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Abstract

Life goals and the opportunities that define them are impaired by the stigma of mental illness. Three kinds of stigma may act as barriers to personal aspirations: public stigma, self-stigma, and label avoidance. Challenging mental illness stigm is essential in helping individuals accomplish recovery-related goals. Public stigma may be changed through protest, education, and contact. Self-stigma can be addressed by fostering group identity, changing the perceived legitimacy of stigma through cognitive rehabilitation, and making strategic decisions about disclosing one's mental health history. Stigma change for label avoidance is not as well understood but may include the education and contact approaches used for public stigma. Evidence-based approaches to stigma change need to be substantiated by rigorous investigations.

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... Psychiatric Services 2020; 71:1047-1064; doi: 10.1176/appi.ps.201900606 Stigmatizing attitudes toward and beliefs about people with experiences of emotional distress have been recognized as both a barrier to seeking professional help for emotional distress (1-3) and a cause of secondary harm due to "lost opportunity and personal demoralization" (4). Reviews of stigma research, however, suggest that mental health professionals (MHPs) may themselves hold stigmatizing beliefs about people experiencing emotional distress (5-10). ...
... Stigmatizing beliefs among MHPs negatively affect service users' experience of care by affecting the "recovery orientation" of mental health services (13). MHPs who have these beliefs are more susceptible to making negative prognoses and overdiagnosing (7), seeking social distance from service users (14), and conveying messages of hopelessness and deviance that are internalized by service users (4). ...
... Research into stigma reduction interventions has found that contact-based education interventions are the most effective in reducing stigmatizing beliefs, especially when the person delivering the education is of a similar social group to the target group (4). Thus the presence of MHPs with lived experience represents a largely untapped resource for reducing stigma in mental health services, if professionals who wish to share their experiences are supported to do so (19). ...
Article
Objective: Research has suggested that some mental health professionals (MHPs) continue to hold stigmatized beliefs about persons with emotional distress. These beliefs may be amenable to contact-based interventions with similar peers. To inform future interventions, policy, and research, this scoping review examined existing literature to identify factors that affect disclosure of lived experience by MHPs to colleagues and supervisors. Methods: A systematic search was conducted of four online databases, gray literature, and the reference lists of included articles. Primary research studies of any design conducted with MHPs with lived experience of emotional distress and their colleagues were included. The findings of included studies were inductively coded within the themes of enabling, constraining, and intrapersonal factors influencing disclosure. Results: A total of 23 studies were included in data extraction and synthesis. Factors that influenced MHPs’ sharing of their lived experience in the workplace were categorized into five overarching themes: the “impaired professional,” the “us and them” divide, the “wounded healer,” belief in the continuum of emotional distress, and negotiating hybrid identities. MHPs with lived experience described feeling conflict between professional and service user identities that affected the integration and use of their clinical and experiential knowledge. Enabling factors reflected best-practice human resource management, such as organizational leadership, access to supervision and training, inclusive recruitment practices, and the provision of reasonable accommodations. Conclusions: Findings of this scoping review suggest that organizational interventions to support MHPs in order to share their lived experience may improve workplace diversity and well-being, with implications for service users’ experience.
... People that are stigmatized by others also experience self-stigmatization which is often accompanied by psychological harm, and they may be negatively affected in their uptake of health care services (6). As a consequence, stigmatization can impede the process of recovery, but also the ability to find a home, a job, or insurance (11,12). ...
... We thus need to better understand the factors driving stigmatization in the general population to design evidence-based programs to reduce it (11). Further research is also warranted given that, notwithstanding diverse efforts, stigmatization of people with mental illnesses such as drug addiction is a fact rather than a rudiment (13). ...
... Attribution Theory postulates that individuals have a tendency to attribute levels of controllability and responsibility in order to better understand and explain the causes of the behaviors and conditions (such as addiction) of others, or related events and outcomes (11,15,18). Thereby, individuals are receptive to or actively search for signals and signaling events which can evoke negative cognitive beliefs (such as blameworthiness and dangerousness), negative affective reactions (such as anger and fear), and discriminatory behaviors (such as coercion and segregation). ...
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Drug abuse and addiction exist around the world. People addicted to drugs such as opium or heroin often encounter dehumanizing discriminatory behaviors and health-care systems that are reluctant to provide services. Experiencing discrimination often serves as a barrier to receiving help or finding a home or work. Therefore, it is important to better understand the mechanisms that lead to the stigmatization of drug addiction and who is more prone to stigmatizing behaviors. There is also a dearth of research on whether different patterns of stigma exist in men and women. Therefore, this study investigated factors affecting gender-specific stigmatization in the context of drug addiction. In our vignette study (N Mensample = 320 and N Womensample = 320) in Iran, we experimentally varied signals and signaling events regarding a person with drug addiction (i.e., N Vignettes = 32 per sample), based on Attribution Theory, before assessing stigmatizing cognitions (e.g., blameworthiness), affective responses (e.g., anger), and discriminatory inclinations (e.g., segregation) with the Attribution Questionnaire. We also tested assumptions from the Familiarity Hypothesis by assessing indicators of respondents' familiarity with drug addiction (e.g., knowledge about addiction). Results, for example, show higher stigma if the person used "harder" drugs, displayed aggressive behavior, or had a less controllable drug urge. Self-attributed knowledge about addiction or prior drug use increased some forms of stigma, but diminished others. These findings only partially converged between men and women. We suggest that anti-stigma initiatives should consider information about the stigmatized person, conditions of the addiction, and characteristics of stigmatizers.
... Stigma is a significant social determinant of health and a driver of poor health outcomes [1][2][3]. Stigma can be manifested in negative stereotypes that cause discrimination and disadvantages for stigmatized persons [4,5]. However, most health-related stigma studies concentrate on an individual level of stigma experience, limiting a broader socioecological perspective to understanding the stigmatization process and interventions [3,5,6]. ...
... When stigma is applied to people, it is usually manifested in stereotypes based on misconceptions, such as believing that people with mental illness are incapable of holding down a "real" job or living independently [4]. These negative stereotypes may cause discrimination contributing to unequal outcomes for the stigmatized person [5]. ...
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This paper explores the barriers to supporting South Asian (Pakistani, Nepalese and Indian) migrant children with special needs that their families encountered navigating Hong Kong’s special needs system and accessing education and healthcare services. It adopts concepts of stigma and disability rights. It draws on semi-structured interviews with fifteen South Asian children and young people with special needs (age 5–21; M = 10; F = 5) and their families, and seven professional practitioners based on the qualitative descriptive method. Informants experienced intersecting stigmatization that included (1) institutional exclusion, (2) daily life microaggressions, and (3) misunderstandings and a lack of awareness education. Simultaneously, some were empowered through (4) support and accommodation, and (5) spiritual support from religion. This paper reveals a paradox embodied by Hong Kong; it is an Asian multicultural city committed to embracing the vision of disability inclusion while failing to ensure necessary support to reduce the stigma experienced by culturally diverse children with a disability. It makes recommendations based on a socioecological framework and concludes that concerted efforts by relevant authorities and organizations should be made to reduce stigma by taking into consideration the intersecting stigmas, specific resources unique to migrant communities, disability rights and cultural sensitivity.
... When it comes to mental illness, stigma "refers to the social judgment, degradation, or devaluation of individuals because they have mental illness symptoms or have been labeled as having a mental illness" (Abdullah & Brown, 2011, p. 936). There are three types of mental illness stigma: public stigma, self-stigma (Corrigan & Wassel, 2008), and perceived stigma (Barney et al., 2006). Public stigma refers to the discrimination of the mentally ill by the public, self-stigma is the internalization of the public stigma regarding their illness by an individual (Corrigan & Wassel, 2008), and perceived stigma is the belief that others hold stigmatizing thoughts (Barney et al., 2006). ...
... There are three types of mental illness stigma: public stigma, self-stigma (Corrigan & Wassel, 2008), and perceived stigma (Barney et al., 2006). Public stigma refers to the discrimination of the mentally ill by the public, self-stigma is the internalization of the public stigma regarding their illness by an individual (Corrigan & Wassel, 2008), and perceived stigma is the belief that others hold stigmatizing thoughts (Barney et al., 2006). Any presence of one or more of these stigmas can impede the efforts of those suffering from mental illness to seek help (Barney et al., 2006). ...
Thesis
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Depression is a serious mental illness affecting a large proportion of the global population, especially the youth. Research has shown that people suffering from depression are at a higher risk of suicide. Tumblr is an online microblogging social media platform, which has been accused of romanticizing mental illnesses such as depression, however, very little research has been done to investigate this issue. The Arab World is the home of most ongoing armed conflicts today and with almost half of the population under 30 and problems like poverty, lack of mental health institutions, stigmatization, war, and refugees, the population is one of the most at risk of depression and its complications. Furthermore, Suicide rates in the region have increased in age groups until 20- 24. Thus, considering its large young population vulnerable to mental illness any research is an important addition to the almost non-existing literature of depression in the Arab World. Identifying the differences between depression manifestations of Western and other cultures could lay the foundation for future research to examine social media as a predictor of depression in other populations by understanding the role of individuals' linguistic expressions and cultural background, while acknowledging the Western influence on non-Western users of a Western platform. We have content analyzed a sample of 609 Tumblr posts (208 Arabic and 401 English language posts) regarding depression symptoms and expressions and our results regarding depression symptoms found depressed mood present in almost all of the posts regardless of their users. Feelings of worthlessness and/or guilt were found in almost equal percentages in both groups, whereas suicidal ideation was found more in Western posts. Finally, the study has also found some differences between the Arab- and English-language posts in that Arabs preferred quoting fictional novels and non-fiction real-life authors to express their symptoms, while Western users preferred quoting and creating gifs of TV and Film scenes and characters – however, both can be interpreted as a way of romanticizing depression. In contrast to these differences, we have found only few gender differences in the posts.
... Stigma in MHP negatively impacts service user experience of care by affecting the "recovery orientation" of mental health services (13). MHP holding these beliefs are more susceptible to making negative prognoses and over-diagnosing (7), seeking social distance from service users (14) and conveying messages of hopelessness and deviance that are internalized by service users (4). ...
... Research into stigma reduction interventions has found that contact-based education (CBE) interventions are the most effective in reducing stigma beliefs, especially when the person delivering the education is of a similar social group to the target group (4). Thus, the presence of MHPLE represents a largely untapped resource for reducing stigma in mental health services, if professionals who wish to share their experiences are supported to do so (19). ...
Preprint
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This paper describes the findings of a scoping review into the factors that enable and constrain mental health professionals sharing their personal lived experience of mental health challenges with colleagues and supervisors.
... People with a mental illness are faced with cognitive, social and interpersonal challenges which arise from the symptoms of their illness (Corrigan & Wassel, 2008). These symptoms, which may include altered perception or delusions, increase the individual's risk of morbidity and mortality (Waters, Furukawa, & Jorissen, 2018), while significantly hindering an individual's capacity for independence and ability to pursue important life goals (Rusch, Angermeyer, & Corrigan, 2005). ...
... Labels such as these are not intended to cause stigmatisation or offence, however, stigmatisation may occur when these labels are linked with negative responses and discrimination (Link & Phelan, 2001). Furthermore, stigma, when internalised, negatively influences a person's self-esteem, personal goal attainment and quality of life (Corrigan & Wassel, 2008). ...
Article
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People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. However, people who are empowered may actively challenge stigma by engaging in meaningful opportunities, furthering their self-worth as they achieve control within their lives. People who are empowered through active treatment participation are more likely to reach recovery goals and experience the benefits of evidence-based practices. Hence, empowerment can be viewed as essential to the recovery and well-being of people with a mental illness. Participants in this quantitative study (N = 173) were diagnosed with a mental illness and were recruited via convenience sampling from mental health support groups in Australia. Internalised stigma was less common and empowerment more prevalent in this study than was found in previous studies. However high internalised stigma and low empowerment were present. The terms ‘individual’ and ‘person with lived experience’ which have been identified as the preferred terms in a previous study were highlighted as both empowering and recovery focussed.
... Further studies should clarify this mechanism in the future. As previous studies have suggested [39,40], recovery knowledge was negatively associated with stigma among mental health professionals in this study. This finding suggests that education, which improves recovery knowledge might be important to reducing stigma among mental health professionals. ...
... Moreover, as previous studies on psychiatrist and psychiatric nurses have suggested [39,[51][52][53], this study also showed that educational history and recovery knowledge are possible factors that can reduce stigma among nurses. Psychiatric social workers had higher levels of recovery knowledge than nurses in the current study. ...
Article
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This study aimed to examine the association between control over practice in work environments and stigma toward people with schizophrenia among mental health professionals. We conducted secondary analyses on data from a self-administered questionnaire survey. The sample in the initial study included mental health professionals from two psychiatric hospitals, 56 psychiatric clinics, and community service agencies in Japan. The Ethics Committee of the University of Tokyo, approved this study. Data from 279 participants were used for secondary analyses (valid response rate = 58.7%). The hierarchical multiple regression analysis was used to determine the association between control over practice and stigma. We performed subgroup analyses among nurses (n = 121) and psychiatric social workers (n = 92). Control over practice was negatively associated with stigma among mental health professionals (β = −0.162, p < 0.01). The subgroup analyses among nurses indicated that control over practice, educational history and recovery knowledge were associated with stigma. However, these variables were not associated with stigma among psychiatric social workers. Control over practice might help to reduce stigma among mental health professionals. Factors related to stigma might differ by occupation. Therefore, further comprehensive studies among various professionals would further our understanding of these factors.
... Drinkers who may be judged as alcoholics-at least in certain contexts-are aware of the implications of owning the stigmatised label, and may respond by rejection of its application via label avoidance (Corrigan & Wassel, 2008;Glass, Mowbray, Link, Kristjansson, & Bucholz, 2013). A notable driver of label avoidance is awareness of the social identity threat of being stigmatised by others irrespective of whether one personally agrees with or adopts the stigmatised identity (Schmader & Major, 2017). ...
... Further, persuasion literature highlights the limitations of statistical information (Braddock & Dillard, 2016;Zillmann, 1999), such that objectively highlighting health risks to harmful drinkers may be futile when stigma and identity-related consequences are more salient. However, personal contact has been highlighted as a promising anti-stigma strategy (Corrigan & Wassel, 2008), operating to reduce perceived difference and allaying fear and anxiety led responses to issues such as mental health or addiction problems Pettigrew & Tropp, 2008). As such, the use of first person language has been called upon as a key addiction anti-stigma strategy (Hartwell et al., 2020), alongside communicating prognostic optimism, sharing humanising narratives, and an emphasis on societal rather than individual causes of addiction problems (McGinty & Barry, 2020). ...
Chapter
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Harmful drinkers are characterized by low problem recognition in that they typically see themselves as ‘non-problem’ drinkers, i.e., they describe themselves as free from alcohol-related harms and distinct from the ‘alcoholic other’. Harmful drinkers are currently underserved by interventions, including those promoting self-change, and represent an important opportunity in public health terms. Opportunities to enhance problem recognition amongst this group may include promoting continuum beliefs or other models that avoid threats presented by a disease-based understanding of problem drinking, notably stigma and the expectation of lifelong abstinence. A conceptual model for problem recognition factors amongst harmful drinkers is presented.
... Patients with serious mental illnesses, such as schizophrenia, have been reported to encounter different forms of stigmatization [2,3]. Corrigan et al. categorized these types of stigma into "public stigma," "self-stigma," and "label avoidance" [4]. Self-stigma arises when people with psychiatric disorders who live in a society that endorses stigmatizing ideas internalize such ideas and believe that they are less valuable because they have a mental illness [5]. ...
... A Japanese version has been prepared and validated by Tanabe et al. [22]. The ISMI consists of 29 items assessed using a 4-point Likert scale ranging from 1. "I do not think so" to 4. "I very much think so," and five subscales (alienation [1,5,8,16,17,21], stereotype endorsement [2,6,10,18,19,23,24], perceived discrimination [3,15,22,25,26], social withdrawal [4,9,[11][12][13]20], and stigma resistance [7,14,[27][28][29]). The average ISMI score is interpreted as follows: 1.00-2.00, ...
Article
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Background Several studies have indicated that self-stigma is associated with depressive symptoms and could be a barrier to recovery in patients with schizophrenia-spectrum disorders. More recently, an association between autistic symptoms and self-stigma was found in schizophrenia-spectrum patients. This study aimed to investigate the association between self-stigma, autistic and depressive symptoms, and recovery in patients with schizophrenia. Methods In total, 105 participants were evaluated using the Autism Spectrum Quotient, the Internalized Stigma of Mental Illness Scale, the Quick Inventory of Depressive Symptomatology, and the Recovery Assessment Scale to investigate autistic symptoms, self-stigma, depressive symptoms, and recovery, respectively. The relationship between self-stigma, autistic symptoms, depressive symptoms, and recovery was assessed using structural equation modeling analysis. Results Impaired attention switching, one symptom of autism, was found to positively affect stereotype endorsement, which negatively influenced recovery through depressive symptoms. Moreover, problems with communication skills negatively affected recovery through depressive symptoms. Concerning self-stigma, stereotype endorsement and perceived discrimination had a negative effect on recovery through depressive symptoms, whereas stigma resistance had a direct negative effect on recovery. Conclusions This study may provide meaningful insight into the psychological structure of recovery and could inform effective interventions for patients with schizophrenia-spectrum disorders. This was a cross-sectionally designed study; therefore, further longitudinal studies are needed to identify the causal relationships between self-stigma, autistic and depressive symptoms, and recovery.
... Several factors such as mental health stigma, disabling medical conditions, barriers to care and time constraints [50] contribute to Veterans' underutilization of mental health services [10]. Rural Veterans face additional barriers to care related to distance to and availability of care services, and suffer from poorer physical and mental health status [51]. ...
... However, two studies of utilization of specialty mental health among veterans with PTSD found that only 6.3-11.4% of eligible veterans initiate trauma-focused psychotherapies [56,57]. Factors including barriers to mental health care such as travel distance and lack of information about availability of effective treatment options [50] contribute to veterans' underutilization of mental health services [10]. Increasing utilization rate by supporting information and access to far more effective treatments is likely to result in improved veteran quality of life and reduce long-term demands on an overstretched VA healthcare system [58]. ...
Article
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Posttraumatic stress disorder (PTSD) and comorbid mild traumatic brain injury (mTBI) are highly prevalent in veterans who served in Iraq [Operation Iraqi Freedom/Operation New Dawn] and Afghanistan [Operation Enduring Freedom]. Complicated psychotropic medications are used for treatment of PTSD and comorbid mTBI symptoms lead to polypharmacy related complications. Primary care providers (PCPs) working in Community Based Outpatient Clinics (CBOCs) are usually burdened with the responsibility of managing this complicated medication regimen or relevant side effects. The PCPs do not feel equipped to provide this complicated psychopharmacological management. Thus, there is a need for a comprehensive yet concise tool for the medication management of PTSD in veterans with comorbid mTBI. (1) To conduct focus groups of interdisciplinary team of experts and other stake holders to assess need, (2) To carefully review current VA/Department of Defense practice guideline to identify content, (3) To develop an evidence based, user friendly, and concise pocket guide for the PCP’s. Content was identified by review of current guidelines and available literature and was finalized after input from stakeholders, multidisciplinary team of experts, and review of qualitative data from focus groups/interviews of clinicians working in remote CBOCs. The pocket tool was formatted and designed by multimedia service. A pocket guide in the form of a bi-fold, 4″ × 5.5″ laminated card was developed. One thousand hard copies were distributed in the local VA medical center. This product is available online for download at the South-Central Mental Illness Research, Education, and Clinical Center website (https://www.mirecc.va.gov/VISN16/ptsd-and-mtbi-pocket-card.asp). This pocket card provides PCPs an easy to carry and user-friendly clinical decision-making tool to effectively treat veterans with PTSD and comorbid mTBI.
... Open access From a stigmatised person's viewpoint, stigma can be understood as taking three forms. [16][17][18][19][20] First, experienced stigma refers to a person experiencing discrimination due to social unacceptability. 16 19 Second, perceived stigma occurs when a person fears shameful, discriminatory situations and/or detrimental treatment because of their condition. ...
... 16 19 Third, self-stigma is when people are aware of negative stereotypes, prejudices, and discrimination regarding themselves, agree with them, and direct these negative and biased beliefs, feelings and behaviours internally. 17 18 20 Perceived stigma occurs in individuals with T2DM before their diagnosis and affects a wide range of individuals' health behaviours. 1 21-26 For example, avoiding screening tests, refusing a diabetes diagnosis, delaying treatment and concealing a diagnosis from family members are forms of perceived stigma. 1 21-26 In contrast, selfstigma occurs in individuals with T2DM during disease management. Empirical research has demonstrated that increased self-stigma negatively impacts the quality of patients' interactions with healthcare professionals and their self-management behaviours, 27 specifically patients' activation to engage in self-care, which it affects directly and indirectly through self-esteem and self-efficacy. 2 28 29 Activating patients to engage in self-care is critical for increasing patients' ability to gain the knowledge, skills, confidence, and behaviours required to manage their illness. ...
Article
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Objectives To examine the associations between self-stigma and diabetes duration in a sample of Japanese people with type 2 diabetes. Design A secondary analysis of a cross-sectional study. Setting Two university hospitals, one general hospital and one clinic in Tokyo, Japan. Participants Outpatients with type 2 diabetes aged 20–74 years and receiving treatment from diabetes specialist physicians (n=209) completed a self-administered questionnaire. Primary and secondary outcome measures Self-stigma was measured as the primary outcome. Patient Activation Measure, body mass index and haemoglobin A1c were measured as secondary outcomes. Results One-way analysis of covariance showed significant differences in self-stigma levels between the five groups of diabetes duration (≤5 years, 6–10 years, 11–15 years, 16–21 years and 22 years or more) after controlling for age, gender, education, marital status, diabetes treatment (insulin use) and diabetes-related complications, F(4,198)=2.83, p=0.026. Multiple comparisons using Bonferroni correction showed statistically significant differences in self-stigma levels between the groups with ≤5 years (95% CI 59.63 to 69.73) and 11–15 years with diabetes (95% CI 71.12 to 80.82; p=0.020). The highest mean level of self-stigma was observed in the group having diabetes for 11–15 years. Conclusions Self-stigma was associated with diabetes duration and was lowest after diagnosis and gradually increased, with its highest levels being observed in those having diabetes for 11–15 years. Self-stigma takes time to develop and gradually increases in individuals as it is learnt through direct experiences of diabetes-related stigma after self-administering treatment in everyday social situations.
... Past research shows that selfstigma is strongly associated with both depression (Yen et al., 2005;Zahn et al., 2015) and anxiety (Busby Grant et al., 2016). Consequently, individuals with mental health concerns avoid seeking treatment and social support (Corrigan & Matthews, 2003;Corrigan & Wassel, 2008;Vogel et al., 2007). Given that people with depression and anxiety tend to be more sensitive and vulnerable to negative stereotypes, it reflects that they tend to suffer from numerous negative mental health consequences (Ociskova et al., 2013). ...
Article
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Literature on the cultural psychological aspect of mental health suggests that antecedents of mental health in individualistic cultures, or societies that prioritize independence, autonomy, and personal uniqueness do not always apply in collectivistic cultures, or societies that prioritize interdependence, social connection, interpersonal harmony, and norms. The aim of the present study was to determine the mechanisms underlying the impact of self-stigma on depression and anxiety in a collectivistic culture such as the Philippines. Specifically, this study sought to examine: (1) the mediating role of self-criticism on the impact of self-stigma on depression and anxiety, and (2) the moderating role of interdependent self-construal on the impact of self-criticism on depression and anxiety in Filipinos. Surveys measuring self-stigma, self-criticism, interdependent self-construal, depression, and anxiety symptoms were administered to 312 adolescents in rural communities in the Philippines. Using structural equation modeling, findings revealed indirect effects of self-stigma on both depression and anxiety via self-criticism. Findings confirmed that interdependent self-construal attenuate the detrimental impact of self-criticism on depression and anxiety in collectivistic contexts. This study offers novel insights about the underlying mechanisms that operate in the impact of self-stigma on depression and anxiety symptoms among individuals in collectivist contexts. We highlight that self-criticism may have both adaptive and maladaptive functions in collectivist cultures. The study provides implications on the importance of culturally sensitive clinical interventions in preventing depression and anxiety by combating self-stigma and the negative aspect of self-criticism in collectivist cultures. Limitations and future directions are discussed.
... In both studies, the education of our samples was consistent with the general U.S. population, while race/ ethnicity was also consistent with the exception of underrepresentation of non-White Hispanic/Latinx participants (U.S. Census Bureau, 2019). However, the predominance of White participants in both samples obscures our ability to examine racial or ethnic differences in how labels affect stigma, which is an important limitation given differences in how Black Americans manifest mental health stigma and respond to stigma mitigation efforts (Abdullah & Brown, 2020;Corrigan & Wassel, 2008;Rao et al., 2007), and other potential racial/ ethnic differences (see Parcesepe & Cabassa, 2013). Both samples had a slightly higher median income than the general U.S. population (U.S. Census Bureau, 2019), which is notable given that higher SES has predicted greater stigma about some conditions (e.g., clinical depression) but not schizophrenia (Foster et al., 2018). ...
Article
Borderline personality disorder (BPD) is highly stigmatized. Although person-first labels are now used for most mental illnesses (e.g., a person with schizophrenia) rather than premodified noun labels (e.g., “he is a schizophrenic”), it is still common to hear people referred to as “borderlines.” In a series of two experimental studies, we examined how diagnostic labels influence negative attitudes about BPD. In Study 1, we presented vignettes with no diagnostic label, a person-first label, or a premodified noun label and compared BPD vignettes to schizophrenia vignettes. In Study 2, we again examined the influence of diagnostic label on attitudes about BPD and manipulated the gender depicted in the BPD vignettes. In Study 1, negative attitudes related to anger and blame were greater for BPD than schizophrenia. Diagnosis and label construction did not interact. In Study 2, we found little evidence of gender effects, except that male characters with BPD were considered more dangerous and evoked more fear, while female characters were viewed with greater pity. Gender and label construction did not interact. Although we expected that attitudes would be most negative in the premodified noun label condition and least negative in the person-first condition, this was not the case. In both Studies 1 and 2, the condition with no diagnostic label produced the greatest negative attitudes in some but not all stigma domains, while person-first and premodified noun labels did not differ. Results suggest that in some contexts, diagnostic labels reduce negative attitudes about BPD regardless of their specific construction. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
... 2, 3 Corrigan et al categorized stigma types into "public", "self-stigma" and "label avoidance." 4 Self-stigma develops when people with mental illnesses apply the stigma projected by the general population has toward them, to themselves. 5 Watson et al hypothesized that self-stigma occurs through three processes: 1) stereotype awareness, 2) stereotype agreement, and 3) self-concurrence. ...
Article
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Purpose: Self-stigma negatively influences self-esteem, quality of life, self-efficacy, treatment adherence, and recovery in psychiatric patients. By revealing personality traits that influence self-stigma, we can gain useful knowledge for the management of self-stigma. A previous meta-analysis indicated that patients with schizophrenia have higher scores on the Autism-Spectrum Quotient (AQ) than healthy controls. However, the relationship between autistic symptoms and self-stigma in patients with schizophrenia spectrum disorders remains unclear. Therefore, the present study aimed to reveal the association between autistic symptoms and self-stigma in patients with schizophrenia spectrum disorders. Patients and methods: We recruited 127 patients with schizophrenia spectrum disorders (schizophrenia, schizoaffective disorder, and delusional disorder). We assessed participants' self-stigma and autistic symptoms using the Internalized Stigma for Mental Illness (ISMI) scale and the Autism-Spectrum Quotient (AQ), respectively. The differences in the scores of ISMI and AQ according to patient characteristics were investigated. Multiple regression analysis controlling for age and gender was performed to determine the relationship between the total scores on the AQ and IMSI scale. Results: Female patients showed a higher level of self-stigma than males. Unmarried patients showed a significantly higher score on the AQ than married patients. Multiple regression analysis adjusted for age and gender indicated that the total score on AQ might be a predictor of the overall rating on ISMI in patients with schizophrenia spectrum disorders. Conclusion: This study is the first to reveal the association between autistic symptoms and self-stigma in patients with schizophrenia spectrum disorders. Our results highlight the importance of considering autistic symptoms in the assessment and management of self-stigma in patients with schizophrenia spectrum disorders.
... Currently, course content and training specific to SMI is often limited in PT curricula. [5,6] This is particularly relevant because physical therapy professionals can be susceptible to the same factors that contribute to the poorer quality of health-care provided by other practitioners, namely stigmatizing attitudes [7][8][9] and the lack of specialized knowledge needed to work effectively with individuals with SMI. [10] Practitioner attitudes are shown to directly correlate with the quality of physical healthcare being delivered. ...
Article
INTRODUCTION: Physical therapists provide important services to improve physical health for the general population; however, physical therapy interventions are less utilized with underserved populations such as those with severe mental illness (SMI). The quality of services for these populations is impacted in part by negative provider attitudes and lack of preparation to work with the SMI population. This study examined the impact of structured educational field experience on the physical therapist's attitudes and knowledge about working with the SMI population. This will inform future educational practices to best prepare students to provide quality of healthcare to the population. MATERIALS AND METHODS: Seven graduates of a doctor of physical therapy (DPT) program from a Mid-Atlantic University in the United States who participated in an SMI service-learning (SL) experience completed a semi-structured qualitative interview in 2016. Questions about how the experience impacted their current work were asked. Interviews were digitally recorded, transcribed, and examined using interpretive phenomenological analysis. Coding and investigator triangulation were conducted. All interviews reached thematic saturation. RESULTS: The graduated DPT students reported attitudinal changes toward people with SMI through qualitative interviews. They reported an improvement in their skills, greater competence to work with the SMI population, and an increased focus in the use of person-centered services. CONCLUSIONS: The results of this study suggest that DPT students gain an understanding of both the SMI population and themselves during SL. Using SL as part of the DPT educational curriculum can offer students and the opportunity to build confidence in working with the SMI population. SL can also improve their skills and attitudes toward the population, key areas that are identified as barriers to receiving quality physical healthcare among the SMI population.
... Furthermore, this study makes a significant contribution to existing literature since it illustrates the influence of knowledge and attitude as an area of study. Earlier research studies have reported that numerous factors, including income and education level might be involved in the expression of student attitudes toward adults with mental health problems (Arbanas et al., 2018;Carroll, 2018;Corrigan & Wassel, 2008;Wallach, 2004). The current study revealed that secondary school students did not have sufficient knowledge about mental health. ...
Article
Objective Examine secondary school students' knowledge and attitude about mental health, mental health problems, and interacting with people with mental health problems. Methods A survey was carried out with 500 students in secondary schools in the northern area of Jordan. Results A variance in knowledge and attitude was predicted by the regression model. Family income, having a family member with a mental disorder, and experience with people with mental health problems were the major predictors of knowledge about and attitude toward interacting with people with mental health problems. Conclusion The results indicate that secondary school students have low knowledge about mental health problems and people with mental health problems. Moreover, they have a negative attitude toward interacting with people with mental health problems. Hence, there is a strong need to better educate young people about mental health and the diverse types of mental health problems that exist, as well as to help them to develop a more constructive and appropriate attitude. Implications for Practice Improving the scope of the school curriculum on topics relating to people with mental health problems would help students to make more objective evaluations of people with mental health problems.
... Specifically, 31% of Americans with MHMI conditions worry about being judged when sharing their mental health service utilization with others, and 21% have lied to avoid sharing (CVN, 2018). Self-stigma can negatively affect all aspects of an individual's life (Caltaux, 2003), potentially resulting in the 'why try' effect: the individual is less likely to pursue life goals, deciding that they have already failed due to having a mental illness Corrigan & Wassel, 2008). Consequences associated with selfstigmatization include diminished self-esteem, low self-efficacy (Rüsch et al., 2009), increased anger or indifference (Corrigan & Watson, 2002), reduced readiness to seek professional help (Clement et al., 2015;Corrigan et al., 2014;Schomerus & Angermeyer, 2008), and suicidality (Oexle et al., 2017). ...
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Despite the proven effectiveness of mental health interventions, services remain limited across the country. Social workers have repeatedly advocated for increased funding, but mental healthcare gaps persist. Disparities could be addressed through the policy process, but critical proposals often do not pass. One of the biggest barriers is the concept of stigma, which could extend into legislatures and influence mental health-related policy outcomes as a form of structural stigma. Factors that influence legislator voting behavior are found in the literature, but studies have not explicitly focused on structural stigma or mental health-specific policy outcomes. Thus, the present study aimed to explore state mental health legislative proposals with goals of exposing forms of structural stigma present in the language and potential effect of the bills as well as identifying and disseminating patterns in mental healthcare policy outcomes. To achieve this aim, quantitative content analysis was conducted on a stratified random sample of bills that were codified into frequencies and examined through multiple logistic regression analyses. The study found that bills were structurally stigmatic in language and potential effect. Male and Republican legislators were more likely to introduce structurally stigmatic mental health bills, while party majority status and structural stigma in the language of the bills predicted mental health bill passage. Mental health advocates can utilize this information to better target policymakers for structural stigma reduction efforts as well as to increase their effectiveness in influencing bill sponsorship or voting behavior.
... It enables a range of social inequalities and discrimination to occur (Parker & Aggleton, 2003), and is evident within structural frameworks of society (Feldman & Crandall, 2007). People may internalize stigma and this can diminish one's sense of self and identity, causing psychological harm (Corrigan et al., 2008). ...
Article
Objective: To systematically review evidence regarding prevalence and choices of disclosure of psychological distress, by mental health professionals within the workplace. Methods: Six databases were searched in June 2020. Studies were included if they were published in English language and included empirical quantitative, qualitative or mixed-methods data. Studies were excluded if they focused on general healthcare professionals or the general population, or on stress or physical health problems. Study quality was assessed using the Mixed Methods Quality Appraisal tool. Results: Nine studies, with a total of 1891 participants, were included. Study quality varied, with studies generally reporting descriptive surveys using hypothetical disclosure scenarios. Distress was often conceptualized in psychiatric terms. These limitations mean conclusions should be treated with caution. Individuals were less likely to disclose in work and had negative experiences of doing so compared to social circles. Fear of stigma inhibited disclosure. There were differing levels of disclosure relating to recipient, trust, quality of supervision, how distress was conceptualized, and type of problem. Disclosure was experienced by some as valuable. Conclusion: There is a need for further research, which addresses the nuanced complexities surrounding disclosure choices for mental health professionals.
... The drug user and the drug dealer are figures that are stereotyped and stigmatized in our collective representations, linked to crime and disease (Askew & Salinas, 2018;Sattler et al., 2017). Stigma is considered here as the result of a "stereotypical and overall damaging process" (Corrigan & Wassel, 2008) leading to a relationship between oneself, others and the social structure that includes reductive labeling, loss of status and discrimination (Link & Phelan, 2001). As Smith et al. (2016) said: "The structural and social stigma associated with substance use is experienced by individuals as enacted, anticipated and internalized stigma". ...
Article
The figure of drug user and dealer is stigmatized, linked to violence and illness. This is due to a reductionist discourse which implements othering processes generating scapegoat figures in the drug world. All drug users and sellers are assimilated with these spoiled identities in the media or in drug policies, while the reality is much more diverse. This article draws on relational sociology to focus on figures who are the antithesis of stereotypes: socially integrated women who use or sell drugs (WUSD) and are invisible to the health and control enforcement agencies. By seeking to avoid the stigma of the drug user's and dealer's identities, how do socially included WUSD distance themselves from the control enforcement agencies and health institutions? This qualitative research is based on 26 semi-structured interviews conducted with socially included WUSD in France. Participants were recruited using a snowball sampling strategy. It appears that the participants normalized their drug use and integrated it into their professional and personal lives. Some were drug user-dealers and had social supply practices, selling the drugs they used to their friends in order to finance their consumption. None of the participants have ever been in contact with harm reduction and addiction services, both because they do not identify with the users of these services, and because these services are not designed to support this population. With the police, the participants play gender games and show their social inclusion to protect themselves from arrest. In both cases, the stigmatized figure of the drug user and drug seller alienate the participants from the health systems and control enforcement agencies. One of the consequences of the othering process is the invisibility of those who do not want to be identified as "others" by the health and law enforcement services. Rethinking drug policy is essential to reach populations that may need information and support.
... More specifically, neoliberalism's ideal of individual self-responsibility operates on this moral level. People tend to be aware of their status as stigmatized and apply that stigma to themselves, acting under neoliberalism as though they are to blame for their plight (Corrigan & Wassel, 2008;Corrigan & Watson, 2002). Positing that the food insecure are morally responsible for their disadvantaged situation de-legitimizes the accounts of those experiencing adversity while at the same time eliciting feelings of shame and potentially also of guilt-the latter relating to the transgression of a moral law. ...
Article
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The researchers conducted a Lacanian discourse analysis of 21 interviews conducted in 2016 of food bank clients of a large city in a southern U.S. state. The study focused on accounts of food insecure individuals regarding their experiences of stigma, shame, and guilt towards receiving non‐profit food assistance and how those experiences—or lack thereof—might play a role in food bank utilization, given the problematic of why many food insecure households do not receive any type of food assistance. The researchers found that superegoic imperatives and stigma under neoliberalism served as major barriers to seeking adequate food assistance. Participants experienced guilt and shame at failing to meet the standard of self‐sufficiency promoted by neoliberalism; neoliberal discourses dominate constructions of food insecurity as being due to personal failings. Participants attempted to mitigate stigma, guilt, and shame through passing as food secure by avoiding asking for needed food assistance; what is more, participants took great lengths to avoid being seen as illegitimately enjoying in accordance with neoliberal ideology (e.g., not wanting to meet the stereotype of “living off of the system,” falling into the category of the underserving poor). In Lacanian terms, to be seen as illegitimately enjoying is to be the object of xenophobia. Some participants were able to resist neoliberal discourses which would render them morally responsible for their plight by adopting egoic discourse identities of being independent, a helper, or a provider by seeking food assistance.
... At the international level, several strategies have been implemented within the general population, as well as medical students, to reduce stigma toward mental disorders (19), and the most successful ones have been those involving direct contact with patients (20,21) as well as programs with strong educational components (16,(22)(23)(24). It has been shown that direct, personto-person contact and activities where the participants and patients share thoughts and experiences around mental health are key to the success of these programs (25)(26)(27). ...
Article
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Stigma toward mental disorders is one of today's most pressing global issues. The Covid-19 pandemic has exacerbated the barriers to social inclusion faced by individuals with mental disorders. Concurrently, stigma reduction interventions, especially those aimed at university students, have been more difficult to implement given social distancing and campus closures. As a result, alternative delivery for programs contributing to stigma reduction is required, such as online implementation. This paper reports the results of a controlled study focused on an online multi-component program on reducing stigma toward mental illness that included project-based learning, clinical simulations with standardized patients and E-Contact with real patients. A total of 40 undergraduate students from the Universidad del Desarrollo in Santiago, Chile, participated in the study. They were randomly divided between an intervention and control group. The intervention group participated in the online multi-component program, while the control group participated in an online educational program on cardiovascular health. We assessed the impact of the program by using the validated Spanish-language versions of the Attribution Questionnaire AQ-27 and the Questionnaire on Student Attitudes toward Schizophrenia with both groups, before and after the intervention. In addition, an ad hoc Likert scale ranging from 0 to 5 was used with the intervention group in order to assess the learning strategies implemented. Following the intervention, the participants belonging to the intervention group displayed significantly lower levels of stereotypes, perception of dangerousness, and global score toward people with schizophrenia (p < 0.001). In addition, participants presented lower levels of dangerousness-fear, avoidance, coercion, lack of solidarity, and global score (p < 0.001). The control group displayed no statistically significant differences in the level of stigma before and after the evaluation, for all of the items assessed. Finally, the overall assessment of each of the components of the program was highly positive. In conclusion, the study shows that online programs can contribute to reducing stigma toward mental disorders. The program assessed in this study had a positive impact on all the dimensions of stigma and all of the components of the program itself were positively evaluated by the participants.
... Even if this population have an independent source of income to pay the rent, their only option is in low-income communities with lower housing standards and a higher risk of crime [2] . Although in these low-income communities, people with mental illness still do not have an advantage in housing competition compared with other potential tenants as some proportion of patients with severe mental illness lack social and coping skills, which makes it difficult to meet the demand for competitive independent housing [5] . According to Kowalchuk, more than half of people with mental illness are dissatisfied with their living conditions [9] . ...
Article
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People with mental illness have not only struggled with the psychological and physical symptoms of the disease but also suffered from social discrimination and prejudice. [1]This article expresses the negative impact of mental illness stigma on the stigmatized group through the study of previous literature. The purpose of this article is to improve the public’s stereotypes and prejudices of people with mental illness, so as to provide a basis for researchers to identify effective de-stigmatization strategies.
... On the other hand, when there is training in the knowledge and belief acquisition that improves the recognition, handling, and prevention of mental illness a reduction of these discriminatory attitudes towards people with mental disorders is generated, which in turn is associated to a minor gap in the treatment and in a better quality of life for the patients and their families (Lam et al., 2010). In a similar vein, it has been seen in health professionals a positive attitude boosted when there is experience in psychiatric services for more than a month (Hsiao et al., 2015), also presenting minor indicators of restrictive attitudes and major benevolent attitudes when a link and contact with users affected by a mental pathology are stablished (Corrigan & Wassel, 2008), particularly in those who have a family member or close friend with this diagnosis (Yuan et al., 2017), which indicates a synergic relation when there is a greater proximity towards this population (Corrigan, 2016). ...
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Psychiatric illnesses affect more than 450 million people worldwide, with several consequences for those who are affected, along with the presence of high numbers of discrimination, stigmatization, and negative attitudes of the general population. These negative attitudes have been observed even in health professionals, negatively impacting on the quality of care, adherence to treatment and well-being of affected users. This study describes attitudes of medical students towards people with psychiatric illness from a qualitative perspective, through the analysis of thematic content of 12 semi-structured interviews conducted with first- to fourth-year medical students. Among the results, a diversity of identified attitudes outstands, including empathy, frustration, indifference and rejection, uncertainty and fear, tolerance and social acceptance. As a discussion, it is stated that most of the findings were consistent with the international literature, however there are new findings that are not described, highlighting the attitude of fear of being harmed and the rejection towards people with psychiatric pathologies. The design and implementation of educative interventions that facilitate contact with users, in order to reduce stigma and negative attitudes in future medical professionals, is concluded as an urgent challenge. Finally, it is proposed for future research to develop longitudinal and comparative studies that consider measuring the impact and effectiveness of these interventions.
... The results of this research showed that students at secondary school held various views about mentally ill people, but that overall, they had adverse perception toward patients with mental health issues. This result is broadly in line with studies on biases against mentally ill people that discovered that stigma is assigned to people with mental illnesses by the public (Crowe et al., 2016;Corrigan and Wassel, 2008;Timmins et al., 2011). On the other hand, in research undertaken among graduate students in Jordan, it was found that the students had some important favorable attitudes toward people with mental illnesses that can be classified into four categories (Hamaideh and Mudallal, 2009). ...
Article
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Aim Mental health disorders in many countries are regarded as taboo and are often concealed. This study aimed to (a) explore students in secondary school' stigma perceptions of mental disorder; (b) examine whether there is a connection between religiosity and stigma toward people with mental illnesses; and (c) identify stigma correlates for stigma perceptions toward people with mental illnesses based on the religiosity and demographic features of the students. Method A cross-sectional correlational study was undertaken among 357 students from two high schools. The participants completed a structured research instrument that consisted of (1) a sociodemographic characteristics questionnaire, (2) a religiosity questionnaire and (3) a devaluation-discrimination scale. Results The regression model was able to forecast a moderate percentage of stigma perception variance (F = 4.74, p = .01). Gender was the only important correlate in the model at p = .05. Conclusion and implications This study found that among students in secondary school in Jordan there is an association between religiosity and stigma toward mental disorders. This result implies that there is a need to increase policy maker information about the importance of applying religious principles to decrease stigma and enhance a positive non-stigmatizing attitude toward mental disorders. Moreover, improving the curriculum content concerning the problems associated with mental ill health may allow students to gain a more precise understanding of mental disorders more generally.
... On the other hand, when there is training in the knowledge and belief acquisition that improves the recognition, handling, and prevention of mental illness a reduction of these discriminatory attitudes towards people with mental disorders is generated, which in turn is associated to a minor gap in the treatment and in a better quality of life for the patients and their families (Lam et al., 2010). In a similar vein, it has been seen in health professionals a positive attitude boosted when there is experience in psychiatric services for more than a month (Hsiao et al., 2015), also presenting minor indicators of restrictive attitudes and major benevolent attitudes when a link and contact with users affected by a mental pathology are stablished (Corrigan & Wassel, 2008), particularly in those who have a family member or close friend with this diagnosis (Yuan et al., 2017), which indicates a synergic relation when there is a greater proximity towards this population (Corrigan, 2016). ...
Article
Full-text available
Psychiatric illnesses affect more than 450 million people worldwide, with several consequences for those who are affected, along with the presence of high numbers of discrimination, stigmatization, and negative attitudes of the general population. These negative attitudes have been observed even in health professionals, negatively impacting on the quality of care, adherence to treatment and well-being of affected users. This study describes attitudes of medical students towards people with psychiatric illness from a qualitative perspective, through the analysis of thematic content of 12 semi-structured interviews conducted with first- to fourth-year medical students. Among the results, a diversity of identified attitudes outstands, including empathy, frustration, indifference and rejection, uncertainty and fear, tolerance and social acceptance. As a discussion, it is stated that most of the findings were consistent with the international literature, however there are new findings that are not described, highlighting the attitude of fear of being harmed and the rejection towards people with psychiatric pathologies. The design and implementation of educative interventions that facilitate contact with users, in order to reduce stigma and negative attitudes in future medical professionals, is concluded as an urgent challenge. Finally, it is proposed for future research to develop longitudinal and comparative studies that consider measuring the effectiveness of these interventions.
... This is especially important as a number of studies have demonstrated that there is little training on sexuality and disability in the health professions [6,39,43,52]. Corrigan's work on stigma supports a framework for contact as decreasing stigma specific to individuals with psychiatric disabilities [53,54]. The advocacy for inclusion of people with disabilities into recreational, vocational, and educational settings can positively influence attitudes towards people with disabilities as well as impacting the quality of life for people with disabilities. ...
Article
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Individuals with disabilities face many misconceptions regarding their sexuality, the most common of which are that they are either asexual or unable to control themselves sexually. These misconceptions are present in members of the general public, parents of individuals with disabilities, and professionals who work with individuals with disabilities. This systematic literature review explores the extant literature on attitudes of the general public towards the sexuality of individuals with disabilities. Thirty-four articles were included in this systematic review, representing attitudes towards individuals with physical disabilities, intellectual disabilities, and psychiatric disabilities. Results were coded into three main themes: People with Disabilities as Sexual Beings, Factors Influencing Societal Attitudes, and Factors Related to the Sexuality of People with Disabilities. Topics such as sexual rights, sexual behavior, relationships, partner factors, sexual orientation, sexual and reproductive health, parenting, and stigma are addressed. Also addressed are the nine measures of attitudes towards sexuality and disability utilized studies included in the systematic review.
... The stigma of mental illness is a reality in our society, especially among healthcare professionals [1,2]. Empathy among mental health nurses is a key element helping to reduce stigma towards patients with mental disorders [3]. ...
Article
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Mental health nurses, together with psychiatrists, are the healthcare professionals who display the highest levels of empathy and the best attitudes towards patients with mental disorders. However, burnout is a common problem among these professionals. The aim of our study is to describe the association between empathy, burnout, and attitudes towards patients with mental disorders among mental health nurses in Spain. A descriptive cross-sectional design was used involving a sample of 750 specialist nurses working in mental health facilities in Spain. An intentional, non-probability, non-discriminative, exponential snowball sampling method was used. The Jefferson Scale of Empathy, the Maslach Burnout Inventory, and the Community Attitudes towards Mental Illness Inventory were used to measure the study variables. A positive correlation was observed between empathy and all the study variables, with the exception of the personal accomplishment dimension of burnout and the social restrictiveness and authoritarianism dimensions of attitudes towards mental illness, where a negative relation was observed. Our findings suggest that empathy is associated with an increase in positive attitudes towards patients with mental disorders, decreasing associated stigma, but did not act as a protective factor against burnout in the study sample.
... Again, there are complex reasons for low utilization of mental health services. The stigma surrounding poor mental health appears to a major contributor to a lack of contact with services (Schomerus & Angermeyer 2008) and anticipated discrimination appears to deter people from coming into contact with services (Corrigan & Wassel 2008). Individuals may be fearful of being discriminated against if they are labelled as having a mental health problem. ...
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International health system comparisons: from measurement challenge to management tool
Article
Background Stigmatising attitudes towards people who use drugs are pervasive amongst the public. We investigated whether public stigma was affected by presentation of a history of adversity, and how substance use was described. Methods A cross-sectional online study using a convenience sample, with a randomised 2 × 2 × 2 factorial design. Participants read one of eight randomly presented vignettes that described a fictional case history of substance use. In each vignette, the gender of the subject (male or female), description of the subject’s substance use (‘addict’ vs substance use disorder), and life history (‘tough life’ vs description of four adverse childhood experiences (ACEs)) were varied. Participants then completed an adapted version of the attribution questionnaire (AQ-9), which assessed stigmatising beliefs. Results Data were obtained from 502 participants (53.0% female; mean age 36.5 ± 13.5 years). There was a significant effect of life history on AQ-9 scores (p = .012), and presentation of ACEs was associated with lower stigmatising attitudes. Conclusion Our findings suggest that describing the life histories of people who have experienced problems with substances may lead to less stigmatising public attitudes. Further research should explore the best ways to utilise this information to develop public-targeted anti-stigma interventions.
Article
Background: Public stigma is a significant deterrent to mental health service use for U.S. veterans. Media campaigns are often used to dispel stigmatizing beliefs and actions. Segmentation is an evidence-based practice for their effective use; however, little data has been published on veteran segments to target with anti-stigma messages. Aims: This article aims to identify and describe initial typologies of stigmatizing attitudes within a group of U.S. military veterans. Methods: Telephone-based cross-sectional surveys were conducted with a national random sample of veterans from 2014 to 2016 (N = 2142). Stigma outcomes were measured using a brief, validated instrument used in population-based surveys of public perceptions toward people with mental illness. Cluster analysis was conducted to identify specific groupings along multiple dimensions. Results: A final four-cluster solution was identified among veterans with distinct patterns of attitudes toward mental illness and include: 1) the undecided, 2) the influencer, 3) the ambivalent, and 4) the potential ally. Several strategies were also identified for designing anti-stigma messaging toward these segments. Conclusions: This research demonstrates veterans can be segmented by attitudes to target with anti-stigma campaign messages.
Article
People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. Avoiding the use of stigmatising language and using terminology that does not exclude the positive characteristics of the individual may play an important role in challenging stigma. This study involved a mixed method approach to identify the terminology preferences of people with a mental illness in Australia. N = 173 participants were recruited via convenience sampling. The humanistic terms ‘individual’ and ‘person with lived experience’ were identified as the preferred terms. Qualitatively there was a wide variation in how the terms made the respondents think or feel, with only one of the terms – ‘survivor,’ having solely negative themes. When contrasting the two most commonly used clinical terms, ‘client’ was significantly preferred to ‘patient’. The term ‘consumer’ was one of the least preferred terms. This suggests that the use of this term, which is in regular use in Australia, should be reconsidered.
Article
Background Service-learning is a powerful tool to promote attitudinal change; however, most findings center the experience of white, middle-class, continuing-generation students and do not reflect the shifting demographics of higher education. Little is known about the impact of service-learning at Hispanic-Serving Institutions (HSIs) on attitudes toward others, and even less is known based on studies experimentally manipulating the presence of service-learning. Objective This study investigated how a service-learning project conducted at an HSI impacted changes in attitudes toward those experiencing homelessness. Method Sixty-three students taking Social Psychology either participated in a course with a service-learning project or one that did not. Attitudes related to those experiencing homelessness and the self were assessed over time. Results Students that participated in service-learning saw increased positive attitudes toward those experiencing homelessness over time compared to those that did not participate in service-learning. Conclusion Service-learning seems to have helped foster positive attitudes toward those experiencing homelessness for students at an HSI. Teaching Implications The current study hopes to encourage wider use and study of service-learning by highlighting positive impacts service-learning may have on students. Service-learning may have profound effects on students, and these effects need to be studied at a variety of institutions.
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The aim of the study is to identify the level of mental health literacy among students from Universiti Pendidikan Sultan Idris (UPSI), to explore the relationship between mental health literacy and help seeking behavior among UPSI students and to identify the significant difference in mental health literacy score for students who have encountered people with mental health disorders. The study adapted cross-sectional quantitative survey design which is an online survey that required participants to answer questions through the online form link disseminated. Mental Health Literacy Scale (MHLS) and General Help-Seeking Questionnaire are used in this study. N=130 UPSI students (n=25 male, n=105 female) completed the online survey that which measure multiple dimension of mental health literacy and help seeking behavior. The finding revealed the level of mental health literacy of UPSI students by measuring the mean score of the MHLS. The result revealed a mean score of the MHLS obtained from the sample is (M=117.97, SD=14.62). This score is lower as compared to previous studies using the same scale. The Pearson correlation between mental health literacy and help-seeking behavior showed a negative, weak correlation (r= -.139) which is in contrast with the previous studies using the same scale. There is a significant difference in the mean score of the students who answer Yes and No for the screening question on knowing people with mental health disorders. Implication, limitation and future recommendation of the study are also discussed. In summary, the topic of mental health literacy is a new area to be explored in Malaysia and limited number of research is available to compare the data. However, there is a growing concern on making mental health literacy as important as physical health literacy.
Conference Paper
Stigmatization is a complex process that emerges in manifold forms in a variety of social contexts. This paper sheds light on people with intellectual disabilities (ID) who are often affected by numerous negative prejudices which can lead to restrictions of human rights and various forms of social discrimination. This qualitative focus group study aims to examine perceived stigmatization experiences by people with ID when using and accessing the Internet. Besides, this study focuses on respondents’ behavior and coping strategies to deal with perceived stigmatizations. Therefore, data from a focus group study with 50 participants with ID (23 males, 27 females, aged between 18 and 35) conducted in 2018 was secondary analyzed for this paper. Findings show that participants are well aware of stigmatization by their social environment (e.g., parents, caregivers). Issues include incompetence, lack of media literacy, weak cognitive skills and low decision making abilities. The results also indicate that participants react in different ways to perceived stigmatization. In this paper, we analyze behavior characteristics and arrange them into three different user types: “the Anxious Avoider, “the Help-Seeking-Realist”, and “the Confident All-Rounder”. The three different types differ in terms of Internet usage and coping strategies.
Article
To analyze the predictors of internalized stigma among people with mood disorders, we conducted an analytical observational cross-sectional study with 108 people with mood disorders in a public service setting in Sao Paulo, Brazil. We applied a sociodemographic and clinical questionnaire, the Internalized Stigma of Mental Illness Scale, the Medication Adherence Scale, the Brief Psychiatric Rating Scale-Anchored, and the Herth Hope Index. We analyzed the data using descriptive statistics, average comparison tests, a correlation test, and multiple linear regression. Internalized stigma was associated with symptomatology, history of aggressive behavior, psychiatric hospitalizations, suicide attempts, hopelessness, nonadherence to psychotropic medications, and unemployment. The predictors of internalized stigma were unemployment, more psychiatric symptoms, history of previous suicide attempts, and less hope. Clinical interventions and investigations for stigma reduction and psychosocial rehabilitation should incorporate the factors associated with self-stigma (aggressive behavior, history of psychiatric hospitalizations, suicide attempts, hopelessness, nonadherence to medication, and unemployment).
Article
Résumé La stigmatisation existe depuis l’antiquité. Il n’en demeure pas moins qu’elle persiste encore aujourd’hui et apporte son lot de conséquences négatives. Les aspects structuraux, interpersonnels et intrapersonnels s’entrecroisent et affectent la vie de plusieurs personnes en termes d’accès aux soins, de rétablissement et de qualité de vie. Même si la réduction et la prévention de la stigmatisation furent une priorité pour les chercheurs et les intervenants du milieu au moyen de campagne de sensibilisation, les résultats demeurent mitigés. S’il est difficile d’expliquer un tel échec, nous pensons que la philosophie peut être utile pour explorer d’autres possibilités. Nous introduirons une perspective philosophique selon la pensée de Georges Canguilhem et de Judith Butler afin d’aborder autrement la stigmatisation. Pour conclure, nous pensons qu’il devient nécessaire d’introduire de nouvelles manières de pratiquer la médecine, la psychiatrie, la psychologie et la sociologie en évitant le piège de la logique binaire du tiers exclu et en élargissant le spectre des possibilités. Promouvoir la subjectivation peut devenir une manière d’aider les personnes à comprendre leur maladie comme une réalité qui favorise le changement et la créativité.
Article
Undetectable = Untransmittable (U = U) is the scientific fact that HIV cannot be transmitted when an individual is virally suppressed. This breakthrough discovery has the potential to greatly reduce HIV stigma and its negative effects. However, U = U is not widely known. Given that Twitter has the potential to raise awareness of health issues, the purpose of this study was to analyze the content of the #UequalsU on Twitter. The results showed that mentioning sex and mentioning love were strong predictors that a tweet would be liked and retweeted. This information could help to spread the message of U = U more widely and potentially lessen HIV stigma.
Chapter
MY Psychology is an online educational platform currently based in Malaysia, formed with the intention to spread awareness towards the general public of not only on issues related with mental health and those who suffer under mental illnesses, but also to create a place where psychology as a basic knowledge can be taught and learned. This is in order to correct misunderstandings from the public toward psychology. Operating on the internet requires the company to shift towards a marketing-oriented direction, in the meantime, coping with internal and external challenges in order to strive for greater reach and engagement from the audience.
Conference Paper
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The Rosetta Wheel framework is a framework for design teams to guide the development of games for health behaviour change. The framework is grounded in evidence-based research of the psychology of behaviour change. It is further informed by game analysis and expert design techniques in order to understand how psychological processes map with game design patterns. The Rosetta Wheel has 10 Change Keys, assisting design teams to create game mechanics which foster the psychological processes of change, alongside 19 Key Considerations which support the overall development process. The presentation will cover the research process that led to the development of the framework, along with an overview of the Rosetta Wheel Framework, and will finish off by introducing some implementation ideas of how the framework can be applied in practice.
Chapter
MY Psychology is an online educational platform currently based in Malaysia, formed with the intention to spread awareness towards the general public of not only on issues related with mental health and those who suffer under mental illnesses, but also to create a place where psychology as a basic knowledge can be taught and learned. This is in order to correct misunderstandings from the public toward psychology. Operating on the internet requires the company to shift towards a marketing-oriented direction, in the meantime, coping with internal and external challenges in order to strive for greater reach and engagement from the audience.
Article
Aim: There are not many studies related to the attitude of healthcare workers towards bipolar patients. The aim of this study was to evaluate the attitudes of psychiatrists and other physicians towards patients with bipolar disorder, and our secondary aim was to evaluate the possible relationship between physicians' attitudes towards bipolar disorder patients and their sociodemographic characteristics. Material and Methods: A total of 514 volunteers; psychiatrists (n=67), family physicians (n=156) and other branches (n=291) were included in the study in March 2019 via an online questionnaire. A structured questionnaire was administered to all participants. The questions were recorded by asking questions about bipolar disorder. Results: A total of 514 volunteers, including psychiatrists (n=67), family physicians (n=156), and other branches (n=291), were included in our study. As a result of our study, it was observed that 21% of family physicians and 32% of physicians from other branches did not feel comfortable while examining patients with bipolar disorder and it was observed that it was significantly higher than psychiatrists (6%). Compared to psychiatrists (4%), it was reported that family physicians (30%) and other specialists (30%) would feel uncomfortable working with someone with a diagnosis of bipolar disorder. Conclusion: Psychiatrists displayed more positive attitudes than family physicians and other branches. Education, which is emphasized to prevent stigmatizing attitudes, is perhaps the most important reason for this. Decreasing negative attitudes towards bipolar patients among healthcare professionals may decrease patients' self-concealment and increase hospital admission and treatment compliance in cases of physical and mental illness. With the decrease in the stigmatizing attitudes of physicians against this disease, the social and professional functionality of the patients will increase and will provide important gains in terms of community mental health.
Article
The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students’ responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5%; 1-4 grades, 189; 5-6 grades, 68); 268 Turkish (females, 43.3%; 1-4 grades, 90; 5-6 grades, 178); 450 Kazakh (females, 28.4%, 71.6%; 1-4 grades, 312; 5-6 grades, 138); 512 Azerbaijani (females, 24%; 1-4 grades, 468; 5-6 grades, 44; females, 24%), and 317 Polish (females, 59.0%; 1-4 grades, 208; 5-6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across at all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of greater opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.
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Introducción: Las personas con trastornos mentales están muy estigmatizadas por poblaciones de todo el mundo y son vistas como una carga para la sociedad. Muchas personas con trastornos mentales son discriminadas, lo que genera oportunidades de vida limitadas. Dado que las creencias sobre los trastornos mentales pueden variar según la cultura, la religión, la nacionalidad y la etnia, es importante comprender los diferentes tipos de estigma relacionados con el trastorno mental que se experimentan en todo el mundo. Materiales y Métodos: Se utilizó la metodología de Whittemore y Knafl (2005) para revisiones integrativas para analizar 18 estudios sobre experiencias vividas de estigma relacionado con el trastorno mental en América del Sur. Resultados: Los resultados sugieren que ciertos tipos de estigma en América del Sur. se basan en normas sociales y de género, como la posición social de hombres y mujeres en la sociedad. Esto conduce a la discriminación, el aislamiento y la violencia por parte de la familia, la pareja íntima, los amigos, la sociedad y los profesionales de la salud. El empleo también es limitado para los sudamericanos con trastornos mentales. Otras consecuencias, como el autoestigma, también afectan la vida de las personas con trastornos mentales en muchos contextos sudamericanos. Discusión: Las relaciones familiares, de amistad y sociales, incluidos los profesionales de la salud, pueden involucrar procesos que conducen al estigma vivido por las personas con trastornos mentales. Conclusión: Esta revisión integradora destaca cómo el estigma relacionado con el trastorno mental afecta a las personas en América del Sur. Como citar este artículo: Raquel Helena Hernandez Fernandes, Bruna Sordi Carrara, Brenda Alice Andrade Vidigal, Arthur Luís Barbosa Martins, Sireesha Jennifer Bobbili, Carla Aparecida Arena Ventura. Stigma experienced by people with mental illness in South America: an integrative review. Revista Cuidarte. 2022; 13(2): e2014 http://dx.doi.org/10.15649/cuidarte.2014
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The purpose of this study was to validate the use and interpretation of scores derived from the Stigma of Loneliness Scale (SLS) with a sample of college students from a large, Midwestern university. A two-factor oblique solution with 10 items was selected through exploratory factor analysis and cross-validated through confirmatory factor analysis. Correlational evidence was demonstrated through positive correlations with loneliness and shame scores, and a negative correlation with social connectedness scores. Construct evidence was demonstrated through positive correlations with self-concealment and depression scores, and a negative association with distress disclosure scores. For incremental validity, items on the SLS accounted for additional variance in predicting contingent self-worth based on approval from others, shame, self-esteem, and social self-efficacy above and beyond scores on a measure of loneliness. The internal structure of the SLS was invariant across gender groups and across Time 1 and Time 2 assessments.
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Viewing a stigmatized group as different from everyone else is believed to be a contentless stigma that leads to disdain. This study tests whether three emotions-intergroup anxiety, anger, and empathy-mediate the path between difference and disdain. Six hundred thirty-eight research participants from MTurk provided valid responses to an online survey via Qualtrics. The survey used standardized measures of difference, disdain, intergroup anxiety, anger, and empathy. The hypothesized path model was tested using structural equation modeling (SEM). Fit indicators from SEM and corresponding betas supported a two-mediator model. Specifically, difference was found to be significantly associated with disdain. The path between the two was positively mediated by anger and negatively mediated by empathy. Difference and disdain may become important constructs in predicting and assessing stigma change. Perspective-taking that enhances empathy may prove especially useful for decreasing difference and disdain perceptions about people with mental illness.
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The aim of the study is to identify the level of mental health literacy among undergraduate students to explore the relationship between mental health literacy and help seeking behavior among UPSI students and to identify the significant difference in mental health literacy score for students who have encountered people with mental health disorders. The study adapted cross-sectional quantitative survey design. Mental Health Literacy Scale (MHLS) and General Help-Seeking Questionnaire are used in this study. N=130 UPSI students (n=25 male, n=105 female) completed the online survey which measure multiple dimensions of mental health literacy and help seeking behavior. The level of mental health literacy of undergraduate students was measured through the mean score of the MHLS. Result revealed a mean score of the MHLS obtained from the sample is (M=117.97, SD=14.62). This score is lower as compared to previous studies using the same scale. The Pearson correlation between mental health literacy and help-seeking behavior showed a negative, weak correlation (r= -.139) which is in contrast with the previous studies using the same scale. There is a significant difference in the mean score of the students who answer Yes and No for the screening question on knowing people with mental health disorders. In summary, the topic of mental health literacy is a new area to be explored in Malaysia and limited number of researches is available to compare the data.
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Mental health courts (MHCs) are increasingly used across the United States as a means of reducing contact with the criminal justice system for individuals experiencing serious mental health conditions. MHCs rely on diversion from incarceration to rehabilitation, services, and treatment to reduce recidivism and other negative outcomes among individuals with mental health disorders. While MHCs are a potential evidence-based remedy for the intensifying mental health and criminal justice crises in America, there is limited research indicating the overall effects these courts have on recidivism, and whether the effects vary across different sub-groups or research design and analytic features. Therefore, we present a meta-analysis of 38 effect sizes collected from 30 evaluations conducted from 1997 through 2020 on the impact of mental health courts on recidivism for adults and juveniles with mental health issues in the United States. Weighted meta-analytic results indicate that MHC participation corresponds to a 74% decrease in recidivism (OR = 0.26). Notably, the strength of MHC effects are similar for adult and juvenile participants, and stable across varied follow-up periods, study design features, and when prior criminal history, gender and race/ethnicity are controlled for in the analyses. Implications for the criminal justice system are also discussed.
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This research study explored the mental health seeking behaviour of racialized and non-racialized female students at a large size public university located in Ontario, Canada. A sample consisting of 570 students participated in the cross-sectional survey. The majority (n = 413, 84.1%) were identified as Canadian racialized female students. The remainder (n = 78, 15.9%) were Canadian non-racialized female students, identifying with dominant Canadian culture. We contended that intersectionality, an emergent theoretical and methodological public health framework, provides a powerful tool for understanding these complex interlocking experiences in the context of mental health. High levels of depression and anxiety symptoms were reported by both the racialized non-racialized female students. The proportion of students with CES-D scores > 16 (indicating that may suffer from depression) was higher among the female racialized students (n = 265, 64.2%) than the non-racialized female students (n = 39, 50.0%). Approximately, half of the racialized students (n = 202, 48.9%) had BAS scores > 10 indicating that they may suffer from anxiety. About half (n = 38, 48.7%) of the non-racialized students also had BAS scores > 10 indicating that they may suffer from anxiety. The findings of this research study advocate university governance, healthcare professionals, and counsellors need to improve their services to address the specific needs and concerns of racialized students. Future research should focus on how findings can be translated into practice by designing culturally adaptive treatment modalities, that focus on resolving mental health problems in racialized and non-racialized female students especially in times of crisis similar to the Corvid-19 pandemic.
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Do disability legislations that are meant to be beneficial for the employment situation of persons with disabilities have nevertheless unintended negative consequences? To provide key resources such as the right to workplace accommodation, governmental agencies first need to identify eligible persons and label them accordingly. However, this label may, in turn, induce public and self stigma that entails negative consequences for labeled individuals. We address this puzzle using a quasi-experimental study design: sharp regression discontinuity design. Specifically, we examine whether individuals officially labeled as “severely disabled” perceive fewer opportunities for relationship building at work than their counterparts with a similarly severe, yet unlabeled, disability condition. We use data from 845 employees with disabilities, which was drawn from a representative German workforce data set. As expected, labeling leads to perceptions of fewer opportunities for relationship building. We find this effect to be independent from supervisor knowledge of subordinate disability, type of disability, and one’s visibility of disability. These robustness checks strengthen the argument that the labeling effect might be driven primarily by self stigma rather than public stigma. Implications for organizations and public authorities are discussed.
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For a variety of reasons, social perceivers may often attempt to actively inhibit stereotypic thoughts before their effects impinge on judgment and behavior. However, research on the psychology of mental control raises doubts about the efficacy of this strategy. Indeed, this work suggests that when people attempt to suppress unwanted thoughts, these thoughts are likely to subsequently reappear with even greater insistence than if they had never been suppressed (i.e., a "rebound" effect). The present research comprised an investigation of the extent to which this kind of rebound effect extends to unwanted stereotypic thoughts about others. The results provide strong support for the existence of this effect. Relative to control Ss (i.e., stereotype users), stereotype suppressors responded more pejoratively to a stereotyped target on a range of dependent measures. We discuss our findings in the wider context of models of mind, thought suppression, and social stereotyping. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Cognitive-behavioral therapy for psychosis is described. It draws on the cognitive models and therapy approach of Beck and colleagues, combined with an application of stress-vulnerability models of schizophrenia and cognitive models of psychotic symptoms. There is encouraging evidence for the efficacy of this approach. Four controlled trials have found that cognitive-behavioral therapy reduces symptoms of psychosis, and there is some evidence that it may contribute to relapse reduction. Studies that have examined factors that predict treatment response are reviewed. There is preliminary evidence that a good outcome is partially predicted by a measure of cognitive flexibility or a “chink of insight.” People who present with only negative symptoms may show poorer outcome. However, there is no evidence that intelligence or symptom severity is associated with outcome. Implications for selecting patients and for optimal duration of treatment are discussed. Finally, the importance of taking account of the heterogeneity of people with psychosis, so that individual treatment goals are identified, is discussed.
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Advocacy, government, and public-service groups rely on a variety of strategies to diminish the impact of stigma on persons with severe mental illness. These strategies include protest, education, and promoting contact between the general public and persons with these disorders. The authors argue that social psychological research on ethnic minority and other group stereotypes should be considered when implementing these strategies. Such research indicates that (a) attempts to suppress stereotypes through protest can result in a rebound effect; (b) education programs may be limited because many stereotypes are resilient to change; and (c) contact is enhanced by a variety of factors, including equal status, cooperative interaction, and institutional support. Future directions for research and practice to reduce stigma toward persons with severe mental illness are discussed.
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The effects of three strategies for changing stigmatizing attitudes--education (which replaces myths about mental illness with accurate conceptions), contact (which challenges public attitudes about mental illness through direct interactions with persons who have these disorders), and protest (which seeks to suppress stigmatizing attitudes about mental illness)--were examined on attributions about schizophrenia and other severe mental illnesses. One hundred and fifty-two students at a community college were randomly assigned to one of the three strategies or a control condition. They completed a questionnaire about attributions toward six groups--depression, psychosis, cocaine addiction, mental retardation, cancer, and AIDS--prior to and after completing the assigned condition. As expected, results showed that education had no effect on attributions about physical disabilities but led to improved attributions in all four psychiatric groups. Contact produced positive changes that exceeded education effects in attributions about targeted psychiatric disabilities: depression and psychosis. Protest yielded no significant changes in attributions about any group. This study also examined the effects of these strategies on processing information about mental illness.
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Poorly defined cohorts and weak study designs have hampered cross-cultural comparisons of course and outcome in schizophrenia. To describe long-term outcome in 18 diverse treated incidence and prevalence cohorts. To compare mortality, 15- and 25-year illness trajectory and the predictive strength of selected baseline and short-term course variables. Historic prospective study. Standardised assessments of course and outcome. About 75% traced. About 50% of surviving cases had favourable outcomes, but there was marked heterogeneity across geographic centres. In regression models, early (2-year) course patterns were the strongest predictor of 15-year outcome, but recovery varied by location; 16% of early unremitting cases achieved late-phase recovery. A significant proportion of treated incident cases of schizophrenia achieve favourable long-term outcome. Sociocultural conditions appear to modify long-term course. Early intervention programmes focused on social as well as pharmacological treatments may realise longer-term gains.
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Many people who would benefit from mental health services opt not to pursue them or fail to fully participate once they have begun. One of the reasons for this disconnect is stigma; namely, to avoid the label of mental illness and the harm it brings, people decide not to seek or fully participate in care. Stigma yields 2 kinds of harm that may impede treatment participation: It diminishes self-esteem and robs people of social opportunities. Given the existing literature in this area, recommendations are reviewed for ongoing research that will more comprehensively expand understanding of the stigma-care seeking link. Implications for the development of antistigma programs that might promote care seeking and participation are also reviewed.
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Stigma impedes the life opportunities of people with mental illness. Research suggests that stigma may be reduced by three approaches: protest, education, and contact. Three programs that adapt these approaches for mass audiences are described: StigmaBusters, which is a form of protest; Elimination of Barriers Initiative, which involves education or social marketing; and In Our Own Voice, which relies on direct contact between people with mental illness and the public. The authors review preliminary research that offers initial support for the feasibility and impact of these programs, with a particular focus on how the components of social marketing (problem identification, description of target audiences, development of the change technology, and process and outcome evaluation) can be adapted to antistigma campaigns.
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This paper hypothesizes that official labeling gives personal relevance to an individual's beliefs about how others respond to mental patients. According to this view, people develop conceptions of what others think of mental patients long before they become patients. These conceptions include the belief that others devalue and discriminate against mental patients. When people enter psychiatric treatment and are labeled, these beliefs become personally applicable and lead to self-devaluation and/or the fear of rejection by others. Such reactions may have negative effects on both psychological and social functioning. This hypothesis was tested by comparing samples of community residents and psychiatric patients from the Washington Heights section of New York city. Five groups were formed (1) first-treatment contact patients, (2) repeat-treatment contact patients, (3) formerly treated community residents, (4) untreated community cases, and (5) community residents with no evidence of severe psychopathology. These groups were administered a scale that measured beliefs that mental patients would be devalued and discriminated against by most people. Scores on this scale were associated with demoralization, income loss, and unemployment in labeled groups but not in unlabeled groups. The results suggest that labeling may produce negative outcomes like those specified by the classic concept of secondary deviance.
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This paper reviews evidence pertaining to the Common Ingroup Identity Model for reducing intergroup bias. This model proposes that intergroup bias and conflict can be reduced by factors that transform members cognitive representations of the memberships from two groups to one more inclusive social entity. Theoretically, a common ingroup identity extends or redirects the cognitive and motivational processes that produce positive feelings toward ingroup members to former outgroup members. It is proposed that the prerequisite features specified by the contact Hypothesis (Allport, 1954; Cook, 1985), such as equal status between the memberships, cooperative interdependence, opportunity for self-revealing interactions and egalitarian norms, successfully reduce bias, in part, because they help transform members' perceptions of the memberships from “Us” and “Them” to a more inclusive “We”. Evidence from a laboratory experiment, two survey studies involving students attending a multi-ethnic high school and executives who have experienced a corporate merger, and a field experiment involving fans attending a college football game are summarized. In general, across these diverse settings, greater perceptions of a superordinate identity predicted lower levels of intergroup bias toward original outgroup members. In particular, this presentation of our research discusses the promise of exploring the role of a dual identity, in which both sub-group and superordinate group identities exist simultaneously, and how contextual features of the situational context may moderate the relation between the strength of a dual identity and intergroup attitudes.
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With the exception of a few studies, little systematic attention has been given to individuals in their postdeviant careers. Drawing on data collected through participant observation and informal interviews with 146 nonchronic ex-psychiatric patients, this article explicates dimensions of their exit process and social reintegration. Specifically, attention is given to ex-patients' perceptions of mental illness as a stigmatizable/stigmatizing attribute, the problems they faced, the manner by which they manage discreditable/discrediting information about themselves, and the consequences of such for altering their deviant identities and social reintegration. This article suggests that ex-psychiatric patients are strategists and negotiators who play active roles in attempting to shape their deviant outcomes, techniques which have implications for identity transformation and reintegration.
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Social science research on stigma has grown dramatically over the past two decades, particularly in social psychology, where researchers have elucidated the ways in which people construct cognitive categories and link those categories to stereotyped beliefs. In the midst of this growth, the stigma concept has been criticized as being too vaguely defined and individually focused. In response to these criticisms, we define stigma as the co-occurrence of its components–labeling, stereotyping, separation, status loss, and discrimination–and further indicate that for stigmatization to occur, power must be exercised. The stigma concept we construct has implications for understanding several core issues in stigma research, ranging from the definition of the concept to the reasons stigma sometimes represents a very persistent predicament in the lives of persons affected by it. Finally, because there are so many stigmatized circumstances and because stigmatizing processes can affect multiple domains of people's li...
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Disclosure of HIV infection can lead to important social support that can mitigate the negative effects of stress (R. B. Hays et al., 1993). However, disclosure can also result in rejection, discrimination, and stigma, making the decision to disclose a dilemma for individuals infected with HIV. This decision may be particularly difficult for Asian/Pacific Islander (A/PI) women, owing to HIV's association with topics considered "taboo" in Asian cultures (T. S. Gock, 1994; G. Yep, 1993). This study explored the process, influencing factors, and consequences of disclosure among a sample of 9 HIV-positive A/PI women. On the basis of qualitative interviews and quantitative social network data, findings suggest that these women are acutely aware of and affected by the stigma attached to HIV and that the decision to disclose is influenced by fears about being stigmatized, concerns about disappointing or burdening others, and concerns about discrimination. The consequences of disclosure were generally positive, with variations over time that include both the exacerbation and amelioration of stress. Results suggest the need for research and interventions to address the cultural factors that affect the disclosure process as well as the varying levels and sources of stress over time. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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This chapter begins with a simple question: What is mental illness? After a brief review of the phenomenology and epidemiology, the authors address a question relevant to stigma: Do the problems that seemingly arise from stigma actually represent the results of prejudice, or a "normal" response to eccentric or dangerous behavior of people with mental illness? The chapter reviews Bruce Link's work on the modified labeling theory to answer this question. The remainder of the chapter describes the ways in which stigma impacts people affected by mental illness. The authors distinguish between public stigma (the results of a naive public endorsing the stereotypes of mental illness) and self-stigma (the consequences of people with mental illness applying stigma to themselves). The discussion of public stigma considers how key power groups negatively impact the lives of people affected by mental illness: landlords, employers, members of the criminal justice system, and health providers, to name a few. Self-stigma examines the impact on the person's psychological well-being, health care choices, and decisions about life goals. The chapter ends with a discussion of societal manifestations of stigma and its impact on people with mental illness. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
A six-stage model of homosexual identity formation is outlined within the framework of interpersonal congruency theory. Stages are differentiated on the basis of the person's perceptions of his/her own behavior and the actions that arise as a consequence of this perception. The person is seen to have an active role in the acquisition of a homosexual identity. Alternative paths of development are proposed within each stage. The notion that people can accept homosexuality as a positively valued status is assumed. Several factors believed to be influential in determining whether a person takes one line of development or another are discussed. The model is intended to be applied to both female and male homosexuals.
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Although thought suppression is a popular form of mental control, research has indicated that it can be counterproductive, helping assure the very state of mind one had hoped to avoid. This chapter reviews the research on suppression, which spans a wide range of domains, including emotions, memory, interpersonal processes, psychophysiological reactions, and psychopathology. The chapter considers the relevant methodological and theoretical issues and suggests directions for future research.
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Reducing prejudice and discrimination: Social psychological perspectives
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