Endorsement Of Stigma Research Articles

Creating a diversity climate in the workplace: A mixed methods study into knowledge of autism and attitudes toward hiring autistic people in the United Kingdom

BACKGROUND: Autistic individuals face challenges accessing employment, particularly as a result of limited knowledge and understanding of autism. OBJECTIVE: This mixed methods study aimed to measure levels of knowledge of autism and examine hiring attitudes in the workplace. METHODS: To determine knowledge of autism, N = 101 professionals in the United Kingdom responded to a survey that included the Autism Stigma & Knowledge Questionnaire (ASK-Q). Open-ended and closed-ended questions were used to examine hiring attitudes and particularly perceived barriers or drivers to employment for autistic candidates. Nine respondents took part in further semi-structured interviews. RESULTS: Findings report adequate knowledge with a lack of stigma endorsement. Data also indicate a significant relationship between self-reported autism knowledge and the overall ASK-Q total. Autism knowledge was statistically significantly higher in participants who knew an autistic individual through work and where professionals or their companies had knowingly employed an autistic person. Qualitative data provide nuanced understanding about barriers and the possibilities for more inclusive autistic employment. CONCLUSION: A strong case was made for understanding the needs and strengths of individuals in order to generate a diversity climate in the workplace.

Endorsement of HIV-related stigma among men in Ghana: What are the determinants?

Stigma and discrimination against people living with HIV (PLHIV) remain a major barrier to effective HIV prevention. Despite the understanding that the creation of a socially inclusive environment for PLHIV is crucial for the promotion of testing, status disclosure, and treatment uptake, HIV stigma persists. Additionally, evidence suggests the endorsement of HIV stigma may be gender specific. Nonetheless, very little is known about the factors influencing men's discrimination against PLHIV in the Ghanaian context. Guided by the theory of planned behavior, our study fills this void by exploring the factors associated with the endorsement of HIV stigma in Ghana. Utilizing a nationally representative data from the 2022 Ghana Demographic and Health Survey (DHS) (N = 7044 men with ages ranging from 15-49 years), and applying logistic regression models, this study examined the factors associated with the endorsement of HIV-related stigma in Ghana. The notion that HIV can be transmitted through the sharing of food with PLHIV was significantly associated with increased odds of stigma endorsement against children with HIV (OR = 3.381; P<0.001) and vendors with HIV (OR = 3.00; P<0.001). On the contrary, knowing that a healthy-looking person can have HIV was significantly associated with decreased odds of endorsement of stigma against children living with HIV (OR = 0.505; P<0.001), and vendors living with HIV (OR = 0.573; P<0.001). Likewise, having knowledge of drugs that help PLHIV to live longer, was significantly associated with decreased odds of stigma endorsement against children living with HIV (OR = 0.768; P<0.001), and vendors living with HIV (OR = 0.719; P<0.001). Moreover, participants with higher educational attainment reported lower odds of stigma endorsement against children living with HIV (OR = 0.255; P<0.01), and vendors living with HIV (OR = 0.327; P<0.01). Furthermore, age was significant and inversely associated with the endorsement of HIV stigma against children living with HIV (OR = 0.951; P<0.05), and vendors living with HIV (OR = 0.961; P<0.05). Also, wealth, ethnicity, and the region of residence significantly predicted endorsement of HIV stigma. For Ghana to achieve UNAIDS target 95-95-95 by 2030, targeted educational campaigns are necessary to dispel misconceptions about HIV and to promote social inclusion for reducing HIV-related stigma and discrimination in the country.

Intersectional HIV- and Depression-Related Stigma Among People with HIV Entering HIV Care in Cameroon.

Mental health-related stigma is a prominent barrier to improved mental health outcomes globally and may be particularly harmful to populations with other stigmatized identities. We aimed to understand intersectional depression- and HIV-related stigma among people with HIV (PWH) entering HIV care in Cameroon. Using baseline data from a cohort of PWH entering HIV care in Cameroon between 2019 and 2020, we characterized depression- and HIV-related stigma in the population overall and by sociodemographic sub-group. We also explored substantively meaningful variation in stigma endorsement by depressive symptom severity (Patient Health Questionnaire-9 [PHQ-9]) and causal attribution of depression. Among those with elevated depressive symptoms (PHQ-9 scores > 4), we estimated the association between stigma type and depressive symptom severity using binomial regression. Among 398 participants, 49% endorsed low HIV- and depression-related stigma (N = 195), 10% endorsed high HIV- and depression-related stigma (N = 38), 29% endorsed high depression-related stigma only (N = 116), and 12% endorsed high HIV-related stigma only (N = 49). Respondents with and without heightened depressive symptoms commonly believed depressive symptoms were caused by HIV (N = 140; 32.9%). Among those with elevated depressive symptoms, the prevalence of moderate to severe symptoms was higher among those endorsing high HIV-related stigma only (prevalence ratio 1.55; 95% confidence interval: 1.01, 2.37) compared to those reporting low HIV- and depression-related stigma. HIV- and depression-related stigma are both common among PWH entering HIV care in Cameroon. The consistent association between HIV-related stigma and poor psychosocial well-being among people with HIV necessitates the urgent scale-up of evidence-based HIV-related stigma interventions specifically.

Stigma Awareness as a Predictor for Mental Help-Seeking Intention: The Mediating Role of Stigma Endorsement Among Malaysian Undergraduates

Stigma Awareness as a Predictor for Mental Help-Seeking Intention: The Mediating Role of Stigma Endorsement Among Malaysian Undergraduates

Correlates of hepatitis B testing in Ghana: The role of knowledge, stigma endorsement and knowing someone with hepatitis B.

Hepatitis B testing is the gateway for prevention and care. However, previous studies document low hepatitis B testing uptake in sub-Saharan Africa. This study investigated knowledge, stigma endorsement and knowing someone with hepatitis B as correlates of hepatitis B testing behaviours among people in the Greater Accra and Northern regions of Ghana. A cross-sectional survey was completed by 971 participants (Greater Accra=503, and Northern region=468) between October 2018 and January 2019. Approximately 54% of the participants reported having been tested for hepatitis B. The logistic regression analyses showed that having greater hepatitis B knowledge was positively associated with hepatitis B testing (OR=1.22, 95% CI: 1.14-1.30). Higher hepatitis B stigma endorsement was negatively related to hepatitis B testing (OR=0.97, 95% CI: 0.96-0.99). Also, participants who knew someone (i.e. parent, sibling and/or friend) with hepatitis B were more likely to have tested compared to those who did not know someone with hepatitis B (OR=7.15, 95% CI: 5.04-10.14). This study demonstrates that knowing someone with hepatitis B increases the likelihood of testing, highlighting the need to create safe and non-judgmental contexts for people with hepatitis B (PWHB) to disclose if they want to. Also, given that greater hepatitis B knowledge increases testing and hepatitis B stigma endorsement impedes testing, interventions that increase knowledge and reduce stigma should be incorporated in efforts to promote testing in Ghana.

Perspectives on mental health difficulties amongst second‐generation Chinese individuals in Germany: Stigma, acculturation, and help seeking

AbstractMigration demands may put Chinese people living abroad at higher risk for mental health difficulties. However, mental illness is stigmatised and often neglected. The aim of this study was to investigate mental illness stigma endorsement amongst second‐generation Chinese individuals in Germany and explore the role of acculturation and stigma on mental health service‐seeking behaviours. In semi‐structured interviews with 23 second‐generation Chinese individuals, half of whom had a history of mental illness and half did not, we explored beliefs contributing to mental illness stigma, manifestations of stigma, the influence of acculturation, experience with mental health difficulties, and barriers to help seeking. Findings indicate that, within Chinese immigrant communities, people with mental illness are perceived as crazy, abnormal, weak, of poor character, having poor genes, or coming from a ‘bad’ family. Manifestations of mental illness stigma were avoidance, social exclusion, labelling, blame, and gossip. Stigma by association of family members was also reported. Acculturation appeared to attenuate stigma endorsement with most participants expressing considerate attitudes towards people with mental illness. However, acculturation also contributed to mental health difficulties through intergenerational differences in view on mental illness and help seeking. Findings highlight the importance of considering family dynamics when providing mental health services to second‐generation Chinese individuals.

Public Stigma and Personal Networks: Confronting the Limitations of Unidimensional Measures of Social Contact.

One of the most promising directions for reducing mental illness stigma lies in Allport's contact theory, which suggests that intergroup interactions reduce stigma. Here, we argue that stigmatizing attitudes are driven by the nature, magnitude, and valence of community-based ties to people with mental illness (PMI), not simply their presence. Using the 2018 General Social Survey (N = 1,113), we compare network-based measures of contact to traditional survey indicators. We find that knowing someone with mental illness, or even number of people known, explains little about desire for social distance, perceptions of dangerousness, or endorsement of treatment coercion. However, having stronger relationships with more PMI, having more friends and family (but not more peripheral ties) with mental illness, and knowing people in treatment are associated with less stigma endorsement. In contrast, we find that exposure to PMI who are perceived as dangerous is associated with greater levels of stigma.

Adverse Childhood Experiences Associated with Greater Internalization of Weight Stigma in Women with Excess Weight.

Adverse childhood experiences (ACEs) may be an early life factor associated with adult weight stigma via biological (e.g., stress response), cognitive (e.g., self-criticism/deprecation), and/or emotional (e.g., shame) mechanisms. This pilot study investigated relationships between ACEs and internalized and experienced weight stigma in adult women with overweight/obesity and explored differential relationships between weight stigma and ACE subtypes (i.e., abuse, neglect, household dysfunction). Adult women (68% white, Mage = 33 ± 10 years, MBMI = 33.7 ± 7.2 kg/m2) completed measures of ACEs (ACE Questionnaire), internalized weight stigma (IWS; Weight Bias Internalization Scale—Modified; WBIS—M), and lifetime experiences of weight stigma (yes/no). Data were analyzed with linear and logistic regression (n = 46), adjusting for age, race, and body mass index (BMI). Linear regressions revealed a positive association between ACE and WBIS—M scores (β = 0.40, p = 0.006), which was driven by Abuse-type ACEs (β = 0.48, p = 0.009). Relationships between WBIS—M scores and Neglect- and Household-Dysfunction-type ACEs did not reach significance (β = 0.20, p = 0.173; β = −0.16, p = 0.273). Though descriptive statistics revealed greater rates of experienced weight stigma endorsement by those with high-3+ ACEs (81%) vs. medium-1–2 ACEs (67%) or low/no-0 ACEs (60%), ACE scores were not significantly associated with experienced weight stigma in logistic regression (Wald = 1.36, p = 0.244, OR = 1.324, 95%, CI = 0.825–2.125). ACEs may be an early life factor that increase the risk for internalizing weight stigma in adulthood. Larger studies should confirm this relationship and follow-up on descriptive findings suggesting a potential association between ACEs and experienced weight stigma.

Awareness and Stigma of Autism Spectrum Disorders in Undergraduate Students.

Social stigma is a barrier for students with autism on college campuses. The purpose of this study is to examine the relationship between autism knowledge and autism stigma endorsement. 144 college undergraduate students were asked to complete the Autism Stigma and Knowledge Questionnaire as well as a brief demographic questionnaire. The relationship between stigma endorsement and ASD knowledge in the areas of diagnosis and symptoms, etiology, and treatment were evaluated using a multiple linear regression. Two independent-sample t-tests were conducted to investigate group differences between participants who know someone with autism and those who do not as well as between male and female participants. A significant regression equation was found (F(3,140) = 51.35, p = .000), with an R2 of .52. While Treatment and Etiology subscale scores significantly predicted Stigma subscale scores, Diagnosis/Symptom subscale score was not. In terms of knowing someone with an autism diagnosis, there was a significant difference in ASD diagnosis and symptom knowledge (t(142) = 4.16, p = .000), etiology knowledge (t(142) = 3.51, p = .001), treatment knowledge (t(62.99) = 3.54, p = .001), and stigma endorsement (t(142) = 3.03, p = .003). No significant differences were found between male and female participants. Contrary to past studies, gender was not associated with ASD knowledge or stigma endorsement. This study suggests that an intervention designed to increase ASD knowledge, particularly in the areas of etiology and treatment, and to increase contact with students diagnosed with autism would be effective in reducing ASD stigma.

Mental Illness Public Stigma and Treatment Seeking among University Students

ABSTRACT While stigma is a complex, multidimensional concept, research regarding mental illness stigma has not been clearly defined or consistently measured across studies, thus limiting the broad application of this research. The current study examined the relationship between several dimensions of public stigma and treatment utilization for mental illness in a university student population. We found significant differences in public stigma endorsement among different treatment utilization groups. Perceptions of dangerousness to others and exclusionary sentiments were the two stigma variables that predicted treatment usage. The implications for using this information about stigma on a university campus are discussed.

Predictors of antiretroviral therapy initiation in eThekwini (Durban), South Africa: Findings from a prospective cohort study.

Despite expanded antiretroviral therapy (ART) eligibility in South Africa, many people diagnosed with HIV do not initiate ART promptly, yet understanding of the reasons is limited. Using data from an 8-month prospective cohort interview study of women and men newly-diagnosed with HIV in three public-sector primary care clinics in the eThekwini (Durban) region, South Africa, 2010–2014, we examined if theoretically-relevant social-structural, social-cognitive, psychosocial, and health status indicators were associated with time to ART initiation. Of 459 diagnosed, 350 returned to the clinic for their CD4+ test results (linkage); 153 (33.3%) were ART-eligible according to treatment criteria at the time; 115 (75.2% of those eligible) initiated ART (median = 12.86 weeks [95% CI: 9.75, 15.97] after linkage). In adjusted Cox proportional hazard models, internalized stigma was associated with a 65% decrease in the rate of ART initiation (Adjusted hazard ratio [AHR] 0.35, 95% CI: 0.19–0.80) during the period less than four weeks after linkage to care, but not four or more weeks after linkage to care, suggesting that stigma-reduction interventions implemented shortly after diagnosis may accelerate ART uptake. As reported by others, older age was associated with more rapid ART initiation (AHR for 1-year age increase: 1.04, 95% CI: 1.01–1.07) and higher CD4+ cell count (≥300μL vs. <150μL) was associated with a lower rate of initiation (AHR 0.38, 95% CI: 0.19–0.80). Several other factors that were assessed prior to diagnosis, including stronger belief in traditional medicine, higher endorsement of stigma toward people living with HIV, food insecurity, and higher psychological distress, were found to be in the expected direction of association with ART initiation, but confidence intervals were wide and could not exclude a null finding.

Is there evidence for defensive projection? The impact of subclinical mental disorder and self-identification on endorsement of stigma.

Is there evidence for defensive projection? The impact of subclinical mental disorder and self-identification on endorsement of stigma.

Psoriasis-related stigma and its intersection with intergroup bias in medical students

Psoriasis-related stigma and its intersection with intergroup bias in medical students

Categorical versus dimensional thinking: improving anti-stigma campaigns by matching health message frames and implicit worldviews

Despite growing applications of social and healthcare marketing to enhance public well-being through anti-stigma campaigns, little research investigates how public stigma surrounding health conditions might limit the outcomes of these campaigns. By drawing on the theory of implicit worldviews, this study identifies reasons for public stigma as well as associated message frames to address these reasons. Study 1a provides evidence that implicit worldviews are relevant to campaign results. Study 1b and Study 2 demonstrate that fitting consumers’ implicit worldview with suitable (i.e., biomedical or biopsychosocial) health frames reduces stigma endorsement. Study 3 identifies the perceived severity of a mental illness as a boundary condition; marketing communications have the greatest impact when they refer to an illness with lower perceived severity. Finally, Study 4 expands understanding of the phenomenon by extending the findings to physical health conditions (i.e., obesity). The article concludes by discussing the implications of these findings for policy and future applications.

Perceptions of attenuated psychosis in a diverse sample of undergraduates.

Prior to the release of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders, experts in the field of psychosis research considered including a psychosis high-risk syndrome-attenuated psychosis syndrome-as a formal diagnosis. Opponents argued that such a diagnosis may increase the risk of stigmatization of individuals whose symptoms often remit. Although previous research has examined provider perceptions of attenuated psychosis syndrome, little work has focused on lay perceptions. A total of 455 college students read three vignettes, each depicting a character with a different level of psychotic disorder (attenuated psychosis syndrome, schizophrenia or no psychosis). Following each vignette, participants responded to questions assessing: (1) identification of the character as mentally ill, (2) stigmatizing attitudes and (3) beliefs regarding the helpfulness of potential treatments. Compared to a character with no psychosis, participants identified the attenuated psychosis syndrome character as more likely to be experiencing mental illness, but endorsed only slightly more stigmatizing attitudes. Participants tended to rate psychological types of treatment as more helpful than other types for an attenuated psychosis syndrome character. Non-expert undergraduates appear to view attenuated psychosis symptoms as indicative of mental illness, though not as severe as schizophrenia symptoms. The minimal level of stigma endorsement indicates that college students may not be especially likely to spontaneously stigmatize peers with attenuated psychosis syndrome.

Norms and stigma around unintended pregnancy in Alabama: Associations with recent contraceptive use and dual method use among young women

ABSTRACTThe role of unintended pregnancy norms and stigma in contraceptive use among young women is understudied. This study investigated relationships between anticipated reactions from others, perceived stigma, and endorsed stigma concerning unintended pregnancy, with any and dual contraceptive use in this population. From November 2014 to October 2015, young women aged 18–24 years (n = 390) and at risk for unintended pregnancy and sexually transmitted infections participated in a survey at a university and public health clinics in Alabama. Multivariable regression models examined associations of unintended pregnancy norms and stigma with contraceptive use, adjusted for demographic and psychosocial characteristics. Compared to nonusers, more any and dual method users, were White, nulliparous, and from the university and had higher income. In adjusted models, anticipated disapproval of unintended pregnancy by close others was associated with greater contraceptive use (adjusted Odds Ratio [aOR] = 1.54, 95 percent confidence interval [CI] = 1.03–2.30), and endorsement of stigma concerning unintended pregnancy was associated with lower odds of dual method use (aOR = 0.71, 95 percent CI = 0.51–1.00). Unintended pregnancy norms and stigma were associated with contraceptive behavior among young women in Alabama. Findings suggest the potential to promote effective contraceptive use in this population by leveraging close relationships and addressing endorsed stigma.

The Stigma of Mental Illness: Using Segmentation for Social Change

Despite the unequivocal incidence and burden that mental illnesses place on the world, those with mental illness remain not only neglected but also deeply stigmatized across societies. The stigma that surrounds mental illness serves as a barrier to treatment and recovery, leading to serious negative consequences such as school failure, job loss, and suicide. While many large-scale social marketing efforts have found some success in reducing stigma, we contend that the recommended approaches, which utilize the input of people with mental illness and those close to them, are inadequate and that a deeper understanding of those who stigmatize is needed. This research first provides a comprehensive examination of the components that comprise stigma and then uses these components to segment the general population. The authors then present recommendations based on differences in the endorsement of stigma among these segments to inform policy and advocacy groups in developing more varied and potentially more effective social marketing campaigns.

Parent-reported stigma and child anxiety: A mixed methods research study

BackgroundStigma has been frequently cited as a barrier to service use for various mental health problems. Studies suggest that stigma may be greater for childhood mental health problems that are perceived as more atypical. AimsThis study utilized a mixed methods research design (qual+QUAN) to examine parental endorsement of stigma and its impact on service utilization among children with significant anxiety—a common childhood problem frequently perceived as normative. MethodsSemi-structured qualitative interviews were conducted with 29 parents of anxious children. Qualitative data were coded using a grounded theory approach, and stigma-related responses were examined for emergent themes. Quantitative data was analyzed with frequency counts and chi-square analysis. ResultsStigma related to children's anxiety symptoms and seeking mental health services was reported by 41.3% (n=12) of parents. Emergent themes included: 1) Parental Concern for Negative Consequences, 2) Parent Internalized Stigma, and 3) Negative Associations with Mental Health Treatment. Latino parents discussed stigma more frequently than non-Latino White parents (70% vs. 17.6%, respectively, X2(1, N=27)=5.33, p<0.05). ConclusionsAlthough anxiety is a common childhood problem, stigma is still frequently reported by parents and may be an important barrier to mental health service use, especially among Latino youth.

Prescription drug advertising and consumer stigma about depression: The moderating role of skepticism toward advertising

The current study was designed to explore how consumers’ exposure to direct-to-consumer advertising (DTCA) of antidepressants would relate to the extent of stigma they hold toward clinical depression, and how such an association would be moderated by the level of skeptical attitudes toward the advertising category. The results showed that when skepticism was low, exposure to DTCA of antidepressants was positively associated with the extent of stigma toward depression. A negative relationship between DTCA exposure and endorsement of stigma was observed only when the level of skepticism was extremely high. In an exploratory analysis, the study further found that among individuals with personal and interpersonal experiences of depression, DTCA exposure might strengthen depression stigma, while such a relationship was not observed among those with a lower level of depression-related life experiences. This study concluded by discussing the implications of the findings for health professionals as well as the practice and social responsibility of DTCA.

Peer Mental Health Stigmatization Scale: psychometric properties of a questionnaire for children and adolescents.

The nature of stigmatizing attitudes towards children and adolescents with mental health problems has received little empirical attention, despite consensus that such attitudes are widespread. As a consequence, much less is known about stigma in childhood and adolescence and methods of stigma measurement are frequently borrowed from the adult literature. For research on this topic to develop, a theoretically based and developmentally appropriate measure is needed. This study aimed to develop a theory-based peer stigma questionnaire suitable for children and adolescents. Participants were 562 children and adolescents aged 9-16years (M=12.99years; SD=1.6years) in the Republic of Ireland, 316 female, all were White. The Peer Mental Health Stigmatization Scale (PMHSS) contains 24 statements (negative and positive) about peers with mental health problems that are rated on a 5-point scale. Participants also completed the Strengths and Difficulties Questionnaire. Re-test data was collected after 2weeks from 109 participants. Principal Components Analysis on the negative statements indicate the presence of two components: Stigma Agreement, personal endorsement of stigmatising statements and Stigma Awareness: awareness of prevailing societal stigma towards youth with mental health problems. The positive statements include three components: Intellectual Ability, Recovery and Friendship. The PMHSS is a psychometrically sound instrument with good retest reliability suitable for use with older children and teenagers. Initial use of the scale suggests that personal endorsement of stigma is lower than perceptions of public stigma.