Nature Of Stigma Research Articles

Thoughts Beyond Stigma-Implications for Change Reflected in the Voices of Previously Incarcerated Citizens

State and federal prisons release more than six hundred thousand people annually, with nearly 95% of those returning to the communities in which they resided before incarceration, albeit frequently with discomfort and marginalization, largely due to stigma (Alexander, 2020; Park & Tietjen, 2021). Programs to foster reintegration exist in almost every locale, yet recidivism remains due to many factors. Stigma has received much attention as a cause of failure for successful reentry and acclimation (Park & Tietjen, 2021). With the surge of interest and empirical study of stigma as a barrier, the voices of returning citizens can further enhance significant theory and knowledge related to stigma to inform successful reentry and adjustment. The purpose of this study was to advance theory regarding the nature of stigma from the perspectives of prior incarcerated informants who also spent varying lengths of time back in their communities after completing a term of incarceration. As is often characteristic of a mixed method study relying on abductive analysis such as that presented herein, the findings often transcend or depart from the original purpose of an inquiry, elevating the richness and theoretical learning to include unexpected results. The study reveals and discusses insights beyond the intended aim of the research.

The Silent Majority: Aging With HIV

Those over the age of 50 represent the majority of people living with HIV (PWH), most of the HIV research, prevention and service retention work is targeted at ‘at-risk’ communities under age 50. Given this diverse and growing population, intersections of age with HIV need to be prioritized. This focus would actively increase quality of care and life experience for older PWH and the growing numbers transitioning into old age. Using local, national, and international data, this symposium will highlight the unmet social needs of older PWH. Presentations will provide evidence of unmet need, decreased self-esteem, enhanced health burden, and the damaging nature of stigma. Given the impact of COVID-19 globally, the data will further demonstrate the need to support immunocompromised older PWH. Older PWH are a marginalized community and the effects of COVID-19 have been disproportionately severe. With the adverse health outcomes experienced because of COVID-19 and intersectional stigma, it is important to understand the support structures that are and are not in place for older PWH. Advance care directives make up an integral part of future planning, especially for those living with chronic health concerns, yet little research has previously evidenced the steps taken by OPWH. Finally, using data from sub-Saharan Africa, emotional and instrumental social support sufficiency will be described to highlight the unmet needs of these older PWH. Our discussion will focus on the need for policies and programs to support this growing segment of the HIV population with increasingly diverse and unmet needs.

HIV-related stigma in the UK then and now: to what extent are we on track to eliminate stigma? A qualitative investigation

BackgroundThe introduction of effective antiretroviral treatment in the late 1990s led to the perception that HIV was a chronic but manageable condition. Nevertheless, stigma remains one of the major hurdles for people living with HIV (PLWH) to accessing healthcare and biomedical preventions. Thus, Fast Track Cities has set a target of zero HIV discrimination by 2030 as part of its strategy to end HIV transmission.MethodsFifty-three participants from the United Kingdom, including PLWH (n = 21, 40%), health and social care workers (n = 24, 45%), and charity workers and activists (n = 13, 25%), were recruited. Semi-structured interviews investigated stigma and discrimination, focusing on both before and after the widespread use of effective antiretroviral treatment in the late 1990s. Data were analysed using a thematic approach.ResultsBefore effective antiretroviral treatment narratives were shaped by two main themes: 1) the media’s role in influencing public opinion and contributing to misunderstandings of HIV transmission; and 2) personal experiences of HIV-related stigma, which for PLWH included incidents of physical violence and aggression, as well as fears of their HIV status being publicised. Contemporary narratives on stigma experiences were organised around four themes: 1) discrimination in healthcare settings; 2) stigma amongst men who have sex with men (MSM); 3) stigma towards African and Afro-Caribbean PLWH; and 4) the limits of change in public HIV-related knowledge and attitudes. Contemporary narratives indicated a reduction in enacted stigma, but continued anticipation of discrimination and self-reported shame, particularly in MSM and African and Afro-Caribbean PLWH.ConclusionThe nature of stigma against those with HIV has evolved. The intersection of PLWH and minority groups (e.g. MSM and African and Afro-Caribbean persons) may enhance anticipatory and internalised stigma, with some suggestion that this may contribute to reduced engagement in HIV care and prevention services. Our findings indicate the need for further research in this area, as well as proactive interventions with community groups to enhance knowledge of HIV.

Mental-Illness-Related Stigma in Health Care in South India: Mixed-Methods Study.

Background:Stigma related to mental illness is a reality among health care providers. This study is an attempt to understand the attitudes of doctors from different specialties toward mental illness and the stigma related to it.Methods:We used a concurrent nested mixed-methods approach to understand and identify the various factors of mental-illness-related stigma in medical practitioners. Between November 2018 and March 2019, 100 medical practitioners from South India were administered a self-reporting OMS-HC (Opening Minds Scale for Health Care Providers), followed by in-depth interviews among 25 of the 100 participants selected using purposive sampling. Quantitative surveys were analyzed using SPSSv23. In-depth interviews were transcribed as extended notes, translated, and initially explored using focused coding and the constant comparative method.Results:Though findings from quantitative analysis show low to moderate stigma (Mean = 53.52, SD = 7.61), the qualitative study revealed unintended and covert negative attitude toward mental illness.Conclusion:As stigma occurs at various levels—structural, institutional, interpersonal, and personal—anti-stigma measures also need to be systematically designed. Qualitative studies give more insight regarding the nature of stigma in medical practitioners toward mental illness

Examining HIV/AIDS-Related Stigma at Play: Power, Structure, and Implications for HIV Interventions

ABSTRACT Drawing on critical theoretical perspectives and ethnographic field research related to HIV/AIDS in northern India, this paper argues for a cultured-centered approach to stigma reduction interventions and communication practices that are based on an assessment of larger social and structural processes on the one hand and the lived experiences and narratives of people living with HIV (PLWH) on the other. This paper suggests that while the complex nature of stigma, particularly as it relates to HIV/AIDS, makes it difficult to understand and respond to, this problem is further exacerbated by a largely individual and behavior-centered research that still dominates the field of Health Communication. Such research sees human cognition as the main source of stigma and underplays issues of power, structure, domination, and control. More specifically, and with concrete examples from the everyday lived experiences of PLWH – such as their experiences within family and health-care settings, this paper demonstrates how power and structure deeply impact their lives and remain central to their experience of (and resistance to) stigma, thus opening up space for alternative theorizing and practices in Health Communication.

Vicarious Experiences of Unemployment Scale Development: Relationships to Mental Health and Help-Seeking Among Undergraduate Students

Vicarious experiences of unemployment (VUE), or having a primary caretaker such as a parent or legal guardian who is unemployed, have been demonstrated to impact adolescent and young adult physical and mental health, career decision-making, and educational development. This study describes the development of a new measure, the VUE Scale designed to tap the nature of stigma and struggle associated with an experience of vicarious unemployment (VU). Following results from pilot testing, 395 undergraduate students participated in the study. Results demonstrated preliminary support for the psychometric properties of the VUE. Consistent with hypotheses, results also indicated that more substantive experiences of VU related significantly and positively to heightened levels of depressive, anxiety, and stress, as well as to lower levels of self-esteem and social support. We also explored the relationship between VUE and help-seeking intentions and attitudes. These exploratory findings suggested that more impactful VU experiences relate to less positive formal help-seeking attitudes and intentions. Limitations and future directions for practice and research are described.

Stigma experienced by persons diagnosed to have a mental illness – a descriptive study

Background In Sri Lanka, mental illness is often considered an embarrassing topic, which is not openly discussed. The stigma associated with mental illness influences the way people choose to seek help and the use of services. Aims To describe the nature of stigma experienced by patients presenting to the adult psychiatry clinic at Teaching Hospital, Peradeniya. Methods The stigma scale by King et al. was translated to Sinhala and modified to suit the Sri Lankan context. This modified version was distributed among 100 patients attending the adult psychiatry clinic at T.H. Peradeniya over a consecutive twomonth period. Results The most commonly endorsed discriminatory items pertaining to stigma were, that the participants felt they could not have a satisfactory married life, and that they felt isolated and talked down to, due to their illness. Almost half said they would avoid telling others about their mental health problems. In contrast, 56.1% reported that they felt that the support from their family has increased due to their mental health problems. Conclusions Stigma experienced by persons with mental illness is complex and varied, and a better understanding of this important area would enable improved patient care in Sri Lanka.

Women Living with HIV in India: Looking up from a Place of Stigma, Identifying Nexus Sites for Change

For women living with HIV infection in India, stigma is a pervasive reality and the greatest barrier to accessing treatment, quality of life and survival. Defining stigma according to Goffman as a socially conceived abnormality, this paper then draws on Engel’s biopsychosocial model for chronic disease to show the pervasive nature of stigma as a continuum affecting all dimensions of life for married, monogamous Indian women with positive HIV sero-status. Two distinct perspectives were identified in the literature: 1) Public: social and relational stigma, or 2) Private: internalised psychological stigma. Only four of the twenty published works reviewed noted interrelationships between these public and private spheres. Only one of those employed an ethnographic methodology to understand stigma from the perspective of the women themselves. While concepts associated with stigma among women living with HIV are diversely employed in research, by considering them as a whole through an intersectional biopsychosocial lens, this paper attempts to provide a basis for implementing integrated and tailored responses. Once the manifestations and interconnected causes of particular groups of HIV-positive women’s marginalisation are identified from their perspective, corresponding HIV-care programs and research activities can be designed. Such programs can be tailored with dual objectives: 1) to respond in a coordinated manner to the particular women’s own identified and prioritised daily needs across biomedical treatment and social and psychological support, and 2) to work to promote change in social constructions of stigma that form barriers to care.

The Relationship Between Stigma and Trauma in Adults Living with HIV

Stigma associated with HIV is considered a major stressor for people living with HIV/AIDS (PLWHA) that affects quality of life and may serve as a barrier to effective care and treatment. This manuscript explores the prevalence of stigma among PLWHA (N = 124), differentiates the ways that stigma manifests itself (i.e., personalized, disclosure concerns, negative self-image, public attitudes), and examines the predictive nature of stigma in how individuals experience an HIV diagnosis. Multiple regression analyses and canonical correlations indicate that stigma was found to be correlated with, and predictive of, experiencing an HIV diagnosis in a consequential and potentially traumatic way. Lastly, implications for mental health counselors are presented.

HIV-related stigma and discrimination in the New Zealand healthcare setting: a mixed-methods study.

This study involved a mixed-methods approach, using a questionnaire to collect quantitative and qualitative data from PLHIV recruited from the HIV Clinic at Auckland City Hospital and from two national HIV peer-support organisations between August 2012 and February 2013. Two hundred and thirteen PLHIV participated in the study. One hundred PLHIV (47%) reported that they had ever experienced HIV-related discrimination by a healthcare worker. The types of discrimination included confidentiality problems (19%), additional infection control measures (19%) and rudeness (18%). Healthcare settings where most of the discrimination had been experienced were other (non-infectious diseases) hospital wards, dental clinics, other (non-HIV) outpatient clinics and general practice clinics. Almost half of the PLHIV in New Zealand have experienced stigma and discrimination in a healthcare setting. The findings of this study show that there is a need to continue to normalise the care of HIV and increase HIV education for healthcare workers.

Family history and its relationship with dementia stigma beliefs among Chinese Americans

It is known that Chinese Americans associate dementia with stigma and "loss of face." However, further research is required to provide a more complete picture of the extent and nature of stigma in Chinese Americans with family histories of dementia (FHD). The present study examined whether FHD are associated with quantitative measures of stigma in Chinese Americans. A total of 300 Chinese Americans in two health seminars answered a 15-item, true/false questionnaire to assess their beliefs toward dementia. Two groups were dichotomized and compared based on FHD. Both groups subscribed to moderately stigmatizing views about dementia. Our findings showed that the group with FHD was more likely to disclose having relatives with dementia. However, this group was also more likely to perceive patients with dementia to be incapable of feeling other people's worries or concerns at once. Strategies to decrease stigma toward dementia are required. Cultural interventions must also extend into the Chinese American general public to reduce stigma of dementia. Geriatr Gerontol Int 2017; 17: 122-125.

Stigma and discrimination related to mental illness in low- and middle-income countries.

This paper aims to provide an overview of evidence from low- and middle-income countries (LAMICs) worldwide to address: the nature of stigma and discrimination, relevant context-specific factors, global patterns of these phenomena and their measurement and quantitative and qualitative evidence of interventions intended to reduce their occurrence and impact. The background to this study is that the large majority of studies concerned with identifying effective interventions to reduce stigma and discrimination originate in high-income countries (HICs). This paper therefore presents such evidence from, and relevant to, LAMICs. Conceptual overview of the relevant peer-reviewed and grey literature on stigma and discrimination related to mental illness in LAMICs are available in English, Spanish, French and Russian. Few intervention studies were identified related to stigma re-education in LAMICs. None of these addressed behaviour change/discrimination, and there were no long-term follow-up studies. There is therefore insufficient evidence at present to know which overall types of intervention may be effective and feasible and in LAMICs, how best to target key groups such as healthcare staff, and how far they may need to be locally customised to be acceptable for large-scale use in these settings. In particular, forms of social contacts, which have been shown to be the most effective intervention to reduce stigma among adults in HICs, have not yet been assessed sufficiently to know whether these methods are also effective in LAMICs. Generating information about effective interventions to reduce stigma and discrimination in LAMICs is now an important mental health priority worldwide.

Negative labeling and social exclusion of people living with human immunodeficiency virus/acquired immune deficiency syndrome in the antiretroviral therapy era: insight from attitudes and behavioral intentions of female heads of households in Zambézia Province, Mozambique

In the age of antiretroviral therapy (ART), unraveling specific aspects of stigma that impede uptake and adherence to human immunodeficiency virus (HIV) services and the complex intersections among them might enhance the efficacy of stigma-reduction interventions targeted at the general public. Few studies have described community stigma in high HIV prevalence regions of Mozambique where program scale-up has been concentrated, but fear of stigma persists as a barrier to HIV service uptake. Principal components analysis of attitudinal data from 3749 female heads of households surveyed in Zambézia Province was used to examine patterns of agreement with stigmatizing attitudes and behavior toward people living with HIV. Inferences were based on comparison of factor loadings and commonality estimates. Construct validity was established through correlations with levels of knowledge about HIV transmission and consistency with the labeling theory of stigma. Two unique domains of community stigma were observed: negative labeling and devaluation (NLD, α = 0.74) and social exclusion (SoE, α = 0.73). NLD is primarily an attitudinal construct, while SoE captures behavioral intent. About one-third of the respondents scored in the upper tertile of the NLD stigma scale (scale: 0–100 stigma points) and the equivalent was 41.3% in the SoE stigma scale. Consistent with literature, NLD and SoE stigma scores were inversely correlated with HIV transmission route knowledge. In item level analysis, fear of being labeled a prostitute/immoral and of negative family affect defined the nature of stigma in this sample. Thus, despite ART scale-up and community education about HIV/acquired immune deficiency syndrome (AIDS), NLD and SoE characterized the community stigma of HIV in this setting. Follow-up studies could compare the impact of these stigma domains on HIV services uptake, in order to inform domain-focused stigma-reduction interventions.

On the Margins of the Periphery: Unassisted Childbirth and the Management of Layered Stigma

This article examines an unusual practice—unassisted childbirth—and the ways in which advocates and practitioners manage the stigma they are accorded. Given their “doubly deviant” status as not only women who birth at home but also as women who choose to give birth without professional assistance, these women provide a unique case for our theoretical understanding of stigma management. As members of homebirth social networks, the women must reckon with what I term layered stigma, the broad stigma of homebirth as well as the deeper in-group stigma within their deviant community that results from their rejection of midwives as appropriate care providers. By examining the dynamics of stigma management among practitioners of unassisted childbirth, I highlight the complex, situation-dependent nature of stigma and the impact of its management on women's sense of self.

Attitudes towards mental illness in Malawi: a cross-sectional survey.

BackgroundStigma and discrimination associated with mental illness are strongly linked to suffering, disability and poverty. In order to protect the rights of those with mental disorders and to sensitively develop services, it is vital to gain a more accurate understanding of the frequency and nature of stigma against people with mental illness. Little research about this issue has been conducted in Sub- Saharan Africa. Our study aimed to describe levels of stigma in Malawi.MethodsA cross-sectional survey of patients and carers attending mental health and non-mental health related clinics in a general hospital in Blantyre, Malawi. Participants were interviewed using an adapted version of the questionnaire developed for the “World Psychiatric Association Program to Reduce Stigma and Discrimination Because of Schizophrenia”.Results210 participants participated in our study. Most attributed mental disorder to alcohol and illicit drug abuse (95.7%). This was closely followed by brain disease (92.8%), spirit possession (82.8%) and psychological trauma (76.1%). There were some associations found between demographic variables and single question responses, however no consistent trends were observed in stigmatising beliefs. These results should be interpreted with caution and in the context of existing research. Contrary to the international literature, having direct personal experience of mental illness seemed to have no positive effect on stigmatising beliefs in our sample.ConclusionsOur study contributes to an emerging picture that individuals in Sub-Saharan Africa most commonly attribute mental illness to alcohol/ illicit drug use and spirit possession. Our work adds weight to the argument that stigma towards mental illness is an important global health and human rights issue.

KNOWLEDGE AND ATTITUDE TOWARDS EPILEPSY AMONG BIOLOGY TEACHERS IN FARS PROVINCE, IRAN

How to Cite this Article: Asadi-Pooya AA, Torabi-Nami M. Knowledge and Attitude Towards Epilepsy Among Biology Teachers in Fars Province, Iran. IranianJournal of Child Neurology 2012;6(1):13-18.ObjectiveThis study investigates the awareness and perception on “epilepsy” amongst biology teachers in Fars province, Iran.Materials & MethodsA sample of high school biology teachers in Fars province, Iran, filled out an investigator designed questionnaire including questions about their knowledge and attitude concerning “epilepsy”. There were 17 questions in the questionnaire. Nine questions addressed the knowledge and the rest were about attitude and perception.ResultsForty two teachers completed the questionnaires. More than two-thirds of the participants had a fairly desirable awareness about the definition; whereas, only approximately 40% knew something about the etiology and treatment of epilepsy. More than two-thirds of the participants had a positive attitude towards epilepsy; however, misconceptions and negative attitudes were observed.ConclusionEducational programs for biology teachers and also other teachers are necessary to improve their knowledge, attitude and perception about epilepsy.References Sander JW, Shorvon SD. Incidence and prevalence studies in epilepsy and their methodological problems: a review. J Neurol Neurosurg Psychiatry 1987;50:829-39. Saraceno B. The WHO world health report 2001 on mental health. Epidemiol Psychiatr Soc 2002;11(2):83-7. Kim MK, Cho KH, Shin J, Kim SJ. A study of public attitudes towards epilepsy in Kwang-Juarea. J Kor Neurol Assoc 1994;12:410-27. DiIorio C, Shafer PO, Letz R, Henry T, Schomer DL, Yeager K, etal. The association of stigma with self-management and perception of health care among adults with epilepsy. Epilepsy Behav 2003;4(3):259-67. Aziz H, Akhtar SW, Hasan KZ. Epilepsy in Pakistan: stigma and psychological problems: a population-based epidemiologic study. Epilepsia 1997;38:1069-73. Ablon. The nature of stigma and medical conditions. Epilepsy Behav 2002;3:2-9. Jacoby A. Stigma, epilepsy and quality of life. Epilepsy Behav 2002;3:10-20. McLin WM, de Boer HM. Public perceptions about epilepsy. Epilepsia 1995;36:957-9. Daoud A, Al-Safi S, Otoom S, Wahba L, Alkofahi A. Public knowledge and attitudes towards epilepsy in Jordan. Seizure 2007;16:521-6. Ndour D, Diop AG, Ndiaye M, Niang C, Sarr MM, Ndiaye IP. A survey of school teachers’ knowledge and behaviour about epilepsy, in a developing country such as Senegal. [Article in French]. Aert Rev Neurol 2004;160(3):338-41. Millogo A, Siranyan AS. Knowledge of epilepsy and attitudes towards the condition among school-teachers in Bobo-Dioulasso (Burkina Faso). Epileptic Disord 2004;6(1):21-6. Masoudnia E. Awareness, understanding and attitudes towards epilepsy among Iranian ethnic groups. Seizure 2009;18(5):369-73. Fernandes PT, Noronha AL, Araujo U, Cabral P, Pataro R, de Boer HM, Prilipko L, Sander JW, Li LM. Teachers’ perception about epilepsy. Arq Neuropsiquiatr 2007;65(1):28-34. Aydin K, Yildiz H.Teacher’s perceptions in central turkey concerning epilepsy and asthma and short term effect of a brief education on the perception of epilepsy. Epilepsy Behav 2007;10:280-90. Caixeta J, Frenandes PT, Bell GS, Sander JW, Li LM. Epilepsy perception amongst university students. A survey. Arq Neuropsiquiatr 2007;65 (suppl 1):43-8.

The Social Construction and Reframing of Attention-Deficit/Hyperactivity Disorder

In this article, I integrate research in social construct theory, the medicalization of attention-deficit/hyperactivity disorder (ADHD), and strengths-based theory to propose a change in the way American society negatively labels and interacts with people diagnosed with ADHD. This article presents examples of global perspectives on ADHD, the nature of stigma that occurs to those who receive a medical diagnosis of ADHD, and the need to reframe ADHD from a disease to that of a positive difference. The reader is asked to consider the implications for millions who suffer from the stigma of ADHD. Starting with children diagnosed with ADHD, I suggest that members of society begin to reframe ADHD as a social construct recognizing the strengths and positive traits because there are many. This is a call to all members of society, especially those professionals of the medical, psychological, social, and educational systems, to adopt a strengths-based model of support for those diagnosed with ADHD.

Quality of life in cancer patients with disfigurement due to cancer and its treatments

Aim:The aim of this study was to evaluate the effect of disfigurement due to cancer and its treatments on quality of life.Materials and Methods:A total of 120 patients from the inpatient/outpatient department of oncology who had undergone various forms of treatment for cancer were included in this study. The WHOQuality of Life BREF (WHOQL-BREF) version was administered to the patients to assess their quality of life.Results:Patients’ overall quality of life score ranged from 34 to 79 with an average of 53.18 (SD 11.94) and a large number of patients had scored from 40 to 54 on the WHOQOL-BREF.The study showed a significant difference between gender groups (t = 3.899, P < 0.05), with a significant difference in the mean quality of life between different categories of the prominent stigma (f = 4.018, P < 0.05) and the nature of stigma. Disfigurement clearly was a stressful experience for both sexes, but substantially more distressing for women. Majority of the patients experienced poor quality of life in all dimensions, namely, physical health, psychological health, social relationships, environmental health, and other sociodemographic variables.Conclusion:Living with a disfiguring body which is visibly different is not always easy. A sudden change either due to cancer or its treatment or due to side effects leads to significant social maladjustment, elevated anxiety, depression, and poor quality of life among the cancer survivors with body disfigurement which calls for multiprofessional involvement in addressing various psychosocial issues.

Being treated differently: Stigma experiences with family, peers, and school staff among adolescents with mental health disorders

Stigma directed at adolescents diagnosed with emotional and behavioral disorders by individuals in their interpersonal network likely undermines their wellbeing, yet little is known about their subjective stigma experiences. In particular, the prospect of diagnosed youth experiencing prejudice and discrimination by family members has not previously been examined. This study examines adolescents' perceptions of being treated 'differently' because of mental health problems by family members, peers, and school staff. Qualitative analysis of narratives from mixed method interviews with 56 adolescents in a mid-western US city demonstrated variation in the perceived extent and nature of stigma and in contextual factors perceived as promoting or protecting from stigmatization, depending on the interpersonal domain. The greatest number of participants experienced stigmatization in relationships with peers (62%); this often led to friendship losses and transitions. Participants reporting no peer stigmatization often reported socializing with others "in the same boat" or concealing problems--methods of avoiding potentially stigmatizing interactions. Close to half (46%) described experiencing stigmatization by family members, which often took the form of unwarranted assumptions, distrust, avoidance, pity, and gossip. About one third (35%) of participants reported stigma perpetrated by school staff, who expressed fear, dislike, avoidance, and under-estimation of their abilities. Fortunately, 22% reported "different" treatment by school staff, but this treatment was interpreted as positive and supportive. Results showed that perceived stigmatization in one domain was associated with perceived stigma in other domains. The results suggest that efforts to combat stigmatization of youth with mental health disorders must help family members, peers, and school staff overcome their inclinations to make negative assumptions and discriminate against these youth.

Stigma of Epilepsy

Epilepsy directly affects 50 million people worldwide. Most can achieve excellent seizure control; however, people living with epilepsy continue to suffer from enacted or perceived stigma that is based on myths, misconceptions and misunderstandings that have persisted for thousands of years. This paper reviews the frequency and nature of stigma toward epilepsy. Significant negative attitudes prevail in the adolescent and adult public worldwide leading to loneliness and social avoidance both in school and in the workplace. People with epilepsy are often wrongly viewed as having mental health and antisocial issues and as being potentially violent toward others. Twenty-five percent of adults having epilepsy describe social stigma as a result of their epilepsy. They fear rejection and often feel shame or loneliness from this diagnosis. The psychosocial and social impact of epilepsy is significant. Yet few specific interventions have been demonstrated to alter this perception. The effect on public education is primarily short-term, while change over the long-term in attitudes and inaccurate beliefs have not presently been proven effective. School education programming demonstrates improved knowledge and attitude a month after a classroom intervention, but persisting change over a longer period of time has not been evaluated. In-depth adult psycho-educational programs for adults with epilepsy improves knowledge, coping skills and level of felt stigma. However these gains have not demonstrated persistence over time. Myths, misconceptions and misunderstandings about epilepsy continue and programs aimed at increasing knowledge and reducing negative public attitudes should be enhanced.