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An Exploration on the Public Stigma of Sexual Addiction
Abstract
This study explored the stigma toward individuals with sexual addiction and how it compared to gambling addiction, alcohol addiction, and depression in both males and females. Undergraduate students (N = 241) were assigned to read one of eight vignettes (mental illness x gender) and completed quantitative stigma measures (e.g., social distance). Results showed that alcohol addiction was the most stigmatized, followed closely by gambling addiction. Sexual addiction and depression had similar levels of stigma. Participants were less stigmatizing toward females with sexual addiction, and no other gender differences emerged. Additional variables and measures (e.g., perceived causes) were also explored.
... Sex differences in hypersexuality have yet to receive extensive scholarly attention, however it appears that like other DSIs (pedophilia and fetishism), men experience more hypersexuality than women [55]. The stigma of hypersexuality remains mostly unexplored, perhaps because it is not listed as a diagnoseable paraphilia within the DSM-V [56]. Recently, Lang and Rosenberg [57] found that women were less willing to associate with men who compulsively view pornography, than with men who engage in other compulsive behaviours. ...
... Findings suggested that heterosexual and male participants were more heavily pathologized and stigmatised for hypersexual tendencies [58]. Conversely, Lindsay et al. [56] found hypersexuality stigma to be mild and comparable to depression stigma within a convenience-sampled participant pool comprised mostly of female undergraduate students. Thus, further research is necessary to clarify the exact nature of the stigmatising and punitive attitudes facing hypersexuality. ...
... Based on findings produced by Lindsay et al. [56], whereby hypersexuality was associated with limited public stigma in comparison to other behavioural addictions, it was hypothesised that fetishism would be subject to harsher punitive attitudes than hypersexuality. However, no evidence of differences in punitive attitudes toward fetishism and hypersexuality were observed. ...
Background: Pedophilia is a deviant sexual interest subject to more public stigma and punitive attitudes than others. Pedophilia has received a disproportionate amount of scholarly attention in comparison to other deviant sexual interests. To address this, the present study offers a comparison of the public stigma and punitive attitudes associated with pedophilia, fetishism, and hypersexuality. Methods: Recruited in Australia, one-hundred and twelve individuals participated in an anonymous online survey. Stigmatising and punitive attitudes toward pedophilia, fetishism, and hypersexuality were assessed via sub-scales of perceived dangerousness, deviance, intentionality, and punitive attitudes. Results: Participants held harsher punitive attitudes toward people with pedophilia and thought them to be more deviant and dangerous than people with fetishism and hypersexuality. Participants perceived hypersexuality to be more dangerous and deviant than fetishism. No consistent combination of perceived dangerousness, deviance, and intentionality predicted punitive attitudes toward all conditions. Rather, combinations of punitive attitude predictors were unique across conditions. Conclusions: This research articulates the unparalleled public stigma and punitive attitudes faced by people with pedophilia, compared to people with fetishism and hypersexuality. Findings which suggest that public stigma is stronger for hypersexuality than it is for fetishism are relatively novel, as are the observed predictors of punitive attitudes toward each condition. Knowledge produced by this study contributes to an improved conceptualisation of how the public views individuals who experience deviant sexual interests.
... This survey was developed as part of the Opening Minds Initiative of the Mental Health Commission of Canada to assess opinions in the workplace towards co-workers who may have a mental illness. There are no right or wrong answers to (at work) 3 I would not want to be supervised by someone who had been treated for a mental illness 4 I would not be close friends with someone I knew (a co-worker) who had a mental illness 10 (8) I would try to avoid someone (a co-worker) with a mental illness 13R I would not mind if someone with a mental illness lived next door to me 16 (12) If I knew someone (a co-worker) who had a mental illness I would not date them 18 (14) I would not want to be taught by a teacher (work with a co-worker) who had been treated for a mental illness 14 (10) People (Employees) with a mental illness are often more dangerous than the average person 17 (13) People (Employees) with a mental illness often become violent if not treated 19 (14) Most violent crimes (in the workplace) are committed by people (employees) with mental illness 23 (19) You can never know what someone (an employee) with a mental illness is going to do 27 (23) People (Employees) with serious mental illnesses need to be locked away 2 ...
The anti-stigma Opening Minds initiative (Mental Health Commission of Canada) identified the workplace as one of four critical areas for stigma evaluation and programming. Researchers found, however, that no validated tool to measure stigma in this context existed at the time. The purpose of the current research was to develop and assess the psychometric properties of a multi-component quantitative measure of public stigma towards mental illnesses in the workplace: Opening Minds Scale for Workplace Attitudes (OMS-WA). Three studies are discussed. Study 1 outlines the initial development of the OMS-WA, finding a five-factor structure with 23 items (EFA analysis; N = 207). Study 2 utilized employees from various businesses to further validate the OMS-WA, (N = 107), finding good internal consistency and good convergent/divergent validity. Study 3 utilized baseline data from two national large-scale stigma reduction and resiliency programs (first responders and general workplaces) to confirm the factor structure, finding good model fit and reliability with both samples (N = 5385; N = 1207). Together, these results provide strong evidence of the OMS-WA. Its use in measuring workplace stigma related to mental illness is recommended. Considerable future evaluation is warranted, and directions for generalizability studies, as well as suggestions for using the OMS-WA in intervention trials, are provided.
... Such inconsistent terminology and classification may enhance stigmatisation of population groups at higher risk for disordered sexual behaviour (e. g. same-sex orientated males; Jaspal and Jaspal, 2019). Since diagnostic criteria remain uncertain, and unanimously accepted information cannot be disseminated to the public to improve awareness or understanding, it is likely that instead of acknowledging the behaviour as a condition, this may be misinterpreted as a manifestation indicative of a specific group (Hall, 2014;Lindsay et al., 2020). This could hamper the development of evidence-based intervention (Kingston and Firestone, 2008), whilst resulting in inconsistent measurement of the effected populations, with prevalence reported to fall anywhere between 3 and 10%, largely dependent upon criteria used to assess disorder, and the populations assessed (Brewer and Tidy, 2017). ...
Contemporary literature and recent classification systems have expanded the field of addictions to include problematic behaviours such as gambling and sexual addiction. However, conceptualisation of behavioural addictions is poorly understood and gender-based differences have emerged in relation to how these behaviours are expressed. The current research conducted partial-correlation and Bayesian network analyses to assess the symptomatic structure of gambling disorder and sexual addiction. Convenience community sampling recruited 937 adults aged 18 to 64 years (315 females, Mage = 30.02; 622 males, Mage = 29.46). Symptoms of problematic behaviours were measured using the Online Gambling Disorder Questionnaire (OGDQ) and the Bergen Yale Sex Addiction Scale (BYSAS). Results indicate distinct gender-based differences in the symptom networks of sexual addiction and gambling disorder, with a more complex network observed amongst men for both conditions. Addiction salience, withdrawal and dishonesty/deception were important components of the addictive network. Interpersonal conflict was more central for women while intrapsychic conflict a more prominent issue for men. Differences in the two symptom networks indicate separate disorders as opposed to a single underlying construct. Treating practitioners and community initiatives aimed at addressing sexual addiction and disordered gambling should consider gender, when designing educational or therapeutic interventions.
... Furthermore, retrospective data about the history and course of CSB provided by clinical patients may be influenced by recall biases (Shiffman et al., 2008) and self-perceived addiction severity (Grubbs et al., 2018a(Grubbs et al., , 2018b. Finally, as argued by several clinicians and researchers, the private nature of sex, the stigma around out-of-control sexual behavior, and the low perception of severity of CSB may discourage patients with mild or moderate symptoms from seeking treatment (Kuzma & Black, 2008;Lindsay et al., 2021). As a result, patients that receive treatment for CSB-and participate in clinical studies, field trials, or constitutes the usual clientele of mental health professionals-likely represent the most severe cases, and not the whole continuum of severity in which this condition may be expressed. ...
Despite the recognition of compulsive sexual behavior (CSB) as a diagnostic entity in the ICD-11, few works have reported on its natural course. The aim of this study was to explore the natural course of CSB over a 1-year period, as well as to analyze the predictive power of different risk factors. A convenience sample of 154 young adults were assessed at baseline and after 1 year. Dimensionally, we found that scores on most CSB symptoms significantly decreased at 1 year (d between .20 and .35). On the contrary, severity of problematic use of online sexual activities increased (d = 0.22). Regression analyses revealed that sexual orientation (being bisexual) and religious beliefs (atheist) were significant predictors of the trajectory of CSB. However, after controlling for baseline levels of CSB, only openness to experience (β between − .167 and − .199), sexual sensation seeking (β between .169 and .252), anxiety (β = .363), and depression (β between .163 and .297) predicted an increased risk of CSB over time. Categorically, diagnostic consistency of CSB at 1 year was modest. These findings suggest that the natural course of CSB tends to be highly transient and inconsistent, and that classic risk factors for its occurrence have a limited predictive power over its natural course.
... Furthermore, women were less willing to affiliate with someone addicted to pornography than were men"(Lang & Rosenberg, 2017, 83). Similar results were found in the study by Lindsay, et al., (2020) with sexual addiction being one of the less understood addictions(Lindsay, et al., (2020). ...
Metacognition plays a role in motivation, executive function, declarative and procedural knowledge, and has been found to develop as early as three years of age (Marulis & Nelson, 2021). Metacognition is “thinking about thinking” (Flavell, 1992), operates across ordered levels of concepts (Seow et al., 2021), and is the knowledge and cognitive process that involves the appraisal, control, and monitoring of thinking (Flavell, 1979). Dysregulation of metacognition has the potential to develop into maladaptive coping rather than healthy self-regulation skills (Wells & Matthews, 1996), which in turn, can develop into mental illness or addiction (Chen, et al., 2021). Maladaptive metacognitions have been implicated in the learning of associations between stimuli, modification of behavior through motivation, and performance of an action to obtain a reward (Liljeholm & O’Doherty, 2012). To what extent pornography exposure and use that began in adolescence interfere with metacognitions in the adult population is lacking in research, therefore, this study aimed to identify associations between pornography use and maladaptive metacognitions in a sample of adults who actively used, or were attempting to quit, using pornography. A survey was created and posted in several Facebook groups, on twitter, and sent through messages. It was also posted on sites dedicated to those who are attempting to quit using pornography. A total of 3301 responses were recorded, however, only 877 were used for the purpose of this study, the rest were omitted due to being incomplete. Results confirmed that pornography use was a predictor of maladaptive metacognitions.
Background and aims:
Impulsivity is regarded as a risk factor for sexual crime reoffending, and a suggested core feature in Compulsive Sexual Behavior Disorder. The aim of this study was to explore clinical (e.g. neurodevelopmental disorders), behavioral and neurocognitive dimensions of impulsivity in disorders of problematic sexuality, and the possible correlation between sexual compulsivity and impulsivity.
Methods:
Men with Compulsive Sexual Behavior Disorder (n = 20), and Pedophilic Disorder (n = 55), enrolled in two separate drug trials in a specialized Swedish sexual medicine outpatient clinic, as well as healthy male controls (n = 57) were assessed with the Hypersexual Behavior Inventory (HBI) for sexual compulsivity, and with the Barratt Impulsiveness Scale (BIS) and Connors' Continuous Performance Test-II (CPT-II) for impulsivity. Psychiatric comorbidity information was extracted from interviews and patient case files.
Results:
Approximately a quarter of the clinical groups had Attention-Deficit/Hyperactivity Disorder (ADHD) or Autism Spectrum Disorder. Both clinical groups reported more compulsive sexuality (r = 0.73-0.75) and attentional impulsivity (r = 0.36-0.38) than controls (P < 0.05). Based on results on univariate correlation analysis, BIS attentional score, ADHD, and Commissions T-score from CPT-II were entered in a multiple linear regression model, which accounted for 15% of the variance in HBI score (P < 0.0001). BIS attentional score was the only independent positive predictor of HBI (P = 0.001).
Discussion:
Self-rated attentional impulsivity is an important associated factor of compulsive sexuality, even after controlling for ADHD. Psychiatric comorbidity and compulsive sexuality are common in Pedophilic Disorder.
Conclusion:
Neurodevelopmental disorders and attentional impulsivity - including suitable interventions - should be further investigated in both disorders.
Importance
Sexual relationships are important for well-being and health. Recent trends in sexual activity among US adults are unknown.
Objectives
To examine trends in reported frequency of sexual activity and number of sexual partners by sex and age and the association between measures of sexual activity and sociodemographic variables.
Design, Setting, and Participants
In this survey study, repeat, cross-sectional analyses of participants aged 18 to 44 years from 10 rounds of the General Social Survey (2000-2018), a US nationally representative survey, were performed for men and women separately.
Main Outcomes and Measures
Sexual frequency in the past year (sexual inactivity, once or twice per year, 1-3 times per month, or weekly or more) and number of sexual partners in the past year (0, 1, 2, or ≥3 partners). The association between measures of sexual activity and sociodemographic variables were assessed using logistic regression.
Results
The study population included 4291 men and 5213 women in the analysis of sexual frequency and 4372 men and 5377 women in the analysis of number of sexual partners (mean [SD] age, 31.4 [7.6] years; survey response rate, 59.5%-71.4%). Between 2000-2002 and 2016-2018, the proportion of 18- to 24-year-old individuals who reported having had no sexual activity in the past year increased among men (18.9% vs 30.9%; age-adjusted odds ratio [aOR] for trend across survey periods, 1.20; 95% CI, 1.04-1.39) but not among women (15.1% vs 19.1%; aOR for trend, 1.03; 95% CI, 0.89-1.18). Smaller absolute increases in sexual inactivity were observed among those aged 25 to 34 years for both men (7.0% vs 14.1%; aOR for trend, 1.23; 95% CI, 1.07-1.42) and women (7.0% vs 12.6%; aOR for trend, 1.17; 95% CI, 1.01-1.35) but not among those aged 35 to 44 years. The increase in sexual inactivity coincided with decreases in the proportion reporting weekly or more sexual frequency (men aged 18-24 years: 51.8% vs. 37.4%; aOR for trend, 0.88 [95% CI, 0.79-0.99]; men aged 25-34 years: 65.3% vs 50.3%; aOR for trend, 0.87 [95% CI, 0.81-0.94]; women aged 25-34 years: 66.4% vs. 54.2%; aOR for trend, 0.90 [95% CI, 0.84-0.96]) or 1 sexual partner (men aged 18-24 years: 44.2% vs. 30.0%; aOR for trend, 0.88 [95% CI, 0.80-0.98]; women aged 25-34 years: 79.6% vs 72.7%; aOR for trend, 0.91 [95% CI, 0.84-0.99]) and occurred mainly among unmarried men (unmarried men aged 18-44 years: 16.2% vs 24.4%; aOR for trend, 1.14 [95% CI, 1.04-1.25]). Among married men and women, weekly or more sexual frequency decreased (men: 71.1 % vs 57.7%; aOR for trend, 0.86 [95% CI, 0.79-0.93]; women: 69.1% vs 60.9%; aOR for trend, 0.92 [95% CI, 0.86-0.99]). Men with lower income (aOR for men with an annual income of ≥0-$9999, 0.37 [95% CI, 0.15-0.90]) and with part-time (aOR vs full-time employment, 2.08; 95% CI, 1.48-2.93) and no employment (aOR vs full-time employment, 2.08; 95% CI, 1.48-2.93) were more likely to be sexually inactive, as were men (aOR vs full-time employment, 2.94; 95% CI, 2.06-4.21) and women (aOR vs full-time employment, 2.37; 95% CI, 1.68-3.35) who were students.
Conclusions and Relevance
This survey study found that from 2000 to 2018, sexual inactivity increased among US men such that approximately 1 in 3 men aged 18 to 24 years reported no sexual activity in the past year. Sexual inactivity also increased among men and women aged 25 to 34 years. These findings may have implications for public health.
It has recently been proposed that compulsive sexual behavior disorder should be included in the 11th version of the International Statistical Classification of Diseases and Related Health Problems. Concerns have been repeatedly expressed regarding the overpathologizing of sexual behaviors and the potential for false-positive results in clinical practice. Empirical evidence indicates that stereotypes related to gender and sexual orientation might influence therapists' assessments of clients. Those stereotypes are likely to be associated with different levels of pathologization and stigmatization of high levels of sexual interest and behavior. The aim of this study was to explore the possible connections between clients' gender and sexual orientation and mental health professionals' (MHP) pathologization of compulsive sexual behavior. A sample of MHPs (N 546) were presented with a case vignette describing a client with compulsive sexual behavior. The information on the client varied by gender (male or female), sexual orientation (homosexual or heterosexual), and clinical condition (ambiguous diagnostic criteria and fulfilled compulsive sexual behavior disorder diagnostic criteria). After reading the vignette, the MHPs rated the client's mental health status and gave an opinion about causation (psychological vs. biological etiology) and stigmatization indicators (blaming the affected individual for their problems, desire for social distance, perception of dangerousness). The MHPs showed significantly fewer tendencies to pathologize when the client was a homosexual woman or man independent of their clinical condition. Mediation analyses revealed that the biological etiological model partly mediated the effects of reduced pathologization in homosexual clients. These results indicate that clinical decisions relating to compulsive sexual behavior are influenced by nosologically irrelevant beliefs about the biological causation of sexual behavior.
Skepticism about the explanatory value of implicit bias in understanding social discrimination has grown considerably. The current article argues that both the dominant narrative about implicit bias as well as extant criticism are based on a selective focus on particular findings that fails to consider the broader literature on attitudes and implicit measures. To provide a basis to move forward, the current article discusses six lessons for a cogent science of implicit bias: (1) There is no evidence that people are unaware of the mental contents underlying their implicit biases. (2) Conceptual correspondence is essential for interpretations of dissociations between implicit and explicit bias. (3) There is no basis to expect strong unconditional relations between implicit bias and behavior. (4) Implicit bias is less (not more) stable over time than explicit bias. (5) Context matters fundamentally for the outcomes obtained with implicit bias measures. (6) Implicit measurement scores do not provide process-pure reflections of bias. The six lessons provide guidance for research that aims to provide more compelling evidence for the properties of implicit bias. At the same time, they suggest that extant criticism does not justify the conclusion that implicit bias is irrelevant for the understanding of social discrimination.
Importance
The veracity, nomenclature, and conceptualizations of sex addiction, out-of-control sexual behavior, hypersexual behavior, and impulsive or compulsive sexual behavior are widely debated. Despite such variation in conceptualization, all models concur on the prominent feature: failing to control one’s sexual feelings and behaviors in a way that causes substantial distress and/or impairment in functioning. However, the prevalence of the issue in the United States is unknown.
Objective
To assess the prevalence of distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors among a nationally representative sample in the United States.
Design, Setting, and Participants
This survey study used National Survey of Sexual Health and Behavior data to assess the prevalence of distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors and determined how prevalence varied across sociodemographic variables. Participants between the ages of 18 and 50 years were randomly sampled from all 50 US states in November 2016.
Main Outcomes and Measures
Distress and impairment associated with difficulty controlling sexual feelings, urges, and behavior were measured using the Compulsive Sexual Behavior Inventory–13. A score of 35 or higher on a scale of 0 to 65 indicated clinically relevant levels of distress and/or impairment.
Results
Of 2325 adults (1174 [50.5%] female; mean [SD] age, 34.0 [9.3] years), 201 [8.6%] met the clinical screen cut point of a score of 35 or higher on the Compulsive Sexual Behavior Inventory. Gender differences were smaller than previously theorized, with 10.3% of men and 7.0% of women endorsing clinically relevant levels of distress and/or impairment associated with difficulty controlling sexual feelings, urges, and behavior.
Conclusions and Relevance
The high prevalence of this prominent feature associated with compulsive sexual behavior disorder has important implications for health care professionals and society. Health care professionals should be alert to the high number of people who are distressed about their sexual behavior, carefully assess the nature of the problem within its sociocultural context, and find appropriate treatments for both men and women.
Measures of self-favoring response biases such as impression management (IM) scales or the overclaiming technique (OCT) have been developed to detect distorted self-reports. However, the validity of these approaches has been questioned. In the present study ( N = 461), we further examined both IM (assessed by the respective subscale of the Balanced Inventory of Desirable Responding [BIDR]) and the OCT as measures of self-favoring response biases and their associations with honesty-humility. Specifically, we tested the 2 competing accounts of IM as a measure of true virtues or a measure of overly positive self-presentation against each other. Using 2 behavioral paradigms, we corroborated recent findings that higher IM scores are associated with higher trait honesty as well as with more honest behavior. At the same time, individuals with high IM scores also presented themselves overly favorably, as IM accounted for discrepancies between hypothetical and actual (incentivized) behavior in a dictator game. Thereby, the present results provide direct evidence for the notion that the IM subscale of the BIDR confounds trait honesty with response bias and thus measures both. In contrast, overclaiming was unrelated to trait honesty, all observed behaviors, and self-presentation, indicating that the OCT is not a valid measure of self-favoring response bias.
The negative psychological effects of public stigma on disordered gamblers have been well documented. Public stigma deters treatment-seeking and other help-seeking behaviors, and negatively impacts individuals’ view of themselves. Different types of disordered gambling activities may attract different degrees of stigma. One increasingly popular form of gambling involves placing bets on the outcomes of competitive video games, also called eSports gambling. This activity shares characteristics with Internet gaming and gambling. The purpose of this study was to compare the degree of public stigma held towards traditional casino gamblers, eSports gamblers, and Internet gamers, as compared to an individual experiencing comparable levels of impairment and distress due to a financial crisis. Using an experimental between-groups vignette study design, we found that all three types of behavioral addictions were more heavily stigmatized than the control condition. The three behavioral addictions were seen as being highly controllable, engendered a significant amount of anger and blame, and resulted in higher levels of desired social distance. Traditional casino gamblers were seen as significantly more dangerous to be around and created a higher level of desired social distance than the Internet gamer. Differences between the Internet gamer and eSports better were less pronounced. These findings underscore the importance of reducing public stigma for gambling and other behavioral addictions, and provide information that can be used when developing interventions to impact stigma.
Background
The burden from depression is affected by the public’s beliefs, stigma, and resulting behavior. Lack of knowledge, misunderstanding, and stigma about depressed people and their surroundings are barriers to improving their mental health. This study aimed to examine public beliefs regarding depression, especially how to recognize depression, treatment, and stigma.
Methods
A self-administered questionnaire was distributed to participants receiving an annual health checkup. We asked whether they agreed with four short sentences: “it is not necessary to worry about depression in a person behaving brightly” (misunderstanding about the behavior of depressed people), “rest is important for treating depression” (belief about the necessity of rest), “medicine is effective for treating depression” (belief about the effectiveness of pharmacotherapy) and “a weak personality causes depression” (stigma about the cause of depression). We also analyzed the association between these beliefs and factors such as health literacy, regularly visiting an outpatient clinic, history of depression, and demographic variables.
Results
Among 1,085 respondents (75.0% response rate), 54.5%, 75.6%, 58.9%, and 70.8% responded appropriately to the “misunderstanding about the behavior of depressed people”, “necessity of rest”, “effectiveness of pharmacotherapy”, and “stigma about the cause of depression” items, respectively. Regarding stigma about the cause of depression, 30.7% of respondents agreed that a weak personality caused depression. Female sex and younger age group were associated with appropriate answers. Health literacy was only associated with appropriate beliefs about the effectiveness of pharmacotherapy.
Conclusions
Thirty percent of participants had the stigmatizing belief that a weak personality causes depression and only 58.9% believed in the effectiveness of pharmacotherapy for depression. Over 70% understood the necessity of rest and knew that depression is possible in those who act brighter. General health literacy alone might not improve knowledge and beliefs about depression. An educational intervention or campaign to reduce stigma toward depression and improve knowledge about the treatment of depression is needed.
During the last decade, there has been heated debate regarding whether compulsive sexual behaviour should be classified as a mental/behavioural disorder. Compulsive sexual behaviour disorder has been proposed for inclusion as an impulse control disorder in the ICD-11. It is characterized by a persistent pattern of failure to control intense, repetitive sexual impulses or urges, resulting in repetitive sexual behaviour over an extended period (e.g., six months or more) that causes marked distress or impairment in personal, family, social, educational, occupational or other important areas of functioning.
This study examined public gambling stigma by testing stigmatization of those diagnosed with a gambling disorder, as specified by the DSM-5 (American Psychiatric Association in Diagnostic and statistical manual of mental disorders, 2013. https://doi.org/10.1176/appi.books.9780890425596.dsm16). The researchers hypothesized that the magnitude of stigmatization would fall in this order, from most stigmatized to least: (a) the target labelled and described in ways consistent with moderate gambling disorder (b) the target described in ways consistent with moderate gambling disorder, (c) the target described in ways consistent with recreational gambling, (d) and control. Participants were randomly presented with one of the four descriptions, then completed measures of cognitive, affective, and behavioral reactions. Results showed that those labelled with gambling disorder evoked slightly more social distance than those meeting criteria for the disorder with no label. However, both groups meeting criteria were more stigmatized than those who gamble without meeting criteria and those who do not gamble. Those described who gamble without meeting criteria were no more stigmatized than those who do not gamble, giving a more total picture of what gambling stigma is by indicating what it is not. Findings and implications are discussed.
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.
Most of the research on public perceptions of people with addictive disorders has focused on alcohol and illicit drugs, rather than addiction to behavioral activities. To expand the range of addictive behaviors and types of perceptions studied, we designed the present study to assess the lay public’s definitions of and willingness to affiliate with people described as addicted to 1 of 2 specific behaviors (i.e., pornography or gambling) or 1 of 3 specific substances (i.e., alcohol, marijuana, or heroin). A nationwide convenience sample (N = 612) of American adults completed online questionnaires during the summer of 2015. Participants rated heroin as more addictive than the other drugs and behaviors and, despite differences among the conditions, were generally unwilling to affiliate with an individual addicted to any of the 2 behaviors or 3 substances. When asked to rate different potential indications of addiction, participants endorsed behavioral signs of impaired control and physiological and psychological dependence as more indicative of all 5 types of addiction than desire to use the substance or engage in the addictive behavior. Despite recent efforts to increase public knowledge about addictive disorders, members of the public continue to endorse some attitudes indicative of stigmatization toward people with selected substance and behavioral addictions.
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.
Aims:
To review the evidence base for classifying compulsive sexual behavior (CSB) as a non-substance or 'behavioral' addiction.
Methods:
Data from multiple domains (e.g. epidemiological, phenomenological, clinical, biological) are reviewed and considered with respect to data from substance and gambling addictions.
Results:
Overlapping features exist between CSB and substance use disorders. Common neurotransmitter systems may contribute to CSB and substance use disorders, and recent neuroimaging studies highlight similarities relating to craving and attentional biases. Similar pharmacological and psychotherapeutic treatments may be applicable to CSB and substance addictions, although considerable gaps in knowledge currently exist.
Conclusions:
Despite the growing body of research linking compulsive sexual behavior (CSB) to substance addictions, significant gaps in understanding continue to complicate classification of CSB as an addiction.
Problem gambling attracts considerable public stigma, with deleterious effects on mental health and use of healthcare services amongst those affected. However, no research has examined the extent of stigma towards problem gambling within the general population. This study aimed to examine the stigma-related dimensions of problem gambling as perceived by the general public compared to other health conditions, and determine whether the publicly perceived dimensions of problem gambling predict its stigmatisation. A sample of 2000 Australian adults was surveyed, weighted to be representative of the state population by gender, age and location. Based on vignettes, the online survey measured perceived origin, peril, concealability, course and disruptiveness of problem gambling and four other health conditions, and desired social distance from each. Problem gambling was perceived as caused mainly by stressful life circumstances, and highly disruptive, recoverable and noticeable, but not particularly perilous. Respondents stigmatised problem gambling more than sub-clinical distress and recreational gambling, but less than alcohol use disorder and schizophrenia. Predictors of stronger stigma towards problem gambling were perceptions it is caused by bad character, is perilous, non-recoverable, disruptive and noticeable, but not due to stressful life circumstances, genetic/inherited problem, or chemical imbalance in the brain. This new foundational knowledge can advance understanding and reduction of problem gambling stigma through countering inaccurate perceptions that problem gambling is caused by bad character, that people with gambling problems are likely to be violent to other people, and that people cannot recover from problem gambling.
In the nationally representative General Social Survey, U.S. Adults (N = 33,380) in 2000-2012 (vs. the 1970s and 1980s) had more sexual partners, were more likely to have had sex with a casual date or pickup or an acquaintance, and were more accepting of most non-marital sex (premarital sex, teen sex, and same-sex sexual activity, but not extramarital sex). The percentage who believed premarital sex among adults was "not wrong at all" was 29 % in the early 1970s, 42 % in the 1980s and 1990s, 49 % in the 2000s, and 58 % between 2010 and 2012. Mixed effects (hierarchical linear modeling) analyses separating time period, generation/birth cohort, and age showed that the trend toward greater sexual permissiveness was primarily due to generation. Acceptance of non-marital sex rose steadily between the G.I. generation (born 1901-1924) and Boomers (born 1946-1964), dipped slightly among early Generation X'ers (born 1965-1981), and then rose so that Millennials (also known as Gen Y or Generation Me, born 1982-1999) were the most accepting of non-marital sex. Number of sexual partners increased steadily between the G.I.s and 1960s-born GenX'ers and then dipped among Millennials to return to Boomer levels. The largest changes appeared among White men, with few changes among Black Americans. The results were discussed in the context of growing cultural individualism and rejection of traditional social rules in the U.S.
Lay beliefs about the causes of common mental health conditions may perpetuate stigmatizing attitudes toward individuals with mental illness. Furthermore, some of these beliefs may be subject to intergroup membership bias based on gender congruence, as depression is more prevalent in women and alcohol dependence is more prevalent in men. Respondents listened to a vignette portraying an individual with depression or alcohol dependence and were asked how likely the vignette character's (X's) symptoms were due to the following causes: X's bad character, genetics, stress, the way X was raised, and the normal ups and downs of life. Respondents endorsed bad character as a more likely cause of alcohol dependence compared to depression, but this was stronger for women respondents. Men, on the other hand, were more likely to endorse bad character as a cause of depression compared to women. A trend suggested that the overall tendency for alcohol to be attributed to genetics more than depression was stronger for men, whereas women endorsed genetics as a more likely cause of depression than men. Finally, men were significantly more likely to attribute characters' symptoms to the normal ups and downs of life compared to women. Overall, these patterns suggest gender differences in attitudes about the underlying causes of alcohol dependence and depression that may be consistent with intergroup membership bias. Anti-stigma interventions aimed at reducing bias toward individuals with these common, gender-typical disorders should consider adapting strategies to target intergroup membership bias.
The study investigated explicit and implicit attitudes towards people with mental illness among medical students (non-professionals) with no previous contact with mentally ill patients and psychiatrists and psychotherapists (professionals) who had at least 2 years of professional contact with mentally ill patients. Explicit attitudes where assessed by self-report. Implicit attitudes were measured with the Go/No-Go Association Task, a variant of the Implicit Association Test that does not require the use of a comparison category. Compared to non-professionals, mental health professionals reported significantly higher approach emotions than non-professionals towards people with mental illness, showed a lesser tendency to discriminate against them, and held less restrictive attitudes. Both groups reported negative implicit attitudes towards mentally ill. Results suggest that both non-professionals and professionals display ambivalent attitudes towards people with mental illness and that professional, long-term contact with people with mental illness does not necessarily modify negative implicit attitudes.
Recently, the concept of addiction has expanded to include many types of problematic repetitive behaviors beyond those related to substance misuse. This trend may have implications for the way that lay people think about addictions and about people struggling with addictive disorders. The aim of this study was to provide a better understanding of how the public understands a variety of substance-related and behavioral addictions.
A representative sample of 4000 individuals from Alberta, Canada completed an online survey. Participants were randomly assigned to answer questions about perceived addiction liability, etiology, and prevalence of problems with four substances (alcohol, tobacco, marijuana, and cocaine) and six behaviors (problematic gambling, eating, shopping, sexual behavior, video gaming, and work).
Bivariate analyses revealed that respondents considered substances to have greater addiction liability than behaviors and that most risk factors (moral, biological, or psychosocial) were considered as more important in the etiology of behavioral versus substance addictions. A discriminant function analysis demonstrated that perceived addiction liability and character flaws were the two most important features differentiating judgments of substance-related versus behavioral addictions. Perceived addiction liability was judged to be greater for substances. Conversely, character flaws were viewed as more associated with behavioral addictions.
The general public appreciates the complex bio-psycho-social etiology underlying addictions, but perceives substance-related and behavioral addictions differently. These attitudes, in turn, may shape a variety of important outcomes, including the extent to which people believed to manifest behavioral addictions feel stigmatized, seek treatment, or initiate behavior changes on their own.
Copyright © 2014 Elsevier Ltd. All rights reserved.
Research on hypersexual behavior consisting of excessive and uncontrollable sexual fantasies, urges, and behavior has increased in recent years. Although no formal diagnosis for hypersexual behavior exists, criteria were proposed for Hypersexual Disorder (HD) for possible inclusion in the DSM-5 (Kafka, 2010). The present article aims to (a) review extant measures of hypersexual behavior, (b) compare the items on the existing measures to the proposed criteria of HD, and (c) evaluate which measures best reflect the proposed criteria. We present and review 32 measures, which fall into 3 categories: (a) clinical interviews, (b) self-report measures of general symptoms, and (c) self-report measures of consequences associated with hypersexual behavior. We conclude by providing recommendations for researchers and clinicians regarding use of these assessments.
To evaluate the effectiveness in reducing social stigma of an intervention and to assess the influence of gender and knowledge.
The program consisted in providing information and contact with users of mental health in order to reduce social stigma in the school environment. A total of 62 secondary school students (age 14-16 years) were evaluated with the Opinions on Mental Illness (OMI) questionnaire before and after the intervention. The subscales of the OMI were: authoritarianism, interpersonal etiology, benevolence, restrictiveness and negativism. The analysis was performed over the total sample, separating by gender and knowledge of someone with a mental disorder. t-test for repeated measures was used in the statistical analysis.
All the OMI subscales showed a significant change after the intervention (P < 0.001), except for benevolence. Women presented significant changes in the subscales of authoritarianism and restrictiveness, while men presented changes in negativism and interpersonal etiology rather than restrictiveness (P < 0.001-0.003). Students that knew someone with a mental disorder presented significant changes in authoritarianism, interpersonal etiology, and negativism (P < 0.001-0.003) and students that do not know anyone with a mental disorder improved in restrictiveness and authoritarianism (P < 0.001-0.001). In all the subscales of the instrument the students improved their perception of mental disorders, reducing their levels of stigma.
The intervention designed to reduce social stigma was effective, especially in the area of authoritarianism. The whole sample showed improved attitudes towards mental illness, although the areas were different depending on gender and knowledge.
Stigma is one of the obstacles in the treatment and regaining the mental health of people with mental illness. The aim was determination of mental illness stigma among nurses in psychiatric wards. This study was conducted in psychiatric wards of teaching hospitals in Tabriz, Urmia, and Ardabil in the north-west of Iran.
This research is a descriptive analysis study in which 80 nurses participated. A researcher-made questionnaire was used, which measured demographic characteristics and mental illness stigma in the three components of cognitive, emotional, and behavioral. All data were analyzed using SPSS13 software and descriptive and analytical statistics.
Majority of nurses (72.5%) had medium level of stigma toward people with mental illness. About half of them (48.8%) had great inclination toward the social isolation of patients. The majority of them (62.5%) had positive emotional responses and 27.5% had stereotypical views. There was a significant correlation between experience of living with and kinship of nurses to person with mental illness, with prejudice toward and discrimination of patients. There was also a significant correlation between interest in the continuation of work in the psychiatric ward and prejudice, and also between educational degree and stereotypical views.
The data suggest there is a close correlation between the personal experience of nurses and existence of mental illness stigma among them. Therefore, the implementation of constant educational programs on mental illness for nurses and opportunities for them to have direct contact with treated patients is suggested.
Three studies investigated implicit biases, and their modifiability, against overweight persons. In Study 1 (N = 144), the authors demonstrated strong implicit anti-fat attitudes and stereotypes using the Implicit Association Test, despite no explicit anti-fat bias. When participants were informed that obesity is caused predominantly by overeating and lack of exercise, higher implicit bias relative to controls was produced; informing participants that obesity is mainly due to genetic factors did not result in lower bias. In Studies 2A (N = 90) and 2B (N = 63), participants read stories of discrimination against obese persons to evoke empathy. This did not lead to lower bias compared with controls but did produce diminished implicit bias among overweight participants, suggesting an in-group bias.
Over the past decades, psychiatry, as a science and a clinical discipline, has witnessed profound changes.
To examine whether these changes are reflected in changes in the public's conceptualisation of mental disorders, the acceptance of mental health treatment and attitudes towards people with mental illness.
In 1990 and 2011, population surveys were conducted in Germany on public attitudes about schizophrenia, depression and alcohol dependence.
Although the public has become more inclined to endorse a biological causation of schizophrenia, the opposite trend was observed with the other two disorders. The public's readiness to recommend help-seeking from mental health professionals and using psychotherapy and psychotropic medication has increased considerably. Attitudes towards people with schizophrenia worsened, whereas for depression and alcohol dependence no or inconsistent changes were found.
The growing divide between attitudes towards schizophrenia and other mental disorders should be of particular concern to future anti-stigma campaigns.
Aims and Method
To assess the effect of factsheets from the Royal College of Psychiatrists' Changing Minds campaign on stigmatised attitudes of members of the general public towards those with mental illness. Participants were recruited at random from a panel of over 1200 members of the general population and presented with questionnaires containing single-page factsheets adapted from the Changing Minds campaign describing schizophrenia or substance use disorders. The Attitudes to Mental Illness Questionnaire (AMIQ) was used to measure the effect on stigmatised attitudes.
Results
In total 200 questionnaires were distributed; 158 completed questionnaires were received (response rate 79%). The AMIQ scores for the alcoholism and schizophrenia vignettes did not differ between experimental and control groups. Fidelity questions included in the questionnaire indicated that participants had read and understood the factsheets.
Clinical Implications
Didactic factsheets produced for the Changing Minds campaign were largely ineffective at changing stigmatised attitudes towards schizophrenia and alcoholism.
Audio Interview
Interview with Dr. Nora Volkow on stigma against people who use drugs and its effects on care delivery and the burden of substance use disorders. (11:26)Download
Among the challenges in delivering appropriate care to the millions of people in the United States with substance use disorder is the chilling effect of stigma. Stigma impedes access to treatment and care delivery and contributes to the disorder on the individual level.
The current opioid crisis in the U.S. is unprecedented and calling for a nationwide reorganization of the public health prevention program. Stigma is a persistent barrier to this agenda, unfortunately with a limited body of research on substance use disorder (SUD) available to inform it. We review the broader research literature on the stigma of behavioral health (i.e., mental illness and SUD) to identify strategies to address the opioid crisis and harmful stigma. A major difference between mental illness and SUD stigma is that the latter is legally and socially sanctioned. In making sense of the behavioral strategies for stigma change, we consider three agendas for stigma prevention (prevention, rights, and self-worth). We suggest that incorporating the rights and the self-worth agendas with an in vivo focused contact model, might be most effective for an integrative strategy aimed at targeting opioid stigma. Involving people in recovery as key drivers of this agenda and evaluating the detrimental impact of using stigma as a health tool (social sanction), will bring new horizons to solving this deadly epidemic.
This is a response to Gola and Potenza’s (2018) Letter to the Editor regarding Walton, Cantor, Bhullar, and Lykins’ (2017a, b) review of hypersexuality. In their Letter, Gola and Potenza referred to problematic hypersexuality as compulsive sexual behavior (CSB), although such behavior has also been variously described as hypersexual behavior, sexual impulsivity, sexual compulsivity, and sex addiction (Cantor et al., 2013; Kafka, 2010). Inherent to these varied theoretical conceptualizations exists the premise that some people experience their sexual behavior as recurrent, uncontrollable, and distressing.
The scientific study of sexual desire is characterized by a series of unconnected mini-theories and dissimilar empirical findings. This research develops a functional theory which deconstructs sexual desire to include two conceptually meaningful variables which comprise a person's “bifurcated lovemap:” an emotional disposition toward fantasy and an emotional disposition toward interpersonal relationships. The purpose of this study was to determine the relationship between objectified, i.e., depersonalized, sexual fantasies and interpersonal attachments, specifically investigating the “personal bias” held toward objectified fantasies among people with chronic hypersexuality, e.g., sexual addiction/compulsivity and the internal working models these persons hold toward “comfortable interpersonal attachments.” A quantitative analysis suggests that 22 (N = 22) self-identified sexual addicts were able to reduce the power of their objectified fantasies and increase their ‘underdeveloped’ sense comfort with interpersonal relationships by experiencing imagery restructuring exercises in the form of guided imageries. A thorough analysis of the data allowed for the emergence of an axiom associated with the two relevant variables: As comfort toward interpersonal relationships increases, the negative power of objectified fantasies is diminished. This study is of special significance as it provides a pragmatic model which is able to link praxis with theory. Further, the results suggest that objectified fantasies are normative, purposeful and enduring and that the meta-communication underlying their symbolic form is a mythical allegory which allows for perceived responsiveness and affirmation. As a means to support this theory's coherence, I suggest that future research be directed toward persons with sexually avoidant behaviors. This would assist in the development of an elegant theory related to the variable nature of sexual desire which is able to link both measurable variables and clear-cut points of intervention to the diversity of its expression when it obstructs humanistic expression.
Background: Men and women differ in their patterns of help-seeking for health and social problems. For people experiencing problem gambling, feelings of stigma may affect if and when they reach out for help. In this study we examine men's and women's perceptions of felt stigma in relation to help-seeking for problematic gambling.
Methods: Using concept mapping, we engaged ten men and eighteen women in group activities. We asked men and women about their perceptions of the pleasurable aspects and negative consequences of gambling; they generated a list of four hundred and sixteen statements. These statements were parsed for duplication and for relevance to the study focal question and reduced to seventy-three statements by the research team. We then asked participants to rate their perceptions of how much felt stigma (negative impact on one's own or family's reputation) interfered with help-seeking for gambling. We analyzed the data using a gender lens.
Findings: Men and women felt that shame associated with gambling-related financial difficulties was detrimental to help-seeking. For men, the addictive qualities of and emotional responses to gambling were perceived as stigma-related barriers to help-seeking. For women, being seduced by the ‘bells and whistles’ of the gambling venue, their denial of their addiction, their belief in luck and that the casino can be beat, and the shame of being dishonest were perceived as barriers to help-seeking.
Conclusions: Efforts to engage people who face gambling problems need to consider gendered perceptions of what is viewed as stigmatizing.
Objective:
To obtain rapid and reproducible opinions that address mental illness stigma around the world.
Method:
Random global Web users were exposed to brief questions, asking whether they interacted daily with someone with mental illness, whether they believed that mental illness was associated with violence, whether it was similar to physical illness, and whether it could be overcome.
Results:
Over a period of 1.7 years, 596,712 respondents from 229 countries completed the online survey. The response rate was 54.3%. China had the highest proportion of respondents in daily contact with a person with mental illness. In developed countries, 7% to 8% of respondents endorsed the statement that individuals with mental illness were more violent than others, in contrast to 15% or 16% in developing countries. While 45% to 51% of respondents from developed countries believed that mental illness was similar to physical illness, only 7% believed that mental illness could be overcome. To test for reproducibility, 21 repeats of the same questions were asked monthly in India for 21 months. Each time, 10.1±0.11% s.e., of respondents endorsed the statement that persons who suffer from mental illness are more violent than others, indicating strong reproducibility of response.
Conclusion:
This study shows that surveys of constructs such as stigma towards mental illness can be carried out rapidly and repeatedly across the globe, so that the impact of policy interventions can be readily measured.
Limitations:
The method engages English speakers only, mainly young, educated males.
Stress represents the main environmental risk factor for mental illness. Exposure to stressful events, particularly early in life, has been associated with increased incidence and susceptibility of major depressive disorders as well as of other psychiatric illnesses. Among the key players in these events are glucocorticoid receptors. Dysfunctional glucocorticoid signalling may indeed contribute to psychopathology through a number of mechanisms that regulate the response to acute or chronic stress and that affect the function of genes and systems known to be relevant for mood disorders. Indeed, exposure to chronic stress early in life as well as in adulthood has been shown to reduce the expression of glucocorticoid receptors (GR), also through epigenetic mechanisms, and to up-regulate the expression of the co-chaperone gene FKBP5, which restrains GR activity by limiting the translocation of the receptor complex to the nucleus. Another mechanism that contributes to changes in GR responsiveness is the state of receptor phosphorylation that controls activation, subcellular localization as well as its transcriptional activity. Moreover, GR phosphorylation may represent an important mechanism for the cross talk between neurotrophic signalling and GR-dependent transcription, bridging two important players for mood disorders. One gene that lies downstream from GR and may contribute to stress-related changes is serum glucocorticoid kinase-1 (SGK1). We have demonstrated that the expression of SGK1 is significantly increased after exposure to chronic stress in rodents as well as in the blood of drug-free depressed patients. We have also shown that SGK1 up-regulation may ultimately reduce hippocampal neurogenesis and contribute to the structural abnormalities that have been reported to occur in depressed patients.
This article will review data obtained from both clinical and preclinical investigations demonstrating that exposure to stress has a significant impact on drug addiction. The preclinical literature suggests that stress increases reward associated with psychomotor stimulants, possibly through a process similar to sensitization. While it is not conclusive that a similar process occurs in humans, a growing clinical literature indicates that there is a link between substance abuse and stress. One explanation for the high concordance between stress-related disorders and drug addiction is the self-medication hypothesis, which suggests that a dually diagnosed person often uses the abused substance to cope with tension associated with life stressors or to relieve symptoms of anxiety and depression resulting from a traumatic event. However, another characteristic of self-administration is that drug delivery and its subsequent effects on the hypothalamo-pituitary-adrenal (HPA) axis are under the direct control of the individual. This controlled activation of the HPA axis may result in the production of an internal state of arousal or stimulation that is actually sought by the individual (i.e., the sensation-seeking hypothesis). During abstinence, exposure to stressors or drug-associated cues can stimulate the HPA axis to remind the individual about the effects of the abused substance, thus producing craving and promoting relapse. Continued investigations into how stress and the subsequent activation of the HPA axis impact addiction will result in the identification of more effective and efficient treatment for substance abuse in humans. Stress reduction, either alone or in combination with pharmacotherapies targeting the HPA axis may prove beneficial in reducing cravings and promoting abstinence in individuals seeking treatment for addiction.
Our paper couples previous research on attitudes toward people with mental illness and more general sociological research on attitudes toward "out-groups " to examine the role of five factors that influence the public's willingness to interact with people with mental health problems, including: the nature of the behavior described, causal attributions of the behavior's source, perceived dangerousness of the person, the label of "mental illness," and the sociodemographic characteristics of respondents. Using vignette data from the 1996 General Social Survey (N = 1,444), we find that respondents discriminate among different types of mental health problems by expressing more desire to avoid those with drug and alcohol problems than with those with mental illness. Consistent with research on racial attitudes, we also find that Americans who attribute mental health problems to structural causes (e.g., stress or genetic/biological causes) are more willing to interact with the vignette person than those who see individual causes (e.g., "bad character" or the "way the person was raised") as the root of the problem. However, even controlling for these factors, respondents who label the vignette a "mental illness " also express a preference for greater social distance. Finally, while the sociodemographic characteristics of the respondent appear to play a minimal role in preferences for social distance, the degree of dangerousness that the public ascribes to people with mental health problems is important and appears to mediate the influence of effects of labeling a person as mentally ill.
Objective
Though unlikely virtues scales have a long history in personality, clinical, and applied psychology for detecting socially desirable responding, using such social desirability (SD) scales has generally failed to improve the validity of personality measures. We examined whether this is because (a) response distortion itself has minimal impact on personality's validity, (b) SD scales are ineffective at assessing response distortion, or (c) SD scales are conflated with substantive trait variance.Method
We compiled a meta-analytic multi-trait multi-method (MTMM) matrix consisting of multi-rater personality traits, SD scales, and performance outcomes. We examined the influence of trait factors and self-report method factors on SD scales and performance.ResultsWe found that self-report method variance (a) was negatively related to performance, (b) would suppress personality-performance relationships for self-report measures, and (c) are (partially) assessed by SD scales. However, relative to the effects of self-report method variance, SD scales are even more strongly influenced by Conscientiousness, Emotional Stability, and Agreeableness.Conclusions
It is not the case that SD scales are insensitive to inflated responding but that their susceptibility to personality trait variance likely outweighs their benefits. We discuss implications of these results for using SD scales in research and practice.
Known since ancient times, sexual excess has been referred to as 'sexual addiction,for three decades. DSM-5 has proposed a new category of 'hypersexual disorder' to bring together disturbing situations of masturbation, pornography use, strip club attendance, multiple affairs, internet procurement of partners, prostitution use, unprotected sex with multiple partners and other sexually arousing behaviors. The conditions under which patients come for assessment differ between single and married, heterosexual and homosexual, paraphilic and nonparaphilic, and sex criminals and law-abiding patients. Treatment depends on apparent causes, comorbidities and the patient's capacities. While questions have been raised about the validity of hypersexual disorder, the numerous requests for assistance from patients should remind the field of psychiatry that utility also drives the employment of a diagnosis.
Eta squared measures the proportion of the total variance in a dependent variable that is associated with the membership of different groups defined by an independent variable. Partial eta squared is a similar measure in which the effects of other independent variables and interactions are partialled out. The development of these measures is described and their characteristics compared. In the past, the two measures have been confused in the research literature, partly because of a labelling error in the output produced by certain versions of the statistical package SPSS. Nowadays, partial eta squared is overwhelmingly cited as a measure of effect size in the educational research literature. Although there are good reasons for this, the interpretation of both measures needs to be undertaken with care. The paper concludes with a summary of the key characteristics of eta squared and partial eta squared.
• Summary: Previous research has shown that people labeled with drug addiction are viewed as more blameworthy and dangerous compared to individuals labeled with mental illness who, in turn, are viewed more harshly than those with physical disabilities. Endorsement of such stereotypes often lead to less helping behavior and more avoidance of people with drug addiction compared to those with mental illness. In this study, attribution and dangerousness models are tested on a stratified random sample of the US population. The sample was recruited from a national online research panel ( N = 815). Research participants read a vignette about a person with one of the three health conditions (mental illness, drug addiction, or physically handicapped in a wheelchair) and were asked to complete items representing attribution and dangerousness judgments about the person.
• Findings: Results are consistent with our hypotheses. Addicted to drugs was seen as more blameworthy and dangerous compared to mental illness.
• Applications : These findings are important for framing the stigma and stereotypes of mental illness and drug addiction are discussed. In turn, these kinds of basic models will inform stigma change efforts of advocates.
The stigma of mental illness remains a serious social problem and critical impediment to treatment seeking among diagnosed individuals. Study 1 evaluated explicit attitudes and stereotypes about persons with mental illness relative to persons with physical illness, and also implicit attitudes that lie outside conscious control (using the Implicit Association Test) in a college sample (N = 119). Study 2 extended the evaluation of explicit and implicit biases to a sample diagnosed with mental illness (N = 35) and a healthy control sample from the general population (N= 36). Results demonstrated implicit negative attitudes and beliefs about the helplessness and blameworthiness of mentally ill persons. Interestingly, relatively negative explicit attitudes and biases about the helplessness (though not blameworthiness) of mentally ill persons were also evident. In addition, being a member of the stigmatized group did not result in lower implicit or explicit biases, suggesting that no protective in-group bias exists.
In response to the availability of a growing literature on the psychological correlates of child sexual abuse (CSA), numerous researchers have conducted literature reviews of these correlates. These reviewers have generally reported that CSA is associated with a wide variety of adjustment problems, and many have additionally implied or concluded that, in the population of persons with CSA experiences, (a) CSA causes psychological harm, (b) this harm is pervasive, (c) this harm is intense, and (d) boys and girls experience CSA equivalently. However, with few exceptions, these reviewers have included in their reviews mostly studies using clinical and legal samples; these samples cannot be assumed to be representative of the general population. To evaluate the implications and conclusions of these reviewers, we conducted a literature review of seven studies using national probability samples, which are more appropriate for making population inferences. We found that, contrary to the implications and conclusions contained in previous literature reviews that were focused on biased samples, in the general population, CSA is not associated with pervasive harm and that harm, when it occurs, is not typically intense. Further, CSA experiences for males and females are not equivalent; a substantially lower proportion of males reports negative effects. Finally, we found that conclusions about a causal link between CSA and later psychological maladjustment in the general population cannot safely be made because of the reliable presence of confounding variables. We concluded by cautioning that analysis at the population level does not characterize individual cases: When CSA is accompanied by factors such as force or close familial ties, it has the potential to produce significant harm.
Disordered gambling stigma was examined. University students (117 male, 132 fe- male) rated vignettes describing males with five health conditions (schizophrenia, alcohol dependence, disordered gambling, cancer, and a no diagnosis control with subclinical problems) on a measure of attitudinal social distance. A mixed ANOVA revealed that, in keeping with hypotheses, disordered gambling was more stigmatized than the cancer and control conditions. Interactions suggested that stigma may be influenced by context (i.e., order of vignette appearance) and partic- ipant characteristics (i.e., sex and ethnicity), although follow-up analyses revealed this was not the case for disordered gambling. Perceived dangerousness attribu- tions and familiarity (previous experience with a disordered gambler) were also ex- amined. As predicted, perceived dangerousness was positively correlated with social distance scores. Familiarity ratings were unrelated to social distance.
Brain disease models of psychopathology, such as the popular chemical imbalance explanation of depression, have been widely disseminated in an attempt to reduce the stigma of mental illness. Ironically, such models appear to increase prejudicial attitudes among the general public toward persons with mental disorders. However, little is known about how biochemical causal explanations affect the perceptions of individuals seeking mental health treatment. Ninety undergraduate students participated in a thought experiment in which they were asked to imagine feeling depressed, seeking help from a doctor who diagnosed them with major depressive disorder, and receiving, in counterbalanced order, a chemical imbalance and biopsychosocial explanation for their symptoms. Ratings of each explanation's credibility and perceptions of self-stigma (e.g., blame), prognosis, and treatment expectancies were obtained. Compared to the biopsychosocial model, the chemical imbalance model was associated with signifi antly less self-stigma but also significantly lower credibility, a worse expected prognosis, and the perception that psychosocial interventions would be ineffective. The chemical imbalance explanation appears to reduce blame at the cost of fostering pessimism about recovery and the efficacy of nonbiological treatments. Research is needed on how the chemical imbalance model affects the clinical response of patients receiving mental health treatment.
This article examines attitudes related to feminism and gender equality by evaluating the trends in, and determinants of, women and men's attitudes from 1974 to 1998. Past accounts suggest two clusters of explanations based on interests and exposure. Using these, we examine opinions on abortion, sexual behavior, public sphere gender roles, and family responsibilities. We find that attitudes have continued to liberalize and converge with the exception of abortion attitudes. The determinants of feminist opinion vary across domains, but have been largely stable. While not identical, the predictors of men and women's opinions are similar. The results suggest the need for more attention to the mechanisms underlying the production of feminist opinions and theoretical integration of both interests and exposure in a dynamic process.
Globally, more than 70% of people with mental illness receive no treatment from health care staff. Evidence suggests that factors increasing the likelihood of treatment avoidance or delay before presenting for care include (1) lack of knowledge to identify features of mental illnesses, (2) ignorance about how to access treatment, (3) prejudice against people who have mental illness, and (4) expectation of discrimination against people diagnosed with mental illness. In this article, we reviewed the evidence on whether large-scale anti-stigma campaigns could lead to increased levels of help seeking. (Am J Public Health. Published online ahead of print March 14, 2013: e1-e4. doi:10.2105/AJPH.2012.301056).