Greater Stigma Research Articles

The association between implicit culture beliefs and intercultural sensitivity: anticipated intergroup exclusion and stigma as underlying processes

South Asians and Chinese mainlanders are two distinct cultural minority groups in the Hong Kong context. Grounded in theories and findings on implicit beliefs, this study examined the mediating roles of anticipated intergroup exclusion and stigma toward these cultural minority groups in the link between implicit culture beliefs and intercultural sensitivity. A total of 192 university students aged between 18 and 26 years old (M = 21.18; SD = 1.82) residing in Hong Kong participated in this study. Participants completed self-report questionnaires that assessed fixed versus malleable beliefs about cultural attributes, anticipated intergroup exclusion towards South Asians and Chinese mainlanders, stigma towards South Asians and Chinese mainlanders, and intercultural sensitivity. Path analysis and bootstrapping were applied to test the mediation model. Results showed that fixed implicit beliefs about cultural attributes were related to anticipated intergroup exclusion, greater stigma towards cultural minority groups, and lower intercultural sensitivity. However, only greater stigma towards South Asians, but not towards Chinese mainlanders, was then significantly associated with lower intercultural sensitivity. Taken together, the present study revealed the partial mediating roles of anticipated intergroup exclusion and stigma towards cultural minorities (i.e., South Asians and Chinese mainlanders) between implicit culture beliefs and intercultural sensitivity in the context of Hong Kong. In addition, the strengths of associations among anticipated intergroup exclusion, stigma, and intercultural sensitivity differed as a function of cultural groups.

Binge eating disorder recognition and stigma among an adult community sample

BackgroundDespite being the most prevalent eating disorder, Binge eating disorder (BED) remains largely unrecognized and lacks awareness among the general public, where it is also highly stigmatized. Common stigma surrounding BED includes the belief that individuals with this disorder are responsible for their condition and lack willpower and self-control. Research on BED recognition and stigma among lay adults is scarce. Enhancing public recognition of BED and reducing the stigma associated with it is crucial, as this could significantly improve access to treatment. The aim of the present study was to examine BED recognition and stigma within an adult community sample, and to identify associated respondent characteristics, including sociodemographic and psychosocial factors.MethodsA sample of 894 adults (88.6% women; Mage = 35.20 ± 14.52) completed an online survey. Participants were presented with a vignette depicting a woman with BED and obesity, followed by questionnaires assessing BED recognition, stigma, and other respondent characteristics. Independent samples t-tests were performed to compare participants who recognized BED in the vignette with those who did not, based on sociodemographic characteristics (i.e., gender, age, income, education) and psychosocial variables (i.e., explicit and internalized weight bias, familiarity with BED). A multiple linear regression analysis was performed to identify the sociodemographic and psychosocial variables that were the most important in explaining the variance in stigma towards BED.ResultsResults indicated that 33% of participants identified BED as the main problem in the vignette. Those who recognized BED were younger, more educated, more familiar with BED, and exhibited lower levels of stigma towards BED. The most significant factor in explaining stigma towards BED was explicit weight bias, particularly attributing obesity to a lack of willpower and disliking people with obesity. Identifying as a man and older age were also associated with greater stigma towards BED.ConclusionThe findings of the current study highlight the importance of comprehensive public awareness campaigns to improve recognition of BED and to reduce associated stigma.

Consent with complications in mind

Parity of esteem describes an aspiration to see mental health valued as much as physical. Proponents point to poorer funding of mental health services, greater stigma and poorer physical health...

Examining the relationship between public stigma, models of addiction, and addictive disorders

Background The stigmatization of addiction has been identified as a barrier to treatment-seeking among individuals with substance use concerns. Although some evidence exists that beliefs in different models of addiction (MOAs) are associated with stigma, the research is limited in several ways. The aim of the current study is to understand the relationship between different MOAs and public stigma toward substance use disorders and behavioral addictions. Method Participants were 755 adults who completed an online survey on MTurk (Mage = 36.2, SD = 10.1, 40.3% women, 59.4% men) and were randomized to one of four vignette conditions describing an individual with alcohol use disorder, opioid use disorder, problem gambling disorder, or diabetes. Participants completed measures assessing perceived stigma toward the vignette character and beliefs related to five MOAs (disease, moral, psychological, sociological, nature). Results Stigma ratings were significantly higher in the alcohol and opioid use disorder conditions compared to the problem gambling and diabetes conditions. Greater beliefs in the disease MOA were associated with greater stigma in the problem gambling condition, whereas greater beliefs in the moral MOA were associated with greater stigma in all addiction conditions. Greater beliefs in the psychological MOA were associated with lower stigma in the opioid use disorder and problem gambling conditions. Conclusions The current study provides further support that addictive disorders are more stigmatized than other health disorders and suggests that beliefs in specific MOAs are differentially associated with stigma. Interventions addressing addiction stigma may consider incorporating information emphasizing MOAs that are less stigmatizing.

Psychosocial health stigma related to COVID-19 disease among COVID-19 patients in Jordan: a comparative study

ObjectiveBeyond its effects on physical health, COVID-19 psychosocial stigma has emerged as a result of this global crisis, making people feel ashamed, alone and discriminated against. This comparative study aims...

Gay & Gray XI: Somewhere Over the Rainbow - Aging with Pride!

Gay & Gray XI: Somewhere Over the Rainbow - Aging with Pride!

Inflammatory breast cancer (IBC) advocacy-Past, present and future!

Patient advocates, referring to those individuals that have been diagnosed with the disease for which they advocate, are essential stake holders in healthcare. For those facing the stages of being diagnosed with Inflammatory Breast Cancer (IBC), the "call to advocate" is an immediate response to being diagnosed with a rare and aggressive disease that progresses rapidly, often in a matter of weeks or months. There is a great stigma and bias in the medical community that has inhibited the education and study of IBC. A lack of understanding of the disease, how it presents and how to treat it leaves many IBC patients facing misdiagnosis. Communication is a cornerstone of healthcare; this goes beyond the patient-provider dynamic. Education of IBC must be a grassroots initiative. There should be no barrier to care in the diagnosis, treatment, study and survivorship of inflammatory Breast Cancer. It is not just an oncologist's lesson to learn, but that of all providers in healthcare. In this chapter you will hear how 4 women who were diagnosed with IBC faced the difficult tasks of navigating through the healthcare system on their own and came out on the other side using their experience to help others. In conclusion, in defining the evolving roles of Patient Advocacy in IBC over the past 25 years, we examine what has been done, along with its challenges, and what work still remains from the perspectives of different patient advocates.

Modifying Our Genes: Theology, Science and “Playing God”

Modifying Our Genes: Theology, Science and “Playing God”

Evaluating the validity of depression-related stigma measurement among diabetes and hypertension patients receiving depression care in Malawi: A mixed-methods analysis.

Mental illness stigma research is sparse in Malawi. Our team previously analyzed the reliability and statistical validity of a quantitative tool to measure depression-related stigma among participants with depressive symptoms using quantitative psychometric methods. This analysis aims to further evaluate the content validity of the stigma tool by comparing participants' quantitative responses with qualitative data. The SHARP project conducted depression screening and treatment at 10 noncommunicable disease clinics across Malawi from April 2019 through December 2021. Eligible participants were 18-65 years with depressive symptoms indicated by a PHQ-9 score ≥5. Questionnaires at each study timepoint included a vignette-based quantitative stigma instrument with three thematic domains: disclosure carryover (i.e., concerns about disclosure), treatment carryover (i.e., concerns about external stigma because of receiving depression treatment), and negative affect (i.e., negative attitudes about people having depression). Sub-scores were aggregated for each domain, with higher scores indicating greater stigma. To better understand participants' interpretation of this quantitative stigma questionnaire, we asked a subset of six participants a parallel set of questions in semi-structured qualitative interviews in a method similar to cognitive interviewing. Qualitative responses were linked with participants' most recent quantitative follow-up interviews using Stata 16 and NVivo software. Participants with lower quantitative stigma disclosure sub-scores had qualitative responses that indicated less stigma around disclosure, while participants with higher quantitative stigma sub-scores had qualitative responses indicating greater stigma. Similarly, in the negative affect and treatment carryover domains, participants had parallel quantitative and qualitative responses. Further, participants identified with the vignette character in their qualitative interviews, and participants spoke about the character's projected feelings and experiences based on their own lived experiences. The stigma tool was interpreted appropriately by participants, providing strong evidence for the content validity of the quantitative tool to measure these stigma domains.

A national longitudinal cohort study of factors contributing to UK medical students’ mental ill-health symptoms

BackgroundThe mental health of current medical students is predictive of their mental health as future doctors. The prevalence of anxiety, depression and burnout is high among medical students, but less...

Opioid use-related stigma and health care decision-making.

Stigma is described as highly relevant to the treatment context for opioid use disorder (OUD) partly because it is known to influence providers' treatment decisions and care provision. However, further study is needed to directly test the salience of stigmatizing views for healthcare decision-making among providers, and particularly those including medication for opioid use disorder (MOUD). This study assessed whether stigma toward illicit opioid use was associated with a willingness to provide or refer patients for MOUD treatment among a sample of healthcare providers. It also evaluated variation in stigmatizing views as a function of familiarity with OUD and MOUD and provider type. Structural equation modeling was utilized to evaluate the antecedents and healthcare decision-making consequences associated with stigma based on survey data from a sample of 144 clinicians participating in a buprenorphine waiver training program (30% female). Providers who have less familiarity with OUD and MOUD and those who are medical students or residents are significantly more likely to endorse stigmatizing views of illicit opioid use. In turn, greater stigma is significantly associated with a lesser willingness to provide treatment or refer patients to MOUD treatment. Further consideration of stigma is recommended in future research to improve clinical practice and increase the implementation of MOUD treatment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Stigma toward cocaine use in Mexico City: does gender matter?

ABSTRACT Stigma toward those using cocaine and other substances remains a barrier to treatment and social inclusion. As part of a larger study exploring stigma toward those experiencing symptoms of various DSM5 diagnoses an experimental vignette methodology was used to examine factors associated with stigma toward individuals using cocaine in Mexico. Results from the subset of 66 individuals who were randomly assigned a vignette featuring cocaine use indicate that the gender of person using cocaine was not associated with differential levels of stigma. Lower levels of stigma were reported by respondents who had familiarity with mental health and substance use issues and by those endorsing higher levels of spirituality. Having a high school education or beyond was associated with greater stigma. Public health and education efforts are needed to inform community members and service providers about how stigma could affect addiction treatment and recovery. Implications for practice and research are explored.

Factors Related To Public Behavior towards Patients with Mental Disorders in Buton Utara District

Background: People with mental disorders often get greater stigma and discrimination from the surrounding community than individuals who suffer from other medical illnesses. This treatment is due to ignorance or misunderstanding of family or community members regarding mental disorders. This study aims to determine the determinants of community behavior towards people with mental disorders. Method: This type of research is an observational analytic using a cross-sectional design which was carried out in North Buton Regency in October 2022 involving 86 respondents who were selected randomly. Results: The results showed that the behavior of the majority was good as many as 47 respondents (54.7%), followed by poor behavior as many as 39 respondents (45.3%). Community behavior towards people with mental disorders in North Buton Regency is related to income (p-value 0.043), knowledge (p-value 0.000), attitude (p-value 0.014) and is not related to education level (p-value 0.489). Knowledge is the factor most related to people’s behavior towards people with mental disorders in North Buton Regency. Conclusion: The conclusion of the study is that people’s behavior towards people with mental disorders is related to good knowledge, good attitudes, and income.

Analisis Fungsi Keluarga (Family Apgar) Terhadap Kualitas Hidup Penderita Kusta

Leprosy is an infectious disease that causes a great stigma in society. Stigma against leprosy in the community makes sufferers delay or avoid treatment until later disability and unproductive occur so that further affects the quality of life of sufferers.The family is the smallest unit of society that is closely related to supporting a person's quality of life. This study aims to analyze the effect of family function (Family APGAR) on the quality of life of leprosy patients in Tuban Regency. This researchmethod is an analytic observational study with the research design used is the cross sectional method and uses a simple random sampling cluster sampling technique. The sample in this study amounted to 142 people who were in all health centers of the TubanDistrict Health Office. Hypothesis test using Spearman correlation test and logistic regression test. Spearman correlation test obtained p-value (0.001 <0.05) and concluded that there is a significant relationship between family function and quality of life of leprosy patients. In the logistic regression test, the factors that significantly influence the quality of life of leprosy patients are resolve with p-value (0.021 <0.05) with a probability of 56.58%. Family function (Family APGAR) affects the quality of life of people with leprosy and the most influential factor is resolve.

The Determinants and Effects of Chronic Pain Stigma: A Mixed Methods Study and the Development of a Model

People with chronic pain report experiencing stigma, but few studies have explored this in detail. This mixed-methods study aimed to investigate factors that contribute to chronic pain stigma, the effects of stigma, and to explore the stigma experiences of people with chronic pain. Participants were 215 adults with chronic pain who completed questionnaires assessing chronic pain stigma, opioid use, mental health conditions, pain, depression, disability and social support, and 179 also answered open-ended questions about stigma experiences. Linear regression and path analysis showed that greater stigma was experienced by those who used more opioids, had a mental health condition, viewed their pain as organic, and were unemployed. Stigma was associated with greater disability, depression and lower social support. Qualitative results supported quantitative findings, with 3 themes: 1. "Faking It": Others disbelieve pain and attribute it to drug seeking, laziness, or mental health problems, 2. A spectrum of stigma: Experiences of stigma vary from none to widespread, and 3. "I hide it well": Concealing pain and avoiding stigmatizing situations lead to isolation & disability. This study demonstrates the negative influence of stigma and presents a novel integrated model of chronic pain stigma which may be used to develop interventions. PERSPECTIVE: This study demonstrates the contributors to, and negative effects of, stigma for people with chronic pain. It presents an integrated model which could guide strategies to reduce chronic pain stigma amongst health professionals and the public, and to reduce self-stigma amongst people with pain.

The Differences in Attitude Toward Mental Health Services Between Japanese and American College Students

To examine the different patterns in utilization of psychological services between Japanese and American college students, a total of 316 American students (122 men and 194 women) and 362 Japanese students (147 men and 215 women) participated in this study. We used the following psychological instruments: Attitude Toward Seeking Professional Psychological Help scale, Interpersonal Openness (openness regarding professional psychological help) and Confidence Self-construal scale, Sex Role Inventory, and Recognition of Psychological Help. This study concluded that collectivism is a significant predictor of recognizing the need for mental health services in the U.S., while it is not in Japan. Compared to American and female participants, Japanese and male participants feel greater stigmas toward mental health professionals. Openness to psychological help collectivism was a significant predictor for openness among the American sample, while it was not in the Japanese sample. Collectivism was a significant predictor for openness among the American sample, while it was not in the Japanese sample. Individualism was a significant predictor for confidence in America, but it was not in Japan. As predicted, Japanese participants feel greater stigma and less recognition, openness, and confidence toward mental health services than Americans. It is important for mental health professionals to educate college students that individual who seek help have high masculine traits to ameliorate the negative attitude toward mental health professionals.

How do Americans perceive the stigma of leprosy?

ABSTRACT The stigma of leprosy will have reduced effects if people cannot reliably perceive it. Two factors impact these perceptions: familiarity and entitativity. One hundred and forty-five participants tested this assertion using an online platform to complete measures of stigma about leprosy as well as measures of familiarity and entitativity. The group of 145 completed the same measures of stigma, entitativity, and familiarity 1 week later. Standard deviations of time 1 and time 2 measures of stigma were used as indices of consistent (reliable) perceptions at the individual level. Results showed partial support for familiarity being positively associated with reliable responding. Moreover, high entitativity scores were associated with greater stigma perceptions at time 1 and time 2. Ongoing research on these indicators may be important in crafting future anti-stigma programs for leprosy.

Psychologists with lived experience of non-suicidal self-injury: Priorities, obstacles, and recommendations for inclusion.

The science and practice of psychology are improved by fostering an inclusive environment for professionals with lived experience of mental illness, sometimes referred to as "prosumers". Non-suicidal self-injury (NSSI) is an increasingly prevalent behavior that occurs across the spectra of mental disorders, and that is associated with greater stigma than many other mental health concerns. Further, individuals with lived experience of NSSI may face unique challenges, for instance, due to the visible nature of NSSI scarring. In this commentary, we describe the negative consequences associated with stigmatizing and excluding people with lived experience of NSSI from the profession of psychology, both for impacted individuals and for the field as a whole. We then provide recommendations to individuals with and without lived experience of NSSI to facilitate inclusion of people with lived experience of NSSI in clinical, research, teaching, and leadership domains. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Preferences regarding therapists' history of personal therapy or suicidal ideation: A comparison of undergraduates and mental healthcare providers.

A majority of mental health care providers seek personal therapy (i.e., are prosumers), and many providers experience suicidal ideation. Although mental health care providers may have more awareness of mental health than undergraduates, stigma is prevalent across both mental health care professionals and within universities. Furthermore, suicidality is a particularly stigmatized aspect of mental health. Stigma may affect a client's willingness to work with therapists who are prosumers. Although client preferences have implications for treatment engagement, retention, and outcomes (Swift & Callahan, 2009, 2010; Swift, Callahan, & Vollmer, 2011), we are unaware of any research that considers clients' preferences regarding a prosumer therapist. The current study used a delay discounting paradigm to compare undergraduates' and mental health care providers' preferences of a prosumer therapist (i.e., with or without prior treatment history or prior suicidal ideation). We hypothesized that mental health care providers would be more accepting of a prosumer therapist, compared to undergraduates. Across both samples we expected a therapist with prior personal therapy to be more preferred than a therapist who has experienced prior suicidal ideation. Results were as expected, which may indicate a greater degree of mental health stigma among undergraduates compared to the mental health profession and greater stigma toward suicide in comparison to therapy experience in general. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Staff perceptions of the management of mental health presentations to the emergency department of a rural Australian hospital: qualitative study

IntroductionCurrent research demonstrates higher prevalence of mental health related emergency department (ED) presentations in rural areas, despite similar overall prevalence of these conditions in rural and metropolitan contexts. This stems from shortages in availability of specialised mental health professionals, greater stigma against mental illness, greater socioeconomic disadvantages, and access to means of self-harm in rural regions. Little is known, however, about the specific characteristics of mental health presentations to rural emergency departments (EDs) in Australia. Additionally, studies have shown that ED staff feel uncomfortable managing mental health presentations to ED due to factors such as lack of confidence and stigma against mental illnesses.AimThis qualitative study sought to examine ED staff perceptions regarding the management of mental health presentations in a rural Australian ED.MethodsA qualitative study design was used, incorporating semi-structured interviews of current ED staff. Ten interviews were conducted in person or over the phone by two researchers and thematically analysed to draw out key themes from the data.ResultsStaff perceived deficiencies in availability of mental health expertise, de-escalation, and referral pathways as major barriers to effective patient management. These factors contributed to increased retention of mental health patients in ED due to uncertainties regarding their definitive care. Despite acknowledging the value of practical experience with mental health presentations as the best way of increasing clinician confidence, staff expressed a desire for more face-to-face training to better equip them to respond to mental health presentations.ConclusionA combination of departmental and hospital-wide issues in conjunction with individual staff attitudes regarding mental health conditions contributes to issues in mental health patient care in this ED. In particular, limited training in mental health and resources available to ED staff affects confidence in managing mental health presentations and contributes to prolonged time to definitive treatment.