Social Rejection Research Articles

Peer interaction in class: exploring students’ self-regulation in relation to peer acceptance and rejection

Peer interaction in class: exploring students’ self-regulation in relation to peer acceptance and rejection

The impact of a child’s suicide on family structure and relationships between its members

The main objective of this article is to analyse the available literature on the impact of a child’s suicide on family structure and relationships between family members. The available literature from 1976-2021 was analysed. The analysis showed that families abandoned after the suicide death of a family member experience feelings of hurt, denial, shock and anger, resentment, shame and guilt. Social ostracism affects the social exclusion of families affected by the suicide death of a child, who are deprived of adequate support from institutions and the community. Bereaved families, being in shock and confusion at the beginning of their bereavement, had no one to turn to for help. The sudden death of a child by suicide leads to a deepening of the trauma and makes the grieving process impossible. People who have suffered a loss feel the need to give the death some meaning. The results of the literature search are, however, not satisfactory, contributing to my own research in terms of the family’s experience of bereavement following the death of their child by suicide. The findings show little development in the topic of postvention following the suicide death of a child. There is no public education on this subject.

Motherhood and Drinking: The Relative Importance of Mental Health and Psychosocial Factors on Maternal Alcohol Misuse During the Postpartum Period.

Being a mother of a young child may be protective against alcohol misuse for some, but not all, women. This is the first study to identify the mental health and psychosocial correlates of alcohol misuse among postpartum mothers. Mothers with a child younger than 12 months (n = 319) were recruited via social media to complete a cross-sectional online survey. Two hierarchical logistic regressions examined unique factors associated with heavy episodic drinking and hazardous alcohol use, including sociodemographic, poor mental health, and psychosocial factors. On average, mothers drank alcohol at low levels (4 drinking days, nine standard drinks in the past month). One in 10 (11.6%) reported heavy episodic drinking during this time, and 1 in 12 (8.5%) were drinking at hazardous or greater levels. In the final models, older age and more severe postpartum anxiety were associated with a higher likelihood of hazardous drinking (odds ratio [OR] = 1.37, 1.09, respectively), whereas breastfeeding was associated with lower odds of heavy episodic drinking (OR = 0.29). Greater perceived social support was associated with lower odds of heavy episodic (OR = 0.56) and hazardous (OR = 0.39) drinking, whereas higher coping-with-anxiety and social-drinking motives were associated with greater odds of both forms of alcohol misuse (ORs = 3.51-10.40). Conformity drinking motives (e.g., drinking to avoid social rejection) were negatively associated with heavy episodic drinking (OR = 0.24). Maternal anxiety, coping-with-anxiety and social-drinking motives, and reduced social support are important factors associated with postpartum alcohol misuse. These modifiable factors are potential targets for screening and intervention for mothers who may need additional support and preventative care.

The Effectiveness of Acceptance and Commitment Therapy on Emotion Regulation, Behavioral Symptoms, and Academic Performance of Children with Attention Deficit/Hyperactivity Disorder

Background: Children with attention-deficit/hyperactivity disorder (ADHD) frequently struggle with emotional regulation, behavioral issues, and academic performance, leading to peer rejection and social isolation. Objectives: The present study aimed to investigate the effects of acceptance and commitment therapy (ACT) on emotion regulation, behavioral symptoms, and academic performance of children with ADHD. Methods: A quasi-experimental study was conducted using a pretest-posttest design. The study population consisted of all primary school students with ADHD aged 7 - 11, as well as their mothers, in Amol in 2021. A purposive sample of 30 individuals was selected for the study. Participants were assigned to either the ACT training group (n = 15) or the control group (n = 15) through a simple random allocation. The participants in the study filled out questionnaires on emotion regulation, children's behavioral symptoms, and academic performance. The data was analyzed using an analysis of covariance. Results: In the pretest phase, the scores for adaptive emotion regulation strategies, maladaptive emotion regulation strategies, behavioral symptoms, and academic performance were 43.07 ± 6.05, 65.13 ± 9.27, 91.20 ± 12.58, and 128.47 ± 29.84, respectively; whereas in the posttest phase, they were 61.20 ± 8.01, 52.00 ± 6.00, 67.13 ± 12.73, and 159.73 ± 21.11, respectively. Acceptance and commitment therapy resulted in enhanced emotion regulation strategies and academic performance, as well as a decrease in behavioral symptoms in children with ADHD (P < 0.001). Conclusions: Given the effectiveness of acceptance and commitment therapy training in emotion regulation, behavioral symptoms, and academic performance, this approach may be employed by counselors and psychologists at counseling and psychotherapy centers to help remedy ADHD.

Association Between Self-Construals, Social Pain Sensitivity, and Gender in Young Adults

We experience pain in response to negative, unwanted social interaction with others (e.g., social rejection), and this type of pain is termed as social pain in the recent literature. While sensitivity to social pain may be beneficial to increase a chance for survival, social pain sensitivity could also be detrimental to elevate the risk of various health issues. Such opposing natures of social pain sensitivity warrants research to better identify factors that are linked to social pain sensitivity. Self-construals show perspectives on how to view oneself in relations to others, characterized as independent and interdependent self-construals, and may be linked to social pain sensitivity. Additionally, pervious data have indicated gender differences in social pain sensitivity, but it is unclear if self-construals explain gender differences in social pain sensitivity. Therefore, this study examined if self-construals were associated with social pain sensitivity, and gender differences in social pain sensitivity were accounted for by self-construals. The participants were 148 college students who completed several self-report questionnaires to evaluate self-construals and social pain sensitivity. The results indicated that interdependent tendency, which showed higher interdependent self-construal than independent self-construal, was associated with social pain sensitivity. While gender differences in social pain sensitivity were confirmed, gender differences in social pain sensitivity were not accounted for by interdependent tendency. The results suggest that interdependent tendency is associated with social pain sensitivity, but is not involved in gender differences in social pain sensitivity.

Study on the Influencing Factors and Countermeasures of Drug Addicts' Relapse

The relapse of drug addicts is a global problem and has serious effects on social and personal health. The purpose of this study was to investigate the influencing factors and countermeasures of drug addicts. By reviewing the literature method, the research results are summarized and analyzed. In terms of individuals, the degree of addiction and mental health status have important effects on relapse behavior; in terms of families, the quality of family relationships and family economic status are related to relapse behavior; in terms of society, social rejection, social networks, and employment barriers are related to relapse. Based on the research results, we propose systematic prevention and intervention measures, such as strengthening mental health services, strengthening government supervision and support, and strengthening family and social support. This study provides a comprehensive perspective and solution to the relapse problem of drug addicts, and provides a scientific basis for relevant policy making and improving the success rate of drug rehabilitation.

Bionic blink improves real-time eye closure in unilateral facial paralysis

Facial paralysis is the inability to move facial muscles thereby impairing the ability to blink and make facial expressions. Depending on the localization of the nerve malfunction it is subcategorised into central or peripheral and is usually unilateral. This leads to health deficits stemming from corneal dryness and social ostracization. Objective: Electrical stimulation shows promise as a method through which to restore the blink function and as a result improve eye health. However, it is unknown whether a real-time, myoelectrically controlled, neurostimulating device can be used as assistance to this pathological condition. Approach: We developed NEURO-BLINK, a wearable robotic system, that can detect the volitional healthy contralateral blink through electromyography and electrically stimulate the impaired subcutaneous facial nerve and orbicularis oculi muscle to compensate for lost blink function. Alongside the system, we developed a method to evaluate optimal electrode placement through the relationship between blink amplitude and injected charge. Main results: Ten patients with unilateral facial palsy were enrolled in the NEURO-BLINK study, with eight completing testing under two conditions. (1) where the stimulation was cued with an auditory signal (i.e. paced controlled) and (2) synchronized with the natural blink (i.e. myoelectrically controlled). In both scenarios, overall eye closure (distance between eyelids) and cornea coverage measured with high FPS video were found to significantly improve when measured in real-time, while no significant clinical changes were found immediately after use. Significance: This work takes steps towards the development of a portable medical device for blink restoration and facial stimulation which has the potential to improve long-term ocular health.

Sexual exploitation of male youth: background characteristics and needs from a life-course perspective

IntroductionSexual exploitation is a human rights violation that has a detrimental impact on the psychological-, physical- and social well-being of victims. Sexually exploited male youth are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent male youth to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame.ObjectivesBy gaining more insight into the background and clinical characteristics of male victims and their care and support needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts.MethodsTwenty-six male youth at high-risk or victims of sexual exploitation participated in this qualitative study. By means of semi-structured interviews and case-file analyses, data was collected by to identify risk and protective factors in their life-course and care and support needs.ResultsResults indicate that several vulnerabilities (e.g. previous experiences of abuse and neglect, mental health problems, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led male youth into high-risk situations. Among these were involvement in pay dates, survival sex and criminality, which contributed to victimization. Experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in care and support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support.ConclusionsThese results will contribute to adequate prevention and intervention strategies and meet the unique needs of male youth at risk for, or victim of sexual exploitation.Disclosure of InterestG. Mercera Grant / Research support from: This research was funded by the Dutch Ministry of Health, Welfare and Sports (grant number: 328604)., S. Leijdesdorff: None Declared, E. Heynen: None Declared, T. van Amelsvoort: None Declared

Dehumanized Voices and Traumatic Articulations in Late Nineteenth-Century Chinese Classical Tales

This study leverages trauma theory to examine Xuan Ding's 宣鼎 (1832–1880) Yeyu qiudeng lu 夜雨秋燈錄 (Recorded on Rainy Nights by Autumn Lamp), a collection of classical tales published in the aftermath of the Taiping Civil War (1850–1864). The analysis here delves into the concept of dehumanization, typically understood as the denial of one's intrinsic human traits by other people. In the late Qing context, dehumanization can occur when an individual is perceived as deviating from the path of self-cultivation, or as inept at or resistant to fulfilling prescribed social and gender roles, often leading to social ostracism. Xuan Ding conveys both the acute trauma of the Taiping war and the quotidian, gender- and class-based traumas imposed by late Qing society through the dramatic depiction of characters who undergo a metamorphosis into subhuman forms. This study also shows that in his preface to the collection, Xuan engages in the artistic dehumanization of his own literary persona. From this strategic position of moral self-exile, he is able to both provide a platform for dissenting voices and suggest the therapeutic potential of writing during times of suffering. This study explores how one writer's depiction of the trauma of dehumanization navigates and illuminates the nuanced boundary between the human and the nonhuman as understood at this time. By investigating the complex interplay of dehumanization and trauma, and their manifestation in literature, this study invites consideration of culturally specific nuances within trauma theory and opens up avenues for comparative analysis.

Anterior insular cortex and the perception of internalized stigma and its components: a scoping review.

IntroductionPersonality neuroscience employs a broad range of methods to identify the neurobiological mechanisms of complex psychological phenomena. The role of the insula is often associated with its involvement in emotion processing.ObjectivesThe study aims to identify the associations between neural activity in the anterior insula cortex (AInC) and self-stigma (or its components) in a scoping review.MethodsWe searched in PubMed (MEDLINE), PsychINFO, EMBASE via the Ovid platform through September 21st, 2022. Included studies had to use fMRI to assess neurophysiological markers in AInC, and to include a measure of association between fMRI results and a measure of self-stigma and/or its components as assessed by a scale or questionnaire in participants aged 18-65 y.o. The PRISMA-ScR checklist was used.ResultsAfter full-text screening 10 of 206 original researches were chosen for the final analysis (Table 1). Table 1:Included studies in the analysis.1DeWall et al. Soc Cogn Affect Neurosci. 2012; 7(2): 184-192.2Masten et al. Neuroimage. 2011; 55(1): 381-388.3Kross et al. Proceedings of the National Academy of Sciences. 2011; 108(15): 6270-6275.4Bolling et al. Neuroimage. 2011; 54(3): 2462-2471.5Lindner et al. PLoS One. 2014; 9(1): e85014.6Achterberg et al. Soc Cogn Affect Neurosci. 2016; 11(5): 712-720.7Muscatell et al. Brain Behav Immun. 2016; 57: 21-29.8Sankar et al. Front Behav Neurosci. 2019;13.9Cáceda et al. Clin Neurosci. 2020; 270(5): 619-631.10Landa et al. J Psychosom Res. 2020; 128: 109881.In 5 studies, the results were presented with MNI-space coordinates. Figure 1 illustrats the regions of local activity change maxima according to MNI-space coordinates based on the results of the included studies in the analysis.Neural activation in the regions of the AInC was positively associated with greater levels of social rejection sensitivity and other components of self-stigma in 9 studies. Reduced activity was observed in only one study (Lindner et al., PLoS One. 2014; 9(1): e85014) among highly self-stigmatized patients with schizophrenia. This finding may reflect a biological manifestation of deficits in self-awareness and affective processing in schizophrenia.Image: Conclusions Associations between neural activity changes in specific brain regions and levels of self-stigma and/or its components, as reported in included neuroimaging studies, have the potential to shed light on the neurobiological mechanisms underlying such a complex psychological phenomenon as stigma.Disclosure of InterestNone Declared

Implication of Social Rejection in Cognitive Bias Modification Interpretation Training in Adolescents With Eating Disorders.

Difficulties in interpersonal relationships intensify negative emotions and act as risk and maintenance factors for eating pathology in eating disorders. Rejection sensitivity refers to the tendency to react sensitively to a rejection. Patients with eating disorders experience difficulties in interpersonal relationships because of their high sensitivity to rejection. Cognitive bias modification interpretation (CBM-I) is a treatment developed to correct interpretation bias for social and emotional stimuli. In this review, we searched for research characteristics and trends through a systematic literature analysis of CBM-I for eating disorders. Five papers that met the selection and exclusion criteria were included in the final literature review and analyzed according to detailed topics (participant characteristics, design, and results). The literature supports the efficacy of the CBM-I in reducing negative interpretation bias and eating disorder psychopathology in patients with eating disorders. CBM-I targets emotional dysregulation in adolescent patients with eating disorders and serves as an additional strengthening psychotherapy to alleviate eating disorder symptoms. The current findings highlight the potential of CBM-I as an individualized adjunctive treatment for adolescents with eating disorders and social functioning problems.

The Nexus of Sleep Disorders and Violence in Patients with Schizophrenia: What do the Data Say?

IntroductionOne of the common symptoms of schizophrenia is sleep disturbances, which can have a significant impact on the quality of life of patients. Several studies suggest the existence of a complex link between sleep disorders and agressive behavior in patients with schizophrenia.Objectivesto determine the impact of sleep disorders on aggressive behavior in patients with schizophrenia.MethodsWe conducted a cross-sectional, descriptive, and analytical study that took place over a period of one month (from 1st to 31nd March 2023) with patients consulting the post-cure of Psychiatry Service D at Razi Hospital, Tunisia. We included patients diagnosed with schizophrenia according to DSM5, and stabilized on a psychiatric plan. We used the Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality over a period of one month. The Buss & Perry Aggression Questionnaire (QABP) was used to measure aspects of aggression. We used the Adult Social Relationships Scales (ASRS), part of the National Institute of Health (NIH) toolkit, assessing six domains of social relationships: perceived rejection, perceived hostility, loneliness, friendship, instrumental support and emotional support.ResultsWe collected data from 40 male patients with a mean age of 42.5 ± 14.02. The mean global PSQI score was 9.23 ± 4.58.Ten patients were on typical antipsychotics, 25 patients were on atypical antipsychotics, and the remaining five patients were on a combination therapy (both atypical and typical antipsychotics). Regarding the use of benzodiazepines, 34 patients were taking lorazepam at a dose of 2.5 to 5 mg per day. he mean QABP global score was 45 ± 12.3 out of 72.For the subjective evaluation, all patients self-reported feeling “irritable,” “dysphoric,” “unable to communicate with others,” and “wanting to break objects” when they experienced insomnia.We found a statistically significant association between QABP and daytime dysfunction (p=0.003).The overall PSQI score was higher, and statistically significantly associated, in patients who reported low emotional support (p=0.018) and perceived social rejection (p=0.04).ConclusionsAn integrated approach that includes the evaluation of sleep disorders, as well as the prevention and management of violence, can play a key role in the overall improvement of the mental health of patients with schizophrenia.Disclosure of InterestNone Declared

Microaggressions towards People with Mental Illness

IntroductionMicroaggressions, or subtle expressions of discrimination directed towards individuals because of their membership in marginalized social groups, are the subject of a growing body of literature (Sue, 2010). As a result of growing understanding of politically correct beliefs over time, they’ve been defined as subtler types of discrimination that have replaced formerly overt discrimination. Microaggressions differ from traditional prejudice in that they are frequently perpetrated by well-intentioned people who are oblivious of the negative implications and consequences of their conduct. Microaggressions have been documented in a variety of social groups, including racial/ethnic minorities (Sue et al., 2008; Torres et al., 2010), gender (Swim et al., 2001), sexual orientation (Shelton and Delgado-Romero, 2011), and ability status (Shelton and Delgado-Romero, 2011). Many people with mental illnesses have reported social rejection experiences that are similar to microaggressions, according to research (Cechnicki et al., 2011; Lundberg et al., 2009; Wright et al., 2000; Yanos et al., 2001).ObjectivesExisting measures of stigmatizing attitudes and behaviors may not capture much of the nuance in behavior that people with mental illness report to be particularly upsetting, so we thought it would be important to examine reliability and validity of the mental illness microaggressions scale-perpetrator version (MIMS-P) for measuring microaggression behavior in the general public in Turkey.Methods The methodological study will be conducted to establish the validity and reliability of the The mental illness microaggressions scale-perpetrator version (MIMS-P) scale to Turkish Culture and to determine the microaggression levels against individuals with mental illness in the general population. The sample of the study will consist of individuals who are reached through an online questionnaire and who agree to participate in the study. Individuals who have psychiatric disorders will not be included in the study.ResultsData collection process is still ongoing. Description of studies and the key findings will be presented.ConclusionsThe MIMS-P is designed to aid future study on the frequency of endorsement of microaggressions performed against people with mental illnesses, with the ultimate goal of understanding the mechanisms that lead to these acts.The development of an extra scale to measure microaggressions from the perspective of people with mental illnesses who encounter them is one of the future research objectives.With a better knowledge of these viewpoints and how they interact, effective therapies and public policy initiatives for reducing stigma against mental illness can be developed.Disclosure of InterestNone Declared

아동용 또래 거부민감성 단축형 척도의 타당화

This study aims to develop a short form of the Peer Rejection Sensitivity Questionnaire (PRSQ; Choi, 2023) and assess its psychometric properties. A sample of 463 children in the 5th and 6th grades from elementary schools participated in the study. Self-report data were collected using questionnaires on peer rejection sensitivity, in-secure friendship attachment, and peer relationship problems. Exploratory factor analyses yielded a short form of the PRSQ consisting of 17 items with four factors including re-jection expectation, anger/depression, interpretation bias, and anxiety/withdrawal. Correlation analyses demonstrated strong associations between scores of the original and the short forms. The short form of the PRSQ exhibited high internal consistency and split-half reliability. Furthermore, it displayed appropriate criterion-related validity, with substantial associations with the CRSQ. Children in the top 30 percent of insecure friend-ship attachment and peer relationship problems scored significantly and practically higher on peer rejection sensitivity than those in the bottom 30%, supporting the known-group validity of the short form. The short form of the PRSQ serves as a valuable instrument for measuring peer rejection sensitivity of school-age children within research and counsel-ing settings.

The Plight of Intersex Individuals: Examination of Marginalization in Pakistan through Faiqa Mansab's This House of Clay and Water

This article aims to shed light on the discrimination, stigmatization, and marginalization experienced by intersex individuals in heteronormative Pakistani society. Intersex individuals face social ostracization in Pakistan. The primary goal of this study is to examine how Bhanggi, the protagonist of Faiqa Mansab's novel This House of Clay and Water (2017), suffers psychologically, physically, and mentally due to the unacceptance of his gender and the strict gender constraints of South Asia, specifically Pakistan. The in-depth analysis of Bhanggi's character helps in understanding the day-to-day struggles and significant obstacles encountered by intersex individuals, especially due to their gender identity. Using the conceptual framework of Sigmund Freud's personality theory, the study also contends that Bhanggi is victimized and condemned throughout his life because of his gender identification and societal prejudice.

Social excluder's face reduces gaze-triggered attention orienting.

Social ostracism, a negative affective experience in interpersonal interactions, is thought to modulate the gaze-cueing effect (GCE). However, it is unclear whether the impact of social exclusion on the GCE is related to the identity of the cueing face. Therefore, the present study employed a two-phase paradigm to address this issue. In the first phase, two groups of participants were instructed to complete a Cyberball game with two virtual avatars to establish a binding relationship between a specific face's identity and the emotions of social exclusion or inclusion. In the second phase, these two virtual avatars (exclusion faces/inclusion faces) and two new faces (control faces) were used as cueing faces in the gaze-cueing task. The results found that, for the exclusion group, the magnitudes of the GCEs for the exclusion and exclusion-control faces were similar in the 200 ms stimulus onset asynchrony (SOA) condition, while the exclusion face's GCE was significantly smaller than that of the exclusion-control face in the 700 ms SOA condition. In contrast, for the inclusion group, the GCEs for inclusion and inclusion-control faces in both the 200 ms SOA and 700 ms SOA conditions did not significantly differ. This study reveals that the effect of social exclusion on the GCE is related to the identity of the cueing face, with individuals more reluctant to follow the gaze direction of excluder and shift their attention and provides experimental evidence that the perception of higher social relations can exert a top-down impact on the processing of social spatial cues.

Behavioral and neural responses to social rejection: Individual differences in developmental trajectories across childhood and adolescence

Dealing with social rejection is challenging, especially during childhood when behavioral and neural responses to social rejection are still developing. In the current longitudinal study, we used a Bayesian multilevel growth curve model to describe individual differences in the development of behavioral and neural responses to social rejection in a large sample (n > 500). We found a peak in aggression following negative feedback (compared to neutral feedback) during late childhood, as well as individual differences during this developmental phase, possibly suggesting a sensitive window for dealing with social rejection across late childhood. Moreover, we found evidence for individual differences in the linear development of neural responses to social rejection in our three brain regions of interest: The anterior insula, the medial prefrontal cortex, and the dorsolateral prefrontal cortex. In addition to providing insights in the individual trajectories of dealing with social rejection during childhood, this study also makes a meaningful methodological contribution: Our statistical analysis strategy (and can be found in this study’s online supplementary materials at https://jeroendmulder.github.io/social-emotion-regulation/) can be used as an example on how to take into account the many complexities of developmental neuroimaging datasets, while still enabling researchers to answer interesting questions about individual-level relationships.

An Exploratory Study of Educators' Perspectives Towards Hospital School Program Support for Children with Special Health Care Needs After Hospitalization.

More than 14 million children in the United States are identified as children with special healthcare needs (CSHCN). Rates of hospitalization for CSHCN with chronic conditions as well as re-admissions have been increasing in recent years. For hospitalized children transitioning back to their school of record, a host of issues may arise such as socioemotional concerns, peer rejection, and being behind in academics. Hospital-based school programs (HBSPs) play an important role in the transition back to a child's school of record. Utilizing a database of inpatient CSHCN at a midwestern children's hospital's HBSP, private and public-school educators associated with the previously hospitalized CSHCN were asked to complete an online survey to gather their perspectives related to the child's transition back to the school of record upon hospital discharge. Overall, educators' perspectives of the HBSP were positive while perceptions related to communication provided by the HBSP were mixed. Educators surveyed reported a lack of training related to working with CSHCN. Finally, accommodations and services offered to students upon return to school focused mostly on academic performance and attendance. Study limitations and implications for practice in schools are discussed.

Social perceptions and the stigmatization towards fifteen mental illnesses in France: a preliminary study on the role of vital force and burden.

This study examined social perceptions and rejection towards fifteen mental illnesses, as well as a preliminary test of the SUBAR model, that hypothesized perceptions of both vital forces and burden would be negatively and positively related to social rejection, respectively. Using an online survey with participants from France (n = 952), social rejection was assessed using a feeling thermometer and a social distance scale, while social perceptions were measured using visual analog scales. A stigma map for these different disorders is drawn up, revealing the social perceptions and levels of stigmatization specific to certain mental illnesses. Controlling for relevant social perceptions (i.e., danger, warmth, competence), we found that perception of burden was positively and significantly associated to social distance and negative feeling for 73% and 67% of mental illnesses, respectively. The perception of vital force was negatively and significantly related to social distance and negative feeling for 87% and 20% of mental illnesses, respectively. The change in R2 between model 1 (i.e. perception of danger, warmth, competence) and model 2 (i.e. model 1 + perceptions of vital force and burden) significantly improved in 100% of cases for social distance and 67% of cases for negative feeling. These preliminary data provide support for the SUBAR model and call for further investigations to better understand the social rejection of people with mental illnesses.

Current barriers to initiating insulin therapy in individuals with type 2 diabetes.

Insulin is an essential drug in the treatment of diabetes, often necessary for managing hyperglycemia in type 2 diabetes mellitus (T2DM). It should be considered in cases of severe hyperglycemia requiring hospitalization, after the failure of other treatments, in advanced chronic kidney disease, liver cirrhosis, post-transplant diabetes, or during pregnancy. Moreover, in specific patient subgroups, early initiation of insulin is crucial for hyperglycemia control and prevention of chronic complications. Clinical guidelines recommend initiating insulin when other treatments fail, although there are barriers that may delay its initiation. The timing of initiation depends on individual patient characteristics. Typically, insulinization starts by adding basal insulin to the patient's existing treatment and, if necessary, progresses by gradually introducing prandial insulin. Several barriers have been identified that hinder the initiation of insulin, including fear of hypoglycemia, lack of adherence, the need for glucose monitoring, the injection method of insulin administration, social rejection associated with the stigma of injections, weight gain, a sense of therapeutic failure at initiation, lack of experience among some healthcare professionals, and the delayed and reactive positioning of insulin in recent clinical guidelines. These barriers contribute, among other factors, to therapeutic inertia in initiating and intensifying insulin treatment and to patients' non-adherence. In this context, the development of once-weekly insulin formulations could improve initial acceptance, adherence, treatment satisfaction, and consequently, the quality of life for patients. Currently, two once-weekly basal insulins, insulin icodec and basal insulin BIF, which are in different stages of clinical development, may help. Their longer half-life translates to lower variability and reduced risk of hypoglycemia. This review addresses the need for insulin in T2DM, its positioning in clinical guidelines under specific circumstances, the current barriers to initiating and intensifying insulin treatment, and the potential role of once-weekly insulin formulations as a potential solution to facilitate timely initiation of insulinization, which would reduce therapeutic inertia and achieve better early control in people with T2DM.