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Sample records for reported experiencing stigma

  1. How Anticipated and Experienced Stigma Can Contribute to Self-Stigma: The Case of Problem Gambling

    Science.gov (United States)

    Hing, Nerilee; Russell, Alex M. T.

    2017-01-01

    The degree to which anticipated and experienced public stigma contribute to self-stigma remains open to debate, and little research has been conducted into the self-stigma of problem gambling. This study aimed to examine which aspects of anticipated and experienced stigma (if any) predict the anticipated level of public stigma associated with problem gambling and the degree of self-stigma felt by people experiencing problem gambling. An online survey of 177 Australians experiencing problem gambling examined whether aspects of the public characterization of problem gambling, anticipated reactions to problem gamblers, and experiences of devaluation and discrimination predicted anticipated level of public stigma and self-stigma. The study found that self-stigma increases with expectations that the public applies a range of negative stereotypes to people with gambling problems, holds demeaning and discriminatory attitudes toward them, and considers them to lead highly disrupted lives. These variables directly predicted anticipated level of public stigma and indirectly predicted self-stigma. These findings lend weight to conceptualizations of self-stigma as an internalization of actual or anticipated public stigma. They also highlight the need for stigma reduction efforts, particularly those that lower negative stereotyping and prejudicial attitudes, to improve currently low rates of help-seeking amongst people with gambling problems. PMID:28270787

  2. Stigma experienced by people using mental health services in San Diego County.

    Science.gov (United States)

    Sarkin, Andrew; Lale, Rachel; Sklar, Marisa; Center, Kimberly C; Gilmer, Todd; Fowler, Chris; Heller, Richard; Ojeda, Victoria D

    2015-05-01

    This paper describes how individuals struggling with severe mental illness experience stigma along multiple dimensions including their experiences of discrimination by others, their unwillingness to disclose information about their mental health, and their internalization or rejection of the negative and positive aspects of having mental health problems. This cross-sectional study employs descriptive analyses and linear regression to assess the relationship between demographics, mental health diagnoses and self-reported stigma among people receiving mental health services in a large and ethnically diverse county public mental health system (n = 1,237) in 2009. We used the King Stigma Scale to measure three factors related to stigma: discrimination, disclosure, and positive aspects of mental illness. Most people (89.7 %) reported experiencing some discrimination from having mental health problems. Regression analyses revealed that younger people in treatment experienced more stigma related to mental health problems. Women reported experiencing more stigma than men, but men were less likely to endorse the potentially positive aspects of facing mental health challenges than women. Although people with mood disorders reported more discomfort with disclosing mental illness than people with schizophrenia, they did not report experiencing more discrimination than people with schizophrenia. Study findings suggest that the multidimensional experiences of stigma differ as a function of age, gender, and diagnosis. Importantly, these findings should inform anti-stigma efforts by describing different potential treatment barriers due to experiences of stigma among people using mental health services, especially among younger people and women who may be more susceptible to stigma.

  3. Racial and Ethnic Differences in Mental Illness Stigma and Discrimination Among Californians Experiencing Mental Health Challenges.

    Science.gov (United States)

    Wong, Eunice C; Collins, Rebecca L; Cerully, Jennifer; Seelam, Rachana; Roth, Beth

    2017-01-01

    Reports racial and ethnic differences on the California Well-Being Survey, a surveillance tool that tracks mental illness stigma and discrimination among a sample of California adults experiencing psychological distress.

  4. Gender differences among discrimination & stigma experienced by depressive patients in Pakistan.

    Science.gov (United States)

    Khan, Nashi; Kausar, Rukhsana; Khalid, Adeela; Farooq, Anum

    2015-01-01

    This study aims to examine Gender Difference in the level of Discrimination and Stigma experienced by people diagnosed with Major Depressive Disorder in Pakistan. It was hypothesized that Women diagnosed with Depression are likely to be experiencing more Discrimination and Internalized Stigma in comparison to Men. This is a Cross Sectional Study. Thirty eight patients diagnosed with Major Depressive Disorder recruited from different Government Sector Hospitals of Lahore; were approached after obtaining informed consent. Discrimination and Stigma were measured through Discrimination and Stigma Scale and Internalized Stigma of Mental Illness Inventory respectively. Both Men and Women experience considerably high level of associated Stigma and Discrimination due to their Mental Illness. However, Women in comparison to Men experience significantly greater level of Internalized Stigma especially in domains of Discrimination Experience and Social Withdrawal. The findings of this study highlight the fact that people with Depression can be more benefited with psychological treatment if dealing with Stigma and Discrimination is also addressed in Intervention Plans.

  5. Stigma Experienced by Parkinson's Disease Patients: A Descriptive Review of Qualitative Studies.

    Science.gov (United States)

    Maffoni, Marina; Giardini, Anna; Pierobon, Antonia; Ferrazzoli, Davide; Frazzitta, Giuseppe

    2017-01-01

    Parkinson's disease (PD) is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient's subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination) and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver's stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients' and caregiver's point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view.

  6. Stigma Experienced by Parkinson's Disease Patients: A Descriptive Review of Qualitative Studies

    Science.gov (United States)

    Maffoni, Marina; Pierobon, Antonia; Ferrazzoli, Davide

    2017-01-01

    Parkinson's disease (PD) is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient's subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination) and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver's stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients' and caregiver's point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view. PMID:28243481

  7. Stigma Experienced by Parkinson’s Disease Patients: A Descriptive Review of Qualitative Studies

    Directory of Open Access Journals (Sweden)

    Marina Maffoni

    2017-01-01

    Full Text Available Parkinson’s disease (PD is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient’s subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver’s stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients’ and caregiver’s point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view.

  8. Stigma and discrimination experienced by people living with severe and persistent mental illness in assertive community treatment settings.

    Science.gov (United States)

    Ye, Jing; Chen, Timothy F; Paul, Diane; McCahon, Rebecca; Shankar, Sumitra; Rosen, Alan; O'Reilly, Claire L

    2016-09-01

    To describe the perceived experiences of stigma and discrimination among people living with severe and persistent mental illness in assertive community treatment (ACT teams) settings in New South Wales (NSW), Australia. The Discrimination and Stigma Scale (DISC) was used in this cross-sectional study with people living with severe and persistent mental illness. The DISC is a reliable and valid, quantitative and qualitative instrument used to explore and measure levels of negative, anticipated and positive discrimination. Relevant clinical history and socio-demographic information were also collected. A total of 50 clients participated, with 40 (80%) reporting experienced negative discrimination in at least one life area. Negative discrimination was most commonly experienced in being avoided or shunned (n=25, 50%), by neighbours (n=24, 48%) and family (n=23, 46%). Anticipated discrimination was common, with half of participants (n=25, 50%) feeling the need to conceal their mental health diagnosis. Discrimination was highly prevalent in everyday aspects of life. While healthcare professionals often tend to increase perceived stigma and discrimination, this was only experienced in interactions with general health professionals, while interactions with ACT team members decreased perceived stigma and increased positive discrimination. This indicates that healthcare professionals potentially have a significant role in reducing stigma and discrimination in mental health and that such an effect may be optimised in an ACT team setting. © The Author(s) 2016.

  9. Measurement of self, experienced, and perceived HIV/AIDS stigma using parallel scales in Chennai, India.

    Science.gov (United States)

    Zelaya, Carla E; Sivaram, Sudha; Johnson, Sethulakshmi C; Srikrishnan, A K; Suniti, Solomon; Celentano, David D

    2012-01-01

    HIV/AIDS stigma can severely compromise the quality of life of people living with HIV/AIDS (PLHA) by reducing access and quality of care, adherence to therapy, and disclosure of HIV status, thereby potentially increasing transmission. The objective of this study was to develop and psychometrically test three parallel scales measuring self, experienced, and perceived stigma among PLHA (n=188) in Chennai, India. Exploratory factor analysis (EFA), which was used to facilitate item reduction and assess construct validity, confirmed the presence of three underlying theoretical domains. The final number of items and Cronbach's Alpha for each scale were: 8 items, Alpha of 0.84, for self stigma; 7 items, Alpha of 0.86, for experienced stigma; and 7 items, Alpha of 0.83, for perceived stigma. External validity was ascertained by confirming a significant positive association between the measure of each type of stigma and depression (measured using CES-D), using structural equation modeling (SEM). Therefore, scales were parsimonious, reliable, and were found to be valid measures of HIV/AIDS stigma. Using these validated scales, researchers can accurately collect data to inform the design of stigma reduction programs and interventions and enable subsequent evaluation of their effectiveness.

  10. Stigma- and non-stigma-related treatment barriers to mental healthcare reported by service users and caregivers.

    Science.gov (United States)

    Dockery, Lisa; Jeffery, Debra; Schauman, Oliver; Williams, Paul; Farrelly, Simone; Bonnington, Oliver; Gabbidon, Jheanell; Lassman, Francesca; Szmukler, George; Thornicroft, Graham; Clement, Sarah

    2015-08-30

    Delayed treatment seeking for people experiencing symptoms of mental illness is common despite available mental healthcare. Poor outcomes are associated with untreated mental illness and caregivers may eventually need to seek help on the service user's behalf. More attention has recently focused on the role of stigma in delayed treatment seeking. This study aimed to establish the frequency of stigma- and non-stigma-related treatment barriers reported by 202 service users and 80 caregivers; to compare treatment barriers reported by service users and caregivers; and to investigate demographic predictors of reporting stigma-related treatment barriers. The profile of treatment barriers differed between service users and caregivers. Service users were more likely to report stigma-related treatment barriers than caregivers across all stigma-related items. Service users who were female, had a diagnosis of schizophrenia or with GCSEs (UK qualifications usually obtained at age 16) were significantly more likely to report stigma-related treatment barriers. Caregivers who were female or of Black ethnicities were significantly more likely to report stigma-related treatment barriers. Multifaceted approaches are needed to reduce barriers to treatment seeking for both service users and caregivers, with anti-stigma interventions being of particular importance for the former group. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Stigma and discrimination experienced by people with schizophrenia living in the community in Guangzhou, China.

    Science.gov (United States)

    Li, Jie; Guo, Yang-Bo; Huang, Yuan-Guang; Liu, Jing-Wen; Chen, Wen; Zhang, Xiang-Yang; Evans-Lacko, Sara; Thornicroft, Graham

    2017-09-01

    The aims of this study were to investigate experienced stigma and discrimination and their associated factors in people with schizophrenia who live in the community in Guangzhou, China. A total of 384 people with schizophrenia were randomly recruited from four districts of Guangzhou and completed the scales and questionnaires: Internalized Stigma of Mental Illness scale (ISMI), Self-Esteem Scale (SES), Discrimination and Stigma Scale (DISC-12), Brief Psychiatric Rating Scale (BPRS), PANSS negative scale (PANSS-N), Global Assessment of Functioning (GAF) and Schizophrenia Quality of Life Scale (SQLS). Insight and medication compliance were evaluated by psychiatrists. Data were analyzed by using descriptive statistics, Pearson correlation and multivariable linear regression. We found a significant positive correlation between BPRS score and PANSS-N score, GAF score was significantly negative correlated with SQLS score, Insight score was significantly negative correlated with medication compliance score, ISMI score was significantly positive correlated with SES score and experienced discrimination score. Multivariable linear regression found SQLS, SES and experienced discrimination were the main independent variables of ISMI and experienced discrimination was the most important factor of ISMI. Our findings suggest that people with schizophrenia often experienced stigma and discrimination in this Chinese population, and more anti-stigma interventions should be provided. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  12. Retrospective accounts of self-stigma experienced by young people with attention-deficit/hyperactivity disorder (ADHD) or depression.

    Science.gov (United States)

    McKeague, Lynn; Hennessy, Eilis; O'Driscoll, Claire; Heary, Caroline

    2015-06-01

    Little is known about self-stigma experienced by young people with mental health problems, despite the fact that research has demonstrated its existence. In the present study, we sought to investigate the experiences of self-stigma in childhood and adolescence, and particularly the nature of change in self-stigma across this developmental period. Young adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) or depression before their 18th birthdays were interviewed about their experiences within their peer groups during childhood and adolescence. This qualitative study involved open-ended interviews with 16 young adults aged 18-30 years. Interviews focused on the experience of stigmatization, responses to stigma, and how these changed over time. Three main themes pertaining to self-stigma emerged: (a) being different, (b) peer stigmatization and associated experiences of self-stigma, and (c) selective disclosure and a move toward greater openness. The findings also suggested that the passing of time and changes in young people's social networks and/or degrees of recovery were associated with changes in their experiences of self-stigma. During childhood and adolescence, self-stigma is characterized by a sense of being different from peers and negative self-evaluation as a consequence of that difference. However, our findings also demonstrated that some young people were prepared to challenge the stigma they experienced. Further research is needed to understand the factors that contribute to these differing responses and to develop antistigma interventions that facilitate the inclusion of young people with mental health problems in their peer groups. (c) 2015 APA, all rights reserved).

  13. Stigma

    Directory of Open Access Journals (Sweden)

    Jussara C. Santos

    2016-09-01

    Full Text Available In this study, we have surveyed how professionals from multidisciplinary teams at psychosocial care centers (CAPS, in the city of São Paulo, understand the concept of mental illness stigma. The aim of the survey was to characterize the actions developed by the team to overcome stigma and, thus, contribute to develop strategies that incorporate overcoming stigma in the territory. Our objective is to get acquainted to the concepts about stigma shared by the participants. This survey was based on the theory of stigma by Erving Goffman; data were collected through semi-structured interviews with mental health professionals belonging to the CAPS teams. Results indicate that social exclusion is understood as a synonym to stigma, and that proximity of CAPS to society in the territory facilitates social inclusion and the overcoming of the mental illness stigma.

  14. Assessing Bisexual Stigma and Mental Health Status: A Brief Report

    OpenAIRE

    Bostwick, Wendy

    2012-01-01

    Bisexual women often report higher rates of depression and mental health problems than their heterosexual and lesbian counterparts. These disparities likely occur, in part, as a result of the unique stigma that bisexual women face and experience. Such stigma can in turn operate as a stressor, thereby contributing to poor mental health status. The current pilot study tested a new measure of bisexual stigma and its association with mental health. Results suggest a moderate positive correlation ...

  15. Impact of the "Like Minds, Like Mine" anti-stigma and discrimination campaign in New Zealand on anticipated and experienced discrimination.

    Science.gov (United States)

    Thornicroft, Calum; Wyllie, Allan; Thornicroft, Graham; Mehta, Nisha

    2014-04-01

    The "Like Minds, Like Mine" anti-stigma and discrimination programme has been running in New Zealand since 1997. We aimed to investigate the nature and degree of anticipated and experienced discrimination reported by people with mental illness, and their views on whether the campaign was contributing to reductions in stigma and discrimination. Questionnaires were sent to randomly selected people who were representative of those who had recently used mental health services in New Zealand. The measure used was the modified Discrimination and Stigma Scale (DISC-12), adding questions on the effect of "Like Minds, Like Mine", and also assessing overall changes in discrimination in the previous 5 years. A total of 1135 participants completed the questionnaire. This included 225 Ma-ori, 196 Pacific, and 152 Asian persons. Over half of all participants reported improvement in discrimination over the previous 5 years, and 48% thought that the "Like Minds Like Mine" programme had assisted in reducing discrimination "moderately" or "a lot". Nevertheless, a clear majority (89%) reported experiencing at least "a little" unfair treatment in the previous 12 months due to their mental health problems. The primary source of both positive and negative discrimination was the family. Many (57%) participants had concealed or hidden their mental health problems from others, and 33% had stopped themselves from applying for work because they anticipated discrimination. Family, friendship, and social life were the most common areas of discrimination reported by the participants; however, many believed the overall level of discrimination had reduced over the previous 5 years. Overall, these results characterize the nature of stigma and discrimination anticipated and experienced by people with mental health problems and indicate modest but clear and positive recent progress in their reduction.

  16. A Preliminary Examination of Sexual Orientation as a Social Vulnerability for Experiencing HIV/AIDS-related Stigma.

    Science.gov (United States)

    Gonzalez, Adam; Weibust, Kristin S; Miller, Carol T; Solomon, Sondra E

    2011-05-01

    This investigation is a preliminary examination of sexual orientation as a social vulnerability for experiencing HIV/AIDS-related stigma, specifically concerns about disclosure and public attitudes. Participants were 36 heterosexual men and 82 gay men with HIV/AIDS. Consistent with prediction, a heterosexual sexual orientation was significantly associated with HIV/AIDS disclosure concerns. This effect was evident after controlling for various demographic variables, CD4 T-cell count, time since HIV diagnosis, self-esteem, and coping styles. Also, as predicted, similar levels of enacted stigma were evident regardless of sexual orientation. Further work is needed to understand the process of HIV/AIDS disclosure for heterosexual men with this illness and to differentiate the experience of HIV/AIDS-related stigma among gay and straight men with HIV/AIDS.

  17. Direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness and social inclusion in young people experiencing psychosis.

    Science.gov (United States)

    Berry, Clio; Greenwood, Kathryn

    2017-07-07

    Social inclusion and vocational activity are central to personal recovery for young people with psychosis. Studies with people experiencing long term psychosis suggest negative self-beliefs are important, but less is known about whether this association is present for young service users or about the potential influence of positive self-beliefs such as hopefulness. The aim of the current paper was to investigate the direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness, social inclusion and vocational activity for young people with psychosis. A 5-month longitudinal study was conducted with young psychosis service users. Measures of dysfunctional attitudes and self-stigma and vocational activity were obtained at baseline. Measures of hopefulness, social inclusion and vocational activity were obtained at follow-up. Hopefulness mediates the associations between self-stigma, social inclusion and vocational activity. Self-stigma may have a greater influence on social inclusion with age. Dysfunctional attitudes do not significantly predict social inclusion or change in vocational activity status. Findings suggest that the impact of self-stigma may extend beyond social and occupational withdrawal and undermine subjective community belonging. Findings encourage an increased emphasis on facilitating hopefulness for young people who experience psychosis. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Sexual stigma and symbolic violence experienced, enacted, and counteracted in young Africans' writing about same-sex attraction.

    Science.gov (United States)

    Winskell, Kate; Sabben, Gaëlle

    2016-07-01

    There is growing recognition of the health disparities faced by sexual minority populations and the critical role played by sexual stigma in increasing their vulnerability. Experienced, anticipated, and internalized, stigma based on sexual orientation reduces access to HIV/STI prevention and treatment services among African men who have sex with men and has been linked to compromised mental health, risk-taking, and HIV status. It is likely that similar processes undermine the health of sexual minority African women and transgender and non-binary people. There is a need for increased understanding of both the contextual factors and the cultural meanings, or symbolic violence, that inform sexual stigma and harmful stigma management strategies in contexts that are culturally and socio-politically oppressive for sexual and gender minorities. Using thematic data analysis and narrative-based methodologies, we analyzed narratives and essays on same-sex attraction contributed by young people aged 13-24 from ten African countries to a Spring 2013 scriptwriting competition on HIV, sexuality, and related themes. Submitted by 27 male and 29 female authors, the texts were written in response to a prompt inviting participants to "Tell a story about someone who is attracted to people of the same sex". We analyzed the ways in which sexual stigma and its effects are described, enacted, and counteracted in the texts. The data provide insights into the social and symbolic processes that create and sustain sexual stigma in the context of broader transnational discourses. The data shed light on psychosocial challenges faced by sexual minority youth and identify both rhetoric, stereotypes, and discourse that devalue them and representations that counteract this symbolic violence. We share our findings in the hope they may inform education and communication programming as part of multi-level efforts to improve the health and human rights of sexual minority populations in sub

  19. Safety in the midst of stigma: Experiencing HIV/AIDS in two Ghanaian communities

    NARCIS (Netherlands)

    Kwansa, B.K.

    2013-01-01

    Stigmatization of people associated with HIV can be devastating, even more so than the virus itself. It destroys the lives of HIV positive people and their loved ones. All too often in Ghana, those with no direct HIV experience do not see the depth of the impact of stigma on individuals, households

  20. Effects of music therapy on self- and experienced stigma in patients on an acute care psychiatric unit: a randomized three group effectiveness study.

    Science.gov (United States)

    Silverman, Michael J

    2013-10-01

    Stigma is a major social barrier that can restrict access to and willingness to seek psychiatric care. Psychiatric consumers may use secrecy and withdrawal in an attempt to cope with stigma. The purpose of this study was to determine the effects of music therapy on self- and experienced stigma in acute care psychiatric inpatients using a randomized design with wait-list control. Participants (N=83) were randomly assigned by cluster to one of three single-session group-based conditions: music therapy, education, or wait-list control. Participants in the music therapy and education conditions completed only posttests while participants in the wait-list control condition completed only pretests. The music therapy condition was a group songwriting intervention wherein participants composed lyrics for "the stigma blues." Results indicated significant differences in measures of discrimination (experienced stigma), disclosure (self-stigma), and total stigma between participants in the music therapy condition and participants in the wait-list control condition. From the results of this randomized controlled investigation, music therapy may be an engaging and effective psychosocial technique to treat stigma. Limitations, suggestions for future research, and implications for clinical practice and psychiatric music therapy research are provided.

  1. Religion-related stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a South African rural-based university.

    Science.gov (United States)

    Mavhandu-Mudzusi, Azwihangwisi Helen; Sandy, Peter Thomas

    2015-01-01

    This paper reports on the stigma and discrimination experienced by lesbian, gay, bisexual and transgender students at a rural university in South Africa. Twenty lesbian, gay, bisexual and transgender students recruited through snowball sampling participated in this study. Interpretative Phenomenological Analysis was used as a framework for data analysis. Findings indicate that religion-related stigma and discrimination are common at a rural-based university in South Africa. Lesbian, gay, bisexual and transgender students are typically ascribed a range of labels, including 'sinners', 'devils' and 'demon possessed'. They are also exposed to a number of discriminatory acts, such as the denial of financial and healthcare services and threats of and/or actual rape. Study participants reported attempts to convert lesbian, gay, bisexual and transgender students' sexual orientation which involved the use of intervention in the form of prayers. Derogatory labelling and associated discriminatory acts, for example the threat of rape, led many students to conceal their sexual identity, not attend specific classes, terminate their studies and even attempt suicide. Universities should develop policies to promote greater social inclusion and the acceptance of lesbian, gay, bisexual and transgender students. Policies should also specify the steps or approaches to be taken in addressing discriminatory practices.

  2. Mental illness stigma and suicidality: the role of public and individual stigma.

    Science.gov (United States)

    Oexle, N; Waldmann, T; Staiger, T; Xu, Z; Rüsch, N

    2016-12-06

    Suicide rates are increased among unemployed individuals and mental illness stigma can contribute to both unemployment and suicidality. Persons with mental illness perceive negative attitudes among the general public and experience discrimination in their everyday life (=public stigma components) potentially leading to self-stigma and anticipated discrimination (=individual stigma components). Previous research found evidence for an association between aspects of mental illness stigma and suicidality, but has not yet clarified the underlying pathways explaining how different stigma components interact and contribute to suicidal ideation. Public and individual stigma components and their association with suicidal ideation were examined among 227 unemployed persons with mental illness. A path model linking public stigma components (experienced discrimination, perceived stigma) with suicidal ideation, mediated by individual stigma components (anticipated discrimination, self-stigma), was examined using structural equation modelling within Mplus. Our sample was equally split in terms of gender, on average 43 years old and about half reported no suicidal ideation during the past 30 days. In bivariate analyses all stigma components were significantly associated with suicidal ideation. In the path model and controlling for symptoms, the association between experienced discrimination and suicidal ideation was fully mediated by anticipated discrimination and self-stigma. Perceived stigma's contribution to suicidal ideation was fully mediated by anticipated discrimination, but not by self-stigma. In general, programmes addressing multiple stigma components seem to be most effective in improving suicide prevention. Besides interventions targeting negative attitudes and discriminating behaviours of the general public, programmes to support persons with mental illness in coping with perceived and experienced stigma could improve suicide prevention. Future studies should test

  3. Parental Reports of Stigma Associated with Child’s Disorder of Sex Development

    Directory of Open Access Journals (Sweden)

    Aimee M. Rolston

    2015-01-01

    Full Text Available Disorders of sex development (DSD are congenital conditions in which chromosomal, gonadal, or anatomic sex development is atypical. DSD-associated stigma is purported to threaten positive psychosocial adaptation. Parental perceptions of DSD-related stigma were assessed in 154 parents of 107 children (newborn–17 years questionnaire comprising two scales, child-focused and parent-focused, and three subscales, perceived stigmatization, future worries, and feelings about the child’s condition. Medical chart excerpts identified diagnoses and clinical management details. Stigma scale scores were generally low. Parents of children with DSD reported less stigma than parents of children with epilepsy; however, a notable proportion rated individual items in the moderate to high range. Stigma was unrelated to child’s age or the number of DSD-related surgeries. Child-focused stigma scores exceeded parent-focused stigma and mothers reported more stigma than fathers, with a moderate level of agreement. Within 46,XY DSD, reported stigma was higher for children reared as girls. In conclusion, in this first quantitative study of ongoing experiences, DSD-related stigma in childhood and adolescence, while limited in the aggregate, is reported at moderate to high levels in specific areas. Because stigma threatens positive psychosocial adaptation, systematic screening for these concerns should be considered and, when reported, targeted for psychoeducational counseling.

  4. Stigma and self-esteem across societies: avoiding blanket psychological responses to gay men experiencing homophobia.

    Science.gov (United States)

    Zervoulis, Karyofyllis; Lyons, Evanthia; Dinos, Sokratis

    2015-08-01

    Aims and method The relationship between homophobia (varying from actual and perceived to internalised) and measures of well-being is well documented. A study in Athens, Greece and London, UK attempted to examine this relationship in two cities with potentially different levels of homophobia. One-hundred and eighty-eight men who have sex with men (MSM) living in London and 173 MSM living in Athens completed a survey investigating their views on their sexuality, perceptions of local homophobia and their identity evaluation in terms of global self-esteem. Results The results confirmed a negative association between homophobia and self-esteem within each city sample. However, Athens MSM, despite perceiving significantly higher levels of local homophobia than London MSM, did not differ on most indicators of internalised homophobia and scored higher on global self-esteem than London MSM. The city context had a significant impact on the relationship. Clinical implications The findings are discussed in relation to the implications they pose for mental health professionals dealing with MSM from communities experiencing variable societal stigmatisation and its effect on a positive sense of self.

  5. Self-reported stigma and symptoms of anxiety and depression in people with intellectual disabilities: Findings from a cross sectional study in England.

    Science.gov (United States)

    Ali, Afia; King, Michael; Strydom, Andre; Hassiotis, Angela

    2015-11-15

    No studies have investigated the relationship between self-reported stigma and multiple health outcomes in people with intellectual disabilities (ID). The association between self-reported stigma and symptoms of anxiety and depression (psychological distress), quality of life, service utilisation and adherence to treatment were examined. Cross sectional study of 229 participants with ID (without mental illness) recruited from 12 centres in England. Self-reported stigma was positively associated with psychological distress, and number of contacts with services, particularly contact with community intellectual disability services and the police, and negatively associated with quality of life. It was not associated with adherence to treatment. Self-reported stigma was also associated with refusal of at least one service in the last six months. The relationship between stigma and quality of life and stigma and service use were mediated by psychological distress. The Cross-sectional design of this study prevents inferences being made about the direction of causality. IQ was not formally assessed but was based on clinical data. This study provides evidence that stigma may contribute to poor psychological health in people with ID, may be a burden on services due to higher service utilisation but may also prevent people from accessing appropriate services. Services should consider screening people at risk of psychological distress due to stigmatising treatment and provide appropriate support. There is an urgent need to develop evidence-based interventions to reduce societal stigma against people with ID and to reduce the impact of stigma when it is experienced by individuals with ID. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Ethnicity and self-reported experiences of stigma in adults with intellectual disability in Cape Town, South Africa.

    Science.gov (United States)

    Ali, A; Kock, E; Molteno, C; Mfiki, N; King, M; Strydom, A

    2015-06-01

    Studies have shown that individuals with intellectual disability (ID) are aware of stigma and are able to describe experiences of being treated negatively. However, there have been no cross-cultural studies examining whether self-reported experiences of stigma vary between ethnic groups. Participants with mild and moderate ID were recruited from a number of different settings in Cape Town, South Africa. Self-reported experiences of stigma in three ethnic groups were measured using the South African version of the Perceived Stigma of Intellectual Disability tool, developed by the authors. One-way anova was used to test whether there were differences in the total stigma score between the ethnic groups. Regression analysis was performed to identify factors associated with stigma. A total of 191 participants agreed to take part; 53 were Black, 70 were of mixed ethnicity and 68 were Caucasian. There were no differences in the levels of stigma reported by the three groups but the Black African ethnic group were more likely to report being physically attacked and being stared at, but were also more likely to report that they thought they were 'the same as other people'. There was an interaction effect between ethnicity and level of ID, with participants with mild ID from the Black African group reporting higher levels of stigma compared with those with moderate ID. Younger age was the only factor that was associated with stigma but there was a trend towards ethnicity, additional disability and socio-economic status being related to stigma. Interventions should target the Black African community in South Africa and should include the reduction of both public stigma and self-reported stigma. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  7. HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada.

    Directory of Open Access Journals (Sweden)

    Carmen H Logie

    2011-11-01

    Full Text Available BACKGROUND: HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada. METHODS AND FINDINGS: We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender described stigma/discrimination and coping across micro (intra/interpersonal, meso (social/community, and macro (organizational/political realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro, social networks and support groups (meso, and challenging stigma (macro. CONCLUSIONS: HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being--as well as opportunities for coping--in HIV-positive women's lives

  8. Extent of podoconiosis-related stigma in Wolaita Zone, Southern Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Tora, Abebayehu; Franklin, Hannah; Deribe, Kebede; Reda, Ayalu A; Davey, Gail

    2014-01-01

    Studies have indicated that social stigma related to podoconiosis (endemic non-filarial elephantiasis) has a major impact on the psychosocial wellbeing of patients. However, little effort has been made so far to quantify the level of both felt and enacted stigma in a range of domains of life. We used a recently developed podoconiosis stigma assessment scale to measure levels of stigma as recalled over the previous 12 months. One hundred and fifty patients with podoconiosis rated the levels of stigma they perceived and experienced in 'interpersonal interactions', 'major life areas' and 'community, social and civic life'. High levels of stigma were observed on both felt and enacted stigma scales. The overall average stigma score was 40.7 (range 0 to 96). Enacted stigma was scored higher than felt stigma (mean score 21.2 vs. 19.5, respectively). The mean enacted stigma score was higher in 'major life areas', and 'community, social and civic life' than 'interpersonal interactions', while felt stigma was experienced most at the interpersonal level. Over half of patients reported that they had considered suicide in response to discrimination and prejudice, particularly in interpersonal interactions. Forced divorce, dissolution of marriage plan, insults and exclusion at social events were some of the most commonly mentioned forms of enacted stigma reported by affected individuals. Scores for overall level of stigma and enacted stigma increased significantly with stage of podoconiosis while the association observed in relation to felt stigma was only marginally significant (p = 0.085). Appropriate stigma reduction strategies must be identified and implemented in communities highly endemic for podoconiosis.

  9. Family Stigma and Caregiver Burden in Alzheimer's Disease

    Science.gov (United States)

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  10. Family Stigma and Caregiver Burden in Alzheimer's Disease

    Science.gov (United States)

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  11. Missing the target: including perspectives of women with overweight and obesity to inform stigma-reduction strategies.

    Science.gov (United States)

    Puhl, R M; Himmelstein, M S; Gorin, A A; Suh, Y J

    2017-03-01

    Pervasive weight stigma and discrimination have led to ongoing calls for efforts to reduce this bias. Despite increasing research on stigma-reduction strategies, perspectives of individuals who have experienced weight stigma have rarely been included to inform this research. The present study conducted a systematic examination of women with high body weight to assess their perspectives about a broad range of strategies to reduce weight-based stigma. Women with overweight or obesity (N = 461) completed an online survey in which they evaluated the importance, feasibility and potential impact of 35 stigma-reduction strategies in diverse settings. Participants (91.5% who reported experiencing weight stigma) also completed self-report measures assessing experienced and internalized weight stigma. Most participants assigned high importance to all stigma-reduction strategies, with school-based and healthcare approaches accruing the highest ratings. Adding weight stigma to existing anti-harassment workplace training was rated as the most impactful and feasible strategy. The family environment was viewed as an important intervention target, regardless of participants' experienced or internalized stigma. These findings underscore the importance of including people with stigmatized identities in stigma-reduction research; their insights provide a necessary and valuable contribution that can inform ways to reduce weight-based inequities and prioritize such efforts.

  12. Interventions for Stigma Reduction – Part 2: Practical Applications

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    Ajit Dalal

    2012-02-01

    Full Text Available This paper reports the endeavours of the Working Group assigned to develop guidelines for interventions to reduce stigma. The group was comprised of academics and experienced field personnel, all of whom had either investigated stigma, implemented actions to address stigma, and/or had experienced stigma. The group’s mandate was to develop an intervention to reduce the stigma of leprosy, but while accepting that there are commonalities relating to stigma that cut across different health conditions, it was hoped that a generic intervention might be developed. This goal proved to be unattainable in the time given: condition-specific peculiarities and the diversity of cultural contexts presented significant challenges. The group agreed, however, that a considerable body of theory and expert opinion does exist, and that general strategies might be developed from this. The Working Group discussed a systematic review of such material. It also discussed other material that was considered to be important but had not met the criteria for the systematic review. One conclusion of the group’s deliberations was that a “Stigma Intervention Matrix” could be a useful guide for cross-checking the development of situation-specific stigma interventions. The Stigma Intervention Matrix is presented in this paper.DOI: 10.5463/dcid.v22i3.72

  13. Situating stigma in stratified reproduction: Abortion stigma and miscarriage stigma as barriers to reproductive healthcare.

    Science.gov (United States)

    Bommaraju, Aalap; Kavanaugh, Megan L; Hou, Melody Y; Bessett, Danielle

    2016-12-01

    To examine whether race and reported history of abortion are associated with abortion stigma and miscarriage stigma, both independently and comparatively. Self-administered surveys with 306 new mothers in Boston and Cincinnati, United States. Abortion stigma perception (ASP); miscarriage stigma perception (MSP); and comparative stigma perception (CSP: abortion stigma perception net of miscarriage stigma perception). Regardless of whether or not they reported having an abortion, white women perceived abortion (ASP) to be more stigmatizing than Black and Latina women. Perceptions of miscarriage stigma (MSP), on the other hand, were dependent on reporting an abortion. Among those who reported an abortion, Black women perceived more stigma from miscarriage than white women, but these responses were flipped for women who did not report abortion. Reporting abortion also influenced our comparative measure (CSP). Among those who did report an abortion, white women perceived more stigma from abortion than miscarriage, while Black and Latina women perceived more stigma from miscarriage than abortion. By measuring abortion stigma in comparison to miscarriage stigma, we can reach a more nuanced understanding of how perceptions of reproductive stigmas are stratified by race and reported reproductive history. Clinicians should be aware that reproductive stigmas do not similarly affect all groups. Stigma from specific reproductive outcomes is more or less salient dependent upon a woman's social position and lived experience. Copyright © 2016 Elsevier B.V. All rights reserved.

  14. HIV, Gender, Race, Sexual Orientation, and Sex Work: A Qualitative Study of Intersectional Stigma Experienced by HIV-Positive Women in Ontario, Canada

    Science.gov (United States)

    Logie, Carmen H.; James, LLana; Tharao, Wangari; Loutfy, Mona R.

    2011-01-01

    Background HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada. Methods and Findings We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% lesbian/bisexual; 22% transgender) described stigma/discrimination and coping across micro (intra/interpersonal), meso (social/community), and macro (organizational/political) realms. Participants across focus groups attributed experiences of stigma and discrimination to: HIV-related stigma, sexism and gender discrimination, racism, homophobia and transphobia, and involvement in sex work. Coping strategies included resilience (micro), social networks and support groups (meso), and challenging stigma (macro). Conclusions HIV-positive women described interdependent and mutually constitutive relationships between marginalized social identities and inequities such as HIV-related stigma, sexism, racism, and homo/transphobia. These overlapping, multilevel forms of stigma and discrimination are representative of an intersectional model of stigma and discrimination. The present findings also suggest that micro, meso, and macro level factors simultaneously present barriers to health and well being—as well as opportunities for coping—in HIV-positive women's lives. Understanding the

  15. The Stigma of Personality Disorders.

    Science.gov (United States)

    Sheehan, Lindsay; Nieweglowski, Katherine; Corrigan, Patrick

    2016-01-01

    This article reviews the recent literature on the stigma of personality disorders, including an overview of general mental illness stigma and an examination of the personality-specific stigma. Overall, public knowledge of personality disorders is low, and people with personality disorders may be perceived as purposefully misbehaving rather than experiencing an illness. Health provider stigma seems particularly pernicious for those with borderline personality disorder. Most stigma research on personality disorders has been completed outside the USA, and few stigma-change interventions specific to personality disorder have been scientifically tested. Limited evidence suggests that health provider training can improve stigmatizing attitudes and that interventions combining positive messages of recovery potential with biological etiology will be most impactful to reduce stigma. Anti-stigma interventions designed specifically for health providers, family members, criminal justice personnel, and law enforcement seem particularly beneficial, given these sources of stigma.

  16. Stigma, medication adherence and coping mechanism among people living with HIV attending General Hospital, Lagos Island, Nigeria

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    Adekemi O. Sekoni

    2012-02-01

    Full Text Available Background: People living with HIV and AIDS (PLWHA experience some form of stigma which could lead to poor medication adherence.Objectives: This study assessed the various domains of stigma experienced by PLWHAs attending an HIV clinic at General Hospital, Lagos Island, their medication adherence patterns and their coping mechanisms for ensuring adherence to antiretroviral therapy.Method: A cross-sectional study design with a sample size of 200 was used. Respondents were selected using systematic random sampling. Interviewers administered structured questionnaires were used to collect information on the domains of stigma. Data was analysed using EPI info©. This was followed by a focus group discussion (FGD with seven participants at the clinic using an interview guide with open-ended questions.Results: Overall, stigma was experienced by 35% of the respondents. Within this group, 6.6%, 37.1%, 43.1% and 98.0% of the respondents reported experiencing negative self image stigma, personalised stigma, disclosure stigma and public attitude stigma respectively. Almost 90% of the respondents were adherent. The FGD revealed that disclosure was usually confined to family members and the coping mechanism for achieving adherence was to put antiretroviral (ARVs in unlabelled pill boxes.Conclusion: This study found that stigma was low and that the most common domain of stigma experienced was public attitude stigma. Medication adherence of respondents was good as a result of the coping mechanism, which involves putting ARVs in unlabelled pill boxes.

  17. Reported stigma and discrimination by people with a diagnosis of schizophrenia.

    Science.gov (United States)

    Rose, D; Willis, R; Brohan, E; Sartorius, N; Villares, C; Wahlbeck, K; Thornicroft, G

    2011-06-01

    This article examines the extent of stigma and discrimination as reported by people with a diagnosis of schizophrenia. The hypothesis is that when people express in their own words the discrimination they experience such discrimination will be found to be widespread. Seventy-five people with a diagnosis of schizophrenia from 15 different countries were interviewed with a mixed methods instrument to assess reported discrimination. The data were analysed for frequency counts and then a thematic analysis was performed. A conceptual map is provided. The study was a cross-cultural one but, contrary to expectations, few transnational differences were found. The main hypothesis was supported. Conversely, we found that when participants reported 'positive discrimination', this could as easily be conceptualised as being treated similarly to how others in society would expect to be treated. Negative discrimination is ubiquitous and sometimes connotatively very strong, with reports of humiliation and abuse. 'Positive discrimination' conversely indicates that people with a mental illness diagnosis expect discrimination and are grateful when it does not occur. The literature on self-stigma is discussed and found wanting. Similarly, the theory that contact with mentally ill people reduces stigma and discrimination is not fully supported by our results.

  18. Felt and enacted stigma in elderly persons with epilepsy: A qualitative approach.

    Science.gov (United States)

    Sleeth, Carolyn; Drake, Kendra; Labiner, David M; Chong, Jenny

    2016-02-01

    Stigma is a common psychological consequence of chronic diseases, including epilepsy; however, little research has been done to determine the effect of stigma on persons with epilepsy, especially the elderly. We interviewed 57 older adults with epilepsy to discover the extent and consequences of, and reasons for, epilepsy-related stigma in their lives. Felt stigma was more frequently reported than enacted stigma, with over 70% having experienced this form of stigma. Participants described ignorance and fear of the disease as the foundation of epilepsy-related stigma. The most common response to stigmatizing events was a decrease in epilepsy disclosure to family or friends. Results from this study could inform interventions designed for elderly persons with epilepsy and their support networks, as well as educational campaigns for the general public.

  19. The Stigma of Families with Mental Illness

    Science.gov (United States)

    Larson, Jon E.; Corrigan, Patrick

    2008-01-01

    Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

  20. The Stigma of Families with Mental Illness

    Science.gov (United States)

    Larson, Jon E.; Corrigan, Patrick

    2008-01-01

    Objective: This article describes family stigma, which is defined as the prejudice and discrimination experienced by individuals through associations with their relatives. Methods: The authors describe family stigma and present current research related to mental illness stigma experienced by family members. Research indicates this type of stigma…

  1. Stigma and psychiatric morbidity among mothers of children with epilepsy in Zambia

    Science.gov (United States)

    Elafros, Melissa A.; Sakubita-Simasiku, Claire; Atadzhanov, Masharip; Haworth, Alan; Chomba, Elwyn; Birbeck, Gretchen L.

    2013-01-01

    Background Epilepsy-associated stigma contributes substantially to the social, medical, and economic burden of disease for people with epilepsy (PWE), but little is known about its impact on caregivers of PWE. Methods To better understand stigma experienced by caregivers of PWE, factors that influence caregiver stigma, and the effect of stigma on a caregiver's psychologic well being, we interviewed 100 caregivers of children with epilepsy in Zambia. Questions assessed maternal knowledge, attitudes, and practices related to epilepsy, maternal stigma, mother's proxy report of child stigma, and maternal psychiatric morbidity. Results Of 100 mothers, 39 (39%) indicated that their child was stigmatized because of his or her epilepsy. Maternal proxy report of child stigma was highly correlated with maternal stigma (OR: 5.4, p=0.04), seizure frequency (p=0.03) and seizure severity (p=0.01). One in five of 100 mothers (20%) reported feeling stigmatized because of their child's epilepsy. Higher maternal stigma was associated with lower familial and community support (ORs: 65.2 and 34.7, respectively; both pepilepsy knowledge were associated with decreased maternal stigma (ORs: 0.8 and 0.7, respectively; both pepilepsy. As maternal stigma is associated with psychiatric morbidity, educating caregivers about epilepsy and screening for anxiety and depression are warranted. PMID:24214528

  2. Understanding the importance of "symbolic interaction stigma": How expectations about the reactions of others adds to the burden of mental illness stigma.

    Science.gov (United States)

    Link, Bruce G; Wells, Jennifer; Phelan, Jo C; Yang, Lawrence

    2015-06-01

    Important components of stigma include imagining what others might think of a stigmatized status, anticipating what might transpire in an interaction with others, and rehearsing what one might do if something untoward occurs. These imagined relations are here called symbolic interaction stigma and can have an impact even if the internalization of negative stereotypes fails to occur. Concepts and measures that capture symbolic interaction stigma are introduced, and a preliminary assessment of their impact is provided. Four self-report measures of symbolic interaction stigma (perceived devaluation discrimination, anticipation of rejection, stigma consciousness, and concern with staying in) were developed or adapted and administered to a sample of individuals who have experienced mental illness (N = 65). Regression analyses examined whether forms of symbolic interaction stigma were associated with withdrawal, self-esteem, and isolation from relatives independent of measures of internalization of stigma and rejection experiences. As evidenced by scores on 4 distinct measures, symbolic interaction stigma was relatively common in the sample, somewhat more common than the internalization of stigma. In addition, measures of symbolic interaction stigma were significantly associated with withdrawal, self-esteem, and isolation from relatives even when a measure of the internalization of stigma was statistically controlled. The study suggests the potential importance of considering symbolic interaction forms of stigma in understanding and addressing stigma and its consequences. Being aware of symbolic interaction stigma could be useful in enhancing rehabilitation goals if an approach to counteracting the negative effects of these aspects of stigma can be developed. (c) 2015 APA, all rights reserved).

  3. Signs of stigma and poor mental health among carriers of MRSA.

    Science.gov (United States)

    Rump, B; De Boer, M; Reis, R; Wassenberg, M; Van Steenbergen, J

    2017-03-01

    Many countries have implemented guidelines to prevent transmission of meticillin-resistant Staphylococcus aureus (MRSA). Important contextual factors of stigma can be identified in the context of MRSA. Over the past decade, concerns have been raised over a possible stigmatizing effect of these actions. To identify and quantify the occurrence of MRSA-associated stigma, and to explore its association with mental health in a country with an MRSA 'search and destroy' policy. In 2014, a questionnaire study among 57 Dutch MRSA carriers (people that carry MRSA without signs of MRSA infection) was performed. Stigma was measured with an adjusted version of the Berger HIV Stigma Scale. Mental health was measured with the five-item RAND Mental Health Inquiry. Thirty-two (56%) MRSA carriers reported stigma; of these, eight (14%) reported 'clear stigma' (Berger score >110) and 24 (42%) reported 'suggestive for stigma' (Berger score 76-110). Educational level, female sex and intensive MRSA eradication therapy were associated with higher stigma scores. Poor mental health (RAND score Stigma and mental health scores were inversely correlated. Stigma was experienced most frequently in healthcare settings, and was seldom experienced in the religious community or at sport facilities. A substantial proportion of MRSA carriers reported stigma due to MRSA, and stigma was associated with poor mental health. Anticipation of MRSA-associated stigma is warranted, both in the way that care is delivered by hospital staff and in the way that care is organized within the hospital. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  4. Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma

    Science.gov (United States)

    Earnshaw, Valerie; Smith, Laramie; Copenhaver, Michael

    2013-01-01

    Experiences of stigma from others among people with a history of drug addiction are understudied in comparison to the strength of stigma associated with drug addiction. Work that has studied these experiences has primarily focused on stigma experienced from healthcare workers specifically even though stigma is often experienced from other sources…

  5. Drug Addiction Stigma in the Context of Methadone Maintenance Therapy: An Investigation into Understudied Sources of Stigma

    Science.gov (United States)

    Earnshaw, Valerie; Smith, Laramie; Copenhaver, Michael

    2013-01-01

    Experiences of stigma from others among people with a history of drug addiction are understudied in comparison to the strength of stigma associated with drug addiction. Work that has studied these experiences has primarily focused on stigma experienced from healthcare workers specifically even though stigma is often experienced from other sources…

  6. Understanding the Importance of “Symbolic Interaction Stigma:” How Expectations about the Reactions of Others Adds to the Burden of Mental illness Stigma

    Science.gov (United States)

    Link, Bruce G.; Wells, Jennifer; Phelan, Jo C.; Yang, Lawrence

    2017-01-01

    Objective Important components of stigma include imagining what others might think of a stigmatized status, anticipating what might transpire in an interaction with others, and rehearsing what one might do if something untoward occurs. These imagined relations are here called “symbolic interaction stigma” and can be impactful even if the internalization of negative stereotypes fails to occur. Concepts and measures that capture symbolic interaction stigma are introduced and a preliminary assessment of their impact provided. Methods Four self-report measures of symbolic interaction stigma (perceived devaluation discrimination, anticipation of rejection, stigma consciousness and concern with staying in) were developed or adapted and administered to a sample of individuals who have experienced mental illness (N=65). Regression analyses examined whether forms of symbolic interaction stigma were associated with withdrawal, self-esteem and isolation from relatives independent of measures of internalization of stigma and rejection experiences. Results As evidenced by scores on four distinct measures symbolic interaction stigma was relatively common in the sample, somewhat more common than the internalization of stigma. Additionally, measures of symbolic interaction stigma were significantly associated with withdrawal, self-esteem and isolation from relatives even when a measure of the internalization of stigma was statistically controlled. Conclusions and Implications for Practice The study suggests the potential importance of considering symbolic interaction forms of stigma in understanding and addressing stigma and its consequences. Being aware of symbolic interaction stigma could be useful in enhancing rehabilitation goals if an approach to counteracting the negative effects of these aspects of stigma can be developed. PMID:26075528

  7. Estigma e discriminação vividos na escola por crianças e jovens órfãos por Aids Stigma and discrimination at school experienced by children and youngsters orphaned by AIDS

    Directory of Open Access Journals (Sweden)

    Eliana Miura Zucchi

    2010-12-01

    analyze episodes of stigma and discrimination related to HIV/AIDS at school. Integrated to a demographic study, an in-depth analysis was made of seven interviews conducted with pedagogical coordinators from six public and private schools of early childhood and fundamental education in the city of São Paulo. The majority of episodes of stigma experienced by children and youngsters within schools took place in circumstances of dating/sexuality, conflict with schoolmates, learning difficulties, disclosure of orphanhood by AIDS, and interaction between teachers and pupils with HIV, with the most frequently mentioned causes being: being HIV-positive, coming from a "dysfunctional family", and inequality in gender roles, age, and social class. Homophobia and racism were pointed out as stigma reinforcements. Descriptions were made of institutional responses to the AIDS stigma and of practices of prevention against STDs/AIDS. The episodes indicate the extent to which the stigma and discrimination related to HIV/AIDS can aggravate the social inequality already present within the sphere of education, obstructing the youngsters' rights to education, to family life, to leisure, to privacy, to secrecy/confidentiality, and to a love life. Such episodes also reveal the lack of prevention programs in the schools visited, and the difficulty of dealing with other forms of stigma (such as racism and the stigma of poverty.

  8. The relationship between stigma and self-reported willingness to use mental health services among rural and urban older adults.

    Science.gov (United States)

    Stewart, Hannah; Jameson, John Paul; Curtin, Lisa

    2015-05-01

    The large number of rural older adults suffering from untreated psychiatric illnesses suggests that stigma may be a significant barrier to the utilization of mental health services in this population. The current study examines self-stigma, public stigma, and attitudes toward specialty mental health care in a community sample of older adults living in a geographically isolated rural area, a rural area adjacent to a metropolitan area, and an urban area. One hundred and 29 older adults age 60 and above from the 3 geographic areas completed self-report measures of these constructs, and differences on the measures were assessed among the groups. Results indicated that older adults living in isolated rural counties demonstrated higher levels of public and self-stigma and lower levels of psychological openness than older adults in urban areas even after accounting for education, employment, and income. However, no differences emerged in reported willingness to use specialized mental health care in the event of significant distress. Results are discussed in the context of rural values, beliefs, and community structural factors. We further suggest that conventional binary rural/urban distinctions are not sufficient to understand the relationship between rurality and stigma. (c) 2015 APA, all rights reserved).

  9. Experiencing your own orthognathic surgery: a personal case report

    NARCIS (Netherlands)

    Mensink, G.; Gooris, P.; Mulder, F.; Gooris-Kuipers, C.; van Merkestyn, R.

    2015-01-01

    There has been much research on minimizing the side effects of orthognathic surgery. However, there are very few doctors and researchers who themselves have undergone this surgery. This case report describes the findings of a maxillofacial surgeon who underwent combined orthodontic and orthognathic

  10. Stroke-related stigma among West Africans: Patterns and predictors.

    Science.gov (United States)

    Sarfo, Fred Stephen; Nichols, Michelle; Qanungo, Suparna; Teklehaimanot, Abeba; Singh, Arti; Mensah, Nathaniel; Saulson, Raelle; Gebregziabher, Mulugeta; Ezinne, Uvere; Owolabi, Mayowa; Jenkins, Carolyn; Ovbiagele, Bruce

    2017-04-15

    Disability-adjusted life-years lost after stroke in Low & Middle-Income Countries (LMICs) is almost seven times those lost in High-income countries. Although individuals living with chronic neurological and mental disorders are prone to stigma, there is a striking paucity of literature on stroke-related stigma particularly from LMICs. To assess the prevalence, severity, determinants and psycho-social consequences of stigma among LMIC stroke survivors. Between November 2015 and February 2016, we conducted a cross-sectional survey of 200 consecutive stroke survivors attending a neurology clinic in a tertiary medical center in Ghana. The validated 8-Item Stigma Scale for Chronic Illness (SSCI-8) questionnaire was administered to study participants to assess internalized and enacted domains of stigma at the personal dimension with further adaptation to capture family and community stigma experienced by stroke participants. Responses on the SSCI-8 were scored from 1 to 5 for each item, where 1=never, 2=rarely, 3=sometimes, 4=often and 5=always with a score range of 8-40. Demographic and clinical data on stroke type and severity as well as depression and Health-Related Quality of Life indicators were also collected. Predictors of stroke-related stigma were assessed using Linear Models (GLM) via Proc GENMOD in SAS 9.4. 105 (52.5%) subjects recruited were males and the mean±SD age of stroke survivors in this survey was 62.0±14.4years. Mean SSCI-8 score was highest for personal stigma (13.7±5.7), which was significantly higher than family stigma (11.9±4.6; p=0.0005) and social/community stigma (11.4±4.4; pstigma. A graded increase in scores on the Geriatric Depression Scale and Centre for Epidemiological Studies-Depression scale was observed across the three categories. Living in an urban setting was associated with higher SSCI-8 scores. Moreover, stroke subjects with more severe post-stroke residual symptom deficits reported a significantly higher frequency of stigma

  11. Determinants of mental illness stigma for adolescents discharged from psychiatric hospitalization.

    Science.gov (United States)

    Moses, Tally

    2014-05-01

    Little is known about the factors that increase the risk for enacted mental illness stigma (i.e. rejection, devaluation and exclusion) as perceived by the stigmatized person. This is particularly true for the population of adolescents diagnosed with a mental illness. The aim of this study was to address this question and examine select social and clinical factors that predict enacted stigma (self-reported) with research that follows eighty American adolescents for 6 months following a first psychiatric hospitalization. Drawing on social identity theory, and research on stigma-threatening environments, social group identification and social support, this study tested four hypotheses: affiliation or identification with higher status and lower status peers predicts more and less stigma respectively (H1); a greater and more supportive social network, and more perceived family support predict less stigma (H2); greater severity of internalizing and externalizing symptoms predicts more stigma (H3); and poorer school functioning predicts more stigma (H4). Results indicated that about 70% of adolescents reported experiencing enacted stigma (at 6 months); disrespect or devaluation was more common than outright social rejection. Using OLS regression analyses, the results provided partial support for H1, H3 and H4, while H2 was not supported. The baseline factors found to be most predictive of enacted stigma ratings at 6-months were: affiliating with more friends with mental health problems, identifying with the 'populars' peer group, higher internalizing symptom ratings, and self-reported disciplinary problems at school. These four factors remained significant when controlling for initial enacted stigma ratings, pointing to their importance in determining changes in social stigma experiences in the follow-up period. They also remained significant when controlling for perceived public stigma ratings at follow-up, indicating that the findings were not due to generalized

  12. Measuring HIV stigma for PLHAs and nurses over time in five African countries.

    Science.gov (United States)

    Holzemer, William L; Makoae, Lucy N; Greeff, Minrie; Dlamini, Priscilla S; Kohi, Thecla W; Chirwa, Maureen L; Naidoo, Joanne R; Durrheim, Kevin; Cuca, Yvette; Uys, Yvette R

    2009-09-01

    The aim of this article is to document the levels of HIV stigma reported by persons living with HIV infections and nurses in Lesotho, Malawi, South Africa, Swaziland and Tanzania over a 1-year period. HIV stigma has been shown to negatively affect the quality of life for people living with HIV infection, their adherence to medication, and their access to care. Few studies have documented HIV stigma by association as experienced by nurses or other health care workers who care for people living with HIV infection. This study used standardised scales to measure the level of HIV stigma over time. A repeated measures cohort design was used to follow persons living with HIV infection and nurses involved in their care from five countries over a 1-year period in a three-wave longitudinal design. The average age of people living with HIV/AIDS (PLHAs) (N=948) was 36.15 years (SD=8.69), and 67.1% (N=617) were female. The average age of nurses (N=887) was 38.44 years (SD=9.63), and 88.6% (N=784) were females. Eighty-four per cent of all PLHAs reported one or more HIV-stigma events at baseline. This declined, but was still significant 1 year later, when 64.9% reported experiencing at least one HIV-stigma event. At baseline, 80.3% of the nurses reported experiencing one or more HIV-stigma events and this increased to 83.7% 1 year later. The study documented high levels of HIV stigma as reported by both PLHAs and nurses in all five of these African countries. These results have implications for stigma reduction interventions, particularly focused at health care providers who experience HIV stigma by association.

  13. Perceived and Actual Weight Stigma Among Romantic Couples

    Directory of Open Access Journals (Sweden)

    Brian Collisson

    2016-12-01

    Full Text Available According to research on weight bias, relationship stigma may be greater among romantic couples comprised of at least one overweight partner, as compared to two healthy-weight partners. However, comparison theories predict that the stigma of being overweight may be greater among mixed-weight couples (i.e., romantic partners with dissimilar body mass indexes; BMI than matched-weight couples (e.g., similarly overweight partners. To test these rival hypotheses, we assessed perceived and actual stigma experienced by mixed-weight and matched-weight couples. In two studies, people inferred (Study 1 or reported the actual amount (Study 2 of relational stigma and weight-related discomfort experienced by a healthy-weight/overweight person in a mixed/matched-weight relationship. Supporting the weight bias hypothesis, people inferred overweight people and their partners experience greater stigma and weight-related discomfort (Study 1. However, only overweight people in a matched-weight, as compared to mixed-weight, relationships actually reported greater relational stigma and weight-related discomfort (Study 2.

  14. Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective

    Directory of Open Access Journals (Sweden)

    Maisara Mhode

    2016-01-01

    Full Text Available Background. The impact of stigma on adherence to antiretroviral therapy (ART has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient. Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV. Design. A phenomenological approach was used to gather information on the lived experiences of stigma and discrimination. The sample size was determined according to the saturation principle. Results. Respondents experienced different forms of HIV-related stigma such as verbal, social, and perceived stigma. Various forms of discrimination were experienced, including relational discrimination, mistreatment by health care workers, blame and rejection by spouses, and workplace discrimination. HIV-related stigma and discrimination compromised ART adherence by reinforcing concealment of HIV status and undermining social suppport. Conclusion. After nearly a decade of increasing the provision of ART in Tanzania, PLHIV still experience stigma and discrimination; these experiences still appear to have a negative impact on treatment adherence. Efforts to reduce stigma and discrimination remain relevant in the ART period and should be given more impetus in order to maximize positive treatment outcomes.

  15. Factors associated with pregnant women's anticipations and experiences of HIV-related stigma in rural Kenya.

    Science.gov (United States)

    Cuca, Yvette P; Onono, Maricianah; Bukusi, Elizabeth; Turan, Janet M

    2012-01-01

    Pregnant women who fear or experience HIV-related stigma may not get care for their own health or medications to reduce perinatal transmission of HIV. This study examined factors associated with anticipating and experiencing HIV-related stigma among 1777 pregnant women attending antenatal care clinics in rural Kenya. Women were interviewed at baseline, offered HIV testing and care, and a sub-set was re-interviewed at 4-8 weeks postpartum. Women who were older, had less education, whose husbands had other wives, and who perceived community discrimination against people with HIV had significantly greater adjusted odds of anticipating HIV stigma. Over half of the HIV-positive women interviewed postpartum reported having experienced stigma, much of which was self-stigma. Women experiencing minor depression, and those whose family knew of their HIV status had significantly greater adjusted odds of experiencing stigma. Lack of women's empowerment, as well as depression, may be important risk factors for HIV-related stigma and discrimination.

  16. Internalized HIV and Drug Stigmas: Interacting Forces Threatening Health Status and Health Service Utilization Among People with HIV Who Inject Drugs in St. Petersburg, Russia.

    Science.gov (United States)

    Calabrese, Sarah K; Burke, Sara E; Dovidio, John F; Levina, Olga S; Uusküla, Anneli; Niccolai, Linda M; Heimer, Robert

    2016-01-01

    Marked overlap between the HIV and injection drug use epidemics in St. Petersburg, Russia, puts many people in need of health services at risk for stigmatization based on both characteristics simultaneously. The current study examined the independent and interactive effects of internalized HIV and drug stigmas on health status and health service utilization among 383 people with HIV who inject drugs in St. Petersburg. Participants self-reported internalized HIV stigma, internalized drug stigma, health status (subjective rating and symptom count), health service utilization (HIV care and drug treatment), sociodemographic characteristics, and health/behavioral history. For both forms of internalized stigma, greater stigma was correlated with poorer health and lower likelihood of service utilization. HIV and drug stigmas interacted to predict symptom count, HIV care, and drug treatment such that individuals internalizing high levels of both stigmas were at elevated risk for experiencing poor health and less likely to access health services.

  17. Brief Reports: Self-Stigma, Empowerment, and Perceived Legitimacy of Discrimination Among Women With Mental Illness

    National Research Council Canada - National Science Library

    Rüsch, Nicolas; Lieb, Klaus; Bohus, Martin; Corrigan, Patrick W

    2006-01-01

    OBJECTIVE: The study sought to better understand why some people with mental illness self-stigmatize and develop low self-esteem while others remain indifferent to stigma or respond with a sense of empowerment...

  18. Socio-demographic and AIDS-related factors associated with tuberculosis stigma in southern Thailand: a quantitative, cross-sectional study of stigma among patients with TB and healthy community members

    Directory of Open Access Journals (Sweden)

    Strauss Ronald P

    2011-08-01

    Full Text Available Abstract Background Tuberculosis (TB remains one of the most important infectious diseases worldwide. A comprehensive approach towards disease control that addresses social factors including stigma is now advocated. Patients with TB report fears of isolation and rejection that may lead to delays in seeking care and could affect treatment adherence. Qualitative studies have identified socio-demographic, TB knowledge, and clinical determinants of TB stigma, but only one prior study has quantified these associations using formally developed and validated stigma scales. The purpose of this study was to measure TB stigma and identify factors associated with TB stigma among patients and healthy community members. Methods A cross-sectional study was performed in southern Thailand among two different groups of participants: 480 patients with TB and 300 healthy community members. Data were collected on socio-demographic characteristics, TB knowledge, and clinical factors. Scales measuring perceived TB stigma, experienced/felt TB stigma, and perceived AIDS stigma were administered to patients with TB. Community members responded to a community TB stigma and community AIDS stigma scale, which contained the same items as the perceived stigma scales given to patients. Stigma scores could range from zero to 30, 33, or 36 depending on the scale. Three separate multivariable linear regressions were performed among patients with TB (perceived and experience/felt stigma and community members (community stigma to determine which factors were associated with higher mean TB stigma scores. Results Only low level of education, belief that TB increases the chance of getting AIDS, and AIDS stigma were associated with higher TB stigma scores in all three analyses. Co-infection with HIV was associated with higher TB stigma among patients. All differences in mean stigma scores between index and referent levels of each factor were less than two points, except for

  19. Socio-demographic and AIDS-related factors associated with tuberculosis stigma in southern Thailand: a quantitative, cross-sectional study of stigma among patients with TB and healthy community members.

    Science.gov (United States)

    Kipp, Aaron M; Pungrassami, Petchawan; Nilmanat, Kittikorn; Sengupta, Sohini; Poole, Charles; Strauss, Ronald P; Chongsuvivatwong, Virasakdi; Van Rie, Annelies

    2011-08-30

    Tuberculosis (TB) remains one of the most important infectious diseases worldwide. A comprehensive approach towards disease control that addresses social factors including stigma is now advocated. Patients with TB report fears of isolation and rejection that may lead to delays in seeking care and could affect treatment adherence. Qualitative studies have identified socio-demographic, TB knowledge, and clinical determinants of TB stigma, but only one prior study has quantified these associations using formally developed and validated stigma scales. The purpose of this study was to measure TB stigma and identify factors associated with TB stigma among patients and healthy community members. A cross-sectional study was performed in southern Thailand among two different groups of participants: 480 patients with TB and 300 healthy community members. Data were collected on socio-demographic characteristics, TB knowledge, and clinical factors. Scales measuring perceived TB stigma, experienced/felt TB stigma, and perceived AIDS stigma were administered to patients with TB. Community members responded to a community TB stigma and community AIDS stigma scale, which contained the same items as the perceived stigma scales given to patients. Stigma scores could range from zero to 30, 33, or 36 depending on the scale. Three separate multivariable linear regressions were performed among patients with TB (perceived and experience/felt stigma) and community members (community stigma) to determine which factors were associated with higher mean TB stigma scores. Only low level of education, belief that TB increases the chance of getting AIDS, and AIDS stigma were associated with higher TB stigma scores in all three analyses. Co-infection with HIV was associated with higher TB stigma among patients. All differences in mean stigma scores between index and referent levels of each factor were less than two points, except for incorrectly believing that TB increases the chance of getting

  20. Hearing Voices: Qualitative Research with Postsecondary Students Experiencing Mental Illness

    Science.gov (United States)

    Venville, Annie; Street, Annette F.

    2014-01-01

    Vocational Education and Training (VET) students experiencing mental illness have been described as one of the most vulnerable student groups in the Australian post-secondary sector. This vulnerability can be attributed to the impacts of illness, the oft-reported experiences of stigma and discrimination, and low educational outcomes. There is…

  1. Hearing Voices: Qualitative Research with Postsecondary Students Experiencing Mental Illness

    Science.gov (United States)

    Venville, Annie; Street, Annette F.

    2014-01-01

    Vocational Education and Training (VET) students experiencing mental illness have been described as one of the most vulnerable student groups in the Australian post-secondary sector. This vulnerability can be attributed to the impacts of illness, the oft-reported experiences of stigma and discrimination, and low educational outcomes. There is…

  2. Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness.

    Science.gov (United States)

    Rüsch, Nicolas; Müller, Mario; Lay, Barbara; Corrigan, Patrick W; Zahn, Roland; Schönenberger, Thekla; Bleiker, Marco; Lengler, Silke; Blank, Christina; Rössler, Wulf

    2014-02-01

    Compulsory admission to psychiatric inpatient treatment can be experienced as disempowering and stigmatizing by people with serious mental illness. However, quantitative studies of stigma-related emotional and cognitive reactions to involuntary hospitalization and their impact on people with mental illness are scarce. Among 186 individuals with serious mental illness and a history of recent involuntary hospitalization, shame and self-contempt as emotional reactions to involuntary hospitalization, the cognitive appraisal of stigma as a stressor, self-stigma, empowerment as well as quality of life and self-esteem were assessed by self-report. Psychiatric symptoms were rated by the Brief Psychiatric Rating Scale. In multiple linear regressions, more self-stigma was predicted independently by higher levels of shame, self-contempt and stigma stress. A greater sense of empowerment was related to lower levels of stigma stress and self-contempt. These findings remained significant after controlling for psychiatric symptoms, diagnosis, age, gender and the number of lifetime involuntary hospitalizations. Increased self-stigma and reduced empowerment in turn predicted poorer quality of life and reduced self-esteem. The negative effect of emotional reactions and stigma stress on quality of life and self-esteem was largely mediated by increased self-stigma and reduced empowerment. Shame and self-contempt as reactions to involuntary hospitalization as well as stigma stress may lead to self-stigma, reduced empowerment and poor quality of life. Emotional and cognitive reactions to coercion may determine its impact more than the quantity of coercive experiences. Interventions to reduce the negative effects of compulsory admissions should address emotional reactions and stigma as a stressor.

  3. The impact of recovery-oriented day clinic treatment on internalized stigma: preliminary report.

    Science.gov (United States)

    Sibitz, Ingrid; Provaznikova, Katarina; Lipp, Madeleine; Lakeman, Richard; Amering, Michaela

    2013-10-30

    Internalized stigma is a complicating feature in the treatment of schizophrenia spectrum disorders and considerably hinders the recovery process. The empowerment and recovery-oriented program of our day clinic might contribute to a reduction in internalized stigma. The aim of the study was to explore the influence of this day clinic program on internalized stigma and other subjectively important outcome measures such as quality of life and psychopathology. Data from two groups of patients had been collected twice, at baseline and after 5 weeks. The experimental group attended the day clinic treatment (N=40) and the control group waited for the day clinic treatment (N=40). The following significant differences between the two groups were found: Patients in day clinic treatment showed a reduction in internalized stigma while the control group showed a minimal increase (Cohen's d=0.446). The experimental group as compared with the control group also showed a greater improvement in the quality of life domain psychological health (Cohen's d=0.6) and in overall psychopathology (Cohen's d=0.452). Interestingly, changes in internalized stigma and psychological quality of life were not associated with changes in psychopathology. Results are encouraging but have to be confirmed in a randomized design. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Factors Associated with Pregnant Women’s Anticipations and Experiences of HIV-related Stigma in Rural Kenya

    Science.gov (United States)

    Cuca, Yvette P.; Onono, Maricianah; Bukusi, Elizabeth; Turan, Janet M.

    2012-01-01

    Pregnant women who fear or experience HIV-related stigma may not get care for their own health or medications to reduce perinatal transmission of HIV. This study examined factors associated with anticipating and experiencing HIV-related stigma among 1,777 pregnant women attending antenatal care clinics in rural Kenya. Women were interviewed at baseline, offered HIV testing and care, and a sub-set was re-interviewed at 4–8 weeks postpartum. Women who were older, had less education, whose husbands had other wives, and who perceived community discrimination against people with HIV had significantly greater adjusted odds of anticipating HIV stigma. Over half of the HIV-positive women interviewed postpartum reported having experienced stigma, much of which was self-stigma. Women experiencing minor depression, and those whose family knew of their HIV status had significantly greater adjusted odds of experiencing stigma. Lack of women’s empowerment, as well as depression, may be important risk factors for HIV-related stigma and discrimination. PMID:22799618

  5. Understanding internalized HIV/AIDS-related stigmas in the Dominican Republic: a short report.

    Science.gov (United States)

    Rael, Christine Tagliaferri; Hampanda, Karen

    2016-01-01

    HIV/AIDS-related stigmas can become internalized, resulting in declines in physical and mental health. Pathways to internalized HIV-related stigma (IS), characterized by persistently negative, self-abasing thoughts, are not well established among women living with HIV/AIDS (WLWHA) in the Dominican Republic (DR). Identifying factors involved in self-directed shaming and blaming is important, given the high HIV prevalence in the DR's most vulnerable populations. The present study sheds light on factors involved in negative and self-abasing thoughts in WLWHA in the DR by examining the relationship between depression, perceived HIV-related stigma from the community (PSC), perceived HIV-related stigma from family (PSF), and IS. The Internalized AIDS-Related Stigma Scale (IA-RSS), the Center for Epidemiologic Studies Short Depression Scale (CES-D 10), and an instrument designed to measure perceived HIV-related stigma from the community and family was administered to 233 WLWHA in Puerto Plata, DR. Data were analyzed using descriptive statistics and ordered multiple logistic regression. Results showed that depression (OR = 1.60; p < .05), PSC (OR = 3.68; p < .001), and PSF (OR = 1.60; p < .01) were positively associated with IS. These findings indicate that IS-reducing interventions should address HIV-related depression. Additionally, HIV-related treatment and care services should work with WLWHA to adopt healthier attitudes about how community members view people living with HIV/AIDS in the DR.

  6. 'This is a natural process': managing menstrual stigma in Nepal.

    Science.gov (United States)

    Crawford, Mary; Menger, Lauren M; Kaufman, Michelle R

    2014-01-01

    Menstrual stigma has been demonstrated in many societies. However, there is little research on menstrual attitudes in South Asia, despite religiously-based menstrual restrictions imposed on women. To understand menstrual stigma in this context, we conducted qualitative research with women in Nepal. Nepali Hinduism forbids menstruating women to enter a temple or kitchen, share a bed with a husband or touch a male relative. During menstruation, women are 'untouchable'. There has been virtually no research on how Nepali women make meaning of these practices. The current study employed focus groups and individual interviews to understand how some Nepali women experience menarche and menstrual stigma. We explored how women describe their experiences and the strategies they adopt to manage age-old stigma in a rapidly modernising society where they have multiple roles as workers, wives and mothers. Participants reported they experienced menarche with little preparation, which caused distress, and were subjected to ongoing stigmatisation as menstruating women. They described coping strategies to reduce the effects of this stigma. This study provides a unique perspective on coping with menstrual stigma in South Asia.

  7. The stigma of migraine.

    Directory of Open Access Journals (Sweden)

    William B Young

    Full Text Available BACKGROUND: People who have a disease often experience stigma, a socially and culturally embedded process through which individuals experience stereotyping, devaluation, and discrimination. Stigma has great impact on quality of life, behavior, and life chances. We do not know whether or not migraine is stigmatizing. METHODS: We studied 123 episodic migraine patients, 123 chronic migraine patients, and 62 epilepsy patients in a clinical setting to investigate the extent to which stigma attaches to migraine, using epilepsy as a comparison. We used the stigma scale for chronic illness, a 24-item questionnaire suitable for studying chronic neurologic diseases, and various disease impact measures. RESULTS: Patients with chronic migraine had higher scores (54.0±20.2 on the stigma scale for chronic illness than either episodic migraine (41.7±14.8 or epilepsy patients (44.6±16.3 (p<0.001. Subjects with migraine reported greater inability to work than epilepsy subjects. Stigma correlated most strongly with the mental component score of the short form of the medical outcomes health survey (SF-12, then with ability to work and migraine disability score for chronic and episodic migraine and the Liverpool impact on epilepsy scale for epilepsy. Analysis of covariance showed adjusted scores for the stigma scale for chronic illness were similar for chronic migraine (49.3; 95% confidence interval, 46.2 to 52.4 and epilepsy (46.5; 95% confidence interval, 41.6 to 51.6, and lower for episodic migraine (43.7; 95% confidence interval, 40.9 to 46.6. Ability to work was the strongest predictor of stigma as measured by the stigma scale for chronic illness. CONCLUSION: In our model, adjusted stigma was similar for chronic migraine and epilepsy, which were greater than for episodic migraine. Stigma correlated most strongly with inability to work, and was greater for chronic migraine than epilepsy or episodic migraine because chronic migraine patients had less ability

  8. Relationship between personality traits and perceived internalized stigma in bipolar patients and their treatment partners.

    Science.gov (United States)

    Bassirnia, Anahita; Briggs, Jessica; Kopeykina, Irina; Mednick, Amy; Yaseen, Zimri; Galynker, Igor

    2015-12-15

    Internalized stigma of mental disorders has significant negative outcomes for patients with bipolar disorder and their families. The aim of this study is to evaluate the association between personality traits and internalized stigma of mental disorders in bipolar patients and their treatment partners. Five different questionnaires were utilized in this study: (1) Demographic data questionnaire, (2) Millon Clinical Multiaxial Inventory-III (MCMI-III) for personality traits, (3) Internalized Stigma of Mental Illness (ISMI) for stigma, (4) Self Report Manic Inventory (SRMI) for mania and (5) Center for Epidemiological Studies-Depression Scale (CES-D) for depression. The scores of personality traits were combined to create externalizing and internalizing personality trait scores. Results showed that patients with bipolar disorder and their treatment partners both experienced internalized stigma of mental health disorders. There was a significant positive correlation between internalized stigma and internalizing personality traits, but not externalizing traits. In a multi-variate regression analysis, internalizing personality trait score was found to be a significant predictor of internalized stigma. In conclusion, patients with bipolar disorder and their treatment partners perceive higher level of internalized stigma of mental disorders if they have internalizing personality traits.

  9. Stigma toward the rural-to-urban migrants in China: A qualitative study

    Directory of Open Access Journals (Sweden)

    Jian Guan

    2011-06-01

    Full Text Available The paper discusses the status stigma of rural-to-urban migrants in China from the perspective of social representations. Stigma associated with social status is frequently reported in academic community but there is little published information about stigma towards rural-to-urban migrants in China. The data were collected by open-ended individual interviews with 138 participants (60 urban citizens and 78 rural-to-urban migrants in a general community in Tianjin city. On the basis of research data, this study identify, describe and analyze the structured content and meaning of social stigma towards rural-to-urban migrants which are entrenched in Chinese society and communicated by urban citizens. This study found the three dimensions (appearance, peril and origin of stigmatizing conditions on rural-to-urban migrants from urban citizens. Interpersonal interaction of stigma between migrants and citizens are differentiation and labeling, linking of labeled differences with stereotypes, differentiation between ingroup and outgroup, involving experienced status loss and discrimination. And then, there are asymmetries between stigma and perceived stigma. The results show, the social stigma towards rural-to-urban migrants as a social representation is embedded deeply in the collective memory of Chinese society, and it is generated from, and dialogically interdependent with the socio-cultural context.

  10. Use of Online Forums for Perinatal Mental Illness, Stigma, and Disclosure: An Exploratory Model.

    Science.gov (United States)

    Moore, Donna; Drey, Nicholas; Ayers, Susan

    2017-02-20

    Perinatal mental illness is a global health concern; however, many women with the illness do not get the treatment they need to recover. Interventions that reduce the stigma around perinatal mental illness have the potential to enable women to disclose their symptoms to health care providers and consequently access treatment. There are many online forums for perinatal mental illness and thousands of women use them. Preliminary research suggests that online forums may promote help-seeking behavior, potentially because they have a role in challenging stigma. This study draws from these findings and theoretical concepts to present a model of forum use, stigma, and disclosure. This study tested a model that measured the mediating role of stigma between online forum use and disclosure of affective symptoms to health care providers. A Web-based survey of 200 women who were pregnant or had a child younger than 5 years and considered themselves to be experiencing psychological distress was conducted. Women were recruited through social media and questions measured forum usage, perinatal mental illness stigma, disclosure to health care providers, depression and anxiety symptoms, barriers to disclosure, and demographic information. There was a significant positive indirect effect of length of forum use on disclosure of symptoms through internal stigma, b=0.40, bias-corrected and accelerated (BCa) 95% CI 0.13-0.85. Long-term forum users reported higher levels of internal stigma, and higher internal stigma was associated with disclosure of symptoms to health care providers when controlling for symptoms of depression and anxiety. Internal stigma mediates the relationship between length of forum use and disclosure to health care providers. Findings suggest that forums have the potential to enable women to recognize and reveal their internal stigma, which may in turn lead to greater disclosure of symptoms to health care providers. Clinicians could refer clients to trustworthy and

  11. Self-reported stigma and its association with socio-demographic factors and physical disability in people with intellectual disabilities: results from a cross-sectional study in England.

    Science.gov (United States)

    Ali, Afia; King, Michael; Strydom, Andre; Hassiotis, Angela

    2016-03-01

    The aim of this study was to investigate whether socio-demographic variables and physical disability (e.g. sensory impairment and mobility problems) were associated with self-reported stigma in people with intellectual disabilities (ID), and to examine whether age, sex and ethnicity modified the relationship between severity of intellectual disability and self-reported stigma. 229 participants with mild or moderate intellectual disabilities were recruited from 12 centres/sites in England from community intellectual disability services, day centres, supported housing schemes, voluntary organisations and invitation letters. Information on physical disability and socio-demographic variables were obtained using a structured data collection form. Self-reported stigma was measured using a validated questionnaire. Age was associated with self-reported stigma, with older adults reporting more stigmatising experiences. Participants with moderate intellectual disabilities were more likely to report being treated differently such as being made fun of and being treated like children. Physical disability such as sensory, mobility and speech problems were not associated with self-reported stigma. Gender modified the relationship between severity of ID and self-reported stigma as participants who were male and had moderate ID were more likely to report stigma compared to females with moderate ID. Categorical age also modified the relationship between severity of ID and self-reported stigma as older participants who had moderate ID were more likely to report stigma compared to younger people with moderate ID. Older adults and those with moderate ID are potentially at higher risk of being targets of public stigma or are more likely to report stigma. Interventions to help individuals cope with stigma could be targeted to this group.

  12. The Experience of Sexual Stigma and the Increased Risk of Attempted Suicide in Young Brazilian People from Low Socioeconomic Group

    Science.gov (United States)

    Brandelli Costa, Angelo; Pasley, Andrew; Machado, Wagner de Lara; Alvarado, Ernesto; Dutra-Thomé, Luciana; Koller, Silvia Helena

    2017-01-01

    This study was intended to analyze the intersection of experience of sexual stigma low-socioeconomic status, and suicide attempt amongst young Brazilians (11–24 years old). In each of the data collection periods (2004–2006: n = 7185; 2010–2012: n = 2734), participants completed a questionnaire-based instrument. Network analysis provided support for a Minority Stress Model, oriented around whether participants had experienced sexual stigma. Although suicide attempts decreased by 20% for participants who had not experienced sexual stigma, there was a 60% increase for those who had experienced sexual stigma. Of particular note were the increases in rates of reported community and familial physical assault, molestation, and rape for those who had experienced sexual stigma. An analysis of centrality statistics demonstrated that both experiences of this Minority Stress Model were fundamentally different, and that those disparities increased over the time frame observed in this study. At the center of this model, shortest paths statistics exhibited a direct conditioned connection between experiencing sexual stigma and suicide attempts. We discuss the social and historical contexts that contributed to these dynamics, and emphasize the need for policy change. PMID:28275356

  13. The Experience of Sexual Stigma and the Increased Risk of Attempted Suicide in Young Brazilian People from Low Socioeconomic Group.

    Science.gov (United States)

    Brandelli Costa, Angelo; Pasley, Andrew; Machado, Wagner de Lara; Alvarado, Ernesto; Dutra-Thomé, Luciana; Koller, Silvia Helena

    2017-01-01

    This study was intended to analyze the intersection of experience of sexual stigma low-socioeconomic status, and suicide attempt amongst young Brazilians (11-24 years old). In each of the data collection periods (2004-2006: n = 7185; 2010-2012: n = 2734), participants completed a questionnaire-based instrument. Network analysis provided support for a Minority Stress Model, oriented around whether participants had experienced sexual stigma. Although suicide attempts decreased by 20% for participants who had not experienced sexual stigma, there was a 60% increase for those who had experienced sexual stigma. Of particular note were the increases in rates of reported community and familial physical assault, molestation, and rape for those who had experienced sexual stigma. An analysis of centrality statistics demonstrated that both experiences of this Minority Stress Model were fundamentally different, and that those disparities increased over the time frame observed in this study. At the center of this model, shortest paths statistics exhibited a direct conditioned connection between experiencing sexual stigma and suicide attempts. We discuss the social and historical contexts that contributed to these dynamics, and emphasize the need for policy change.

  14. Work-related discrimination and change in self-stigma among people with mental illness during supported employment.

    Science.gov (United States)

    Rüsch, Nicolas; Nordt, Carlos; Kawohl, Wolfram; Brantschen, Elisabeth; Bärtsch, Bettina; Müller, Mario; Corrigan, Patrick W; Rössler, Wulf

    2014-12-01

    The relationship of work-related discrimination to the change in self-stigma and stigma stress was assessed among supported employment participants in Switzerland. Self-stigma and the cognitive appraisal of mental illness stigma as a stressor were measured at baseline among supported employment participants (N=116). These variables and work-related discrimination in the past year were assessed one year later (N=96). Compared with participants who did not find employment (N=30), those who worked without experiencing discrimination (N=25) had lower levels of self-stigma and stigma stress at one year. Among those who worked and reported work-related discrimination (N=38), these measures did not decrease significantly. Experiencing discrimination at work may determine whether employment has positive effects in terms of self-stigma and stigma stress among individuals with mental illness. Interventions to reduce discrimination in work settings and to improve coping resources of these individuals could augment the positive effects of supported employment.

  15. Dentistry and HIV/AIDS related stigma

    Science.gov (United States)

    Elizondo, Jesus Eduardo; Treviño, Ana Cecilia; Violant, Deborah

    2015-01-01

    OBJECTIVE To analyze HIV/AIDS positive individual’s perception and attitudes regarding dental services. METHODS One hundred and thirty-four subjects (30.0% of women and 70.0% of men) from Nuevo León, Mexico, took part in the study (2014). They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis. RESULTS Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients’ HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%); the ones who have not had those experiences, but feel somewhat concerned (12.7%); and the ones who underwent stigma and discrimination and feel concerned (2.3%). CONCLUSIONS We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment. PMID:26538100

  16. Dentistry and HIV/AIDS related stigma

    Directory of Open Access Journals (Sweden)

    Jesus Eduardo Elizondo

    2015-01-01

    Full Text Available OBJECTIVE To analyze HIV/AIDS positive individual’s perception and attitudes regarding dental services.METHODS One hundred and thirty-four subjects (30.0% of women and 70.0% of men from Nuevo León, Mexico, took part in the study (2014. They filled out structured, analytical, self-administered, anonymous questionnaires. Besides the sociodemographic variables, the perception regarding public and private dental services and related professionals was evaluated, as well as the perceived stigma associated with HIV/AIDS, through a Likert-type scale. The statistical evaluation included a factorial and a non-hierarchical cluster analysis.RESULTS Social inequalities were found regarding the search for public and private dental professionals and services. Most subjects reported omitting their HIV serodiagnosis and agreed that dentists must be trained and qualified to treat patients with HIV/AIDS. The factorial analysis revealed two elements: experiences of stigma and discrimination in dental appointments and feelings of concern regarding the attitudes of professionals or their teams concerning patients’ HIV serodiagnosis. The cluster analysis identified three groups: users who have not experienced stigma or discrimination (85.0%; the ones who have not had those experiences, but feel somewhat concerned (12.7%; and the ones who underwent stigma and discrimination and feel concerned (2.3%.CONCLUSIONS We observed a low percentage of stigma and discrimination in dental appointments; however, most HIV/AIDS patients do not reveal their serodiagnosis to dentists out of fear of being rejected. Such fact implies a workplace hazard to dental professionals, but especially to the very own health of HIV/AIDS patients, as dentists will not be able to provide them a proper clinical and pharmaceutical treatment.

  17. Use of indigenous cultural idioms by Chinese immigrant relatives for psychosis: impacts on stigma and psychoeducational approaches.

    Science.gov (United States)

    Yang, Lawrence H; Singla, Daisy R

    2011-11-01

    Indigenous interpretations of mental illness might negatively impact treatment adherence. However, psychiatric "labeling" potentially leads to stigma among Chinese groups, thus encouraging the use of indigenous idioms. We examined how relatives' use of indigenous labeling varied with the consumers' experience of illness and whether indigenous labeling protected relatives from internalized and experienced forms of stigma. Forty-nine relatives of Chinese-immigrant consumers with psychosis were sampled. Although consumers had progressed to the middle stages of psychosis, 39% of relatives used indigenous idioms to label psychosis. Indigenous labeling decreased when illness duration increased and when visual hallucinations were present. Indigenous labeling further predicted lower internalized stigma among relatives. Relatives who used indigenous labeling also reported fewer indirect stigma experiences, although not after controlling for illness severity. The frequency of direct discrimination among relatives did not differ by labeling. These forms of felt stigma might be embedded into relatives' psychoeducation programs to mitigate adverse consequences of psychiatric labeling.

  18. Experiences of HIV-related stigma among young men who have sex with men.

    Science.gov (United States)

    Dowshen, Nadia; Binns, Helen J; Garofalo, Robert

    2009-05-01

    Young men who have sex with men (MSM) represent an increasing number of new HIV infections in many communities. Many individuals still hold beliefs that may lead to discrimination against HIV-positive individuals. HIV stigma is associated with negative health and psychosocial outcomes and may lead to greater challenges for this marginalized population. This study describes stigma experienced by HIV-positive young MSM, explores its relationship to psychosocial measures, and tests the hypothesis that stigma scores will be higher in those diagnosed less than 1 year ago versus more than 1 year. From August 2004 to September 2005 young MSM completed a questionnaire including demographic information and psychosocial measures. Descriptive and bivariate analyses of association were used to interpret data from the total stigma scale and four subscales: personalized stigma (PS), public attitudes (PA), negative self-image (NSI), and disclosure concerns (DC). Index scores were calculated by standardizing each subscale for direct comparisons. The 42 participants were: mean 21.3 years; 45% black, 24% Hispanic, 26% white; 14% transgender; and 50% diagnosed HIV-positive less than 1 year. Participants reported HIV-related stigma across all domains with mean index subscale scores: PS 0.57, PA 0.61, NSI 0.63, DC 0.75 indicating that disclosure concerns were prevalent in comparison to other forms of HIV-related stigma. Stigma scores correlated with depression, social support, self-esteem, and romantic loneliness. Stigma scores did not differ for those diagnosed less than 1 year ago versus more than 1 year ago. Providers should address HIV-related stigma concerns, particularly disclosure, throughout the trajectory of the illness when caring for HIV-positive young MSM as a factor affecting health outcomes and psychosocial functioning.

  19. A qualitative study of stigma and discrimination against people living with HIV in Ho Chi Minh City, Vietnam.

    Science.gov (United States)

    Thi, Mai Doan Anh; Brickley, Deborah Bain; Vinh, Dang Thi Nhat; Colby, Donn J; Sohn, Annette H; Trung, Nguyen Quang; Giang, Le Truong; Mandel, Jeffrey S

    2008-07-01

    Stigma and discrimination against people living with HIV/AIDS (PLHIV) are a pressing problem in Vietnam, in particular because of propaganda associating HIV with the "social evils" of sex work and drug use. There is little understanding of the causes and sequelae of stigma and discrimination against PLHIV in Vietnam. Fifty-three PLHIV participated in focus group discussions in Ho Chi Minh City. Nearly all participants experienced some form of stigma and discrimination. Causes included exaggerated fears of HIV infection, misperceptions about HIV transmission, and negative representations of PLHIV in the media. Participants faced problems getting a job, perceived unfair treatment in the workplace and experienced discrimination in the healthcare setting. Both discrimination and support were reported in the family environment. There is a need to enforce laws against discrimination and provide education to decrease stigma against PLHIV in Vietnam. Recent public campaigns encouraging compassion toward PLHIV and less discrimination from healthcare providers who work with PLHIV have been encouraging.

  20. Stigma, agency and recovery amongst people with severe mental illness.

    Science.gov (United States)

    Whitley, Rob; Campbell, Rosalyn Denise

    2014-04-01

    Evidence suggests that people with a severe mental illness still suffer high levels of stigma and discrimination. However little is known about how people with a severe mental illness manage such stigma. As such, the overall aim of this study is to document and analyze behavioral and psychological strategies of stigma management and control in a sample of people in recovery from a severe mental illness. To meet this aim, we conducted a five-year (2008-2012) qualitative longitudinal study in Washington D.C. Participants were recruited from small-scale congregate housing units ('recovery communities') for people in recovery, provided by a public mental health agency. We conducted regular focus groups at these communities, augmented by in-depth participant observation. Analysis was propelled by the grounded theory approach. A key finding of this study is that stigma and discrimination were not perceived as commonly experienced problems by participants. Instead, stigma and discrimination were perceived as omnipresent potential problems to which participants remained eternally vigilant, taking various preventive measures. Most notable among these measures was a concerted and self-conscious effort to behave and look 'normal'; through dress, appearance, conduct and demeanor. In this endeavor, participants possessed and deployed a considered degree of agency to prevent, avoid or preempt stigma and discrimination. These efforts appeared to have a strong semiotic dimension, as participants reported their developing 'normality' (and increased agentic power) was tangible proof of their ongoing recovery. Participants also routinely discussed severe mental illness in normative terms, noting its similarity to physical illnesses such as diabetes, or to generic mental health problems experienced by all. These behavioral and psychological strategies of normalization appeared to be consolidated within the recovery communities, which provided physical shelter and highly-valued peer

  1. LSD Flashbacks - The Appearance of New Visual Imagery Not Experienced During Initial Intoxication: Two Case Reports.

    Science.gov (United States)

    G Lerner, Arturo; Goodman, Craig; Rudinski, Dmitri; Lev-Ran, Shaul

    2014-01-01

    A side effect associated with the use of synthetic hallucinogens such as lysergic acid diethylamide-(LSD) is the partial or total recurrence of perceptual disturbances which previously appeared during intoxication, despite absence of recent use. These are commonly referred to as "flashbacks" or Hallucinogen Persisting Perception Disorder (HPPD). Here we present two cases of patients with a prior history of LSD use who turned to psychiatric consultation following brief episodes of HPPD. Surprisingly, in both cases new visual imagery appeared during episodes of flashbacks which was not experienced during primary LSD use. Both subjects reported the ability to discern between LSD-associated visual disturbances and new visual imagery. This phenomenon did not cause functional impairment and in both cases caused gradual concern due to its persistence. Both patients refused medical treatment and continued psychiatric follow-up. At one year follow-up both patients reported almost complete spontaneous remission. To the best of our knowledge these are the first reported cases of LSD-related benign flashbacks in which new imagery is experienced. Reasons for this reversible and apparently harmless side effect are proposed. Conclusions from case reports should be taken with caution.

  2. Measuring Type 1 diabetes stigma: development and validation of the Type 1 Diabetes Stigma Assessment Scale (DSAS-1).

    Science.gov (United States)

    Browne, J L; Ventura, A D; Mosely, K; Speight, J

    2017-09-11

    To develop and validate a self-report measure designed to assess perceived and experienced stigma for adults with Type 1 diabetes: the Type 1 Diabetes Stigma Assessment Scale. A large item-pool (64 items) was drafted based on qualitative data from interviews with 27 adults with Type 1 diabetes. Eleven adults with Type 1 diabetes completed the draft questionnaire (responding to items using a five-point Likert scale), and participated in cognitive debriefing interviews. Based on their feedback, the item-pool was reduced and refined. Adults with Type 1 diabetes (N=898) completed an online survey including the draft stigma questionnaire (41 items) and other validated measures. Psychometric validation included principal components analysis and confirmatory factor analysis (split samples), internal consistency reliability assessment and Spearman's rho correlations. Scale reduction techniques resulted in 19 items (α=0.93). An unforced three-factor solution suggested three subscales: Treated Differently (six items, α=0.89); Blame and Judgement (six items, α=0.88); and Identity Concerns (seven items, α=0.89). This was corroborated with a confirmatory factor analysis, which demonstrated reasonable model fit with the three factors; less so for a single-factor model. Satisfactory concurrent, convergent and discriminant validity were demonstrated. The 19-item Type 1 Diabetes Stigma Assessment Scale is a valid and reliable measure of the perceptions and experiences of Type 1 diabetes stigma. This novel, relatively brief measure has satisfactory psychometric properties. The Type 1 Diabetes Stigma Assessment Scale is now available for investigations into the nature and magnitude of the relationships between diabetes stigma and diabetes self-care behaviours and outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  3. The Stigma of Hearing Loss

    Science.gov (United States)

    Wallhagen, Margaret I.

    2010-01-01

    Purpose: To explore dimensions of stigma experienced by older adults with hearing loss and those with whom they frequently communicate to target interventions promoting engagement and positive aging. Design and Methods: This longitudinal qualitative study conducted interviews over 1 year with dyads where one partner had hearing loss. Participants…

  4. The Stigma of Hearing Loss

    Science.gov (United States)

    Wallhagen, Margaret I.

    2010-01-01

    Purpose: To explore dimensions of stigma experienced by older adults with hearing loss and those with whom they frequently communicate to target interventions promoting engagement and positive aging. Design and Methods: This longitudinal qualitative study conducted interviews over 1 year with dyads where one partner had hearing loss. Participants…

  5. Youth Homelessness and Social Stigma

    Science.gov (United States)

    Kidd, Sean A.

    2007-01-01

    Building upon previous exploratory qualitative research (Kidd S.A. (2003) "Child Adol. Social Work J." 20(4):235-261), this paper examines the mental health implications of social stigma as it is experienced by homeless youth. Surveys conducted with 208 youths on the streets and in agencies in New York City and Toronto revealed…

  6. Youth Homelessness and Social Stigma

    Science.gov (United States)

    Kidd, Sean A.

    2007-01-01

    Building upon previous exploratory qualitative research (Kidd S.A. (2003) "Child Adol. Social Work J." 20(4):235-261), this paper examines the mental health implications of social stigma as it is experienced by homeless youth. Surveys conducted with 208 youths on the streets and in agencies in New York City and Toronto revealed significant…

  7. Caregiver Stigma and Burden in Memory Disorders: An Evaluation of the Effects of Caregiver Type and Gender

    Directory of Open Access Journals (Sweden)

    Phoebe V. Kahn

    2016-01-01

    Full Text Available Despite considerable gains in public awareness of dementia, dementia patients and their caregivers continue to be stigmatized. Previous work has explored stigma and burden among adult children of persons with dementia in Israel, but no similar data exist for spousal caregivers or caregivers in general in the United States. This study examines the differences in stigma and burden experienced by spousal and adult child caregivers and male and female caregivers of persons with dementia. Eighty-two caregivers were given the Zarit Burden Inventory Short Form (ZBI and the Caregiver Section of the Family Stigma in Alzheimer’s Disease Scale (FS-ADS-C. Scores on the FS-ADS-C and ZBI were positively correlated (rs=.51, p<.001. Female caregivers reported experiencing more stigma on the FS-ADS-C (t(80 = −4.37, p<.001 and more burden on the ZBI (t(80 = −2.68, p=.009 compared to male caregivers, and adult child caregivers reported experiencing more stigma on the FS-ADS-C (t(30.8 = −2.22, p=.034 and more burden on the ZBI (t(80 = −2.65, p=.010 than spousal caregivers. These results reinforce the importance of support for caregivers, particularly adult child and female caregivers who may experience higher levels of stigma and burden.

  8. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti.

    Science.gov (United States)

    Surkan, Pamela J; Mukherjee, Joia S; Williams, David R; Eustache, Eddy; Louis, Ermaze; Jean-Paul, Thierry; Lambert, Wesler; Scanlan, Fiona C; Oswald, Catherine M; Fawzi, Mary Smith

    2010-07-01

    In many settings worldwide, HIV-positive individuals have experienced a significant level of stigma and discrimination. This discrimination may also impact other family members affected by the disease, including children. The aim of our study was to identify factors associated with stigma and/or discrimination among HIV-affected youth and their HIV-positive caregivers in central Haiti. Recruitment of HIV-positive patients with children aged 10-17 years was conducted in 2006-2007. Data on HIV-related stigma and/or discrimination were based on interviews with 451 youth and 292 caregivers. Thirty-two percent of caregivers reported that children were discriminated against because of HIV/AIDS. Commune of residence was associated with discrimination against children affected by HIV/AIDS and HIV-related stigma among HIV-positive caregivers, suggesting variability across communities. Multivariable regression models showed that lacking social support, being an orphan, and caregiver HIV-related stigma were associated with discrimination in HIV-affected children. Caregiver HIV-related stigma demonstrated a strong association with depressive symptoms. The results could inform strategies for potential interventions to reduce HIV-related stigma and discrimination. These may include increasing social and caregiver support of children affected by HIV, enhancing support of caregivers to reduce burden of depressive symptoms, and promoting reduction of HIV-related stigma and discrimination at the community-level.

  9. Perceived and measured stigma among workers with serious mental illness.

    Science.gov (United States)

    Baldwin, Marjorie L; Marcus, Steven C

    2006-03-01

    This research analyzed the extent to which self-reports of job-related discrimination by persons with serious mental illness are associated with econometric measures of discrimination. Data were from the 1994-1995 National Health Interview Survey-Disability Supplement. Data for workers with mood, psychotic, or anxiety disorders (N=1,139) were compared with data for those without such disorders (N=66,341). The main outcome measures were self-reports of wages and stigmatizing experiences in the workplace. After the analyses controlled for functional limitations and job characteristics, no significant difference in mean wages was found between workers with serious mental illness who did not report experiencing stigma and those with no mental illness. In contrast, for all types of mental disorders examined, mean wages for workers with serious mental illness who reported experiencing stigma were significantly lower than mean wages for those with no mental illness. Workers' self-reports of stigmatizing experiences in the labor market appear to be consistent with econometric measures of the effect of stigma on wages, suggesting that workers know when they are being discriminated against.

  10. Perceived mental health related stigma, gender, and depressive symptom severity in a psychiatric facility in South India.

    Science.gov (United States)

    Kulesza, Magdalena; Raguram, R; Rao, Deepa

    2014-06-01

    Few studies exist on the topic of gender associated with depression and mental health-related stigma coming out of non-Western countries such as India. We aimed to add to the literature by assessing these relationships among adults seeking psychiatric services in India. Participants were 60 individuals seeking care at a psychiatric clinic in Bangalore, India. The majority of participants were female with a mean age of 36 years (SD=9.75). Contrary to our prediction, there were no significant differences between men (M=28.96; SD=9.85) and women (M=33.03; SD=12.08) on depression severity, t(58)=1.42, p=.16. Yet, women (M=10.09, SD=8.23) reported significantly more perceived stigma than men (M=5.79, SD=5.86), t(58)=2.30, p=.02. While men and women seeking psychiatric services at the psychiatric clinic in India report similar levels of depression severity, women reported more perceived mental illness stigma. Having experienced regular forms of discrimination associated with female status in India, it may be the case that women are more attuned to other forms of stigma, such as mental health stigma investigated in the present study. Given the detrimental impact of stigma on treatment adherence and engagement in care, additional research is needed support this work, including research on interventions to reduce stigma and improve engagement in care. Copyright © 2014 Elsevier B.V. All rights reserved.

  11. Acceptability of mental health stigma-reduction training and initial effects on awareness among military personnel

    National Research Council Canada - National Science Library

    Hurtado, Suzanne L; Simon-Arndt, Cynthia M; McAnany, Jennifer; Crain, Jenny A

    2015-01-01

    The purpose of this paper is to report on the development of a mental health stigma reduction toolkit and training, and the acceptability and level of stigma awareness following the stigma-reduction...

  12. Adaptation into Spanish of the Internalised Stigma of Mental Illness scale to assess personal stigma.

    Science.gov (United States)

    Bengochea-Seco, Rosario; Arrieta-Rodríguez, Marta; Fernández-Modamio, Mar; Santacoloma-Cabero, Iciar; Gómez de Tojeiro-Roce, Juan; García-Polavieja, Bárbara; Santos-Zorrozúa, Borja; Gil-Sanz, David

    2016-03-09

    Patients with schizophrenia sometimes internalise social stigma associated to mental illness, and they develop personal stigma. Personal stigma includes self-stigma (internalisation of negative stereotypes), perceived stigma (perception of rejection), and experienced stigma (experiences of discrimination). Personal stigma is linked with a poorer treatment adherence, and worst social functioning. For this reason, it is important to have good measurements of personal stigma. One of the most frequently used measurements is the Internalised Stigma of Mental Illness (ISMI) scale. There is a Spanish version of the scale available, although its psychometric properties have not been studied. The main aim of this study is to analyse the psychometric properties of a new Spanish version of the ISMI scale. The new version was translated as Estigma Interiorizado de Enfermedad Mental (EIEM). Internal consistency and test-retest reliability were calculated in a sample of 69 patients with a diagnosis of schizophrenia or schizoaffective disorder. The rate of patients showing personal stigma was also studied, as well as the relationship between personal stigma and sociodemographic and clinical variables. The adapted version obtained good values of internal consistency and test-retest reliability, for the total score of the scale (0.91 and 0.95 respectively), as well as for the five subscales of the EIEM, except for the Stigma Resistance subscale (Cronbach's alpha 0.42). EIEM is an appropriate measurement tool to assess personal stigma in a Spanish population with severe mental disorder, at least in those with a diagnosis of schizophrenia or schizoaffective disorder. Copyright © 2016. Published by Elsevier España.

  13. Conceptualising abortion stigma

    NARCIS (Netherlands)

    A. Kumar; L. Hessini; E.M.H. Mitchell

    2009-01-01

    Abortion stigma is widely acknowledged in many countries, but poorly theorised. Although media accounts often evoke abortion stigma as a universal social fact, we suggest that the social production of abortion stigma is profoundly local. Abortion stigma is neither natural nor 'essential' and relies

  14. Mental illness stigma: concepts, consequences, and initiatives to reduce stigma.

    Science.gov (United States)

    Rüsch, Nicolas; Angermeyer, Matthias C; Corrigan, Patrick W

    2005-12-01

    Persons with mental illness frequently encounter public stigma and may suffer from self-stigma. This review aims to clarify the concept of mental illness stigma and discuss consequences for individuals with mental illness. After a conceptual overview of stigma we discuss two leading concepts of mental illness stigma and consequences of stigma, focussing on self-stigma/empowerment and fear of stigma as a barrier to using health services. Finally, we discuss three main strategies to reduce stigma -- protest, education, and contact -- and give examples of current anti-stigma campaigns. Well-designed anti-stigma initiatives will help to diminish negative consequences of mental illness stigma.

  15. Family Care giving in Bipolar disorder: Experiences of Stigma.

    Directory of Open Access Journals (Sweden)

    Farshid Shamsaei

    2013-12-01

    Full Text Available Stigma is a serious impediment to the well-being of those who experience it. Many family- caregivers are challenged by the stereotypes and prejudice that result from misconceptions about bipolar disorder.The purpose of this study was to explore the stigma experienced by family caregivers of patients with bipolar disorder.This was a qualitative and phenomenological study. In this study, we selected the family caregivers of patients with bipolar disorder in a psychiatric hospital (Iran using purposive sampling in 2011. By reaching data saturation, the number of participant was 12. Data were gathered through in-depth interviews and analyzed by the "Collaizi" method.Stigma was a pervasive concern to almost all participants. Family caregivers of patients with Bipolar disorders reported feelings and experiences of stigma and were most affected by them. Analysis of the interviews revealed 3 themes: Negative judgment, Shame, Stigmatization and Social Isolation.For a person with bipolar disorder, this illness is associated with the following problems: worse recovery, difficulty accessing health services, receiving poor treatment and support, and difficulty gaining community acceptance. Rejection of people with mental illness might also affect their family caregivers at various levels.

  16. Drug addiction stigma in relation to methadone maintenance treatment by different service delivery models in Vietnam.

    Science.gov (United States)

    Tran, Bach Xuan; Vu, Phuong Bich; Nguyen, Long Hoang; Latkin, Sophia Knowlton; Nguyen, Cuong Tat; Phan, Huong Thu Thi; Latkin, Carl A

    2016-03-08

    The rapid expansion of methadone maintenance treatment (MMT) services has significantly improved health status and quality of life of patients. However, little is known about its impacts on addiction-related stigma and associated factors. A cross-sectional survey was conducted in 2013 in Vietnam's capital, Hanoi, and Nam Dinh province among 1016 methadone maintenance patients; 26.6 % at provincial AIDS centers (PAC) and 73.4 % at district health centers (DHC), respectively. Drug addiction history and related stigma, health status, MMT-related covariates, and sociodemographic characteristics were interviewed. More than one-sixth of the sample reported experiencing felt or enacted stigma, including Blame or Judgement (17.2 %), Shame (19.9 %), or Others' fear of HIV transmission (17.1 %). These proportions were higher in PACs than in DHCs, which are integrated with other HIV or general health care services. Very few patients reported being discriminated at the workplace (2.5 %) or at health care services (1.7 %); however, 15.6 % of patients at PACs and 10.6 % of patients at DHCs reported discrimination in their communities. Drug users taking MMT for longer periods were less likely to report felt stigma. Other factors associated with stigma against MMT patients included the lack of comprehensive services, higher education, presence of pain/discomfort, and anxiety/depression, self-reported HIV positive, and number of previous drug rehabilitation episodes. The study shows a high level of stigma against MMT patients and emphasizes the necessity to integrate MMT with comprehensive health and support services. Mass communication campaigns to reduce stigma against people with drug addiction and HIV/AIDS, as well as vocational trainings and jobs referrals for MMT patients, are needed to maximize the benefits of MMT programs in Vietnam.

  17. Self-Stigma, Perceived Stigma, and Help-Seeking Communication in People with Mental Illness

    Directory of Open Access Journals (Sweden)

    Jen Lee Teh

    2014-02-01

    Full Text Available People with mental illness (PWMI often internalise negative beliefs (self-stigma or anticipate external sources of stigma (perceived stigma. This study examines how the two types of stigma affect the willingness to communicate for help – such communication is a vital aspect of good patient care and treatment outcome. Seventy-two participants from different ethnic backgrounds who had experienced mental illness responded to an online survey about their level of agreement with statements reflecting self- and perceived stigma and their willingness to disclose to various help sources. Face-to-face interviews with 17 of these respondents provided a deeper understanding of how stigma affected their help-seeking communication. The quantitative results seemed to suggest that self-stigma has a stronger negative correlation with willingness to seek help. Respondents preferred disclosing to friends above family members and health professionals. The results highlight the importance of building resilience to reduce self-stigma and thereby increase help seeking. Given the different ethnic backgrounds of the participants, there emerged some multicultural issues that would seem to contribute to persisting mental illness stigma. These and any cultural differences are discussed.

  18. Increased cognitive problem reporting after information about chemotherapy-induced cognitive decline: The moderating role of stigma consciousness.

    Science.gov (United States)

    Jacobs, W; Das, E; Schagen, S B

    2017-01-01

    Information about treatment side effects can increase their occurrence; breast cancer (BC) patients showed increased cognitive problem reporting (CPR) and decreased memory performance after information about cognitive side effects. The current study extends previous research on adverse information effects (AIE) by investigating (a) risk factors, (b) underlying mechanisms and (c) an intervention to reduce AIE. In an online experiment, 175 female BC patients were randomly assigned to one of three conditions. In the two experimental groups, patients were informed about the possible occurrence of cognitive problems after chemotherapy with (intervention group) or without (experimental group) reassuring information that 'there are still patients who score well on memory tests'. In the control group, no reference to chemotherapy-related cognitive problems was made. Main dependent measure was CPR. Four moderating and five mediating processes were examined. CPR increased with higher levels of stigma consciousness in the two experimental groups, but not in the no-information control group. Merely informing patients about cognitive side effects may increase their occurrence, especially among individuals vulnerable to patient stereotypes. Adding reassuring information is not sufficient to reduce AIE.

  19. Association between stigma, depression and quality of life of people living with HIV/AIDS (PLHA in South India – a community based cross sectional study

    Directory of Open Access Journals (Sweden)

    Charles Bimal

    2012-06-01

    Full Text Available Abstract Background India has around 2.27 million adults living with HIV/AIDS who face several challenges in the medical management of their disease. Stigma, discrimination and psychosocial issues are prevalent. The objective of the study was to determine the prevalence of severe stigma and to study the association between this, depression and the quality of life (QOL of people living with HIV/AIDS (PLHA in Tamil Nadu. Methods This was a community based cross sectional study carried out in seven districts of Tamil Nadu, India, among 400 PLHA in the year 2009. The following scales were used for stigma, depression and quality of life, Berger scale, Major Depression Inventory (MDI scale and the WHO BREF scale. Both Stigma and QOL were classified as none, moderate or severe/poor based on the tertile cut off values of the scale scores. Depression was classified as none, mild, moderate and severe. Logistic regression analyses were performed to study the risk factors. Results Twenty seven per cent of PLHA had experienced severe forms of stigma. These were severe forms of personalized stigma (28.8%, negative self-image (30.3%, perceived public attitude (18.2% and disclosure concerns (26%. PLHA experiencing severe depression were 12% and those experiencing poor quality of life were 34%. Poor QOL reported in the physical, psychological, social and environmental domains was 42.5%, 40%, 51.2% and 34% respectively. PLHA who had severe personalized stigma and negative self-image had 3.4 (1.6-7.0 and 2.1 (1.0-4.1 times higher risk of severe depression respectively (p  Conclusions Severe forms of stigma were equivalently prevalent among all the categories of PLHA. However, PLHA who had experienced severe depression had only developed poor QOL. A high level of social support was associated with a high level of QOL.

  20. Use of Online Forums for Perinatal Mental Illness, Stigma, and Disclosure: An Exploratory Model

    Science.gov (United States)

    Drey, Nicholas; Ayers, Susan

    2017-01-01

    Background Perinatal mental illness is a global health concern; however, many women with the illness do not get the treatment they need to recover. Interventions that reduce the stigma around perinatal mental illness have the potential to enable women to disclose their symptoms to health care providers and consequently access treatment. There are many online forums for perinatal mental illness and thousands of women use them. Preliminary research suggests that online forums may promote help-seeking behavior, potentially because they have a role in challenging stigma. This study draws from these findings and theoretical concepts to present a model of forum use, stigma, and disclosure. Objective This study tested a model that measured the mediating role of stigma between online forum use and disclosure of affective symptoms to health care providers. Methods A Web-based survey of 200 women who were pregnant or had a child younger than 5 years and considered themselves to be experiencing psychological distress was conducted. Women were recruited through social media and questions measured forum usage, perinatal mental illness stigma, disclosure to health care providers, depression and anxiety symptoms, barriers to disclosure, and demographic information. Results There was a significant positive indirect effect of length of forum use on disclosure of symptoms through internal stigma, b=0.40, bias-corrected and accelerated (BCa) 95% CI 0.13-0.85. Long-term forum users reported higher levels of internal stigma, and higher internal stigma was associated with disclosure of symptoms to health care providers when controlling for symptoms of depression and anxiety. Conclusions Internal stigma mediates the relationship between length of forum use and disclosure to health care providers. Findings suggest that forums have the potential to enable women to recognize and reveal their internal stigma, which may in turn lead to greater disclosure of symptoms to health care providers

  1. Experienced-Based Career Education, Part D, 13.502. First Interim Report.

    Science.gov (United States)

    Muse, Ivan D.; Coombs, Garn

    An evaluation was conducted on the first year operations (academic 1976-77) of an experienced based career education (EBCE) project designed for tenth grade students from Weber County School District (Utah) and ninth and tenth grade students from Morgan County School District (Utah). Students were pre- and posttested in the areas of career skills,…

  2. Experienced and anticipated discrimination reported by individuals in treatment for substance use disorders within the Netherlands

    NARCIS (Netherlands)

    van Boekel, L.C.; Brouwers, E.P.M.; van Weeghel, J.; Garretsen, H.F.L.

    2016-01-01

    Experiences and expectations of discrimination (anticipated discrimination) may delay treatment seeking among people with substance use disorders. In addition, experienced and anticipated discrimination can be a barrier to successful recovery and rehabilitation. The aim of this study was to study th

  3. From discrimination to internalized mental illness stigma: The mediating roles of anticipated discrimination and anticipated stigma.

    Science.gov (United States)

    Quinn, Diane M; Williams, Michelle K; Weisz, Bradley M

    2015-06-01

    Internalizing mental illness stigma is related to poorer well-being, but less is known about the factors that predict levels of internalized stigma. This study explored how experiences of discrimination relate to greater anticipation of discrimination and devaluation in the future and how anticipation of stigma in turn predicts greater stigma internalization. Participants were 105 adults with mental illness who self-reported their experiences of discrimination based on their mental illness, their anticipation of discrimination and social devaluation from others in the future, and their level of internalized stigma. Participants were approached in several locations and completed surveys on laptop computers. Correlational analyses indicated that more experiences of discrimination due to one's mental illness were related to increased anticipated discrimination in the future, increased anticipated social stigma from others, and greater internalized stigma. Multiple serial mediator analyses showed that the effect of experiences of discrimination on internalized stigma was fully mediated by increased anticipated discrimination and anticipated stigma. Experiences of discrimination over one's lifetime may influence not only how much future discrimination people with mental illness are concerned with but also how much they internalize negative feelings about the self. Mental health professionals may need to address concerns with future discrimination and devaluation in order to decrease internalized stigma. (c) 2015 APA, all rights reserved).

  4. Experiences of mental illness stigma, prejudice and discrimination: a review of measures

    National Research Council Canada - National Science Library

    Brohan, Elaine; Slade, Mike; Clement, Sarah; Thornicroft, Graham

    2010-01-01

    .... This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness...

  5. Experiences of mental illness stigma, prejudice and discrimination: a review of measures

    Directory of Open Access Journals (Sweden)

    Clement Sarah

    2010-03-01

    Full Text Available Abstract Background There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. Method A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. Results 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. Conclusions The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose.

  6. Experiences of mental illness stigma, prejudice and discrimination: a review of measures

    Science.gov (United States)

    2010-01-01

    Background There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. Method A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. Results 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. Conclusions The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose. PMID:20338040

  7. Experiences of mental illness stigma, prejudice and discrimination: a review of measures.

    Science.gov (United States)

    Brohan, Elaine; Slade, Mike; Clement, Sarah; Thornicroft, Graham

    2010-03-25

    There has been a substantial increase in research on mental illness related stigma over the past 10 years, with many measures in use. This study aims to review current practice in the survey measurement of mental illness stigma, prejudice and discrimination experienced by people who have personal experience of mental illness. We will identify measures used, their characteristics and psychometric properties. A narrative literature review of survey measures of mental illness stigma was conducted. The databases Medline, PsychInfo and the British Nursing Index were searched for the period 1990-2009. 57 studies were included in the review. 14 survey measures of mental illness stigma were identified. Seven of the located measures addressed aspects of perceived stigma, 10 aspects of experienced stigma and 5 aspects of self-stigma. Of the identified studies, 79% used one of the measures of perceived stigma, 46% one of the measures of experienced stigma and 33% one of the measures of self-stigma. All measures presented some information on psychometric properties. The review was structured by considering perceived, experienced and self stigma as separate but related constructs. It provides a resource to aid researchers in selecting the measure of mental illness stigma which is most appropriate to their purpose.

  8. “Don’t Judge a Book by Its Cover”: A Qualitative Study of Methadone Patients’ Experiences of Stigma

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    Julia Woo

    2017-02-01

    Full Text Available Introduction: Despite its efficacy and widespread use, methadone maintenance treatment (MMT continues to be widely stigmatized. Reducing the stigma surrounding MMT will help improve the accessibility, retention, and treatment outcomes in MMT. Methods: Semi-structured interviews were conducted with 18 adults undergoing MMT. Thematic content analysis was used to identify overarching themes. Results: In total, 78% of participants reported having experienced stigma surrounding MMT. Common stereotypes associated with MMT patients included the following: methadone as a way to get high, incompetence, untrustworthiness, lack of willpower, and heroin junkies. Participants reported that stigma resulted in lower self-esteem; relationship conflicts; reluctance to initiate, access, or continue MMT; and distrust toward the health care system. Public awareness campaigns, education of health care workers, family therapy, and community meetings were cited as potential stigma-reduction strategies. Discussion and Conclusion: Stigma is a widespread and serious issue that adversely affects MMT patients’ quality of life and treatment. More efforts are needed to combat MMT-related stigma.

  9. Is Stigma Internalized? The Longitudinal Impact of Public Stigma on Self-Stigma

    Science.gov (United States)

    Vogel, David L.; Bitman, Rachel L.; Hammer, Joseph H.; Wade, Nathaniel G.

    2013-01-01

    Stigma is considered an important barrier to seeking mental health services. Two types of stigma exist: public stigma and self-stigma. Theoretically, it has been argued that public stigma leads to the development of self-stigma. However, the empirical support for this assertion is limited to cross-sectional data. Therefore, the goal of this…

  10. On the self-stigma of mental illness: stages, disclosure, and strategies for change.

    Science.gov (United States)

    Corrigan, Patrick W; Rao, Deepa

    2012-08-01

    People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result. In our article, we more fully define the concept of self-stigma and describe the negative consequences of self-stigma for people with mental illness. We also examine the advantages and disadvantages of disclosure in reducing the impact of stigma. In addition, we argue that a key to challenging self-stigma is to promote personal empowerment. Lastly, we discuss individual- and societal-level methods for reducing self-stigma, programs led by peers as well as those led by social service providers.

  11. Levels of stigma among community mental health staff in Guangzhou, China.

    Science.gov (United States)

    Li, Jie; Li, Juan; Thornicroft, Graham; Huang, Yuanguang

    2014-08-13

    Stigma and discrimination are widely experienced by people with mental illness, even in healthcare settings. The purposes of this study were to assess mental health stigma among community mental health staff in Guangzhou, China and in doing so also to assess the psychometric properties of the Reported and Intended Behaviour Scale (RIBS) - Chinese version. A cross-sectional survey was undertaken among 214 community mental health staff in Guangzhou from September to November, 2013. The Mental Health Knowledge Schedule (MAKS) and RIBS were administered together with the Mental Illness: Clinicians' Attitudes Scale (MICA) to evaluate staff stigma from the perspective of knowledge, attitudes and behaviour. The total scores of RIBS, MAKS and MICA were (11.97 ± 3.41), (16.80 ± 5.39) and (51.69 ± 6.94) respectively. Female staff members were more willing to contact people with mental illness than males (t(212) = -2.85,P = 0.005) and had more knowledge about mental illness (t(212) = -2.28,P = 0.024). The Chinese version of RIBS had good internal consistency (alpha = 0.82), test-retest reliability (r = 0.68,P stigma toward people with mental illness among community mental health staff in Guangzhou, China. There are slightly gender differences in discriminatory behaviours and stigma related knowledge of mental illness among community mental health staff, with female staff in general less stigmatising. Accordingly, anti-stigma programmes should be established among healthcare staff. In addition, the Chinese version of RIBS is a reliable, valid and acceptable measure which can be used to assess the willingness of participants to contact people with mental illness in future anti-stigma campaigns.

  12. Experiences of Stigma and Discrimination among Caregivers of Persons with Schizophrenia in China: A Field Survey

    Science.gov (United States)

    Yin, Yi; Zhang, Weijun; Hu, Zhenyu; Jia, Fujun; Li, Yafang; Xu, Huiwen; Zhao, Shuliang; Guo, Jing; Tian, Donghua; Qu, Zhiyong

    2014-01-01

    In China, caregivers for family members with schizophrenia play an important role in treatment and recovery but may experience stigma and discrimination simply because of their family relationship. The object of this study was to measure the degrees and correlates of stigma and discrimination experiences among this group. Four hundred twenty-seven caregivers participated in this hospital-based and cross-sectional study in Ningbo and Guangzhou, China. Data were collected by trained interviewers using fixed questionnaires. Stigma and discrimination experiences were measured by the Modified Consumer Experiences of Stigma Questionnaire (MCESQ). Caregivers’ social support was measured by the Social Support Rating Scale. Parametric analysis, nonparametric analysis and multivariate linear regression were used. The mean (SD) score of MCESQ was 2.44(0.45), 2.91(0.71) for stigma experiences and 1.97(0.37) for discrimination experiences on a five-point score (“1 = never” and “5 = very often”). Approximately 65% of caregivers reported that they tried to conceal their family members’ illness, and 71% lacked the support of friends. The experience of stigma was significantly negatively associated with the perceived social support of caregivers (standard β = −0.2,pstigmas than other (standard β = −0.18, pstigmas. In addition, stigma and discrimination was more experienced in Zhejiang than in Guangdong (pstigmas and rare discrimination and found the relations with social support, kinship, patient’s educational level and regional differences. More interventions and supports should been given to caregivers who are lack of social support, who live in rural area and who are the patients’ parents, spouses or siblings. PMID:25259732

  13. Persisting stigma reduces the utilisation of HIV-related care and support services in Viet Nam

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    Thanh Duong Cong

    2012-11-01

    Full Text Available Abstract Background Seeking and utilisation of HIV prevention, treatment, care, and support services for people living with HIV is often hampered by HIV-related stigma. The study aimed to explore the perceptions and experiences regarding treatment, care, and support amongst people living with HIV in Viet Nam, where the HIV epidemic is concentrated among injecting drug users, sex workers, and men who have sex with men. Methods In-depth interviews and focus group discussions were conducted during September 2007 in 6 districts in Hai Phong with a very high HIV prevalence among injecting drug users. The information obtained was analysed and merged within topic areas. Illustrative quotes were selected. Results Stigma and discrimination against people living with HIV in the community and healthcare settings was commonly reported, and substantially hampered the seeking and the utilisation of HIV-related services. The informants related the high level of stigma to the way the national HIV preventive campaigns played on fear, by employing a “scare tactic” mainly focusing on drug users and sex workers, who were defined as “social evils” in the anti-drug and anti-prostitution policy. There was a strong exclusion effect caused by the stigma, with serious implications, such as loss of job opportunities and isolation. The support and care provided by family members was experienced as vital for the spirit and hope for the future among people living with HIV. Conclusions A comprehensive care and support programme is needed. The very high levels of stigma experienced seem largely to have been created by an HIV preventive scare tactic closely linked to the “social evil“ approach in the national policy on drug and prostitution. In order to reduce the stigma and create more effective interventions, this tactic will have to be replaced with approaches that create better legal and policy environments for drug users and sex workers.

  14. Conceptualising abortion stigma.

    Science.gov (United States)

    Kumar, Anuradha; Hessini, Leila; Mitchell, Ellen M H

    2009-08-01

    Abortion stigma is widely acknowledged in many countries, but poorly theorised. Although media accounts often evoke abortion stigma as a universal social fact, we suggest that the social production of abortion stigma is profoundly local. Abortion stigma is neither natural nor 'essential' and relies upon power disparities and inequalities for its formation. In this paper, we identify social and political processes that favour the emergence, perpetuation and normalisation of abortion stigma. We hypothesise that abortion transgresses three cherished 'feminine' ideals: perpetual fecundity; the inevitability of motherhood; and instinctive nurturing. We offer examples of how abortion stigma is generated through popular and medical discourses, government and political structures, institutions, communities and via personal interactions. Finally, we propose a research agenda to reveal, measure and map the diverse manifestations of abortion stigma and its impact on women's health.

  15. Comparing perceived public stigma and personal stigma of mental health treatment seeking in a young adult sample.

    Science.gov (United States)

    Pedersen, Eric R; Paves, Andrew P

    2014-09-30

    Perceived public stigma regarding seeking mental health treatment can be a barrier to accessing services for young adults. While factors associating with personal stigma regarding how one would view and treat others have been identified, the discrepancies between perceived and personal stigma have received less research attention. We designed the current study to expand on previous research and examine the discrepancies between perceived public stigma and personal stigma among a sample of 386 primarily White and Asian college students. Participants completed surveys of mental health symptoms, treatment experience and attitudes, perceived public, and personal stigma. Overall, participants generally reported greater perceived public stigma than personal stigma; an effect that was particularly evident for women and those with mental health symptoms. The majority of participants disagreed with items assessing personal stigma. Negative attitudes toward treatment and anxiety symptoms associated with perceived public stigma, while male gender, Asian ethnicity, and negative attitudes toward treatment associated with personal stigma. Findings have implications for interventions and marketing programs to help change perceptions about mental health stigma to encourage utilization of services for those young people who could benefit from care. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Correlation between lamivudine plasma concentrations and patient self-reported adherence to antiretroviral treatment in experienced HIV patients

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    Minzi OM

    2011-11-01

    Full Text Available OM Minzi1, V Mugoyela2, LL Gustafsson31Unit of Pharmacology and Therapeutics, 2Department of Medicinal Chemistry, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania; 3Division of Clinical Pharmacology, Department of Laboratory Medicine, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, SwedenBackground: Adherence to antiretroviral treatment (ART is important to achieve treatment success in human immunodeficiency virus (HIV-infected patients. Most HIV clinics apply the patient self-report (PSR method. However, the reliability of this method in experienced HIV patients remains questionable.Purpose: To validate the PSR method for measuring adherence to ART using lamivudine (3TC plasma concentrations in experienced HIV patients.Methods: The study was conducted in Dar Es Salaam and involved 220 patients who were receiving ART services at HIV clinics for more than 12 months. Self-reported adherence information to ART was obtained on the day of HIV clinic visit. The patients were asked to mention the number of doses missed within the past 7 days. In addition, blood samples (2 mL were collected from each patient on the same day. The blood samples were determined for 3TC plasma concentrations. The target 3TC plasma concentration as indicator concentration for adherent patients was determined in 20 patients who took their evening dose of antiretrovirals under supervision. The blood from these patients was drawn 3 hours after drug administration.Results: Complete drug levels of 3TC and self-reported adherence data was obtained in 200 treatment-experienced HIV patients. Lamivudine plasma concentrations obtained in these patients ranged between 0.02–17.36 µg/mL. The mean time from dose administration to blood drawing was 3.1 ± 1.2 hours with coefficient of variation >39%. The mean 3TC plasma concentration obtained in 20 patients who took their antiretroviral dose under supervision was

  17. Reporting Misconduct of a Coworker to Protect a Patient: A Comparison between Experienced Nurses and Nursing Students

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    Abraham Mansbach

    2014-01-01

    Full Text Available Purpose. Whistleblowing is the reporting of illegal, immoral, or illegitimate practices to persons or organizations that may affect the action. The current study compares experienced nurses to nursing students regarding their willingness to blow the whistle to protect a patient’s interests. Methods. 165 participants were divided into two groups: 82 undergraduate nursing students and 83 experienced nurses. Participants responded to two vignettes that described a colleague’s and a manager’s misconduct at work. Results. The nursing students perceived the severity of the misconduct significantly lower compared to the experienced nurses. The nursing students also ranked the internal and external whistleblowing indices higher than the nurses, but the differences did not reach statistical significance. For each of the examined internal and external indices, professional experience was found to be significant in multivariate regression analyses. Conclusions. Even though nursing students perceived the severity of the misconduct significantly lower than the experienced nurses, the students demonstrated a greater readiness to blow the whistle, both internally and externally. Recommendations for handling comparable situations are offered.

  18. Experiences of stigma in healthcare settings among adults living with HIV in the Islamic Republic of Iran

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    Rahmati-Najarkolaei Fatemeh

    2010-07-01

    Full Text Available Abstract Background People living with HIV (PLHIV sometimes experience discrimination. There is little understanding of the causes, forms and consequences of this stigma in Islamic countries. This qualitative study explored perceptions and experiences of PLHIV regarding both the quality of healthcare and the attitudes and behaviours of their healthcare providers in the Islamic Republic of Iran. Methods In-depth, semi-structured interviews were held with a purposively selected group of 69 PLHIV recruited from two HIV care clinics in Tehran. Data were analyzed using the content analysis approach. Results and discussion Nearly all participants reported experiencing stigma and discrimination by their healthcare providers in a variety of contexts. Participants perceived that their healthcare providers' fear of being infected with HIV, coupled with religious and negative value-based assumptions about PLHIV, led to high levels of stigma. Participants mentioned at least four major forms of stigma: (1 refusal of care; (2 sub-optimal care; (3 excessive precautions and physical distancing; and (4 humiliation and blaming. The participants' healthcare-seeking behavioural reactions to perceived stigma and discrimination included avoiding or delaying seeking care, not disclosing HIV status when seeking healthcare, and using spiritual healing. In addition, emotional responses to perceived acts of stigma included feeling undeserving of care, diminished motivation to stay healthy, feeling angry and vengeful, and experiencing emotional stress. Conclusions While previous studies demonstrate that most Iranian healthcare providers report fairly positive attitudes towards PLHIV, our participants' experiences tell a different story. Therefore, it is imperative to engage both healthcare providers and PLHIV in designing interventions targeting stigma in healthcare settings. Additionally, specialized training programmes in universal precautions for health providers will

  19. Report of the Stigma Research Workshop for the development of scientific consensus papers and field guidelines on health-related stigma, held in Amsterdam, the Netherlands from 11-14 october 2010.

    Science.gov (United States)

    Voorend, Carlijn G N; Van Brakel, Wim H; Cross, Hugh; Augustine, Valsa; Ebenso, Bassey

    2011-06-01

    Summary In concurrence with the broad body of literature published on health-related stigma, there is a need for practical field guidance to contribute to the fight against leprosy-related stigma and discrimination. To this end, much can be gained by considering the accumulated knowledge and learned from experience with different stigmatising conditions; primarily HIV/AIDS, disability, tuberculosis, and mental health. Therefore a Stigma Research Workshop was organised from 11-14 October in Amsterdam, The Netherlands. The primary aim of the workshop was to produce scientific papers and field guidelines that could be used to target actions against health-related stigma and discrimination. Keynote presentations were offered by scientists and professionals from different health domains who shared their knowledge, experiences and research findings regarding health-related stigma. Group work was subsequently conducted to work towards agreed outputs on four different themes: i.e. research priorities, measurement, interventions, and counselling. The spectrum of expertise present enabled an interdisciplinary and inter-profession sharing of knowledge and practices. This resulted in the commencement of consensus papers and field guidelines related to the four themes. An evaluation by participants concluded that the workshop had been an informative and worthwhile activity that will strengthen the fight against stigma.

  20. Individual attitudes and perceived social norms: Reports on HIV/AIDS-related stigma among service providers in China

    Science.gov (United States)

    Li, Li; Liang, Li-Jung; Wu, Zunyou; Lin, Chunqing; Wen, Yi

    2009-01-01

    This study examined HIV/AIDS-related stigma among Chinese service providers by comparing their personal attitudes toward people living with HIV/AIDS with their perception of social norms related to people living with HIV/AIDS. We randomly selected three provincial hospitals, four city/prefecture hospitals, 10 county hospitals, 18 township health clinics, and 54 village clinics from Yunnan, China. Doctors and nurses were randomly sampled proportionally to the doctor-nurse ratio of each hospital or clinic. Lab technicians were over-sampled in order to include an adequate representation in the analysis. A total of 1,101 service providers participated in a voluntary, anonymous survey where demographic characteristics, individual attitude and perceived social norms toward people living with HIV/AIDS, discrimination intent at work, general prejudicial attitude and knowledge on HIV/AIDS were measured. A majority of the sample demonstrated a similarity between their personal views and what they thought most people in society believe. Multiple logistic regressions revealed that participants who were younger or reported personal contact with people living with HIV/AIDS were significantly more likely to report personal attitudes toward the population that were more liberal than their perceived social norms. Holding a more liberal personal attitude toward people living with HIV/AIDS than perceived social norms was significantly and negatively related to the level of discrimination intent at work, perceived discrimination at interpersonal level and the level of general prejudicial attitude toward people living with HIV/AIDS. Results underscored the importance of understanding social norms and personal attitudes in studying HIV-related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs. Cette étude a examiné le VIH/SIDA lié à stigmatisation parmi les agences chinoises fournissant des soins en comparant leurs attitudes

  1. Internalized stigma and stigma resistance among patients with mental illness in Han Chinese population.

    Science.gov (United States)

    Lien, Yin-Ju; Kao, Yu-Chen; Liu, Yia-Ping; Chang, Hsin-An; Tzeng, Nian-Sheng; Lu, Chien-Wen; Loh, Ching-Hui

    2015-06-01

    Research suggests that accurate measurement is essential in evaluating internalized stigma and abilities to combat with stigma for treatment compliances and outcomes in individuals with mental illness. The purpose of this study was to assess the reliability and validity of the Chinese version of the Internalized Stigma of Mental Illness Scale (ISMIS-C), which is one of the few tools available to measure internalized stigma and stigma resistance (SR) simultaneously. A total of 160 outpatients with (n = 103) and without (n = 57) psychotic disorders were administrated with the ISMIS-C, and measures of self-esteem, self-efficacy, depression, and hopelessness. Overall, the 29-item ISMIS-C was presented to be internal reliable (Cronbach's alpha = 0.90), and reliable over time (intraclass correlation coefficients = 0.36-0.73). The construct validity of the ISMIS-C derived from the factor analysis was nearly identical to the original version. ISMIS-C dimension scores were well correlated with each other and measures of self-esteem, self-efficacy, depression, and hopelessness. Our data also demonstrated that psychotic patients experienced higher internalized stigma scores than those without psychotic diagnoses, but endorsed indifferently on SR scores. This scale can be used as an informative device when investigating "internalized stigma" and "SR" among individuals with or without psychotic disorders.

  2. Acceptability of Mental Health Stigma-Reduction Training and Initial Effects on Awareness Among Military Personnel

    Science.gov (United States)

    2015-10-13

    Hurtado et al. SpringerPlus (2015) 4:606 DOI 10.1186/s40064-015-1402-z RESEARCH Acceptability of  mental health stigma -reduction training and...purpose of this paper is to report on the development of a mental health stigma reduction toolkit and training, and the acceptability and level of stigma ...the usefulness and helpfulness of the training among other factors, and stigma awareness was measured with 10 items about mental health stigma . The

  3. Stigma in Mothers of Deaf Children

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    Hossein Ebrahimi

    2015-03-01

     Results: Results showed that most mothers suffer from stigma due to having a deaf child. The mean stigma score was 96.48 ±27.72. In total, 24.4% of mothers reported that they had received strange and mocking looks; 72.2% regarded child deafness as a sign of divine retribution; and 33.3% felt ashamed of their child’s deafness. There was an inverse relationship between the mother’s level of education and mean stigma scores (P

  4. The delaying effect of stigma on mental health help-seeking in Sri Lanka.

    Science.gov (United States)

    Fernando, Sunera M; Deane, Frank P; McLeod, Hamish J

    2017-03-01

    Mental health stigma has been associated with delays in seeking treatment. To describe perceived stigma experienced by patients and carers in Sri Lanka and to determine the effects of stigma on help-seeking delay. Survey of outpatients and family carers (n = 118 dyads) attending two psychiatric hospitals in Sri Lanka, using the Disclosure and Discrimination subscales of the Stigma Scale. Stigma was positively related to help-seeking delay for carers but not patients. Public stigma experienced by carers accounted for 23% of the variance in help-seeking delay. Reducing stigma may reduce help-seeking delays during the course of treatment. © 2016 John Wiley & Sons Australia, Ltd.

  5. Stigma and psychological distress in suicide survivors.

    Science.gov (United States)

    Scocco, Paolo; Preti, Antonio; Totaro, Stefano; Ferrari, Alessandro; Toffol, Elena

    2017-03-01

    Suicide bereavement is frequently related to clinically significant psychological distress and affected by stigma. This study was designed to evaluate the relationship between psychological distress by psychopathological domains and stigma, in a sample of individuals bereaved by suicide (suicide survivors). The data were collected between January 2012 and December 2014 and included information on sociodemographic variables (gender, age, marital status and education level) and responses to the Stigma of Suicide Survivor scale (STOSSS) and the Brief Symptom Inventory (BSI). One hundred and fifty-five suicide survivors completed the evaluation and were included in the study. Levels of psychological distress in suicide survivors, as measured by BSI, were positively related to levels of perceived stigma toward suicide survivors, as measured by STOSSS. The association was not affected by age and gender, or by marital status, education level, days from suicide or a personal history of suicide attempt. Participants with higher scores on almost all subscales of the BSI, particularly the interpersonal sensitivity and paranoid ideation subscales, reported the highest levels of perceived stigma toward suicide survivors. Levels of distress in subjects bereaved by the suicide of a relative or friend were positively associated with levels of perceived stigma toward suicide survivors. Specific interventions dedicated to the bereavement of suicide survivors might help to alleviate not only psychological distress but also stigma towards loss by suicide. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Stigma in Mothers of Deaf Children

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    Hossein Ebrahimi

    2015-03-01

    Full Text Available Introduction: A deaf child creates a feeling of stigma in many hearing parents. Stigma in mothers can have a negative impact on a child’s treatment and rehabilitation process. Therefore, this study was conducted to evaluate the extent of stigma in mothers with deaf children.  Materials and Methods: This descriptive, cross-sectional study was conducted in 2013 among 90 mothers with deaf children. The data-collection instrument included the stigma scale in the mothers of children with disabilities. The reliability and validity of the instrument were confirmed through content validity and Cronbach’s alpha coefficient (α=86%, respectively. Data were analyzed using SPSS-15 software.   Results: Results showed that most mothers suffer from stigma due to having a deaf child. The mean stigma score was 96.48 ±27.72. In total, 24.4% of mothers reported that they had received strange and mocking looks; 72.2% regarded child deafness as a sign of divine retribution; and 33.3% felt ashamed of their child’s deafness. There was an inverse relationship between the mother’s level of education and mean stigma scores (P

  7. Application of the Thyroid Imaging Reporting and Data System in thyroid ultrasonography interpretation by less experienced physicians

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    Ko, Su Yeon; Kim, Eun Kyung; Kwak, Jin Young [Dept. of Radiology, Severance Hospital, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul (Korea, Republic of); Lee, Hye Sun [Biostatistics Collaboration Unit, Medical Research Center, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-03-15

    To verify the usefulness of the Thyroid Imaging Reporting and Data System (TI-RADS) for thyroid nodule diagnosis by less experienced physicians. From March 2012 to May 2012, ultrasonography-guided fine needle aspiration was performed in 204 thyroid nodules in 195 consecutive patients by four less experienced radiologists (<1 year in thyroid imaging). The number of suspicious ultrasonography features and the total risk score of each thyroid nodule were calculated according to the previous two models suggested by Kwak et al. The Delong method was used to compare the areas under the curve (AUCs) of the two models. Associations between the two models and the risk of malignancy were analyzed using penalized B-splines and the Cochran-Armitage trend test. Among 204 thyroid nodules, 65 were malignant and 139 were benign. The probability of malignancy tended to increase as the number of suspicious ultrasonography features, and the sum of risk scores increased. There was no significant difference in the AUCs of the two models (P=0.673). The Cochran-Armitage trend test demonstrated an increased risk of malignancy as the number of suspicious ultrasonography features and the total risk score increased (P=0.001). Both the number of suspicious ultrasonography features and the total risk score are applicable and show comparable results in the risk stratification of thyroid nodules by less experienced radiologists in thyroid imaging.

  8. Association of perceived stigma and mood and anxiety disorders : results from the World Mental Health Surveys

    NARCIS (Netherlands)

    Alonso, J.; Buron, A.; Bruffaerts, R.; He, Y.; Posada-Villa, J.; Lepine, J-P.; Angermeyer, M. C.; Levinson, D.; de Girolamo, G.; Tachimori, H.; Mneimneh, Z. N.; Medina-Mora, M. E.; Ormel, J.; Scott, K. M.; Gureje, O.; Haro, J. M.; Gluzman, S.; Lee, S.; Vilagut, G.; Kessler, R. C.; Von Korff, M.

    2008-01-01

    Objective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability. Me

  9. Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys

    NARCIS (Netherlands)

    Alonso, J.; Buron, A.; Bruffaerts, R.; He, Y.; Posada-Villa, J.; Lepine, J.P.; Angermeyer, M.C.; Levinson, D.; De Girolamo, G.; Tachimori, H.; Mneimneh, Z.N.; Medina-Mora, M.E.; Ormel, J.; Scott, K.M.; Gureje, O.; Haro, J.M.; Gluzman, S.; Lee, S.; Vilagut, G.; Kessler, R.C.; Von Korff, M.

    2008-01-01

    Objective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability.

  10. Association of perceived stigma and mood and anxiety disorders : results from the World Mental Health Surveys

    NARCIS (Netherlands)

    Alonso, J.; Buron, A.; Bruffaerts, R.; He, Y.; Posada-Villa, J.; Lepine, J-P.; Angermeyer, M. C.; Levinson, D.; de Girolamo, G.; Tachimori, H.; Mneimneh, Z. N.; Medina-Mora, M. E.; Ormel, J.; Scott, K. M.; Gureje, O.; Haro, J. M.; Gluzman, S.; Lee, S.; Vilagut, G.; Kessler, R. C.; Von Korff, M.

    2008-01-01

    Objective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability.

  11. Association of perceived stigma and mood and anxiety disorders : results from the World Mental Health Surveys

    NARCIS (Netherlands)

    Alonso, J.; Buron, A.; Bruffaerts, R.; He, Y.; Posada-Villa, J.; Lepine, J-P.; Angermeyer, M. C.; Levinson, D.; de Girolamo, G.; Tachimori, H.; Mneimneh, Z. N.; Medina-Mora, M. E.; Ormel, J.; Scott, K. M.; Gureje, O.; Haro, J. M.; Gluzman, S.; Lee, S.; Vilagut, G.; Kessler, R. C.; Von Korff, M.

    2008-01-01

    Objective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability. Me

  12. Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys

    NARCIS (Netherlands)

    Alonso, J.; Buron, A.; Bruffaerts, R.; He, Y.; Posada-Villa, J.; Lepine, J.P.; Angermeyer, M.C.; Levinson, D.; De Girolamo, G.; Tachimori, H.; Mneimneh, Z.N.; Medina-Mora, M.E.; Ormel, J.; Scott, K.M.; Gureje, O.; Haro, J.M.; Gluzman, S.; Lee, S.; Vilagut, G.; Kessler, R.C.; Von Korff, M.

    2008-01-01

    Objective: We assessed the prevalence of perceived stigma among persons with mental disorders and chronic physical conditions in an international study. Method: Perceived stigma (reporting health-related embarrassment and discrimination) was assessed among adults reporting significant disability. Me

  13. Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey.

    Science.gov (United States)

    Thornicroft, Graham; Brohan, Elaine; Rose, Diana; Sartorius, Norman; Leese, Morven

    2009-01-31

    Many people with schizophrenia experience stigma caused by other people's knowledge, attitudes, and behaviour; this can lead to impoverishment, social marginalisation, and low quality of life. We aimed to describe the nature, direction, and severity of anticipated and experienced discrimination reported by people with schizophrenia. We did a cross-sectional survey in 27 countries, in centres affiliated to the INDIGO Research Network, by use of face-to-face interviews with 732 participants with schizophrenia. Discrimination was measured with the newly validated discrimination and stigma scale (DISC), which produces three subscores: positive experienced discrimination; negative experienced discrimination; and anticipated discrimination. Negative discrimination was experienced by 344 (47%) of 729 participants in making or keeping friends, by 315 (43%) of 728 from family members, by 209 (29%) of 724 in finding a job, 215 (29%) of 730 in keeping a job, and by 196 (27%) of 724 in intimate or sexual relationships. Positive experienced discrimination was rare. Anticipated discrimination affected 469 (64%) in applying for work, training, or education and 402 (55%) looking for a close relationship; 526 (72%) felt the need to conceal their diagnosis. Over a third of participants anticipated discrimination for job seeking and close personal relationships when no discrimination was experienced. Rates of both anticipated and experienced discrimination are consistently high across countries among people with mental illness. Measures such as disability discrimination laws might, therefore, not be effective without interventions to improve self-esteem of people with mental illness.

  14. The stigma of migraine.

    Science.gov (United States)

    Young, William B; Park, Jung E; Tian, Iris X; Kempner, Joanna

    2013-01-01

    People who have a disease often experience stigma, a socially and culturally embedded process through which individuals experience stereotyping, devaluation, and discrimination. Stigma has great impact on quality of life, behavior, and life chances. We do not know whether or not migraine is stigmatizing. We studied 123 episodic migraine patients, 123 chronic migraine patients, and 62 epilepsy patients in a clinical setting to investigate the extent to which stigma attaches to migraine, using epilepsy as a comparison. We used the stigma scale for chronic illness, a 24-item questionnaire suitable for studying chronic neurologic diseases, and various disease impact measures. Patients with chronic migraine had higher scores (54.0±20.2) on the stigma scale for chronic illness than either episodic migraine (41.7±14.8) or epilepsy patients (44.6±16.3) (pStigma correlated most strongly with the mental component score of the short form of the medical outcomes health survey (SF-12), then with ability to work and migraine disability score for chronic and episodic migraine and the Liverpool impact on epilepsy scale for epilepsy. Analysis of covariance showed adjusted scores for the stigma scale for chronic illness were similar for chronic migraine (49.3; 95% confidence interval, 46.2 to 52.4) and epilepsy (46.5; 95% confidence interval, 41.6 to 51.6), and lower for episodic migraine (43.7; 95% confidence interval, 40.9 to 46.6). Ability to work was the strongest predictor of stigma as measured by the stigma scale for chronic illness. In our model, adjusted stigma was similar for chronic migraine and epilepsy, which were greater than for episodic migraine. Stigma correlated most strongly with inability to work, and was greater for chronic migraine than epilepsy or episodic migraine because chronic migraine patients had less ability to work.

  15. Experiencing variation

    DEFF Research Database (Denmark)

    Kobayashi, Sofie; Berge, Maria; Grout, Brian William Wilson

    2017-01-01

    This study contributes towards a better understanding of learning dynamics in doctoral supervision by analysing how learning opportunities are created in the interaction between supervisors and PhD students, using the notion of experiencing variation as a key to learning. Empirically, we have based...... were discussed, created more complex patterns of variation. Both PhD students and supervisors can learn from this. Understanding of this mechanism that creates learning opportunities can help supervisors develop their competences in supervisory pedagogy....

  16. Negotiating identity: a qualitative analysis of stigma and support seeking for individuals with cerebral palsy.

    Science.gov (United States)

    Read, Stuart A; Morton, Thomas A; Ryan, Michelle K

    2015-01-01

    The current research investigates how adults with cerebral palsy construct their personal and social identities in the face of stigma when support seeking, and considers the dilemmas they might face when doing so. Participants were 28 adults with cerebral palsy who completed an online survey reporting on their identity as a person with cerebral palsy and their experiences of stigma when seeking and accessing support. Qualitative analyses indicated that the majority of participants sought support to help manage their cerebral palsy. Of these, half reported experiencing stigma in these environments, although they largely continued seeking support despite this. The majority viewed both their personal identity (i.e. as a unique individual) and their social identity (i.e. as a person with cerebral palsy) as important to their sense of self. However, how participants constructed their identity also appeared to vary according to context. While they appeared to value being seen as an individual to receive support that was unique to their needs (their personal identity), they also reported valuing the group to facilitate coping with stigma (their social identity). Yet, despite their utilities, enacting their identity in each of these ways was associated with costs. In order to access desired support, they had to incorporate their social identity as similar to other disabled people, which led to stigmatization through feelings of difference to the non-disabled. Conversely emphasizing individuality and difference from the disabled stereotype was associated with concerns about the degree to which their suitability for support might be questioned by their care provider. As has been observed in many fields, stigma can complicate identity. In this domain, people with cerebral palsy face a number of threats in how they construe their identity, both in navigating stigma and maintaining access to needed support. Implications for Rehabilitation Stigma in help and support settings

  17. Development and Psychometric Assessment of a Multidimensional Measure of Internalized HIV Stigma in a sample of HIV-positive Adults

    OpenAIRE

    Sayles, Jennifer N.; Hays, Ron D.; Sarkisian, Catherine A.; Mahajan, Anish P.; Spritzer, Karen L.; Cunningham, William E.

    2008-01-01

    There is a need for a psychometrically sound measure of the stigma experienced by diverse persons living with HIV/AIDS (PLHA). The goal of this study was to develop and evaluate a multidimentional measure of internalized HIV stigma that captures stigma related to treatment and other aspects of the disease among sociodemographically diverse PLHA. We developed a 28-item measure of internalized HIV stigma composed of four scales based on previous qualitative work. Internal consistency reliabilit...

  18. INSIGHT AND SELF-STIGMA IN PATIENTS WITH SCHIZOPHRENIA.

    Science.gov (United States)

    Vidović, Domagoj; Brecić, Petrana; Vilibić, Maja; Jukić, Vlado

    2016-03-01

    Poor insight and high level of self-stigma are often present among patients with schizophrenia and are related to poorer treatment adherence, poorer social function and rehabilitation, aggressive behavior, higher level of depression, social anxiety, lower quality of life and self-esteem. Reports on a relationship between insight and stigma are controversial. We examined the relationship of the level of insight and self-stigma in a sample of 149 patients with schizophrenia. Insight was measured with the Scale to assess Unawareness of Mental Disorder and self-stigma with the Internalized Stigma of Mental Illness. Results showed 88.6% of the patients to have high or moderate insight, with a mean value of 2.73. General insight showed the highest level (2.58) and insight in positive symptoms the lowest level (2.9). The self-stigma score in general was 2.13, with stereotype endorsement being lowest (1.98). According to study results, 77.1% of patients felt minimal or low self-stigma across all subscales, except for stigma resistance subscale. Statistically significant correlation was found between insight and four subscales of self-stigma, while no correlation was found for the stigma resistance subscale only. These results imply the need of individually tailored antistigma and insight promoting programs for patients with schizophrenia.

  19. Stigma Management in International Relations

    DEFF Research Database (Denmark)

    Adler-Nissen, Rebecca

    2014-01-01

    with their stigma and may, in some cases, challenge and even transform a dominant moral discourse. A typology of stigma management strategies is presented: stigma recognition (illustrated by Germany); stigma rejection (illustrated by Austria); and finally counter-stigmatization (illustrated by Cuba). Because...

  20. Stigma and disability in schizophrenia: developing countries' perspective.

    Science.gov (United States)

    Thirthalli, Jagadisha; Kumar, Chennaveerachari Naveen

    2012-10-01

    Stigma and disability are two important consequences of schizophrenia that individuals afflicted with it experience. Sociocultural milieu can influence these. We review the literature on stigma and disability experienced by individuals with schizophrenia in the developing countries. We searched English-language literature from developing countries on stigma and disability in schizophrenia using PubMed and Scopus databases. As individual studies adopted widely varying methodologies, the retrieved papers did not yield themselves for a systematic review. We present a narrative review. Much of the literature on stigma and disability in schizophrenia has come from India and only a few other developing countries. Stigma associated with schizophrenia is highly prevalent across regions and across patients themselves, families, communities and professionals. Research is scanty with regard to determinants of stigma and interventions against stigma. A number of tools have been developed for assessment of disability. Preliminary evidence suggests that initiation and continuation of antipsychotic medications is associated with lesser disability. Psychosocial interventions may reduce disability further. Comprehensive, prospective studies evaluating the determinants of stigma and disability need to be conducted in the developing countries. Models of interventions to minimize these adverse consequences, developed based on their results, need to be tested.

  1. Predictors of HIV enacted stigma among Chilean women.

    Science.gov (United States)

    Cianelli, Rosina; Villlegas, Natalia; De Oliveira, Giovanna; Hires, Kimberly; Gattamorta, Karina; Ferrer, Lilian; Peragallo, Nilda

    2015-09-01

    To investigate if socio-demographic factors, religiosity, HIV-related knowledge, Marianismo, history of having been tested for HIV, knowing someone who died of AIDS and HIV risk perception were predictive factors to HIV enacted stigma predictors among Chilean women. HIV infection is the number one cause of death among women during their reproductive years. In Chile, studies with people living with HIV demonstrate the existence of HIV-related stigma. However, limited evidence is available about the underlying causes of HIV enacted stigma that results in stigmatisation and discrimination. The current cross-sectional study is a secondary analysis of data collected to assess the impact of an HIV prevention intervention (Mano a Mano-Mujer) designed for Chilean women. A quasi-experimental design was used in the original study. This study was conducted in two communities in Santiago, Chile. The sample for this study consisted of 496 Chileans between ages 18-49. Descriptive statistics and multiple regression were used for the analysis. Participants in the study reported high levels (77·8%) of HIV enacted stigma. Higher levels of HIV-related knowledge were associated with lower levels of HIV enacted stigma. Women with higher education had lower levels of HIV enacted stigma than women with elementary education. In addition, greater levels of marianismo (cultural belief that women should be passive, faithful, and devoted to family) were associated with higher HIV enacted stigma scores. The findings reflected the presence of HIV enacted stigma among Chilean women. Identifying the significant predictors of HIV enacted stigma can help the nursing community to design HIV prevention interventions that include the reduction in HIV enacted stigma. HIV evidence-based prevention interventions should incorporate contents related to stigma to contribute to prevent HIV enacted stigma at individual and community levels in accordance with the bioecological model. The results of this study

  2. Family Cohesion, Stigma, and Quality of Life in Dyads of Children With Epilepsy and Their Parents.

    Science.gov (United States)

    Mendes, Teresa P; Crespo, Carla A; Austin, Joan K

    2017-01-30

    OBJECTIVE : To examine the mediating role of stigma on the links between family cohesion and quality of life (QoL) in children with epilepsy and their parents. METHODS : Participants were 192 families attending three Portuguese public hospitals. Children and parents completed self-report measures of family cohesion, stigma, QoL, and health-related QoL (HRQoL). Neurologists assessed clinical variables. Structural equation modeling within the framework of the actor-partner interdependence model was used. RESULTS : The final model showed a good fit to the data, explaining 43% and 35% of the QoL outcomes of children and parents, respectively. Family cohesion was positively linked to QoL outcomes, directly for children and parents, and indirectly for children only, by way of negative links with perceived stigma. At the dyadic level, parents' perceptions of family cohesion were positively associated with children's HRQoL. CONCLUSIONS : A routine screening of those patients experiencing poorer HRQoL should include the assessment of family relationships and stigma.

  3. Urban and rural differences in HIV/AIDS stigma in five African countries

    National Research Council Canada - National Science Library

    Naidoo, Joanne R; Uys, Leana R; Greeff, Minrie; Holzemer, William L; Makoae, Lucy; Dlamini, Priscilla; Phetlhu, René D; Chirwa, Maureen; Kohi, Thecla

    2007-01-01

    .... Decreasing stigma is therefore an important goal in HIV/AIDS programmes. This paper explores whether urban and rural differences existed in reported incidents of HIV stigma from five African countries...

  4. Social context surrounding HIV diagnosis and construction of masculinity: a qualitative study of stigma experiences of heterosexual HIV positive men in southwest Nigeria.

    Science.gov (United States)

    Okoror, Titilayo Ainegbesua; Falade, Catherine Olufunke; Walker, Ebunlomo Mary; Olorunlana, Adetayo; Anaele, Agaptus

    2016-06-13

    Though research has documented experiences of stigma and its effects on the lives of women living with HIV/AIDS, there is limited research on heterosexual positive HIV men experience of stigma in Nigeria. This study explored how social context surrounding HIV diagnosis impacts stigma experiences of heterosexual HIV positive men and their construction of masculinity in southwest Nigeria. Using purposive sampling, 17 heterosexual HIV positive men were recruited through community based organization to participate in two hours focus group discussions or 45 min in-depth interviews that were audio-recorded. Without using the word stigma, discussions and interviews were guided by four questions that explored participants' experiences of living with HIV/AIDS. Interviews and discussions were conducted in three languages: English, Yoruba and Pidgin English. Thematic data analysis approach was in coding transcribed data, while social constructivist thinking guided data analysis. Participants ranged in age from 30 to 57 years old, and all were receiving antiretroviral therapy. Findings indicated that participants' experiences of stigma might be moderated by the social context surrounding their HIV diagnosis, and whether they have met the socio-cultural construction of masculinity. Participants whose diagnosis were preceded by immediate family members' diagnosis were less likely to report experiencing HIV stigma and more likely to report "not feeling less than a man" and educating others about HIV/AIDS. Contrarily, participants whose diagnosis was preceded by their own sickness were more likely to report isolation, sigma and feeling of being less than a man. All participants reported limiting their sexual intimacy, and those with children reported adjusting how they performed their role as fathers. Social context surrounding HIV diagnosis impact how heterosexual HIV positive men experience HIV related stigma and how they perceive themselves as men, which may influence their

  5. Social stigma and disclosure about induced abortion: results from an exploratory study.

    Science.gov (United States)

    Shellenberg, Kristen M; Moore, Ann M; Bankole, Akinrinola; Juarez, Fatima; Omideyi, Adekunbi Kehinde; Palomino, Nancy; Sathar, Zeba; Singh, Susheela; Tsui, Amy O

    2011-01-01

    It is well recognised that unsafe abortions have significant implications for women's physical health; however, women's perceptions and experiences with abortion-related stigma and disclosure about abortion are not well understood. This paper examines the presence and intensity of abortion stigma in five countries, and seeks to understand how stigma is perceived and experienced by women who terminate an unintended pregnancy and influences her subsequent disclosure behaviours. The paper is based upon focus groups and semi-structured in-depth interviews conducted with women and men in Mexico, Nigeria, Pakistan, Peru and the United States (USA) in 2006. The stigma of abortion was perceived similarly in both legally liberal and restrictive settings although it was more evident in countries where abortion is highly restricted. Personal accounts of experienced stigma were limited, although participants cited numerous social consequences of having an abortion. Abortion-related stigma played an important role in disclosure of individual abortion behaviour.

  6. Coping with stigma and discrimination: evidence from mental health service users in England.

    Science.gov (United States)

    Isaksson, A; Corker, E; Cotney, J; Hamilton, S; Pinfold, V; Rose, D; Rüsch, N; Henderson, C; Thornicroft, G; Evans-Lacko, S

    2017-05-02

    Mental health stigma and discrimination are significant problems. Common coping orientations include: concealing mental health problems, challenging others and educating others. We describe the use of common stigma coping orientations and explain variations within a sample of English mental health service users. Cross-sectional survey data were collected as part of the Viewpoint survey of mental health service users' experiences of discrimination (n = 3005). Linear regression analyses were carried out to identify factors associated with the three stigma coping orientations. The most common coping orientation was to conceal mental health problems (73%), which was strongly associated with anticipated discrimination. Only 51% ever challenged others because of discriminating behaviour, this being related to experienced discrimination, but also to higher confidence to tackle stigma. Although stigma coping orientations vary by context, individuals often choose to conceal problems, which is associated with greater anticipated and experienced discrimination and less confidence to challenge stigma. The direction of this association requires further investigation.

  7. The effect of disclosure of mental illness by interviewers on reports of discrimination experienced by service users: a randomized study.

    Science.gov (United States)

    Hamilton, Sarah; Pinfold, Vanessa; Rose, Diana; Henderson, Claire; Lewis-Holmes, Elanor; Flach, Clare; Thornicroft, Graham

    2011-01-01

    User involvement in research is widely valued, but evidence of its impact in quantitative research is lacking. We investigate whether survey responses are affected by interviewers' experience of mental health problems. We hypothesized that when the interviewer has experienced mental health problems, participants would be more likely to consent to participate, leave fewer items unanswered, report higher levels of discrimination and express greater satisfaction with the interview. The study was nested within a telephone survey of service users' experiences of discrimination. Participants were randomly assigned to three groups: peer disclosing, peer non-disclosing and non-peer interviewers, where 'peer interviewers' have personal experience of mental health problems. Analyses explored the impact on response rate, number of unanswered questions, reported discrimination and interview experience. No difference was found in prevalence of discrimination reported to interviewers. A significantly lower response rate was attained in the peer-disclosing group (5% compared to 6.5%, p = 0.005). Significantly fewer questions were left unanswered in the peer-disclosing group (Mean = 0.07 compared to 0.4, p = 0.004). Findings suggest that interviewers' experiences of mental health problems broadly do not impact on quantitative data collected in structured interviews about discrimination. Disclosure of peer status prior to consent may have affected recruitment.

  8. Stigma in patients with schizophrenia receiving community mental health care: a review of qualitative studies

    OpenAIRE

    Hansen, Bart; Mestdagh, Annelien

    2014-01-01

    PURPOSE The aim of this review is to identify consistent themes among the qualitative literature on stigma as experienced by community mental health patients with schizophrenia. With the treatment focus of schizophrenia nowadays shifting more and more towards community-based mental health care, professionals need to be aware of the increased vulnerability of their clients in their social environment as a result of stigma towards their disease. In-depth knowledge on stigma is cr...

  9. Stigma and work.

    Science.gov (United States)

    Stuart, Heather

    2004-01-01

    This paper addresses what is known about workplace stigma and employment inequity for people with mental and emotional problems. For people with serious mental disorders, studies show profound consequences of stigma, including diminished employability, lack of career advancement and poor quality of working life. People with serious mental illnesses are more likely to be unemployed or to be under-employed in inferior positions that are incommensurate with their skills or training. If they return to work following an illness, they often face hostility and reduced responsibilities. The result may be self-stigma and increased disability. Little is yet known about how workplace stigma affects those with less disabling psychological or emotional problems, even though these are likely to be more prevalent in workplace settings. Despite the heavy burden posed by poor mental health in the workplace, there is no regular source of population data relating to workplace stigma, and no evidence base to support the development of best-practice solutions for workplace anti-stigma programs. Suggestions for research are made in light of these gaps.

  10. Exploring the cultural context of HIV stigma on antiretroviral therapy adherence among people living with HIV/AIDS in southwest Nigeria.

    Science.gov (United States)

    Okoror, Titilayo A; Falade, Catherine O; Olorunlana, Adetayo; Walker, Ebunlomo M; Okareh, Oladapo T

    2013-01-01

    This study explored the cultural context of HIV stigma on antiretroviral therapy adherence among people living with HIV/AIDS (PLWHA) in southwest Nigeria. Using purposive sampling, participants were recruited through a community-based organization. Consenting PLWHA participated in in-depth interviews and focus group discussions that were audio-taped. Using Deacon's conceptual framework of stigma, four opinion guides facilitated the interviews and discussions. Interviews and discussions were conducted in three languages, and lasted from 45 min to 2 h. A total of 35 women and men participated in the study. Participants ranged in age from 22 to 58 years, with an average of 4 years since clinical diagnosis of HIV/AIDS. All participants were receiving ART, and self-reported high adherence level. Using thematic analysis, three themes emerged: life before ART, life after ART, and strategies used in ART adherence. In describing their lives before ART, participants reported experiencing self, anticipated and enacted stigmas due to their sickly appearance from HIV-related complications. After initiating ART, participants talked about friends and families "returning to them" and "apologizing for abandoning" them once they started "looking well." In response to anticipated stigma, many reported sticking to their medications. Drawing from the cultural milieu as part of their strategies, participants discussed the use of plastic bags for medications and àkònpó, as ways of diverting attention from their use of many medications. Implications for ART program policies and stigma interventions were discussed, along with limitation of a short-term ART study on stigma since long-term use of ART can contribute to stigma by way of lipoatrophy as PLWHA age.

  11. Difficulties with diagnosis and consequential poor outcome due to stigma of acquired immunodeficiency syndrome – a case report

    Science.gov (United States)

    Vuletic, Vladimira; Nevajda, Branimir; Spero, Martina; Chudy, Darko

    2013-01-01

    Low incidence of human immunodeficiency virus (HIV) infections and acquired immunodeficiency syndrome (AIDS) has been detected in Croatia so far. Toxoplasmic encephalitis (TE) is the most common opportunistic cerebral infection in AIDS patients and is highly responsive to antiparasitic chemotherapy, if treated at an early stage. We present the case of the brain biopsy confirmed as TE on a 36-year-old female patient who at admission presented with unconsciousness and a right hemiplegia. A MSCT was performed and two hypodense lesions were diagnosed. The patient’s family initially denied the presence or history of any medical problem or infection. An MRI showed multiple ring-enhanced mass lesions. An infectologist required a brain biopsy to exclude cerebral lymphoma and multiple metastases. Pathohistological analysis suggested TE. Meanwhile, patient’s blood samples were found to be HIV positive. The patient was transferred to University Hospital for Infectious Diseases in Zagreb, where she died 2 days following admission. The patient’s family terminally confessed that the patient had been HIV positive for 10 years and had refused any treatment. Family’s denial of infection as well as ‘hiding information’ concerning patient’s health from physicians involved in her treatment caused a delay in proper on-time patient treatment. We would like to emphasize that TE must be considered as a differential diagnosis in patients presenting with multiple cerebral lesions, including patients without acknowledged past history of HIV infection. A stigma towards HIV infection and ignorance of the disease still exist and therefore hinders proper treatment. PMID:24091082

  12. Experiences of HIV-related stigma among HIV-positive older ...

    African Journals Online (AJOL)

    Monica O. Kuteesa

    2014-07-23

    Jul 23, 2014 ... disclosure in a cohort of HIV-positive older people in Uganda. ... (rural site) and Wakiso district (peri-urban site) residents, we measured self-reported stigma levels for 183 ...... A Comparison of HIV Stigma and Disclosure Patterns .... Stigma among HIV-positive Mothers and Their Uninfected Adolescent Chil-.

  13. The weight of stigma: Cortisol reactivity to manipulated weight stigma

    National Research Council Canada - National Science Library

    Himmelstein, Mary S; Incollingo Belsky, Angela C; Tomiyama, A. Janet

    2015-01-01

    .... The psychological and physiological consequences of weight stigma remain understudied. This study examined the effects of experimentally manipulated weight stigma on the stress-responsive hypothalamic-pituitary-adrenal axis (HPA...

  14. The stigma of disability: Croatian experiences.

    Science.gov (United States)

    Buljevac, Marko; Majdak, Marijana; Leutar, Zdravka

    2012-01-01

    The aim of this paper is to get an insight into understanding the stigma of disability based on the experience and perception of people with disabilities and professionals who work with them. Qualitative research methods were used with two focus groups: one with people with disabilities (five participants) and other with professionals (seven participants). After data were collected, a qualitative content analysis was made. The results indicated that participants perceived and experienced stigma of disability through intrinsic and extrinsic elements of stigmatization. The intrinsic elements refer to the feeling of being different as a result of negative attitudes, prejudices and stereotypes. The extrinsic elements derive from the relationship of the system towards people with disabilities: discrimination and labelling. Some of the major findings of this research are that the stigma of disability is shown through the inability of the people with disabilities to make their own decisions, the perception of the disability as the main feature of the person, the lack of criteria during education, perceiving disability as a precondition in choosing a partner and parental capability, parents' decision-making about their children's lives, overprotection and stigmatization in education and employment. Stigmatization leads to social exclusion and influences the quality of life. The stigma of disability is manifested through the impossibility of realizing basic human rights, of living life independently and of taking equal part in a local community.

  15. A patient who experienced thyroid storm complicated by rhabdomyolysis, deep vein thrombosis, and a silent pulmonary embolism: a case report

    Science.gov (United States)

    2013-01-01

    Background Thyroid storm is a serious condition of thyrotoxicosis. Hyperthyroidism often presents with thrombotic events, especially at cerebral sites; however, the possible association between a lower extremity deep vein thrombosis (LEDVT) and thyroid storm has not been previously reported. We encountered a patient who developed thyroid storm, associated with rhabdomyolysis, followed by LEDVT and a small silent pulmonary embolism (PE). The case is discussed with references to the pertinent literature. Case presentation A 50-year-old woman with no past medical history was referred to our hospital because of severe diarrhea, muscle weakness in her lower limbs (manual muscle testing: MMT 3), and disturbances of consciousness. She was diagnosed as having Graves’ disease based on the presence of struma, exophthalmos, and hyperthyroidism with TSH receptor antibody positivity; we further determined that the patient was experiencing thyroid storm based on the results of the Burch-Wartofsky scoring system and a Japanese diagnostic criteria. Treatment with steroids, iodine potassium, methimazole, and propranolol was initiated. Severe watery diarrhea continued, and the laboratory data revealed hypokalemia (2.0 meq/L). On day 14, a blood analysis showed a sudden elevation in her creatinine kinase (CK) level, leading to a diagnosis of rhabdomyolysis. Thereafter, the muscle weakness in her lower limbs advanced to a degree of MMT 1. Seven days after the diagnosis of rhabdomyolysis, pitting edema began to appear in bilateral lower extremities. Contrast-enhanced CT scans revealed a LEDVT involving the left common iliac vein, bilateral femoral veins, and left popliteal vein. Furthermore, a small PE was identified. Hyperthyroidism often presents with thrombotic events, especially at cerebral sites, but few reports of PE or LEDVT have been made. Conclusion This case suggests that the occurrence of thyroid storm may be associated with a risk of LEDVT and/or PE. We suggest that DVT

  16. Stigma as ego depletion: how being the target of prejudice affects self-control.

    Science.gov (United States)

    Inzlicht, Michael; McKay, Linda; Aronson, Joshua

    2006-03-01

    This research examined whether stigma diminishes people's ability to control their behaviors. Because coping with stigma requires self-regulation, and self-regulation is a limited-capacity resource, we predicted that individuals belonging to stigmatized groups are less able to regulate their own behavior when they become conscious of their stigmatizing status or enter threatening environments. Study 1 uncovered a correlation between stigma sensitivity and self-regulation; the more Black college students were sensitive to prejudice, the less self-control they reported having. By experimentally activating stigma, Studies 2 and 3 provided causal evidence for stigma's ego-depleting qualities: When their stigma was activated, stigmatized participants (Black students and females) showed impaired self-control in two very different domains (attentional and physical self-regulation). These results suggest that (a) stigma is ego depleting and (b) coping with it can weaken the ability to control and regulate one's behaviors in domains unrelated to the stigma.

  17. Understanding the stigma of leprosy

    African Journals Online (AJOL)

    Angel_D

    Self stigma - the fear of being discriminated against5. .... self-esteem and status in the ... World Health Organization 'Global Leprosy Situation 2008', Weekly ... 5. van Brakel, W. 'Measuring leprosy stigma – a preliminary review of the.

  18. Confronting the stigma of epilepsy

    Directory of Open Access Journals (Sweden)

    Sanjeev V Thomas

    2011-01-01

    Full Text Available Stigma and resultant psychosocial issues are major hurdles that people with epilepsy confront in their daily life. People with epilepsy, particularly women, living in economically weak countries are often ill equipped to handle the stigma that they experience at multiple levels. This paper offers a systematic review of the research on stigma from sociology and social psychology and details how stigma linked to epilepsy or similar conditions can result in stereotyping, prejudice and discrimination. We also briefly discuss the strategies that are most commonly utilized to mitigate stigma. Neurologists and other health care providers, social workers, support groups and policy makers working with epilepsy need to have a deep understanding of the social and cultural perceptions of epilepsy and the related stigma. It is necessary that societies establish unique determinants of stigma and set up appropriate strategies to mitigate stigma and facilitate the complete inclusion of people with epilepsy as well as mitigating any existing discrimination.

  19. Stigma-related stress, shame and avoidant coping reactions among members of the general population with elevated symptom levels.

    Science.gov (United States)

    Schibalski, J V; Müller, M; Ajdacic-Gross, V; Vetter, S; Rodgers, S; Oexle, N; Corrigan, P W; Rössler, W; Rüsch, N

    2017-04-01

    It is unclear whether mental illness stigma affects individuals with subthreshold syndromes outside clinical settings. We therefore investigated the role of different stigma variables, including stigma-related stress and shame reactions, for avoidant stigma coping among members of the general population with elevated symptom levels. Based on a representative population survey, general stress resilience, stigma variables, shame about having a mental illness as well as avoidant stigma coping (secrecy and social withdrawal) were assessed by self-report among 676 participants with elevated symptom levels. Stigma variables and resilience were examined as predictors of avoidant stigma coping in a path model. Increased stigma stress was predicted by lower general stress resilience as well as by higher levels of perceived stigma, group identification and perceived legitimacy of discrimination. More shame was associated with higher perceived legitimacy. Lower resilience as well as more perceived stigma, group identification and perceived legitimacy predicted avoidant coping. Stigma stress partly mediated effects of resilience, perceived stigma and group identification on avoidant coping; shame partly mediated effects of perceived legitimacy on coping. Stigma stress and shame were also directly and positively related to avoidant stigma coping. Analyses were adjusted for symptoms, neuroticism and sociodemographic variables. Stigma may affect a larger proportion of the population than previously thought because stigma variables predicted secrecy and withdrawal among members of the general population with elevated, but overall mild symptom levels. Avoidant stigma coping likely has harmful effects, potentially exacerbating pre-existing psychological distress and undermining social networks. This highlights the need to reduce public stigma as well as to support individuals with subthreshold syndromes in their coping with stigma stress and shame reactions. Copyright © 2017

  20. Diabetes-related stigma affects the quality of life of people living with diabetes mellitus in Switzerland: implications for healthcare providers.

    Science.gov (United States)

    Gredig, Daniel; Bartelsen-Raemy, Annabelle

    2017-09-01

    There is a growing body of scientific evidence that stigma represents a reality for many people living with diabetes (PWD). However, little is known about the impact of experienced stigma. Against this background, the present study aimed to establish, by means of an in-depth consideration of the situation in Switzerland, whether and how experienced and perceived stigma impact the quality of life of those PWD affected. In this cross-sectional study, an anonymous paper-and-pencil self-administered questionnaire (SAQ) was used for data collection. The SAQ drew on a qualitative elicitation study and was distributed in 2013 to the readers of a Swiss journal destined to people living with diabetes. Data were analysed using descriptive statistics and structural equation modelling. The sample included 3347 people (response rate of 16%) with type 1 and 2 diabetes, aged 16-96. Respondents who reported higher levels of perceived stigma reported higher levels of psychological distress (β = 0.37), more pronounced depressive symptoms (β = 0.33) and less social support (β = -0.22). Higher psychological distress (β = -0.29) and more pronounced depressive symptoms (β = -0.28), in turn, predicted lower quality of life. Findings suggest that stigma should be considered as an additional predictor of quality of life in PWD. Therefore, healthcare providers should support PWD's fight against stigma. Especially, social workers are called to engage in advocacy to reduce discrimination against PWD and claim equal chances for them. They are also called to develop and implement interventions to correct stereotypes about PWD. © 2016 The Authors. Health and Social Care in the Community published by John Wiley & Sons Ltd.

  1. The stigma of mental illness

    OpenAIRE

    Kordosi A; Saridi M; Souliotis K

    2015-01-01

    Introduction:The stigma of mental illness is not a modern phenomenon, but it can now be approached scientifically. The stigma, because of the mental illness which characterizes a person, can be explained by the natural propensity of man to deliver biased and stereotyped estimates to phenomena he cannot explain, accept or face. Methodology:This study is an attempt to describe the concept of stigma and the impact of the stigma of mental illness in the personal and social life of the...

  2. Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities.

    Directory of Open Access Journals (Sweden)

    Diane M Quinn

    Full Text Available Understanding how stigmatized identities contribute to increased rates of depression and anxiety is critical to stigma reduction and mental health treatment. There has been little research testing multiple aspects of stigmatized identities simultaneously. In the current study, we collected data from a diverse, urban, adult community sample of people with a concealed stigmatized identity (CSI. We targeted 5 specific CSIs--mental illness, substance abuse, experience of domestic violence, experience of sexual assault, and experience of childhood abuse--that have been shown to put people at risk for increased psychological distress. We collected measures of the anticipation of being devalued by others if the identity became known (anticipated stigma, the level of defining oneself by the stigmatized identity (centrality, the frequency of thinking about the identity (salience, the extent of agreement with negative stereotypes about the identity (internalized stigma, and extent to which other people currently know about the identity (outness. Results showed that greater anticipated stigma, greater identity salience, and lower levels of outness each uniquely and significantly predicted variance in increased psychological distress (a composite of depression and anxiety. In examining communalities and differences across the five identities, we found that mean levels of the stigma variables differed across the identities, with people with substance abuse and mental illness reporting greater anticipated and internalized stigma. However, the prediction pattern of the variables for psychological distress was similar across the substance abuse, mental illness, domestic violence, and childhood abuse identities (but not sexual assault. Understanding which components of stigmatized identities predict distress can lead to more effective treatment for people experiencing psychological distress.

  3. Examining Effects of Anticipated Stigma, Centrality, Salience, Internalization, and Outness on Psychological Distress for People with Concealable Stigmatized Identities

    Science.gov (United States)

    Quinn, Diane M.; Williams, Michelle K.; Quintana, Francisco; Gaskins, Jennifer L.; Overstreet, Nicole M.; Pishori, Alefiyah; Earnshaw, Valerie A.; Perez, Giselle; Chaudoir, Stephenie R.

    2014-01-01

    Understanding how stigmatized identities contribute to increased rates of depression and anxiety is critical to stigma reduction and mental health treatment. There has been little research testing multiple aspects of stigmatized identities simultaneously. In the current study, we collected data from a diverse, urban, adult community sample of people with a concealed stigmatized identity (CSI). We targeted 5 specific CSIs – mental illness, substance abuse, experience of domestic violence, experience of sexual assault, and experience of childhood abuse – that have been shown to put people at risk for increased psychological distress. We collected measures of the anticipation of being devalued by others if the identity became known (anticipated stigma), the level of defining oneself by the stigmatized identity (centrality), the frequency of thinking about the identity (salience), the extent of agreement with negative stereotypes about the identity (internalized stigma), and extent to which other people currently know about the identity (outness). Results showed that greater anticipated stigma, greater identity salience, and lower levels of outness each uniquely and significantly predicted variance in increased psychological distress (a composite of depression and anxiety). In examining communalities and differences across the five identities, we found that mean levels of the stigma variables differed across the identities, with people with substance abuse and mental illness reporting greater anticipated and internalized stigma. However, the prediction pattern of the variables for psychological distress was similar across the substance abuse, mental illness, domestic violence, and childhood abuse identities (but not sexual assault). Understanding which components of stigmatized identities predict distress can lead to more effective treatment for people experiencing psychological distress. PMID:24817189

  4. The Stigma of Mental Illness

    Science.gov (United States)

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  5. The Stigma of Mental Illness

    Science.gov (United States)

    Overton, Stacy L.; Medina, Sondra L.

    2008-01-01

    Stigma surrounding major mental illness creates many barriers. People who experience mental illness face discrimination and prejudice when renting homes, applying for jobs, and accessing mental health services. The authors review the current literature regarding stigma and mental illness. They define stigma and review theories that explain its…

  6. Enacted Sexual Stigma, Stigma Consciousness, and Subjective Happiness Scale Adaptation: A Two-Country Study.

    Science.gov (United States)

    Strizzi, Jenna; Fernández-Agis, Inmaculada; Parrón-Carreño, Tesifon; Alarcón-Rodríguez, Raquel

    2016-01-01

    Violence against people due to their sexual orientation is a phenomenon that exists within a framework of sexual stigma and sexual prejudice that can result in enacted stigma. The present study primarily aimed to validate the Stigma Consciousness Questionnaire (SCQ) and the Subjective Happiness Scale (SHS; for lesbian, gay, and bisexual [LGB] populations) in the Spanish context by using samples from two countries (Spain [N = 157] and the United States [N = 83]). Also, to examine how the construct of stigma consciousness correlates with anti-LGBQ (anti-lesbian, gay, bisexual, and queer) hate crime victimization and violent incidents, as well as examine whether the former influences subjective happiness. The population from the United States reported higher stigma consciousness and received more anti-LGBQ threats and insults. Hate crime victimization was the same across the two samples and positively correlated with violent incidents in both samples. Subjective happiness was negatively correlated with SCQ, although its subscales it did not correlate with enacted stigma measures. © The Author(s) 2014.

  7. Mental health stigma: what is being done to raise awareness and reduce stigma in South Africa?

    Science.gov (United States)

    Kakuma, R; Kleintjes, S; Lund, C; Drew, N; Green, A; Flisher, A J

    2010-05-01

    Stigma plays a major role in the persistent suffering, disability and economic loss associated with mental illnesses. There is an urgent need to find effective strategies to increase awareness about mental illnesses and reduce stigma and discrimination. This study surveys the existing anti-stigma programmes in South Africa. The World Health Organization's Assessment Instrument for Mental Health Systems Version 2.2 and semi-structured interviews were used to collect data on mental health education programmes in South Africa. Numerous anti-stigma campaigns are in place in both government and non-government organizations across the country. All nine provinces have had public campaigns between 2000 and 2005, targeting various groups such as the general public, youth, different ethnic groups, health care professionals, teachers and politicians. Some schools are setting up education and prevention programmes and various forms of media and art are being utilized to educate and discourage stigma and discrimination. Mental health care users are increasingly getting involved through media and talks in a wide range of settings. Yet very few of such activities are systematically evaluated for the effectiveness and very few are being published in peer-review journals or in reports where experiences and lessons can be shared and potentially applied elsewhere. A pool of evidence for anti-stigma and awareness-raising strategies currently exists that could potentially make a scientific contribution and inform policy in South Africa as well as in other countries.

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

    Science.gov (United States)

    Hasson-Ohayon, Ilanit; Mashiach-Eizenberg, Michal; Lysaker, Paul H; Roe, David

    2016-06-30

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

  9. The development and validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N).

    Science.gov (United States)

    Uys, Leana R; Holzemer, William L; Chirwa, Maureen L; Dlamini, Priscilla S; Greeff, Minrie; Kohi, Thecla W; Makoae, Lucia N; Stewart, Anita L; Mullan, Joseph; Phetlhu, René D; Wantland, Dean J; Durrheim, Kevin L; Cuca, Yvette P; Naidoo, Joanne R

    2009-02-01

    Illness-related stigma remains a serious problem in the management of HIV disease in Africa. This article describes a series of study phases conducted to develop and validate an instrument to measure HIV/AIDS-related stigma as perpetrated and experienced by nurses. Data were collected in Lesotho, Malawi, South Africa, Swaziland and Tanzania, from 2004-2006. The first phase was a qualitative study with focus group participants (n=251) to gather emic and etic descriptions of HIV/AIDS-related stigma in the five countries. Based on the qualitative data, a 46-item instrument was developed and tested during a second phase in the same five countries (n=244). The result of this phase was a 33-item, three-factor instrument with an average Cronbach alpha of 0.85. A third phase tested the instrument in 1474 nurses. The result was a final 19-item instrument, the HIV/AIDS Stigma Instrument - Nurse (HASI-N), comprised of two factors (Nurses Stigmatizing Patients and Nurses Being Stigmatized) with a Cronbach alpha of 0.90. Concurrent validity was tested by comparing the level of stigma with job satisfaction and quality of life. A significant negative correlation was found between stigma and job satisfaction. The HASI-N is the first inductively derived instrument measuring stigma experienced and enacted by nurses. It has the potential to be used not only to measure stigma, but also to develop stigma-reduction interventions.

  10. Perceived stigma among individuals with common mental disorders.

    Science.gov (United States)

    Alonso, Jordi; Buron, Andrea; Rojas-Farreras, Sonia; de Graaf, Ron; Haro, Josep M; de Girolamo, Giovanni; Bruffaerts, Ronny; Kovess, Viviane; Matschinger, Herbert; Vilagut, Gemma

    2009-11-01

    Severe mental disorders are associated with social distance from the general population, but there is lack of data on the stigma reported by individuals with common mental disorders. To identify the correlates and the impact of stigma among individuals with common mental disorders. Cross-sectional, household interview survey of 8796 representing the non-institutionalized adults of Belgium, France, Germany, Italy, the Netherlands and Spain. Two perceived stigma questions (embarrassment and discrimination) were asked to respondents with significant disability. Health-related quality of life measured by the SF-12, work and activity limitation and social limitation were also assessed. Among the 815 participants with a 12-month mental disorder and significant disability, 14.8% had perceived stigma. Stigma was significantly associated with low education, being married/living with someone and being unemployed. Perceived stigma was associated with decreased quality of life (SF-12 PCS score -4.65; pstigma if they have lower education, are married, or are unemployed. Perceived stigma is associated with considerably decrease in quality of life and role functioning. Health professionals and society at large must be aware of these findings, which suggest that fighting stigma should be a public health priority.

  11. Stigma and GPs' perceptions of dementia

    NARCIS (Netherlands)

    Gove, D.; Downs, M.; Vernooij-Dassen, M.; Small, N.

    2016-01-01

    OBJECTIVES: General practitioners (GPs) are crucial to improving timely diagnosis, but little is reported about how they perceive dementia, and whether their perceptions display any elements of stigma. The aim of this study was to explore how GPs' perceptions of dementia map onto current

  12. Stigma in patients with schizophrenia receiving community mental health care: a review of qualitative studies.

    Science.gov (United States)

    Mestdagh, Annelien; Hansen, Bart

    2014-01-01

    The aim of this review is to identify consistent themes among the qualitative literature on stigma as experienced by patients with schizophrenia receiving community mental health care. With the treatment focus of schizophrenia nowadays shifting more and more towards community-based mental health care, professionals need to be aware of the increased vulnerability of their clients in their social environment as a result of stigma towards their disease. In-depth knowledge on stigma is critical in order to offer a dignifying community mental health care. A systematic search of the qualitative literature in Web of Science, PubMed, PsycINFO and Francis was performed to review the subjective experiences and ideas on stigma in outpatients with schizophrenia. Three major themes were identified in 18 studies and need to be taken into consideration when implementing an adequate community mental health care: (i) the continuing existence of stigma inherent in the health care setting, (ii) the importance of relational aspects of stigma encounters in daily life and (iii) the significance of the behavioural aspects related to previous stigma experiences and beliefs among patients. Despite much effort in community treatment, patients still experience stigma and discrimination. Community mental health care professionals should not only be aware of structural problems in mental health care, but should also pay considerable attention towards the relational and behavioural aspects in their clients' life concerning stigma. Furthermore, they have the crucial role in the community to raise awareness about stigma in order to increase their clients' acceptance in society.

  13. Appearances, Stigma, and Prevention.

    Science.gov (United States)

    Kauffman, James M.

    2003-01-01

    In this article, the practical aspects of clothing are compared to effective practices in special education. Actual competence is more important than the appearance, or cloak, of competence. It is argued that speaking openly about disability will do more to reduce its stigma than will euphemisms. (Contains references.) (Author/CR)

  14. Services for Families of Infants and Toddlers Experiencing Trauma. A Research-to-Practice Brief. OPRE Report 2015-14

    Science.gov (United States)

    Harden, Branda Jones

    2015-01-01

    Infancy is a time of extreme opportunity, but it is also a time of extreme vulnerability, particularly for those reared in high-risk environments. Although infant exposure to any risk is important to understand, this brief focuses on the experience and impact of "trauma," defined as witnessing or experiencing an event that poses a real…

  15. Product Stigmaticity: Understanding, Measuring and Managing Product-Related Stigma

    NARCIS (Netherlands)

    Vaes, K.

    2014-01-01

    Stigma-free Product Design. Many of the products intended to relieve us from discomforting or unsafe situations and many medical and assistive devices are experienced as unpleasant and uncomfortable. On top of their discomfort, product users may also experience social unease from the people around

  16. Product Stigmaticity: Understanding, Measuring and Managing Product-Related Stigma

    NARCIS (Netherlands)

    Vaes, K.

    2014-01-01

    Stigma-free Product Design. Many of the products intended to relieve us from discomforting or unsafe situations and many medical and assistive devices are experienced as unpleasant and uncomfortable. On top of their discomfort, product users may also experience social unease from the people around t

  17. Development and psychometric assessment of a multidimensional measure of internalized HIV stigma in a sample of HIV-positive adults.

    Science.gov (United States)

    Sayles, Jennifer N; Hays, Ron D; Sarkisian, Catherine A; Mahajan, Anish P; Spritzer, Karen L; Cunningham, William E

    2008-09-01

    There is a need for a psychometrically sound measure of the stigma experienced by diverse persons living with HIV/AIDS (PLHA). The goal of this study was to develop and evaluate a multidimentional measure of internalized HIV stigma that captures stigma related to treatment and other aspects of the disease among sociodemographically diverse PLHA. We developed a 28-item measure of internalized HIV stigma composed of four scales based on previous qualitative work. Internal consistency reliability estimates in a sample of 202 PLHA was 0.93 for the overall measure, and exceeded 0.85 for three of the four stigma scales. Items discriminated well across scales, and correlations of the scales with shame, social support, and mental health supported construct validity. This measure should prove useful to investigators examining in the role of stigma in HIV treatment and health outcomes, and evaluating interventions designed to mitigate the impacts of stigma on PLHA.

  18. Postsecondary Students and Disability Stigma: Development of the Postsecondary Student Survey of Disability-Related Stigma (PSSDS)

    Science.gov (United States)

    Trammell, Jack

    2009-01-01

    Few instruments or studies have been designed to measure the degree of stigmatization experienced by college and University students with disabilities. Yet, many researchers acknowledge through qualitative studies and other forms of experiential data that postsecondary students with disabilities do in fact encounter significant stigma effects.…

  19. Validity and reliability of the Internalized Stigma of Smoking Inventory: An exploration of shame, isolation, and discrimination in smokers with mental health diagnoses.

    Science.gov (United States)

    Brown-Johnson, Cati G; Cataldo, Janine K; Orozco, Nicholas; Lisha, Nadra E; Hickman, Norval J; Prochaska, Judith J

    2015-08-01

    De-normalization of smoking as a public health strategy may create shame and isolation in vulnerable groups unable to quit. To examine the nature and impact of smoking stigma, we developed the Internalized Stigma of Smoking Inventory (ISSI), tested its validity and reliability, and explored factors that may contribute to smoking stigma. We evaluated the ISSI in a sample of smokers with mental health diagnoses (N = 956), using exploratory and confirmatory factor analysis, and assessed construct validity. Results reduced the ISSI to eight items with three subscales: smoking self-stigma related to shame, felt stigma related to social isolation, and discrimination experiences. Discrimination was the most commonly endorsed of the three subscales. A multivariate generalized linear model predicted 21-30% of the variance in the smoking stigma subscales. Self-stigma was greatest among those intending to quit; felt stigma was highest among those experiencing stigma in other domains, namely ethnicity and mental illness-based; and smoking-related discrimination was highest among women, Caucasians, and those with more education. Smoking stigma may compound stigma experiences in other areas. Aspects of smoking stigma in the domains of shame, isolation, and discrimination were related to modeled stigma responses, particularly readiness to quit and cigarette addiction, and were found to be more salient for groups where tobacco use is least prevalent. The ISSI measure is useful for quantifying smoking-related stigma in multiple domains. © American Academy of Addiction Psychiatry.

  20. Validity and Reliability of the Internalized Stigma of Smoking Inventory: An Exploration of Shame, Isolation, and Discrimination in Smokers with Mental Health Diagnoses

    Science.gov (United States)

    Brown-Johnson, Cati G.; Cataldo PhD, Janine K.; Orozco, Nicholas; Lisha, Nadra E.; Hickman, Norval; Prochaska, Judith J.

    2015-01-01

    Background and Objectives De-normalization of smoking as a public health strategy may create shame and isolation in vulnerable groups unable to quit. To examine the nature and impact of smoking stigma, we developed the Internalized Stigma of Smoking Inventory (ISSI), tested its validity and reliability, and explored factors that may contribute to smoking stigma. Methods We evaluated the ISSI in a sample of smokers with mental health diagnoses (N=956), using exploratory and confirmatory factor analysis, and assessed construct validity. Results Results reduced the ISSI to 8 items with three subscales: smoking self-stigma related to shame, felt stigma related to social isolation, and discrimination experiences. Discrimination was the most commonly endorsed of the three subscales. A multivariate generalized linear model predicted 21-30% of the variance in the smoking stigma subscales. Self-stigma was greatest among those intending to quit; felt stigma was highest among those experiencing stigma in other domains, namely ethnicity and mental illness-based; and smoking-related discrimination was highest among women, Caucasians, and those with more education. Discussion and Conclusion Smoking stigma may compound stigma experiences in other areas. Aspects of smoking stigma in the domains of shame, isolation, and discrimination related to modeled stigma responses, particularly readiness to quit and cigarette addiction and was found to be more salient for groups where tobacco use is least prevalent. Scientific Significance The ISSI measure is useful for quantifying smoking-related stigma in multiple domains. PMID:25930661

  1. Substance Use and Mental Health Stigma in Veterans With Co-Occurring Disorders.

    Science.gov (United States)

    Harnish, Autumn; Corrigan, Patrick; Byrne, Thomas; Pinals, Debra A; Rodrigues, Stephanie; Smelson, David

    2016-01-01

    This pilot study examined whether substance use or mental illness was more stigmatizing among individuals with co-occurring mental health and substance abuse problems. This study included 48 individuals with co-occurring substance use and mental health problems enrolled in a Substance Abuse and Mental Health Services funded treatment program. Subjects received a baseline assessment that included addiction, mental health, and stigma measures. The sample consisted primarily of White males with an average age of 38 years. Substance abuse was found to be more stigmatizing than mental illness, F(1, 47) = 14.213, p stigma varied across four different levels of stigma (Aware, Agree, Apply, and Harm), F(2.099, 98.675) = 117.883, p stigma was also significant, F(2.41, 113.284) = 20.250, p stigma between types varied across levels of stigma. Post hoc tests found a significant difference between all levels of stigma except for the comparison between Apply and Harm. Reported stigma was significantly higher for substance abuse than mental illness at the Aware and Agree levels. In addition, pairwise comparisons found significant differences between all levels of stigma with the exception of the comparison between Apply and Harm, indicating a pattern whereby reported stigma generally decreased from the first level (Aware stage) to subsequent levels. These results have important implications for treatment, suggesting the need to incorporate anti-stigma interventions for individuals with co-occurring disorders with a greater focus on substance abuse.

  2. Migrants and HIV stigma: findings from the Stigma Index Study (UK).

    Science.gov (United States)

    Chinouya, Martha; Hildreth, Anthony; Goodall, Deborah; Aspinall, Peter; Hudson, Alistair

    2017-01-01

    This paper is based on data collected in 2009 for the international Stigma Index Study which measured the experiences of stigma among participants living with HIV in the UK. Data were collected using a self-completed survey questionnaire and focus group discussions. Quantitative data were analysed using SPSS, while qualitative data were subjected to thematic analysis. The Stigma Index attempts to establish a baseline for documenting the experience of stigma and discrimination by people living with HIV while also acting as an advocacy tool whose power lay in the involvement of people living with HIV in the design of study instruments and data collection. Participants were recruited through collaborations with a broad range of UK HIV support organisations. The ethics protocols used were those described in the Stigma Index guidebook. A total of 867 people living with HIV took part, of whom 276 described themselves as 'immigrants'. Most of this 'migrant' subsample (70%) was women. Nearly, all (91%) identified as heterosexual, while 9% were attracted to someone of the same sex as them. Socioeconomic deprivation was a key theme and they reported other stigmatised chronic conditions in addition to HIV. It is not possible to ascertain from the questionnaire, the migrants' countries of origin and length of stay in the UK. Control of information about HIV was critically managed, with respect to family and partners. Felt stigma increased anxieties about personal safety, particularly among men. Strategies for safeguarding against the negative impact of stigma included avoiding social gatherings, intimacy, and clinical and HIV social care settings. Most participants were unaware of policies and declarations that protected them as persons living with HIV. Specific recommendations include creating awareness about rights as enshrined in various legal frameworks that protect the right of people living with HIV, which has been reconfigured as a 'disability'. © 2014 John Wiley

  3. Stigma and restriction on the social life of families of children with intellectual disabilities in Vietnam.

    Science.gov (United States)

    Ngo, Hong; Shin, Jin Y; Nhan, Nguyen Viet; Yang, Lawrence H

    2012-07-01

    Intellectual disabilities are as prevalent in East Asian countries as in the West (0.06%-1.3%). Widespread discrimination against intellectual disabilities in Asia may initiate stigma that places unfair restrictions on the social life of these individuals and their caregivers. We utilised established stigma frameworks to assess the extent to which a child's intellectual disability contributes to the social exclusion of caregivers in Vietnam. A mixed quantitative and qualitative approach was employed to examine the experience of social life restriction among parents of children with intellectual disabilities. The child's disability level and restrictions on caregivers' social experiences were assessed among 70 mothers and fathers recruited from schools in Hue City, Vietnam. Qualitative responses describing social exclusion were also recorded. Caregivers reported elevated levels of social exclusion. As hypothesised, parents of children with greater intellectual disability experienced more restrictions on their social life (Beta = 0.79, 95% confidence interval 0.27-1.30, standard error = 0.26, p stigma, which in turn restricts key social interactions among caregivers. Psycho-educational interventions may address the social domains in which caregivers are impacted and encourage sustained help-seeking among caregivers for their children.

  4. Perceived stigma in Korean adolescents with epilepsy: Effects of knowledge about epilepsy and maternal perception of stigma.

    Science.gov (United States)

    Ryu, Han Uk; Lee, Sang-Ahm; Eom, Soyong; Kim, Heung-Dong

    2015-01-01

    There has been little research on whether the knowledge that adolescents with epilepsy (AWE) or their family have about the condition reduces their perception of stigma. In this study we determine the relation between AWE's perceived stigma of, and knowledge about, epilepsy and maternal perception of stigma. This was a cross-sectional multicenter study involving AWE and their mothers from 25 secondary or tertiary hospitals in Korea. The level of knowledge about epilepsy was assessed using 34 medical items of the Epilepsy Knowledge Profile-General (EKP-M). Additional questionnaires included the Child Stigma Scale, Parent Stigma Scale, and the Maternal Disclosure Management Scale. A total of 243 AWE and their mothers were included. The mean EKP-M score was 20.7 (range, 12-31) for AWE and 22.0 (range, 11-31) for their mothers. AWE and mothers had a neutral perception of stigma on average, but the maternal concealment behavior was high. Multiple linear regression indicated that AWE's knowledge about epilepsy was significantly related to their perception of stigma. Unexpectedly, AWE with a low level of knowledge reported a higher perception of stigma than those with a very low level of knowledge (β=0.280, p=0.040). In addition, higher maternal concealment behavior (β=0.070, p=0.002) and receiving polytherapy (β=0.240, p=0.046) were independent factors predicting higher perception of stigma in AWE. The knowledge that the AWE had about their epilepsy, maternal concealment behavior, and receiving polytherapy were significantly related to the AWE's perception of stigma. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  5. Unpacking the public stigma of problem gambling: The process of stigma creation and predictors of social distancing.

    Science.gov (United States)

    Hing, Nerilee; Russell, Alex M T; Gainsbury, Sally M

    2016-09-01

    Background and aims Public stigma diminishes the health of stigmatized populations, so it is critical to understand how and why stigma occurs to inform stigma reduction measures. This study aimed to examine stigmatizing attitudes held toward people experiencing problem gambling, to examine whether specific elements co-occur to create this public stigma, and to model explanatory variables of this public stigma. Methods An online panel of adults from Victoria, Australia (N = 2,000) was surveyed. Measures were based on a vignette for problem gambling and included demographics, gambling behavior, perceived dimensions of problem gambling, stereotyping, social distancing, emotional reactions, and perceived devaluation and discrimination. A hierarchical linear regression was conducted. Results People with gambling problems attracted substantial negative stereotypes, social distancing, emotional reactions, and status loss/discrimination. These elements were associated with desired social distance, as was perceived that problem gambling is caused by bad character, and is perilous, non-recoverable, and disruptive. Level of contact with problem gambling, gambling involvement, and some demographic variables was significantly associated with social distance, but they explained little additional variance. Discussion and conclusions This study contributes to the understanding of how and why people experiencing gambling problems are stigmatized. Results suggest the need to increase public contact with such people, avoid perpetuation of stereotypes in media and public health communications, and reduce devaluing and discriminating attitudes and behaviors.

  6. Normal Deviants and Erving Goffman: Extending the Literature on Organizational Stigma

    Directory of Open Access Journals (Sweden)

    Tommy Jensen

    2015-12-01

    Full Text Available The paper highlights two problematic tendencies in the burgeoning literature on organizational stigma. The first tendency is conceptual, where stigma is treated at the organizational level, thereby neglecting social encounters at the micro-level. As a way of remedying this, we enroll the seminal writings of Erving Goffman to situate organizational stigma in the interaction order. The second tendency is empirical, where the inclusion of actors performing stigma management is limited to managerial and organizational actors, thus neglecting many of those faced with managing organizational stigma. We report from an explorative study of ordinary wage laborers in the Swedish arms and pornography industries situated toward the bottom of their organizations and referred to as ‘normal deviants’. The paper shows how and why the organizational stigma literature could be more sensitive and inclusive toward whom, how, when, and where organizational stigma is managed.

  7. Jail Inmates’ Perceived and Anticipated Stigma: Implications for Post-release Functioning

    Science.gov (United States)

    Moore, Kelly; Stuewig, Jeffrey; Tangney, June

    2014-01-01

    Research shows that offenders perceive stigma, but the accuracy of these perceptions has not been assessed, nor their impact on successful reintegration. In a longitudinal study, jail inmates (N = 168) reported perceptions of stigma toward criminals and anticipated stigma just prior to release. A diverse college sample completed a parallel survey assessing stigmatizing attitudes toward criminals. Inmates’ perceived stigma was significantly higher than students’ stigmatizing attitudes. Perceived stigma positively predicted post-release employment for African-American inmates, but not for Caucasians. Anticipated stigma negatively predicted arrests for Caucasian inmates, but not for African Americans. Perceived and anticipated stigma may have different implications for reintegration, and these implications may vary across race. PMID:25045324

  8. A Mechanism Facilitates Pollination due to Stigma Behavior in Campsis radicans (Bignoniaceae)

    Institute of Scientific and Technical Information of China (English)

    YANGShu-Xiang; YANGChun-Feng; ZHANGTao; WANGQing-Feng

    2004-01-01

    The precise factors affecting stigma behavior in Campsis radicans (L.) Seem. ex Bureau. remain unclear up to now. In this study mechanical touch, self- and cross-pollination, and pollination with variable amounts of pollen grains separately contacting with stigmas have been conducted to determine the exact factor affecting the stigma behavior. Results show that mechanical touch alone cannot make the stigmas close permanently. It is the adequate pollen (>350) deposition that causes the stigma permanent closure, which is in accordance with previous reports that sufficient pollen grains are necessary for fruit development. In addition, the stigma behavior does not display differences when pollinated with cross- or self-pollen separately; both self and cross pollen grains can germinate and grow successfully. Our results cannot demonstrate that the stigma behavior in C. radicans is an outcrossing mechanism, but strongly indicate it acts as a mechanism to facilitate pollination, and then enhance the reproductive success.

  9. Perceptions of stigma

    OpenAIRE

    Šadl, Zdenka

    2016-01-01

    In this article the author investigates paid domestic work in Slovenia to obtain information on domestic workers' perceptions of their work. Cleaning up after other people is usually considered dirty work with a stigma attached to it. Given this, we draw on indepth interviews with paid domestic workers to examine how they deal with society's negative perceptions and potential individual strategies for coping with a stigmatised social identity. On the basis of previous research on paid domesti...

  10. Managing uncertainty: a grounded theory of stigma in transgender health care encounters.

    Science.gov (United States)

    Poteat, Tonia; German, Danielle; Kerrigan, Deanna

    2013-05-01

    A growing body of literature supports stigma and discrimination as fundamental causes of health disparities. Stigma and discrimination experienced by transgender people have been associated with increased risk for depression, suicide, and HIV. Transgender stigma and discrimination experienced in health care influence transgender people's health care access and utilization. Thus, understanding how stigma and discrimination manifest and function in health care encounters is critical to addressing health disparities for transgender people. A qualitative, grounded theory approach was taken to this study of stigma in health care interactions. Between January and July 2011, fifty-five transgender people and twelve medical providers participated in one-time in-depth interviews about stigma, discrimination, and health care interactions between providers and transgender patients. Due to the social and institutional stigma against transgender people, their care is excluded from medical training. Therefore, providers approach medical encounters with transgender patients with ambivalence and uncertainty. Transgender people anticipate that providers will not know how to meet their needs. This uncertainty and ambivalence in the medical encounter upsets the normal balance of power in provider-patient relationships. Interpersonal stigma functions to reinforce the power and authority of the medical provider during these interactions. Functional theories of stigma posit that we hold stigmatizing attitudes because they serve specific psychological functions. However, these theories ignore how hierarchies of power in social relationships serve to maintain and reinforce inequalities. The findings of this study suggest that interpersonal stigma also functions to reinforce medical power and authority in the face of provider uncertainty. Within functional theories of stigma, it is important to acknowledge the role of power and to understand how stigmatizing attitudes function to maintain

  11. Stigma, explanatory models and unmet needs of caregivers of children with developmental disorders in a low-income African country: a cross-sectional facility-based survey.

    Science.gov (United States)

    Tilahun, Dejene; Hanlon, Charlotte; Fekadu, Abebaw; Tekola, Bethlehem; Baheretibeb, Yonas; Hoekstra, Rosa A

    2016-04-27

    Understanding the perspectives of caregivers of children with developmental disorders living in low-income countries is important to inform intervention programmes. The purpose of this study was to examine the stigma experiences, explanatory models, unmet needs, preferred interventions and coping mechanisms of caregivers of children with developmental disorders in Ethiopia. Participants comprised caregivers (n = 102) of children with developmental disorders attending two child mental health clinics in Addis Ababa. The majority (66.7%; n = 68) had a diagnosis of intellectual disability (ID); 34 children (33.3%) had autism spectrum disorder (ASD) as their primary diagnosis. All caregivers were administered a structured questionnaire via a face-to-face interview, which included an adaptation of the Family Interview Schedule, closed questions about socio-demographic characteristics, explanatory models of illness, type of interventions used or desired and coping strategies, and an open ended question regarding the family's unmet needs. Most caregivers reported experience of stigma: 43.1% worried about being treated differently, 45.1% felt ashamed about their child's condition and 26.7% made an effort to keep their child's condition secret. Stigma did not depend on the type of developmental disorder, the child's age or gender, or on the age or level of education of the caregiver (all p > 0.05). Reported stigma was significantly higher in caregivers who had sought traditional help (p stigma experienced by families caring for a child with a developmental disorder. Designing interventions appropriate for low-income settings that improve awareness about developmental disorders, decrease stigma, improve access to appropriate education and strengthen caregivers' support are needed.

  12. The role of stigmas in mental health: A comparative study

    Directory of Open Access Journals (Sweden)

    Erhabor S. Idemudia

    2012-05-01

    Full Text Available Background: HIV (Human immunodeficiency Virus, AIDS and cancer are feared terminal diseases. HIV sufferers are known to be stigmatized. The stigma surrounding cancer, unfortunately, is hardly the focus of psychological investigations, and hence this provoked the need to compare the stigma suffered by both groups, and how these have impacted on the psychological functioning of the disease sufferer. Objectives: The study had two main objectives, firstly, to explore whether HIV patients suffer more stigma than cancer patients or not, and secondly, to understand the most common type of stigma and if stigma is associated with psychopathology. Psychopathology is measured with GHQ–28 which evaluates somatic complaints, anxiety, depression and social dysfunction.Method: The study was a survey, and descriptive in nature, and anchored on two hypotheses: Firstly, that HIV patients will experience more stigmas than cancer patients and consequently report more psychological dysfunctions. Secondly that there will be a significant difference between types of stigma and the symptoms reported about them. Data were collected from a conveniently sampled group of 50 HIV positive patients and another 50 patients diagnosed with cancer, in two clinics and a hospital around the Gauteng Province. The majority of the participants were females, numbering 62 (62, 0%, whilst 38 (38.0% were males. The age of the respondents ranged from 20–73 years with a mean age of 44.4 years (s.d. = 11.6.Results: Results revealed a significant main effect for enacted stigma F = (1.98, = 17.629, p < .001 and anxiety F = (1.98 = 5.750, p < .001. A post hoc Bonferroni also showed that HIV patients had a higher mean score of enacted stigma (X-bar = 4.22 than cancer patients (X-bar = 1.28 and also HIV patients reported more anxiety (X-bar = 8.81 than cancer patients (X-bar = 6.42. Enacted stigma significantly influenced the GHQ Total (F = (98 = 1.700, p < .05; anxiety (F = (97 = 2.578, p

  13. Measuring mental illness stigma with diminished social desirability effects.

    Science.gov (United States)

    Michaels, Patrick J; Corrigan, Patrick W

    2013-06-01

    For persons with mental illness, stigma diminishes employment and independent living opportunities as well as participation in psychiatric care. Public stigma interventions have sought to ameliorate these consequences. Evaluation of anti-stigma programs' impact is typically accomplished with self-report questionnaires. However, cultural mores encourage endorsement of answers that are socially preferred rather than one's true belief. This problem, social desirability, has been circumvented through development of faux knowledge tests (KTs) (i.e., Error-Choice Tests); written to assess prejudice. Our KT uses error-choice test methodology to assess stigmatizing attitudes. Test content was derived from review of typical KTs for façade reinforcement. Answer endorsement suggests bias or stigma; such determinations were based on the empirical literature. KT psychometrics were examined in samples of college students, community members and mental health providers and consumers. Test-retest reliability ranged from fair (0.50) to good (0.70). Construct validity analyses of public stigma indicated a positive relationship with the Attribution Questionnaire and inverse relationships with Self-Determination and Empowerment Scales. No significant relationships were observed with self-stigma measures (recovery, empowerment). This psychometric evaluation study suggests that a self-administered questionnaire may circumvent social desirability and have merit as a stigma measurement tool.

  14. Parents with serious mental illness: differences in internalised and externalised mental illness stigma and gender stigma between mothers and fathers.

    Science.gov (United States)

    Lacey, Melanie; Paolini, Stefania; Hanlon, Mary-Claire; Melville, Jessica; Galletly, Cherrie; Campbell, Linda E

    2015-02-28

    Research demonstrates that people living with serious mental illness (SMI) contend with widespread public stigma; however, little is known about the specific experiences of stigma that mothers, and in particular fathers, with SMI encounter as parents. This study aimed to explore and compare the experiences of stigma for mothers and fathers with SMI inferred not only by living with a mental illness but also potential compounding gender effects, and the associated impact of stigma on parenting. Telephone surveys were conducted with 93 participants with SMI who previously identified as parents in the Second Australian National Survey of Psychosis. Results indicated that mothers were more likely than fathers to perceive and internalise stigma associated with their mental illness. Conversely, fathers were more inclined to perceive stigma relating to their gender and to hold stigmatising attitudes towards others. Mental illness and gender stigma predicted poorer self-reported parenting experiences for both mothers and fathers. These findings may assist in tailoring interventions for mothers and fathers with SMI.

  15. TEACHERS’ VIEWS ON STIGMA TENDENCY

    Directory of Open Access Journals (Sweden)

    Erkan YAMAN

    2014-06-01

    Full Text Available As we consider educators’ responsibility of training new generations healthy, we can say that educators’ stigma tendency is no doubt to inhibit fulfilling this responsibility. In this regard, results about teachers’ views’ on stigma tendency and suggestions are given in this study. The purpose of the study is to determine stigma tendencies of teachers’ by using quantitative research methods. Relational survey model of causal-comparative research type is used in research. Teachers’ views on stigma tendency are surveyed. Research sample is cAs we consider educators’ responsibility of training new generations healthy, we can say that educators’ stigma tendency is no doubt to inhibit fulfilling this responsibility. In this regard, results about teachers’ views’ on stigma tendency and suggestions are given in this study. The purpose of the study is to determine stigma tendencies of teachers’ by using quantitative research methods. Relational survey model of causal-comparative research type is used in research. Teachers’ views on stigma tendency are surveyed. Research sample is consisted of 655 teachers. Stigma Scale which is developed by Yaman and Güngör (2013 and personal information form which is prepared by researchers is used for data collection. Independent samples t-test, one way Anova, Scheffe test, two-way Anova, multiple comparison analysis between the pores, and Tukey test was used by analyzing of collected data. According to research results; teachers’ stigma tendencies are significantly different according to gender, educational status, seniority, marital status, school type of teachers’ studying, level of religious feelings. Teachers should participate to focus groups, therapy groups and so on to reduce discrimination, prejudice and stigma tendency of their own.

  16. Adapting and validating a scale to measure sexual stigma among lesbian, bisexual and queer women.

    Directory of Open Access Journals (Sweden)

    Carmen H Logie

    Full Text Available Lesbian, bisexual and queer (LBQ women experience pervasive sexual stigma that harms wellbeing. Stigma is a multi-dimensional construct and includes perceived stigma, awareness of negative attitudes towards one's group, and enacted stigma, overt experiences of discrimination. Despite its complexity, sexual stigma research has generally explored singular forms of sexual stigma among LBQ women. The study objective was to develop a scale to assess perceived and enacted sexual stigma among LBQ women. We adapted a sexual stigma scale for use with LBQ women. The validation process involved 3 phases. First, we held a focus group where we engaged a purposively selected group of key informants in cognitive interviewing techniques to modify the survey items to enhance relevance to LBQ women. Second, we implemented an internet-based, cross-sectional survey with LBQ women (n=466 in Toronto, Canada. Third, we administered an internet-based survey at baseline and 6-week follow-up with LBQ women in Toronto (n=24 and Calgary (n=20. We conducted an exploratory factor analysis using principal components analysis and descriptive statistics to explore health and demographic correlates of the sexual stigma scale. Analyses yielded one scale with two factors: perceived and enacted sexual stigma. The total scale and subscales demonstrated adequate internal reliability (total scale alpha coefficient: 0.78; perceived sub-scale: 0.70; enacted sub-scale: 0.72, test-retest reliability, and construct validity. Perceived and enacted sexual stigma were associated with higher rates of depressive symptoms and lower self-esteem, social support, and self-rated health scores. Results suggest this sexual stigma scale adapted for LBQ women has good psychometric properties and addresses enacted and perceived stigma dimensions. The overwhelming majority of participants reported experiences of perceived sexual stigma. This underscores the importance of moving beyond a singular focus on

  17. Labeling of mental disorders and stigma in young people.

    Science.gov (United States)

    Wright, Annemarie; Jorm, Anthony F; Mackinnon, Andrew J

    2011-08-01

    Mental disorders are common in young people, yet many do not seek help. The use of psychiatric labels to describe mental disorders is associated with effective help-seeking choices, and is promoted in community awareness initiatives designed to improve help-seeking. However these labels may also be coupled with stigmatizing beliefs and therefore inhibit help-seeking: lay mental health or non-specific labels may be less harmful. We examined the association between labeling of mental disorders and stigma in youth using data from a national telephone survey of 2802 Australians aged 12-25 years conducted from June 2006 to August 2006. Label use and stigmatizing beliefs were assessed in response to vignettes of a young person experiencing depression, psychosis or social phobia. Logistic regressions examined the association between a range of labels commonly used, including psychiatric labels, and a range of stigma components. There were no significant associations between label use and the stigma components of "stigma perceived in others", "reluctance to disclose" and for the most part "social distance". Most mental health labels were associated with seeing the person as "sick" rather than "weak" and accurate psychiatric labels had the strongest effect sizes. However, for the psychosis vignette, the "dangerous/unpredictable" component was predicted by the labels "schizophrenia/psychosis", "mental illness" and "psychological problem", and the accurate psychiatric label showed the strongest association. For all vignettes, generic lay labels were not associated with stigma, but also rarely had a counter stigma effect. These findings suggest that the use of accurate psychiatric labels by young people is seldom associated with stigma and may assist young people by reducing perceptions of weakness. However, community education that promotes accurate labeling of psychosis should proceed with caution and address beliefs about dangerousness and unpredictability. Copyright

  18. The stigma of mental illness

    Directory of Open Access Journals (Sweden)

    Kordosi A

    2015-10-01

    Full Text Available Introduction:The stigma of mental illness is not a modern phenomenon, but it can now be approached scientifically. The stigma, because of the mental illness which characterizes a person, can be explained by the natural propensity of man to deliver biased and stereotyped estimates to phenomena he cannot explain, accept or face. Methodology:This study is an attempt to describe the concept of stigma and the impact of the stigma of mental illness in the personal and social life of the individual. The search for sources of this review was made through books on the topic and articles of the last twenty years, from online internet sources (pubmed, scopus, google scholar. Literature Review:Stigma brought about by illness from mental illness, is a complex process and concept, located in social interaction and the dynamics of social relations. The social stigma borne by mental illness in general, as well as the lack of information, ignorance, stereotypes, myths and prejudices, are the main reasons that characterize, even today, depression as a taboo subject. The stigma of mental illness is indeliblyimprinted in the identity of human suffering. In any case, the impact of stigma is critical for people who are sick. The psychological stress and difficult conditions that shape their daily lives aggravate their already compromised mental health, having a significant impact on the course and outcome of the disease itself. Key strategies to address stigma are protest, education and contact. Conclusions:A significant step in combating the stigma is to raise public awareness on the issues of mental health and their inclusion in society.

  19. HIV stigma and associated factors among antiretroviral treatment clients in Jimma town, Southwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Nikus Fido N

    2016-11-01

    Full Text Available Neno Nikus Fido, Mamusha Aman, Zewdie Brihnu Department of Health Education and Behavioral Sciences, Jimma University, Jimma, Ethiopia Background: HIV stigma has an important role in the spread of the AIDS epidemic. It profoundly affects the lives of individuals living with HIV/AIDS. Fear of being identified as having HIV may discourage a person from getting tested, accessing medical services, and obtaining medications. Thus, this study was aimed at assessing HIV-related stigma and associated factors among antiretroviral treatment (ART clients in Jimma town, Oromia region, Southwest Ethiopia. Methods: A facility-based cross-sectional study was conducted from March 11 to April 26, 2015, in ART clinics in Jimma town. Consecutively identified sample was obtained from ART clients who voluntarily participated in the survey after signing written consent. A structured interviewer-administered questionnaire was used to collect the data. Multiple linear regressions were conducted to assess the factors associated with various stigma domains. Results: Out of 349 clients requested, 318 (91.1% respondents voluntarily participated in the study; among them, 204 (64.2% respondents were females and the mean age of the respondents was 32.9 years. The mean score (and possible range of experienced HIV stigma was 41.5±12.6 (20.0–86.7, internalized stigma was 50.5±16.4 (20–96.5, and perceived stigma was 56.2±19.2 (20–100. Conclusion: The study revealed that duration of ART use and provider-initiated and forced HIV testing were significantly associated with the three HIV stigma domains. Despite the lower experienced HIV stigma, there were higher internalized and perceived stigmas. Therefore, HIV counseling services should be strengthened for new ART beginners, including pretest counseling. Keywords: HIV/AIDS, Jimma, stigma, ART clients, PLWHA

  20. Experiences of HIV-related stigma among HIV-positive older persons in Uganda--a mixed methods analysis.

    Science.gov (United States)

    Kuteesa, Monica O; Wright, Stuart; Seeley, Janet; Mugisha, Joseph; Kinyanda, Eugene; Kakembo, Frederick; Mwesigwa, Richard; Scholten, Francis

    2014-01-01

    There is limited data on stigma among older HIV-infected adults in sub-Saharan Africa. We describe the experiences of stigma and disclosure in a cohort of HIV-positive older people in Uganda. Using data from the Wellbeing of Older Peoples' Study of Kalungu (rural site) and Wakiso district (peri-urban site) residents, we measured self-reported stigma levels for 183 respondents (94 on antiretroviral therapy (ART); 88, not on ART) using a stigma score generated using three questions on stigma perceptions where 0 meant no stigma at all and 100 was maximum stigma. Based on two questions on disclosure, an overall score was computed. High disclosure was assigned to those who often or very often disclosed to the family and were never or seldom afraid to disclose elsewhere. We examined the experiences of HIV stigma of 25 adults (52% females) using semi-structured, open-ended interviews and monthly oral diaries over one year. Mean age of the respondents was 70 years (range 60-80 years) and 80% of all respondents were enrolled in ART. Interview transcripts were analysed using thematic content analysis. Overall, 55% of respondents had a high disclosure score, meaning they disclosed easily, and 47% had a high stigma score. The stigma scores were similar among those with high and low disclosure scores. In multivariate analyses with disclosure and stigma scores as dependent variables none of the respondents' characteristics had a significant effect at the 5% level. Qualitative data revealed that stigma ranges from: (1) perceptions (relatively passive, but leading to behaviour such as gossip, especially if not intended maliciously); to (2) discriminatory behaviour (active or enacted stigma; from malicious gossip to outright discrimination). Despite the relatively high levels of disclosure, older people suffer from high levels of stigma of various forms apart from HIV-related stigma. Efforts to assess for different forms of stigma at an individual level deserve greater attention

  1. Stigma, Social Comparison and Self-Esteem in Adults with an Intellectual Disability

    OpenAIRE

    Paterson, Lucy; McKenzie, Karen; Lindsay, William

    2012-01-01

    Background: The paper examines the perception of stigma in 43 adults with an intellectual disability, the relationship this has with their psychological well-being and whether the process of social comparison has a moderating effect on this relationship.\\ud \\ud Materials and Methods: A questionnaire-based, within-participant design was used. Participants completed three self-report measures of perception of stigma, self-esteem and social comparison.\\ud \\ud Results: Perception of stigma was fo...

  2. Stigma, Social Comparison and Self-Esteem in Adults with an Intellectual Disability

    OpenAIRE

    Paterson, Lucy; McKenzie, Karen; Lindsay, William

    2012-01-01

    Background: The paper examines the perception of stigma in 43 adults with an intellectual disability, the relationship this has with their psychological well-being and whether the process of social comparison has a moderating effect on this relationship.\\ud \\ud Materials and Methods: A questionnaire-based, within-participant design was used. Participants completed three self-report measures of perception of stigma, self-esteem and social comparison.\\ud \\ud Results: Perception of stigma was fo...

  3. Occupational Stigma as a Primary Barrier To Health Care For Street-Based Sex Workers in Canada

    Science.gov (United States)

    Lazarus, Lisa; Deering, Kathleen N; Nabess, Rose; Gibson, Kate; Tyndall, Mark W; Shannon, Kate

    2011-01-01

    Individuals working in the sex industry continue to experience many negative health outcomes. As such, disentangling the factors shaping poor health access remains a critical public health priority. Within a quasi-criminalised prostitution environment, this study aimed to evaluate the prevalence of occupational stigma associated with sex work and its relationship to barriers to accessing health services. Analyses draw on baseline questionnaire data from a community-based cohort of women in street-based sex work in Vancouver, Canada (2006–8). Of a total of 252 women, 141 (58.5%) reported occupational sex work stigma (defined as hiding occupational sex work status from family, friends and/or home community), while 125 (49.6%) reported barriers to accessing health services in the previous six months. In multivariable analysis, adjusting for socio-demographic, interpersonal and work environment risks, occupational sex work stigma remained independently associated with an elevated likelihood of experiencing barriers to health access. Study findings indicate the critical need for policy and societal shifts in views of sex work as a legitimate occupation, combined with improved access to innovative, accessible and non-judgmental health care delivery models for street-based sex workers that include the direct involvement of sex workers in development and implementation. PMID:22084992

  4. The impact of self-perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients: results of a cross-sectional study.

    Science.gov (United States)

    Broersma, Feddrik; Oeseburg, Barth; Dijkstra, Jacob; Wynia, Klaske

    2017-09-01

    To examine the impact of perceived limitations, stigma and sense of coherence on quality of life in multiple sclerosis patients. Cross-sectional survey. Department of Neurology, University Medical Center Groningen, the Netherlands. Multiple sclerosis patients. World Health Organization Quality of Life - abbreviated version, Stigma Scale for Chronic Illness, Sense of Coherence Scale, background and disease-related questions. In total, 185 patients (61% response rate) participated in the study with moderate to severe limitations. Stigma was highly prevalent but low in severity. Patients with a higher sense of coherence experienced a lower level of limitations ( B = -0.063, P sense of coherence experienced better quality of life (physical health B = 0.059, P life (physical health B = -0.364, P life (self-stigma: physical health B = -0.073, P sense of coherence experienced better quality of life. Patients with a higher sense of coherence experienced a lower level of limitations and less stigma.

  5. Experienced barriers and facilitators for integrating smoking cessation advice and support into daily dental practice. A short report

    NARCIS (Netherlands)

    Rosseel, J.P.; Jacobs, J.E.; Hilberink, S.R.; Maassen, I.M.; Segaar, D.; Plasschaert, A.J.M.; Grol, R.P.T.M.

    2011-01-01

    In a controlled study, primary care dental professionals in the intervention group were encouraged to provide smoking cessation advice and support for all smoking patients with the help of a stage-based motivational protocol. The barriers and facilitators reported by the dental professionals on two

  6. Tuberculosis stigma as a social determinant of health: a systematic mapping review of research in low incidence countries.

    Science.gov (United States)

    Craig, G M; Daftary, A; Engel, N; O'Driscoll, S; Ioannaki, A

    2017-03-01

    Tuberculosis (TB)-related stigma is an important social determinant of health. Research generally highlights how stigma can have a considerable impact on individuals and communities, including delays in seeking health care and adherence to treatment. There is scant research into the assessment of TB-related stigma in low incidence countries. This study aimed to systematically map out the research into stigma. A particular emphasis was placed on the methods employed to measure stigma, the conceptual frameworks used to understand stigma, and whether structural factors were theorized. Twenty-two studies were identified; the majority adopted a qualitative approach and aimed to assess knowledge, attitudes, and beliefs about TB. Few studies included stigma as a substantive topic. Only one study aimed to reduce stigma. A number of studies suggested that TB control measures and representations of migrants in the media reporting of TB were implicated in the production of stigma. The paucity of conceptual models and theories about how the social and structural determinants intersect with stigma was apparent. Future interventions to reduce stigma, and measurements of effectiveness, would benefit from a stronger theoretical underpinning in relation to TB stigma and the intersection between the social and structural determinants of health.

  7. The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review

    Science.gov (United States)

    Hanschmidt, Franz; Lehnig, Franziska; Riedel-Heller, Steffi G.; Kersting, Anette

    2016-01-01

    Background considerable proportion of the population experiences major life disruptions after losing a loved one to suicide. Social stigma attached to suicide survivors adds to complications occurring in the course of suicide bereavement. Despite its known risks, stigma related to suicide survivors has been sparsely investigated. Methods We conducted a systematic literature search in PubMed, Web of Science, PsycInfo and PsyArticles, of studies indexed up through August 2015. Articles were eligible for inclusion if they addressed experiences of stigma in suicide survivors, compared them to other bereavement populations, or investigated stigmatizing attitudes within the public. The search was restricted to English-language studies. Results 25 records matched inclusion criteria. Study designs were heterogeneous, making comparisons difficult. Results demonstrated that suicide survivors experience stigma in the form of shame, blame, and avoidance. Suicide survivors showed higher levels of stigma than natural death survivors. Stigma was linked to concealment of the death, social withdrawal, reduced psychological and somatic functioning, and grief difficulties. Only one study investigated stigmatizing attitudes towards suicide survivors among the general population. Limitations Internal and external validity of the studies was restricted by a lack of valid measures and selection bias. Conclusions More methodologically sound research is needed to understand the impact of stigma on suicide survivors’ grief trajectories and to separate it from other grief aspects. Clinicians and grief-counselors as well as the public should be educated about the persistent stigma experienced by suicide survivors. PMID:27657887

  8. Stigma, deviance and morality in young adults' accounts of inflammatory bowel disease.

    Science.gov (United States)

    Saunders, Benjamin

    2014-09-01

    For young adults with inflammatory bowel disease (IBD), perceived stigma has been found to be a salient concern. Drawing on interviews with individuals with IBD aged 18-29 (n = 16), this article uses rhetorical discourse analysis to explore how stigma is discursively constructed by young adults, with a focus on the moral underpinnings of the participants' talk. Their representations showed both felt stigma and enacted stigma; principally related to the perceived taboo surrounding the symptoms of their condition, which often led to the non-disclosure or concealment of the condition. The different ways in which stigma is manifested in the accounts present a challenge to recent arguments questioning the relevance of this concept in chronic illness research, though it was found that it is not adequate to look at stigma alone and, given the unstable nature of IBD, negotiating stigma in relation to possible charges of deviance is a pertinent issue for these young adults. For instance, non-disclosure because of shame could result in individuals experiencing blame. Accounts were constructed through a range of discursive strategies, allowing the participants to present themselves in morally appropriate ways throughout. Suggestions are made about future directions in addressing stigma and deviance in relation to this cohort.

  9. HIV and depression in Eastern Nigeria: the role of HIV-related stigma.

    Science.gov (United States)

    Onyebuchi-Iwudibia, Oscar; Brown, Amy

    2014-01-01

    To examine the prevalence of depression among HIV-positive patients in Eastern Nigeria and to explore its association with HIV-related stigma. One hundred and five patients with a diagnosis of HIV attending HIV clinics in Eastern Nigeria completed a questionnaire consisting of demographic and health background, the Patients Health Questionnaire (to measure depression) and the Berger HIV stigma scale. As many as 33.3% of participants were considered depressed. Depression was positively correlated with overall stigma score with further analysis finding a positive correlation with all four subscales of the questionnaire (personalised stigma, disclosure, negative self-image and public attitudes). Individuals experiencing more side effects of HIV treatment were also rated as more depressed. A regression analysis found that negative self-image and number of treatment side effects were significant predictors of depression. Depression is positively associated with HIV-related stigma in this sample in Eastern Nigeria. As both stigma and depression have been shown to have a negative impact on quality of life for those with HIV, health professionals working to support them should be aware of the impact of stigma on risk of depression. Screening for both HIV-related stigma and depression would be an important intervention to promote both physical and psychological well-being amongst HIV-positive patients in Eastern Nigeria.

  10. Does suppressing the thought of a self-relevant stigma affect interpersonal interaction?

    Science.gov (United States)

    Borton, Jennifer L S; Reiner, David R; Vazquez, Erica V; Ruddiman, Jessica F; Anglin, Stephanie M

    2011-01-01

    In the current study, we examined the effects of women's suppressing negative gender stereotypes while interacting with a male confederate. Compared with control participants, those who suppressed negative thoughts about women's ability experienced less self-confidence, lower self-esteem, and were more nonverbally submissive during the interaction, particularly if they were high in stigma consciousness (Pinel, 1999). These findings illustrate the negative intra- and interpersonal consequences of stigma suppression.

  11. Experiences of HIV-Related Stigma Among Young Men Who Have Sex with Men

    OpenAIRE

    Dowshen, Nadia; Binns, Helen J.; Garofalo, Robert

    2009-01-01

    Young men who have sex with men (MSM) represent an increasing number of new HIV infections in many communities. Many individuals still hold beliefs that may lead to discrimination against HIV-positive individuals. HIV stigma is associated with negative health and psychosocial outcomes and may lead to greater challenges for this marginalized population. This study describes stigma experienced by HIV-positive young MSM, explores its relationship to psychosocial measures, and tests the hypothesi...

  12. HIV stigma among substance abusing people living with HIV/AIDS: implications for HIV treatment.

    Science.gov (United States)

    Levi-Minzi, Maria A; Surratt, Hilary L

    2014-08-01

    HIV-related stigma has a major impact on quality of life and health among people living with HIV and AIDS (PLWHA). This study examines demographic, mental health, behavioral, contextual, and HIV care-related correlates of HIV stigma among 503 substance abusing PLWHA. Stigma was measured with the HIV Internalized Stigma Measure which has four subscales: stereotypes about HIV, self-acceptance, disclosure concerns, and social relationships. Severe substance dependence (55.3%) and depression (54.7%) were associated with higher HIV stigma across all domains. 49.9% of the sample reported antiretroviral (ARV) medication diversion (the unlawful sale and trading of ARV medications); diverters endorsed significantly higher stigma related to disclosure. 54.1% of the sample reported ≥95% ARV adherence; these individuals reported significantly lower stigma for self-acceptance, disclosure, and social relationships. Multivariate linear regression showed that depression and social support demonstrated significant main effects across stigma domains. Findings suggest that interventions to decrease HIV related stigma may be an important component of initiatives to increase engagement in HIV care.

  13. Stigma toward mental illness in Latin America and the Caribbean: a systematic review

    Directory of Open Access Journals (Sweden)

    Franco Mascayano

    2016-03-01

    Full Text Available Objective: Stigma toward individuals with mental disorders has been studied extensively. In the case of Latin America and the Caribbean, the past decade has been marked by a significant increase in information on stigma toward mental illness, but these findings have yet to be applied to mental health services in Latin America. The objective of this study was to conduct a systematic review of studies relating to stigma toward mental illness in Latin America and the Caribbean. The authors specifically considered differences in this region as compared with manifestations reported in Western European countries. Methods: A systematic search of scientific papers was conducted in the PubMed, MEDLINE, EBSCO, SciELO, LILACS, Imbiomed, and Bireme databases. The search included articles published from 2002 to 2014. Results: Twenty-six studies from seven countries in Latin America and the Caribbean were evaluated and arranged into the following categories: public stigma, consumer stigma, family stigma, and multiple stigmas. Conclusion: We identified some results similar to those reported in high-income settings. However, some noteworthy findings concerning public and family stigma differed from those reported in Western European countries. Interventions designed to reduce mental illness-related stigma in this region may benefit from considering cultural dynamics exhibited by the Latino population.

  14. Stigma toward mental illness in Latin America and the Caribbean: a systematic review.

    Science.gov (United States)

    Mascayano, Franco; Tapia, Thamara; Schilling, Sara; Alvarado, Rubén; Tapia, Eric; Lips, Walter; Yang, Lawrence H

    2016-03-01

    Stigma toward individuals with mental disorders has been studied extensively. In the case of Latin America and the Caribbean, the past decade has been marked by a significant increase in information on stigma toward mental illness, but these findings have yet to be applied to mental health services in Latin America. The objective of this study was to conduct a systematic review of studies relating to stigma toward mental illness in Latin America and the Caribbean. The authors specifically considered differences in this region as compared with manifestations reported in Western European countries. A systematic search of scientific papers was conducted in the PubMed, MEDLINE, EBSCO, SciELO, LILACS, Imbiomed, and Bireme databases. The search included articles published from 2002 to 2014. Twenty-six studies from seven countries in Latin America and the Caribbean were evaluated and arranged into the following categories: public stigma, consumer stigma, family stigma, and multiple stigmas. We identified some results similar to those reported in high-income settings. However, some noteworthy findings concerning public and family stigma differed from those reported in Western European countries. Interventions designed to reduce mental illness-related stigma in this region may benefit from considering cultural dynamics exhibited by the Latino population.

  15. Structural Stigma and Sexual Orientation Disparities in Adolescent Drug Use

    Science.gov (United States)

    Hatzenbuehler, Mark L.; Jun, Hee-Jin; Corliss, Heather L.; Austin, S. Bryn

    2015-01-01

    Although epidemiologic studies have established the existence of large sexual orientation disparities in illicit drug use among adolescents and young adults, the determinants of these disparities remain understudied. This study sought to determine whether sexual orientation disparities in illicit drug use are potentiated in states that are characterized by high levels of stigma surrounding sexual minorities. State-level structural stigma was coded using a previously established measure based on a 4-item composite index: (1) density of same-sex couples; (2) proportion of Gay-Straight Alliances per public high school; (3) 5 policies related to sexual orientation discrimination (e.g., same-sex marriage, employment non-discrimination); and (4) public opinion toward homosexuality (aggregated responses from 41 national polls). The index was linked to individual-level data from the Growing Up Today Study, a prospective community-based study of adolescents (2000–2010). Sexual minorities report greater illicit drug use than their heterosexual peers. However, for both men and women, there were statistically significant interactions between sexual orientation status and structural stigma, such that sexual orientation disparities in marijuana and illicit drug use were more pronounced in high-structural stigma states than in low-structural stigma states, controlling for individual- and state-level confounders. For instance, among men, the risk ratio indicating the association between sexual orientation and marijuana use was 24% greater in high- versus low-structural stigma states, and for women it was 28% greater in high- versus low-structural stigma states. Stigma in the form of social policies and attitudes may contribute to sexual orientation disparities in illicit drug use. PMID:25753931

  16. Structural stigma and sexual orientation disparities in adolescent drug use.

    Science.gov (United States)

    Hatzenbuehler, Mark L; Jun, Hee-Jin; Corliss, Heather L; Bryn Austin, S

    2015-07-01

    Although epidemiologic studies have established the existence of large sexual orientation disparities in illicit drug use among adolescents and young adults, the determinants of these disparities remain understudied. This study sought to determine whether sexual orientation disparities in illicit drug use are potentiated in states that are characterized by high levels of stigma surrounding sexual minorities. State-level structural stigma was coded using a previously established measure based on a 4-item composite index: (1) density of same-sex couples; (2) proportion of Gay-Straight Alliances per public high school; (3) 5 policies related to sexual orientation discrimination (e.g., same-sex marriage, employment non-discrimination); and (4) public opinion toward homosexuality (aggregated responses from 41 national polls). The index was linked to individual-level data from the Growing Up Today Study, a prospective community-based study of adolescents (2001-2010). Sexual minorities report greater illicit drug use than their heterosexual peers. However, for both men and women, there were statistically significant interactions between sexual orientation status and structural stigma, such that sexual orientation disparities in marijuana and illicit drug use were more pronounced in high-structural stigma states than in low-structural stigma states, controlling for individual- and state-level confounders. For instance, among men, the risk ratio indicating the association between sexual orientation and marijuana use was 24% greater in high- versus low-structural stigma states, and for women it was 28% greater in high- versus low-structural stigma states. Stigma in the form of social policies and attitudes may contribute to sexual orientation disparities in illicit drug use. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Exploring the Relationships Among Level of Contact, Nature of Contact, and Mental Illness Stigma in Adolescent Girls.

    Science.gov (United States)

    Greenblatt, Amy M; Pinto, Melissa D; Higgins, Melinda K; Berg, Carla J

    2016-01-01

    This study explored the relationship of individuals' level of contact with someone with mental illness, and the nature of that contact, to mental illness stigma in adolescent females (N = 156). There were no significant associations among stigma and level of contact. The nature of the contact was significantly associated with stigma, such that those who knew someone who received treatment in a psychiatric facility had lower stigma, and those who attributed a deterioration of a past personal relationship to mental illness reported greater stigma.

  18. AIDS-related stigma among Black and Hispanic young adults.

    Science.gov (United States)

    Darrow, William W; Montanea, Julie E; Gladwin, Hugh

    2009-12-01

    Telephone surveys with national probability samples of English-speaking adults have suggested that popular support for punitive policies toward people living with HIV/AIDS (PLWHA) declined in the 1990s, but AIDS-related stigma persists in the United States. Our aim was to assess the prevalence and impact of AIDS-related stigma in non-Hispanic Black and Hispanic communities. A cross-sectional computer-assisted telephone-interview survey was conducted in summer 2003 with African-American, Afro-Caribbean, Haitian, and Hispanic 18-39 year-old residents of 12 high AIDS-incidence areas in Broward County, Florida. Stigma items were adopted from national surveys, but interviews were conducted in Spanish and Haitian Creole as well as in English. Stigma scores were higher than those reported for national samples, especially among Haitians interviewed in Creole. AIDS-related stigma was associated with never receiving an HIV-antibody test (adjusted odds ratio [AOR] = 0.78, 95% confidence interval [CI]: 0.62-0.99, P = .046), an elevated perception of HIV risk (AOR = 1.32, 95% CI: 1.01-1.73, P = .045) and a failure to participate in HIV-prevention efforts (AOR = 0.53, 95% CI: 0.34-0.85, P = .008). Interventions are needed to mitigate the pernicious effects of AIDS-related stigma.

  19. HIV-Related Stigma Among Spanish-speaking Latinos in an Emerging Immigrant Receiving City.

    Science.gov (United States)

    Dolwick Grieb, Suzanne M; Shah, Harita; Flores-Miller, Alejandra; Zelaya, Carla; Page, Kathleen R

    2016-09-27

    HIV-related stigma has been associated with a reluctance to test for HIV among Latinos. This study assessed community HIV-related stigma within an emerging Latino immigrant receiving city. We conducted a brief survey among a convenience sample of 312 Spanish-speaking Latinos in Baltimore, Maryland. HIV-related stigma was assessed through six items. Associations between stigma items, socio-demographic characteristics, and HIV testing history were considered. Gender, education, and religiosity were significantly associated with stigmatizing HIV-related beliefs. For example, men were 3.4 times more likely to hold more than three stigmatizing beliefs than women, and were also twice as likely as women to report feeling hesitant to test for HIV for fear of people's reaction if the test is positive. These findings can help inform future stigma interventions in this community. In particular, we were able to distinguish between drivers of stigma such as fear and moralistic attitudes, highlighting specific actionable items.

  20. Gendered aspects of perceived and internalized HIV-related stigma in China.

    Science.gov (United States)

    Li, Li; Lin, Chunqing; Ji, Guoping

    2016-09-14

    Although studies have demonstrated that females experience more HIV-related stigma than males do, questions remain regarding the different dimensions of the stigma (i.e., perceived versus internalized) in China. The present study investigated gender differences in perceived and internalized HIV-related stigma, taking into account the potential influence of education. The study was conducted between October 2011 and March 2013. A total of 522 people living with HIV (PLH) were recruited from Anhui Province, China. The PLH participated in a survey using the Computer Assisted Personal Interview (CAPI) method. The gender differences in perceived and internalized HIV-related stigma were calculated with and without stratifying by education level. Female participants had significantly less education than the male participants. No significant difference was observed between females and males with respect to perceived stigma. However, females reported significantly higher internalized stigma than males did (p PLH in China and other regions with similar gender dynamics.

  1. Structure of the stigma and style in sunflower (Helianthus annuus L.).

    Science.gov (United States)

    Gotelli, M M; Galati, B G; Medan, D

    2010-12-01

    This is the first report of the ultrastructure of the stigma and style during and after anthesis in Helianthus annuus L. using light and transmission electron microscopy. The stigma is bifid with unicellular papillae. There is no secretion of lipids, carbohydrates or proteins at anthesis. The style is semisolid in the upper portion, closer to the stigma, and becomes solid below. Ultrastructural changes on cells of the stigma and the style are described. The transmitting tissue of the ovule is first evident 40 minutes after pollination and persists during the first stages of embryogenesis. Only one pollen tube per micropyle was observed growing through this tissue.

  2. Changing stigma through a consumer-based stigma reduction program.

    Science.gov (United States)

    Michaels, Patrick J; Corrigan, Patrick W; Buchholz, Blythe; Brown, Jennifer; Arthur, Thomas; Netter, Clarissa; Macdonald-Wilson, Kim L

    2014-05-01

    This study assessed the Anti-Stigma Project workshop, a contact/education intervention developed by On Our Own of Maryland, Inc. and the Maryland Mental Hygiene Administration. Two separate randomized controlled trials administered pre- and post-test questionnaire assessments. One included people with mental illness (N = 127) and a second included mental health providers (N = 131). Post-intervention, people with mental illness were more aware of stigma, had lower levels of prejudice, and increased belief in recovery. Providers were more aware of stigma, had lower levels of prejudice, and increased concurrence in self-determination of people with mental illness. Increasing providers' stigma awareness and recognition can promote higher quality service delivery. Increasing stigma awareness and recognition for people with mental illness can foster confidence in overcoming psychiatric disabilities. Using a participatory action research team, our protocol included extant and newly developed stigma change tools. Organizations seeking to conduct effective evaluation studies should consider collaborative processes including the expertise of affected constituents.

  3. Self-stigma, perceived discrimination and empowerment among people with a mental illness in six countries: Pan European stigma study.

    Science.gov (United States)

    Krajewski, Christin; Burazeri, Genc; Brand, Helmut

    2013-12-30

    A cross-sectional study including 796 individuals with a psychiatric disorder was conducted in Croatia, Israel, Lithuania, Malta, Romania and Sweden in 2010 aiming to assess correlates of self-stigma. The Internalized Stigma of Mental Illness (ISMI) was used to measure self-stigma, whereas the Boston University Empowerment Scale was used to measure the self-efficacy/self-esteem (SESE) and sense of power/powerlessness (PP). Perceived discrimination and devaluation was measured with the Perceived Devaluation and Discrimination (PDD) Scale. Thirty three percent of participants had moderate-to-high ISMI scores. In multivariable-adjusted analysis, significant 'predictors' of high ISMI scores were: age-group of 50-59 years, current employment, lower social contacts, and minimal-to-low SESE and PP scores. Remarkably, no significant association between ISMI and PDD was evident. Furthermore, there was evidence of a significant interaction between SESE and country. Study participants might not be representative to all individuals with mental disorders in countries included in this survey. Our findings indicate that people with psychiatric diseases suffer both self-stigma and perceived discrimination and devaluation. This is one of the very few reports highlighting country differences and diagnosis disparities of self-stigma among individuals with mental illnesses. Between-country differences should be considered and carefully addressed in the process of policy formulation and interventional programs against stigma. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  4. Emotional, physical and financial burdens of stigma against people living with HIV/AIDS in China.

    Science.gov (United States)

    Zhang, Chen; Li, Xiaoming; Liu, Yu; Qiao, Shan; Zhang, Liying; Zhou, Yuejiao; Shen, Zhiyong; Tang, Zhengzhu

    2016-01-01

    Numerous researches have shown pernicious effects of stigma against people living with HIV/AIDS (PLWHA). However, no available studies have reported these negative effects including emotional, physical to financial burdens to PLWHA. In the current study, we aim to explore different types of stigma (e.g., perceived, internalized and enacted) and the relevant consequences among PLWHA in China. A cross-sectional study was conducted from 2012 to 2013 in the Guangxi Autonomous Region in China. The validated Berger HIV Stigma Scale was used to measure various types of stigma. We employed a series of linear, logistic and polytomous regression models to assess the association between stigma and different consequences while accounting for potential confounders for each specific model. Of the total sample, 2987 PLWHA provided valid responses with 63% being male and having an average age of 42.9 years. Perceived, internalized and enacted HIV stigma were prevalent among participants, and resulted in various burdens with different magnitudes in their life contexts. Specially, PLWHA who reported higher perceived and internalized stigma were more likely to be imposed on emotional and physical burdens (p financial burden compared to their peers (p < .05). Our findings revealed that devastating consequences of HIV-related stigma in China. The prevalent stigmatizing attitudes have pushed PLWHA to the fringes of society and affected them at multiple aspects in their life context. We call for tailored efforts to overcome stigma and discrimination against PLWHA.

  5. Perception and coping with stigma of mental illness: Arab families' perspectives.

    Science.gov (United States)

    Dalky, Heyam F

    2012-07-01

    Family stigma is well documented in the research literature; however, it has only been recently that efforts have been undertaken to discuss the perception of stigma as reported by Arab families of relatives with mental illness. This clinical paper aims to identify families' perception of stigma related to mental illness, and to compare Arab families' approaches with various aspects of caring from different countries. Further, this paper discusses, in-depth, specific areas related to families' perceptions of stigma: What impacts does stigma perception have on those families and on their relatives' care outcomes and what are coping strategies are used to handle stigma and its impacts in such countries? This paper emphasizes that chronic mental illness contributes the most to families' perception of stigma. In this study, Arab families perceived the experience of caring for a family member with a mental illness with fear, loss, embarrassment, and disgrace of family reputations. Further, secrecy, isolation, despair, and helplessness were reported the most among different family groups in Jordan and Morocco. This paper reminds us that cultural norms and beliefs shape family members' perception of coping and their ability to manage caring for relatives with mental illnesses. Thus, more studies are needed concerning coping and management strategies that are culturally relevant. This could eventually guide the establishment of stigma reduction initiatives and expand understanding of stigma from different cultural perspectives.

  6. Understanding the stigma of leprosy

    African Journals Online (AJOL)

    Angel_D

    to lack of understanding and knowledge about leprosy - which increases misconceptions ... Perceived - stigma viewed from the perspective of the patient. It ... interpersonal ... community interaction is affected, such as social relationships and.

  7. Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination.

    Science.gov (United States)

    van Brakel, Wim H; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I; Wilder-Smith, Annelies

    2012-01-01

    Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing monitoring to facilitate early prevention

  8. Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

    Science.gov (United States)

    van Brakel, Wim H.; Sihombing, Benyamin; Djarir, Hernani; Beise, Kerstin; Kusumawardhani, Laksmi; Yulihane, Rita; Kurniasari, Indra; Kasim, Muhammad; Kesumaningsih, Kadek I.; Wilder-Smith, Annelies

    2012-01-01

    Background Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. Methods We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA) scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma), Explanatory Model Interview Catalogue (EMIC) stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Results Overall 1,358 persons with leprosy-related disability (PLD) and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%). Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. Discussion The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment justifies ongoing

  9. Disability in people affected by leprosy: the role of impairment, activity, social participation, stigma and discrimination

    Directory of Open Access Journals (Sweden)

    Wim H. van Brakel

    2012-07-01

    Full Text Available Background: Leprosy-related disability is a challenge to public health, and social and rehabilitation services in endemic countries. Disability is more than a mere physical dysfunction, and includes activity limitations, stigma, discrimination, and social participation restrictions. We assessed the extent of disability and its determinants among persons with leprosy-related disabilities after release from multi drug treatment. Methods: We conducted a survey on disability among persons affected by leprosy in Indonesia, using a Rapid Disability Appraisal toolkit based on the International Classification of Functioning, Disability and Health. The toolkit included the Screening of Activity Limitation and Safety Awareness (SALSA scale, Participation Scale, Jacoby Stigma Scale (anticipated stigma, Explanatory Model Interview Catalogue (EMIC stigma scale and Discrimination assessment. Community members were interviewed using a community version of the stigma scale. Multivariate linear regression was done to identify factors associated with social participation. Results: Overall 1,358 persons with leprosy-related disability (PLD and 931 community members were included. Seventy-seven percent of PLD had physical impairments. Impairment status deteriorated significantly after release from treatment (from 59% to 77%. Around 60% of people reported activity limitations and participation restrictions and 36% anticipated stigma. As for participation restrictions and stigma, shame, problems related to marriage and difficulties in employment were the most frequently reported problems. Major determinants of participation were severity of impairment and level of education, activity and stigma. Reported severity of community stigma correlated with severity of participation restrictions in the same districts. Discussion: The majority of respondents reported problems in all components of disability. The reported physical impairment after release from treatment

  10. Implementing a stigma reduction intervention in healthcare settings

    Directory of Open Access Journals (Sweden)

    Li Li

    2013-11-01

    Full Text Available Introduction: Globally, HIV-related stigma is prevalent in healthcare settings and is a major barrier to HIV prevention and treatment adherence. Some intervention studies have showed encouraging outcomes, but a gap continues to exist between what is known and what is actually delivered in medical settings to reduce HIV-related stigma. Methods: This article describes the process of implementing a stigma reduction intervention trial that involved 1760 service providers in 40 hospitals in China. Guided by Diffusion of Innovation theory, the intervention identified and trained about 15–20% providers as popular opinion leaders (POLs to disseminate stigma reduction messages in each intervention hospital. The intervention also engaged governmental support in the provision of universal precaution supplies to all participating hospitals in the trial. The frequency of message diffusion and reception, perceived improvement in universal precaution practices and reduction in the level of stigma in hospitals were measured at 6- and 12-month follow-up assessments. Results: Within the intervention hospitals, POL providers reported more frequent discussions with their co-workers regarding universal precaution principles, equal treatment of patients, provider-patient relationships and reducing HIV-related stigma. Service providers in the intervention hospitals reported more desirable intervention outcomes than providers in the control hospitals. Our evaluation revealed that the POL model is compatible with the target population, and that the unique intervention entry point of enhancing universal precaution and occupational safety was the key to improved acceptance by service providers. The involvement of health authorities in supporting occupational safety was an important element for sustainability. Conclusions: This report focuses on explaining the elements of our intervention rather than its outcomes. Lessons learned from the intervention implementation will

  11. Variations in weight stigma concerns

    Directory of Open Access Journals (Sweden)

    Jessica E. Cornick

    2016-12-01

    Full Text Available Over the past 40 years, obesity rates in the United States have grown significantly; these rates have not grown uniformly across the United States (18 of the 20 counties with the highest obesity rates are located in the South. Obesity increases cardiovascular disease risk factors and new research has highlighted the negative psychological effects of obesity, known as weight stigma, including decreased selfcontrol resources, over eating, and exercise avoidance. The primary objective of this study was to determine if weight stigma concerns varied regionally and if social behaviors influenced this variation. In two studies, we collected cross-sectional data from participants in the United States including height and weight, weight stigma concerns, and perception of friends’ preoccupation with weight and dieting. We also collected each participant’s home zip code which was used to locate local obesity rate. We established differences in the relationship between body mass index and weight stigma concerns by local county obesity rate and showed that perceived friend preoccupation with weight and dieting mediated this relationship for individuals in low and medium obesity rate counties. For individuals living in United States counties with lower levels of obesity, increases in personal body mass index leads to increased weight stigma concerns due to an increase in perceived friend preoccupation with weight and dieting. These results indicate that relationships between body mass index, weight stigma concerns, and social networks vary significantly for subpopulations throughout the United States.

  12. Variations in Weight Stigma Concerns

    Science.gov (United States)

    Teter, Cambridge; K.Thaw, Andrew

    2016-01-01

    Over the past 40 years, obesity rates in the United States have grown significantly; these rates have not grown uniformly across the United States (18 of the 20 counties with the highest obesity rates are located in the South). Obesity increases cardiovascular disease risk factors and new research has highlighted the negative psychological effects of obesity, known as weight stigma, including decreased selfcontrol resources, over eating, and exercise avoidance. The primary objective of this study was to determine if weight stigma concerns varied regionally and if social behaviors influenced this variation. In two studies, we collected cross-sectional data from participants in the United States including height and weight, weight stigma concerns, and perception of friends’ preoccupation with weight and dieting. We also collected each participant’s home zip code which was used to locate local obesity rate. We established differences in the relationship between body mass index and weight stigma concerns by local county obesity rate and showed that perceived friend preoccupation with weight and dieting mediated this relationship for individuals in low and medium obesity rate counties. For individuals living in United States counties with lower levels of obesity, increases in personal body mass index leads to increased weight stigma concerns due to an increase in perceived friend preoccupation with weight and dieting. These results indicate that relationships between body mass index, weight stigma concerns, and social networks vary significantly for subpopulations throughout the United States. PMID:28058288

  13. Living in 'Birdsville': exploring the impact of neighbourhood stigma on health.

    Science.gov (United States)

    Kelaher, Margaret; Warr, Deborah J; Feldman, Peter; Tacticos, Theonie

    2010-03-01

    The stigma of living in a disadvantaged area is a consistent theme in discussions with residents of neighbourhood renewal (NR) areas in Victoria, Australia. Despite this, stigma is rarely examined explicitly in studies of neighbourhood disadvantage and health. This study will address four questions: (1) How do residents of disadvantaged areas describe their experiences of neighbourhood stigma? (2) Do experiences of neighbourhood stigma vary within neighbourhoods? (3) Is neighbourhood stigma related to health? (4) Is the relationship between neighbourhood stigma and health explained by other social factors that may contribute to poorer health? Cross-sectional community interviews comparing people living in NR areas (n = 4029) to people living in other parts of the same local government areas (LGAs) (n = 1857). Recruitment was achieved using community interviewers in NR areas and stratified random sampling in LGAs. A neighbourhood stigma variable, self-reported health, and satisfaction with life. About half (47.7%) of residents living in NR neighbourhoods compared to 9.4% of residents living elsewhere in the same LGAs felt that their neighbourhoods did not have a good reputation in surrounding areas. In NR areas, reported neighbourhood stigma was higher among people born in a non-English speaking country, receiving benefits or pensions, educated above year 10, or who reported having a disability. Reported neighbourhood stigma decreased with age. Stigma was associated with being in fair/poor health status (OR = 1.33, 1.06-1.89) and life satisfaction (OR = 0.66, 0.55-0.8). Neighbourhood stigma may be a useful addition to the portfolio of variables that describe 'place' and its relationship with health. Copyright 2009 Elsevier Ltd. All rights reserved.

  14. Genetic Causal Attribution of Epilepsy and its Implications for Felt Stigma

    Science.gov (United States)

    Sabatello, Maya; Phelan, Jo C.; Hesdorffer, Dale C.; Shostak, Sara; Goldsmith, Jeff; Sorge, Shawn T.; Winawer, Melodie R.; Chung, Wendy K.; Ottman, Ruth

    2015-01-01

    Summary Objective Research in other disorders suggests that genetic causal attribution of epilepsy might be associated with increased stigma. We investigated this hypothesis in a unique sample of families containing multiple individuals with epilepsy. Methods 181 people with epilepsy and 178 biological relatives without epilepsy completed a self-administered survey. In people with epilepsy, felt stigma was assessed through the Epilepsy Stigma Scale (ESS), scored 1 to 7 with higher scores indicating more stigma and >4 indicating some felt stigma. Felt stigma related to having epilepsy in the family was assessed through the Family Epilepsy Stigma Scale (FESS), created by replacing “epilepsy” with “epilepsy in my family” in each ESS item. Genetic attribution was assessed through participants’ perceptions of the (1) role of genetics in causing epilepsy in the family, (2) chance they had an epilepsy-related mutation, and (3) (in people with epilepsy) influence of genetics in causing their epilepsy. Results Among people with epilepsy, 22% met criteria for felt stigma (ESS score >4). Scores were increased among individuals who were aged ≥60 years, were unemployed, reported epilepsy-related discrimination, or had seizures within the last year or >100 seizures in their lifetime. Adjusting for other variables, ESS scores in people with epilepsy were significantly higher among those who perceived genetics played a “medium” or “big” role in causing epilepsy in the family than in others (3.4 vs. 2.7, p=0.025). Only 4% of relatives without epilepsy had felt stigma. Scores in relatives were unrelated to genetic attribution. Significance In these unusual families, predictors of felt stigma in individuals with epilepsy are similar to those in other studies, and stigma levels are low in relatives without epilepsy. Felt stigma may be increased in people with epilepsy who believe epilepsy in the family has a genetic cause, emphasizing the need for sensitive

  15. Managing and resisting stigma: a qualitative study among people living with HIV in South Africa

    Directory of Open Access Journals (Sweden)

    Naeemah Abrahams

    2012-08-01

    Full Text Available Background: Living with HIV is of daily concern for many South Africans and poses challenges including adapting to a chronic illness and continuing to achieve and meet social expectations. This study explored experiences of being HIV-positive and how people manage stigma in their daily social interactions. Methods: Using qualitative methods we did repeat interviewed with 42 HIV-positive men and women in Cape Town and Mthatha resulting in 71 interviews. Results: HIV was ubiquitous in our informants’ lives, and almost all participants reported fear of stigma (perceived stigma, but this fear did not disrupt them completely. The most common stigma experiences were gossips and insults where HIV status was used as a tool, but these were often resisted. Many feared the possibility of stigma, but very few had experiences that resulted in discrimination or loss of social status. Stigma experiences were intertwined with other daily conflicts and together created tensions, particularly in gender relations, which interfered with attempts to regain normality. Evidence of support and resistance to stigma was common, and most encouraging was the evidence of how structural interventions such as de-stigmatizing policies impacted on experiences and transference into active resistance. Conclusions: The study showed the complex and shifting nature of stigma experiences. These differences must be considered when we intensify stigma reduction with context- and gender-specific strategies focussing on those not yet on ARV programmes.

  16. HIV stigma: perceptions from HIV-positive and HIV-negative patients in a community dental clinic.

    Science.gov (United States)

    Toth, Steven; A York, Jill; DePinto, Nicholas

    2016-01-01

    Background. In the medical sense, stigma has been defined as the collection of negative attitudes and beliefs that are directed at people living with a particular condition or disease process. A cohort study was conducted to explore the HIV stigma that is perceived by HIV-positive individuals versus that perceived by the general population within a community-based dental clinic. Methods. Two separate and independent cross-sectional surveys, the Berger Stigma Scale and the Rutgers-Modified Berger Stigma Scale, were employed in order to analyze the stigma factors of an HIV-positive population versus an HIV-negative general population, respectively. The HIV stigma factors studied included personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. Results. The total stigma scale scores for the studied HIV-positive population were significantly lower than the total stigma scale scores for the studied HIV-negative population (P HIV-positive individuals experience more stigma than the HIV-positive population in the clinic actually reported. Interventions to reduce HIV stigma should be an integral component of comprehensive care for all patients.

  17. Assessing the Impact of Food Assistance on Stigma Among People Living with HIV in Uganda Using the HIV/AIDS Stigma Instrument-PLWA (HASI-P).

    Science.gov (United States)

    Maluccio, John A; Wu, Fan; Rokon, Redwan B; Rawat, Rahul; Kadiyala, Suneetha

    2017-03-01

    HIV-related stigma among persons living with HIV/AIDS (PLHIV) is prevalent throughout sub-Saharan Africa. There is limited evidence, however, on which interventions are effective in reducing it. We used data from a prospective impact evaluation of a 12-month food assistance intervention among 904 antiretroviral therapy (ART)- naïve PLHIV in Uganda to examine the program impact on stigma. Stigma was measured using the comprehensive HASI-P scale, which demonstrated good internal consistency (Cronbach's alpha = 0.87) and was correlated with several related constructs including physical and mental health-related quality of life, disclosure, and physical health symptoms in the sample. Using quasi-experimental difference-in-difference matching methods to better infer causality, we tested whether the intervention improved the overall stigma scale and its subscales. The food assistance intervention had a significant effect on reported internalized (but not external) stigma of approximately 0.2 SD (p stigma scale is a useful tool for measuring and tracking stigma. Food assistance interventions, embedded in an HIV care program, can reduce internalized stigma.

  18. Developing Internet interventions to target the individual impact of stigma in health conditions

    Directory of Open Access Journals (Sweden)

    Neil Thomas

    2015-09-01

    Full Text Available A number of health problems are associated with significant stigma, a social phenomenon in which individuals become the object of negative stereotypes. In addition to experiencing negative reactions from others, stigmatised individuals and groups can experience harmful consequences when they internalise these negative prevailing attitudes. The objective of this paper was to consider the potential to develop Internet-based health-related interventions explicitly targeting the effects of stigma on the individual. A review of the literature was conducted to synthesise current conceptualisations of stigma and self-stigma across a number of groups, and to identify current intervention developments. Self-stigma reduction strategies developed for in-person services include cognitive reframing, myth busting, contact with other members of the stigmatised group, and disclosure promotion. The development and provision of interventions targeting self-stigma within an online environment is in its infancy. Our review considers there to be particular potential of online interventions for this target, associated with the capacity of the Internet to promote having contact with peers within one’s stigmatised group, and for user interaction and empowerment. We conclude that self-stigma is a domain in which there is significant potential for innovation with health-related interventions, and provide a number of recommendations for online intervention development.

  19. Does self-stigma reduce the probability of seeking mental health information?

    Science.gov (United States)

    Lannin, Daniel G; Vogel, David L; Brenner, Rachel E; Abraham, W Todd; Heath, Patrick J

    2016-04-01

    An important first step in seeking counseling may involve obtaining information about mental health concerns and treatment options. Researchers have suggested that some people may avoid such information because it is too threatening due to self-stigma and negative attitudes, but the link to actual help-seeking decisions has not been tested. Therefore, the purpose of the present study was to examine whether self-stigma and attitudes negatively impact decisions to seek information about mental health concerns and counseling. Probit regression models with 370 undergraduates showed that self-stigma negatively predicted decisions to seek both mental health and counseling information, with attitudes toward counseling mediating self-stigma's influence on these decisions. Among individuals experiencing higher levels of distress, the predicted probabilities of seeking mental health information (8.5%) and counseling information (8.4%) for those with high self-stigma were nearly half of those with low self-stigma (17.1% and 15.0%, respectively). This suggests that self-stigma may hinder initial decisions to seek mental health and counseling information, and implies the need for the development of early interventions designed to reduce help-seeking barriers. (c) 2016 APA, all rights reserved).

  20. Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India.

    Science.gov (United States)

    Koschorke, Mirja; Padmavati, R; Kumar, Shuba; Cohen, Alex; Weiss, Helen A; Chatterjee, Sudipto; Pereira, Jesina; Naik, Smita; John, Sujit; Dabholkar, Hamid; Balaji, Madhumitha; Chavan, Animish; Varghese, Mathew; Thara, R; Patel, Vikram; Thornicroft, Graham

    2017-04-01

    Stigma associated with schizophrenia significantly affects family caregivers, yet few studies have examined the nature and determinants of family stigma and its relationship to their knowledge about the condition. This paper describes the experiences and determinants of stigma reported by the primary caregivers of people living with schizophrenia (PLS) in India. The study used mixed methods and was nested in a randomised controlled trial of community care for people with schizophrenia. Between November 2009 and October 2010, data on caregiver stigma and functional outcomes were collected from a sample of 282 PLS-caregiver dyads. In addition, 36 in-depth-interviews were conducted with caregivers. Quantitative findings indicate that 'high caregiver stigma' was reported by a significant minority of caregivers (21%) and that many felt uncomfortable to disclose their family member's condition (45%). Caregiver stigma was independently associated with higher levels of positive symptoms of schizophrenia, higher levels of disability, younger PLS age, household education at secondary school level and research site. Knowledge about schizophrenia was not associated with caregiver stigma. Qualitative data illustrate the various ways in which stigma affected the lives of family caregivers and reveal relevant links between caregiver-stigma related themes ('others finding out', 'negative reactions' and 'negative feelings and views about the self') and other themes in the data. Findings highlight the need for interventions that address both the needs of PLS and their family caregivers. Qualitative data also illustrate the complexities surrounding the relationship between knowledge and stigma and suggest that providing 'knowledge about schizophrenia' may influence the process of stigmatisation in both positive and negative ways. We posit that educational interventions need to consider context-specific factors when choosing anti-stigma-messages to be conveyed. Our findings suggest

  1. Gender, Self-Stigma, and Public Stigma in Predicting Attitudes toward Psychological Help-Seeking

    Science.gov (United States)

    Topkaya, Nursel

    2014-01-01

    Using a sample of university students (N = 362), the role of gender and both the self-stigma and public stigma associated with one's decision to seek psychological help in predicting attitudes toward psychological helpseeking were examined. Moreover, gender differences regarding both the self-stigma and the public stigma associated with…

  2. The Internalized Stigma of Mental Illness (ISMI) scale: validation of the Japanese version.

    Science.gov (United States)

    Tanabe, Yosuke; Hayashi, Kunihiko; Ideno, Yuki

    2016-04-29

    The present study investigated the reliability and validity of a Japanese version of the Internalized Stigma of Mental Illness (ISMI) scale, designed to assess internalized stigma experienced by people with mental illness. A survey was conducted with 173 outpatients with mental illness who attended psychiatric clinics on a regular basis. A retest was conducted with 51 participants to evaluate the scale's psychometric properties. The alpha coefficient for the overall internal consistency was 0.91, and the coefficients of the individual ISMI subscales ranged from 0.57 to 0.81. The test-retest reliability was r = 0.85 (n = 51, P stigma resistance items excluded. The Japanese version of the ISMI scale demonstrated similar reliability and validity to the original English version. Therefore, the Japanese version of the ISMI scale may be an effective and valid tool to measure internalized stigma among Japanese people who have a mental illness.

  3. Bariatric surgery patients’ perceptions of weight-related stigma in healthcare settings impair post-surgery dietary adherence

    Directory of Open Access Journals (Sweden)

    Danielle M. Raves

    2016-10-01

    Full Text Available Background: Weight-related stigma is reported frequently by higher body-weight patients in healthcare settings. Bariatric surgery triggers profound weight loss. This weight loss may therefore alleviate patients’ experiences of weight-related stigma within healthcare settings. In non-clinical settings, weight-related stigma is associated with weight-inducing eating patterns. Dietary adherence is a major challenge after bariatric surgery.Objectives: (1 Evaluate the relationship between weight-related stigma and post-surgical dietary adherence; (2 understand if weight loss reduces weight-related stigma, thereby improving post-surgical dietary adherence; and (3 explore provider and patient perspectives on adherence and stigma in healthcare settings. Design: This mixed methods study contrasts survey responses from 300 postoperative bariatric patients with ethnographic data based on interviews with 35 patients and extensive multi-year participant-observation within a clinic setting. The survey measured experiences of weight-related stigma, including from healthcare professionals, on the Interpersonal Sources of Weight Stigma scale and internalized stigma based on the Weight Bias Internalization Scale. Dietary adherence measures included patient self-reports, non-disordered eating patterns reported on the Disordered Eating after Bariatric Surgery scale, and food frequencies. Regression was used to assess the relationships among post-surgical stigma, dietary adherence, and weight loss. Qualitative analyses consisted of thematic analysis.Results: The quantitative data show that internalized stigma and general experiences of weight-related stigma predict worse dietary adherence, even after weight is lost. The qualitative data show patients did not generally recognize this connection, and health professionals explained it as poor patient compliance.Conclusion: Reducing perceptions of weight-related stigma in healthcare settings and weight bias

  4. Stigma Resistance in Patients With Schizophrenia

    OpenAIRE

    Sibitz, Ingrid; Unger, Annemarie; Woppmann, Andreas; Zidek, Thomas; Amering, Michaela

    2009-01-01

    Background: An individual's capacity to counteract the stigma of mental illness, stigma resistance (SR), is considered as playing a crucial role in fighting stigma. However, little is known about SR and its correlates in patients with schizophrenia or schizoaffective disorder. Aim: Exploring SR in patients with schizophrenia or schizoaffective disorder. Method: One hundred fifty-seven participants completed the “Internalized Stigma of Mental Illness” (ISMI) Scale including its subscale on SR....

  5. A Positive Stigma for Child Labor?

    Science.gov (United States)

    Patrinos, Harry Anthony; Shafiq, M. Najeeb

    2008-01-01

    We introduce a simple empirical model that assumes a positive stigma (or norm) towards child labor that is common in some developing countries. We then illustrate our positive stigma model using data from Guatemala. Controlling for several child- and household-level characteristics, we use two instruments for measuring stigma: a child's indigenous…

  6. Disease and Stigma: A Review of Literature

    Science.gov (United States)

    Pettit, Michele L.

    2008-01-01

    This article presents a review of literature pertaining to disease and stigma. Specifically, a definition of stigma is provided along with an historical overview of disease and stigma and research trends related to three public health perils-AIDS, mental illness, and obesity.

  7. Resisting and challenging stigma in Uganda

    DEFF Research Database (Denmark)

    Mburu, Gitau; Ram, Mala; Skovdal, Morten

    2013-01-01

    Global scale up of antiretroviral therapy is changing the context of HIV-related stigma. However, stigma remains an ongoing concern in many countries. Groups of people living with HIV can contribute to the reduction of stigma. However, the pathways through which they do so are not well understood....

  8. Dual Psychological Processes Underlying Public Stigma and the Implications for Reducing Stigma

    OpenAIRE

    Pryor, John B.; Glenn D Reeder

    2008-01-01

    People with serious illness or disability are often burdened with social stigma that promotes a cycle of poverty via unemployment, inadequate housing and threats to mental health. Stigma may be conceptualized in terms of self-stigma (e.g., shame and lowered self-esteem) or public stigma (e.g., the general public's prejudice towards the stigmatized). This article examines two psychological processes that underlie public stigma: associative processes and rule-based processes. Associative proces...

  9. Stigma in response to mental disorders: a comparison of Australia and Japan

    Directory of Open Access Journals (Sweden)

    Jorm Anthony F

    2006-05-01

    Full Text Available Abstract Background There are few national or cross-cultural studies of the stigma associated with mental disorders. Australia and Japan have different systems of psychiatric health care, and distinct differences in cultural values, but enjoy similar standards of living. This study seeks to compare the nature and extent of stigma among the public in the two countries. Methods A household survey of the public was conducted in each country using similar methodologies. The Australian study comprised a national survey of 3998 adults aged over 18 years. The Japanese survey involved 2000 adults aged 20 to 69 from 25 regional sites distributed across the country. Interviewees reported their personal attitudes (personal stigma, social distance and perceptions of the attitudes of others (perceived stigma, perceived discrimination in the community with respect to four case vignettes. These vignettes described a person with: depression; depression with suicidal ideation; early schizophrenia; and chronic schizophrenia. Results Personal stigma and social distance were typically greater among the Japanese than the Australian public whereas the reverse was true with respect to the perception of the attitudes and discriminatory behaviour of others. In both countries, personal stigma was significantly greater than perceived stigma. The public in both countries showed evidence of greater social distance, greater personal stigma and greater perceived stigma for schizophrenia (particularly in its chronic form than for depression. There was little evidence of a difference in stigma for depression with and without suicide for either country. However, social distance was greater for chronic compared to early schizophrenia for the Australian public. Conclusion Stigmatising attitudes were common in both countries, but negative attitudes were greater among the Japanese than the Australian public. The results suggest that there is a need to implement national public

  10. Internalized stigma among patients with schizophrenia in Ethiopia: a cross-sectional facility-based study

    Science.gov (United States)

    2012-01-01

    Background Despite the potential impact on treatment adherence and recovery, there is a dearth of data on the extent and correlates of internalized stigma in patients with schizophrenia in low income countries. We conducted a study to determine the extent, domains and correlates of internalized stigma amongst outpatients with schizophrenia in Ethiopia. Methods The study was a cross-sectional facility-based survey conducted at a specialist psychiatric hospital in Addis Ababa, Ethiopia. Consecutive consenting individuals with a diagnosis of schizophrenia were recruited and assessed using an Amharic version of the Internalized Stigma of Mental Illness (ISMI) scale. Results Data were collected from 212 individuals, who were mostly single (71.2%), unemployed (70.3%) and male (65.1%). Nearly all participants (97.4%) expressed agreement to at least one stigma item contained in the ISMI; 46.7% had a moderate to high mean stigma score. Rural residence (OR = 5.67; 95% CI = 2.30, 13.00; p stigma score. Almost half of those who discontinued their treatment reported that they had done so because of perceived stigma. Those who had attempted suicide (45.3%) were more likely to have a high stigma score (OR = 2.29; 95% CI = 1.27, 4.11; p = 0.006). Over 60% of the variation in the experience of stigma was explained by four factors: social withdrawal (16.7%), perceived discrimination (14.1%), alienation (13.9%) and stereotype endorsement (12.7%). Conclusion Internalized stigma is a major problem among persons with schizophrenia in this outpatient setting in Ethiopia. Internalized stigma has the potential to substantially affect adherence to medication and is likely to affect the recovery process. PMID:23272796

  11. Internalized HIV/AIDS-related stigma in a sample of HIV-positive people in Bangladesh.

    Science.gov (United States)

    Hasan, M Tanvir; Nath, Samir Ranjan; Khan, Nabilah S; Akram, Owasim; Gomes, Tony Michael; Rashid, Sabina F

    2012-03-01

    Internalized stigma among people living with HIV/AIDS (PLHA) is prevalent in Bangladesh. A better understanding of the effects of stigma on PLHA is required to reduce this and to minimize its harmful effects. This study employed a quantitative approach by conducting a survey with an aim to know the prevalence of internalized stigma and to identify the factors associated with internalized stigma among a sample of 238 PLHA (male=152 and female=86) in Bangladesh. The findings suggest that there is a significant difference between groups with the low- and the high-internalized HIV/AIDS stigma in terms of both age and gender. The prevalence of internalized stigma varied according to the poverty status of PLHA. An exploratory factor analysis (EFA) found 10 of 15 items loaded highly on the three factors labelled self-acceptance, self-exclusion, and social withdrawal. About 68% of the PLHA felt ashamed, and 54% felt guilty because of their HIV status. More than half (87.5% male and 19.8% female) of the PLHA blamed themselves for their HIV status while many of them (38.2% male and 8.1% female) felt that they should be punished. The male PLHA more frequently chose to withdraw themselves from family and social gatherings compared to the female PLHA. They also experienced a higher level of internalized stigma compared to the female PLHA. The results suggest that the prevalence of internalized stigma is high in Bangladesh, and much needs to be done by different organizations working for and with the PLHA to reduce internalized stigma among this vulnerable group.

  12. Interlocking oppressions: the effect of a comorbid physical disability on perceived stigma and discrimination among mental health consumers in Canada.

    Science.gov (United States)

    Bahm, Allison; Forchuk, Cheryl

    2009-02-01

    People living with mental health problems often face stigma and discrimination; however, there is a lack of research that examines how comorbid conditions affect this perceived stigma. This study sought to determine whether people who have a comorbid physical and psychiatric disability experience more stigma than those with only a psychiatric disability. It also looked at how perceived stigma and discrimination affect physical and mental health. A secondary analysis on data from interviews with 336 former and current clients of the mental health system in a mid-size Canadian city in 2005 was performed. Of these, 203 (60.4%) reported they had a psychiatric disability, 112 (33.0%) reported that they had a physical disability, with 74 reporting both a psychiatric and a physical disability. People with a self-reported psychiatric disability and a self-reported comorbid physical disability faced more overall perceived discrimination/stigma (P = 0.04), than those with a psychiatric disability alone. Perceived discrimination/stigma was positively correlated with psychiatric problem severity (P = 0.02), and negatively correlated with self-rated general health (P disability on the perceived stigma for those living with a mental illness, and also strengthen the knowledge that stigma and discrimination have a negative impact on health. Healthcare providers should recognise this negative impact and screen for these comorbid conditions. Policy-makers should take measures such as improving access to housing and employment services to help reduce stigma and discrimination against this particularly vulnerable group.

  13. Stigma Management in International Relations

    DEFF Research Database (Denmark)

    Adler-Nissen, Rebecca

    2014-01-01

    This article develops a theoretical approach to stigma in international relations and resituates conventional approaches to the study of norms and international order. Correcting the general understanding that common values and norms are the building blocks of social order, this article claims...... that international society is in part constructed through the stigmatization of “transgressive” and norm-violating states and their ways of coping with stigma. Drawing on Erving Goffman, this article shows that states are not passive objects of socialization, but active agents. Stigmatized states cope strategically...... avenues for research on norms, identities, and international order....

  14. Anti-Stigma Programs: Stigma in Campus Police Officers

    Science.gov (United States)

    Rafacz, Jennifer D.

    2012-01-01

    It has been proposed that the most effective way to combat mental illness stigma is to focus on power groups who have a direct impact on the lives of persons with serious mental illness. With the increase of violence and need for mental health services on college campuses, campus police officers are seen as an important power group for persons…

  15. Anti-Stigma Programs: Stigma in Campus Police Officers

    Science.gov (United States)

    Rafacz, Jennifer D.

    2012-01-01

    It has been proposed that the most effective way to combat mental illness stigma is to focus on power groups who have a direct impact on the lives of persons with serious mental illness. With the increase of violence and need for mental health services on college campuses, campus police officers are seen as an important power group for persons…

  16. Physical functioning in patients with ankylosing spondylitis: comparing approaches of experienced ability with self-reported and objectively measured physical activity.

    Science.gov (United States)

    van Genderen, Simon; van den Borne, Carlie; Geusens, Piet; van der Linden, Sjef; Boonen, Annelies; Plasqui, Guy

    2014-04-01

    Physical functioning can be assessed by different approaches that are characterized by increasing levels of individual appraisal. There is insufficient insight into which approach is the most informative in patients with ankylosing spondylitis (AS) compared with control subjects. The objective of this study was to compare patients with AS and control subjects regarding 3 approaches of functioning: experienced ability to perform activities (Bath Ankylosing Spondylitis Functional Index [BASFI]), self-reported amount of physical activity (PA) (Baecke questionnaire), and the objectively measured amount of PA (triaxial accelerometer). This case-control study included 24 AS patients and 24 control subjects (matched for age, gender, and body mass index). Subjects completed the BASFI and Baecke questionnaire and wore a triaxial accelerometer. Subjects also completed other self-reported measures on disease activity (Bath AS Disease Activity Index), fatigue (Multidimensional Fatigue Inventory), and overall health (EuroQol visual analog scale). Both groups included 14 men (58%), and the mean age was 48 years. Patients scored significantly worse on the BASFI (3.9 vs 0.2) than their healthy peers, whereas PA assessed by Baecke and the accelerometer did not differ between groups. Correlations between approaches of physical functioning were low to moderate. Bath Ankylosing Spondylitis Functional Index was associated with disease activity (r = 0.49) and physical fatigue (0.73) and Baecke with physical and activity related fatigue (r = 0.54 and r = 0.54), but total PA assessed by accelerometer was not associated with any of these experience-based health outcomes. Different approaches of the concept physical functioning in patients with AS provide different information. Compared with matched control subjects, patients with AS report more difficulties but report and objectively perform the same amount of PA.

  17. The prevalence and predictors of self-stigma of individuals with mental health illness in two Chinese cities.

    Science.gov (United States)

    Young, Daniel Kim-Wan; Ng, Petrus Yat-Nam

    2016-03-01

    Although self-stigma is found to have adverse effects on the lives of persons with mental illness, little is known on the self-stigma of these individuals in Chinese societies. This research study explores the prevalence rate and predicting factors of self-stigma of consumers in two Chinese cities, Hong Kong and Guangzhou. A cross-sectional research design is adopted which involves a random sample of 266 consumers from Hong Kong and a convenient sample of 208 consumers from Guangzhou. These individuals have been assessed in terms of their self-stigma, recovery, self-esteem and quality of life by using standardized assessment scales. In all, 38.3% of the Hong Kong participants and 49.5% of the Guangzhou participants report to have self-stigma. Also, self-stigma is found to be negatively related to self-esteem and quality of life. A logistic regression analysis shows that hope and well-being are predicting factors of self-stigma. Self-stigma is found to be higher in Guangzhou, probably due to the influence of traditional cultural values. Also, as hope and well-being are found to be predicting factors of self-stigma, suitable recovery-orientated interventions that facilitate hope and well-being should be developed so as to reduce self-stigma of consumers in Chinese societies. © The Author(s) 2015.

  18. HIV stigma, disclosure and psychosocial distress among Thai youth living with HIV.

    Science.gov (United States)

    Rongkavilit, C; Wright, K; Chen, X; Naar-King, S; Chuenyam, T; Phanuphak, P

    2010-02-01

    The objective of the present paper is to assess stigma and to create an abbreviated 12-item Stigma Scale based on the 40-item Berger's Stigma Scale for Thai youth living with HIV (TYLH). TYLH aged 16-25 years answered the 40-item Stigma Scale and the questionnaires on mental health, social support, quality of life and alcohol/substance use. Sixty-two (88.6%) of 70 TYLH reported at least one person knowing their serostatus. Men having sex with men were more likely to disclose the diagnosis to friends (43.9% versus 6.1%, P Stigma Scale was reliable (Cronbach's alpha, 0.75) and highly correlated with the 40-item scale (r = 0.846, P Stigma Scale score was significantly associated with mental health problems (beta = 0.21, P HIV were associated with poorer quality of life (beta = -1.41, P Stigma Scale was reliable for TYLH. Increasing public understanding and education could reduce stigma and improve mental health and quality of life in TYLH.

  19. Internalized stigma and its psychosocial correlates in Korean patients with serious mental illness.

    Science.gov (United States)

    Kim, Woo Jung; Song, Youn Joo; Ryu, Hyun-Sook; Ryu, Vin; Kim, Jae Min; Ha, Ra Yeon; Lee, Su Jin; Namkoong, Kee; Ha, Kyooseob; Cho, Hyun-Sang

    2015-02-28

    We aimed to examine internalized stigma of patients with mental illness in Korea and identify the contributing factors to internalized stigma among socio-demographic, clinical, and psychosocial variables using a cross-sectional study design. A total of 160 patients were recruited from a university mental hospital. We collected socio-demographic data, clinical variables and administered self-report scales to measure internalized stigma and levels of self-esteem, hopelessness, social support, and social conflict. Internalized stigma was identified in 8.1% of patients in our sample. High internalized stigma was independently predicted by low self-esteem, high hopelessness, and high social conflict among the psychosocial variables. Our finding suggests that simple psychoeducation only for insight gaining cannot improve internalized stigma. To manage internalized stigma in mentally ill patients, it is needed to promote hope and self-esteem. We also suggest that a relevant psychosocial intervention, such as developing coping skills for social conflict with family, can help patients overcome their internalized stigma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. The effects of news stories on the stigma of mental illness.

    Science.gov (United States)

    Corrigan, Patrick W; Powell, Karina J; Michaels, Patrick J

    2013-03-01

    The media are often identified as partially responsible for increasing the stigma of mental illness through their negatively focused representations. For many years, training programs have educated journalists on how to report on mental illness to reduce stigma. This purpose of this study was to evaluate the benefits of reading a positive, neutral or a negative journalism article that discusses mental illness. Consenting adult participants were randomly assigned to read one of three published articles about recovery from mental illness, a dysfunctional public mental health system, or dental hygiene. The participants completed measures immediately before and after the intervention; the measures administered evaluated stigmatizing and affirming attitudes toward people with mental illness. Public stigma was assessed using the nine-item Attribution Questionnaire and the Stigma Through Knowledge Test (STKT). The STKT is a measure of mental illness stigma less susceptible to the impact of social desirability. Affirming attitudes represent public perceptions about recovery, empowerment, and self-determination, indicated as important to accepting and including people with psychiatric disabilities into society. Significant differences were observed between the articles on recovery and dysfunctional public mental health system, as well as the control condition, on the measures of stigma and affirming attitudes. The recovery article reduced stigma and increased affirming attitudes, whereas the dysfunctional public mental health system article increased stigma and decreased affirming attitudes. Not all journalistic stories have positive effects on attitudes about mental illness.

  1. Stigma and Student Mental Health in Higher Education

    Science.gov (United States)

    Martin, Jennifer Marie

    2010-01-01

    Stigma is a powerful force in preventing university students with mental health difficulties from gaining access to appropriate support. This paper reports on an exploratory study of university students with mental health difficulties that found most students did not disclose their mental health problems to staff at university. This was primarily…

  2. Stigma and Student Mental Health in Higher Education

    Science.gov (United States)

    Martin, Jennifer Marie

    2010-01-01

    Stigma is a powerful force in preventing university students with mental health difficulties from gaining access to appropriate support. This paper reports on an exploratory study of university students with mental health difficulties that found most students did not disclose their mental health problems to staff at university. This was primarily…

  3. Effect Of Acess To Antiretroviral Therapy On Stigma, Jimma ...

    African Journals Online (AJOL)

    JU

    with HIV/AIDS was low 45 (16.6%) when compared with the fear of being stigmatized (perceived stigma) which was195 ... providing emotional support from others, on the ... employed where all PLWHA who happened to come to JUH ..... Death/illness of partner. Travel/visa .... sero-status reported not let any body know about.

  4. Constructs and concepts comprising the stigma of mental illness

    OpenAIRE

    2012-01-01

    People with mental illness frequently confront public stigma andmay experience self-stigma. This review discusses the concepts of mental illness stigma and its consequences for those with mental illness. After a conceptual overview of stigma prominent consequences pertaining to public stigma (i.e.,employment, health care quality) and self-stigma (i.e., self-confidence, quality of life, “why try” effect) are reviewed. We discuss the three main public stigma change strategies - protest, educati...

  5. Understanding and Coping with Stigma

    Science.gov (United States)

    Mittan, Robert J.

    2010-01-01

    Having a disability or chronic health condition saddles the person with more than just the physical complaint. One has to struggle with the social meaning of that disorder as well. Often society is not very accepting of illness and disability and the person affected becomes stigmatized as a result. Stigma is a common problem among the disabled…

  6. Differential experiences of discrimination among ethnoracially diverse persons experiencing mental illness and homelessness.

    Science.gov (United States)

    Zerger, Suzanne; Bacon, Sarah; Corneau, Simon; Skosireva, Anna; McKenzie, Kwame; Gapka, Susan; O'Campo, Patricia; Sarang, Aseefa; Stergiopoulos, Vicky

    2014-12-14

    This mixed methods study explored the characteristics of and experiences with perceived discrimination in an ethnically diverse urban sample of adults experiencing homelessness and mental illness. Data were collected in Toronto, Ontario, as part of a 4-year national randomized field trial of the Housing First treatment model. Rates of perceived discrimination were captured from survey questions regarding perceived discrimination among 231 ethnoracially diverse participants with moderate mental health needs. The qualitative component included thirty six in-depth interviews which explored how individuals who bear these multiple identities of oppression navigate stigma and discrimination, and what affects their capacity to do so. Quantitative analysis revealed very high rates of perceived discrimination related to: homelessness/poverty (61.5%), race/ethnicity/skin colour (50.6%) and mental illness/substance use (43.7%). Immigrants and those who had been homeless three or more years reported higher perceived discrimination on all three domains. Analysis of qualitative interviews revealed three common themes related to navigating these experiences of discrimination among participants: 1) social distancing; 2) old and new labels/identities; and, 3) 'homeland' cultures. These study findings underscore poverty and homelessness as major sources of perceived discrimination, and expose underlying complexities in the navigation of multiple identities in responding to stigma and discrimination. Current Controlled Trials ISRCTN42520374 . Registered 18 August 2009.

  7. A qualitative exploration of the perspectives of mental health professionals on stigma and discrimination of mental illness in Malaysia.

    Science.gov (United States)

    Hanafiah, Ainul Nadhirah; Van Bortel, Tine

    2015-01-01

    Stigma of mental illness has been identified as a significant barrier to help-seeking and care. Basic knowledge of mental illness - such as its nature, symptoms and impact - are neglected, leaving room for misunderstandings on mental health and 'stigma'. Numerous researches have been conducted on stigma and discrimination of people with mental disorders. However, most of the literature investigates stigma from a cultural conception point of view, experiences of patients or public attitudes towards mental illness but little to none from the standpoint of mental health professionals. In Malaysia, this research on stigma is particularly limited. Therefore, the state of stigma and discrimination of people with mental illness was investigated from the perspectives of mental health professionals in Malaysia. In-depth, face-to-face, semi-structured interviews were conducted with 15 mental health professionals from both government and private sectors including psychiatrists, psychologists and counsellors. The interviews were approximately 45-minutes long. The data was subsequently analysed using the basic thematic approach. Seven principal themes, each with their own sub-themes, emerged from the analysis of 'stigma of mental illness' from mental health professionals' point of view, including: (1) main perpetrators, (2) types of mental illness carrying stigma, (3) demography and geography of stigma, (4) manifestations of stigma, (5) impacts of stigma, (6) causes of stigma and (7) proposed initiatives to tackle stigma. Stigma of mental illness is widespread in Malaysia. This is most evident amongst people suffering from conditions such as schizophrenia, bipolar disorder and depression. Stigma manifests itself most often in forms of labelling, rejection, social exclusion and in employment. Family, friends and workplace staff are reported to be the main perpetrators of discriminatory conducts. According to the perspectives of the mental health professionals, implications of

  8. The Association of HIV-Related Stigma to HIV Medication Adherence: A Systematic Review and Synthesis of the Literature.

    Science.gov (United States)

    Sweeney, Shannon M; Vanable, Peter A

    2016-01-01

    This paper provides a review of the quantitative literature on HIV-related stigma and medication adherence, including: (1) synthesis of the empirical evidence linking stigma to adherence, (2) examination of proposed causal mechanisms of the stigma and adherence relationship, and (3) methodological critique and guidance for future research. We reviewed 38 studies reporting either cross-sectional or prospective analyses of the association of HIV-related stigma to medication adherence since the introduction of antiretroviral therapies (ART). Although there is substantial empirical evidence linking stigma to adherence difficulties, few studies provided data on psychosocial mechanisms that may account for this relationship. Proposed mechanisms include: (a) enhanced vulnerability to mental health difficulties, (b) reduction in self-efficacy, and (c) concerns about inadvertent disclosure of HIV status. Future research should strive to assess the multiple domains of stigma, use standardized measures of adherence, and include prospective analyses to test mediating variables.

  9. The Public Stigma of Mental Illness: What Do We Think; What Do We Know; What Can We Prove?

    Science.gov (United States)

    Pescosolido, Bernice

    2015-01-01

    By the 1990s, sociology faced a frustrating paradox. Classic work on mental illness stigma and labeling theory reinforced that the “mark” of mental illness created prejudice and discrimination for individuals and family members. Yet that foundation, coupled with deinstitutionalization of mental health care, produced contradictory responses. Claims that stigma was dissipating were made, while others argued that intervention efforts were needed to reduce stigma. While signaling the critical role of theory-based research in establishing the pervasive effects of stigma, both claims directed resources away from social science research. Yet the contemporary scientific foundation underlying both claims was weak. A reply came in a resurgence of research directed toward mental illness stigma nationally and internationally, bringing together researchers from different disciplines for the first time. The author reports on the general population’s attitudes, beliefs, and behavioral dispositions that targeted public stigma and implications for the next decade of research and intervention efforts. PMID:23325423

  10. What matters most': stigma towards severe mental disorders in Chile, a theory-driven, qualitative approach.

    Science.gov (United States)

    Mascayano, Franco; Toso-Salman, Josefina; Ruiz, Bernalyn; Warman, Kathleen; Jofre Escalona, Ana; Alvarado Muñoz, Ruben; Sia, Kathleen Janel; Yang, Lawrence Hsin

    2015-01-01

    Stigma towards severe mental illness manifests in different ways across cultures and only recently has a theoretical perspective emerged to understand such cultural differences. The 'What Matters Most' framework identifies culturally specific dimensions of stigma by identifying the interactions between cultural norms, roles, and values that impact personhood. This study explores the cultural underpinnings that create and maintain stigmatizing attitudes towards severe mental illness in Chile. In-depth interviews developed using the 'Scale of Perceived Discrimination and Devaluation', and the 'What Matters Most' framework were conducted with twenty people identified as having a severe mental illness. Interviews were coded and discussed until agreement was reached, then analyzed by an independent reviewer to determine inter-rater reliability. A key factor shaping stigma among women was the loss of capacity to accomplish family roles (i.e. take care of children).or men, cultural notions of 'Machismo' prevented them from disclosing their psychiatric diagnosis as a means to maintain status and ability to work. A protective factor against stigma for men was their ability to guide and provide for the family, thus fulfilling responsibilities attributable to 'Familismo'. Social appearances could play either a shaping or protecting role,contingent on the social status of the individual. In Chilean culture, stigma is rooted in gendered social characteristics and shared familial roles. Interventions should aim to address these norms and incorporate culturally salient protective factors to reduce stigma experienced by individuals with serious mental illness in Chile and other Latin American settings.

  11. Diminishing the self-stigma of mental illness by coming out proud.

    Science.gov (United States)

    Corrigan, Patrick W; Larson, Jonathon E; Michaels, Patrick J; Buchholz, Blythe A; Rossi, Rachel Del; Fontecchio, Malia Javier; Castro, David; Gause, Michael; Krzyżanowski, Richard; Rüsch, Nicolas

    2015-09-30

    This randomized controlled trial examined the impact of the Coming Out Proud (COP) program on self-stigma, stigma stress, and depression. Research participants who experienced mental health challenges were randomly assigned to a three session COP program (n=51) or a waitlist control (n=75). Outcome measures that assessed the progressively harmful stages of self-stigma, stigma stress appraisals, and depression were administered at pre-test, post-test, and one-month follow-up. People completing COP showed significant improvement at post-test and follow-up in the more harmful aspects of self-stigma compared to the control group. COP participants also showed improvements in stigma stress appraisals. Women participating in COP showed significant post-test and follow-up reductions in depression after COP compared to the control group. Men did not show this effect. Future research should determine whether these benefits also enhance attitudes related to recovery, empowerment, and self-determination. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Care burden of parents of adult children with mental illness: The role of associative stigma.

    Science.gov (United States)

    Park, Keunwoo; Seo, Mikyung

    2016-10-01

    Parents of offspring with mental illness must endure endless child care burden despite their old age, and must cope with associative stigma. This study analyzed the mediator effect of associative stigma on relationships between the main stressors, psychiatric symptoms and lowered social function of offspring with mental illness, assessed by the parents, and their care burden. 215 parents caring for an adult child with mental illness in Korea were surveyed (Mage=60.68, SD=13.58; 74.4% mothers). They were asked to assess the psychiatric symptoms and social function of their offspring, the stigma they experienced, and the objective/subjective care burdens they felt. Our findings suggest that the symptoms and function of offspring directly affect the care burden of parents, but also have an indirect effect mediated by associative stigma. Among the predictor variables, symptoms have a greater effect on the subjective/objective burden and associative stigma than social function. We suggest strategies for parents to overcome associative stigma and emphasize the professional endeavor required to meet the service needs of elderly parents taking care of an adult child with mental illness. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Internalized stigma of mental illness and depressive and psychotic symptoms in homeless veterans over 6 months.

    Science.gov (United States)

    Boyd, Jennifer E; Hayward, H'Sien; Bassett, Elena D; Hoff, Rani

    2016-06-30

    We investigated the relationship between internalized stigma of mental illness at baseline and depressive and psychotic symptoms 3 and 6 months later, controlling for baseline symptoms. Data on homeless veterans with severe mental illness (SMI) were provided by the Northeast Program Evaluation Center (NEPEC) Special Needs-Chronic Mental Illness (SN-CMI) study (Kasprow and Rosenheck, 2008). The study used the Internalized Stigma of Mental Illness (ISMI) scale to measure internalized stigma at baseline and the Symptom Checklist-90-R (SCL-90-R) to measure depressive and psychotic symptoms at baseline and 3 and 6 month follow-ups. Higher levels of internalized stigma were associated with greater levels of depressive and psychotic symptoms 3 and 6 months later, even controlling for symptoms at baseline. Alienation and Discrimination Experience were the subscales most strongly associated with symptoms. Exploratory analyses of individual items yielded further insight into characteristics of potentially successful interventions that could be studied. Overall, our findings show that homeless veterans with SMI experiencing higher levels of internalized stigma are likely to experience more depression and psychosis over time. This quasi-experimental study replicates and extends findings of other studies and has implications for future controlled research into the potential long-term effects of anti-stigma interventions on mental health recovery. Published by Elsevier Ireland Ltd.

  14. Multilevel stigma as a barrier to HIV testing in Central Asia: a context quantified.

    Science.gov (United States)

    Smolak, Alex; El-Bassel, Nabila

    2013-10-01

    Central Asia is experiencing one of the fastest growing HIV epidemics in the world, with some areas' infection rates doubling yearly since 2000. This study examines the impact of multilevel stigma (individual, family, and community) on uptake of HIV testing and receipt of HIV testing results among women in Central Asia. The sample consists of 38,884 ever-married, Central Asian women between the ages of 15 and 49. Using multilevel modeling (MLM), HIV stigma variables at the individual, family, and community levels were used to assess the significance of differences in HIV testing and receipt of HIV test results among participants while adjusting for possible confounding factors, such as age, wealth, and education. MLM results indicate that HIV stigma is significantly associated with decreased HIV testing uptake at the individual, family, and community levels and with a decrease in receipt at the community level. A one standard deviation increase in individual, family, and community level composite stigma score was associated with a respective 49 %, 59 %, and 94 % (p < 0.001) decrease in the odds of having been tested for HIV. A one standard deviation increase in community composite stigma score was associated with a 99 % (p < 0.001) decrease in the odds of test receipt. HIV stigma operates on the individual, family, and community levels to hinder HIV testing uptake and at the community level to hinder receipt. These findings have important interventions implications to improve uptake of HIV testing and receipt of HIV test results.

  15. Stigma as a barrier to seeking health care among military personnel with mental health problems.

    Science.gov (United States)

    Sharp, Marie-Louise; Fear, Nicola T; Rona, Roberto J; Wessely, Simon; Greenberg, Neil; Jones, Norman; Goodwin, Laura

    2015-01-01

    Approximately 60% of military personnel who experience mental health problems do not seek help, yet many of them could benefit from professional treatment. Across military studies, one of the most frequently reported barriers to help-seeking for mental health problems is concerns about stigma. It is, however, less clear how stigma influences mental health service utilization. This review will synthesize existing research on stigma, focusing on those in the military with mental health problems. We conducted a systematic review and meta-analysis of studies between 2001 and 2014 to examine the prevalence of stigma for seeking help for a mental health problem and its association with help-seeking intentions/mental health service utilization. Twenty papers met the search criteria. Weighted prevalence estimates for the 2 most endorsed stigma concerns were 44.2% (95% confidence interval: 37.1, 51.4) for "My unit leadership might treat me differently" and 42.9% (95% confidence interval: 36.8, 49.0) for "I would be seen as weak." Nine studies found no association between anticipated stigma and help-seeking intentions/mental health service use and 4 studies found a positive association. One study found a negative association between self-stigma and intentions to seek help. Counterintuitively, those that endorsed high anticipated stigma still utilized mental health services or were interested in seeking help. We propose that these findings may be related to intention-behavior gaps or methodological issues in the measurement of stigma. Positive associations may be influenced by modified labeling theory. Additionally, other factors such as self-stigma and negative attitudes toward mental health care may be worth further attention in future investigation.

  16. Assessing the consequences of stigma for tuberculosis patients in urban Zambia.

    Directory of Open Access Journals (Sweden)

    Anne Lia Cremers

    Full Text Available Stigma is one of the many factors hindering tuberculosis (TB control by negatively affecting hospital delay and treatment compliance. In Zambia, the morbidity and mortality due to TB remains high, despite extended public health attempts to control the epidemic and to diminish stigma.To enhance understanding of TB-related stigmatizing perceptions and to describe TB patients' experiences of stigma in order to point out recommendations to improve TB policy.We conducted a mixed method study at Kanyama clinic and surrounding areas, in Lusaka, Zambia; structured interviews with 300 TB patients, multiple in-depth interviews with 30 TB patients and 10 biomedical health workers, 3 focus group discussions with TB patients and treatment supporters, complemented by participant observation and policy analysis of the TB control program. Predictors of stigma were identified by use of multivariate regression analyses; qualitative analysis of the in-depth interviews, focus group discussions and participant observation was used for triangulation of the study findings.We focused on the 138/300 patients that described TB-related perceptions and attitudes, of whom 113 (82% reported stigma. Stigma provoking TB conceptions were associated with human immunodeficiency virus (HIV-infection, alleged immoral behaviour, (perceived incurability, and (traditional myths about TB aetiology. Consequences of stigma prevailed both among children and adults and included low self-esteem, insults, ridicule, discrimination, social exclusion, and isolation leading to a decreased quality of life and social status, non-disclosure, and/or difficulties with treatment compliance and adherence. Women had significantly more stigma-related problems than men.The findings illustrate that many TB patients faced stigma-related issues, often hindering effective TB control and suggesting that current efforts to reduce stigma are not yet optimal. The content and implementation of sensitization

  17. "Depression is who I am": Mental illness identity, stigma and wellbeing.

    Science.gov (United States)

    Cruwys, Tegan; Gunaseelan, Sathiavaani

    2016-01-01

    Previous research has found that in the face of discrimination, people tend to identify more strongly with stigmatized groups. Social identification can, in turn, buffer wellbeing against the negative consequences of discrimination. However, this rejection identification model has never been tested in the context of mental illness identity. A survey was conducted with 250 people with diagnosed depression or current symptoms of at least moderate clinical severity. Experiencing mental illness stigma was associated with poorer wellbeing. Furthermore, people who had experienced such stigma were more likely to identify as a depressed person. Social identification as depressed magnified, rather than buffered, the relationship between stigma and reduced wellbeing. This relationship was moderated by perceived social norms of the depressed group for engaging in depressive thoughts and behaviors. These findings suggest that mental illness stigma is a double-edged sword: as well as the direct harms for wellbeing, by increasing identification with other mental illness sufferers, stigma might expose sufferers to harmful social influence processes. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

  18. Systematic review of stigma reducing interventions for African/Black diasporic women

    Directory of Open Access Journals (Sweden)

    Mona Loutfy

    2015-04-01

    Full Text Available Introduction: Literature indicates that racism, sexism, homophobia and HIV-related stigma have adverse impacts on health, well-being, and quality of life among HIV-positive women of African descent (African/Black diaspora. However, limited evidence exists on the effectiveness of interventions aimed at reducing stigma tailored for these women. This study systematically reviewed randomized controlled trials (RCTs, non-randomized observational and quasi-experimental studies evaluating the effectiveness of interventions aimed at reducing stigma experienced by this population. Methods: The Cochrane methodology was used to develop a search strategy in consultation with a librarian scientist. Databases searched included the Cochrane Library, Ovid EMBASE, PsycInfo, and 10 others. Two reviewers independently assessed the studies for potential relevance and conducted the Cochrane grading of RCTs to assess risk of bias and the Newcastle–Ottawa scale to assess the quality of non-randomized studies. Eligible papers were selected if they employed an intervention design with African/Black diasporic women living with HIV as the target population and had a primary outcome of stigma reduction. Results: Of the five studies that met all of the eligibility criteria, four demonstrated the effectiveness of interventions in reducing HIV-related stigma. Only two of the five studies were designed specifically for HIV-positive African/Black diasporic women. Limitations included the absence of interventions addressing other forms of stigma and discrimination (e.g. gender discrimination, racism, heterosexism. Conclusions: Our findings suggest that there are limited interventions designed to address multiple forms of stigma, including gender and racial discrimination, experienced by HIV-positive African/Black diasporic women.

  19. Forms of Stigma and Discrimination in the Daily Lives of HIV-Positive Individuals in Mauritania.

    Science.gov (United States)

    Mohamed Boushab, Boushab; Fatim-Zahra, Malick Fall; Cheikh Melaïnine Mohamed Limame, Ould; Leonardo Kishi, Basco

    2017-01-01

    People living with HIV/AIDS (PLWHA) are often discriminated against in their daily lives. The objective of this descriptive and transversal study was to describe the experiences of PLWHA followed at a specialized outpatient center in Nouakchott to assess the forms of stigma from the perspective of those who suffer from discrimination. All HIV-positive patients over the age of 18 years who were aware of their HIV status and provided consent to participate in the study were included from June 1 to 29, 2015. Data collection was conducted using a pre-tested questionnaire. A total of 210 PLWHA were interviewed. Men accounted for 54% of the sample population with a sex ratio of 1.2. About half of respondents were married (51%) and resided in Nouakchott (55%). Subjects who had never attended school represented 42% of the cases. Among our respondents, 64% knew their HIV status for over a year and admitted that they refused to reveal this information to any person. The distribution of forms of stigma experienced by PLWHA by demographic category was, in descending order, stigma in interpersonal relationships (78%), self-stigma (20%), and stigma in health services (2%). There was a significant association between the form of stigma and marital status (p = 0.007) and between the form of stigma and knowledge of HIV status for a period greater than one year (p = 0.02). The forms of stigma can be sources of discrimination and are a major obstacle to reintegration and support of PLWHA. This creates a vicious circle that, on the one hand, leads to the suffering, marginalization, and isolation of PLWHA, and on the other hand, has deleterious effects on their family and social relationships, self-esteem and self-confidence.

  20. Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study.

    Science.gov (United States)

    Farrelly, Simone; Clement, Sarah; Gabbidon, Jheanell; Jeffery, Debra; Dockery, Lisa; Lassman, Francesca; Brohan, Elaine; Henderson, R Claire; Williams, Paul; Howard, Louise M; Thornicroft, Graham

    2014-05-29

    The unfair treatment of individuals with severe mental illness has been linked to poorer physical and mental health outcomes. Additionally, anticipation of discrimination may lead some individuals to avoid participation in particular life areas, leading to greater isolation and social marginalisation. This study aimed to establish the levels and clinical and socio-demographic associations of anticipated and experienced discrimination amongst those diagnosed with a schizophrenia and comparator severe mental illnesses (bipolar and major depressive disorders). This study was a cross-sectional analysis of anticipated and experienced discrimination from 202 individuals in South London (47% with schizophrenia, 32% with depression and 20% with bipolar disorder). 93% of the sample anticipated discrimination and 87% of participants had experienced discrimination in at least one area of life in the previous year. There was a significant association between the anticipation and the experience of discrimination. Higher levels of experienced discrimination were reported by those of a mixed ethnicity, and those with higher levels of education. Women anticipated more discrimination than men. Neither diagnosis nor levels of functioning were associated with the extent of discrimination. Clinical symptoms of anxiety, depression and suspiciousness were associated with more experienced and anticipated discrimination respectively. The unfair treatment of individuals with severe mental illnesses remains unacceptably common. Population level interventions are needed to reduce levels of discrimination and to safeguard individuals. Interventions are also required to assist those with severe mental illness to reduce internalised stigma and social avoidance.

  1. Identifying Strategies to Cope with HIV-Related Stigma in a Group of Women Living with HIV/AIDS in the Dominican Republic: A Qualitative Study.

    Science.gov (United States)

    Rael, Christine Tagliaferri; Carballo-Diéguez, Alex; Norton, Rachel; Thorley, Eryka; Giguere, Rebecca; Sheinfil, Alan; Rios, Javier López

    2016-12-20

    Internalized HIV-related stigma negatively impacts the mental and physical health of women living with HIV/AIDS (WLWHA). Yet, some women can successfully confront stigma. The present work uses qualitative methods to investigate the successful stigma coping strategies displayed by 19 WLWHA who reported the least internalized stigma possible on the Internalized AIDS-Related Stigma Scale out of a larger pool of 233 WLWHA in San Felipe de Puerto Plata, Dominican Republic. Such strategies included, HIV disclosure control; preemptive disclosure of HIV-status; educating oneself/others about HIV; viewing HIV as a manageable condition; and looking to family, friends and partners for support. Our findings add to current knowledge about how WLWHA successfully manage internalized stigma, particularly in the context of the Dominican Republic. Clinicians should work closely with WLWHA to counsel them about the stigma coping strategies that best fit their life context.

  2. Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries.

    Science.gov (United States)

    Evans-Lacko, S; Brohan, E; Mojtabai, R; Thornicroft, G

    2012-08-01

    Little is known about how the views of the public are related to self-stigma among people with mental health problems. Despite increasing activity aimed at reducing mental illness stigma, there is little evidence to guide and inform specific anti-stigma campaign development and messages to be used in mass campaigns. A better understanding of the association between public knowledge, attitudes and behaviours and the internalization of stigma among people with mental health problems is needed. This study links two large, international datasets to explore the association between public stigma in 14 European countries (Eurobarometer survey) and individual reports of self-stigma, perceived discrimination and empowerment among persons with mental illness (n=1835) residing in those countries [the Global Alliance of Mental Illness Advocacy Networks (GAMIAN) study]. Individuals with mental illness living in countries with less stigmatizing attitudes, higher rates of help-seeking and treatment utilization and better perceived access to information had lower rates of self-stigma and perceived discrimination and those living in countries where the public felt more comfortable talking to people with mental illness had less self-stigma and felt more empowered. Targeting the general public through mass anti-stigma interventions may lead to a virtuous cycle by disrupting the negative feedback engendered by public stigma, thereby reducing self-stigma among people with mental health problems. A combined approach involving knowledge, attitudes and behaviour is needed; mass interventions that facilitate disclosure and positive social contact may be the most effective. Improving availability of information about mental health issues and facilitating access to care and help-seeking also show promise with regard to stigma.

  3. Impacts of HIV/AIDS Stigma on Family Identity and Interactions in China

    OpenAIRE

    Li, Li; Wu, Zunyou; Wu, Sheng; Jia, Manhong; Lieber, Eli; Lu, Yao

    2008-01-01

    This study examines the impact of HIV-related stigma on families living with HIV/AIDS in China. In-depth, semistructured interviews were conducted with 30 people living with HIV/AIDS and with 15 of their family members, including spouses, parents, and siblings. Findings show that HIV-related stigma is associated with bringing shame to the family, losing family “face,” and damaging within-family relations and broader family social networks. HIV/AIDS stigma was reported to have major impacts on...

  4. Self-Compassion as a Resource in the Self-Stigma Process of Overweight and Obese Individuals

    Directory of Open Access Journals (Sweden)

    Anja Hilbert

    2015-10-01

    Full Text Available Objective: Self-stigma in overweight and obese individuals has strong associations with impairment in mental and global health. This study sought to explore self-compassion as a psychological resource in the self-stigma process. Methods: In a 2012 representative German population survey of N = 1,158 overweight and obese individuals, self-compassion was examined as a mediator between self-stigma and mental and physical health outcomes, including BMI (kg/m2, using structural equation modeling and controlling for sociodemographic factors. Results: Psychological variables were assessed using validated self-report questionnaires. Self-compassion partially mediated the relationships between self-stigma and depression, somatic symptoms, and health status / quality of life, lowering the predictive effect of self-stigma on the outcomes by approximately one-third. In contrast, self-compassion, because it was unrelated to BMI, did not mediate the association between self-stigma and BMI. Conclusion: Self-compassion has the potential to act as a buffer against the mental and global health detriments of self-stigma in overweight and obesity and could thus represent a target for interventions to reduce self-stigma and prevent these health impairments. In order to influence the association between self-stigma and BMI, self-compassion should conceptually be linked to weight management.

  5. Verifying quantitative stigma and medication adherence scales using qualitative methods among Thai youth living with HIV/AIDS.

    Science.gov (United States)

    Fongkaew, Warunee; Viseskul, Nongkran; Suksatit, Benjamas; Settheekul, Saowaluck; Chontawan, Ratanawadee; Grimes, Richard M; Grimes, Deanna E

    2014-01-01

    HIV/AIDS-related stigma has been linked to poor adherence resulting in drug resistance and the failure to control HIV. This study used both quantitative and qualitative methods to examine stigma and its relationship to adherence in 30 HIV-infected Thai youth aged 14 to 21 years. Stigma was measured using the HIV stigma scale and its 4 subscales, and adherence was measured using a visual analog scale. Stigma and adherence were also examined by in-depth interviews. The interviews were to determine whether verbal responses would match the scale's results. The mean score of stigma perception from the overall scale and its 4 subscales ranged from 2.14 to 2.45 on a scale of 1 to 4, indicating moderate levels of stigma. The mean adherence score was .74. The stigma scale and its subscales did not correlate with the adherence. Totally, 17 of the respondents were interviewed. Contrary to the quantitative results, the interviewees reported that the stigma led to poor adherence because the fear of disclosure often caused them to miss medication doses. The differences between the quantitative and the qualitative results highlight the importance of validating psychometric scales when they are translated and used in other cultures.

  6. The Fight against Stigma toward Mental Illness

    Directory of Open Access Journals (Sweden)

    Olcay Cam

    2010-02-01

    Full Text Available In many health conditions, stigma is receiving increasing attention. Public stigmatization toward mental illness can affect particularly the patients and family memberships to help seeking behavior and treatment. These stigmatized persons in the society are deprived of rights and benefits. In this paper, reasons and consequences of stigma associated with mental illness are reviewed and combat against mental illnesses originated stigma are discussed. [TAF Prev Med Bull 2010; 9(1.000: 71-78

  7. Stigma in attention deficit hyperactivity disorder

    OpenAIRE

    Anna K Mueller; Fuermaier, Anselm B. M.; Koerts, Janneke; Tucha, Lara

    2012-01-01

    Attention deficit hyperactivity disorder (ADHD) is a frequently diagnosed disorder in child- and adulthood with a high impact affecting multiple facets of social life. Therefore, patients suffering from ADHD are at high risk to be confronted with stigma, prejudices, and discrimination. A review of the empirical research in the field of ADHD with regard to stigma was performed. The findings of investigations in this field were clustered in different categories, including stigma in children wit...

  8. Stigma-pollen recognition: a new look

    Directory of Open Access Journals (Sweden)

    C. Dumas

    2014-01-01

    Full Text Available During the last two decades, there have been several conceptual developments in our understanding of pollen-stigma recognition and molecular mechanisms involved. The main models proposed are compared. Based on additional data a hypothesis to complete these models especially for pollen hydration and adhesion is proposed. After attachment of the pollen to the stigma surface a close interaction exists involving lipoproteic membrane-like compounds (pollenkitt and stigma pellicle and pollen agglutinating ability.

  9. Does Mental Illness Stigma Contribute to Adolescent Standardized Patients' Discomfort With Simulations of Mental Illness and Adverse Psychosocial Experiences?

    Science.gov (United States)

    Hanson, Mark D.; Johnson, Samantha; Niec, Anne; Pietrantonio, Anna Marie; High, Bradley; MacMillan, Harriet; Eva, Kevin W.

    2008-01-01

    Objective: Adolescent mental illness stigma-related factors may contribute to adolescent standardized patients' (ASP) discomfort with simulations of psychiatric conditions/adverse psychosocial experiences. Paradoxically, however, ASP involvement may provide a stigma-reduction strategy. This article reports an investigation of this hypothetical…

  10. Does Mental Illness Stigma Contribute to Adolescent Standardized Patients' Discomfort With Simulations of Mental Illness and Adverse Psychosocial Experiences?

    Science.gov (United States)

    Hanson, Mark D.; Johnson, Samantha; Niec, Anne; Pietrantonio, Anna Marie; High, Bradley; MacMillan, Harriet; Eva, Kevin W.

    2008-01-01

    Objective: Adolescent mental illness stigma-related factors may contribute to adolescent standardized patients' (ASP) discomfort with simulations of psychiatric conditions/adverse psychosocial experiences. Paradoxically, however, ASP involvement may provide a stigma-reduction strategy. This article reports an investigation of this hypothetical…

  11. STIGMA AROUND HIV IN DENTAL CARE: PATIENTS' EXPERIENCES.

    Science.gov (United States)

    Brondani, Mario A; Phillips, J Craig; Kerston, R Paul; Moniri, Nardin R

    2016-02-01

    Tooth decay and other oral diseases can be highly prevalent among people living with HIV/AIDS (PLWHA). Even though dental professionals are trained to provide equal and non-judgemental services to all, intentional or unintentional biases may exist with regard to PLWHA. We conducted qualitative descriptive research using individual interviews to explore the experiences of PLWHA accessing dental care services in Vancouver, Canada. We interviewed 25 PLWHA, aged 23-67 years; 21 were men and 60% reported fair or poor oral health. Thematic analysis showed evidence of both self-stigma and public stigma with the following themes: fear, self-stigma and dental care; overcoming past offences during encounters with dental care professionals; resilience and reconciliation to achieve quality care for all; and current encounters with dental care providers. Stigma attached to PLWHA is detrimental to oral care. The social awareness of dental professionals must be enhanced, so that they can provide the highest quality care to this vulnerable population.

  12. Stigma in Canada: Results From a Rapid Response Survey

    Science.gov (United States)

    Stuart, Heather; Patten, Scott B; Koller, Michelle; Modgill, Geeta; Liinamaa, Tiina

    2014-01-01

    Objective: Our paper presents findings from the first population survey of stigma in Canada using a new measure of stigma. Empirical objectives are to provide a descriptive profile of Canadian’s expectations that people will devalue and discriminate against someone with depression, and to explore the relation between experiences of being stigmatized in the year prior to the survey among people having been treated for a mental illness with a selected number of sociodemographic and mental health–related variables. Method: Data were collected by Statistics Canada using a rapid response format on a representative sample of Canadians (n = 10 389) during May and June of 2010. Public expectations of stigma and personal experiences of stigma in the subgroup receiving treatment for a mental illness were measured. Results: Over one-half of the sample endorsed 1 or more of the devaluation discrimination items, indicating that they believed Canadians would stigmatize someone with depression. The item most frequently endorsed concerned employers not considering an application from someone who has had depression. Over one-third of people who had received treatment in the year prior to the survey reported discrimination in 1 or more life domains. Experiences of discrimination were strongly associated with perceptions that Canadians would devalue someone with depression, younger age (12 to 15 years), and self-reported poor general mental health. Conclusions: The Mental Health Experiences Module reflects an important partnership between 2 national organizations that will help Canada fulfill its monitoring obligations under the United Nations Convention on the Rights of Persons with Disabilities and provide a legacy to researchers and policy-makers who are interested in monitoring changes in stigma over time. PMID:25565699

  13. Coping strategies and self-stigma among adolescents discharged from psychiatric hospitalization: a 6-month follow-up study.

    Science.gov (United States)

    Moses, Tally

    2015-03-01

    The effects of mental illness stigma on adolescents receiving psychiatric treatment may largely be determined by their coping strategies. Yet, little is known about adolescents' use of stigma-coping strategies, or how helpful these are for addressing stigma-related stress. This study explores how adolescents discharged from psychiatric hospitalization anticipate coping with a hypothetical social stigma event related to hospitalization. We examine how well anticipated coping strategies predict adolescents' self-stigma ratings following 6 months. To evaluate the direction of causality, the reverse order of effects, the influence of self-stigma on coping strategies, is also assessed. A voluntary sample of 80 adolescents participated in two face-to-face interviews that assessed coping and self-stigma. Anticipated (baseline) and actual (follow-up) coping strategies were measured with a modified Response to Stress Questionnaire (primary and secondary control engagement coping, disengagement) and two stigma-specific strategies developed for this study (disconfirming stereotypes and aggression/confrontation). Relationships between anticipated coping strategies and self-stigma were assessed with ordinary least squares (OLS) regression; multivariate general linear modeling (GLM) and structural equation modeling (SEM) explored the reverse associations. Youth reporting higher self-stigma ratings at follow-up anticipated using more disengagement and effort to disconfirm stereotypes and less secondary control engagement coping at baseline. Anticipated use of secondary control engagement coping was uniquely significant in predicting participants' self-stigma when controlling for baseline self-stigma. At the same time, higher baseline self-stigma ratings predicted less adaptive coping (disengagement and effort to disconfirm stereotypes) at follow-up. The results point to the particular importance of secondary control engagement coping for helping to mitigate the impact of peer

  14. [SOCIO STRUCTURAL FACTORS AND HIV/AIDS STIGMA: EXPERIENCES FROM PUERTO RICANS LIVING WITH HIV/AIDS ACCESING HEALTH SERVICES.

    Science.gov (United States)

    Rivera-Diaz, Marinilda; Varas-Diaz, Nelson; Reyes-Estrada, Marcos; Suro, Beatriz; Coriano, Doralis

    2012-01-01

    HIV/AIDS stigma continues affecting the provision of health services to people living with HIV/AIDS, as well as their physical and mental well-being. Scientific literature has highlighted the importance of understanding stigma manifestations that surpass one-on-one social interactions. For that reason, social research in Puerto Rico and elsewhere has highlighted the importance of understanding the Socio-Structural Factors (SSF) that foster HIV/AIDS stigma. With the objective of exploring the SSF that influence stigma manifestations related to HIV/AIDS, we conducted 9 focus groups composed by women and men on HIV/AIDS treatment that had experienced social stigma related to the disease. Participants identified SSF that they understood were related to stigma such as a) development of housing projects for people with HIV/AIDS, b) decentralization of health related services, and c) health services administrative protocols that fostered exclusion. Results evidence the importance of addressing SSF when developing stigma related interventions for this population.

  15. Back to Bentham? Explorations of Experienced Utility

    NARCIS (Netherlands)

    D. Kahneman (Daniel); P.P. Wakker (Peter); R.K. Sarin (Rakesh)

    1997-01-01

    textabstractTwo core meanings of “utility” are distinguished. “Decision utility” is the weight of an outcome in a decision. “Experienced utility” is hedonic quality, as in Bentham’s usage. Experienced utility can be reported in real time (instant utility), or in retrospective evaluations of past

  16. Back to Bentham? Explorations of Experienced Utility

    NARCIS (Netherlands)

    D. Kahneman (Daniel); P.P. Wakker (Peter); R.K. Sarin (Rakesh)

    1997-01-01

    textabstractTwo core meanings of “utility” are distinguished. “Decision utility” is the weight of an outcome in a decision. “Experienced utility” is hedonic quality, as in Bentham’s usage. Experienced utility can be reported in real time (instant utility), or in retrospective evaluations of past epi

  17. [The Stigma-discrimination Complex Associated With Mental Disorder as a Risk Factor for Suicide].

    Science.gov (United States)

    Campo-Arias, Adalberto; Herazo, Edwin

    2015-01-01

    The concept stigma-discrimination complex associated with mental disorder (SDCAMD) is proposed to encompass the terms used in the attribution theory: stigma, stereotype, prejudice and discrimination. SDCAMD is one of the most frequent disorders worldwide. Internalized and perceived SDCAMD may explain a number of suicide cases. To update the factors that may explain the association between SDCAMD and suicide, and postulate possible underlying mechanisms. Articles were identified in MEDLINE using the descriptors for "stigma", "mental disorders" and "suicide" or "suicide rate". Articles published between January 2000 and June 2014 were included. Reviews and case studies were not considered. The two included studies showed that stigma increased the risk of suicidal behaviors. It was evident that people who meet criteria for mental disorder and reported high self-stigma made a greater number of suicide attempts, and countries with high stigma in the general population have a higher suicide rate. It was considered that the relationship between SDCAMD and suicide is established by a set of interrelated mechanisms. A "direct" mechanism involving perceived stigma and is configured as a barrier to access mental health services, and an "indirect" mechanism involving the self-stigma, which increases the vulnerability to depressive episodes and repeated self-injurious behaviors that ultimately end in suicide. The SDCAMD impacts negatively on the quality of life of people who meet criteria for mental disorders, and accounts for a significant number of suicides. One way is related to the perceived stigma that is configured as a barrier to access mental health services and, the second one includes repeated self-injurious behaviors that reduce self-esteem and increases perceived stress. Further research is required to increase the knowledge of this association. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Public Stigma Associated With Psychosis Risk Syndrome in a College Population: Implications for Peer Intervention

    Science.gov (United States)

    Yang, Lawrence H.; Anglin, Deidre M.; Wonpat-Borja, Ahtoy J.; Opler, Mark G.; Greenspoon, Michelle; Corcoran, Cheryl M.

    2013-01-01

    Objectives This study compared stigma associated with the psychosis risk label and diagnostic labels for nonpsychotic and psychotic mental disorders among young adult peers. Methods Urban college respondents (N=153) read an experimental vignette describing a young adult experiencing prodromal symptoms who was randomly assigned a diagnostic label (major depression, generalized anxiety disorder, schizophrenia, or psychosis risk with and without accurate information about the psychosis risk label) and answered questions about stigma toward the individual in the vignette. Results Compared with labels for non-psychotic disorders, schizophrenia elicited more negative stereotyping and the at-risk label invoked greater social distance and less willingness to help. Any increased social distance appeared to be reduced by accurate information about the at-risk state. No differences in stigma were found for the psychosis risk and schizophrenia labels. Conclusions The psychosis risk label alone appeared to evoke greater status loss and discrimination. Accurate information may minimize some stigmatizing attitudes among college peers. PMID:23450386

  19. Stigma and social participation in Southern India: differences and commonalities among persons affected by leprosy and persons living with HIV/AIDS.

    Science.gov (United States)

    Stevelink, S A M; van Brakel, W H; Augustine, V

    2011-12-01

    Stigma is a common phenomenon worldwide and infectious diseases like HIV/AIDS and leprosy are often associated with high levels of stigma. Several studies have been conducted concerning the effects of stigma and the impact on social participation, but comparative studies are rare. The objective of this study was to identify differences and similarities between HIV/AIDS and leprosy-related stigma. From April till July 2009, 190 questionnaire-based interviews were conducted to assess the levels of internalized stigma (Internalized Stigma of Mental Illness scale), perceived stigma (Explanatory Model Interview Catalogue stigma scale) and social participation (Participation scale) in a cross-sectional sample of people affected by leprosy (PL) and people living with HIV/AIDS (PLHA). Respondents were selected from several hospitals, charity projects and during home visits in Vellore district, Tamil Nadu. Our results showed that both PLHA (n = 95) and leprosy-affected respondents (n = 95) faced a substantial burden of internalized and perceived stigma, with the former reporting a significantly higher level of stigma. As a result, PLHA faced more frequent and also more severe participation restrictions than PL. Especially, restrictions in work-related areas were reported by the majority of the respondents. In conclusion, PLHA faced a significantly higher level of stigma and participation restriction than PL. However, the latter also reported a substantial burden of stigma and participation restrictions. The study suggests that it may be possible to develop joint interventions based on the commonalities found. More research is needed to define these more precisely and to test the effectiveness of such joint interventions in reducing stigma and improving social participation.

  20. Dual psychological processes underlying public stigma and the implications for reducing stigma

    Directory of Open Access Journals (Sweden)

    John B. Pryor

    2008-01-01

    Full Text Available People with serious illness or disability are often burdened with social stigma that promotes a cycle of poverty via unemployment, inadequate housing and threats to mental health. Stigma may be conceptualized in terms of self-stigma (e.g, shame and lowered self-esteem or public stigma (e.g, the general public's prejudice towards the stigmatized. This article examines two psychological processes that underlie public stigma: associative processes and rule-based processes. Associative processes are quick and relatively automatic whereas rule-based processes take longer to manifest themselves and involve deliberate thinking. Associative and rule-based thinking require different assessment instruments, follow a different time course and lead to different effects (e.g, stigma-by-association vs attributional processing that results in blame. Of greatest importance is the fact that each process may require a different stigma-prevention strategy.

  1. Dual psychological processes underlying public stigma and the implications for reducing stigma.

    Science.gov (United States)

    Reeder, Glenn D; Pryor, John B

    2008-01-01

    People with serious illness or disability are often burdened with social stigma that promotes a cycle of poverty via unemployment, inadequate housing and threats to mental health. Stigma may be conceptualized in terms of self-stigma (e.g., shame and lowered self-esteem) or public stigma (e.g., the general public's prejudice towards the stigmatized). This article examines two psychological processes that underlie public stigma: associative processes and rule-based processes. Associative processes are quick and relatively automatic whereas rule-based processes take longer to manifest themselves and involve deliberate thinking. Associative and rule-based thinking require different assessment instruments, follow a different time course and lead to different effects (e.g., stigma-by-association vs attributional processing that results in blame). Of greatest importance is the fact that each process may require a different stigma-prevention strategy.

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

    Science.gov (United States)

    Brohan, Elaine; Elgie, Rodney; Sartorius, Norman; Thornicroft, Graham

    2010-09-01

    There is a growing interest in examining self-stigma as a barrier to recovery from schizophrenia. To date, no studies have examined mental health service user's experiences of self-stigma throughout Europe. This study describes the level of self-stigma, stigma resistance, empowerment and perceived discrimination reported by mental health service users with a diagnosis of schizophrenia or other psychotic disorder across 14 European countries. Data were collected from 1229 people using a postal survey from members of mental health non-governmental organisations. Almost half (41.7%) reported moderate or high levels of self-stigma, 49.2% moderate or high stigma resistance, 49.7% moderate or high empowerment and 69.4% moderate or high perceived discrimination. In a reduced multivariate model 42% of the variance in self-stigma scores was predicted by levels of empowerment, perceived discrimination and social contact. These results suggest that self-stigma appears to be common and sometimes severe among people with schizophrenia or other psychotic disorders in Europe. (c) 2010 Elsevier B.V. All rights reserved.

  3. Public Stigma towards Older Adults with Depression: Findings from the Sao Paulo-Manaus Elderly in Primary Care Study.

    Directory of Open Access Journals (Sweden)

    Marcia Scazufca

    Full Text Available This study investigates three domains of public stigma (perceived negative reactions, perceived discrimination, and dangerousness against older adults with depression. The sample comprised of older adults registered with primary care clinics (n = 1,291 and primary health care professionals (n = 469 from São Paulo and Manaus, Brazil. Participants read a vignette describing a 70-year-old individual (Mary or John with a depressive disorder and answered questions measuring stigma. The prevalence of the three stigma domains was between 30.2 and 37.6% among older participants from São Paulo and between 27.6 and 35.4% among older participants from Manaus. Older adults from both cities reported similar prevalence of perceived stigma. Key factors associated with stigmatizing beliefs among older participants were reporting depressive symptoms, having physical limitations, and identifying the case of the vignette as a case of mental disorder. Among health professionals, the prevalence of the three stigma domains was between 19.8 and 34.8% in São Paulo and 30.2 and 44.6% in Manaus. The key factor associated with stigma among primary health care professionals was city, with consistently higher risk in Manaus than in São Paulo. Findings confirm that public stigma against older adults in Brazil is common. It is important to educate the public and primary health care providers in Brazil on stigma related to mental illness in order to reduce barriers to adequate mental health treatment.

  4. Disgust sensitivity, obesity stigma, and gender: contamination psychology predicts weight bias for women, not men.

    Science.gov (United States)

    Lieberman, Debra L; Tybur, Josh M; Latner, Janet D

    2012-09-01

    Recent research has established a link between disgust sensitivity and stigmatizing reactions to various groups, including obese individuals. However, previous research has overlooked disgust's multiple evolved functions. Here, we investigated whether the link between disgust sensitivity and obesity stigma is specific to pathogen disgust, or whether sexual disgust and moral disgust--two separate functional domains--also relate to negative attitudes toward obese individuals. Additionally, we investigated whether sex differences exist in the manner disgust sensitivity predicts obesity stigma, whether the sexes differ across the subtypes of obesity bias independent of disgust sensitivity, and last, the association between participants' BMI and different subtypes of obesity stigma. In study 1 (N = 92), we established that obesity elicits pathogen, sexual, and moral disgust. In study 2, we investigated the relationship between these types of disgust sensitivity and obesity stigma. Participants (N = 387) reported their level of disgust toward various pathogen, sexual, and moral acts and their attitudes toward obese individuals. For women, but not men, increased pathogen disgust sensitivity predicted more negative attitudes toward obese individuals. Men reported more negative general attitudes toward obese individuals whereas women reported greater fear of becoming obese. The sexes also differed in how their own BMI related to the subtypes of obesity stigma. These findings indicate that pathogen disgust sensitivity plays a role in obesity stigma, specifically for women. Defining the scope of disgust's activation in response to obesity and its relationship with other variables can help identify possible mechanisms for understanding and ultimately alleviating prejudice and discrimination.

  5. Coming out as Fat: Rethinking Stigma

    Science.gov (United States)

    Saguy, Abigail C.; Ward, Anna

    2011-01-01

    This paper examines the surprising case of women who "come out as fat" to test and refine theories about social change, social mobilization, stigma, and stigma resistance. First, supporting theories about "social movement spillover," we find that overlapping memberships in queer and fat activist groups, as well as networks between these groups,…

  6. Social Work Faculty and Mental Illness Stigma

    Science.gov (United States)

    Watson, Amy C.; Fulambarker, Anjali; Kondrat, David C.; Holley, Lynn C.; Kranke, Derrick; Wilkins, Brittany T.; Stromwall, Layne K.; Eack, Shaun M.

    2017-01-01

    Stigma is a significant barrier to recovery and full community inclusion for people with mental illnesses. Social work educators can play critical roles in addressing this stigma, yet little is known about their attitudes. Social work educators were surveyed about their general attitudes about people with mental illnesses, attitudes about practice…

  7. Tuberculosis stigma in Gezira State, Sudan

    DEFF Research Database (Denmark)

    Suleiman MM, Ahmed; Sahal, Nagla; Sodemann, Morten

    2013-01-01

    OBJECTIVE: To evaluate the prevalence of tuberculosis (TB) stigma and to determine the relation between socio-demographic characteristics and TB stigma among TB cases and their controls in Gezira State, Sudan. METHODS: A case-control study design was used. New smear-positive TB patients registered...

  8. Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

    Science.gov (United States)

    Whitehead, J; Shaver, John; Stephenson, Rob

    2016-01-01

    Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender) populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers. LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas. Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men. The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

  9. Pollen and stigma size changes during the transition from tristyly to distyly in Oxalis alpina (Oxalidaceae).

    Science.gov (United States)

    Baena-Díaz, Fernanda; Fornoni, Juan; Sosenski, Paula; Weller, Stephen G; Domínguez, César A

    2017-08-23

    (1)Pollen and stigma size have the potential of influencing male fitness of hermaphroditic plants, particularly in species presenting floral polymorphisms characterized by marked differences in these traits among floral morphs. In this study, we take advantage of the evolutionary transition from tristyly to distyly experienced by Oxalis alpina (Oxalidaceae) and examined whether modifications in the ancillary traits (pollen and stigma size) respond to allometric changes in other floral traits. Also, we tested if these modifications are in accordance with what would be expected under the hypothesis that novel competitive scenarios (as in distylous derived reproductive system) exerts morph- and whorl-specific selective pressures to match the available stigmas. (2) We measure pollen- and stigma size in five populations of O. alpina representing the tristyly-distyly transition. (3) A general reduction in pollen and stigma size occurred along the tristyly-distyly transition and pollen size from the two anther levels within each morph converged to a similar size that was characterized by whorl specific changes (increases or decreases) in pollen size of different anthers in each floral type. (4) Overall, results from this study show that the evolution of distyly in this species is characterized not only by changes in sexual organ position and flower size, but also by morph-specific changes in pollen and stigma size. This evidence supports the importance of selection on pollen and stigma size that increase fitness of remaining morphs following the evolution of distyly, and raises questions to explore the functional value of pollen size in heterostylous systems under pollen competition. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  10. Outness, Stigma, and Primary Health Care Utilization among Rural LGBT Populations.

    Directory of Open Access Journals (Sweden)

    J Whitehead

    Full Text Available Prior studies have noted significant health disadvantages experienced by LGBT (lesbian, gay, bisexual, and transgender populations in the US. While several studies have identified that fears or experiences of stigma and disclosure of sexual orientation and/or gender identity to health care providers are significant barriers to health care utilization for LGBT people, these studies have concentrated almost exclusively on urban samples. Little is known about the impact of stigma specifically for rural LGBT populations, who may have less access to quality, LGBT-sensitive care than LGBT people in urban centers.LBGT individuals residing in rural areas of the United States were recruited online to participate in a survey examining the relationship between stigma, disclosure and "outness," and utilization of primary care services. Data were collected and analyzed regarding LGBT individuals' demographics, health care access, health risk factors, health status, outness to social contacts and primary care provider, and anticipated, internalized, and enacted stigmas.Higher scores on stigma scales were associated with lower utilization of health services for the transgender & non-binary group, while higher levels of disclosure of sexual orientation were associated with greater utilization of health services for cisgender men.The results demonstrate the role of stigma in shaping access to primary health care among rural LGBT people and point to the need for interventions focused towards decreasing stigma in health care settings or increasing patients' disclosure of orientation or gender identity to providers. Such interventions have the potential to increase utilization of primary and preventive health care services by LGBT people in rural areas.

  11. The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review.

    Science.gov (United States)

    Hanisch, Sabine E; Twomey, Conal D; Szeto, Andrew C H; Birner, Ulrich W; Nowak, Dennis; Sabariego, Carla

    2016-01-06

    The majority of people experiencing mental-health problems do not seek help, and the stigma of mental illness is considered a major barrier to seeking appropriate treatment. More targeted interventions (e.g. at the workplace) seem to be a promising and necessary supplement to public campaigns, but little is known about their effectiveness. The aim of this systematic review is to provide an overview of the evidence on the effectiveness of interventions targeting the stigma of mental illness at the workplace. Sixteen studies were included after the literature review. The effectiveness of anti-stigma interventions at the workplace was assessed by examining changes in: (1) knowledge of mental disorders and their treatment and recognition of signs/symptoms of mental illness, (2) attitudes towards people with mental-health problems, and (3) supportive behavior. The results indicate that anti-stigma interventions at the workplace can lead to improved employee knowledge and supportive behavior towards people with mental-health problems. The effects of interventions on employees' attitudes were mixed, but generally positive. The quality of evidence varied across studies. This highlights the need for more rigorous, higher-quality evaluations conducted with more diverse samples of the working population. Future research should explore to what extent changes in employees' knowledge, attitudes, and supportive behavior lead to affected individuals seeking help earlier. Such investigations are likely to inform important stakeholders about the potential benefits of current workplace anti-stigma interventions and provide guidance for the development and implementation of effective future interventions.

  12. Experiencing Security in Interaction Design

    DEFF Research Database (Denmark)

    Mathiasen, Niels Raabjerg; Bødker, Susanne

    2011-01-01

    Security is experienced differently in different contexts. This paper argues that in everyday situations, users base their security decisions on a mix of prior experiences. When approaching security and interaction design from an experience approach, tools that help bring out such relevant...... experiences for design are needed. This paper reports on how Prompted exploration workshops and Acting out security were developed to target such experiences when iteratively designing a mobile digital signature solution in a participatory design process. We discuss how these tools helped the design process...

  13. Stigma and difficulty accessing medical care in a sample of adults with serious mental illness.

    Science.gov (United States)

    Ostrow, Laysha; Manderscheid, Ron; Mojtabai, Ramin

    2014-11-01

    Wellness of people with mental illness is increasingly a public health priority. This study examined factors associated with difficulties receiving medical care in adults with mental illness. In a sample of 1,670 adults with mental illness, we assessed difficulties in accessing medical care and stigma. A total of 465 (28%) participants reported difficulties in accessing medical care; 211 (13%) attributed difficulties in access to stigma. Lack of comprehensive medical care coverage and mental health symptoms were associated with increased odds of perceived difficulties in accessing medical care; personal empowerment was negatively associated with perceived difficulties attributed to stigma; education was positively associated. The findings highlight unmet need for medical care in this population and the need to recognize stigma as a barrier medical care. Interventions to empower patients and educate medical providers about wellness for people with serious mental illness could help to reduce barriers.

  14. Mental Illness Stigma Intervention in African Americans: Examining Two Delivery Methods.

    Science.gov (United States)

    Vinson, Ebony S; Abdullah, Tahirah; Brown, Tamara L

    2016-05-01

    Stigma surrounding mental illness and mental health treatment remains a significant problem, particularly among African Americans. This study sought to examine the effects of 2 intervention delivery methods in reducing reported stigma. African Americans (n = 158) were nonrandomly assigned to an in-person contact or video condition and administered a survey immediately before, after, and 2 weeks following the stigma intervention. The in vivo contact condition consisted of an African American man discussing his experiences with mental illness and psychotherapy. The session was recorded, and the recording was used for the video condition. There were no significant effects based on delivery method; however, there was a significant effect for time on stigma and help-seeking attitude measures. Further research is needed to determine the overall effectiveness of the intervention.

  15. Are you experienced?

    DEFF Research Database (Denmark)

    This paper investigates the relationship between the level of experience of managers and founders, and the likelihood of survival of their new firms. We take advantage of a comprehensive dataset covering the entire Danish labor market from 1980-2000. This is used to trace the activities of top...... ranked members of start-ups prior to their founding, and follow the fate of these firms. More specifically, we compare the survival of spin-offs from surviving parents, spin-offs from exiting parents, and other start-ups. Moreover, we investigate whether firms managed and founded by more experienced...... teams with higher levels of industry-specific experience are more likely to survive. Distinguishing between survivors and firms that have been acquired, we find that spin-offs from a surviving parent company combined with and industry-specific experience, positively affects the likelihood of survival...

  16. Are you experienced?

    DEFF Research Database (Denmark)

    This paper investigates the relationship between the level of experience of managers and founders, and the likelihood of survival of their new firms. We take advantage of a comprehensive dataset covering the entire Danish labor market from 1980-2000. This is used to trace the activities of top...... ranked members of start-ups prior to their founding, and follow the fate of these firms. More specifically, we compare the survival of spin-offs from surviving parents, spin-offs from exiting parents, and other start-ups. Moreover, we investigate whether firms managed and founded by more experienced...... teams with higher levels of industry-specific experience are more likely to survive. Distinguishing between survivors and firms that have been acquired, we find that spin-offs from a surviving parent company combined with and industry-specific experience, positively affects the likelihood of survival...

  17. Challenging the public stigma of mental illness: a meta-analysis of outcome studies.

    Science.gov (United States)

    Corrigan, Patrick W; Morris, Scott B; Michaels, Patrick J; Rafacz, Jennifer D; Rüsch, Nicolas

    2012-10-01

    Public stigma and discrimination have pernicious effects on the lives of people with serious mental illnesses. Given a plethora of research on changing the stigma of mental illness, this article reports on a meta-analysis that examined the effects of antistigma approaches that included protest or social activism, education of the public, and contact with persons with mental illness. The investigators heeded published guidelines for systematic literature reviews in health care. This comprehensive and systematic review included articles in languages other than English, dissertations, and population studies. The search included all articles from the inception of the databases until October 2010. Search terms fell into three categories: stigma, mental illness (such as schizophrenia and depression), and change program (including contact and education). The search yielded 72 articles and reports meeting the inclusion criteria of relevance to changing public stigma and sufficient data and statistics to complete analyses. Studies represented 38,364 research participants from 14 countries. Effect sizes were computed for all studies and for each treatment condition within studies. Comparisons between effect sizes were conducted with a weighted one-way analysis of variance. Overall, both education and contact had positive effects on reducing stigma for adults and adolescents with a mental illness. However, contact was better than education at reducing stigma for adults. For adolescents, the opposite pattern was found: education was more effective. Overall, face-to-face contact was more effective than contact by video. Future research is needed to identify moderators of the effects of both education and contact.

  18. Public stigma in intellectual disability: do direct versus indirect questions make a difference?

    Science.gov (United States)

    Werner, S

    2015-10-01

    Stigma may negatively impact individuals with intellectual disabilities (ID). However, most studies in the field have been based on the use of direct measurement methods for assessing stigma. This study examined public stigma towards individuals with ID within a representative sample of the Israeli public by comparing direct versus indirect questioning. Vignette methodology was utilised with two questionnaire versions. In the direct questionnaire (n = 306), the participants were asked how they would think, feel and behave if a man with ID asked them a question in a public place. In the indirect questionnaire (n = 301), the participants were asked to report how a hypothetical 'other man' would think, feel and behave in the same situation. Higher levels of stigma were reported among participants that answered the indirect questionnaire version. Furthermore, among those participants that answered the indirect questionnaire version, subjective knowledge of ID was a less important correlate of stigma than for those participants that answered the direct questionnaire. Several explanations are suggested for the finding that indirect questioning elicits more negative stigmatic attitudes. Among others, indirect questioning may be a more appropriate methodology for eliciting immediate beliefs. Furthermore, the results call for implementing a comprehensive, multi-level programme to change stigma. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  19. Evaluation of a health setting-based stigma intervention in five African countries.

    Science.gov (United States)

    Uys, Leana; Chirwa, Maureen; Kohi, Thecla; Greeff, Minrie; Naidoo, Joanne; Makoae, Lucia; Dlamini, Priscilla; Durrheim, Kevin; Cuca, Yvette; Holzemer, William L

    2009-12-01

    The study aim is to explore the results of an HIV stigma intervention in five African health care settings. A case study approach was used. The intervention consisted of bringing together a team of approximately 10 nurses and 10 people living with HIV or AIDS (PLHA) in each setting and facilitating a process in which they planned and implemented a stigma reduction intervention, involving both information giving and empowerment. Nurses (n = 134) completed a demographic questionnaire, the HIV/AIDS Stigma Instrument-Nurses (HASI-N), a self-efficacy scale, and a self-esteem scale, both before and after the intervention, and the team completed a similar set of instruments before and after the intervention, with the PLHA completing the HIV/AIDS Stigma Instrument for PLHA (HASI-P). The intervention as implemented in all five countries was inclusive, action-oriented, and well received. It led to understanding and mutual support between nurses and PLHA and created some momentum in all the settings for continued activity. PLHA involved in the intervention teams reported less stigma and increased self-esteem. Nurses in the intervention teams and those in the settings reported no reduction in stigma or increases in self- esteem and self-efficacy, but their HIV testing behavior increased significantly. This pilot study indicates that the stigma experience of PLHA can be decreased, but that the stigma experiences of nurses are less easy to change. Further evaluation research with control groups and larger samples and measuring change over longer periods of time is indicated.

  20. A tale of two cities: stigma and health outcomes among people with HIV who inject drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia.

    Science.gov (United States)

    Burke, Sara E; Calabrese, Sarah K; Dovidio, John F; Levina, Olga S; Uusküla, Anneli; Niccolai, Linda M; Abel-Ollo, Katri; Heimer, Robert

    2015-04-01

    Experiences of stigma are often associated with negative mental and physical health outcomes. The present work tested the associations between stigma and health-related outcomes among people with HIV who inject drugs in Kohtla-Järve, Estonia and St. Petersburg, Russia. These two cities share some of the highest rates of HIV outside of sub-Saharan Africa, largely driven by injection drug use, but Estonia has implemented harm reduction services more comprehensively. People who inject drugs were recruited using respondent-driven sampling; those who indicated being HIV-positive were included in the present sample (n = 381 in St. Petersburg; n = 288 in Kohtla-Järve). Participants reported their health information and completed measures of internalized HIV stigma, anticipated HIV stigma, internalized drug stigma, and anticipated drug stigma. Participants in both locations indicated similarly high levels of all four forms of stigma. However, stigma variables were more strongly associated with health outcomes in Russia than in Estonia. The St. Petersburg results were consistent with prior work linking stigma and health. Lower barriers to care in Kohtla-Järve may help explain why social stigma was not closely tied to negative health outcomes there. Implications for interventions and health policy are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Does type of disability make a difference in affiliate stigma among family caregivers of individuals with autism, intellectual disability or physical disability?

    Science.gov (United States)

    Werner, S; Shulman, C

    2015-03-01

    Studies have shown that beyond public and self stigma, stigma can also impact family members. Only scant research has examined the internalised aspects of stigma, known as affiliate stigma, among family caregivers of individuals with disabilities. This study examined affiliate stigma among family caregivers of individuals with developmental disabilities via a comparison between caregivers of individuals with intellectual disabilities (ID), autism spectrum disorders (ASD) and physical disabilities (PD) in Israel. Family caregivers (n = 171) of individuals with developmental disabilities, mainly ID (22.4%), ASD (32.9%) and PD (27.1%), completed a self-report structured questionnaire including the Affiliate Stigma Scale and background variables. Results supported a one-factor structure for the Affiliate Stigma Scale. Overall, affiliate stigma was relatively low in this sample, but was found to be higher among caregivers of individuals with ASD when compared with caregivers of individuals with ID or PD. Findings from this study point to the importance of supporting caregivers of individuals with ASD to decrease their feelings of stigma. It is also important to further develop scales measuring affiliate stigma in order to capture the multi-dimensional nature of the concept. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  2. Intragroup Stigma Among Men Who Have Sex with Men: Data Extraction from Craigslist Ads in 11 Cities in the United States

    Science.gov (United States)

    Vansia, Dhrutika; Stephenson, Rob

    2016-01-01

    Background Gay, bisexual, and other men who have sex with men (MSM) regularly experience homophobic discrimination and stigma. While previous research has examined homophobic and HIV-related intergroup stigma originating from non-MSM directed at MSM, less is known about intragroup stigma originating from within MSM communities. While some research has examined intragroup stigma, this research has focused mostly on HIV-related stigma. Intragroup stigma may have a unique influence on sexual risk-taking behaviors as it occurs between sexual partners. Online sexual networking venues provide a unique opportunity to examine this type of stigma. Objective The purpose of this study is to examine the presence and patterns of various types of intragroup stigma represented in Men Seeking Men Craigslist sex ads. Methods Data were collected from ads on Craigslist sites from 11 of the 12 US metropolitan statistical areas with the highest HIV/AIDS prevalence. Two categories of data were collected: self-reported characteristics of the authors and reported biases in the ads. Chi-square tests were used to examine patterns of biases across cities and author characteristics. Results Biases were rarely reported in the ads. The most commonly reported biases were against men who were not “disease and drug free (DDF),” representing stigma against men living with HIV or a sexually transmitted infection. Patterns in bias reporting occurred across cities and author characteristics. There were no variations based on race, but ageism (mostly against older men) varied based on the ad author’s age and self-reported DDF status; bias against feminine gender expression varied based on self-reported sexual orientation; bias against “fat” men varied by self-reported DDF status; bias against “ugly” men varied by a self-report of being good-looking; and bias against people who do not have a DDF status varied based on self-reported HIV status and self-reported DDF status. Conclusions

  3. Atomic force microscopic view of the fine topography on the tobacco stigma surface during its response to pollination

    Institute of Scientific and Technical Information of China (English)

    WU Hui; LI Meng; SUN MengXiang

    2008-01-01

    During compatible pollination in tobacco, an extracellular matrix (ECM) is secreted from the stigma surface; however, it is unknown whether the pattern of secretion across the stigma depends on the pollen source. In fact, technical limitations have prevented clear observation of ECM secretion. Here, we report the detailed topographic changes on the stigma surface that accompanies intraspecies and interspecies pollination in tobacco using contact mode atomic force microscopy (AFM). Our results, which show the dynamics and time course of ECM secretion after pollination, indicate that a certain pattern of secretion already exists on the stigma prior to pollination. Intraspecies induced a two-step response, characterized by topograPhical changes on the stigma surface several hours after pollina-tion, which was distinct from the pattern of ECM secretion induced by interspecies pollination. This difference was confirmed by root-mean-square analysis, which assessed the roughness of the stigma surface. Our findings indicate that compatible pollination not only induces ECM secretion from the stigma, but also results in a specific distribution of the ECM. Thus, this study demonstrates the pow-erful potential of AFM in studying the pollen-stigma interaction.

  4. Predictors of internalised HIV-related stigma: a systematic review of studies in sub-Saharan Africa.

    Science.gov (United States)

    Pantelic, Marija; Shenderovich, Yulia; Cluver, Lucie; Boyes, Mark

    2015-01-01

    This systematic review aims to synthesise evidence on predictors of internalised HIV stigma amongst people living with HIV in sub-Saharan Africa. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used. Studies were identified through electronic databases, grey literature, reference harvesting and contacts with key researchers. Quality of findings was assessed through an adapted version of the Cambridge Quality Checklists. A total of 590 potentially relevant titles were identified. Seventeen peer-reviewed articles and one draft book chapter were included. Studies investigated socio-demographic, HIV-related, intra-personal and interpersonal correlates of internalised stigma. Eleven articles used cross-sectional data, six articles used prospective cohort data and one used both prospective cohort and cross-sectional data to assess correlates of internalised stigma. Poor HIV-related health weakly predicted increases in internalised HIV stigma in three longitudinal studies. Lower depression scores and improvements in overall mental health predicted reductions in internalised HIV stigma in two longitudinal studies, with moderate and weak effects, respectively. No other consistent predictors were found. Studies utilising analysis of change and accounting for confounding factors are necessary to guide policy and programming but are scarce. High-risk populations, other stigma markers that might layer upon internalised stigma, and structural drivers of internalised stigma need to be examined.

  5. More than Skin Deep: Perceptions of, and Stigma against, Tattoos

    Science.gov (United States)

    Martin, Benjamin A.; Dula, Chris S.

    2010-01-01

    Previous research indicates stigmas can produce feelings of fear, isolation, and discrimination, and that negative stigma has been and still is, associated with tattooing. Due to the rise in tattoo popularity, a method to analyze stigma against tattooed individuals is needed. The Martin Stigma Against Tattoos Survey (MSATS), was created, taken by…

  6. More than Skin Deep: Perceptions of, and Stigma against, Tattoos

    Science.gov (United States)

    Martin, Benjamin A.; Dula, Chris S.

    2010-01-01

    Previous research indicates stigmas can produce feelings of fear, isolation, and discrimination, and that negative stigma has been and still is, associated with tattooing. Due to the rise in tattoo popularity, a method to analyze stigma against tattooed individuals is needed. The Martin Stigma Against Tattoos Survey (MSATS), was created, taken by…

  7. A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come?

    OpenAIRE

    Stangl, Anne L; Lloyd, Jennifer K; Brady, Laura M; Claire E Holland; Stefan Baral

    2013-01-01

    Introduction: HIV-related stigma and discrimination continue to hamper efforts to prevent new infections and engage people in HIV treatment, care and support programmes. The identification of effective interventions to reduce stigma and discrimination that can be integrated into national responses is crucial to the success of the global AIDS response. Methods: We conducted a systematic review of studies and reports that assessed the effectiveness of interventions to reduce HIV stigma and disc...

  8. Socio-economic status and HIV/AIDS stigma in Tanzania.

    Science.gov (United States)

    Amuri, Mbaraka; Mitchell, Steve; Cockcroft, Anne; Andersson, Neil

    2011-03-01

    Tanzania has a generalised AIDS epidemic but the estimated adult HIV prevalence of 6% is much lower than in many countries in Southern Africa. HIV infection rates are reportedly higher in urban areas, among women and among those with more education. Stigma has been found to be more common in poorer, less-educated people, and those in rural areas. We examined associations between poverty and other variables and a stigmatising attitude (belief that HIV/AIDS is punishment for sinning). The variables we examined in a multivariate model included: food sufficiency (as an indicator of poverty), age, sex, marital status, education, experience of intimate partner violence, condom-related choice disability, discussion about HIV/AIDS, sources of information about HIV/AIDS and urban or rural residence. Of the 1,130 men and 1,803 women interviewed, more than half (58%) did not disagree that "HIV/AIDS is punishment for sinning". Taking other variables into account, people from the poorest households (without enough food in the last week) were more likely to believe HIV/AIDS is punishment for sinning (Odds Ratio [OR] 1.29, 95% confidence intervals [CI] 1.06-1.59). Others factors independently associated with this stigmatising attitude were: having less than primary education (OR 1.29, 95% CI 1.03-1.62); having experienced intimate partner violence in the last year (OR 1.40, 95% CI 1.12-1.75); being choice disabled for condom use (OR 1.36, 95% CI 1.08-1.71); and living in rural areas (OR 1.76, 95% CI 1.06-2.90). The level of HIV and AIDS stigma in Tanzania is high with independent associations with several disadvantages: poverty, less education and living in rural areas. Other vulnerable groups, such as survivors of intimate partner violence, are also more likely to have a stigmatising attitude. HIV prevention programmes should take account of stigma, especially among the disadvantaged, and take care not to increase it.

  9. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies.

    Science.gov (United States)

    Clement, S; Schauman, O; Graham, T; Maggioni, F; Evans-Lacko, S; Bezborodovs, N; Morgan, C; Rüsch, N; Brown, J S L; Thornicroft, G

    2015-01-01

    Individuals often avoid or delay seeking professional help for mental health problems. Stigma may be a key deterrent to help-seeking but this has not been reviewed systematically. Our systematic review addressed the overarching question: What is the impact of mental health-related stigma on help-seeking for mental health problems? Subquestions were: (a) What is the size and direction of any association between stigma and help-seeking? (b) To what extent is stigma identified as a barrier to help-seeking? (c) What processes underlie the relationship between stigma and help-seeking? (d) Are there population groups for which stigma disproportionately deters help-seeking? Five electronic databases were searched from 1980 to 2011 and references of reviews checked. A meta-synthesis of quantitative and qualitative studies, comprising three parallel narrative syntheses and subgroup analyses, was conducted. The review identified 144 studies with 90,189 participants meeting inclusion criteria. The median association between stigma and help-seeking was d = - 0.27, with internalized and treatment stigma being most often associated with reduced help-seeking. Stigma was the fourth highest ranked barrier to help-seeking, with disclosure concerns the most commonly reported stigma barrier. A detailed conceptual model was derived that describes the processes contributing to, and counteracting, the deterrent effect of stigma on help-seeking. Ethnic minorities, youth, men and those in military and health professions were disproportionately deterred by stigma. Stigma has a small- to moderate-sized negative effect on help-seeking. Review findings can be used to help inform the design of interventions to increase help-seeking.

  10. Machismo, public health and sexuality-related stigma in Cartagena.

    Science.gov (United States)

    Quevedo-Gómez, María Cristina; Krumeich, Anja; Abadía-Barrero, César Ernesto; Pastrana-Salcedo, Eduardo; van den Borne, Hubertus

    2012-01-01

    This paper reports on an ethnographic study in Cartagena, Colombia. Over a seven-month fieldwork period, 35 men and 35 women between 15 and 60 years of age discussed the social context of HIV/AIDS through in-depth interviews, life histories and drawing. Participants considered the transgression of traditional gender roles as prescribed by machismo a major risk factor for HIV infection. In addition, they integrated public-health concepts of risk groups with these long-standing constructions of gender roles and sexuality-related stigma to create the notion of 'AIDS carriers'. The bricolage between machismo, public health and sexuality-related stigma that participants created and consequent preventive measures (based on an avoidance of sex with people identified as 'AIDS carriers') was a dynamic process in which participants were aware that changes in this particular interpretation of risk were necessary to confront the local epidemic.

  11. "Before and after" diet advertisements escalate weight stigma.

    Science.gov (United States)

    Geier, A B; Schwartz, M B; Brownell, K D

    2003-12-01

    The stigma-producing effects of "before and after" diet advertisements on a healthy weight sample were examined. Subjects (n = 59) were exposed to a presentation containing either a "before and after" diet ad, or solely the "before" or "after" picture embedded in a different ad. Subjects were then given measures to assess negative attitudes and endorsement of stereotypes about overweight people. Across all subjects, strong implicit anti-fat bias was present. Subjects in the Before and After condition indicated that weight is more easily controllable than did subjects in either the Before Picture Only or the After Picture Only conditions. There were two moderating variables for this effect. Subjects who reported greater life satisfaction endorsed fewer anti-fat stereotypes, and those who enjoyed an emotionally close relationship with an overweight person were less biased. These results suggest that "before and after" diet ads enhance weight stigma and perpetuate damaging stereotypes.

  12. Psychiatric stigma in treatment seeking adults with personality problems: evidence from a sample of 214 patients.

    Directory of Open Access Journals (Sweden)

    Kirsten eCatthoor

    2015-07-01

    Full Text Available Stigmatization is a major hindrance in adult psychiatric patients with Axis-I diagnoses, as shown consistently in most studies. Significantly fewer studies on the emergence of psychiatric stigma in adult patients with personality disorders exist, although the resulting evidence is conclusive. Some authors consider patients with personality disorders at risk for severe stigmatization because of intense difficulties during interpersonal contact, even in a psychotherapeutic relationship. The aim of this study was primarily the assessment of pre-existing stigma in patients referred for intensive treatment for personality disorders. The study enrolled 214 patients admitted to the adult department of a highly specialized mental health care institute offering psychotherapy for patients with severe and complex personality pathology. All patients underwent a standard assessment with self-report questionnaires and a semi-structured interview to measure Axis II personality disorders. The Stigma Consciousness Questionnaire (SCQ and the Perceived Devaluation-Discrimination Questionnaire (DDQ, both validated instruments, were used to measure perceived and actual experiences of stigma. Independent sample t-tests were used to investigate differences in the mean total stigma scores for patients both with and without a personality disorder. One-way ANOVA’s were performed to assess the differences between having a borderline personality disorder, another personality disorder, or no personality disorder diagnosis.Multiple regression main effect analyses were conducted in order to explore the impact of the different personality disorder diagnosis on the level of stigma. The mean scores across all patient groups were consistent with rather low stigma. No differences were found for patients with or without a personality disorder diagnosis. Level of stigma in general was not associated with an accumulating number of personality disorders.

  13. Self-stigma among caregivers of people with mental illness: toward caregivers' empowerment.

    Science.gov (United States)

    Girma, Eshetu; Möller-Leimkühler, Anne Maria; Dehning, Sandra; Mueller, Norbert; Tesfaye, Markos; Froeschl, Guenter

    2014-01-01

    In addition to economic and material burdens, caregivers of people with mental illness are exposed to psychosocial challenges. Self-stigma is among the psychological challenges that can be exacerbated by intrinsic and/or extrinsic factors. Caregivers' self-stigma can negatively influence the patients' treatment and rehabilitation process. The objective of this study was to measure the level and correlates of self-stigma among caregivers of people with mental illness. An interviewer-administered cross-sectional study was conducted in the Jimma University Specialized Hospital Psychiatry Clinic in Ethiopia on a sample of 422 caregivers. Data were collected by trained nurses working in the clinic using a pretested questionnaire. Multivariate linear regression was performed to identify the correlates of self-stigma among caregivers of people with mental illness. The majority (70.38%) of the caregivers were male. On a scale of 0 to 15, with 0 being low and 15 being high, the average self-stigmatizing attitude score was 4.68 (±4.11). A statistically significant difference in mean self-stigma score was found between urban and rural respondents (t=3.95, Pmental illness (r=0.18, Pmental illness (r=0.26, Pmental illness (r=0.12, Pmental illness (standardized β=0.22, Pmental health information was also reported. Caregivers' self-stigma in this study was significantly correlated with perceived supernatural explanation of mental illness. Since caregivers' self-stigma may negatively influence patients' treatment-seeking, adherence, and rehabilitation processes, programs that enhance coping strategies by strengthening self-esteem and empowerment by health care providers and establish family support groups may be helpful to tackle self-stigma among caregivers of people with mental illness.

  14. Identity threat and stigma in cancer patients

    Directory of Open Access Journals (Sweden)

    Sarah Knapp

    2014-09-01

    Full Text Available Cancer stigma has undergone an important transformation in recent decades. In general, this disease no longer fits squarely into Goffman’s classic taxonomy of stigmatized conditions. This review will demonstrate that, with important adaptations, an identity-threat model of stigma can be used to organize cancer stigma research post-Goffman. This adapted model postulates that one’s personal attributions, responses to situational threat, and disease/treatment characteristics can be used to predict identity threat and well-being of individuals with cancer. Implications for further research and clinical practice are discussed.

  15. Experiences of stigma by association among family members of people with mental illness.

    Science.gov (United States)

    van der Sanden, Remko L M; Bos, Arjan E R; Stutterheim, Sarah E; Pryor, John B; Kok, Gerjo

    2013-02-01

    To investigate the relationships between public stigma, stigma by association (SBA), psychological distress, perceived closeness, perceived heredity, and the type of family relationship among family members of people with a mental illness. In this cross-sectional survey, data from 527 family members of people with a mental illness were analyzed. Perceptions of public stigma were found to be positively related to SBA and SBA correlated with greater psychological distress and less perceived closeness. SBA also mediated relationships between perceived public stigma and psychological distress, and between perceived public stigma and perceived closeness. Further, among participants who reported SBA, immediate family members showed lower levels of perceived closeness than extended family members. Also, the perceived heredity of mental illness was associated with perceptions of public stigma and psychological distress. The findings suggest that family members of people with a mental illness could benefit from education on mental illnesses, their treatment, and the extent to which they are hereditary. Additionally, particular attention should be paid to the psychological needs that arise from being a caregiver of someone with a mental illness.

  16. ‘Their Words Cut me Like a Knife’ : coping responses of Dutch lesbian, gay and bisexual youth to stigma

    NARCIS (Netherlands)

    van Bergen, Diana; Spiegel, Tali

    2014-01-01

    Stigmatization experienced by lesbian, gay and bisexual youth (LGB) is associated with reduced psychological well-being and suggests that coping is an important mediator. The current study investigates the coping with stigma of Dutch LGB youth, and examines the social and individual mechanisms that

  17. Parent's alcoholism severity and family topic avoidance about alcohol as predictors of perceived stigma among adult children of alcoholics: Implications for emotional and psychological resilience.

    Science.gov (United States)

    Haverfield, Marie C; Theiss, Jennifer A

    2016-01-01

    Alcoholism is a highly stigmatized condition, with both alcohol-dependent individuals and family members of the afflicted experiencing stigmatization. This study examined the severity of a parent's alcoholism and family topic avoidance about alcohol as two factors that are associated with family members' perceptions of stigma. Three dimensions of stigma were considered: discrimination stigma, disclosure stigma, and positive aspect stigma. In addition, this study assessed associations between perceived stigmatization and individuals' experiences of depressive symptoms, self-esteem, and resilience. Adult children of alcoholics (N = 622) were surveyed about family conditions, perceived stigma, and their emotional and psychological well-being. Regression analyses revealed that the severity of a parent's alcoholism predicted all three types of stigma for females, but not for males. In addition, family topic avoidance about alcohol predicted all types of stigma for males and discrimination stigma and positive aspect stigma for females. With few exceptions, the three types of stigma predicted depressive symptoms, self-esteem, and resilience for both male and female adult children of alcoholics. The results are discussed in terms of their implications for promoting a family environment that mitigates stigma and encourages emotional and psychological well-being. In 2012, approximately 3.3 million deaths worldwide were due to the harmful use of alcohol (World Health Organization [WHO], 2014). Individuals who abuse alcohol are susceptible to a variety of negative health outcomes (Rehm et al., 2009) and display inappropriate social behaviors (Klingemann, 2001; Schomerus et al., 2011a). General societal perceptions tend to characterize alcohol-dependent individuals as irresponsible and lacking in self-control (Schomerus et al., 2011b). Research in the United Kingdom found that 54% of the population believes alcohol-dependent individuals are personally to blame for their own

  18. Weight stigma in maternity care: women’s experiences and care providers’ attitudes

    Directory of Open Access Journals (Sweden)

    Mulherin Kate

    2013-01-01

    Full Text Available Abstract Background Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives. Methods Study One investigated associations between pre-pregnancy body mass index (BMI and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses. Results Women with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal-weight pregnant women. Even care providers who reported few weight stigmatising attitudes responded less positively to overweight and obese pregnant women. Conclusions Overall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals’ training.

  19. Obesity stigma as a determinant of poor birth outcomes in women with high BMI: a conceptual framework.

    Science.gov (United States)

    DeJoy, Sharon Bernecki; Bittner, Krystle

    2015-04-01

    Obesity stigma has been linked to poor health outcomes on an individual and population basis. However, little research has been conducted on the role of chronic or recent obesity stigma in the health disparities experienced by pregnant women with high body mass index. The purpose of this article is to discuss poor birth outcomes in this population from an integrated perinatal health framework perspective, incorporating obesity stigma as a social determinant. In studies of non-pregnant populations, obesity stigma has been associated with stress, unhealthy coping strategies, psychological disorders, and exacerbations of physical illness. This article examines the mechanisms by which obesity stigma influences health outcomes and suggests how they might apply to selected complications of pregnancy, including macrosomia, preterm birth and cesarean delivery. Given the rates of obesity and associated pregnancy complications in the United States, it is critical to examine the determinants of those problems from a life course and multiple determinants perspective. This paper offers a conceptual framework to guide exploratory research in this area, incorporating the construct of obesity stigma.

  20. Obesity Stigma: Important Considerations for Public Health

    Science.gov (United States)

    Heuer, Chelsea A.

    2010-01-01

    Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health. PMID:20075322

  1. Compensatory mechanisms in fish populations: Literature reviews: Volume 1, Critical evaluation of case histories of fish populations experiencing chronic exploitation or impact: Final report

    Energy Technology Data Exchange (ETDEWEB)

    Saila, S.B.; Chen, X.; Erzini, K.; Martin, B.

    1987-05-01

    This study includes case histories of certain fish species which are experiencing chronic perturbations and related literature pertaining to compensation processes. ''Compensation'' has been defined as the ability of fish to offset the population reduction caused by natural or man-induced stresses. Certain compensation methods are widely accepted, and include cannibalism, competition, disease, growth and predation, among others. These compensation methods are examined in relation to each fish species included in the study. Stock-recruit relationships and empirical observations of changes in growth and mortality have been the focus of much of the background on compensation. One of the conclusions drawn from this study is that a significant amount of recruitment variability exists and can be attributed to environmental (rather than compensatory) factors. The stock-recruitment problem appears to be the most significant scientific problem related to compensation in the types of fish included in this study. Results of the most recent studies of the American shad support this theory. Life histories, breeding biology and other pertinent data relating to each species included in the study will be found in the appendices.

  2. Stigma and Parenting Children Conceived From Sexual Violence

    Science.gov (United States)

    Rouhani, Shada A.; Scott, Jennifer; Greiner, Ashley; Albutt, Katherine; Hacker, Michele R.; Kuwert, Philipp; VanRooyen, Michael; Bartels, Susan

    2016-01-01

    BACKGROUND AND OBJECTIVES Since armed conflict began in 1996, widespread sexual violence in eastern Democratic Republic of Congo has resulted in many sexual violence-related pregnancies (SVRPs). However, there are limited data on the relationships between mothers and their children from sexual violence. This study aimed to evaluate the nature and determinants of these maternal–child relationships. METHODS Using respondent-driven sampling, 757 women raising children from SVRPs in South Kivu Province, Democratic Republic of Congo were interviewed. A parenting index was created from questions assessing the maternal–child relationship. The influences of social stigma, family and community acceptance, and maternal mental health on the parenting index were assessed in univariate and multivariable analyses. RESULTS The majority of mothers reported positive attitudes toward their children from SVRPs. Prevalence of perceived family or community stigma toward the women or their children ranged from 31.8% to 42.9%, and prevalence of perceived family or community acceptance ranged from 45.2% to 73.5%. In multivariable analyses, stigma toward the child, as well as maternal anxiety and depression, were associated with lower parenting indexes, whereas acceptance of the mother or child and presence of a spouse were associated with higher parenting indexes (all P ≤ .01). CONCLUSIONS In this study with a large sample size, stigma and mental health disorders negatively influenced parenting attitudes, whereas family and community acceptance were associated with adaptive parenting attitudes. Interventions to reduce stigmatization, augment acceptance, and improve maternal mental health may improve the long-term well-being of mothers and children from SVRPs. PMID:26438704

  3. Subthreshold psychotic symptom distress, self-stigma, and peer social support among college students with mental health concerns.

    Science.gov (United States)

    Denenny, Danielle; Thompson, Elizabeth; Pitts, Steven C; Dixon, Lisa B; Schiffman, Jason

    2015-06-01

    The primary aim of this study was to explore the potential moderating effect of social support on the relation between distress caused by psychosis risk symptoms and self-stigma among college students with mental health diagnoses. Participants were young adult college students who endorsed having a past or present mental health diagnosis (n = 63). Self-report data were examined from the Prodromal Questionnaire-Brief, a measure of subthreshold psychosis risk symptoms; the Self-Concurrence/Application subscale of the Self-Stigma of Mental Illness Scale, a measure of self-stigma; and the Friendships subscale of the Lubben Social Network Scale-Revised, a measure of social support from peers. There was a modest direct relation between distress associated with psychosis risk symptoms and self-stigma. There was a larger relation between distress from risk symptoms and self-stigma for those with low social support compared to those with mean and high social support. Although causality cannot be determined based on this study, a strong relation between symptom distress and stigma was found among those reporting low peer social support. Interventions that target both self-stigma and social support might be relevant for young adults with a history of mental health concerns who currently endorse subthreshold psychotic symptoms. (c) 2015 APA, all rights reserved).

  4. Sexual stigma and discrimination as barriers to seeking appropriate healthcare among men who have sex with men in Swaziland

    Directory of Open Access Journals (Sweden)

    Kathryn Risher

    2013-11-01

    Full Text Available Introduction: Same-sex practices and orientation are both stigmatized and criminalized in many countries across sub-Saharan Africa. This study aimed to assess the relationship of fear of seeking healthcare and disclosure of same-sex practices among a sample of men who have sex with men (MSM in Swaziland with demographic, socio-economic and behavioural determinants. Methods: Three hundred and twenty-three men who reported having had anal sex with a man in the past year were recruited using respondent-driven sampling and administered a structured survey instrument. Asymptotically unbiased estimates of prevalence of stigma and human rights abuses generated using the RDSII estimator are reported with bootstrapped confidence intervals (CIs. Weighted simple and multiple logistic regressions of fear of seeking healthcare and disclosure of same-sex practices to a healthcare provider with demographic, social and behavioural variables are reported. Results: Stigma was common, including 61.7% (95% CI=54.0–69.0% reporting fear of seeking healthcare, 44.1% (95% CI=36.2–51.3% any enacted stigma and 73.9% (95% CI=67.7–80.1% any perceived social stigma (family, friends. Ever disclosing sexual practices with other men to healthcare providers was low (25.6%, 95% CI=19.2–32.1%. In multiple logistic regression, fear of seeking healthcare was significantly associated with: having experienced legal discrimination as a result of sexual orientation or practice (aOR=1.9, 95% CI=1.1–3.4, having felt like you wanted to end your life (aOR=2.0, 95% CI=1.2–3.4, having been raped (aOR=11.0, 95% CI=1.4–84.4, finding it very difficult to insist on condom use when a male partner does not want to use a condom (aOR=2.1, 95% CI=1.0–4.1 and having a non-Swazi nationality at birth (aOR=0.18, 95% CI=0.05–0.68. In multiple logistic regression, disclosure of same-sex practices to a healthcare provider was significantly associated with: having completed secondary

  5. Insight, self-stigma and psychosocial outcomes in Schizophrenia: a structural equation modelling approach.

    Science.gov (United States)

    Lien, Y-J; Chang, H-A; Kao, Y-C; Tzeng, N-S; Lu, C-W; Loh, C-H

    2016-12-15

    Poor insight is prevalent in patients with schizophrenia and has been associated with acute illness severity, medication non-adherence and poor treatment outcomes. Paradoxically, high insight has been associated with various undesirable outcomes, including low self-esteem, depression and low subjective quality of life (QoL) in patients with schizophrenia. Despite the growing body of studies conducted in Western countries supporting the pernicious effects of improved insight in psychosis, which bases on the level of self-stigma, the effects are unclear in non-Western societies. The current study examined the role of self-stigma in the relationship between insight and psychosocial outcomes in a Chinese population. A total of 170 outpatients with schizophrenia spectrum disorders were recruited from two general university hospitals. Sociodemographic data and clinical variables were recorded and self-report scales were employed to measure self-stigma, depression, insight, self-esteem and subjective QoL. Structural equation modelling (SEM) was used to analyse the cross-sectional data. High levels of self-stigma were reported by 39% of the participants (n = 67). The influences of insight, self-stigma, self-esteem and depression on subjective QoL were confirmed by the SEM results. Our model with the closest fit to the data (χ 2 = 33.28; df = 20; p = 0.03; χ 2/df = 1.66; CFI = 0.98; TLI = 0.97; RMSEA = 0.06) demonstrated that self-stigma might fully mediate the association of insight with low self-esteem, depression and poor subjective QoL. High insight into illness contributed to self-stigma, which caused low self-esteem and depression and, consequently, low QoL. Notably, insight did not directly affect self-esteem, depression or QoL. Furthermore, the association of insight with poor psychosocial outcomes was not moderated by self-stigma. Our findings support the mediating model of insight relevant to the poor psychosocial outcomes of individuals diagnosed with

  6. Mental Health Stigma: Where do We Stand?

    Directory of Open Access Journals (Sweden)

    Salomé Xavier

    2014-06-01

    Full Text Available Mental illness stigma has been the focus of increasing attention in the past few years, with an exponential increase in scientific publications on the subject. This phenomenon is a source of suffering for the patient undermining the achievement of personal goals and full social integration. In this article, the authors present a selective review of the literature on mental illness stigma, going through its definition, origins, repercussions, patients’ subjective experiences and strategies to challenge stigma. The literature presents stigma as being a complex phenomenon, whose definitions derive from different epis- temological roots (sociology, psychology and psychiatry. Its impact on the lives of people with a mental illness is well acknowledged and seems to translate into decreased opportunities, loss of self-esteem and self-concept, decreased quality of life, social support and empowerment, thus limiting the adoption or performance of regular social roles. Stigma has also been shown to compromise access to health care, not only psychiatric treatment but also general medical care, thus increasing the morbidity and mortality in this vulnerable population. A considerable amount of effort has been put into the comprehension of this phenomenon and to designing strategies for fighting stigma, which also include promoting health-care professionals’ awareness of the topic in order to improve clinical practice and global quality of care.

  7. Stigma resistance in patients with schizophrenia.

    Science.gov (United States)

    Sibitz, Ingrid; Unger, Annemarie; Woppmann, Andreas; Zidek, Thomas; Amering, Michaela

    2011-03-01

    An individual's capacity to counteract the stigma of mental illness, stigma resistance (SR), is considered as playing a crucial role in fighting stigma. However, little is known about SR and its correlates in patients with schizophrenia or schizoaffective disorder. Exploring SR in patients with schizophrenia or schizoaffective disorder. One hundred fifty-seven participants completed the "Internalized Stigma of Mental Illness" (ISMI) Scale including its subscale on SR. Measures of perceived devaluation and discrimination, depression, self-esteem, empowerment, quality of life, and demographic and clinical variables were obtained. Two-thirds of all patients showed high SR. SR correlated positively with self-esteem, empowerment, and quality of life and negatively with stigma measures and depression. A social network with a sufficient number of friends, being single or married, in contrast to being separated, as well as receiving outpatient treatment, was associated with higher SR. SR is a new and promising concept. The development of stigma-resisting beliefs might help individuals in their hope of finding a fulfilling life and in their recovery from mental illness.

  8. [Stigma of tuberculosis scale: validity and reliability].

    Science.gov (United States)

    Özpınar, Saliha; Taner, Şafak; Yıldırım, Gülay; Mahleç Anar, Ceyda; Altıparmak, Osman; Baydur, Hakan

    2015-09-01

    In many health conditions, stigma is receiving increasing attention. Public stigmatization toward social illness can affect particularly the patients and family memberships to help seeking behavior and treatment. This study, the aim of this study was to investigate the validity and reliability of the Turkish "Stigma of Tuberculosis Scale " which was developed to evaluate of perception of stigma with tuberkulosis patient. This methodological study was conducted with 150 with tuberculosis disease people who above 18 age and without known psychological and mental disability. In the study, "Stigma of Tuberculosis Scale" was used as data collection tool. During the study, language equivalence, content validity, reliability and construct validity of the scale was performed. The data was assessed by using mean, median, standard deviation, Spearman Correlation, Cronbach Alpha coefficient and confirmatory factor analysis. The mean age of study participants was 45.6 ± 16.1 (20 - 85). years. Spearman correlation coefficient of the scale for test-retest reliability was 0.853 and the Cronbach Alpha coefficient was 0.95. According to fit indexes of confirmatory factor analysis [x2/SD= 481.38/230= 2.09; RMSEA= 0.087; GFI= 0.776; CFI= 0.776; NNFI= 0.875] it was found that one factors were appropriate for the scale. The adoption of the translated "Stigma of Tuberculosis Scale"in Turkey is found reliable and valid to evaluate of perception of stigma with tuberkulosis patient.

  9. "What matters most:" a cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma.

    Science.gov (United States)

    Yang, Lawrence H; Chen, Fang-pei; Sia, Kathleen Janel; Lam, Jonathan; Lam, Katherine; Ngo, Hong; Lee, Sing; Kleinman, Arthur; Good, Byron

    2014-02-01

    To understand Chinese immigrants' experiences with mental illness stigma and mental health disparities, we integrate frameworks of 'structural vulnerability' and 'moral experience' to identify how interaction between structural discrimination and cultural engagements might shape stigma. Fifty Chinese immigrants, including 64% Fuzhounese immigrants who experienced particularly harsh socio-economical deprivation, from two Chinese bilingual psychiatric inpatient units in New York City were interviewed from 2006 to 2010 about their experiences of mental illness stigma. Interview questions were derived from 4 stigma measures, covering various life domains. Participants were asked to elaborate their rating of measure items, and thus provided open-ended, narrative data. Analysis of the narrative data followed a deductive approach, guided by frameworks of structural discrimination and "what matters most" - a cultural mechanism signifying meaningful participation in the community. After identifying initial coding classifications, analysis focused on the interface between the two main concepts. Results indicated that experiences with mental illness stigma were contingent on the degree to which immigrants were able to participate in work to achieve "what mattered most" in their cultural context, i.e., accumulation of financial resources. Structural vulnerability - being situated in an inferior position when facing structural discrimination - made access to affordable mental health services challenging. As such, structural discrimination increased healthcare spending and interfered with financial accumulation, often resulting in future treatment nonadherence and enforcing mental health disparities. Study participants' internalizing their structurally-vulnerable position further led to a depreciated sense of self, resulting in a reduced capacity to advocate for healthcare system changes. Paradoxically, the multi-layered structural marginalization experienced by Chinese

  10. Constructs and concepts comprising the stigma of mental illness

    Directory of Open Access Journals (Sweden)

    Patrick J. Michaels

    2012-11-01

    Full Text Available People with mental illness frequently confront public stigma andmay experience self-stigma. This review discusses the concepts of mental illness stigma and its consequences for those with mental illness. After a conceptual overview of stigma prominent consequences pertaining to public stigma (i.e.,employment, health care quality and self-stigma (i.e., self-confidence, quality of life, “why try” effect are reviewed. We discuss the three main public stigma change strategies - protest, education, and contact – as well as current selfstigma change strategies (e.g., psychoeducation, cognitive-behavioral therapy.We conclude by noting that anti-stigma initiatives with more tailored content for specific groups (e.g., police officers vs. general public may diminish the negative consequences of mental illness stigma by providing more concrete ways to help stigmatized people.

  11. The theoretical basis of stigma as applied to genital herpes.

    Science.gov (United States)

    Breitkopf, Carmen Radecki

    2004-04-01

    This paper defines stigma and its characteristics, outlines strategies and consequences of stigma management, describes the theoretical basis of stigma, and offers methodological considerations for those applying stigma theory to the domain of genital herpes. Stigma is an interactional process, defined within societies, in which particular social identities are collectively devalued. The subjective experience of stigma may vary due to features associated with the stigmatizing condition (e.g. concealability, course, strain, aesthetic qualities, cause and peril). The interpersonal management of stigma may include secrecy, withdrawal, covering, informing or disclosing. Future research addressing herpes-associated stigma should benefit from theoretical frameworks including attribution theory, social-cognitive theory, preoccupation model of secrecy and the illness intrusiveness framework, although the difficulty in identifying and recruiting stigmatized individuals and the lack of domain-specific measures of herpes-related stigma remain barriers to progress.

  12. Impact of anxiety and depressive symptoms on perceptions of stigma in persons living with HIV disease in rural versus urban North Carolina.

    Science.gov (United States)

    Costelloe, Stephanie; Kemppainen, Jeanne; Brion, John; MacKain, Sally; Reid, Paula; Frampton, Art; Rigsbee, Elizabeth

    2015-01-01

    This analysis examined the relationships between HIV-related stigma, depression, and anxiety in rural and urban sites. Participants were HIV-positive urban (n = 100) and rural (n = 100) adult residents of a US southern state, drawn from a sample for a larger international study of self-esteem and self-compassion. Measures included demographic and health information, the HIV Stigma Scale, the Center for Epidemiology Studies Depression Scale (CES-D), and the Symptom Checklist 90 Revised (SCL-R-90) anxiety scale. Independent sample t-tests showed no significant differences between urban/rural groups on measures of HIV-related stigma, anxiety, or depression, except that rural participants reported greater disclosure concerns (t = 2.11, df = 196, p = .036). Both groups indicated high levels of depression and anxiety relative to published norms and clinically relevant cut-off scores. Hierarchical regression analyses were conducted for the HIV Stigma Scale including its four subscales and total stigma scores. Block 1 (control) contained health and demographic variables known to predict HIV-related stigma. Block 2 included the CES-D and the SCL-R-90, and Block 3 was urban/rural location. Mental health symptom scores contributed a significant amount to explained variance in total stigma scores (5.5%, FΔ = 6.020, p stigma (4.8%, FΔ = 5.035, p disclosure concerns. Urban/rural location made significant additional contributions to the variance for total stigma (1.7%, FΔ = 3.899, p disclosure concerns (2.6%, FΔ = 5.446, p stigma or negative self-image. Depression scores consistently and significantly predicted perceived stigma total and subscale scores. Findings suggest that mental health symptoms and urban/rural location play important roles in perceived stigma, and treatment implications are presented.

  13. Self Stigma in People with Intellectual Disabilities and Courtesy Stigma in Family Carers: A Systematic Review

    Science.gov (United States)

    Ali, Afia; Hassiotis, Angela; Strydom, Andre; King, Michael

    2012-01-01

    People with intellectual disability are one of the most stigmatised groups in society. Despite this, research in this area has been limited. This paper provides a review of studies examining self stigma in people with intellectual disability, and courtesy and affiliate stigma in family carers. An electronic search of studies published between 1990…

  14. HIV, violence, blame and shame: pathways of risk to internalized HIV stigma among South African adolescents living with HIV.

    Science.gov (United States)

    Pantelic, Marija; Boyes, Mark; Cluver, Lucie; Meinck, Franziska

    2017-08-21

    Internalized HIV stigma is a key risk factor for negative outcomes amongst adolescents living with HIV (ALHIV), including non-adherence to anti-retroviral treatment, loss-to-follow-up and morbidity. This study tested a theoretical model of multi-level risk pathways to internalized HIV stigma among South African ALHIV. From 2013 to 2015, a survey using total population sampling of ALHIV who had ever initiated anti-retroviral treatment (ART) in 53 public health facilities in the Eastern Cape, South Africa was conducted. Community-tracing ensured inclusion of ALHIV who were defaulting from ART or lost to follow-up. 90.1% of eligible ALHIV were interviewed (n = 1060, 55% female, mean age = 13.8, 21% living in rural locations). HIV stigma mechanisms (internalized, enacted, and anticipated), HIV-related disability, violence victimization (physical, emotional, sexual abuse, bullying victimization) were assessed using well-validated self-report measures. Structural equation modelling was used to test a theoretically informed model of risk pathways from HIV-related disability to internalized HIV stigma. The model controlled for age, gender and urban/rural address. Prevalence of internalized HIV stigma was 26.5%. As hypothesized, significant associations between internalized stigma and anticipated stigma, as well as depression were obtained. Unexpectedly, HIV-related disability, victimization, and enacted stigma were not directly associated with internalized stigma. Instead significant pathways were identified via anticipated HIV stigma and depression. The model fitted the data well (RMSEA = .023; CFI = .94; TLI = .95; WRMR = 1.070). These findings highlight the complicated nature of internalized HIV stigma. Whilst it is seemingly a psychological process, indirect pathways suggest multi-level mechanisms leading to internalized HIV stigma. Findings suggest that protection from violence within homes, communities and schools may interrupt risk pathways from HIV

  15. [Self-Awareness of Disease Stigma: Reflections of Healthcare Professionals].

    Science.gov (United States)

    Chen, Chih-Hsuan; Wang, Ying-Ting; Shu, Bih-Ching

    2017-06-01

    People who suffer from disease frequently experience disease-related stigmas. Stigma presents in daily life during normal human interactions. The stereotypes promoted by the media often impact public opinion significantly. Moreover, healthcare professionals may exacerbate stigmatization due to their misunderstanding of patients and their disease issues. Therefore, the reflection on stigma of healthcare professionals cannot be ignored. The present article illustrates the issue of stigmas held by healthcare professionals, their related stigmas, and their self-awareness. It is hoped that all healthcare professionals may cooperate to develop an anti-stigma strategy and to become true spokespersons for their patients.

  16. Representation stigma: Perceptions of tools and processes for design graphics

    Directory of Open Access Journals (Sweden)

    David Barbarash

    2016-12-01

    Full Text Available Practicing designers and design students across multiple fields were surveyed to measure preference and perception of traditional hand and digital tools to determine if common biases for an individual toolset are realized in practice. Significant results were found, primarily with age being a determinant in preference of graphic tools and processes; this finding demonstrates a hard line between generations of designers. Results show that while there are strong opinions in tools and processes, the realities of modern business practice and production gravitate towards digital methods despite a traditional tool preference in more experienced designers. While negative stigmas regarding computers remain, younger generations are more accepting of digital tools and images, which should eventually lead to a paradigm shift in design professions.

  17. Conceptualizing and experiencing compassion.

    Science.gov (United States)

    Condon, Paul; Feldman Barrett, Lisa

    2013-10-01

    Does compassion feel pleasant or unpleasant? Westerners tend to categorize compassion as a pleasant or positive emotion, but laboratory compassion inductions, which present another's suffering, may elicit unpleasant feelings. Across two studies, we examined whether prototypical conceptualizations of compassion (as pleasant) differ from experiences of compassion (as unpleasant). After laboratory-based neutral or compassion inductions, participants made abstract judgments about compassion relative to various emotion-related adjectives, thereby providing a prototypical conceptualization of compassion. Participants also rated their own affective states, thereby indicating experiences of compassion. Conceptualizations of compassion were pleasant across neutral and compassion inductions. After exposure to others' suffering, however, participants felt increased levels of compassion and unpleasant affect, but not pleasant affect. After neutral inductions, participants reported more pleasant than unpleasant affect, with moderate levels of compassion. Thus, prototypical conceptualizations of compassion are pleasant, but experiences of compassion can feel pleasant or unpleasant. The implications for emotion theory in general are discussed.

  18. Internalized stigma and quality of life domains among people with mental illness: the mediating role of self-esteem.

    Science.gov (United States)

    Oliveira, Sandra E H; Carvalho, Helena; Esteves, Francisco

    2016-01-01

    People with mental illness who internalize stigma often experience reduced self-esteem and impaired quality of life (QOL). To propose a theoretical model in which self-esteem mediates the effects of internalized stigma on the multidimensional domains comprising QOL. In 403 inpatients and outpatients (DSM-IV, American Psychiatric Association, 1994), from hospital-based and community mental health facilities, self-report measures of internalized stigma (ISMI), self-esteem (RSES) and QOL (WHOQOL-Bref) were administrated. Structural equation modeling results supported the proposed model. Self-esteem fully mediated the relation between internalized stigma and the physical and the social relationships domains, and partially mediated the relationship between internalized stigma and psychological, environment and level of independence QOL domains. Such results provided empirical support and shed light upon previous research. Specifically the results emphasize the mediating role that self-esteem plays in the degree to which internalized stigma exerts a negative effect on specific QOL domains. Self-esteem appears to be a core element in reducing the negative effects of internalized stigma on aspects of QOL among people with mental illness. These findings suggest there is a crucial impact regarding clinical mental health interventions along with important theoretical implications.

  19. Perceived HIV-associated stigma among HIV-seropositive men: psychometric study of HIV stigma scale

    Directory of Open Access Journals (Sweden)

    Adrian eValle

    2015-07-01

    Full Text Available Objectives: To assess the internal consistency and factor structure of the abridged Spanish version of the Berger HIV Stigma Scale (HSS-21, provide evidence for its convergent and discriminant validity, and describe perceived stigma in an urban population from northeast Mexico. Methods: Seventy five HIV-positive men who have sex with men (MSM were recruited. Participants answered the Spanish versions of three Likert-type scales: HSS-21, Robsenberg’s self-esteem scale, and the abbreviated version of the Zung’s Depression Scale.Results: HSS-21 showed high reliability and validity; its factor structure included four components: concern with public attitudes; negative self-image; disclosure concerns; and enacted stigma. The level of stigma was high in 27 out of 75 (36% participants; nevertheless, the score found in the component related to disclosure concerns indicated high level of stigma in 68% of participants. The score of HSS-21 was positively correlated with the score of depression and negatively correlated with the score of self-esteem. Conclusion: Results demonstrated high reliability for the HSS-21; correlations with other scales supported its validity. This scale demonstrated to be a practical tool for assessing stigma among Mexican HIV-positive MSM. High level of stigma was found only in the factor related to disclosure concerns. Policy Implications: Identifying HIV-associated stigma through a short, reliable and validated instrument will allow the development of interventions that cope and manage stigma in HIV-positive MSM. HSS-21 distinguishes between different dimensions of stigma and will contribute to a better understanding of this phenomenon.

  20. Perceived HIV-Associated Stigma among HIV-Seropositive Men: Psychometric Study of HIV Stigma Scale.

    Science.gov (United States)

    Valle, Adrian; Treviño, Ana Cecilia; Zambrano, Farith Francisco; Urriola, Karla Elizabeth; Sánchez, Luis Antonio; Elizondo, Jesus Eduardo

    2015-01-01

    To assess the internal consistency and factor structure of the abridged Spanish version of the Berger HIV Stigma Scale (HSS-21), to provide evidence for its convergent and discriminant validity, and to describe perceived stigma in an urban population from northeast Mexico. Seventy-five HIV-positive men who have sex with men (MSM) were recruited. Participants answered the Spanish versions of three Likert-type scales: HSS-21, Robsenberg's self-esteem scale, and the abbreviated version of the Zung's Depression Scale. HSS-21 showed high reliability and validity; its factor structure included four components: concern with public attitudes; negative self-image; disclosure concerns; and enacted stigma. The level of stigma was high in 27 out of 75 (36%) participants; nevertheless, the score found in the component related to disclosure concerns indicated high level of stigma in 68% of participants. The score of HSS-21 was positively correlated with the score of depression and negatively correlated with the score of self-esteem. Results demonstrated high reliability for the HSS-21; correlations with other scales supported its validity. This scale demonstrated to be a practical tool for assessing stigma among Mexican HIV-positive MSM. High level of stigma was found only in the factor related to disclosure concerns. Identifying HIV-associated stigma through a short, reliable, and validated instrument will allow the development of interventions that cope and manage stigma in HIV-positive MSM. HSS-21 distinguishes between different dimensions of stigma and will contribute to a better understanding of this phenomenon.

  1. Economic evaluation of the anti-stigma social marketing campaign in England 2009-2011.

    Science.gov (United States)

    Evans-Lacko, Sara; Henderson, Claire; Thornicroft, Graham; McCrone, Paul

    2013-04-01

    Evidence on the economic impact of social marketing anti-stigma campaigns in relation to people with mental illness is limited. To describe the economic impact of the Time to Change (TTC) anti-stigma social marketing campaign, including the potential effects on the wider economy. Data collected for the evaluation of TTC were combined with the social marketing campaign expenditure data to investigate differences in knowledge, attitudes and behaviour in relation to campaign awareness. To evaluate the return on investment, we applied a decision model that estimated the impact on employment for people with depression. Based on average national social marketing campaign costs, the economic benefits outweighed costs even if the campaign resulted in only 1% more people with depression accessing services and gaining employment if they experienced a health improvement. The cost per person with improved intended behaviour was at most £ 4 if we assume the campaign was responsible for 50% of the change. Costs associated with improved knowledge and attitudes, however, were more variable. The findings suggest that the TTC anti-stigma social marketing campaign is a potentially cost-effective and low-cost intervention for reducing the impact of stigma on people with mental health problems.

  2. Pattern of experienced and anticipated discrimination among people with depression in Nigeria: a cross-sectional study.

    Science.gov (United States)

    Oshodi, Yewande O; Abdulmalik, Jibril; Ola, Bolanle; James, Bawo O; Bonetto, Chiara; Cristofalo, Doriana; Van Bortel, Tine; Sartorius, Norman; Thornicroft, Graham

    2014-02-01

    Stigma is commonly encountered by individuals with mental illness and leads to discrimination. These phenomena restrict access to and use of mental health care services. This study evaluated the impact of stigma and discrimination among individuals with major depression in Nigeria. A cross-sectional study was conducted across four tertiary psychiatric facilities located in different regions of Nigeria. Consenting adults attending the psychiatric units in the participating sites with a diagnosis of a major depressive disorder and having an episode within the past 12 months were recruited. Interviews were conducted using a socio-demographic questionnaire, the Discrimination and Stigma Scale, the Internalized Stigma of Mental Illness Scale, the Boston University Self Empowerment Scale, and the Rosenberg Self Esteem Scale. One hundred and three interviews were completed. The mean age of the participants was 35.5 years. The most frequent item for experienced discrimination was being unfairly treated in dating or intimate relationships (13.6%), while concealment of mental illness was the most common for anticipated discrimination (51.5%). Younger people (age less than 40 years) with a higher level of education appear to be at high risk for experienced discrimination. Important suggestions may be derived for clinicians, caregivers, and policy makers to appreciate the role of stigma in the burden, treatment, and rehabilitation of individuals with depression, especially for younger people with higher level of education.

  3. Laboratory medicine handoff gaps experienced by primary care practices: A report from the shared networks of collaborative ambulatory practices and partners (SNOCAP).

    Science.gov (United States)

    West, David R; James, Katherine A; Fernald, Douglas H; Zelie, Claire; Smith, Maxwell L; Raab, Stephen S

    2014-01-01

    The majority of errors in laboratory medicine testing are thought to occur in the pre- and postanalytic testing phases, and a large proportion of these errors are secondary to failed handoffs. Because most laboratory tests originate in ambulatory primary care, understanding the gaps in handoff processes within and between laboratories and practices is imperative for patient safety. Therefore, the purpose of this study was to understand, based on information from primary care practice personnel, the perceived gaps in laboratory processes as a precursor to initiating process improvement activities. A survey was used to assess perceptions of clinicians, staff, and management personnel of gaps in handoffs between primary care practices and laboratories working in 21 Colorado primary care practices. Data were analyzed to determine statistically significant associations between categorical variables. In addition, qualitative analysis of responses to open-ended survey questions was conducted. Primary care practices consistently reported challenges and a desire/need to improve their efforts to systematically track laboratory test status, confirm receipt of laboratory results, and report results to patients. Automated tracking systems existed in roughly 61% of practices, and all but one of those had electronic health record-based tracking systems in place. One fourth of these electronic health record-enabled practices expressed sufficient mistrust in these systems to warrant the concurrent operation of an article-based tracking system as backup. Practices also reported 12 different procedures used to notify patients of test results, varying by test result type. The results highlight the lack of standardization and definition of roles in handoffs in primary care laboratory practices for test ordering, monitoring, and receiving and reporting test results. Results also identify high-priority gaps in processes and the perceptions by practice personnel that practice improvement

  4. Stigma and intellectual disability: potential application of mental illness research.

    Science.gov (United States)

    Ditchman, Nicole; Werner, Shirli; Kosyluk, Kristin; Jones, Nev; Elg, Brianna; Corrigan, Patrick W

    2013-05-01

    Individuals with intellectual disabilities (ID) and individuals with mental illness are consistently found to be among the most socially excluded populations and continue to face substantial health, housing, and employment disparities due to stigma. Although this has spurred extensive research efforts and theoretical advancements in the study of stigma toward mental illness, the stigma of ID has received only limited attention. In this article we explore the application of mental illness stigma research for ID. We carefully reviewed the existing research on mental illness stigma as a foundation for a parallel summary of the empirical literature on attitudes and stigma related to ID. Based on our review, there has not been a systematic approach to the study of stigma toward ID. However, multilevel conceptual models of stigma have received much attention in the mental illness literature. These models have been used to inform targeted interventions and have application to the study of the stigma process for individuals with ID. Nonetheless, there are indeed key differences between-as well as substantial variability within-the ID and mental illness populations that must be considered. Stigma is an issue of social justice impacting the lives of individuals with ID, yet there remains virtually no systematic framework applied to the understanding of the stigma process for this group. Future research can draw on the stigma models developed in the mental illness literature to guide more rigorous research efforts and ultimately the development of effective, multilevel stigma-change strategies for ID.

  5. Anticipated stigma in chronic illness patients in Cambodia, Myanmar and Vietnam.

    Science.gov (United States)

    Peltzer, Karl; Pengpid, Supa

    2016-12-01

    The aim of this study was to explore the prevalence and relationship of anticipated chronic illness stigma among patients diagnosed with a variety of chronic diseases in three Southeast Asian countries (Cambodia, Myanmar and Vietnam). A cross-sectional survey was conducted in 4,803 adult chronic disease patients (mean age 49.3 years; SD=16.5) recruited systematically from health facilities. Overall, the results indicate that 20.7% of patients reported that for any of the 12 stigma items, they anticipated they were likely or very likely to experience chronic disease stigma. A multivariate analysis of sociodemographics revealed the following were associated with anticipated chronic disease stigma: older versus younger age, OR (odds ratio) = 0.71; 95% Confidence Interval (CI) [0.58, 0.87]; higher versus lower education, OR = 2.23; 95% CI [1.81, 2.75]; origin from Myanmar or Vietnam, being single, divorced or widowed, rural residence, and health status (having three or more chronic conditions versus having one chronic condition), OR = 1.93; 95% CI [1.58, 2.35]; lower versus higher quality of life, OR = 0.73; 95% CI [0.63, 0.85]); health risk behavior (physical inactivity, poor diet, current smoking, and problem drinking) and low versus medium or high medication adherence (OR = 0.69; 95% CI [0.55,0.86]). This study demonstrated the possible consequences of anticipated stigma on the health and behavior of people living with chronic diseases, and several factors for chronic disease stigma were identified that can help guide interventions to reduce chronic illness stigma in this population.

  6. Mental-health-related stigma among Japanese children and their parents and impact of renaming of schizophrenia.

    Science.gov (United States)

    Koike, Shinsuke; Yamaguchi, Sosei; Ohta, Kazusa; Ojio, Yasutaka; Watanabe, Kei-Ichiro; Ando, Shuntaro

    2017-03-01

    Mental-health-related stigma affects help-seeking behavior and service utilization among young people. Whether mental-health-related stigma is different or correlated between parents and their children is unknown. It is also unknown whether the name change of schizophrenia in 2002 has had long-term effects on reducing stigma for adults in the general population. We recruited 143 parent-child pairs (mean ages [SD]: 51.5 [3.6] and 21.2 [1.2] years, respectively) to complete self-report questionnaires regarding mental-health-related stigma and experience. We also assessed negative stereotypes for three psychiatric disease names (old and new names of schizophrenia, and depression), and for diabetes mellitus as a physical illness comparison. The questionnaires also asked respondents to identify the old and new names of schizophrenia and dementia, respectively, among 10 names for mental and physical illnesses and conditions. Parents showed lower stigma levels toward mental illness and diabetes mellitus, but similar or greater stigma levels toward schizophrenia, compared with their children. Stigma levels toward mental illness in parents and their children were significantly correlated. The rate of correct identification of the old and new names for schizophrenia was higher in parents than in their children (64.7% vs 41.4%, P stigma toward mental illness is shared between family members, and the name change of schizophrenia has effectively reduced stigma levels toward this disorder in adults of various ages. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  7. Perceptions of stigma and its correlates among patients with major depressive disorder: A multicenter survey from China.

    Science.gov (United States)

    Shi-Jie, Feng; Hong-Mei, Gao; Li, Wang; Bin-Hong, Wang; Yi-Ru, Fang; Gang, Wang; Tian-Mei, Si

    2017-09-01

    The stigma of major depressive disorder (MDD) is an important public health problem. This study evaluated stigma in MDD patients in China using explanatory model interview catalogue (EMIC) questionnaire and the demographic and clinical symptom factors associated with the stigma of these patients. A total of 158 MDD patients from domestic 3 mental health centers were surveyed. We used the EMIC questionnaire to assess stigma of these patients, Montgomery and Asberg depression rating scale (MADRS) to assess depressive severity, self-reporting inventory (SCL-90) to assess mental health level, Sheehan disability scale (SDS) to assess social function, and fatigue severity scale (FSS) to assess degree of fatigue. The stigma scores were significantly higher in the 18- to 30-year-old (z = 2.875, P = .024) and 31- to 40-year-old (z = 3.204, P = .008) groups than the 51- to 65-year-old group; in the full-time employment group than the retired group (z = 3.163, P = .016). The stigma scores exhibited significant negative correlation with age (r = -0.169, P = .034) but positive correlations with the scores of MADRS (r = .212, P = .007), total scores (r = .273, P = .001) and subscales of interpersonal sensitivity (r = .233, P = .003), depression (r = .336, P stigma. The age, employment status, fatigue, and depressive severity are closely associated with the perceived stigma of MDD patients and may be important factors considered for stigma interventions of MDD in China. © 2016 John Wiley & Sons Australia, Ltd.

  8. Reflood completion report: Volume 1. A phenomenological thermal-hydraulic model of hot rod bundles experiencing simultaneous bottom and top quenching and an optimization methodology for closure development

    Energy Technology Data Exchange (ETDEWEB)

    Nelson, R.A. Jr.; Pimentel, D.A.; Jolly-Woodruff, S.; Spore, J.

    1998-04-01

    In this report, a phenomenological model of simultaneous bottom-up and top-down quenching is developed and discussed. The model was implemented in the TRAC-PF1/MOD2 computer code. Two sets of closure relationships were compared within the study, the Absolute set and the Conditional set. The Absolute set of correlations is frequently viewed as the pure set because the correlations is frequently viewed as the pure set because the correlations utilize their original coefficients as suggested by the developer. The Conditional set is a modified set of correlations with changes to the correlation coefficient only. Results for these two sets indicate quite similar results. This report also summarizes initial results of an effort to investigate nonlinear optimization techniques applied to the closure model development. Results suggest that such techniques can provide advantages for future model development work, but that extensive expertise is required to utilize such techniques (i.e., the model developer must fully understand both the physics of the process being represented and the computational techniques being employed). The computer may then be used to improve the correlation of computational results with experiments.

  9. Stigma, survivorship and solutions: Addressing the challenges of ...

    African Journals Online (AJOL)

    Stigma. Stigma refers to the attachment of negative connotations to a diagnosis. ... social problems following primary treatment of breast cancer.[9] Of ... effects of cancer treatment.[14] .... breast disease due to an increase in media campaigns.

  10. Understanding and measuring AIDS-related stigma in health care ...

    African Journals Online (AJOL)

    Key words: Stigma, discrimination, health care worker, HIV/AIDS. Journal of Social ... reproductive health issues, stigma and discrimination, and the structural vulnerabilities to HIV. ..... local AIDS service organisations, as well as caregivers.

  11. The Influence of Training, Reluctance, Efficacy, and Stigma on Suicide Intervention Behavior Among NCOs in the Army and Marine Corps.

    Science.gov (United States)

    Ayer, Lynsay; Ramchand, Rajeev; Geyer, Lily; Burgette, Lane; Kofner, Aaron

    2016-06-01

    The Army and Marine Corps have consistently experienced the highest rates of suicide relative to the other services. In both the Army and Marine Corps, the service members responsible for identifying and referring individuals at risk for suicide are called "gatekeepers" and are typically noncommissioned officers (NCOs). We used structural equation modeling on survey responses from 1184 Army soldiers and 796 marines to estimate the relationships between training, intervention efficacy, reluctance, and mental health stigma on NCO intervention behaviors. Efficacy and reluctance were independently associated with intervention behaviors, and stigma was only associated with intervention behaviors among Army NCOs. Study results suggest that while quantity of training may help NCOs feel more confident about their ability to intervene, other efforts such as changing training content and delivery mode (e.g., interactive vs. didactic training) may be necessary in order to reduce reluctance and stigma to intervene with service members at risk for suicide.

  12. [Shame, embarrassment and trouble...relatives of patients with OCD describe stigma experiences in every-day life].

    Science.gov (United States)

    Trosbach, Johanna; Stengler-Wenzke, Katarina; Angermeyer, Matthias C

    2003-03-01

    There are numerous studies on the stigma of mental illness. However, the subjective stigma experiences of patients with obsessive-compulsive disorder and their relatives have, so far not been investigated. Narrative interviews with 22 family members of patients with OCD were carried out as part of a study on the burden of mental illness on the family. Experience of stigma was analysed as an aspect of subjective burden using a grounded theory approach. Different areas of life could be described, in which stigmatization is anticipated or experienced by family members of patients with OCD. Concealing is a relevant strategy for the members in dealing with the illness. Stigmatization can be minimized by impartially handling the illness and cooperation of patients, their relevant others and professionals.

  13. Cumulative risk and AIDS-orphanhood: interactions of stigma, bullying and poverty on child mental health in South Africa.

    Science.gov (United States)

    Cluver, Lucie; Orkin, Mark

    2009-10-01

    Research shows that AIDS-orphaned children are more likely to experience clinical-range psychological problems. Little is known about possible interactions between factors mediating these high distress levels. We assessed how food insecurity, bullying, and AIDS-related stigma interacted with each other and with likelihood of experiencing clinical-range disorder. In South Africa, 1025 adolescents completed standardised measures of depression, anxiety and post-traumatic stress. 52 potential mediators were measured, including AIDS-orphanhood status. Logistic regressions and hierarchical log-linear modelling were used to identify interactions among significant risk factors. Food insecurity, stigma and bullying all independently increased likelihood of disorder. Poverty and stigma were found to interact strongly, and with both present, likelihood of disorder rose from 19% to 83%. Similarly, bullying interacted with AIDS-orphanhood status, and with both present, likelihood of disorder rose from 12% to 76%. Approaches to alleviating psychological distress amongst AIDS-affected children must address cumulative risk effects.

  14. Mental health stigma in Ireland: exploring occupational therapists perspectives

    OpenAIRE

    Hanby, Louise

    2012-01-01

    non-peer-reviewed Stigma is considered the main barrier to recovery for people living with a mental illness. The process of stigma can be inconspicuous, operating through individual, systemic, institutional and structural levels and can leave those working in mental health care unsure of their role in the stigma process. Semi-structured interviews explored views of nine occupational therapists working in mental health, focusing on their perspectives of stigma and drawing on experiences of ...

  15. Self-Stigma and Coming Out about One's Mental Illness

    Science.gov (United States)

    Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rusch, Nicolas

    2010-01-01

    Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with…

  16. Self-Stigma and Coming Out about One's Mental Illness

    Science.gov (United States)

    Corrigan, Patrick W.; Morris, Scott; Larson, Jon; Rafacz, Jennifer; Wassel, Abigail; Michaels, Patrick; Wilkniss, Sandra; Batia, Karen; Rusch, Nicolas

    2010-01-01

    Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with…

  17. Hepatitis C, stigma and cure.

    Science.gov (United States)

    Marinho, Rui Tato; Barreira, David Pires

    2013-10-28

    The infection with hepatitis C virus (HCV) is one of the most important global chronic viral infections worldwide. It is estimated to affect around 3% of the world population, about 170-200 million people. Great part of the infections are asymptomatic, the patient can be a chronic carrier for decades without knowing it. The most severe consequences of the chronic infection are liver cirrhosis and hepatocellular carcinoma, which appears in 20%-40% of the patients, leading to hepatic failure and death. The HCV was discovered 25 years ago in 1989, is a RNA virus and classified by the World Health Organization as an oncogenic one. Hepatocellular carcinoma is one of the most important cancers, the fifth worldwide in terms of mortality. It has been increasing in the Ocidental world, mainly due to chronic hepatitis C. Hepatitis C is not only a liver disease and a cause of cirrhosis, but also a mental, psychological, familiar, and social disease. The stigma that the infected person sometimes carries is tremendous having multiple consequences. The main cause is lack of adequate information, even in the health professionals setting. But, besides the "drama" of being infected, health professionals, family, society and the infected patients, must be aware of the chance of real cure and total and definitive elimination of the virus. The treatment for hepatitis C has begun in the last 80's with a percentage of cure of 6%. Step by step the efficacy of the therapy for hepatitis C is rapidly increasing and nowadays with the very new medications, the so called Direct Antiviral Agents-DAAs of new generation, is around 80%-90%.

  18. Public Stigma towards Older Adults with Depression: Findings from the São Paulo-Manaus Elderly in Primary Care Study.

    Science.gov (United States)

    Scazufca, Marcia; P de Paula Couto, Maria Clara; Huang, Hsiang; Kester, Rachel; Braga, Patrícia Emília; Peluso, Érica T P; Blay, Sérgio L; R Menezes, Paulo; E Ribeiro, Euler

    2016-01-01

    This study investigates three domains of public stigma (perceived negative reactions, perceived discrimination, and dangerousness) against older adults with depression. The sample comprised of older adults registered with primary care clinics (n = 1,291) and primary health care professionals (n = 469) from São Paulo and Manaus, Brazil. Participants read a vignette describing a 70-year-old individual (Mary or John) with a depressive disorder and answered questions measuring stigma. The prevalence of the three stigma domains was between 30.2 and 37.6% among older participants from São Paulo and between 27.6 and 35.4% among older participants from Manaus. Older adults from both cities reported similar prevalence of perceived stigma. Key factors associated with stigmatizing beliefs among older participants were reporting depressive symptoms, having physical limitations, and identifying the case of the vignette as a case of mental disorder. Among health professionals, the prevalence of the three stigma domains was between 19.8 and 34.8% in São Paulo and 30.2 and 44.6% in Manaus. The key factor associated with stigma among primary health care professionals was city, with consistently higher risk in Manaus than in São Paulo. Findings confirm that public stigma against older adults in Brazil is common. It is important to educate the public and primary health care providers in Brazil on stigma related to mental illness in order to reduce barriers to adequate mental health treatment.

  19. 'You are labelled by your children's disability' - A community-based, participatory study of stigma among Somali parents of children with autism living in the United Kingdom.

    Science.gov (United States)

    Selman, Lucy Ellen; Fox, Fiona; Aabe, Nura; Turner, Katrina; Rai, Dheeraj; Redwood, Sabi

    2017-03-02

    Social stigma is commonly experienced by parents of children with autism. Our aim was to understand the nature of stigma experienced by Somali parents of children with autism in the United Kingdom (UK), and to consider how they coped with or resisted such stigma. We used a community-based participatory research approach, collaborating with a community organisation of Somali parents. In-depth interviews with simultaneous translation were conducted with 15 Somali parents of children with autism living in Bristol, UK, in 2015. Parents were sampled purposively to capture diversity in children's age, severity of autism and time since diagnosis. Directed thematic analysis used Link and Phelan's model of stigma. Of the 15 participants, 12 were mothers (mean age 36). The 17 children with autism they cared for were 4-13 years' old, and five were girls. Two main themes with sub-themes were identified: the nature of stigma (labelling and stereotyping; separation; emotional reactions, discrimination and power), and coping and resistance (the power of language; faith as a resource; learning, peer support and community relationships). Children with autism were labelled and stereotyped (e.g. as 'sick', 'naughty', 'different') and parents blamed for not controlling them, leading to social rejection and isolation. Stigma was associated with a poor understanding of autism, a lack of vocabulary related to autism in the Somali community, and prejudice against mental illness and disability. There was evidence of enacted and felt stigma and examples of discrimination. Finding their own language to describe their child's condition and drawing on faith, learning and peer support were important resources in resisting stigma. Findings inform support for this community, highlighting the need to raise awareness of autism, enable parents to speak openly, and ensure appropriate professional services and interventions are available.

  20. Cloning and characterization of a glucosyltransferase from Crocus sativus stigmas involved in flavonoid glucosylation

    Directory of Open Access Journals (Sweden)

    Ahrazem Oussama

    2009-08-01

    Full Text Available Abstract Background Flavonol glucosides constitute the second group of secondary metabolites that accumulate in Crocus sativus stigmas. To date there are no reports of functionally characterized flavonoid glucosyltransferases in C. sativus, despite the importance of these compounds as antioxidant agents. Moreover, their bitter taste makes them excellent candidates for consideration as potential organoleptic agents of saffron spice, the dry stigmas of C. sativus. Results Using degenerate primers designed to match the plant secondary product glucosyltransferase (PSPG box we cloned a full length cDNA encoding CsGT45 from C. sativus stigmas. This protein showed homology with flavonoid glucosyltransferases. In vitro reactions showed that CsGT45 catalyses the transfer of glucose from UDP_glucose to kaempferol and quercetin. Kaempferol is the unique flavonol present in C. sativus stigmas and the levels of its glucosides changed during stigma development, and these changes, are correlated with the expression levels of CsGT45 during these developmental stages. Conclusion Findings presented here suggest that CsGT45 is an active enzyme that plays a role in the formation of flavonoid glucosides in C. sativus.

  1. Burnout and depression: Label-related stigma, help-seeking, and syndrome overlap.

    Science.gov (United States)

    Bianchi, Renzo; Verkuilen, Jay; Brisson, Romain; Schonfeld, Irvin Sam; Laurent, Eric

    2016-11-30

    We investigated whether burnout and depression differed in terms of public stigma and help-seeking attitudes and behaviors. Secondarily, we examined the overlap of burnout and depressive symptoms. A total of 1046 French schoolteachers responded to an Internet survey in November-December 2015. The survey included measures of public stigma, help-seeking attitudes and behaviors, burnout and depressive symptoms, self-rated health, neuroticism, extraversion, history of anxiety or depressive disorder, social desirability, and socio-demographic variables. The burnout label appeared to be less stigmatizing than the depression label. In either case, however, fewer than 1% of the participants exhibited stigma scores signaling agreement with the proposed stigmatizing statements. Help-seeking attitudes and behaviors did not differ between burnout and depression. Participants considered burnout and depression similarly worth-treating. A huge overlap was observed between the self-report, time-standardized measures of burnout and depressive symptoms (disattenuated correlation: .91). The overlap was further evidenced in a confirmatory factor analysis. Thus, while burnout and depression as syndromes are unlikely to be distinct, how burnout and depression are socially represented may differ. To our knowledge, this study is the first to compare burnout- and depression-related stigma and help-seeking in the French context. Cross-national, multi-occupational studies examining different facets of stigma are needed. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Characterization of Courtesy Stigma Perceived by Parents of Overweight Children with Bardet-Biedl Syndrome.

    Directory of Open Access Journals (Sweden)

    Barbara Hamlington

    Full Text Available A child's obesity is generally perceived by the public to be under the control of the child's parents. While the health consequences of childhood obesity are well understood, less is known about psychological and social effects of having an obese child on parents. We set out to characterize stigma and courtesy stigma experiences surrounding obesity among children with Bardet-Biedl syndrome (BBS, a multisystem genetic disorder, and their parents.Twenty-eight parents of children with BBS participated in semi-structured interviews informed by social stigmatization theory, which describes courtesy stigma as parental perception of stigmatization by association with a stigmatized child. Parents were asked to describe such experiences.Parents of children with BBS reported the child's obesity as the most frequent target of stigmatization. They perceived health care providers as the predominant source of courtesy stigma, describing interactions that resulted in feeling devalued and judged as incompetent parents.Parents of children with BBS feel blamed by others for their child's obesity and described experiences that suggest health care providers may contribute to courtesy stigma and thus impede effective communication about managing obesity. Health care providers may reinforce parental feelings of guilt and responsibility by repeating information parents may have previously heard and ignoring extremely challenging barriers to weight management, such as a genetic predisposition to obesity. Strategies to understand and incorporate parents' perceptions and causal attributions of their children's weight may improve communication about weight control.

  3. Trends in mental health services utilization and stigma in US soldiers from 2002 to 2011.

    Science.gov (United States)

    Quartana, Phillip J; Wilk, Joshua E; Thomas, Jeffrey L; Bray, Robert M; Rae Olmsted, Kristine L; Brown, Janice M; Williams, Jason; Kim, Paul Y; Clarke-Walper, Kristina; Hoge, Charles W

    2014-09-01

    We characterized trends in mental health services utilization and stigma over the course of the Afghanistan and Iraq wars among active-component US soldiers. We evaluated trends in mental health services utilization and stigma using US Army data from the Health-Related Behavior (HRB) surveys from 2002, 2005, and 2008 (n = 12,835) and the Land Combat Study (LCS) surveys administered to soldiers annually from 2003 to 2009 and again in 2011 (n = 22,627). HRB and LCS data suggested increased mental health services utilization and decreased stigma in US soldiers between 2002 and 2011. These trends were evident in soldiers with and without posttraumatic stress disorder (PTSD), major depressive disorder (MDD), or PTSD and MDD. Despite the improving trends, more than half of soldiers with mental health problems did not report seeking care. Mental health services utilization increased and stigma decreased over the course of the wars in Iraq and Afghanistan. Although promising, these findings indicate that a significant proportion of US soldiers meeting criteria for PTSD or MDD do not utilize mental health services, and stigma remains a pervasive problem requiring further attention.

  4. Masculinity and the persistence of AIDS stigma

    Science.gov (United States)

    Wyrod, Robert

    2011-01-01

    With the expansion of access to HIV testing and antiretroviral therapy in sub-Saharan Africa, questions have emerged if stigma remains a useful concept for understanding the effects of AIDS. There is, however, a paucity of research on how HIV-positive Africans—especially African men—experience living with AIDS. This paper addresses this gap and draws on findings from ethnographic fieldwork in 2004 and 2009 with a support group for HIV-positive men in Kampala, Uganda. The paper demonstrates that stigma is central to how men in this context coped with HIV and AIDS, and it provides a conceptual framework that links men’s experiences of AIDS stigma to conceptions of masculinity. In so doing, findings highlight both the possibilities and challenges of involving African men more fully in HIV prevention. PMID:21246426

  5. Stigma and the perpetuation of obesity.

    Science.gov (United States)

    Brewis, Alexandra A

    2014-10-01

    Even as obesity rates reach new highs, the social stigmatization of obesity seems to be strengthening and globalizing. This review identifies at least four mechanisms by which a pervasive environment of fat stigma could reinforce high body weights or promote weight gain, ultimately driving population-level obesity. These are direct effects through behavior change because of feeling judged, and indirect effects of social network changes based on stigmatizing actions and decisions by others, psychosocial stress from feeling stigmatized, and the structural effects of discrimination. Importantly, women and children appear especially vulnerable to these mechanisms. The broader model provides an improved basis to investigate the role of stigma in driving the etiology of obesity, and explicates how individual, interpersonal, and structural dimensions of stigma are connected to variation in health outcomes, including across generations.

  6. The Stigma of Childhood Mental Disorders: A Conceptual Framework

    Science.gov (United States)

    Mukolo, Abraham; Heflinger, Craig Anne; Wallston, Kenneth A.

    2010-01-01

    Objective: To describe the state of the literature on stigma associated with children's mental disorders and highlight gaps in empirical work. Method: We reviewed child mental illness stigma articles in (English only) peer-reviewed journals available through Medline and PsychInfo. We augmented these with adult-oriented stigma articles that focus…

  7. Understanding stigma and HIV/AIDS in South Africa

    African Journals Online (AJOL)

    2016-01-18

    Jan 18, 2016 ... 2010). Its impact on the epidemic and on people living with. HIV/AIDS ... 2006). While these academic exercises provide a more nuanced ... stigmas of the body; stigmas of character; and stigmas associated with social ...... Gilbert, L. & Walker, L. (2002) Treading the Path of Least Resistance – HIV/. AIDS and ...

  8. Anatomy of the unusual stigma in Orchidantha (Lowiaceae)

    DEFF Research Database (Denmark)

    Pedersen, Louise B; Johansen, Bo

    2004-01-01

    The stigma of Orchidantha is unlike any other stigma in the Zingiberales. It is zygomorphic and dorsiventral, and its complicated structure has confused botanists resulting in many different descriptions and interpretations. Basally and ventrally on the three-lobed stigma, a specialized "secretio...

  9. The Stigma of Childhood Mental Disorders: A Conceptual Framework

    Science.gov (United States)

    Mukolo, Abraham; Heflinger, Craig Anne; Wallston, Kenneth A.

    2010-01-01

    Objective: To describe the state of the literature on stigma associated with children's mental disorders and highlight gaps in empirical work. Method: We reviewed child mental illness stigma articles in (English only) peer-reviewed journals available through Medline and PsychInfo. We augmented these with adult-oriented stigma articles that focus…

  10. Best practices: Strategic stigma change (SSC): five principles for social marketing campaigns to reduce stigma.

    Science.gov (United States)

    Corrigan, Patrick W

    2011-08-01

    This column describes strategic stigma change (SSC), which comprises five principles and corresponding practices developed as a best practice to erase prejudice and discrimination associated with mental illness and promote affirming behaviors and social inclusion. SSC principles represent more than ten years of insights from the National Consortium on Stigma and Empowerment. The principles, which are centered on consumer contact that is targeted, local, credible, and continuous, were developed to inform the growth of large-scale social marketing campaigns supported by governments and nongovernmental organizations. Future social marketing efforts to address stigma and the need for evidence to determine SSC's penetration and impact are also discussed.

  11. Weight Stigma Reduction and Genetic Determinism.

    Science.gov (United States)

    Hilbert, Anja

    2016-01-01

    One major approach to weight stigma reduction consists of decreasing beliefs about the personal controllability of-and responsibility for-obesity by educating about its biogenetic causes. Evidence on the efficacy of this approach is mixed, and it remains unclear whether this would create a deterministic view, potentially leading to detrimental side-effects. Two independent studies from Germany using randomized designs with delayed-intervention control groups served to (1) develop and pilot a brief, interactive stigma reduction intervention to educate N = 128 university students on gene × environment interactions in the etiology of obesity; and to (2) evaluate this intervention in the general population (N = 128) and determine mechanisms of change. The results showed (1) decreased weight stigma and controllability beliefs two weeks post-intervention in a student sample; and (2) decreased internal attributions and increased genetic attributions, knowledge, and deterministic beliefs four weeks post-intervention in a population sample. Lower weight stigma was longitudinally predicted by a decrease in controllability beliefs and an increase in the belief in genetic determinism, especially in women. The results underline the usefulness of a brief, interactive intervention promoting an interactionist view of obesity to reduce weight stigma, at least in the short term, lending support to the mechanisms of change derived from attribution theory. The increase in genetic determinism that occurred despite the intervention's gene × environment focus had no detrimental side-effect on weight stigma, but instead contributed to its reduction. Further research is warranted on the effects of how biogenetic causal information influences weight management behavior of individuals with obesity.

  12. Weight Stigma Reduction and Genetic Determinism

    Science.gov (United States)

    Hilbert, Anja

    2016-01-01

    One major approach to weight stigma reduction consists of decreasing beliefs about the personal controllability of—and responsibility for—obesity by educating about its biogenetic causes. Evidence on the efficacy of this approach is mixed, and it remains unclear whether this would create a deterministic view, potentially leading to detrimental side-effects. Two independent studies from Germany using randomized designs with delayed-intervention control groups served to (1) develop and pilot a brief, interactive stigma reduction intervention to educate N = 128 university students on gene × environment interactions in the etiology of obesity; and to (2) evaluate this intervention in the general population (N = 128) and determine mechanisms of change. The results showed (1) decreased weight stigma and controllability beliefs two weeks post-intervention in a student sample; and (2) decreased internal attributions and increased genetic attributions, knowledge, and deterministic beliefs four weeks post-intervention in a population sample. Lower weight stigma was longitudinally predicted by a decrease in controllability beliefs and an increase in the belief in genetic determinism, especially in women. The results underline the usefulness of a brief, interactive intervention promoting an interactionist view of obesity to reduce weight stigma, at least in the short term, lending support to the mechanisms of change derived from attribution theory. The increase in genetic determinism that occurred despite the intervention’s gene × environment focus had no detrimental side-effect on weight stigma, but instead contributed to its reduction. Further research is warranted on the effects of how biogenetic causal information influences weight management behavior of individuals with obesity. PMID:27631384

  13. Rural Parents’ Perceived Stigma of Seeking Mental Health Services for their Children: Development and Evaluation of a New Instrument

    Science.gov (United States)

    Williams, Stacey L.; Polaha, Jodi

    2014-01-01

    The purpose of this paper was to examine the validity of score interpretations of an instrument developed to measure parents’ perceptions of stigma about seeking mental health services for their children. The validity of the score interpretations of the instrument was tested in two studies. Study 1 examined confirmatory factor analysis (CFA) employing a split half approach, and construct and criterion validity using the entire sample of parents in rural Appalachia whose children were experiencing psychosocial concerns (N=347), while Study 2 further examined CFA, construct and criterion validity, as well as predictive validity of the scores on the new scale using a general sample of parents in rural Appalachia (N=184). Results of exploratory and confirmatory factor analyses revealed support for a two factor model of parents’ perceived stigma, which represented both self and public forms of stigma associated with seeking mental health services for their children, and correlated with existing measures of stigma and other psychosocial variables. Further, the new self and public stigma scale significantly predicted parents’ willingness to seek services for children. PMID:24749752

  14. The Impact of Stigma and Social Support on Development of Post-traumatic Growth Among Persons Living with HIV.

    Science.gov (United States)

    Kamen, Charles; Vorasarun, Chaniga; Canning, Ty; Kienitz, Eliza; Weiss, Carolyn; Flores, Sergio; Etter, Darryl; Lee, Susanne; Gore-Felton, Cheryl

    2016-06-01

    Given high rates of trauma in people living with HIV (PLH) and the health benefits of posttraumatic growth (PTG), understanding how to foster PTG in PLH exposed to trauma could be of interest to clinical psychologists working with this population. The current study examined factors theoretically related to development of PTG in PLH, namely HIV-related stigma, disclosure of HIV status, and emotional support. A sample of 334 HIV-positive adults answered a battery of self-report questionnaires. HIV-related stigma, disclosure to sexual partners, and emotional support were significant predictors of PTG: stigma was associated with lower PTG, whereas disclosure and emotional support were associated with higher PTG. Disclosure and emotional support remained significantly associated with PTG in the model including demographic factors and stigma. These findings highlight the need for development of interventions that can aid PLH in disclosing their HIV status to sexual partners and increasing available social support.

  15. The Theory of Industrial Society and Cultural Schemata: Does the "Cultural Myth of Stigma" Underlie the WHO Schizophrenia Paradox?

    Science.gov (United States)

    Pescosolido, Bernice A; Martin, Jack K; Olafsdottir, Sigrun; Long, J Scott; Kafadar, Karen; Medina, Tait R

    2015-11-01

    The WHO's International Studies of Schizophrenia conclude that schizophrenia may have a more benign course in "developing" societies than in the West. The authors focus on this finding's most common corollary: cultural schemata are shaped by the transition from agrarian to industrial society. Developing societies are viewed as traditional, gemeinschaft cultures lacking the stigmatizing beliefs about persons with mental illness held in modern, gesellschaft cultures of developed societies. The Stigma in Global Context-Mental Health Study formalized the cultural myth of public stigma (CMPS) with propositions linking level of development to intolerant, exclusionary, and individualistic attitudes. In 17 countries, the authors find no support for the corollary; where support is found, the findings are opposite expectations, with developed societies reporting lower stigma levels. Reconceptualizing of the cultural landscape on more specific dimensions also produces null or contrary findings. This correction to nostalgic myths of cultural context in developing societies thwarts misguided treatment, policy, and stigma-reduction efforts.

  16. Mental illness-related stigma in healthcare

    Science.gov (United States)

    Mantler, Ed; Szeto, Andrew

    2017-01-01

    Mental illness-related stigma, including that which exists in the healthcare system and among healthcare providers, creates serious barriers to access and quality care. It is also a major concern for healthcare practitioners themselves, both as a workplace culture issue and as a barrier for help seeking. This article provides an overview of the main barriers to access and quality care created by stigmatization in healthcare, a consideration of contributing factors, and a summary of Canadian-based research into promising practices and approaches to combatting stigma in healthcare environments.

  17. AIDS-related stigma and mental disorders among people living with HIV: a cross-sectional study in Cambodia.

    Directory of Open Access Journals (Sweden)

    Siyan Yi

    Full Text Available AIDS-related stigma and mental disorders are the most common conditions in people living with HIV (PLHIV. We therefore conducted this study to examine the association of AIDS-related stigma and discrimination with mental disorders among PLHIV in Cambodia.A two-stage cluster sampling method was used to select 1,003 adult PLHIV from six provinces. The People Living with HIV Stigma Index was used to measure stigma and discrimination, and a short version of general health questionnaire (GHQ-12 was used to measure mental disorders. Multivariate logistic regression analysis was conducted.The reported experiences of discrimination in communities in the past 12 months ranged from 0.8% for reports of being denied health services to 42.3% for being aware of being gossiped about. Internal stigma was also common ranging from 2.8% for avoiding going to a local clinic and/or hospital to 59.6% for deciding not to have (more children. The proportions of PLHIV who reported fear of stigma and discrimination ranged from 13.9% for fear of being physically assaulted to 34.5% for fear of being gossiped about. The mean score of GHQ-12 was 3.2 (SD = 2.4. After controlling for several potential confounders, higher levels of mental disorders (GHQ-12≥ 4 remained significantly associated with higher levels of experiences of stigma and discrimination in family and communities (AOR = 1.9, 95% CI = 1.4-2.6, higher levels of internal stigma (AOR = 1.7, 95% CI = 1.2-2.3, and higher levels of fear of stigma and discrimination in family and communities (AOR = 1.5, 95% CI = 1.1-2.2.AIDS-related stigma and discrimination among PLHIV in Cambodia are common and may have potential impacts on their mental health conditions. These findings indicate a need for community-based interventions to reduce stigma and discrimination in the general public and to help PLHIV to cope with this situation.

  18. Mental illness, poverty and stigma in India: a case–control study

    Science.gov (United States)

    Trani, Jean-Francois; Bakhshi, Parul; Kuhlberg, Jill; Narayanan, Sreelatha S; Venkataraman, Hemalatha; Mishra, Nagendra N; Groce, Nora E; Jadhav, Sushrut; Deshpande, Smita

    2015-01-01

    Objective To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste. Design Matching case (hospital)–control (population) study. Setting University Hospital (cases) and National Capital Region (controls), India. Participants A case–control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. Main outcome measures Higher risk of poverty due to stigma among PSMI. Results 38.5% of PSMI compared with 22.2% of controls were found poor on six dimensions or more. The difference in multidimensional poverty index was 69% between groups with employment and income of the main contributors. Multidimensional poverty was strongly associated with stigma (OR 2.60, 95% CI 1.27 to 5.31), scheduled castes/scheduled tribes/other backward castes (2.39, 1.39 to 4.08), mental illness (2.07, 1.25 to 3.41) and female gender (1.87, 1.36 to 2.58). A significant interaction between stigma, mental illness and gender or caste indicates female PSMI or PSMI from ‘lower castes’ were more likely to be poor due to stigma than male controls (ppoverty linked to SMI are pervasive and intertwined. In particular for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family. Mental health professionals need to be aware of and address these issues. PMID:25712818

  19. Mental illness, poverty and stigma in India: a case-control study.

    Science.gov (United States)

    Trani, Jean-Francois; Bakhshi, Parul; Kuhlberg, Jill; Narayanan, Sreelatha S; Venkataraman, Hemalatha; Mishra, Nagendra N; Groce, Nora E; Jadhav, Sushrut; Deshpande, Smita

    2015-02-23

    To assess the effect of experienced stigma on depth of multidimensional poverty of persons with severe mental illness (PSMI) in Delhi, India, controlling for gender, age and caste. Matching case (hospital)-control (population) study. University Hospital (cases) and National Capital Region (controls), India. A case-control study was conducted from November 2011 to June 2012. 647 cases diagnosed with schizophrenia or affective disorders were recruited and 647 individuals of same age, sex and location of residence were matched as controls at a ratio of 1:2:1. Individuals who refused consent or provided incomplete interview were excluded. Higher risk of poverty due to stigma among PSMI. 38.5% of PSMI compared with 22.2% of controls were found poor on six dimensions or more. The difference in multidimensional poverty index was 69% between groups with employment and income of the main contributors. Multidimensional poverty was strongly associated with stigma (OR 2.60, 95% CI 1.27 to 5.31), scheduled castes/scheduled tribes/other backward castes (2.39, 1.39 to 4.08), mental illness (2.07, 1.25 to 3.41) and female gender (1.87, 1.36 to 2.58). A significant interaction between stigma, mental illness and gender or caste indicates female PSMI or PSMI from 'lower castes' were more likely to be poor due to stigma than male controls (ppoverty linked to SMI are pervasive and intertwined. In particular for low caste and women, it is a strong predictor of poverty. Exclusion from employment linked to negative attitudes and lack of income are the highest contributors to multidimensional poverty, increasing the burden for the family. Mental health professionals need to be aware of and address these issues. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come?

    Science.gov (United States)

    Stangl, Anne L; Lloyd, Jennifer K; Brady, Laura M; Holland, Claire E; Baral, Stefan

    2013-01-01

    Introduction HIV-related stigma and discrimination continue to hamper efforts to prevent new infections and engage people in HIV treatment, care and support programmes. The identification of effective interventions to reduce stigma and discrimination that can be integrated into national responses is crucial to the success of the global AIDS response. Methods We conducted a systematic review of studies and reports that assessed the effectiveness of interventions to reduce HIV stigma and discrimination between 1 January 2002 and 1 March 2013. Databases searched for peer-reviewed articles included PubMed, Scopus, EBSCO Host –CINAHL Plus, Psycinfo, Ovid, Sociofile and Popline. Reports were obtained from the www.HIVAIDSClearinghouse.eu, USAID Development Experience Clearinghouse, UNESCO HIV and AIDS Education Clearinghouse, Google, WHO and UNAIDS. Ancestry searches for articles included in the systematic review were also conducted. Studies of any design that sought to reduce stigma as a primary or secondary objective and included pre- and post-intervention measures of stigma were included. Results Of 2368 peer-reviewed articles and reports identified, 48 were included in our review representing 14 different target populations in 28 countries. The majority of interventions utilized two or more strategies to reduce stigma and discrimination, and ten included structural or biomedical components. However, most interventions targeted a single socio-ecological level and a single domain of stigma. Outcome measures lacked uniformity and validity, making both interpretation and comparison of study results difficult. While the majority of studies were effective at reducing the aspects of stigma they measured, none assessed the influence of stigma or discrimination reduction on HIV-related health outcomes. Conclusions Our review revealed considerable progress in the stigma-reduction field. However, critical challenges and gaps remain which are impeding the identification of

  1. A systematic review of interventions to reduce HIV-related stigma and discrimination from 2002 to 2013: how far have we come?

    Directory of Open Access Journals (Sweden)

    Anne L Stangl

    2013-11-01

    Full Text Available Introduction: HIV-related stigma and discrimination continue to hamper efforts to prevent new infections and engage people in HIV treatment, care and support programmes. The identification of effective interventions to reduce stigma and discrimination that can be integrated into national responses is crucial to the success of the global AIDS response. Methods: We conducted a systematic review of studies and reports that assessed the effectiveness of interventions to reduce HIV stigma and discrimination between 1 January 2002 and 1 March 2013. Databases searched for peer-reviewed articles included PubMed, Scopus, EBSCO Host –CINAHL Plus, Psycinfo, Ovid, Sociofile and Popline. Reports were obtained from the www.HIVAIDSClearinghouse.eu, USAID Development Experience Clearinghouse, UNESCO HIV and AIDS Education Clearinghouse, Google, WHO and UNAIDS. Ancestry searches for articles included in the systematic review were also conducted. Studies of any design that sought to reduce stigma as a primary or secondary objective and included pre- and post-intervention measures of stigma were included. Results: Of 2368 peer-reviewed articles and reports identified, 48 were included in our review representing 14 different target populations in 28 countries. The majority of interventions utilized two or more strategies to reduce stigma and discrimination, and ten included structural or biomedical components. However, most interventions targeted a single socio-ecological level and a single domain of stigma. Outcome measures lacked uniformity and validity, making both interpretation and comparison of study results difficult. While the majority of studies were effective at reducing the aspects of stigma they measured, none assessed the influence of stigma or discrimination reduction on HIV-related health outcomes. Conclusions: Our review revealed considerable progress in the stigma-reduction field. However, critical challenges and gaps remain which are impeding

  2. Stigma of People with Epilepsy in China: Views of health professionals, teachers, employers and community leaders

    Science.gov (United States)

    Yang, Rongrong; Wang, Wenzhi; Snape, Dee; Chen, Gong; Zhang, Lei; Wu, Jianzhong; Baker, Gus A; Zheng, Xiaoying; Jacoby, Ann

    2011-01-01

    To identify the possible sources of stigma of epilepsy in key informant groups, “mini-ethnographic” studies were conducted in rural and urban locations in China. Data from 45 semi-structured interviews and 8 focus group discussions (6 persons each) were analysed to investigate the world experienced by people with epilepsy. Underpinned by a social constructionist approach to data analysis, emerging themes were identified with the use of computer-assisted data analysis (NVivo 8). A hierarchical model was then constructed, to include: Practical Level issues: attitudes to risk, attitudes towards costs of epilepsy; and Cultural Level issues: the contrast between rurality and tradition and urbanization and modernity in the Chinese context. The analysis enriches current research on factors and sources of stigma of epilepsy and highlights issues for future practice. PMID:21606005

  3. PTSD, stigma and barriers to help-seeking within the UK Armed Forces.

    Science.gov (United States)

    Murphy, Dominic; Busuttil, Walter

    2015-12-01

    Among the general public, much is known about the longer-term consequences of not seeking support for mental health difficulties. However, within military populations, and in particular, the UK Armed Forces, less is known. Understanding the factors that present barriers for UK service personnel with mental health difficulties accessing support is important because this may provide a means for support personnel to seek help sooner. This paper explores the literature relating to the impact of untreated post-traumatic stress disorder (PTSD) among military personnel, attempts to draw conclusions about the barriers that may prevent personnel seeking help and the efficacy of previous interventions to address these. Stigma has been highlighted as the key barrier to help-seeking behaviours, in particular, internal stigma, which can be classified as negative beliefs about the self that an individual may hold as a result of experiencing symptoms of PTSD.

  4. Violence, stigma and mental health among female sex workers in China: A structural equation modeling.

    Science.gov (United States)

    Zhang, Liying; Li, Xiaoming; Wang, Bo; Shen, Zhiyong; Zhou, Yuejiao; Xu, Jinping; Tang, Zhenzhu; Stanton, Bonita

    2016-05-26

    Intimate partner violence is prevalent among female sex workers (FSWs) in China, and it is significantly associated with mental health problems among FSWs. However, limited studies have explored the mechanisms/process by which violence affects mental health. The purpose of this study was to explore the relationships among partner violence, internalized stigma, and mental health problems among FSWs. Data were collected using a self-administered cross-sectional survey administered to 1,022 FSWs in the Guangxi Zhuang Autonomous Region (Guangxi), China during 2008-2009. We used structural equation modeling to test the hypothesized relationships. Results indicated that violence perpetrated by either stable sexual partners or clients was directly and positively associated with mental health problems. Violence also had an indirect relation to mental health problems through stigma. Results highlight the need for interventions on counseling and care for FSWs who have experienced violence and for interventions to increase FSWs' coping skills and empowerment strategies.

  5. Perceived stigma reductions following participation in mental health services integrated within community-based HIV primary care.

    Science.gov (United States)

    Farber, Eugene W; Shahane, Amit A; Brown, Jennifer L; Campos, Peter E

    2014-01-01

    HIV stigma remains a significant challenge for individuals living with HIV disease that can adversely affect overall well-being and patterns of HIV health service engagement. Finding ways to effectively address stigma concerns is, therefore, an important consideration in the clinical management of HIV disease. This study examined changes in perceived stigma in a sample of 48 adults living with HIV disease as an outcome of their participation in a mental health services program integrated with community-based HIV primary care. Participants completed a self-report instrument that provided a multidimensional measure of perceived HIV stigma, including distancing, blaming, and discrimination dimensions. This scale was administered at the baseline mental health service visit and then re-administered at the three-month follow-up point. Study results showed reductions in self-reported perceived HIV stigma over time for the distancing (t = 4.01, p = 0.000, d = 0.43), blaming (t = 2.79, p = 0.008, d = 0.35), and discrimination (t = 2.90, p = 0.006, d = 0.42) dimensions of stigma. These findings suggest that participation in HIV mental health services may have a favorable impact on perceived HIV stigma. Implications of these findings are discussed, including possible mechanisms that might explain the observed results as well as suggested directions for future research in this area. Randomized controlled trials would represent an important next step to investigate the extent to which HIV mental health services can reduce levels of perceived HIV stigma.

  6. Social Stigma and Knowledge of Tuberculosis and HIV among Patients with Both Diseases in Thailand

    Science.gov (United States)

    Jittimanee, Sirinapha X.; Nateniyom, Sriprapa; Kittikraisak, Wanitchaya; Burapat, Channawong; Akksilp, Somsak; Chumpathat, Nopphanath; Sirinak, Chawin; Sattayawuthipong, Wanchai; Varma, Jay K.

    2009-01-01

    Introduction Disease-related stigma and knowledge are believed to be associated with patients' willingness to seek treatment and adherence to treatment. HIV-associated tuberculosis (TB) presents unique challenges, because TB and HIV are both medically complex and stigmatizing diseases. In Thailand, we assessed knowledge and beliefs about these diseases among HIV-infected TB patients. Methods We prospectively interviewed and examined HIV-infected TB patients from three provinces and one national referral hospital in Thailand from 2005–2006. At the beginning of TB treatment, we asked patients standardized questions about TB stigma, TB knowledge, and HIV knowledge. Responses were grouped into scores; scores equal to or greater than the median score of study population were considered high. Multiple logistic regression analysis was used to identify factors associated with scores. Results Of 769 patients enrolled, 500 (65%) reported high TB stigma, 177 (23%) low TB knowledge, and 379 (49%) low HIV knowledge. Patients reporting high TB stigma were more likely to have taken antibiotics before TB treatment, to have first visited a traditional healer or private provider, to not know that monogamy can reduce the risk of acquiring HIV infection, and to have been hospitalized at enrollment. Patients with low TB knowledge were more likely to have severe TB disease, to be hospitalized at enrollment, to be treated at the national infectious diseases referral hospital, and to have low HIV knowledge. Patients with low HIV knowledge were more likely to know a TB patient and to have low TB knowledge. Discussion We found that stigma and low disease-specific knowledge were common among HIV-infected TB patients and associated with similar factors. Further research is needed to determine whether reducing stigma and increasing TB and HIV knowledge among the general community and patients reduces diagnostic delay and improves patient outcomes. PMID:19626120

  7. Self-stigma and empowerment in combined-CMHA and consumer-run services: two controlled trials.

    Science.gov (United States)

    Segal, Steven P; Silverman, Carol J; Temkin, Tanya L

    2013-10-01

    Self-help agencies (SHAs) are consumer-operated service organizations managed as participatory democracies involving members in all management tasks. Hierarchically organized board- and staff-run consumer-operated service programs (BSR-COSPs) are consumer managed, but they afford members less decision-making power. This study considered the relative effectiveness of SHAs and BSR-COSPs working jointly with community mental health agencies (CMHAs) and the role of organizational empowerment in reducing self-stigma. Clients seeking CMHA services were assigned in separate randomized controlled trials to a trial of combined SHA and CMHA services versus regular CMHA services (N=505) or to a trial of combined BSR-COSP and CMHA services versus regular CMHA services (N=139). Self-stigma, organizational empowerment, and self-efficacy were assessed at baseline and eight months with the Attitudes Toward Persons With Mental Illness Scale, the Organizationally Mediated Empowerment Scale, and the Self-Efficacy Scale. Outcomes were evaluated with fully recursive path analysis models. SHA-CMHA participants experienced greater positive change in self-stigma than CMHA-only participants, a result attributable to participation in the combined condition (b=1.20, p=.016) and increased organizational empowerment (b=.27, p=.003). BSR-COSP-CMHA participants experienced greater negative change in self-stigma than CMHA-only participants, a result attributable to participation in the combined service (b=-4.73, p=.031). In the SHA-CMHA trial, participants showed positive change in self-efficacy, whereas the change among BSR-COSP-CMHA participants was negative. Differential organizational empowerment efforts in the SHA and BSR-COSP appeared to account for the differing outcomes. Members experienced reduced self-stigma and increases in self-efficacy when they were engaged in responsible roles.

  8. Measuring stigma in people with HIV: psychometric assessment of the HIV stigma scale.

    Science.gov (United States)

    Berger, B E; Ferrans, C E; Lashley, F R

    2001-12-01

    An instrument to measure the stigma perceived by people with HIV was developed based on the literature on stigma and psychosocial aspects of having HIV. Items surviving two rounds of content review were assembled in a booklet and distributed through HIV-related organizations across the United States. Psychometric analysis was performed on 318 questionnaires returned by people with HIV (19% women, 21% African American, 8% Hispanic). Four factors emerged from exploratory factor analysis: personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes toward people with HIV. Extraction of one higher-order factor provided evidence of a single overall construct. Construct validity also was supported by relationships with related constructs: self-esteem, depression, social support, and social conflict. Coefficient alphas between .90 and .93 for the subscales and .96 for the 40-item instrument provided evidence of internal consistency reliability. The HIV Stigma Scale was reliable and valid with a large, diverse sample of people with HIV.

  9. Stigma in the Area of Intellectual Disabilities: Examining a Conceptual Model of Public Stigma.

    Science.gov (United States)

    Werner, Shirli

    2015-09-01

    Studies in the area of intellectual disability (ID) stigma are few and atheoretical. This study examined the adequacy of the conceptual framework of stigma from the mental illness field regarding ID. Telephone interviews were conducted with a nationally representative sample of 304 adults in Israel. Participants were read a vignette describing a man with ID and answered items related to cognitive, emotional, and behavioral reactions. Behavioral dimensions included: Withdrawal, Social distance, and Helping behaviors. The stigma process leading to Withdrawal was drawn through Negative affect, whereas the process to Social distance was drawn through Calm affect. One unique aspect of the stigma process in ID is the importance of Calm affect, which helped reduce Social distance.

  10. Pollen size strongly correlates with stigma depth among Pedicularis species

    Institute of Scientific and Technical Information of China (English)

    Xiang-Ping Wang; Wen-Bin Yu; Shi-Guo Sun; Shuang-Quan Huang

    2016-01-01

    Darwin proposed that pollen size should be positively correlated with stigma depth rather than style length among species given that pollen tubes first enter the stigma autotrophically, then grow through the style heterotrophically. However, studies often show a positive relationship between pollen size and style length. Five floral traits were observed to be correlated among 42 bumblebee-pollinated Pedicularis species (Orobanchaceae) in which stigmas are distinct from styles. The phylogenetic independent contrast analysis revealed that pollen grain volume was more strongly correlated with stigma depth than with style length, consistent with Darwin’s functional hypothesis between pollen size and stigma depth.

  11. Stigma of Mental Illness-2: Non-compliance and Intervention

    Directory of Open Access Journals (Sweden)

    Amresh Shrivastava

    2012-01-01

    Full Text Available The consequences of stigma are preventable. We argue that individual attention should be provided to patients when dealing with stigma. Also, in order to deal with the impact of stigma on an individual basis, it needs to be assessed during routine clinical examinations, quantified and followed up to observe whether or not treatment can reduce its impact. A patient-centric anti-stigma programme that delivers the above is urgently needed. To this end, this review explores the experiences, treatment barriers and consequences due to stigma. We also offer putative solutions to this problem.

  12. Impact of HIV-related stigma on treatment adherence: systematic review and meta-synthesis

    Directory of Open Access Journals (Sweden)

    Ingrid T Katz

    2013-11-01

    Full Text Available Introduction: Adherence to HIV antiretroviral therapy (ART is a critical determinant of HIV-1 RNA viral suppression and health outcomes. It is generally accepted that HIV-related stigma is correlated with factors that may undermine ART adherence, but its relationship with ART adherence itself is not well established. We therefore undertook this review to systematically assess the relationship between HIV-related stigma and ART adherence. Methods: We searched nine electronic databases for published and unpublished literature, with no language restrictions. First we screened the titles and abstracts for studies that potentially contained data on ART adherence. Then we reviewed the full text of these studies to identify articles that reported data on the relationship between ART adherence and either HIV-related stigma or serostatus disclosure. We used the method of meta-synthesis to summarize the findings from the qualitative studies. Results: Our search protocol yielded 14,854 initial records. After eliminating duplicates and screening the titles and abstracts, we retrieved the full text of 960 journal articles, dissertations and unpublished conference abstracts for review. We included 75 studies conducted among 26,715 HIV-positive persons living in 32 countries worldwide, with less representation of work from Eastern Europe and Central Asia. Among the 34 qualitative studies, our meta-synthesis identified five distinct third-order labels through an inductive process that we categorized as themes and organized in a conceptual model spanning intrapersonal, interpersonal and structural levels. HIV-related stigma undermined ART adherence by compromising general psychological processes, such as adaptive coping and social support. We also identified psychological processes specific to HIV-positive persons driven by predominant stigmatizing attitudes and which undermined adherence, such as internalized stigma and concealment. Adaptive coping and social

  13. Perceived HIV-Associated Stigma among HIV-Seropositive Men: Psychometric Study of HIV Stigma Scale

    OpenAIRE

    Valle, Adrian; Treviño,Ana Cecilia; Zambrano, Farith Francisco; Urriola, Karla Elizabeth; Sánchez, Luis Antonio; Elizondo,Jesus Eduardo

    2015-01-01

    Objectives To assess the internal consistency and factor structure of the abridged Spanish version of the Berger HIV Stigma Scale (HSS-21), to provide evidence for its convergent and discriminant validity, and to describe perceived stigma in an urban population from northeast Mexico. Methods Seventy-five HIV-positive men who have sex with men (MSM) were recruited. Participants answered the Spanish versions of three Likert-type scales: HSS-21, Robsenberg’s self-esteem scale, and the abbreviate...

  14. Perceived HIV-associated stigma among HIV-seropositive men: psychometric study of HIV stigma scale

    OpenAIRE

    Adrian eValle; Ana Cecilia Treviño; Farith Francisco Zambrano; Karla Elizabeth Urriola; Luis Antonio Sánchez; Jesus Eduardo Elizondo

    2015-01-01

    Objectives: To assess the internal consistency and factor structure of the abridged Spanish version of the Berger HIV Stigma Scale (HSS-21), provide evidence for its convergent and discriminant validity, and describe perceived stigma in an urban population from northeast Mexico. Methods: Seventy five HIV-positive men who have sex with men (MSM) were recruited. Participants answered the Spanish versions of three Likert-type scales: HSS-21, Robsenberg’s self-esteem scale, and the abbreviated ve...

  15. Weight stigma and eating behaviors on a college campus: Are students immune to stigma's effects?

    Directory of Open Access Journals (Sweden)

    Alexandra Brewis, PhD

    2016-12-01

    Full Text Available College populations are groups of emerging adults undergoing significant transitions in eating and diet, being exposed to new social influences; many experience weight gain. Theoretically, college campuses should be places where weight stigma is evident and matters for dietary decision-making. We present the findings from two studies conducted within the same college population at a large public university, including anthropometric measures of body mass. Study 1 included two different measures of weight stigma (implicit and explicit and measures of weight-control eating behaviors and fruit and vegetable consumption in a randomized representative sample of 204 students. Study 2 included a measure of weight responsibility and multiple measures of eating (food frequency, alcohol intake, and 24-hour dietary recalls, among freshman students (n = 202, n = 157 with 24-hour dietary recalls. Study 1 showed that the three types of stigmas were prevalent. Study 2 had a high prevalence of weight stigma attitudes and demonstrated the occurrence of unhealthful eating and binge drinking behaviors. Both studies found no relationship between weight stigma/responsibility and eating behaviors regardless of weight status. Beyond considering limitations of the study design, we propose two possible reasons for college students' relative immunity to the effects of weight stigma. Those with very high levels of stigma could be suppressing stigmatizing attitudes based on what they think others think is acceptable in a liberal college setting, or the chaotic form of “normal” eating in this population hides the effects of weight stigma.

  16. Changing College Students' Conceptions of Autism: An Online Training to Increase Knowledge and Decrease Stigma

    Science.gov (United States)

    Gillespie-Lynch, Kristen; Brooks, Patricia J.; Someki, Fumio; Obeid, Rita; Shane-Simpson, Christina; Kapp, Steven K.; Daou, Nidal; Smith, David Shane

    2015-01-01

    College students with autism may be negatively impacted by lack of understanding about autism on college campuses. Thus, we developed an online training to improve knowledge and decrease stigma associated with autism among college students. Participants (N = 365) completed a pre-test, online training, and post-test. Women reported lower stigma…

  17. Stigma variability in saffron (Crocus sativus L.)

    African Journals Online (AJOL)

    STORAGESEVER

    2009-02-18

    Feb 18, 2009 ... Iran, Asia Minor or Greece and later became widespread in India, China, the ... food colorant, and as a component of drugs and perfumes (Mathew .... lation between the above trend and genetic variability, the stigma yield of ...

  18. An EST database from saffron stigmas

    Directory of Open Access Journals (Sweden)

    Chiusano Maria Luisa

    2007-10-01

    Full Text Available Abstract Background Saffron (Crocus sativus L., Iridaceae flowers have been used as a spice and medicinal plant ever since the Greek-Minoan civilization. The edible part – the stigmas – are commonly considered the most expensive spice in the world and are the site of a peculiar secondary metabolism, responsible for the characteristic color and flavor of saffron. Results We produced 6,603 high quality Expressed Sequence Tags (ESTs from a saffron stigma cDNA library. This collection is accessible and searchable through the Saffron Genes database http://www.saffrongenes.org. The ESTs have been grouped into 1,893 Clusters, each corresponding to a different expressed gene, and annotated. The complete set of raw EST sequences, as well as of their electopherograms, are maintained in the database, allowing users to investigate sequence qualities and EST structural features (vector contamination, repeat regions. The saffron stigma transcriptome contains a series of interesting sequences (putative sex determination genes, lipid and carotenoid metabolism enzymes, transcription factors. Conclusion The Saffron Genes database represents the first reference collection for the genomics of Iridaceae, for the molecular biology of stigma biogenesis, as well as for the metabolic pathways underlying saffron secondary metabolism.

  19. Stigma in attention deficit hyperactivity disorder

    NARCIS (Netherlands)

    Müller, Kathi; Fuermaier, Anselm B M; Koerts, Janneke; Tucha, Lara

    Attention deficit hyperactivity disorder (ADHD) is a frequently diagnosed disorder in child- and adulthood with a high impact affecting multiple facets of social life. Therefore, patients suffering from ADHD are at high risk to be confronted with stigma, prejudices, and discrimination. A review of

  20. Why Frankenstein is a Stigma Among Scientists.

    Science.gov (United States)

    Nagy, Peter; Wylie, Ruth; Eschrich, Joey; Finn, Ed

    2017-06-26

    As one of the best known science narratives about the consequences of creating life, Mary Shelley's Frankenstein; or, The Modern Prometheus (1818) is an enduring tale that people know and understand with an almost instinctive familiarity. It has become a myth reflecting people's ambivalent feelings about emerging science: they are curious about science, but they are also afraid of what science can do to them. In this essay, we argue that the Frankenstein myth has evolved into a stigma attached to scientists that focalizes the public's as well as the scientific community's negative reactions towards certain sciences and scientific practices. This stigma produces ambivalent reactions towards scientific artifacts and it leads to negative connotations because it implies that some sciences are dangerous and harmful. We argue that understanding the Frankenstein stigma can empower scientists by helping them revisit their own biases as well as responding effectively to people's expectations for, and attitudes towards, scientists and scientific artifacts. Debunking the Frankenstein stigma could also allow scientists to reshape their professional identities so they can better show the public what ethical and moral values guide their research enterprises.

  1. Resisting the Stigma of Mental Illness

    Science.gov (United States)

    Thoits, Peggy A.

    2011-01-01

    The relationship between stigmatization and the self-regard of patients/consumers with mental disorder is negative but only moderate in strength, probably because a subset of persons with mental illness resists devaluation and discrimination by others. Resistance has seldom been discussed in the stigma and labeling literatures, and thus conditions…

  2. Reducing the Stigma of Mental Illness.

    Science.gov (United States)

    Brown, Kaylene; Bradley, Loretta J.

    2002-01-01

    Each year, an estimated 50 million Americans will experience a mental disorder while only one fourth of them will seek mental health services. Contends that this disparity results from the stigma attached to mental illness. Proposes that counselors must educate the general public about the misconceptions of mental illness and advocate for parity…

  3. Stigma in attention deficit hyperactivity disorder

    NARCIS (Netherlands)

    Müller, Kathi; Fuermaier, Anselm B M; Koerts, Janneke; Tucha, Lara

    2012-01-01

    Attention deficit hyperactivity disorder (ADHD) is a frequently diagnosed disorder in child- and adulthood with a high impact affecting multiple facets of social life. Therefore, patients suffering from ADHD are at high risk to be confronted with stigma, prejudices, and discrimination. A review of t

  4. Resisting the Stigma of Mental Illness

    Science.gov (United States)

    Thoits, Peggy A.

    2011-01-01

    The relationship between stigmatization and the self-regard of patients/consumers with mental disorder is negative but only moderate in strength, probably because a subset of persons with mental illness resists devaluation and discrimination by others. Resistance has seldom been discussed in the stigma and labeling literatures, and thus conditions…

  5. The Stigma of Suicide Scale. Psychometric properties and correlates of the stigma of suicide.

    Science.gov (United States)

    Batterham, Philip J; Calear, Alison L; Christensen, Helen

    2013-01-01

    There are presently no validated scales to adequately measure the stigma of suicide in the community. The Stigma of Suicide Scale (SOSS) is a new scale containing 58 descriptors of a "typical" person who completes suicide. To validate the SOSS as a tool for assessing stigma toward suicide, to examine the scale's factor structure, and to assess correlates of stigmatizing attitudes. In March 2010, 676 staff and students at the Australian National University completed the scale in an online survey. The construct validity of the SOSS was assessed by comparing its factors with factors extracted from the Suicide Opinion Questionnaire (SOQ). Three factors were identified: stigma, isolation/depression, and glorification/normalization. Each factor had high internal consistency and strong concurrent validity with the Suicide Opinion Questionnaire. More than 25% of respondents agreed that people who suicided were "weak," "reckless," or "selfish." Respondents who were female, who had a psychology degree, or who spoke only English at home were less stigmatizing. A 16-item version of the scale also demonstrated robust psychometric properties. The SOSS is the first attitudes scale designed to directly measure the stigma of suicide in the community. Results suggest that psychoeducation may successfully reduce stigma.

  6. Stigma in leprosy: miles to go!

    Science.gov (United States)

    Sinha, A; Kushwaha, A S; Kotwal, A; Sanghi, S; Verma, A K

    2010-01-01

    No disease has been more closely associated with stigma than leprosy such that it has become a metaphor for stigma. Stigma has been difficult to measure and little research has been done on this issue. Stigma reduction has not been an important component of anti-leprosy program. The study was undertaken to measure the stigma associated with leprosy by using P scale which is used for assessing participation restriction of those affected by the disease. This comparative questionnaire based study was carried out in two sets of patients. Two groups of 30 patients each were studied. First group belonged to a Government run Leprosarium and group two from a tertiary care skin and leprosy centre. The study used the Participation (P) scale and data was collected by interviewing the patients. Participation restriction was defined as any score equal to and more than 13. Participation restriction was observed in 27 (90%) cases of group 1while participation restriction was present in only 7 (23.3%) subjects of group 2. It was observed that mean score of participation restriction in group 1 was quite high at 31.9 while it was only 8.3 for group 2. The participation restriction was directly related to the duration of disease and the grade of disability. Longer the duration of disease, greater was the likelihood of restriction. The participation restriction was found to be negatively correlated with the education. Recommendation about prevention of disability would require program about early diagnosis of nerve damage and subsequent action at the patient-family-community level and health care providers.

  7. Descriptive epidemiology of stigma against depression in a general population sample in Alberta

    Directory of Open Access Journals (Sweden)

    Wang JianLi

    2010-04-01

    Full Text Available Abstract Background Mental health illnesses, such as depression, are responsible for a growing disease burden worldwide. Unfortunately, effective treatment is often impeded by stigmatizing attitudes of other individuals, which have been found to lead to a number of negative consequences including reduced help-seeking behavior and increased social distance. Despite the high prevalence of depression in Canada, little research has been conducted to examine stigma against depression in the Canadian general population. Such information is crucial to understanding the current state of stigmatizing attitudes in the Canadian communities, and framing future stigma reduction initiatives. The objectives of this study were to estimate the percentages of various stigmatizing attitudes toward depression in a general population sample and to compare the percentages by demographics and socioeconomic characteristics. Methods We conducted a cross-sectional telephone survey in Alberta, Canada, between February and June 2006. Random digit dialing was used to recruit participants who were aged 18-74 years old (n = 3047. Participants were presented a case vignette describing a depressed individual, and responded to a 9-item Personal Stigma questionnaire. The percentages of stigmatizing attitudes were estimated and compared by demographic and socioeconomic variables. Results Among the participants, 45.9% endorsed that depressed individuals were unpredictable and 21.9% held the view that people with depression were dangerous. Significant differences in stigmatizing attitudes were found by gender, age, education, and immigration status. A greater proportion of men than women held stigmatizing views on each stigma item. No consistent trend emerged by age in stigma against depression. Participants with higher levels of education reported less stigmatizing attitudes than those with less education. Participants who were not born in Canada were more likely to hold

  8. Perceived Stigma and Quality of Life in Patients Following Recovery From Delirium.

    Science.gov (United States)

    Kim, Seon-Young; Kim, Jae-Min; Kim, Sung-Wan; Kang, Hee-Ju; Lee, Ju-Yeon; Bae, Kyung-Yeol; Shin, Il-Seon; Yoon, Jin-Sang

    2017-07-01

    To elucidate the factors related to perceived stigma and quality of life (QoL) in patients who have recovered from delirium. This prospective cohort investigation of patients with delirium, as diagnosed according to DSM-IV-TR criteria, was conducted from July 2011 to May 2013. The perceived stigma level and QoL of each patient was assessed using the Perceived Stigma of Delirium Scale (PSDS) and European Quality of Life Visual Analog Scale (EQ-VAS), respectively, following recovery from delirium. Several clinical characteristics were assessed at baseline and after recovery from delirium, and a multivariate linear regression analysis was conducted. This study included 128 patients who completed a follow-up assessment after recovery from delirium. A multivariate analysis revealed that patients who had a history of depression (B = 3.34, P = .026), could recall their experiences with delirium (B = 1.71, P = .011), and had a longer duration from delirium detection to recovery (B = 1.39, P = .012) obtained higher PSDS scores than patients without these characteristics. The ability to recall delirium experiences (B = -7.17, P = .026) and the use of antipsychotics at follow-up assessment (B = -7.87, P = .039) were associated with lower EQ-VAS scores. Additionally, PSDS scores were negatively correlated with EQ-VAS scores (r = -0.37, P delirium reported varying degrees of perceived stigma and that the ability to recall their delirium experiences was associated with a higher stigma and a poorer QoL. These findings suggest that care teams should pay more attention to perceived stigma in patients with delirium.

  9. Self-motion perception compresses time experienced in return travel.

    Science.gov (United States)

    Seno, Takeharu; Ito, Hiroyuki; Shoji, Sunaga

    2011-01-01

    It is often anecdotally reported that time experienced in return travel (back to the start point) seems shorter than time spent in outward travel (travel to a new destination). Here, we report the first experimental results showing that return travel time is experienced as shorter than the actual time. This discrepancy is induced by the existence of self-motion perception.

  10. Antiretroviral treatment knowledge and stigma--implications for programs and HIV treatment interventions in rural Tanzanian populations.

    Directory of Open Access Journals (Sweden)

    Abela Mpobela Agnarson

    Full Text Available OBJECTIVE: To analyse antiretroviral treatment (ART knowledge and HIV- and ART-related stigma among the adult population in a rural Tanzanian community. DESIGN: Population-based cross-sectional survey of 694 adults (15-49 years of age. METHODS: Latent class analysis (LCA categorized respondents' levels of ART knowledge and of ART-related stigma. Multinomial logistic regression assessed the association between the levels of ART knowledge and HIV- and ART-related stigma, while controlling for the effects of age, gender, education, marital status and occupation. RESULTS: More than one-third of men and women in the study reported that they had never heard of ART. Among those who had heard of ART, 24% were east informed about ART, 8% moderately informed, and 68% highly informed. Regarding ART-related stigma, 28% were least stigmatizing, 41% moderately stigmatizing, and 31% highly stigmatizing toward persons taking ART. Respondents that had at least primary education were more likely to have high levels of knowledge about ART (OR 3.09, 95% CI 1.61-5.94. Participants highly informed about ART held less HIV- and ART-related stigma towards ART patients (OR 0.26, 95% CI 0.09-0.74. CONCLUSION: The lack of ART knowledge is broad, and there is a strong association between ART knowledge and individual education level. These are relevant findings for both HIV prevention and HIV treatment program interventions that address ART-related stigma across the entire spectrum of the community.

  11. Insight and satisfaction with life among adolescents with mental disorders: assessing associations with self-stigma and parental insight.

    Science.gov (United States)

    Gaziel, M; Hasson-Ohayon, I; Morag-Yaffe, M; Schapir, L; Zalsman, G; Shoval, G

    2015-02-01

    The purpose of the current study was to assess the associations of illness perception-related variables with satisfaction with life (SwL) among adolescents with mental disorders. Insight into mental disorder (SAI-E), Internalized stigma of mental illness (ISMI) and Multidimensional Students' Life Satisfaction Scale (MSLSS) were administrated to 30 adolescent patients. Adapted version for parents of the SAI-E was also administrated to 37 of their parents. Significant positive correlations were found between insight into the illness, self-stigma and parental insight. Insight and self-stigma were significantly negatively related to the total score of SwL and few of its dimensions while parental insight was significantly associated only with the SwL dimensions of school and self. Regression models revealed main negative effects of insight and self-stigma on SwL and no interaction effect. The possible independent contribution of insight and self-stigma to SwL should be addressed in interventions designed for family and adolescents coping with mental illness. Special attention should be given to the possible negative implications that insight possesses. In lack of support of the moderation role of self-stigma, reported in studies among adults with mental illness, future studies should trace other variables in order to further understand the insight paradox among adolescents. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  12. Stigma as a stressor and transition to schizophrenia after one year among young people at risk of psychosis.

    Science.gov (United States)

    Rüsch, Nicolas; Heekeren, Karsten; Theodoridou, Anastasia; Müller, Mario; Corrigan, Patrick W; Mayer, Benjamin; Metzler, Sibylle; Dvorsky, Diane; Walitza, Susanne; Rössler, Wulf

    2015-08-01

    According to stress-vulnerability models, social stressors contribute to the onset of schizophrenia. Stigma and discrimination associated with mental illness may be a stressor for young people at risk of psychosis even prior to illness onset, but quantitative longitudinal data on this issue are lacking. We examined the cognitive appraisal of stigma-related stress as predictor of transition to schizophrenia among young people at risk of psychosis. In Zürich, Switzerland, 172 participants between 13 and 35years old and with either high or ultra-high risk of psychosis or risk of bipolar disorder were included. With 71 dropouts, transition was assessed during 12months among 101 participants of whom 13 converted to schizophrenia. At baseline, the cognitive appraisal of stigma as a stressor was measured by self-report, based on the primary appraisal of stigma as harmful and the secondary appraisal of resources to cope with stigma. Positive and negative symptoms were examined using the Positive and Negative Syndrome Scale. Compared with participants who did not convert to schizophrenia, converters had significantly more positive (prisk of transition to schizophrenia. Research is needed on interventions that reduce public negative attitudes towards young people at risk and that support individuals at risk to cope with stigma-related stress. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. When Ideals Get in the Way of Self-Care: Perfectionism and Self-Stigma for Seeking Psychological Help among High School Students

    Science.gov (United States)

    Zeifman, Richard J.; Atkey, Sarah K.; Young, Rebecca E.; Flett, Gordon L.; Hewitt, Paul L.; Goldberg, Joel O.

    2015-01-01

    In the current study, we investigated whether adolescents high in perfectionism are prone to experiencing self-stigma for seeking psychological help. This work is based on the premise that the need to seek help for psychological difficulties is not consistent with idealistic personal goals of perfectionistic young people and their desire to retain…

  14. Managing the terror of a dangerous world: Political attitudes as predictors of mental health stigma.

    Science.gov (United States)

    DeLuca, Joseph S; Yanos, Philip T

    2016-02-01

    Previous research has associated self-reported political conservatism to mental health stigma. Although the limitations of self-reported political attitudes are well documented, no study has evaluated this relationship from a more nuanced perspective of sociopolitical identity. To assess the relationship between political attitudes and mental health stigma (i.e. negative stereotypes and intended social distance), particularly from a standpoint of Right-Wing Authoritarianism (RWA)--a more specific measure of political conservatism. A sample of 505 New York State residents completed an online survey. The results of this study indicated significant relationships between endorsements of self-reported conservatism and RWA to negative stereotypes and social distance in relation to mental illness. Individuals with 'High RWA' were more likely to see individuals with mental illness as dangerous and unpredictable, and less willing to want to socially associate with individuals with mental illness. These results remained statistically significant even when controlling for other factors that consistently predict mental health stigma. Negative stereotypes also partially mediated individuals with RWA's significant relationship to social distance. Characteristics of political conservatives and right-wing authoritarians (e.g. threat-aversion, personal responsibility) are predictive of mental health stigma. Terror Management Theory may also help to explain this phenomenon. © The Author(s) 2015.

  15. Stigma and perception of psychological distress and depression in Australian-trained medical students: results from an inter-state medical school survey.

    Science.gov (United States)

    Cheng, Daryl R; Poon, Flora; Nguyen, Tran T; Woodman, Richard J; Parker, Jun D

    2013-10-30

    Stigmatisation towards depression has previously been reported amongst medical students from a variety of backgrounds. This study explored personal and perceived stigmas associated with depression, and their relationship with demographics, knowledge of depression, levels of personal stress and history of medical illness amongst Australian-trained medical students. A cross-sectional survey was undertaken amongst students enroled June-to-August 2009 across four Australian medical schools. In total, 1010 students completed the survey, a response rate of 29.6%. Approximately 25% of students reported a past history of depression. Higher stress (K-10 scores) was reported by females and those with a past history of depression. On a scale of 0-to-5, the mean (±S.D.) personal and perceived stigma depression scores were 1.83±1.49 and 4.05±1.42 respectively. In multivariate analysis, higher perceived stigma and K-10 scores, a past history of anxiety and Year 3 of medical school indicated higher personal stigma scores. Perceived stigma was positively associated with K-10 scores, personal stigma scores, and a Caucasian background. Our findings suggest a high level of personal and particularly perceived stigma associated with depression amongst medical students, especially those displaying higher levels of stress. Adequate support and screening for psychological stress may de-stigmatise depression and improve mental health amongst future Australian doctors.

  16. Self-stigma among caregivers of people with mental illness: toward caregivers’ empowerment

    Directory of Open Access Journals (Sweden)

    Girma E

    2014-01-01

    perceived psychosocial and biological explanations of mental illness (r=0.12, P<0.01. The only independent predictor of caregivers' self-stigma was perceived supernatural explanation of mental illness (standardized β=0.22, P<0.001. Conclusion: The tendency of caregivers to avoid being identified with the patients was observed. Low exposure to mental health information was also reported. Caregivers' self-stigma in this study was significantly correlated with perceived supernatural explanation of mental illness. Since caregivers' self-stigma may negatively influence patients' treatment-seeking, adherence, and rehabilitation processes, programs that enhance coping strategies by strengthening self-esteem and empowerment by health care providers and establish family support groups may be helpful to tackle self-stigma among caregivers of people with mental illness. Keywords: self-stigma, internalized stigma, caregivers, mental illness

  17. Associations between HIV-related stigma, racial discrimination, gender discrimination, and depression among HIV-positive African, Caribbean, and Black women in Ontario, Canada.

    Science.gov (United States)

    Logie, Carmen; James, Llana; Tharao, Wangari; Loutfy, Mona

    2013-02-01

    Abstract African, Caribbean, and Black (ACB) women are greatly overrepresented in new HIV infections in comparison with Canada's general population. Social and structural factors such as HIV-related stigma, gender discrimination, and racial discrimination converge to increase vulnerability to HIV infection among ACB women by reducing access to HIV prevention services. Stigma and discrimination also present barriers to treatment, care, and support and may contribute to mental health problems. We administered a cross-sectional survey to HIV-positive ACB women (n=173) across Ontario in order to examine the relationships between HIV-related stigma, gender discrimination, racial discrimination, and depression. One-third of participants reported moderate/severe depression scores using the Beck Depression Inventory Fast-Screen guidelines. Hierarchical block regression, moderation, and mediation analyses were conducted to measure associations between independent (HIV-related stigma, gender discrimination, racial discrimination), moderator/mediator (social support, resilient coping), and dependent (depression) variables. Findings included: (1) HIV-related stigma was associated with increased depression; (2) resilient coping was associated with reduced depression but did not moderate the influence of HIV-related stigma on depression; and (3) the effects of HIV-related stigma on depression were partially mediated through resilient coping. HIV-related stigma, gender discrimination, and racial discrimination were significantly correlated with one another and with depression, highlighting the salience of examining multiple intersecting forms of stigma. Generalizability of findings may be limited due to nonrandom sampling. Findings emphasize the importance of multi-component interventions, including building resilient coping skills, mental health promotion and assessment, and stigma reduction programs.

  18. HIV/AIDS stigma among a sample of primarily African-American and Latino men who have sex with men social media users.

    Science.gov (United States)

    Garett, Renee; Smith, Justin; Chiu, Jason; Young, Sean D

    2016-01-01

    The recent increase in social media use allows these technologies to rapidly reach communities with higher HIV prevalence, such as African-American and Latino men who have sex with men (MSM). However, no studies have looked at HIV/AIDS stigma among social media users from African-American and Latino MSM communities, or the association between stigma and social media use among these groups. This study sought to assess the level of HIV/AIDS stigma among a sample of social media-using African-American and Latino MSM from Los Angeles. A total of 112 (primarily African-American and Latino, n = 98, 88%) MSM Facebook users completed a survey on demographics, online social network use, and HIV/AIDS stigma. A composite stigma score was created by taking the cumulative score from a 15-item stigma questionnaire. Cumulative logistic models were used to assess the association between HIV/AIDS stigma and online social network use. In general, participants reported a low level of HIV/AIDS stigma (mean = 22.2/75, SD = 5.74). HIV/AIDS stigma composite score was significantly associated with increased time spent on online social networks each day (Adjusted odds ratios (AOR): 1.07, 95% CI: 1.00, 1.15). Among this diverse sample of MSM online social network users, findings suggest that HIV/AIDS stigma is associated with usage of social media. We discuss the implications of this work for future HIV prevention.

  19. A comparison of stigma among patients with leprosy in rural Tanzania and urban United States: a role for public health in dermatology.

    Science.gov (United States)

    Roosta, Neda; Black, David S; Rea, Thomas H

    2013-04-01

      Leprosy is a chronic infection of the skin and peripheral nerves caused by the bacterium Mycobacterium leprae, which causes peripheral insensitivity and disfigurements of the skin, limbs, and digits. Social stigma is a common consequence of leprosy and may differ according to level of physical disfigurement and geographic location. The objective of this study was to assess social stigma encountered by patients with leprosy in clinical settings located in rural Tanzania and urban USA and to compare the social stigma reported in these regions.   A total of 56 respondents were recruited from one leprosy inpatient facility in Shirati, Tanzania (n = 28), and one outpatient clinic in Los Angeles, USA (n = 28). Cross-sectional data were obtained from face-to-face interviews, which were conducted with respondents at each clinic location. Measures of perceived stigma were assessed in family relationship, vocational, social interaction, and interpersonal contexts.   Patients in Tanzania, as compared with those in the USA, reported significantly higher levels of stigma in family relationship and vocational contexts. Tanzanian patients also reported higher levels of stigma in social interaction and self-esteem contexts, but these differences were marginally significant and may reflect the small sample size.   Leprosy-related social stigma is a major problem in regions of both developed and developing countries; however, patients with leprosy in developing countries reported higher levels of stigma in four social contexts. A public health role in dermatology is discussed as an agent of early diagnosis, control, and education in order to reduce social stigma and promote social rehabilitation. © 2013 The International Society of Dermatology.

  20. "When you're in a crisis like that, you don't want people to know": mortgage strain, stigma, and mental health.

    Science.gov (United States)

    Keene, Danya E; Cowan, Sarah K; Baker, Amy Castro

    2015-05-01

    We analyzed experiences of stigmatization, concealment, and isolation among African American homeowners who were experiencing mortgage strain. We conducted semistructured interviews between March 2012 and May 2013 with 28 African American homeowners in a northeastern US city who were experiencing mortgage strain. We coded all of the transcripts and reviewed data for codes relating to stigma, sharing information, social support, social isolation, and the meaning of homeownership. Our data showed that mortgage strain can be a concealable stigma. Participants internalized this stigma, expressing shame about their mortgage situation. Additionally, some participants anticipated that others would view them as less worthy given their mortgage trouble. In an effort to avoid stigmatization, many concealed their mortgage trouble, which often led to isolation. This stigmatization, concealment, and isolation seemed to contribute to participants' depression, anxiety, and emotional distress. Stigma may exacerbate stress associated with mortgage strain and contribute to poor mental health, particularly among upwardly mobile African Americans who have overcome significant structural barriers to home ownership. Reducing stigma associated with mortgage strain may help to reduce the health consequences of this stressful life event.

  1. Hubungan Ketidakpatuhan Pengobatan Dan Stigma Pada Keluarga Dengan Perawatan Kembali Pasien Skizofrenia Di RSJ Daerah Provinsi Sumatera Utara

    OpenAIRE

    Marpaung, Vera R.B.

    2010-01-01

    Schizophrenia is a chronic psychotic disorder which always relapses.The data obtained from the Medical Record of the Mental Hospital of North Sumatera Province showed that in 2008, 65% of the patients of schizophrenia treated experienced a relapse and caused their rehospitalization. The high rate of relapse in the patients of schizophrenia is predicted to be related to medication non-adherence and family stigma. The purpose of this explanatory survey study was to analyze the relationship...

  2. Abortion stigma: a reconceptualization of constituents, causes, and consequences.

    Science.gov (United States)

    Norris, Alison; Bessett, Danielle; Steinberg, Julia R; Kavanaugh, Megan L; De Zordo, Silvia; Becker, Davida

    2011-01-01

    Stigmatization is a deeply contextual, dynamic social process; stigma from abortion is the discrediting of individuals as a result of their association with abortion. Abortion stigma is under-researched and under-theorized, and the few existing studies focus only on women who have had abortions. We build on this work, drawing from the social science literature to describe three groups whom we posit are affected by abortion stigma: Women who have had abortions, individuals who work in facilities that provide abortion, and supporters of women who have had abortions, including partners, family, and friends, as well as abortion researchers and advocates. Although these groups are not homogeneous, some common experiences within the groups--and differences between the groups--help to illuminate how people manage abortion stigma and begin to reveal the roots of this stigma itself. We discuss five reasons why abortion is stigmatized, beginning with the rationale identified by Kumar, Hessini, and Mitchell: The violation of female ideals of sexuality and motherhood. We then suggest additional causes of abortion stigma, including attributing personhood to the fetus, legal restrictions, the idea that abortion is dirty or unhealthy, and the use of stigma as a tool for anti-abortion efforts. Although not exhaustive, these causes of abortion stigma illustrate how it is made manifest for affected groups. Understanding abortion stigma will inform strategies to reduce it, which has direct implications for improving access to care and better health for those whom stigma affects.

  3. Mental health stigma and primary health care decisions.

    Science.gov (United States)

    Corrigan, Patrick W; Mittal, Dinesh; Reaves, Christina M; Haynes, Tiffany F; Han, Xiaotong; Morris, Scott; Sullivan, Greer

    2014-08-15

    People with serious mental illness have higher rates of mortality and morbidity due to physical illness. In part, this occurs because primary care and other health providers sometimes make decisions contrary to typical care standards. This might occur because providers endorse mental illness stigma, which seems inversely related to prior personal experience with mental illness and mental health care. In this study, 166 health care providers (42.2% primary care, 57.8% mental health practice) from the Veteran׳s Affairs (VA) medical system completed measures of stigma characteristics, expected adherence, and subsequent health decisions (referral to a specialist and refill pain prescription) about a male patient with schizophrenia who was seeking help for low back pain due to arthritis. Research participants reported comfort with previous mental health interventions. Path analyses showed participants who endorsed stigmatizing characteristics of the patient were more likely to believe he would not adhere to treatment and hence, less likely to refer to a specialist or refill his prescription. Endorsement of stigmatizing characteristics was inversely related to comfort with one׳s previous mental health care. Implications of these findings will inform a program meant to enhance VA provider attitudes about people with mental illness, as well as their health decisions. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

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

    Science.gov (United States)

    Makanjuola, Victor; Esan, Yomi; Oladeji, Bibilola; Kola, Lola; Appiah-Poku, John; Harris, Benjamin; Othieno, Caleb; Price, Leshawndra; Seedat, Soraya; Gureje, Oye

    2016-12-01

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

  5. Stigma and Discrimination in People Suffering with a Mood Disorder: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    L. Lazowski

    2012-01-01

    Full Text Available Background. Much research is done on the stigma of mental illness, but little research has been done to characterize these phenomena from the perspective of people with mood disorders. Objective. To characterize the extent to which individuals with bipolar disorder and depression are stigmatized, determine factors related to higher levels of stigmatization, and assess the reliability of the Inventory of Stigmatizing Experiences in a population of people with a mood disorder. Methods. Two hundred and fourteen individuals with depression and bipolar disorder were recruited from a tertiary care psychiatric hospital and surveyed using the Inventory of Stigmatizing Experiences. Results. Participants reported high levels of stigma experiences and this did not differ by diagnosis (P=0.578. However, people with bipolar disorder reported greater psychosocial impact of stigma on themselves and their family members compared to people with depression (P=0.019. The two subscales produced internally consistent results with both populations. Conclusion. Stigma negatively affects those with both depression and bipolar disorder but appears to have a greater psychosocial impact on those with bipolar disorder.

  6. Stigma and barriers to accessing mental health services perceived by Air Force nursing personnel.

    Science.gov (United States)

    Hernandez, Stephen H A; Bedrick, Edward J; Parshall, Mark B

    2014-11-01

    We investigated perceptions of stigma and barriers associated with accessing mental health services among active component U.S. Air Force officer and enlisted nursing personnel (N = 211). The Britt and Hoge et al Stigma scale and Hoge et al Barriers to Care scale were administered via an anonymous, online survey. Stigma items pertained to concerns that might affect decisions to seek mental health treatment. Most of the sample agreed with the items "Members of my unit might have less confidence in me" and "My unit leadership might treat me differently." Approximately 20% to 46% agreed with the other four stigma items. Officer nursing personnel were significantly more likely than enlisted to agree that accessing mental health services would be embarrassing, harm their career, or cause leaders to blame them for the problem (p ≤ 0.03 for each comparison). Getting time off from work for treatment and scheduling appointments were perceived as barriers by 41% and 21% of respondents, respectively. We conclude that proportions of Air Force nursing personnel reporting concerns about potential stigmatizing consequences of seeking mental health care are substantial and similar to ranges previously reported by military service members screening positive for mental health problems after deployment.

  7. Feasibility of using an iPod touch device and acceptability of a stigma reduction intervention with HIV-infected women in the Deep South.

    Science.gov (United States)

    Relf, Michael V; Silva, Susan G; Williams, Megan Scull; Moore, Elizabeth; Arscott, Joyell; Caiola, Courtney; Barroso, Julie

    2015-10-01

    As with many infectious diseases throughout history, stigma is a part of the trajectory of the HIV disease process. HIV-related stigma impedes women from being tested for HIV. Once infected, HIV-related stigma hinders women from disclosing their HIV status to sexual partners and health care providers, engaging in medical care, effectively self-managing the disease after infection, and adhering to anti-retroviral therapy. After three decades of the HIV epidemic, no evidenced-based, culturally relevant, gender-specific interventions exist to help women infected with HIV manage the stigma associated with HIV infection. This manuscript reports the feasibility of using an iPod touch device and acceptability of a stigma reduction intervention with HIV-infected women in the Deep South in a mixed-method, randomized clinical trial. Results from the study demonstrate that it is feasible to utilize an iPod touch device to deliver an HIV-related stigma intervention to women. Further, women report that the HIV-related stigma intervention is acceptable and meaningful.

  8. Stigma-Stop: A Serious Game against the Stigma toward Mental Health in Educational Settings.

    Science.gov (United States)

    Cangas, Adolfo J; Navarro, Noelia; Parra, José M A; Ojeda, Juan J; Cangas, Diego; Piedra, Jose A; Gallego, Jose

    2017-01-01

    This paper presents the results from the application of a serious game called Stigma-Stop among a group of high school students with the aim of reducing the stigma toward mental illnesses. The video game features characters with various mental disorders (schizophrenia, depression, bipolar disorder, and panic disorder with agoraphobia) and provides information about these problems. Additionally, the game asks players about whether they have ever felt the same as the characters, if they believe the characters are psychologically well, and if they think they could help these individuals. Similarly, a variety of reactions are provided for players to choose from when they encounter the characters with these problems. A total of 552 students between the ages of 14 and 18 participated in the study, and they were randomly assigned to either the experimental group, which used Stigma-Stop, or the control group, which utilized a video game completely unrelated to mental health. Both video games were used for similar lengths of time. Following the application of Stigma-Stop, a statistically significant decrease was obtained in levels of stigma toward schizophrenia, both in terms of stereotypes and, to a greater extent, its potential dangerousness. However, this was not the case in the control group. Results thus demonstrate the video game's usefulness toward eradicating erroneous notions about serious mental disorders like schizophrenia.

  9. Measuring stigma among abortion providers: assessing the Abortion Provider Stigma Survey instrument.

    Science.gov (United States)

    Martin, Lisa A; Debbink, Michelle; Hassinger, Jane; Youatt, Emily; Eagen-Torkko, Meghan; Harris, Lisa H

    2014-01-01

    We explored the psychometric properties of 15 survey questions that assessed abortion providers' perceptions of stigma and its impact on providers' professional and personal lives referred to as the Abortion Provider Stigma Survey (APSS). We administered the survey to a sample of abortion providers recruited for the Providers' Share Workshop (N = 55). We then completed analyses using Stata SE/12.0. Exploratory factor analysis, which resulted in 13 retained items and identified three subscales: disclosure management, resistance and resilience, and discrimination. Stigma was salient in abortion provider's lives: they identified difficulties surrounding disclosure (66%) and felt unappreciated by society (89%). Simultaneously, workers felt they made a positive contribution to society (92%) and took pride in their work (98%). Paired t-test analyses of the pre- and post-Workshop APSS scores showed no changes in the total score. However, the Disclosure Management subscale scores were significantly lower (indicating decreased stigma) for two subgroups of participants: those over the age of 30 and those with children. This analysis is a promising first step in the development of a quantitative tool for capturing abortion providers' experiences of and responses to pervasive abortion stigma.

  10. Stigma-Stop: A Serious Game against the Stigma toward Mental Health in Educational Settings

    Directory of Open Access Journals (Sweden)

    Adolfo J. Cangas

    2017-08-01

    Full Text Available This paper presents the results from the application of a serious game called Stigma-Stop among a group of high school students with the aim of reducing the stigma toward mental illnesses. The video game features characters with various mental disorders (schizophrenia, depression, bipolar disorder, and panic disorder with agoraphobia and provides information about these problems. Additionally, the game asks players about whether they have ever felt the same as the characters, if they believe the characters are psychologically well, and if they think they could help these individuals. Similarly, a variety of reactions are provided for players to choose from when they encounter the characters with these problems. A total of 552 students between the ages of 14 and 18 participated in the study, and they were randomly assigned to either the experimental group, which used Stigma-Stop, or the control group, which utilized a video game completely unrelated to mental health. Both video games were used for similar lengths of time. Following the application of Stigma-Stop, a statistically significant decrease was obtained in levels of stigma toward schizophrenia, both in terms of stereotypes and, to a greater extent, its potential dangerousness. However, this was not the case in the control group. Results thus demonstrate the video game’s usefulness toward eradicating erroneous notions about serious mental disorders like schizophrenia.

  11. Experiences of stigma among hepatitis B and C patients in Rawalpindi and Islamabad, Pakistan.

    Science.gov (United States)

    Rafique, I; Saqib, M A N; Siddiqui, S; Munir, M A; Qureshi, H; Javed, N; Naz, S; Tirmazi, I Z

    2015-02-02

    Hepatitis B and C are chronic diseases with mental and social impacts which can result in poor quality of life. The aim of this study was to determine the experiences of stigma in a sample of hepatitis B- and C-positive patients in Pakistan. In a cross-sectional study, 140 inpatients and outpatients from 3 tertiary-care hospitals in Islamabad and Rawalpindi answered a semi-structured questionnaire about stigma experienced from relatives, friends, spouse and health-care providers, and about work/financial problems. The majority of patients (75%) said they had had to change their lifestyle, and significantly more were males than females. Stigma was marked in terms of disease transmission, with 66% of patients fearing that they could transmit the infection to others; 19% said that family members avoided sharing towels, soap and eating and drinking utensils. Marital relationships were affected for 51% of married patients who had told their spouse. Patients' comments showed a sense of family and societal discrimination resulting in feelings of disappointment and isolation.

  12. 'We just stick together': how disabled teens negotiate stigma to create lasting friendship.

    Science.gov (United States)

    Salmon, N

    2013-04-01

    Friendship is a crucial relationship offering practical support, enjoyment and improved health. When disability is added into the mix, the permutations of friendship shift. Despite the presence of inclusive social policies many disabled teens continue to experience stigma and social isolation, yet some teens are able to establish long-term friendships. A nuanced understanding about how disabled teens navigate stigma to create lasting friendships was constructed through this qualitative study. Seven boys and seven girls between the ages 15 to 20 years who experienced disability engaged in research interviews and participant observation sessions. Nine adults were also interviewed. A critical approach to data analysis was complimented by coding in Atlas.ti. This article describes the strategies used by these disabled teens to make and keep friends: disrupting norms about friendship, coming out as disabled, connecting through stigma and choosing self-exclusion. Disabled teens in this study felt a greater sense of belonging when with peers who shared the disability experience, thus self-exclusion was a viable strategy for creating sustainable friendships in the context of oppression. Social policy informed by the experiences of disabled youth in the current study will more effectively promote social inclusion by first acknowledging and then disrupting ableism. © 2012 The Author. Journal of Intellectual Disability Research © 2012 Blackwell Publishing Ltd.

  13. A questionnaire to assess social stigma.

    Science.gov (United States)

    Tavormina, Maurilio Giuseppe Maria; Tavormina, Romina; Nemoianni, Eugenio; Tavormina, Giuseppe

    2015-09-01

    Psychiatric patients often suffer for two reasons: due to the illness and due to the social stigma of mental illness, that increases the uneasiness and psychic pain of the person suffering from serious psychiatric disorder. This unwell person is often the object of stigma because he is "different" from others, and he also can be margenalised by society. In this study we intend to assess whether these margenalising attitudes might be also present among mental health professionals who have presented psychic problems in a previous period of their life, against sick persons suffering of the same illness even if he is a mental health professional. Two questionnaires have been developed, one for professionals and another for the patients, with the aim of identifying these marginalising attitudes. We intend that this study shall be a multicenter, observational and international study, promoted by the Mental Health Dept. of Naples (ASL Naples 3 South, Italy).

  14. Noma in Laos: stigma of severe poverty in rural Asia.

    Science.gov (United States)

    Srour, M Leila; Watt, Bryan; Phengdy, Bounthom; Khansoulivong, Keutmy; Harris, Jim; Bennett, Christopher; Strobel, Michel; Dupuis, Christian; Newton, Paul N

    2008-04-01

    Noma, or cancrum oris, is a debilitating necrotizing ulcerative stomatitis that destroys the mouth and face. It usually starts in early childhood and is associated with severe poverty, malnutrition, and infections. It is most frequently described from sub-Saharan Africa but is under-reported. There have been very few reports from Asia. We describe the clinical and social features of a series of 12 patients with noma from remote poor villages in rural Lao People's Democratic Republic (Laos). Noma is an ominous stigma of severe poverty and the description of this disease emphasizes the importance of poverty reduction and nutritional improvement in Lao development. In the meantime, more awareness of the problem and the importance of early therapy in acute noma by primary health care workers may reduce mortality and prevent progression to severe disfigurement.

  15. Factors associated with HIV stigma and the impact of a nonrandomized multi-component video aimed at reducing HIV stigma among a high-risk population in New York City.

    Science.gov (United States)

    Rivera, Alexis V; DeCuir, Jennifer; Crawford, Natalie D; Amesty, Silvia; Harripersaud, Katherine; Lewis, Crystal F

    2015-01-01

    We examined characteristics associated with HIV stigma and evaluated a multi-component video designed to normalize HIV and reduce HIV stigma. Three pharmacies located in heavy, drug-active neighborhoods in New York City and registered to sell nonprescription syringes were trained to recruit their nonprescription syringe customers who inject drugs and their under/uninsured customers. Syringe customer participants were trained to recruit up to three of their peers. As part of a larger intervention to increase HIV testing, participants in two of three study arms viewed the "Health Screenings for Life" video and were administered pre/post-video surveys capturing HIV stigma. Participants in the nonvideo arm were administered one assessment of HIV stigma. Log-binomial regression with generalized estimating equations to account for clustering of peer networks was used to: (1) determine factors associated with HIV stigma and (2) determine differences in HIV stigma by study arm. A total of 716 participants were recruited. Factor analyses showed HIV stigma measures loading on two factors: HIV blame and HIV shame. After adjustment, HIV blame was positively associated with younger age (PR: 1.24; 95% CI: 1.07-1.43) and inversely associated with educational attainment (PR: 0.66; 95% CI: 0.58-0.76) and employment (PR: 0.76; 95% CI: 0.60-0.96). HIV shame was inversely associated with educational attainment (PR: 0.75; 95% CI: 0.62-0.92), HIV-positive status (PR: 0.60; 95% CI: 0.39-0.92), and injecting drugs (PR: 0.72; 95% CI: 0.54-0.94) and was positively associated with multiple sex partnerships (PR: 1.24; 95% CI: 1.01-1.52). Those who viewed the video were also less likely to report HIV blame and HIV shame, post-video, compared to those in the nonvideo arm. These data provide evidence of an association between HIV stigma and lower socioeconomic status groups, and between HIV stigma and HIV sexual risk. These data also provide evidence that a multi-component video aimed at

  16. DSM-V and the stigma of mental illness.

    Science.gov (United States)

    Ben-Zeev, Dror; Young, Michael A; Corrigan, Patrick W

    2010-08-01

    Stigma associated with mental illness has been shown to have devastating effects on the lives of people with psychiatric disorders, their families, and those who care for them. In the current article, the relationship between diagnostic labels and stigma is examined in the context of the forthcoming DSM-V. Three types of negative outcomes are reviewed in detail - public stigma, self-stigma, and label avoidance. The article illustrates how a clinical diagnosis may exacerbate these forms of stigma through socio-cognitive processes of groupness, homogeneity, and stability. Initial draft revisions recently proposed by the DSM-V work groups are presented, and their possible future implications for stigma associated with mental illness are discussed.

  17. Mental Health Stigma in the Military

    Science.gov (United States)

    2014-01-01

    disorder, history or disturbance of conduct, impulse control , other behavior and personality disorders, eating disorders, suicidal behavior... perceived as being more inadequate and incompetent in [his or her] behavior than a control person.” x Goffman, 1963g “Stigma is a relationship...Patients with Schizophrenia: An Exploratory Randomised Controlled Trial,” Criminal Behaviour and Mental Health, Vol. 21, 2011, pp. 163–176. AI 8—See

  18. Anti-Stigma Projekte in der Psychiatrie

    OpenAIRE

    2006-01-01

    Die Stigmatisierung psychiatrischer Patienten und die daraus entstehenden negativen Folgen für Früherkennung, Behandlung und Compliance sind ein großes Problem für die Betroffenen und für das gesamte psychiatrische Versorgungssystem. Die World Psychiatric Association hat deshalb weltweit Anti-Stigma Projekte ins Leben gerufen und auch andere Institutionen versuchen auf verschiedenste Weise, die Stigmatisierung und Diskriminierung psychisch Kranker zu bekämpfen. Ziel der vorliegenden Arbeit wa...

  19. The Stigma of Failure in Organizations

    Science.gov (United States)

    2008-01-15

    one” ( Goffman , 1963, p. 3; Sutton & Callahan, 1987, p. 406). For example, while failed entrepreneurs are often stigmatized in France and Japan, a...criminals and traitors to advertise their moral status as unfit for society ( Goffman , 1963). In the middle ages, the ritual pollution of...32), 333–350. Goffman , E. (1963). Stigma: Notes on the management of spoiled identity. Engelwood Cliffs: Simon and Schuster. Gromb, D

  20. Nature and extent of perceived stigma among epileptics in Pakistan

    OpenAIRE

    Rehana Khalil; Saadia Gul; Zahid Naeem

    2016-01-01

    Background: Epilepsy is one of the oldest disorders known to mankind. Often the social stigma (whether a and ldquo;felt and rdquo; stigma or an and ldquo;enacted and rdquo; stigma) attached to epilepsy is a greater handicap to the person with epilepsy compared to the disability associated with seizures or the side-effects from medications. The aim of this study was to explore the perceived sigma and discrimination among epileptics of Karachi, Pakistan. Methods: A descriptive cross sectio...

  1. Stigma Against Mental Illness and Cerebral Palsy in China

    OpenAIRE

    Shen, Liying

    2016-01-01

    This dissertation examines the stigmatization of two health conditions: mental disability and physical disability in the context of China. In particular, it addresses two main themes: the processes and impacts of stigma, and the variables that moderate the association of stigma with social attributes. The first paper applied a qualitative approach to identify the sources of burdens of raising a child with cerebral palsy in China and how stigma and “face” as a cultural factor affect childr...

  2. Stigma and its correlates in patients with schizophrenia attending a general hospital psychiatric unit

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    Aakanksha Singh

    2016-01-01

    Conclusion: Significant proportion of patients with schizophrenia experience stigma and stigma is associated with lower level of functioning and better knowledge about illness is associated with lower level of stigma.

  3. Non-Suicidal Self-Injury: The Movie Industry's Influence on Its Stigma

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    Raymondy, Courtney M.

    2012-10-01

    Full Text Available Non-Suicidal Self-Injury (NSSI is a concerning behavior disproportionately affecting adolescents today. Rates of NSSI have increased, as have depictions of NSSI in the media. Therefore, some researchers believe that increased media exposure is contributing to increased rates of NSSI. Research has shown that NSSI is a coping mechanism and/or a cry for help among those who display such behaviors. However, studies also show that many adolescents with this behavior do not seek help. This may be because persons engaging in NSSI feel that their behavior, thoughts, or feelings are stigmatized by the general population. The purpose of this study is twofold: first, to describe the level of stigma that currently exists among a college population; and second, to examine the relationship between popular media exposure to NSSI and perceptions, or stigma, toward NSSI. Seventy-eight college students completed a survey including a stigma measure, an exposure measure, and reacted to a vignette describing a scene from Catherine Hardwicke’s movie, Thirteen (2003. Analyses revealed the level of stigma was at a mid-level, and that it was not significantly related to reported level of movie media exposure.

  4. Mental Health-Related Stigma and Discrimination in Ghana: Experience of Patients and Their Caregivers.

    Science.gov (United States)

    Tawiah, P E; Adongo, P B; Aikins, M

    2015-03-01

    Mental health is now attracting increased public health attention from health professionals, policy makers and the general population. However, stigma and discrimination usually have enormous negative impact on the patients and their families. This study reports on stigma and discrimination faced by mental health patients and their caregivers in a suburban area of Ghana and the coping strategies used. This is a cross-sectional exploratory study which used both quantitative and qualitative approaches. Two hundred and seventy seven mental health patients were purposively interviewed. Focus group discussions were held with caregivers and in-depth interviews were held with mental health professionals. The quantitative data were analyzed using SPSS and Microsoft Excel(®) whilst the qualitative data were coded and manually analyzed thematically. Mental disorder cuts across all age, sex, education, ethnicity, employment, and marital status. More females were stigmatized than males at the work/employment and educational levels. Various forms of stigma were observed at the economic, psychological and social levels, whilst for discrimination it was only observed at the economic and social levels. Caregivers were also stigmatized and discriminated. The coping strategies adopted by the mental patients and their caregivers were also economic, psychological and social in nature. Mental health patients and their families suffer from stigma and discrimination from the individual, family, work, employment, education to the health level. Thus, community level policy on mental health care needs to be developed and implemented. Furthermore mental health education needs to be intensified at the community level.

  5. Local projects of the world psychiatric association programme to reduce stigma and discrimination.

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    Warner, Richard

    2005-05-01

    The World Psychiatric Association Programme to Reduce Stigma and Discrimination Because of Schizophrenia, which was launched in 1996, has established projects to fight stigma in 20 countries, using social-marketing techniques to enhance their effectiveness. This article describes some of the strategies used and the lessons learned in implementing two local antistigma projects. At each site the first steps were to establish an action committee and to conduct a local survey of perceived stigma. On the basis of the survey, the local action committee selected a few homogeneous and accessible target groups, such as students, employers, and criminal justice personnel. These smaller groups were targeted, because focusing on the general public is expensive and unlikely to have a measurable impact. Messages for the target groups and the media used to reach them were carefully selected, tested, and refined. The author gives examples of the work that was done with such target groups as high school students and the criminal justice system. Guidelines are provided for setting up a consumer speakers' bureau, which is valuable for addressing target groups. The bureau can be made up of people who have experienced mental illness, family members, and mental health professionals. Guidelines are also provided for establishing a media-watch organization, which can lobby news and entertainment media to exclude negative portrayals of people with mental illness. Organizers of local projects should be on the lookout for useful changes that can become permanent, such as changes in the curriculum for high school students or for police officers in training. Projects such as these can be effective in reducing stigma and can be relatively inexpensive.

  6. Pride and prejudice--identity and stigma in leprosy work.

    Science.gov (United States)

    Harris, Kristine

    2011-06-01

    This article sets out to expand the way stigma, and those affected by it, are understood within leprosy discourse and to apply these insights to the analysis of the experiences of leprosy workers. The term stigma is often used simply as shorthand for 'negative social experience'. However, to reduce the negative aspects of complex everyday life experiences to a single word is often overly simplistic and can serve to objectify, rather than illuminate, the experiences of those affected. This article argues that in order to understand the lived experience of stigma we must come to understand stigma as an ongoing, dialectical social process and develop an approach to stigma that analytically separates stigma from its negative social consequences. The article applies these insights to data collected during 14 months of fieldwork with front-line leprosy workers in India, which suggests that falling leprosy prevalence rates and a rapidly changing policy landscape have led to leprosy workers feeling marginalised and stigmatised within their own organisation. The article argues that, rather than seeing stigma merely as a negative process in which leprosy workers are passive victims, we must recognise that stigma also plays a key role in the creation and maintenance of leprosy workers' identity and is utilised as a strategic tool in the struggle for influence between different groups within the organisation. Finally, the article argues for the benefit of expanding our understanding of stigma across public health and of applying these insights to designing future interventions.

  7. A systematic review of the impact of stigma and nihilism on lung cancer outcomes

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    Chambers Suzanne K

    2012-05-01

    Full Text Available Abstract Background This study systematically reviewed the evidence on the influence of stigma and nihilism on lung cancer patterns of care; patients’ psychosocial and quality of life (QOL outcomes; and how this may link to public health programs. Methods Medline, EMBASE, ProQuest, CINAHL, PsycINFO databases were searched. Inclusion criteria were: included lung cancer patients and/or partners or caregivers and/or health professionals (either at least 80% of participants had lung cancer or were partners or caregivers of lung cancer patients, or there was a lung cancer specific sub-group focus or analysis, assessed stigma or nihilism with respect to lung cancer and published in English between 1st January 1999 and 31st January 2011. Trial quality and levels of evidence were assessed. Results Eighteen articles describing 15 studies met inclusion criteria. The seven qualitative studies were high quality with regard to data collection, analysis and reporting; however most lacked a clear theoretical framework; did not address interviewer bias; or provide a rationale for sample size. The eight quantitative studies were generally of low quality with highly selected samples, non-comparable groups and low participation rates and employed divergent theoretical and measurement approaches. Stigma about lung cancer was reported by patients and health professionals and was related to poorer QOL and higher psychological distress in patients. Clear empirical explorations of nihilism were not evident. There is qualitative evidence that from the patients’ perspectives public health programs contribute to stigma about lung cancer and this was supported by published commentary. Conclusions Health-related stigma presents as a part of the lung cancer experience however there are clear limitations in the research to date. Future longitudinal and multi-level research is needed and this should be more clearly linked to relevant theory.

  8. The Role of the Family in Attributing Meaning to Living With HIV and Its Stigma in Turkey

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    Pınar Öktem

    2015-11-01

    Full Text Available Stigma attached to HIV/AIDS remains a global problem, with severe negative consequences for people living with HIV (PLHIV. Family support is fundamental for PLHIV’s psychological and physical well-being. HIV-related stigma is high in Turkey, where HIV/AIDS prevalence is low and the epidemic is not considered a priority. Based on qualitative data generated with HIV-positive women and men, this article explores the process of stigmatization, as experienced and perceived by PLHIV in Turkey, focusing on the institution of the family. Results indicated that enacted stigma from family members is lower than anticipated. While most participants’ narratives showed patterns of support rather than rejection from families, the strong expectations around the cultural value attributed to “the family” are found to be the main facilitators of internalized stigma. The article critically discusses the meaning and implications of family support, addressing the role of patriarchal values attributed to womanhood, manhood, and sexuality in Turkey.

  9. 'People insult her as a sexy woman': sexuality, stigma and vulnerability among widowed and divorced women in Oromiya, Ethiopia.

    Science.gov (United States)

    Newton-Levinson, Anna; Winskell, Kate; Abdela, Berissa; Rubardt, Marcie; Stephenson, Rob

    2014-01-01

    Widowed and divorced women, sometimes referred to as 'female heads of household', are one of the most impoverished and marginalised groups in the world. Widowed and divorced women are often overlooked in the literature or are seen primarily as economically or socially marginalised beings; their sexuality is rarely addressed. In an effort to understand the experiences and challenges faced by such women, we conducted and analysed four focus-group discussions, seven in-depth interviews and four interactive activities with 32 widowed and divorced women and with 25 other community members in Oromiya, Ethiopia. Findings indicate that women experienced high levels of community stigma in relation to their sexuality. Participants' fear of community stigma, and the actions they took to avert it, further served to marginalise them within their community and had negative impact on their economic, social and health support systems and, ultimately, on their overall well-being. Future interventions need to acknowledge sexual stigma as a driving force in the many challenges these women face. Further programmatic work is needed to reduce stigma related to widowed and divorced women's sexuality and to decrease their vulnerability to rape.

  10. Self-stigma, insight, and family burden among Israeli mothers of people with serious mental illness: Ethno-national considerations.

    Science.gov (United States)

    Zisman-Ilani, Yaara; Hasson-Ohayon, Ilanit; Levy-Frank, Itamar; Tuval-Mashiach, Rivka; Roe, David

    2017-06-01

    The current cross-sectional study investigated and compared the associations between insight, self-stigma, and family burden among Jewish and Arab mothers of an adult son or daughter with serious mental illness (SMI) in Israel. A total of 162 Israeli mothers of a person with SMI participated in the study; 95 were Jewish (58.6%), and 67 were Arab (41.4%). Insight, self-stigma, and family burden scales were administered. Jewish mothers reported higher levels of insight into their son's or daughter's illness and reported greater family burden compared to Arab mothers. No significant differences in self-stigma scores were found between Jewish and Arab mothers. The pattern of associations between insight, self-stigma, and burden differed between Jewish and Arab mothers. Self-stigma was found to mediate the relationship between insight and burden among Jewish mothers but not among Arab mothers. Ethno-national affiliation should be taken into consideration regarding how family members conceptualize and experience mental illness, as this might affect care.

  11. Effects of HIV-related stigma among an early sample of patients receiving antiretroviral therapy in Botswana.

    Science.gov (United States)

    Wolfe, W R; Weiser, S D; Bangsberg, D R; Thior, I; Makhema, J M; Dickinson, D B; Mompati, K F; Marlink, R G

    2006-11-01

    Botswana, with its estimated HIV prevalence of 37%, instituted a policy of universal access to antiretroviral therapy (ART) in 2002. Initial enrolment lagged behind expectations, with a shortfall in voluntary testing that observers have attributed to HIV-related stigma - although there are no published data on stigma among HIV-positive individuals in Botswana. We interviewed 112 patients receiving ART in 2000, finding evidence of pervasive stigma in patterns of disclosure, social sequelae, and delays in HIV testing. Ninety-four percent of patients reported keeping their HIV status secret from their community, while 69% withheld this information even from their family. Twenty-seven percent of patients said that they feared loss of employment as a result of their HIV status. Forty percent of patients reported that they delayed getting tested for HIV; of these, 51% cited fear of a positive test result as the primary reason for delay in seeking treatment, which was often due to HIV-related stigma. These findings suggest that success of large-scale national ART programmes will require initiatives targeting stigma and its social, economic and political correlates.

  12. The stigma of autism in china: an analysis of newspaper portrayals of autism between 2003 and 2012.

    Science.gov (United States)

    Tang, Lu; Bie, Bijie

    2016-01-01

    Autism is a highly stigmatized developmental disability in many societies, and the media are major contributors to such stigma. Presented here is the first systematic analysis of Chinese newspapers' coverage of autism for stigma-causing content. More specifically, this analysis examines the age of autistic people reported, the image of autistic people, and the use of stigma cues (in terms of peril, mark, and shame) and challenge cues (in terms of personification, hope, and fight) in five leading newspapers in China between 2003 and 2012. It finds that while the reportage of autism increases over time, which might contribute to the public's heightened awareness of the condition, such reportage is often biased. The most common stereotypes about autism in Chinese newspapers are autistic people as children, as patients, or as savants. The most often-used challenge cues are personification and hope, but their uses significantly decrease in percentage from 2003 to 2012. The most often used stigma cues are peril and mark. The use of the shame cue is relatively less frequent, but it increases significantly over the 10-year period. Theoretically, this article provides an application of stigma communication theory in a non-Western context. Practically, it not only contributes to the current knowledge about media representation of autism in China, but also suggests that it is important for media agencies and health care professionals to promote media guidelines and train health journalists for reporting disability issues in a nonstigmatizing way.

  13. Mass social contact interventions and their effect on mental health related stigma and intended discrimination

    National Research Council Canada - National Science Library

    Evans-Lacko, Sara; London, Jillian; Japhet, Sarah; Rüsch, Nicolas; Flach, Clare; Corker, Elizabeth; Henderson, Claire; Thornicroft, Graham

    2012-01-01

    Stigma and discrimination associated with mental health problems is an important public health issue, and interventions aimed at reducing exposure to stigma and discrimination can improve the lives...

  14. Preexposure prophylaxis-related stigma: strategies to improve uptake and adherence – a narrative review

    Directory of Open Access Journals (Sweden)

    Haire BG

    2015-10-01

    Full Text Available Bridget G Haire Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, NSW, Australia Abstract: Despite high levels of efficacy, the implementation of preexposure prophylaxis (PrEP as a strategy to prevent new HIV infection has been slow. Studies show that PrEP works so long as it is taken, making adherence one of the great challenges of effective PrEP implementation alongside issues of access and uptake. Given that effective PrEP use requires ongoing self-administration of pills by people at high risk of HIV acquisition, it is a strategy best understood not as simply biomedical, but as biobehavioral or biopsychosocial, meaning that that social, psychological, cultural, and structural factors all contribute to the success or failure of the intervention. The willingness of people at risk of HIV to take up and adhere to PrEP depends greatly upon social understandings – whether it is seen as effective, as a healthy option, and a socially acceptable strategy for preventing HIV. Stigma – unfavorable associations – can negatively influence the implementation of PrEP. Because it is associated with high-risk sexual activity, PrEP risks multiple stigmas that can differ according to specific cultural conditions. This includes the stigma of being related to HIV (which may also relate to other stigmas, such as homosexuality, sex work, and/or drug use and the stigma of PrEP being an alternative to condoms (as condom use is associated with responsible sexual activity. PrEP-related stigma has emerged as a significant social harm that can arise from PrEP research participation, reported by trial participants from a range of different trial sites, different trial populations, and spanning different continents. Social marketing needs to redress PrEP-related stigmas through health promotion campaigns aimed at clinicians, HIV-affected communities, and people at high risk of HIV who might benefit from PrEP access. Pr

  15. Especial Skills in Experienced Archers.

    S