether significant relationships between autism acceptance, camouflaging, and mental health difficulties replicate in a cross-cultural sample of autistic adults, and (2) to compare these variables across cultures. To fulfil these aims, 306 autistic adults from eight countries (Australia, Belgium, Canada, Japan, New Zealand, South Africa, the United Kingdom, and the United States) completed a series of online questionnaires. We found that external acceptance and personal acceptance were associated with lower levels of depression but not camouflaging or stress. Higher camouflaging was associated with elevated levels of depression, anxiety, and stress. Significant differences were found across countries in external acceptance, personal acceptance, depression, anxiety, and stress, even after controlling for relevant covariates. Levels of camouflaging also differed across countries however this effect became non-significant after controlling for the covariates. These findings have significant implications, identifying priority regions for anti-stigma interventions, and highlighting countries where greater support for mental health difficulties is needed.

Stigmatisation of schizophrenia and alcohol use disorder: relationship with evangelicalism in a U.S. sample

ABSTRACT Stigmatisation of mental illness and substance use disorders has negative health implications. Previous research suggests that religious fundamentalism relates to stigmatising attitudes; Christian evangelicalism, as one type of fundamentalism, is a prevalent influence on personal belief systems in the United States. We recruited 380 participants from Amazon’s Mechanical Turk, who self-identified as evangelical or non-evangelical, read vignettes depicting schizophrenia, alcohol use disorder (AUD), or asthma (control), and completed a stigmatisation measure. Notably, about a quarter of the non-evangelical group were non-religious individuals. Evangelicals had higher stigmatisation of schizophrenia and asthma, but no between-group difference was found regarding AUD. Higher stigmatisation of schizophrenia among evangelicals might reflect perceived violations of societal and religious norms, while widespread stigmatising attitudes related to AUD in the general population might explain the comparable stigmatisation of AUD among both groups. These findings highlight the importance of considering evangelical religious beliefs in stigma research and anti-stigma interventions.

The Effects of Peer Mental Illness Narratives on Reducing Stigma Among U.S. Marginalized College Students

ABSTRACT Mental health stigma remains a significant barrier to accessing mental health care and treatment, particularly among racial, ethnic, gender, and LGBTQIA+ underrepresented groups in the United States. This study aimed to investigate the relative persuasiveness of mental health narratives featuring both marginalized and non-marginalized characters in reducing stigma among college students. We conducted an online between-subjects experiment with a sample size of 292 participants to explore the impacts of message format (narrative vs. non-narrative), narrative point of view (first-person vs. third-person), and character similarity (marginalized vs. non-marginalized voices) on the persuasion process, specifically targeting the reduction of stigma and changes in attitudes toward those seeking mental health services. Findings revealed that the use of narrative messaging had no effect on reducing mental health stigma or treatment attitudes, but narrative campaigns featuring members of underrepresented groups did enhance one’s perceived similarity with mediated characters, which in turn resulted in more support for seeking mental health treatment. These findings have implications for the design of social media-based anti-stigma interventions and narrative persuasion in mental health research.

Exploring the impact of immersive virtual reality on depression knowledge and stigma reduction: a cross-over RCT fMRI study

The stigma of mental illness is a form of negative judgmental knowledge and is a barrier to individual seeking treatment. Contact-based educational interventions with first-person perspective (1PP) combined with immersive virtual reality (IVR) is promising as an anti-stigma intervention. This study aims to investigate the effectiveness of 1PP anti-stigma IVR intervention compared to video in enhancing depression knowledge and reducing stigma, as well as to examine the corresponding depression knowledge brain activity change using functional magnetic resonance imaging (fMRI). Participants engaged in a 1PP anti-stigma intervention using both IVR and conventional video, focusing on the daily life and recovery of a patient with mild depression. The change in depression knowledge, stigma-related behavioral, and brain activity using fMRI were measured at pre- and post-interventions. Depression knowledge improved for both interventions; however, only the IVR intervention reduced stigma. In the IVR intervention, depression knowledge score was positively associated with neural response in the right superior frontal gyrus activation, indicative of empathic concern. Conversely, the video intervention correlated with increased activity in the right anterior insula, suggesting a distress-related response. The findings demonstrate that the immersive nature of IVR can reduce stigma more effectively than video intervention. This effectiveness is underpinned by the change in depression knowledge on neural activity, with IVR fostering empathy-related behavioral responses. The results highlight the potential of IVR in enhancing empathic understanding and reducing stigma towards mental illness, emphasizing the need for further exploration into immersive technologies for mental health education.

Stigma of nursing students towards people with mental illness: Protocol of a mixed‐method systematic review

AimsTo synthesize the influencing factors of the stigma of nursing students towards people with mental illness (PMI). BackgroundThe stigma of nursing students towards PMI may affect their career choices and negatively impact people seeking health services. While many studies have examined the educational aspects of mental health, they often overlook the multiple dimensions of possible factors influencing nursing students' perceptions. DesignA mixed‐method systematic review using the Framework Integrating Normative Influences on Stigma (FINIS). MethodsWe will search six databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and PsycINFO. The reference list of the included literature will be thoroughly examined to identify if any additional studies meet the criteria. Two authors will independently screen all titles, abstracts, full text and extract data. The Mixed-method Appraisal Tool will be used to assess quality. The extracted data will be disposed to different levels, including micro (demographic characteristics, disease characteristics), meso (social networks, treatment systems) and macro (media images, national context) to comply with the FINIS. Expected resultsThis systematic review aims to comprehensively analyze the influencing factors of the stigma of nursing students towards PMI, providing a reference basis for anti-stigma intervention measures.Prospero registration number: CRD42022374419.