Higher Levels Of Self-stigma Research Articles

Examining Personal, Perceived, Treatment, and Self-Stigma in College Students: The Role of Parent Beliefs and Mental Health Literacy

ABSTRACT Although college student mental health concerns are on the rise, many struggling students do not seek psychological treatment when needed. Stigma toward psychological treatment has been demonstrated to influence intent to seek treatment in college student populations. This study aimed to identify factors that predict treatment stigma in college students by examining other forms of student-held stigma, parent-held stigma, and mental health literacy. Results indicated that student-held personal, perceived, and self-stigma all predicted student attitudes toward treatment, while parent-held personal stigma was found to predict self-stigma in students. Those individuals who had received previous education about psychological disorders had lower levels of personal stigma, and, surprisingly, higher levels of self-stigma. Implications for campus outreach programming are discussed.

Stigmatizing Attitudes Toward Police Officers Seeking Psychological Services

Police officers are continuously involved in various roles that prove to be highly stressful and require a developed skill set. Consequently, demands from this career put officers at an increased risk for a range of mental-health related concerns. Although officers who suffer from these mental health concerns may need to seek psychological services, there is, unfortunately, a stigma that surrounds mental health causing officers to be reluctant to seek help. This research examines public perceptions and attitudes toward law enforcement professionals seeking mental health treatment. Findings suggest that when a higher level of self-stigma toward mental health is reported, there is also a higher level of stigma toward law enforcement. Males also showed higher levels of stigma toward officers. Implications of the findings and limitations of the study are discussed.

Depression stigma and migration \u2013 results of a survey from Germany

BackgroundThere are barely any studies focusing on migration in relation to mental illness stigma. We explore present attitudes regarding depression among migrants (either born in Germany or born abroad) and non-migrants in Germany, drawing upon three components of public stigma: stereotypes, emotional reactions and desire for social distance. Furthermore, differences in self-stigma of depression between the two groups are analyzed.MethodsAnalyses are based on a representative telephone survey (N = 2013) in Germany. Respondents were presented with a vignette depicting either someone from Turkey or from Germany affected by depression, followed by questions on stereotypes, emotional reactions and desire for social distance. The (anticipated) self-stigma of depression was also assessed. Analyses of variance tested for differences between migrant and non-migrant respondents, stratified by migrant status in the vignette.ResultsRegarding the depression vignette depicting a non-migrant, there were only few differences between subgroups. However, when presented with a vignette describing someone from Turkey, respondents with migrant background who were foreign-born expressed greater stigmatizing attitudes, e.g. when it comes to stereotypes or desire for social distance. Furthermore, this subsample displayed higher levels of self-stigma of depression, especially regarding the ascription of own responsibility.ConclusionsThe results underline the need to incorporate migration status/ethnicity in stigma research. Differences in attitudes as well as in (anticipated) self-stigma of depression identify foreign-born migrants in Germany as important target groups for tailored anti-stigma interventions, which need to consider diverse cultural backgrounds.

Internalized stigma in people with severe mental illness in rural China.

It is unknown whether there are differences in self-stigma among persons with different types of severe mental illness (SMI) in rural communities. This study was to examine the differences of self-stigma and its correlates in persons with schizophrenia, major depressive disorder or bipolar disorder in a rural community in China. A total of 453 persons with schizophrenia, major depressive disorder or bipolar disorder in a rural community participated in the study. The Internalized Stigma of Mental Illness (ISMI) was used to measure self-stigma. The t-test and analyses of variance (ANOVA) were used to examine the differences in mean scores of ISMI and subscales among the three diagnoses. Logistic regression was used to explore the contributing factors to the level of self-stigma among the three groups. Self-stigma was moderate and severe with 94.7% of the total sample. Persons with schizophrenia had significantly higher mean scores of total ISMI, alienation and discrimination experience than those with bipolar disorders. Lower family income was significantly associated with higher levels of self-stigma in persons with schizophrenia and major depressive disorder. Factors predicting the level of self-stigma among the three groups were various. Self-stigma is common and severe in persons with schizophrenia, major depressive disorder and bipolar disorder, especially those with lower income status in rural community in China. Persons with schizophrenia may have higher levels of self-stigma than those with bipolar disorder. Individual-level interventions should be developed to reduce self-stigma among persons with SMI in Chinese rural communities.

Self-stigma and its associations with stress, physical health, and health care satisfaction in adults who stutter

PurposeThe aim of this study was to identify potential relationships between self-stigma (stigma awareness and stigma application) and stress, physical health, and health care satisfaction among a large sample of adults who stutter. It was hypothesized that both stigma awareness and stigma application would be inversely related to measures of physical health and health care satisfaction, and positively related to stress. Furthermore, it was anticipated that stress mediated the relationship between self-stigma and physical health. MethodA sample of adults who stutter in the United States (n=397) completed a web survey that assessed levels of stigma awareness and stigma application, stress, physical health, and health care satisfaction. Correlational analyses were conducted to determine the relationships between these variables. ResultsHigher levels of stigma awareness and stigma application were associated with increased stress, decreased overall physical health, and decreased health care satisfaction (i.e., discomfort obtaining health care due to stuttering, and adverse health care outcomes due to stuttering), and these relationships were statistically significant. Stress was identified as a mediator between stigma application and physical health. ConclusionBecause adults who stutter with higher levels of self-stigma are at risk for decreased physical health through increased stress, and lower satisfaction with their health care experiences as a result of stuttering, it is important for professionals to assess and manage self-stigma in clients who stutter. Self-stigma has implications for not only psychological well-being, but stress, physical health, and health care satisfaction as well.

Psychological factors, sociodemographic characteristics, and coping mechanisms associated with the self-stigma of problem gambling.

Background and aimsFew studies have examined the stigma of problem gambling and little is known about those who internalize this prejudice as damaging self-stigma. This paper aimed to identify psychological factors, sociodemographic characteristics, and coping mechanisms associated with the self-stigma of problem gambling.MethodsAn online survey was conducted on 177 Australian adults with a current gambling problem to measure self-stigma, self-esteem, social anxiety, self-consciousness, psychological distress, symptom severity, most problematic gambling form, stigma coping mechanisms, and sociodemographic characteristics.ResultsAll variables significantly correlated with self-stigma were considered for inclusion in a regression model. A multivariate linear regression indicated that higher levels of self-stigma were associated with: being female, being older, lower self-esteem, higher problem gambling severity score, and greater use of secrecy (standardized coefficients: 0.16, 0.14, −0.33, 0.23, and 0.15, respectively). Strongest predictors in the model were self-esteem, followed by symptom severity score. Together, predictors in the model accounted for 38.9% of the variance in self-stigma.Discussion and conclusionsThese results suggest that the self-stigma of problem gambling may be driven by similar mechanisms as the self-stigma of other mental health disorders, and impact similarly on self-esteem and coping. Thus, self-stigma reduction initiatives used for other mental health conditions may be effective for problem gambling. In contrast, however, the self-stigma of problem gambling increased with female gender and older age, which are associated with gaming machine problems. This group should, therefore, be a target population for efforts to reduce or better cope with the self-stigma of problem gambling.

Investigating quality of life and self-stigma in Hong Kong children with specific learning disabilities

BackgroundChildren with specific learning disabilities (SpLD) are likely to develop self-stigma and have a poor quality of life (QoL) because of their poor academic performance. Although both self-stigma and poor QoL issues are likely to be found in low academic achievers without SpLD, children with SpLD have worse situation because their diagnosis of SpLD suggests that their learning struggles are biological and permanent. Specifically, students’ perception of own capabilities may be affected more by the diagnosis of SpLD than their own actual performance. AimsWe examined the self-stigma and QoL of children with SpLD in Hong Kong, a region with an academics-focused culture. Methods and proceduresChildren with SpLD (n=49,Mage±SD=9.55±1.21; SpLD group) and typically developing children (n=32,Mage±SD=9.81±1.40; TD group) completed a Kid-KINDL to measure QoL and a Modified Self-Stigma Scale to measure self-stigma. All parents completed a parallel Kid-KINDL to measure QoL of their children. Outcomes and resultsCompared with the TD group, the SpLD group had a higher level of self-stigma (p=0.027) and lower QoL (child-reported Kid-KINDL: p=0.001; parent-reported Kid-KINDL: p<0.001). Conclusions and implicationsIn the academics-focused environment in Hong Kong, SpLD was associated with impaired QoL and higher self-stigma. Treatments targeting the learning process of children with SpLD may be designed to overcome self-stigma and to improve QoL. In addition, the program may involve parents of the children with SpLD or other people (e.g., the peer of the children with SpLD) for improving their understanding and perceptions of SpLD.

Psychological and behavioural patterns of stigma among patients with type 2 diabetes: a cross-sectional study

ObjectivesThe aim of this study was to test the psychological and behavioural patterns of stigma (self-esteem and social participation) and their relationship to self-stigma, patient activation for engaging in self-care...

Collective Self-Esteem and Depressive Symptomatology in Lesbians and Gay Men: A Moderated Mediation Model of Self-Stigma and Psychological Abuse

ABSTRACTThe context of stigma, in which lesbians and gay men live in most countries, exposes them to possible discrimination and promotes the internalization of negative attitudes about their own sexual orientation, which may have negative consequences for their mental health. Their psychological distress may increase when lesbians and gay men are exposed to other sources of stress such as intimate partner violence. With the aim of analyzing the relationship between these variables, this study intends to present a moderated mediation model that proposes: (a) self-stigma mediates the relationship between private collective self-esteem and depressive symptomatology; (b) receiving psychological abuse within same-sex couples moderates the relationship between self-stigma and depressive symptomatology. For this purpose we conducted an online survey with a sample of 357 Spanish lesbians and gay men. Our findings show that self-stigma mediates the relationship between private collective self-esteem and depressive symptomatology. Furthermore, participants who had higher levels of self-stigma and received more psychological abuse by the partner showed stronger negative effects on depressive symptomatology. Theoretical and practical implications are discussed.

Explanatory model of psychosis: impact on perception of self-stigma by patients in three sub-saharan African cities.

Most cultures in sub-Saharan Africa subscribe to the belief that the root cause of psychosis is supernatural. Individuals in the community who hold a religiomagical explanatory model of causation have been shown to exhibit more stigmatizing attitudes towards people with psychosis. Self-stigma among individuals with psychosis is less frequently studied. We used a mixed-method approach, consisting of key informant's interviews to elicit information on explanatory models of causation of psychosis and questionnaire assessment of internalized stigma with an adapted version of the Scale for Internalized Stigma of Mental Illness. Twenty-four, 31, and 30 subjects with recent experience of utilizing the service of traditional or faith healers for severe mental disorders in Ibadan (Nigeria), Kumasi (Ghana), and Nairobi (Kenya), respectively, were interviewed. About 44% (42.1%) of the Nigerian respondents had a high (severe) level of self-stigma with the respective proportions among Ghanaian and Kenyan respondents being 20.7 and 37.5%. Compared with 4 out of a total of 12 respondents (33.3%) who reported low self-stigma reported supernatural attribution, 14 out of 20 respondents (70%) with the highest level of self-stigma reported supernatural attribution across the three sites. When low scorers ascribed supernatural causation, it was often with a religious focus. There is a greater tendency for persons with high levels of self-stigma than those with low levels to ascribe supernatural attribution to their experience of a severe mental health condition.

Connection between self-stigma, adherence to treatment, and discontinuation of medication

IntroductionSelf-stigma plays a role in many areas of the patient’s life. Furthermore, it also discourages therapy. The aim of our study was to examine associations between self-stigma and adherence to treatment and discontinuation of medication in patients from various diagnostic groups.MethodsThis cross-sectional study involved outpatients attending the Department of Psychiatry, University Hospital Olomouc, Czech Republic. The level of self-stigma was measured with the Internalized Stigma of Mental Illness and adherence with the Drug Attitude Inventory. The patients also anonymously filled out a demographic questionnaire which included a question asking whether they had discontinued their medication in the past.ResultsWe examined data from 332 patients from six basic diagnostic categories (substance abuse disorders, schizophrenia, bipolar disorders, depressive disorders, anxiety disorders, and personality disorders). The study showed a statistically significant negative correlation between self-stigma and adherence to treatment in all diagnostic groups. Self-stigma correlated positively and adherence negatively with the severity of disorders. Another important factor affecting both variables was partnership. Self-stigma positively correlated with doses of antidepressants and adherence with doses of anxiolytics. Self-stigma also negatively correlated with education, and positively with a number of hospitalizations and number of psychiatrists visited. Adherence was further positively correlated with age and age of onset of disorders. Regression analysis showed that self-stigma was an important factor negatively influencing adherence to treatment and significantly contributing to voluntary discontinuation of drugs. The level of self-stigma did not differ between diagnostic categories. Patients suffering from schizophrenia had the lowest adherence to treatment.ConclusionThe study showed a significant correlation between self-stigma and adherence to treatment. High levels of self-stigma are associated with discontinuation of medications without a psychiatrist’s recommendation. This connection was present in all diagnostic groups.

Self-clarity and different clusters of insight and self-stigma in mental illness

The current study explored the self-experience of persons with Serious Mental Illness (SMI) by investigating the associations between different insight and self-stigma clusters, self-clarity, hope, recovery, and functioning. One hundred seven persons diagnosed with a SMI were administered six scales: self-concept clarity, self-stigma, insight into the illness, hope, recovery, and functioning. Correlations and cluster analyses were performed. Insight, as measured by a self-report scale was not related to any other variable. Self-stigma was negatively associated with self-clarity, hope, recovery and functioning. Three clusters emerged: moderate stigma/high insight (n=31), high stigma/moderate insight (n=28), and low stigma/low insight (n=42). The group with low stigma and low insight had higher mean levels of self-clarity and hope than the other two groups. There were no significant differences between cluster 1 (moderate stigma/high insight) and cluster 2 (high stigma/moderate insight) in all the variables beside self-clarity. The group with moderate stigma and high insight had significantly higher mean levels of self-clarity than the group with high stigma and moderate insight. Results reveal that when people diagnosed with SMI do not have high levels of self-stigma they often report a positive and clear sense of self accompanied with hope, regardless of having low insight.

La thérapie informatisée : une option pouvant faciliter l’accès à la thérapie chez les jeunes adultes ?

Introduction Of all age groups, young Canadian adults have the highest prevalence rates of anxiety and depression. Yet, theyare also the least likely to access traditional face-to-face mental health services. Facilitating access to evidence-based therapy among young adults is thus particularly important, namely in rural parts of Canada as well as among its linguistic minorities. Computerized therapy could be a cost-effective alternative. However, little is known about how young adults perceive it.Objectives This study aimed to assess the influence of self-stigma,need for autonomy and attitudes toward computerized therapy on the intent of Francophone young adults to use computerized therapy. The impact of visiting the Website of a virtual psychology clinic on their intent to use computerized therapy was also assessed.Method Forty-four young adults attending a French University in New Brunswick completed online self-report measures before and after visiting the Website of the MindSpot Clinic, a virtual psychology clinic offering evidence-based computerized therapy programs for anxiety and depression.Results Higher levels of self-stigma were moderately correlated with higher levels of need for autonomy, which in turn were moderately associated with more positive attitudes toward computerized therapy. Only more positive attitudes toward computerized therapy were moderately and directly correlated with a higher intent of using this type of therapy. T-tests revealed that visiting the MindSpot Clinic's Website produced a significant and large increase in the intent to use computerized therapy.Conclusions Computerized therapy may facilitate access to evidence-based treatments of anxiety and depression among Francophone young adults from New Brunswick, and perhaps from other parts of Canada as well. Websites similar to the one of the MindSpot Clinic may be an efficient strategy to provide young Canadian adults with helpful information on computerized therapy, as this therapy format is not established yet in Canada. A research program conducted by the first author aims to make it accessible in New Brunswick in both official languages.

Insight in paranoia: The role of experiential avoidance and internalized stigma

Evidence suggests that insight in psychosis has been related to treatment adherence, recovery and good prognosis, but also to depression, low self-esteem, and diminished quality of life. Thus, insight might not be advantageous under all circumstances. Internalized-stigma (i.e. self-acceptance of stigmatizing images of illness) and experiential avoidance (i.e. unwillingness to experience negative private events) have been proposed as moderating variables between insight, and psychological health variables and/or distress. We investigated the patterns of association of insight with satisfaction with life, self-esteem, depression, anxiety and psychotic psychopathology as moderated by self-stigmatizing beliefs and experiential avoidance, in a sample of 47 participants with persecutory beliefs and diagnosed with schizophrenia or other psychotic disorder. Moderation analyses confirm the importance of internalized-stigma and experiential avoidance. The presence of insight was associated with more depression when there were high levels of self-stigma. Whereas, the absence of insight was associated with a greater life satisfaction when there were high levels of experiential avoidance. To summarize, our results help understand the complex relationship between insight, psychological health variables and emotional distress, pointing to a differential pattern of moderation for negative and positive outcomes. We discuss the implications of these results for research and treatment of paranoia.

Relationship Between Personality and Self-stigma in Mixed Neurotic Spectrum and Depressive Disorders – Cross Sectional Study

The goal of the study was to identify psychological features that are significantly connected to the presence of self-stigma. Method 76 neurotic inpatients undergoing a six week hospitalization in the psychotherapeutic department attended the study. The probands completed these psychodiagnostic methods at the start of the treatment – ISMI (Internalized Stigma of Mental Illness Scale), TCI-R (Temperament and Character Inventory, revised version), ADHS (Adult Dispositional Hope Scale), DES (Dissociative Experiences Scale), BAI (Beck Anxiety Scale), BDI-II (Beck Depression Scale, second edition), and CGI (Clinical Global Impression, both the subjective and objective versions). The scores of the scales and the inventory were processed by descriptive statistics, t-tests, correlations, linear regression, and backward stepwise regression. Results The overall level of self-stigma in the patients with a neurosis and possible comorbid depression significantly correlated with several psychological features. Self-stigma was significantly positively connected to the harm avoidance trait, the symptoms of dissociation, anxiety, and depression, and the overall level of psychopathology measured by objCGI and sucjCGI. It also correlated significantly negatively with the persistence and self-directedness traits and hope and its subscales – pathway thinking and agency. After applying backward stepwise regression, only three of the mentioned factors predicted the level of self-stigma – self-directedness, hope, and the subjective evaluation of own mental state. Other factors were suppressed during the analysis. Conclusion Patients with more severe psychopathology show larger tendencies to stigmatize themselves. Low self-directedness and lack of hope are also typical for individuals with higher levels of self-stigma.

Perspectives on perceived stigma and self-stigma in adult male patients with depression

There are two principal types of stigma in mental illness, ie, “public stigma” and “self-stigma”. Public stigma is the perception held by others that the mentally ill individual is socially undesirable. Stigmatized persons may internalize perceived prejudices and develop negative feelings about themselves. The result of this process is “self-stigma”. Stigma has emerged as an important barrier to the treatment of depression and other mental illnesses. Gender and race are related to stigma. Among depressed patients, males and African-Americans have higher levels of self-stigma than females and Caucasians. Perceived stigma and self-stigma affect willingness to seek help in both genders and races. African-Americans demonstrate a less positive attitude towards mental health treatments than Caucasians. Religious beliefs play a role in their coping with mental illness. Certain prejudicial beliefs about mental illness are shared globally. Structural modeling indicates that conformity to dominant masculine gender norms (“boys don’t cry”) leads to self-stigmatization in depressed men who feel that they should be able to cope with their illness without professional help. These findings suggest that targeting men’s feelings about their depression and other mental health problems could be a more successful approach to change help-seeking attitudes than trying to change those attitudes directly. Further, the inhibitory effect of traditional masculine gender norms on help-seeking can be overcome if depressed men feel that a genuine connection leading to mutual understanding has been established with a health care professional.

Self-stigma, empowerment and perceived discrimination among people with bipolar disorder or depression in 13 European countries: The GAMIAN–Europe study

Background There is little information on the degree to which self-stigma is experienced by individuals with a diagnosis of bipolar disorder or depression across Europe. This study describes the levels of self-stigma, stigma resistance, empowerment and perceived discrimination reported in these groups. Methods Data were collected from 1182 people with bipolar disorder or depression using a mail survey with members of national mental health non-governmental organisations. Results Over one fifth of the participants (21.7%) reported moderate or high levels of self-stigma, 59.7% moderate or high stigma resistance, 63% moderate or high empowerment, and 71.6% moderate or high perceived discrimination. In a reduced multivariate model 27% of the variance in self-stigma scores, among people with a diagnosis of bipolar disorder or depression, was accounted for by levels of empowerment, perceived discrimination, number of areas of social contact, education and employment. Limitations Findings are limited by the use of an unweighted sample of members of mental health charity organisations which may be unrepresentative of the reference population. Conclusions These findings suggest that self-stigma occurs among approximately 1 in 5 people with bipolar disorder or depression in Europe. The tailoring of interventions to counteract (or fight against) the elements of self-stigma which are most problematic for the group, be they alienation, stereotype endorsement, social withdrawal or discrimination experience, may confer benefit to people with such disorders.

Self-stigma, empowerment and perceived discrimination among people with schizophrenia in 14 European countries: The GAMIAN-Europe study

There is a growing interest in examining self-stigma as a barrier to recovery from schizophrenia. To date, no studies have examined mental health service user's experiences of self-stigma throughout Europe. This study describes the level of self-stigma, stigma resistance, empowerment and perceived discrimination reported by mental health service users with a diagnosis of schizophrenia or other psychotic disorder across 14 European countries. Data were collected from 1229 people using a postal survey from members of mental health non-governmental organisations. Almost half (41.7%) reported moderate or high levels of self-stigma, 49.2% moderate or high stigma resistance, 49.7% moderate or high empowerment and 69.4% moderate or high perceived discrimination. In a reduced multivariate model 42% of the variance in self-stigma scores was predicted by levels of empowerment, perceived discrimination and social contact. These results suggest that self-stigma appears to be common and sometimes severe among people with schizophrenia or other psychotic disorders in Europe.

Intentionality of medication non-adherence among individuals living with HIV/AIDS in Hong Kong

Adherence to antiretroviral therapy is essential to treatment success for individuals living with HIV/AIDS. Despite the wealth of studies in examining antiretroviral non-adherence, few have distinguished between intentional and unintentional non-adherence. The present study attempted to identify factors associated with adherence, intentional non-adherence, and unintentional non-adherence among HIV+ individuals using a longitudinal design. Dietary instructions and medication schedule were also included to measure the subtleties of antiretroviral adherence. One hundred and two HIV+ patients who were under antiretroviral therapy were recruited in an outpatient clinic in Hong Kong at baseline with six months follow-up. Using the conventional adherence rate, only 12 (11.8%) of participants reported having missed/ altered medication in the past four days. However, using a more comprehensive assessment, only 27 (26.5%) participants were classified as adherers. Results showed that, adherers were significantly older and had higher adherence self-efficacy than those who were unintentional or intentional non-adherers. Participants classified as unintentional non-adherers had longer length of diagnosis and started medication longer than adherers and intentional non-adherers. Participants classified as intentional non-adherers had worse mental health, higher level of self-stigma, and reported higher score in avoidant coping than adherers and unintentional non-adherers. They also scored higher in physical symptoms than adherers. Findings highlight the importance of a reliable, comprehensive measurement for adherence and extend on previous adherence literature that intentional and unintentional non-adherence are separate entities and are associated with different factors. Future research should understand the intentions behind non-adherence and this would serve as an important guide in the development of interventions aimed at improving antiretroviral adherence for HIV+ patients.

Cognitive Insight and Causal Attribution in the Development of Self-Stigma Among Individuals With Schizophrenia

Stigma has dampening effects on the overall rehabilitation of individuals given a diagnosis of schizophrenia. This study was an initial attempt to understand the relationship between cognitive insight and attribution in the development of self-stigma among this group of mental health consumers. In a cross-sectional design, the investigators interviewed 162 mental health consumers with broad diagnoses of schizophrenia from 15 community-based psychiatric rehabilitation centers in Hong Kong. After controlling for the effects of demographic and illness-related factors, the authors used hierarchical multiple regression analysis to investigate the effects of cognitive insight and causal attribution on self-stigma. Better cognitive insight and attribution of personal responsibility to the cause of the illness were significantly associated with higher levels of self-stigma. Given that awareness and interpretation of participants' illness were related to self-stigma, cognitive restructuring is needed to alleviate self-stigma among individuals with schizophrenia.