Severe Stigma Research Articles

Sociopsychological factors of drug abuse among young females in Bangladesh and gender-specific vulnerabilities: Aligning with SDG 3 and SDG 5.

Drug consumption among young women in Bangladesh is increasing day by day. The research aims to analyze the factors influencing young females to take drugs in Bangladesh. This exploratory study was carried out using a qualitative research method. Primary data were collected via in-depth interviews. Seventeen addicted young women from Bangladesh were chosen for this study by a snowball sampling technique. The data from the interviews were thoroughly examined. Intimate relationships with family and friends have the greatest impact on women's drug use. Aligning with Sustainable Development Goal (SDG) 5 and SDG target 3.5, the study underscores the critical need for gender-sensitive approaches to address the unique vulnerabilities faced by young women. The findings revealed several factors that significantly impacted drug consumption among young women in Bangladesh, including the influence of social groups and peers, family-related issues, inadequate awareness and education on drugs, the ready availability of drugs, and psychological factors such as stress and curiosity. Additionally, women who use drugs often face severe social stigma and gender-based violence, which deters them from seeking help and exacerbates their addiction. Limited access to health services due to economic and societal constraints further hinders their ability to receive proper care and support. Implementing strategies that address these gender-specific factors will not only help mitigate drug abuse but also contribute to improved public health outcomes and advance sustainable development.

Psychometric performance of tools to measure internalized drug use stigma among people who use drugs and people on medication-assisted treatment in Dar es Salaam, Tanzania

BackgroundPeople who use drugs (PWUD) and people who use medication-assisted treatment (MAT) to treat opioid use disorder face severe stigma. Stigma may manifest in delayed health-seeking behaviors, which adversely affects health and increases disease risk. Few validated measures assess internalized drug use stigma or MAT disclosure concerns in sub-Saharan Africa. This study examines the performance of internalized drug use stigma scales and characterizes the prevalence of these stigmas among PWUD and people who use MAT in Dar es Salaam, Tanzania. MethodsWe conducted a cross-sectional survey among 250 PWUD and 251 MAT clinic clients. Internalized drug use and MAT disclosure concerns were measured using scales adapted to the Tanzanian context. We conducted exploratory factor analysis to identify latent constructs and evaluate reliability of the scales. We then used confirmatory factor analysis to assess construct validity and reliability. ResultsThe six-item internalized drug use stigma scale (IDUSS) was unidimensional, reflected acceptable goodness-of-fit, and acceptable reliability (Cronbach’s α = 0.79). The eight-item internalized drug use stigma scale for people using MAT (IDUSS-MAT) was bidimensional. Allowing error terms of related items to covary improved goodness-of-fit. The IDUSS-MAT demonstrated acceptable reliability (Cronbach’s α = 0.79). Among PWUD and MAT clinic clients, higher levels of stigma were associated with increased depression and reduced social support and quality of life. ConclusionsBoth the IDUSS and IDUSS-MAT demonstrated good construct validity and acceptable reliability. These validated scales provide the foundation for collecting data to inform the development of stigma reduction interventions in Tanzania and among similar Sub-Saharan populations of PWUD and the tools needed to assess those interventions.

Leprosy in the Modern Age: clinical diagnosis and challenges in the 21st Century

The bacterium Mycobacterium leprae is the source of leprosy, also known as Hansen's disease, which is mainly transmitted through person-to-person contact and has a long incubation period of 2–6 years. The disease primarily affects the skin and peripheral nerves, often resulting in long-term disability and severe social stigma. The purpose of this review is to provide an up-to-date analysis of leprosy, focusing on recent discoveries in genetics, susceptibility factors, and carriers of the disease. These results have implications for patient outcomes and management of leprosy. Historical diagnostic and therapeutic efforts have focused primarily on adult leprosy, but pediatric leprosy remains understudied. This review aims to fill this gap by providing updated diagnostic and treatment recommendations for adults and children with leprosy. We summarize clinical, bacteriological, and immunological methods for diagnosing leprosy and also consider contemporary issues facing clinicians and patients, including their impact on migration and disease spread. Directions for future research are also highlighted, emphasizing the need for innovative approaches to diagnosis and treatment. As advances in knowledge continue to progress, renewed focus on the control, prevention, and eradication of leprosy is critical to improving global health outcomes.

Emboldened in the rap "game": How severely stigmatized video models navigate disrespect and vulnerability to workplace mistreatment.

Moral stigma attached to an occupation can scar workers through discrediting, shaming, and denying respect. It can also open the door to interpersonal mistreatment, but little is known about how morally stigmatized workers navigate anticipated disrespect to potentially avoid harm. We explore this issue in a study of an occupation carrying severe moral stigma and where disrespect and workplace mistreatment are pervasive: models in hip-hop and rap music videos. Through analyses of 71 interviews with 48 video models and 19 industry informants, field observations, and archival data, we show how severe moral stigma and industry constraints promote generalized disrespect of video models (i.e., denial of worth to all role occupants) and, thus, each model's personal vulnerability to mistreatment. Two distinct groups of models emerged from our analysis-those who viewed themselves as emboldened in their role identity and those who did not-and this emboldened role identity was associated with differing perceptions of their personal vulnerability to mistreatment and their behaviors to mitigate it. The first group of models, those reporting an emboldened role identity, perceived their vulnerability to mistreatment as controllable. They strategically used both assertive behaviors (that earned respect from others) and passive behaviors (that avoided disrespect from others) to mitigate mistreatment. By contrast, the second group perceived their vulnerability to mistreatment as uncontrollable and reported using only passive behaviors (to avoid disrespect) when mistreatment was imminent. We discuss theoretical and practical implications of our findings, advancing knowledge of dirty work, workplace mistreatment, respect dynamics, and identity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Resilience throughout COVID-19: Unmasking the realities of COVID-19 and vaccination facilitators, barriers, and attitudes among Black Canadians.

Black communities have suffered disproportionately higher numbers of COVID-19 cases and deaths in Canada. Recognizing the significance of supporting targeted strategies with vulnerable populations extends beyond the COVID-19 pandemic, as it addresses longstanding health disparities and promotes equitable access to healthcare. The present study investigated 1) experiences with COVID-19, 2) COVID-19's impact, and 3) factors that have influenced COVID-19 vaccine acceptance and uptake among stakeholders and partners from the Federation of Black Canadians' (FBC). We conducted semi-structured interviews with 130 individuals and four focus groups with FBC, including stakeholders and partners, between November 2021 and June 2022. The semi-structured interviews and focus group discussions were conducted virtually over Zoom and lasted about 45 minutes each. Conversations from interviews and focus groups were transcribed and coded professionally using team-based methods. Themes were developed using an inductive-deductive approach and defined through consensus. The deductive approach was based on Consolidated Framework for Implementation Research (CFIR) domains and constructs. First, regarding experiences with COVID-19, 36 codes were identified and mapped onto 13 themes. Prominent themes included 39 participants who experienced highly severe COVID-19 infections, 25 who experienced stigma, and 18 who reported long recovery times. Second, COVID-19 elicited lifestyle changes, with 23 themes emerging from 62 codes. As many as 97 participants expressed feelings of isolation, while 63 reported restricted mobility. Finally, participants discussed determinants that influenced their vaccination decisions, in which 46 barriers and four facilitators were identified and mapped onto nine overarching themes. Themes around the CFIR domains Individuals, Inner Setting, and Outer Setting were most prominent concerning vaccine adoption. As for barriers associated with the constructs limited available resources and low motivation, 55 (41%) and 46 (34%) of participants, respectively, mentioned them most frequently. Other frequently mentioned barriers to COVID-19 vaccines fell under the construct policies & laws, e.g., vaccine mandates as a condition of employment. Overall, these findings provide a comprehensive and contextually rich understanding of pandemic experiences and impact, along with determinants that have influenced participants' vaccination decisions. Furthermore, the data revealed diverse experiences within Black communities, including severe infections, stigma, and vaccine-related challenges, highlighting the importance of targeted interventions, support, and consideration of social determinants of health in addressing these effects.

Stigma and its Correlation in Patients with Schizophrenia

ABSTRACT The aim of the present study was to assess the stigma in patients with schizophrenia attending a tertiary referral government hospital. This was a cross-sectional research involving 60 schizophrenia patients at a government tertiary referral hospital. ICD-10 research diagnostic criteria were used for mental assessment. Statistics were analyzed using relevant tests. Of the 30 males, 21 (70%) experienced moderate stigma, two (6.67%) had mild stigma, and seven (23.33%) had severe stigma. The 30 females got 20 (66.67%) moderate ratings, one (3.33%) got a light grade, and nine (30%) had severe stigma grades associated with stigma disclosure. Twenty of 30 males (66.67%) reported moderate stigma, eight (26.67%) reported mild stigma, and two (6.66%) had severe stigma. With respect to positive stigma, 25 (83.33%) of 30 females exhibited moderate stigma. Also, four (13.33%) girls exhibited moderate stigma and one (3.33%) had severe stigma. Significant proportion of patients with schizophrenia experience stigma and stigma is associated with lower level of functioning. Better knowledge about illness is associated with a lower level of stigma.

Global perspectives on the burden of sexually transmitted diseases: A narrative review.

Sexually transmitted diseases (STDs) pose a significant global health challenge with far-reaching social, economic, and public health implications. These infections have haunted humanity from ancient times to today, transcending geographical boundaries and cultural contexts. This article explores the multifaceted landscape of STDs, delving into their epidemiology, pathophysiology, clinical manifestations, and global response strategies. The global prevalence of STDs is staggering, with millions of new cases reported annually. Prominent among these infections is HIV/AIDS, which remains a major global health crisis, affecting over 38 million people worldwide. Additionally, bacterial STDs like chlamydia, gonorrhea, and syphilis continue to pose significant health risks, with millions of new cases reported yearly. Beyond the physical manifestations, STDs have profound social and economic implications. They can result in severe reproductive health issues, stigma, discrimination, and psychological distress, burdening healthcare systems and affecting individuals' quality of life. The global response to STDs has been multifaceted, with international organizations and governments implementing various prevention and control strategies, including sexual education programs and scaling up access to testing and treatment. However, challenges persist, including disparities in healthcare access, sociocultural factors influencing transmission, and evolving pathogens with increasing resistance to treatment. Through case studies and real-world examples, we illuminate the human stories behind the statistics, highlighting the lived experiences of individuals grappling with STDs and the complex interplay of factors shaping their journeys. Ultimately, this review calls for continued research, innovative strategies, and sustained global commitment to mitigating the burden of STDs and promoting sexual health and well-being for all.

Stigma and mental health among people living with HIV across the COVID-19 pandemic: a cross-sectional study

BackgroundMental health (MH) is extremely relevant when referring to people living with a chronic disease, such as people living with HIV (PLWH). In fact – although life expectancy and quality have increased since the advent of antiretroviral therapy (ART) – PLWH carry a high incidence of mental disorders, and this burden has been exacerbated during the COVID-19 pandemic. In this scenario, UNAIDS has set new objectives for 2025, such as the linkage of at least 90% of PLWH to people-centered, context-specific MH services. Aim of this study was to determine the prevalence of MD in PLWH followed at the Clinic of Infectious Diseases of the University of Bari, Italy.MethodsFrom January 10th to September 10th, 2022, all PLWH patients accessing our outpatient clinic were offered the following standardized tools: HAM-A for anxiety, BDI-II for depression, PC-PTSD-5 for post-traumatic stress disorder, CAGE-AID for alcohol-drug abuse. Factors associated with testing positive to the four MD were explored with a multivariable logistic regression model.Results578 out of 1110 HIV-patients agreed to receive MH screening, with 141 (24.4%) people resulting positive to at least one MH disorder. HAM-A was positive in 15.8% (n = 91), BDI-II in 18% (n = 104), PC-PTSD-5 in 5% (n = 29) and CAGE in 6.1% (n = 35). The multivariable logistic regression showed a higher probability of being diagnosed with anxiety, depression and post-traumatic stress disorder for PLWH who reported severe stigma, social isolation, psychological deterioration during the COVID-19 pandemic and for those receiving a dolutegravir (DTG)-based regimen. Moreover, history of drug use (OR 1.13; [95% CE 1.06–4.35]), family stigma (2.42 [1.65–3.94]) and social isolation (2.72 [1.55;4.84]) were found to be associated to higher risk for substance use disorder.ConclusionsIn this study, stigma was a strong predictor for being diagnosed of a MH disorder among PLWH. Also, the possible role of dolutegravir as a risk factor for the onset of MH disorders should be considered in clinical practice, and MH of patients receiving DTG-containing regimens should be constantly monitored.

Spatial mapping and predictors of ever-tested for HIV in adolescent girls and young women in Ethiopia.

Adolescent girls and young women (AGYW) are expected to be healthy in life. However, the unique health challenges faced by AGYW include unsafe sex practices and substance abuse. Only 46.3% of AGYW in Africa are aware of their HIV status, and difficulties are underlined in HIV testing among adolescents and young people. To demarcate the areas with low and high HIV testing, this study aimed to map predictors of ever-tested for HIV among adolescent girls and young women in Ethiopia. Secondary data analysis was conducted using the dataset from the 2016 Ethiopia Demographic and Health Survey (EHDS). We conducted spatial autocorrelation and Moran's I statistics to investigate the regional variance of HIV being ever-tested in AGYW. In addition, spatial regression analyses such as ordinary least squares (OLS) regression and geographically weighted regression (GWR) were carried out to determine the predictors of being ever-tested for HIV among AGYW. Addis Ababa, some parts of Amhara, Dire Dawa, Gambela, and Tigray were the primary regions and city administrations for being ever-tested for HIV among AGYW. A lesser proportion of AGYW being ever-tested for HIV was found in Somalia, Afar, Benshangul Gumuz, and southern nations. Spatial regression analyses identified an age range of 15-19 years, being Muslim, having no formal education, having no knowledge about HIV, and experiencing severe stigma as predictors of being ever-tested for HIV among AGYW. The proportion of AGYW being ever-tested for HIV was high in Addis Ababa, some parts of Amhara, Dire Dawa, Gambela, and Tigray. Spatial regression analyses identified that AGYW aged 15-19 years, having no formal education, having no knowledge about HIV, and experiencing severe community stigma as predictors negatively affecting the proportion of being ever-tested for HIV, while being Muslim was a predictor that positively affected the proportion of being ever-tested for HIV. The governments and other stakeholders should focus on increasing HIV testing among these special groups of the population.

Employing Bayesian analysis to establish a cut-off point and assess stigma prevalence in substance use disorder: a comprehensive study of the Chinese version of the Substance Use Stigma Mechanism Scale.

In China, individuals with substance use disorders (SUD) face severe stigma, but reliable stigma assessment tool is lacking. Therefore, this study aimed to validate the Chinese version of the Substance Use Stigma Mechanism Scale (SU-SMS-C) and set its cut-off point. We recruited 1005 individuals with SUDs from Chinese rehabilitation centers. These participants completed a battery of questionnaires that included the SU-SMS-C, The Multidimensional Scale of Perceived Social Support (MSPSS), Center for Epidemiologic Studies Depression Scale (CES-D), General Self-Efficacy Scale (GSES), and Perceived Devaluation and Discrimination (PDD). Confirmatory factor analysis was used to assess the construct validity of the scale. Additionally, the Naive Bayes classifier was used to establish the cut-off point for the SU-SMS-C. We additionally explored the correlation between patient demographic characteristics and stigma. A confirmatory factor analysis was utilized, revealing a second-order five-factor model. Based on the Naive Bayes classifier, the area under the receiver operating characteristic (AUCROC) of 0.746, the cut-off point for the SU-SMS-C was established at 44.5. The prevalence of stigma observed in the study population was 49.05%. Significant disparities were observed in the distribution of stigma across genders, with males experiencing more pronounced stigma than females. Moreover, patients consuming different primary substances reported diverse levels of stigma. Notably, those primarily using heroin endured a higher degree of stigma than users of other substances. The study is the first to identify a cut-off point for the SU-SMS-C by Naive Bayes classifier, bridging a major gap in stigma measurement research. SU-SMS-C may help treat and manage SUDs by reducing stigma.

Caregivers' perspectives of community acceptance before and after surgical treatment for their child's disability.

In Tanzania, about 600 000 youth between 5 and 24 years old have a disability. Individuals with disabilities face numerous obstacles due to social stigma. The aim of this formative evaluation is to assess how caregivers of children with correctable disabilities (e.g., cleft lip/palate, club foot, and burn scar contractures) in Tanzania perceive their community's acceptance of their child before and after surgical treatment. Semi-structured interviews were conducted with 80 caregivers of children with disabilities treated at Kafika House in Arusha, Tanzania. The constant comparative method identified themes regarding the caregivers' feelings on their child's functional abilities and experiences of stigma in their community. Caregiver perceptions of stigma before and after surgical treatment were categorized and quantified as 'positive', 'neutral' and 'negative'. Thematic analysis of the 80 interviews resulted in five major themes: (1) stigma and acceptance (pre-treatment) and (2) post-treatment; (3) functional abilities (pre-treatment) and (4) post-treatment; and (5) emotional impact (pre- and post-treatment). These themes indicate caregivers and their children experience a range of emotional impacts before and after treatment, more severe stigma before treatment, and overall better social, emotional and functional status after treatment. Frequency analysis of caregiver experiences indicated that stigma experienced by children and their families decreased from 75% before surgical treatment to 2.5% after surgery. Surgical intervention and rehabilitation of physical disabilities mitigated experiences of social stigma for both children and their caregivers. Findings support the need for expanded treatment of correctable disabilities, larger investments in community-based rehabilitation programmes and further interventions to support stigmatized parents and their children.

Association between demographics, socioeconomics, and disease-related factors and the perception of stigma in people with MS.

Stigma is prevalent among individuals with chronic diseases, such as multiple sclerosis (MS) and those with comorbid mental health disorders, but its associated factors are poorly understood. To investigate the prevalence and correlates of stigma in people living with MS. We analyzed data from the MS Partners Advancing Technology and Health Solutions (MS PATHS) network, which collected patient information and outcomes during routine clinic visits. We used a multinomial logistic regression model to examine the cross-sectional association between stigma and demographic, socioeconomics, and MS-related factors. We included 11,634 participants. The mean Neuro-QoL stigma T-score was 47.2 ± 8.6, and 17.7% of participants were classified as having moderate to severe stigma using established cutoffs. Multinomial logistic regression models suggest that higher disability levels, progressive form of the disease, shorter duration of the disease, and unemployment were associated with higher stigma while being male, married, undergoing treatment with high-efficacy disease-modifying therapies (DMTs), and being from European MS centers were associated with lower stigma perception. Disability levels, measured by Patient-Determined Disease Steps (PDDS), had the strongest independent association with stigma. Stigma remains a relevant issue for people living with MS. Factors, such as physical and cognitive disability, DMT, and employment status may influence the severity of perceived stigma.

Hope level and associated factors among older people living with HIV/AIDS: a cross-sectional study.

In China, little is known about the hope level of older people living with HIV/AIDS (PLWHA). This study was to examine the hope level of older PLWHA in China and identify related factors. This cross-sectional study was conducted in Sichuan province in China among older PLWHA. A standardized self-report questionnaire, the Herth Hope Index, was adopted. Multiple linear regression was used to identify factors influencing hope level. p-values <0.05 were considered statistically significant. There were 314 participants with an average age of 64.5 (SD ± 8.7). Most of the participants were males (72.6%), primary school and below (65.9%), rural household registration (58.6%) and married (64.3%). More than half of the older adults had pension insurance, had a monthly income of more than RMB 1,000 and considered themselves to be in good health. About 80% confirmed being diagnosed for more than a year and disclosed their HIV status to family and friends. The majority of the population had low medium social support (79%). More than 80% had moderate and severe HIV stigma. Many older PLWHA had medium and high levels of hope, with an average score of 34.31 (SD ± 4.85). Multiple linear regression showed that having pension insurance (β = 1.337, p = 0.015), longer diagnosis (β = 0.497, p = 0.031), better self-reported health (β = 1.416, p<0.001) and higher levels of social support (β = 2.222, p < 0.001) were positively associated with higher levels of hope. HIV stigma (β = -1.265, p < 0.001) was negatively correlated with hope level. The hope level of older PLWHA is good, but there is still room for improvement, and its hope is related to multiple factors. Therefore, the AIDS-related healthcare sector should pay special attention to the hope of older PLWHA, help them to improve their health, provide financial assistance and social aid to those with financial difficulties, and take measures to reduce HIV stigma, improve family support for the older adults, and guide the older adults to adopt a positive approach to life.

The Impact Of Education On The Lives Of Transgender Individuals: A Comprehensive Study

Transgender individuals face a relentless battle for acceptance, often ostracized and ridiculed by society. They encounter severe stigma in nearly every aspect of their lives, including healthcare, education, employment, and access to social services and entitlements. This extreme social exclusion erodes their self-esteem and sense of social responsibility. In India, transgender individuals are recognized as a third gender by the Constitution. Despite this recognition, they face significant social and cultural exclusion, limiting their access to education, healthcare, and public spaces. Reports and discussions with the community and stakeholders indicate that transgender individuals often remain uneducated or undereducated, with most achieving only secondary or senior secondary levels of education. Enrolment rates are low, and dropout rates at primary and secondary levels remain high due to societal non-acceptance and daily harassment in educational institutions. This study emphasizes the multifaceted challenges faced by transsexual individuals in a rural tertiary care setting. While the completion of high school is a positive finding, further education and economic support are crucial for their advancement. Encouraging further education is a strategic intervention to help transsexual individuals overcome societal barriers and achieve greater personal and professional success.

SMARThealth PRegnancy And Mental Health study: protocol for a situational analysis of perinatal mental health in women living in rural India.

The situation for women experiencing mental health problems during pregnancy and postpartum in rural India is critical: a high burden of disease, a high estimated number of women are undiagnosed and untreated with mental health problems, a substantial gap in research on women's perinatal health, and severe stigma and discrimination. The SMARThealth Pregnancy study is a cluster randomised trial using a digital intervention to identify and manage anaemia, hypertension, and diabetes in the first year after birth in rural India. Within this study, the SMARThealth Pregnancy and Mental Health (PRAMH) study is a situational analysis to understand mental health problems during pregnancy and in the first year following birth in this population. This situational analysis aims to analyse and to assess the context of perinatal mental health, health services, barriers, facilitators, and gaps in Siddipet district of Telangana state in India, to develop an implementation framework for a future intervention. A tested, standardised situational analysis tool will be adapted and applied to perinatal mental health in rural India. A desktop and policy review will be conducted to identify and analyse relevant mental health and pregnancy care policies at the national and state levels. We will conduct in-depth interviews with policymakers, planners, mental health professionals and other experts in perinatal mental health (n = 10-15). We will also conduct focus group discussions with key stakeholders, including women with perinatal mental health problems, their families and carers, and community health workers (n = 24-40). A theory of change workshop with key stakeholders will be conducted which will also serve as a priority setting exercise, and will clarify challenges and opportunities, priorities, and objectives for a pilot intervention study. The analysis of qualitive data will be done using thematic analysis. Based on the data analysis and synthesis of the findings, an implementation framework will be developed to guide development, testing and scale up of a contextually relevant intervention for perinatal mental health. The situational analysis will help to establish relationships with all relevant stakeholders, clarify the context and hypotheses for the pilot intervention and implementation.

Non-Verbal Language Contributing to Stigma towards Involuntary Childless Women in the Gikùyù Community, Kenya

Putting women in a position where motherhood is associated with womanhood has led to stigma towards women who are involuntary childless. They are viewed as outsiders and language is used to advance the ideologies that justify their discrimination. Language has had a significant role in stigmatising and stereotyping childless people. Non-verbal communication, in addition to spoken discourses, which are frequently used in the stigma, is quite important. Nonverbal language communicates our unconscious ideas, feelings, and hidden beliefs. The context of the situation is created by the nonverbal cues. Women are subjected to extremely severe linguistic stigma through nonverbal communication. The paper's main focus was on nonverbal linguistic expressions that spread stigma towards involuntary childless women. The work was informed by Fairclough and Van Dijk's Critical Discourse Analysis (CDA). According to CDA, grammar, vocabulary, and semantics should not be analysed separately. Instead, their roles are more important and should not be disregarded. The study set out to evaluate and investigate the linguistic stigma that involuntary childless women experience. The study used a purposive sampling technique to pick communities in Tetu sub-county of Nyeri County. These were the villages: Ihithe, Ihῠrῠrῠ, Mῠthὶnga and Kangaita. Focus group discussions (FGDs) and interviews supplemented by an audio recorder were used in the study to collect data. For the FGD, twenty involuntarily childless women participated as respondents. The study will be important in shedding light on important facts about the discourses used to spread linguistic stigma and how it is done. Most importantly, the results of the study will help the general public in understanding infertility concerns and discourage them from using discursive discourses to spread stereotypes about childless women. According to the study, just as vocal language, non-verbal language is used in the infertility discourse as a tool to stigmatitise the involuntary childless women.

Relationship between stigma, self-esteem and quality of life among patients with depression at a tertiary care unit of North India: a cross-sectional study

BACKGROUND: Depression is one of the debilitating mental illness currently. The stigma attached to this illness and self-esteem of individuals with depression are one of the most important factors which have an impact on the quality of life and issues related to these may impede recovery. The aim of the study was to assess relationship between stigma, self-esteem and quality of life in patients with depression.METHODS: One hundred and ten patients who were diagnosed depression as per ICD-10DCR (F32, F33) were assessed using Mini-International Neuropsychiatric Interview 6.0 version, Hamilton Depression Rating Scale, Internalized Stigma of Mental Illness scale, State Self-esteem Scale, and WHO-Quality of Life-BREF.RESULTS: As per the study, 47% of patients experience severe stigma. Most patients reported higher performance proportion of self-esteem in SSES with a mean score of 16.89±4.46 and reported more effect in environmental aspects of quality of life among all the domains of WHOQOL-BREF with a mean score of 73.56±10.80. Stigma was found to have a statistically significantly negative correlation with self-esteem and quality of life and a positive correlation with the severity of symptoms. Self-esteem positively correlated with quality of life.CONCLUSIONS: The present study revealed stigma is higher in patients of depression having more severe symptoms and that self-esteem and the overall quality of life were negatively affected by stigma. Self-esteem was strongly related to the quality of life. Treatment focused on to reduce stigma and improving patients’ self-esteem would boost long term recovery and quality of life. The results of the study therefore suggest the need for measures aimed at reducing stigma, improving patients’ self-esteem and psychological well-being.

Mental Health of Asian American Caregivers of Family Members With Severe Mental Illness.

Within the general population, caregivers of individuals with severe mental illness experience considerable mental health burdens. Less is known about these burdens among Asian Americans, who frequently serve as primary caregivers of family members in accordance with cultural values of familism and interdependence. Asian American caregivers experience severe stigma regarding mental health issues as well as other barriers to care, often resulting in decreased help-seeking behaviors and poorer mental health. Given a paucity of research, the authors systematically reviewed the literature on mental health outcomes among Asian American caregivers. This column offers policy and practice suggestions for supporting the mental health of Asian American families affected by severe mental illness.

The Formation of the Resilience of Sexual Minorities: The Critical Role of the Family

Sexual minorities in China suffer from severe stigma, with more than half of Chinese sexual minorities believing that their families discriminate against them However, research on family and sexual minorities is extremely limited in China. This study focuses on how families increase the stigma and resilience of sexual minorities. Given the high degree of invisibility of sexual minorities in China and the subjective nature of resilience, Case analysis will be used as the method of this study. Based on long-term follow-up, two representative respondents will describe the stigma they have suffered because of their sexual orientation, whether their families support them, and how their families have affected their stigma and resilience. After that, further conclusions are drawn through case reduction and analysis. This study will fill the gap in Chinese academic circles related to family and sexual minorities and open a new field of research on stigmatization and family interaction in China.

Effect of a Positive Psychology Expressive Writing on Stigma, Hope, Coping Style, and Quality of Life in Hospitalized Female Patients with Schizophrenia: A Randomized, Controlled Trial

Purpose. Schizophrenia accounts for more than 50% of psychiatric inpatients, and its special manifestations and recurring illnesses not only bring great harm to patients and their families but also pose great challenges to social security and management. Schizophrenia is associated with the most severe stigma of all mental illnesses. This stigma seriously affects the psychological functioning and quality of life of people with schizophrenia. Female patients’ experiences with stigma tend to be more severe than those of male patients and their self-denial and discrimination may be more serious. As expressive writing is a relatively simple, brief intervention that may serve as a useful and cost-effective alternative intervention or adjunct to other treatments, it is important to assess its effectiveness for female patients with schizophrenia. In this study, we explored the effect of a positive psychology expressive writing intervention on stigma, hope, coping style, and quality of life in hospitalized female patients with schizophrenia. Methods. This randomized controlled trial investigated the psychophysiological benefits of a positive psychology expressive writing (PPEW) in 54 schizophrenia patients recruited from the psychiatry department of a tertiary psychiatric hospital in Nanjing, China. Patients were randomized into the experimental group (n = 27) and control group (n = 27). The experimental group participated in the positive psychology expressive writing for 2 weeks, while the control group received routine psychiatric care. As outcome measures, all patients completed the Personal Information Form, Perceived Devaluation-Discrimination (PDD), Simplified Coping Style Questionnaire (SCSQ), Herth Hope Index Scale (HHIS), and Quality of Life Scale for Schizophrenia (SQLS). Results. There were significant differences in PDD, SCSQ, HHIS, and SQLS pretest to posttest scores between the experimental and control groups shown by the per protocol (PP) and intent-to-treat (ITT) analysis ( P &lt; 0.05). PPEW decreased the level of stigma and improved hope, coping style, and quality of life among patients with schizophrenia. Conclusion. These findings highlight the benefits of including positive psychology expressive writing (PPEW) in daily psychological treatment of patients with schizophrenia to promote their rehabilitation and improve their quality of life.