International Journal of Environmental Research and Public Health

Editorial

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12 pages, 296 KiB

Open AccessEditorial

Stigma, Health and Well-Being

by Chung-Ying Lin and Hector W. H. Tsang

Int. J. Environ. Res. Public Health 2020, 17(20), 7615; https://doi.org/10.3390/ijerph17207615 - 19 Oct 2020

Cited by 17 | Viewed by 4210

Abstract

In order to understand the phenomenon of stigma in different populations (e.g., different ethnicities, different diseases, and different conditions), this Special Issue collects papers from around the world to illustrate the stigma phenomenon. After a rigorous process of peer review, a total of [...] Read more.

In order to understand the phenomenon of stigma in different populations (e.g., different ethnicities, different diseases, and different conditions), this Special Issue collects papers from around the world to illustrate the stigma phenomenon. After a rigorous process of peer review, a total of 24 papers were published and included in the Special Issue. These papers were contributed from different continents and countries, including the Americas (e.g., United States), Europe (e.g., Finland), and Asia (e.g., Saudi Arabia). Therefore, the diversity of ethnicity was ensured in the Special Issue. Moreover, these papers address different stigmatized populations/conditions (e.g., mental illness, obesity, public housing, homosexuality, and transgender). The most discussed populations were those with mental illness and those with obesity/overweight. However, additional evidence on the stigma topic is still needed. Specifically, future studies could consider the following directions to explore in depth the issues of stigma in different populations: (1) using longitudinal designs to understand the temporal or causal relationship between stigma and other related psychosocial factors; (2) designing treatment programs to fight stigma—this could be carried out in healthcare providers, healthcare trainees, the public, caregivers, and the stigmatized populations. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

Research

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14 pages, 315 KiB

Open AccessArticle

The Effect of Discrimination on Stress among Public Housing Residents: A Comparative Study between Social-Mix and Independent Public Housing Complexes

by Hee-Jung Jun and Soojeong Han

Int. J. Environ. Res. Public Health 2020, 17(18), 6788; https://doi.org/10.3390/ijerph17186788 - 17 Sep 2020

Cited by 4 | Viewed by 2997

Abstract

This study aims to examine the differential effect of discrimination on stress between social-mix and independent public housing complexes. We analyzed the 2017 Seoul Public Housing Residents Panel Study data that were collected from public housing residents living in Seoul, Korea by running [...] Read more.

This study aims to examine the differential effect of discrimination on stress between social-mix and independent public housing complexes. We analyzed the 2017 Seoul Public Housing Residents Panel Study data that were collected from public housing residents living in Seoul, Korea by running ordinal logit analyses. The empirical analysis shows that discrimination has a lower effect on stress in social-mix housing complexes than in independent public housing complexes. In addition, the moderating effect of community-based activities on the relationship between discrimination and stress was found in the independent public housing complex model. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

15 pages, 1058 KiB

Open AccessArticle

An Exploration of Family Caregiver Experiences of Burden and Coping While Caring for People with Mental Disorders in Saudi Arabia—A Qualitative Study

by Loujain Sharif, Shimaa Basri, Fidaa Alsahafi, Mashael Altaylouni, Shihanah Albugumi, Maram Banakhar, Alaa Mahsoon, Nofaa Alasmee and Rebecca J. Wright

Int. J. Environ. Res. Public Health 2020, 17(17), 6405; https://doi.org/10.3390/ijerph17176405 - 2 Sep 2020

Cited by 34 | Viewed by 10111

Abstract

Family caregivers of people with mental disorders face a number of burdens and stressors, such as associative stigma and burnout. These burdens are often a result of their caring role coupled with insufficient support or ineffective coping strategies, which can affect their quality [...] Read more.

Family caregivers of people with mental disorders face a number of burdens and stressors, such as associative stigma and burnout. These burdens are often a result of their caring role coupled with insufficient support or ineffective coping strategies, which can affect their quality of life and biopsychosocial integrity that, in turn, may affect the care they provide. This study aimed to explore the experiences of family caregivers of people with mental disorders, through examining the burdens that they face and the coping strategies that they use. Using a descriptive qualitative approach, 13 semi-structured interviews were conducted with members of the Saudi public, recruited through popular social media platforms and analyzed using thematic analysis. Five main themes were constructed from the data: Type of care, Challenges, Coping and support, Perceptions of public awareness, and Messages to others. The findings emphasize the different types of burdens that caregivers experience, and their needs that require a range of responses such as educational training on effective coping strategies, and psychological support in the form of counseling or group therapy. This study highlights the voice of caregivers and their message to the public, in order to correct the misconceptions surrounding mental disorders and those associated with them. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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18 pages, 834 KiB

Open AccessArticle

Tensions and Paradoxes of Stigma: Discussing Stigma in Mental Health Rehabilitation

by Jenny Paananen, Camilla Lindholm, Melisa Stevanovic and Elina Weiste

Int. J. Environ. Res. Public Health 2020, 17(16), 5943; https://doi.org/10.3390/ijerph17165943 - 16 Aug 2020

Cited by 8 | Viewed by 5919

Abstract

Mental illness remains as one of the most stigmatizing conditions in contemporary western societies. This study sheds light on how mental health professionals and rehabilitants perceive stigmatization. The qualitative study is based on stimulated focus group interviews conducted in five Finnish mental health [...] Read more.

Mental illness remains as one of the most stigmatizing conditions in contemporary western societies. This study sheds light on how mental health professionals and rehabilitants perceive stigmatization. The qualitative study is based on stimulated focus group interviews conducted in five Finnish mental health rehabilitation centers that follow the Clubhouse model. The findings were analyzed through inductive content analysis. Both the mental health rehabilitants and the professionals perceived stigmatization as a phenomenon that concerns the majority of rehabilitants. However, whereas the professionals viewed stigma as something that is inflicted upon the mentally ill from the outside, the rehabilitants perceived stigma as something that the mentally ill themselves can influence by advancing their own confidence, shame management, and recovery. Improvements in treatment, along with media coverage, were seen as the factors that reduce stigmatization, but the same conceptualization did not hold for serious mental illnesses. As the average Clubhouse client was thought to be a person with serious mental illness, the rehabilitation context designed to normalize attitudes toward mental health problems was paradoxically perceived to enforce the concept of inevitable stigma. Therefore, it is important for professionals in rehabilitation communities to be reflexively aware of these tensions when supporting the rehabilitants. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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19 pages, 517 KiB

Open AccessArticle

Media Coverage of Pedophilia: Benefits and Risks from Healthcare Practitioners’ Point of View

by Daniela Stelzmann, Sara Jahnke and Laura F. Kuhle

Int. J. Environ. Res. Public Health 2020, 17(16), 5739; https://doi.org/10.3390/ijerph17165739 - 8 Aug 2020

Cited by 14 | Viewed by 8987

Abstract

The fierce stigma associated with pedophilia may interfere with attempts to prevent sexual offending. Prior research on the effects of media reports about pedophilia mostly focused on their role in perpetuating stigma in the general population. In order to better understand potential benefits [...] Read more.

The fierce stigma associated with pedophilia may interfere with attempts to prevent sexual offending. Prior research on the effects of media reports about pedophilia mostly focused on their role in perpetuating stigma in the general population. In order to better understand potential benefits and risks of the media coverage on people with pedophilia and specialized prevention and treatment efforts, we conducted semi-structured qualitative interviews with 11 healthcare practitioners of the German Prevention Network “Don’t offend”. Healthcare practitioners described positive (e.g., raising awareness for prevention offers) as well as negative (e.g., perpetuating the existing public stigma) effects of the media coverage and estimated that only about one-third of media coverage portrays pedophilia realistically. To destigmatize pedophilia and benefit the prevention of child sexual abuse, a fact box for journalists was developed based on practitioners’ expert knowledge. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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11 pages, 284 KiB

Open AccessArticle

Parental Support, Beliefs about Mental Illness, and Mental Help-Seeking among Young Adults in Saudi Arabia

by Alaa Mahsoon, Loujain Sharif, Maram Banakhar, Nofaa Alasmee, Esraa Almowallad, Razan Jabali, Amjad Bahamil and Sara Assur

Int. J. Environ. Res. Public Health 2020, 17(15), 5615; https://doi.org/10.3390/ijerph17155615 - 4 Aug 2020

Cited by 11 | Viewed by 5832

Abstract

Mental illness is not uncommon among young adults, but negative attitudes towards mental disorders and lack of parental support might be associated with hesitancy in seeking professional help. This study aimed to examine the relationships of parental support, beliefs about mental illness, and [...] Read more.

Mental illness is not uncommon among young adults, but negative attitudes towards mental disorders and lack of parental support might be associated with hesitancy in seeking professional help. This study aimed to examine the relationships of parental support, beliefs about mental illness, and mental help-seeking among young adults in Saudi Arabia. This quantitative cross-sectional study included a convenience sample of 236 young adults (ages 18–25) with the majority of the total (86.4%) being female. Data were collected via three self-administered questionnaires: The Perceived Parental Support Scale, Beliefs toward Mental Illness scale, and Mental Help Seeking Attitude Scale. Results indicated that the participants had a moderately negative attitude toward mental illness, a moderately positive attitude toward parental support, and a highly positive attitude toward mental help-seeking. No significant relationships were found among the study variables. The study highlights that despite young adults’ positive attitude toward mental help-seeking and parental support, they have negative views toward people with mental illnesses. Educational programs in schools and media are needed to improve attitudes and enhance readiness to interact with people with mental illness. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

10 pages, 685 KiB

Open AccessFeature PaperArticle

An Anti-Stigma Course for Occupational Therapy Students in Taiwan: Development and Pilot Testing

by Hui-Ing Ma and Chu-En Hsieh

Int. J. Environ. Res. Public Health 2020, 17(15), 5599; https://doi.org/10.3390/ijerph17155599 - 3 Aug 2020

Cited by 10 | Viewed by 3873

Abstract

Attitudes of healthcare professionals towards people with disorders/disabilities are important for the development of therapeutic relationships, as well as to the evaluation and intervention processes. Therefore, it is critical to be aware and reduce stigmatizing attitudes in future healthcare professionals. An 18-week anti-stigma [...] Read more.

Attitudes of healthcare professionals towards people with disorders/disabilities are important for the development of therapeutic relationships, as well as to the evaluation and intervention processes. Therefore, it is critical to be aware and reduce stigmatizing attitudes in future healthcare professionals. An 18-week anti-stigma course was developed for occupational therapy students based on literature review and focus group interview. The course consisted of three components, including social contact, roleplaying, and critical reflection strategies. A quasi-experimental design was implemented to evaluate participants at three time points (i.e., pre-test, post-test, and one year after completion) using the Social Distance Scale and several questionnaires (i.e., stigmatising attitudes towards mental illness, physical disabilities, and children with emotional behavioural disorders). A total of 16 students completed the course and had significantly decreased social distance and stigmatising attitudes towards mental illness and emotional behavioural disorders in the post-test. These decreases remained one year later. The results support the provision of an anti-stigma course for occupational therapy students to reduce stigmatising attitudes. Future research should extend the anti-stigma course to occupational therapy students at other universities to increase both the sample size and overall generalisability. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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12 pages, 599 KiB

Open AccessArticle

Adolescent Endorsement of the “Weak-Not-Sick” Stereotype for Generalised Anxiety Disorder: Associations with Prejudice, Discrimination, and Help-Giving Intentions toward Peers

by Holly R. Hanlon and Lorraine Swords

Int. J. Environ. Res. Public Health 2020, 17(15), 5415; https://doi.org/10.3390/ijerph17155415 - 28 Jul 2020

Cited by 6 | Viewed by 4392

Abstract

Stigma, comprising negative stereotypes, prejudice (negative affective reactions) and discrimination towards a member of a particular group, is of increasing interest in the context of mental illness. However, studies examining clinical anxiety stigma are lacking, particularly with regard to generalised anxiety disorder (GAD). [...] Read more.

Stigma, comprising negative stereotypes, prejudice (negative affective reactions) and discrimination towards a member of a particular group, is of increasing interest in the context of mental illness. However, studies examining clinical anxiety stigma are lacking, particularly with regard to generalised anxiety disorder (GAD). There is also a lack of research into adolescent anxiety stigma, despite adolescence being a key period for early intervention for anxiety disorders, and research showing that stigma has been implicated in low rates of help-seeking and problematic peer relationships among adolescents with mental illness. Stigma has also been negatively associated with help-giving responses toward those with mental illness. Initial studies suggest that the ‘weak-not-sick’ (WNS) stereotype may be central to anxiety stigma. The present study aims to examine the endorsement of the WNS stereotype in the context of GAD, and its relationship to prejudice, discrimination, and help-giving responses among adolescents. A vignette-based survey measure was completed by 242 adolescents (74 male, 165 female, and three participants who recorded their gender as “other”) in Ireland aged between 15 and 19 years. The results of the study found that endorsement of the WNS stereotype was significantly associated with higher prejudice and discrimination, as well as lower levels of help-giving intentions. A multiple mediator model is presented showing both a direct relationship between endorsement of WNS and help-giving, and an indirect relationship between WNS and help-giving mediated by the prejudicial components of anger, fear and pity, and discrimination as assessed by desired social distance. This study adds to the limited knowledge base on stigma towards GAD in adolescents and provides a model for how anxiety stigma may relate to help-giving. This has implications for interventions to reduce stigmatising and increase help-giving responses. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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10 pages, 957 KiB

Open AccessArticle

RETRACTED: Nurses’ Attitudes toward Psychiatric Help for Depression: The Serial Mediation Effect of Self-Stigma and Depression on Public Stigma and Attitudes toward Psychiatric Help

by Eunmi Lee, Yoo Mi Jeong and Su Jeong Yi

Int. J. Environ. Res. Public Health 2020, 17(14), 5073; https://doi.org/10.3390/ijerph17145073 - 14 Jul 2020

Cited by 11 | Viewed by 4433 | Retraction

Abstract

This study aimed to examine the mediating effects of self-stigma and depression on the public stigma and nurses’ attitudes toward psychiatric help. A cross-sectional study with 184 nurses at one general hospital in South Korea was conducted employing a self-administered survey, using the [...] Read more.

This study aimed to examine the mediating effects of self-stigma and depression on the public stigma and nurses’ attitudes toward psychiatric help. A cross-sectional study with 184 nurses at one general hospital in South Korea was conducted employing a self-administered survey, using the Attitudes toward Seeking Psychological Help Scale, the Beck Depression Inventory-II Scale, and the modified Depression Stigma Scale. A multiple-mediation analysis procedure was applied to analyze the data. Each indirect effect of self-stigma (B = −0.0974, bootLLCI, bootULCI: −0.1742, −0.0436) and depression (B = −0.0471, bootLLCI, bootULCI: −0.1014, −0.0060) is statistically significant in the relationship between public stigma and attitudes toward psychiatric help. The individualized intervention for enhancing positive attitude or motivation for seeking help at the personal level of the nurse and depression tests—including regular physical health check-ups—is necessary. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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13 pages, 1110 KiB

Open AccessArticle

Is It Weird to Enjoy Solitude? Relationship of Solitude Capacity with Personality Traits and Physical and Mental Health in Junior College Students

by Pin-Hsuan Lin, Po-Yu Wang, Ying-Lien Lin and Shang-Yu Yang

Int. J. Environ. Res. Public Health 2020, 17(14), 5060; https://doi.org/10.3390/ijerph17145060 - 14 Jul 2020

Cited by 15 | Viewed by 5044

Abstract

Background: Teenagers described as enjoying their own company have been claimed to have a weird personality and experience loneliness and negative emotions and have often been labeled with negative attributes. However, previous studies have provided a limited understanding of teenagers’ capacity for [...] Read more.

Background: Teenagers described as enjoying their own company have been claimed to have a weird personality and experience loneliness and negative emotions and have often been labeled with negative attributes. However, previous studies have provided a limited understanding of teenagers’ capacity for solitude. Objectives: The purpose of this study was to explore the correlations between teenagers’ capacity for solitude and both personality traits and physical and mental health. Methods: This study employed a cross-sectional research design and collected data from a junior college located in Taiwan using a structured questionnaire, which consisted of demographic questions, a solitude capacity scale, a personality trait scale, and a physical and mental health scale. Results: A total of 562 participants were recruited (age = 17.56 ± 1.58 years). The total score of the solitude capacity scale was significantly correlated with four elements of the personality traits subscale: neuroticism, extraversion, openness, and conscientiousness. The solitude capacity subscale (i.e., the solitude-coping subscale) showed significant correlations with two of the physical and mental health elements, i.e., anxiety and insomnia and severe depression. Conclusions: The results verified the correlations between capacity for solitude and personality traits and did not show a positive association with negative personality traits (i.e., neuroticism). Moreover, the solitude coping capacity correlated positively with anxiety levels and negatively with depression. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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15 pages, 353 KiB

Open AccessArticle

Characterizing Lifetime and Daily Experiences of Weight Stigma among Sexual Minority Women with Overweight and Obesity: A Descriptive Study

by Emily Panza, KayLoni Olson, Carly M. Goldstein, Edward A. Selby and Jason Lillis

Int. J. Environ. Res. Public Health 2020, 17(13), 4892; https://doi.org/10.3390/ijerph17134892 - 7 Jul 2020

Cited by 13 | Viewed by 4114

Abstract

Sexual minority women are disproportionately impacted by obesity yet are underrepresented in weight stigma research. This Ecological Momentary Assessment (EMA) study is a secondary analysis that aimed to elucidate the frequency and contextual characteristics of perceived experiences of lifetime and momentary weight stigma [...] Read more.

Sexual minority women are disproportionately impacted by obesity yet are underrepresented in weight stigma research. This Ecological Momentary Assessment (EMA) study is a secondary analysis that aimed to elucidate the frequency and contextual characteristics of perceived experiences of lifetime and momentary weight stigma among sexual minority women with overweight/obesity. Participants were 55 sexual minority women ages 18–60 with a body mass index ≥25 kg/m². Perceived lifetime weight stigma events were assessed at baseline. For the subsequent five days, participants used a smartphone to complete five daily, random EMA prompts assessing the frequency/characteristics of perceived weight stigma events in daily life. All participants reported at least one lifetime weight stigma event. During the EMA period, participants reported 44 momentary weight stigma events (M = 0.80), with 24% of participants reporting at least one event. During most instances of weight stigma, women perceived the stigma’s cause to be their weight and another minority identity (e.g., sexual orientation). Findings showing high rates of perceived lifetime weight stigma in this sample and frequent co-occurrence of perceived weight stigma with stigma due to other marginalized identities in daily life underscore the need for future, larger studies investigating weight stigma through an intersectional lens in sexual minority women with overweight/obesity. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

19 pages, 371 KiB

Open AccessArticle

Stigma and Smoking in the Home: Parents’ Accounts of Using Nicotine Replacement Therapy to Protect Their Children from Second-Hand Smoke

by Grace Lewis, Neneh Rowa-Dewar and Rachel O’Donnell

Int. J. Environ. Res. Public Health 2020, 17(12), 4345; https://doi.org/10.3390/ijerph17124345 - 17 Jun 2020

Cited by 5 | Viewed by 4047

Abstract

Evidence and campaigns highlighting smoking and second-hand smoke risks have significantly reduced smoking prevalence and denormalised smoking in the home in Scotland. However, smoking prevalence remains disproportionally high in socioeconomically disadvantaged groups. Using stigma as a theoretical lens, this article presents a thematic [...] Read more.

Evidence and campaigns highlighting smoking and second-hand smoke risks have significantly reduced smoking prevalence and denormalised smoking in the home in Scotland. However, smoking prevalence remains disproportionally high in socioeconomically disadvantaged groups. Using stigma as a theoretical lens, this article presents a thematic analysis of parents’ accounts of attempting to abstain from smoking at home, using nicotine replacement therapy (NRT), in disadvantaged areas of Edinburgh and the Lothians. Smoking stigma, particularly self-stigma, underpinned accounts, with two overarching themes: interplaying barriers and enablers for creation of a smoke-free home and reconceptualisation of the study as an opportunity to quit smoking. Personal motivation to abstain or stop smoking empowered participants to reduce or quit smoking to resist stigma. For those struggling to believe in their ability to stop smoking, stigma led to negative self-labelling. Previously hidden smoking in the home gradually emerged in accounts, suggesting that parents may fear disclosure of smoking in the home in societies where smoking stigma exists. This study suggests that stigma may act both as an enabler and barrier in this group. Reductions in smoking in the home were dependent on self-efficacy and motivations to abstain, and stigma was entwined in these beliefs. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

14 pages, 392 KiB

Open AccessFeature PaperArticle

Weight Stigmatization and Binge Eating in Asian Americans with Overweight and Obesity

by Ya-Ke Wu, Diane C. Berry and Todd A. Schwartz

Int. J. Environ. Res. Public Health 2020, 17(12), 4319; https://doi.org/10.3390/ijerph17124319 - 17 Jun 2020

Cited by 11 | Viewed by 3834

Abstract

Weight stigma and binge eating have been found to be associated in Western populations; however, this relationship is understudied among Asian Americans. The aims of the study were to (1) investigate the prevalence of binge eating and its relationship with experienced weight stigma [...] Read more.

Weight stigma and binge eating have been found to be associated in Western populations; however, this relationship is understudied among Asian Americans. The aims of the study were to (1) investigate the prevalence of binge eating and its relationship with experienced weight stigma in higher-weight Asian Americans, and (2) examine whether the level of acculturation moderates this relationship. Data were collected from a cross-sectional study with 166 higher-weight Asian American adults living in North Carolina, United States. Demographic data, the frequency of experiencing weight stigma, the severity of binge eating, the levels of acculturation, the perceived racism against Asians, and perceived stress were assessed via self-reported questionnaires. The results indicated that experienced weight stigma was a significant independent predictor over and above the effects of other stressors, such as racism and general stress. The level of acculturation did not influence the relationship between the experienced weight stigma and binge eating after adjusting for relevant covariates. Our findings contribute to the limited literature examining weight stigma and binge eating among Asian American populations, highlighting that higher levels of experienced weight stigma are associated with a greater degree of binge eating. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

10 pages, 275 KiB

Open AccessArticle

Association Between Family Caregiver Burden and Affiliate Stigma in the Families of People with Dementia

by Jian-An Su and Chih-Cheng Chang

Int. J. Environ. Res. Public Health 2020, 17(8), 2772; https://doi.org/10.3390/ijerph17082772 - 17 Apr 2020

Cited by 41 | Viewed by 5998

Abstract

Family caregivers of people with dementia (PWD) have a heavy care burden. Affiliate stigma is the stigma internalized by individuals associated with PWD. Limited research has addressed the affiliate stigma among caregivers of PWD and its influence on caregiver burden. Thus, our study [...] Read more.

Family caregivers of people with dementia (PWD) have a heavy care burden. Affiliate stigma is the stigma internalized by individuals associated with PWD. Limited research has addressed the affiliate stigma among caregivers of PWD and its influence on caregiver burden. Thus, our study investigated the burden of caregivers of PWD and its relationship with affiliate stigma. In addition, we examined the factors related to affiliate stigma. This cross-sectional study was conducted in a general hospital in Taiwan. We recruited 270 PWD and their family caregivers from the outpatient department. Relevant demographic and clinical assessment data of the patients and caregivers were evaluated. Regression analysis was performed to examine the factors associated with affiliate stigma. In total, 23.7% of the family caregivers had depression and 37.4% had anxiety. Male caregivers had higher levels of anxiety and heavier care burdens related to affiliate stigma compared with female caregivers. Moreover, characteristics such as younger age and low levels of dependence in daily activities among PWD were associated with increased affiliate stigma. A higher family caregiver burden was related to more severe affiliate stigma. Interventions for decreasing the family caregiver burden might reduce the effect of affiliate stigma. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

10 pages, 350 KiB

Open AccessArticle

Measuring Discrimination Against Transgender People at the University of the Basque Country and in a Non-University Sample in Spain

by Naiara Ozamiz-Etxebarria, Maitane Picaza, Eneritz Jiménez-Etxebarria and Jeffrey H. D. Cornelius-White

Int. J. Environ. Res. Public Health 2020, 17(7), 2374; https://doi.org/10.3390/ijerph17072374 - 31 Mar 2020

Cited by 20 | Viewed by 4732

Abstract

Transgender people suffer from others’ negative attitudes in many situations. The university context is one environment where further progress has to be made to ensure the inclusion of transgender people. In this study, a sample of 376 undergraduate students was collected and their [...] Read more.

Transgender people suffer from others’ negative attitudes in many situations. The university context is one environment where further progress has to be made to ensure the inclusion of transgender people. In this study, a sample of 376 undergraduate students was collected and their attitudes towards transgender people were analyzed. A comparison was made between number of years in university, and a sample from the general public. In addition, comparisons were made by gender, since the literature shows more negative attitudes toward transgender people in men than in women. The results show relatively positive attitudes toward transgender people among higher education students, but they have little knowledge of transgender identity. In turn, researchers found significant differences between different years in the university and between genders. These results support the need to expand knowledge about transgender people in the university environment. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

15 pages, 1293 KiB

Open AccessArticle

Psychological Quality of Life in People with Physical Disability: The Effect of Internalized Stigma, Collective Action and Resilience

by Prado Silván-Ferrero, Patricia Recio, Fernando Molero and Encarnación Nouvilas-Pallejà

Int. J. Environ. Res. Public Health 2020, 17(5), 1802; https://doi.org/10.3390/ijerph17051802 - 10 Mar 2020

Cited by 20 | Viewed by 6919

Abstract

Purpose: The main objective of this study was to examine the role of social identification, collective action and resilience in reducing the negative consequences of internalized stigma on the psychological quality of life of people with physical disability using path analysis. We propose [...] Read more.

Purpose: The main objective of this study was to examine the role of social identification, collective action and resilience in reducing the negative consequences of internalized stigma on the psychological quality of life of people with physical disability using path analysis. We propose a model with two paths: the first through social identification and collective action and the second via resilience. Method: A total of 288 Spanish people with physical disability aged between 18 and 82 years (46.4% males; mean [SD] of age = 45.1 [12.3] responded to the questionnaire. Data were collected for three months through an online survey. Results: The tested model adequately fit the data. We found that the relationship between internalized stigma and the psychological quality of life of people with physical disability was mediated by resilience. However, neither social identification nor collective action mediated the association between internalized stigma and quality of life among our participants. Conclusions: The results confirmed the negative association between internalized stigma and quality of life in the population with physical disability. The results show that some interactive processes, such as resilience, may contribute to decreasing the negative effects of internalized stigma. In contrast, no effects of identification with the group or collective action intention were found. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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13 pages, 362 KiB

Open AccessArticle

The Relationship between Affiliate Stigma in Parents of Children with Autism Spectrum Disorder and Their Children’s Activity Participation

by Carmen K. M. Ng, Stephen H. F. Lam, Sally T. K. Tsang, Cheong M. C. Yuen and Chi-Wen Chien

Int. J. Environ. Res. Public Health 2020, 17(5), 1799; https://doi.org/10.3390/ijerph17051799 - 10 Mar 2020

Cited by 27 | Viewed by 5400

Abstract

Children with autism spectrum disorder (ASD) are reported to participate less in everyday activities, and their parents face stigma on account of having a child with ASD, which they often internalize as affiliate stigma. Studies have examined the impact of affiliate stigma on [...] Read more.

Children with autism spectrum disorder (ASD) are reported to participate less in everyday activities, and their parents face stigma on account of having a child with ASD, which they often internalize as affiliate stigma. Studies have examined the impact of affiliate stigma on parents’ psychological well-being and social behaviors, but little is known about how affiliate stigma impacts their children’s activity participation. This study aimed to investigate the relationship between parents’ affiliate stigma and activity participation of their children with ASD. Sixty-three parents of children with ASD (aged 2–6 years) were recruited. They completed questionnaires, which captured affiliate stigma, their child’s participation (frequency and involvement) in home, preschool, and community activities, and demographic characteristics. Results indicated that these parents had a moderate level of affiliate stigma, which did not correlate with the frequency of their children’s participation in activities. However, the parents’ affiliate stigma was found to have negative impacts on their children’s involvement in overall community participation and participation in one particular activity at home. The findings highlight the importance of destigmatization of parents of children with ASD in order to promote their children’s participation in community activities. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

15 pages, 301 KiB

Open AccessArticle

Associations of Perceived Socially Unfavorable Attitudes toward Homosexuality and Same-Sex Marriage with Suicidal Ideation in Taiwanese People before and after Same-Sex Marriage Referendums

by Nai-Ying Ko, I-Hsuan Lin, Yu-Te Huang, Mu-Hong Chen, Wei-Hsin Lu and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2020, 17(3), 1047; https://doi.org/10.3390/ijerph17031047 - 7 Feb 2020

Cited by 24 | Viewed by 4468

Abstract

This study examined the associations of perceived socially unfavorable attitudes toward homosexuality and same-sex marriage with suicidal ideation in non-heterosexual and heterosexual participants from first (Wave 1, 23 months prior to same-sex marriage referendums) and second (Wave 2, one week after the referendums) [...] Read more.

This study examined the associations of perceived socially unfavorable attitudes toward homosexuality and same-sex marriage with suicidal ideation in non-heterosexual and heterosexual participants from first (Wave 1, 23 months prior to same-sex marriage referendums) and second (Wave 2, one week after the referendums) wave surveys in Taiwan. Data provided by 3239 participants in Wave 1 and 1337 participants in Wave 2 who were recruited through a Facebook advertisement were analyzed. Participants completed an online questionnaire assessing suicidal ideation and perceived unfavorable attitudes toward homosexuality and same-sex marriage from Taiwanese society, heterosexual friends, and family members. The results indicate that perceived unfavorable attitudes toward homosexuality from Taiwanese society, heterosexual friends, and family members were positively associated with suicidal ideation among non-heterosexual individuals in the first but not the second survey. In addition, among non-heterosexual individuals, such attitudes toward same-sex marriage in family members and in heterosexual friends were positively associated with suicidal ideation in the Wave 1 and Wave 2 surveys, respectively. Perceived unfavorable attitudes toward homosexuality and same-sex marriage in heterosexual friends were associated with suicidal ideation in heterosexual participants with a favorable attitude but not in those individuals with an unfavorable attitude toward homosexuality, in both surveys. Perceived socially unfavorable attitudes toward homosexuality and same-sex marriage were significantly associated with suicidal ideation before and after same-sex marriage referendums; however, the associations varied between non-heterosexual and heterosexual individuals. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

14 pages, 485 KiB

Open AccessArticle

Affiliate Stigma and Related Factors in Family Caregivers of Children with Attention-Deficit/Hyperactivity Disorder

by Chih-Cheng Chang, Yu-Min Chen, Tai-Ling Liu, Ray C. Hsiao, Wen-Jiun Chou and Cheng-Fang Yen

Int. J. Environ. Res. Public Health 2020, 17(2), 576; https://doi.org/10.3390/ijerph17020576 - 16 Jan 2020

Cited by 38 | Viewed by 5437

Abstract

This cross-sectional questionnaire study examined factors related to affiliate stigma among caregivers of children with attention-deficit/hyperactivity disorder (ADHD) and the association of affiliate stigma with caregivers’ unfavorable attitude toward ADHD and moderators. The affiliate stigma of 400 caregivers of children with ADHD was [...] Read more.

This cross-sectional questionnaire study examined factors related to affiliate stigma among caregivers of children with attention-deficit/hyperactivity disorder (ADHD) and the association of affiliate stigma with caregivers’ unfavorable attitude toward ADHD and moderators. The affiliate stigma of 400 caregivers of children with ADHD was assessed using the Affiliate Stigma Scale. Caregivers’ and children’s factors related to affiliate stigma were examined using multiple regression analysis. Associations of affiliate stigma with caregivers’ unfavorable attitudes toward children’s diagnoses, pharmacotherapy, behavioral therapy, and biological explanations of the etiologies of ADHD were examined using logistic regression analysis. Female caregivers and those caring for girls with ADHD had higher levels of affiliate stigma than did male caregivers and those caring for boys. Higher education levels in caregivers and more severe inattention symptoms in children were associated with higher levels of affiliate stigma. A higher level of affiliate stigma was also significantly associated with unfavorable attitudes toward children’s diagnoses, pharmacotherapy and behavioral therapy, and etiological explanations for ADHD. Multiple factors of caregivers and children were related to affiliate stigma in caregivers of children with ADHD. Affiliate stigma is significantly associated with caregivers’ unfavorable attitude toward ADHD. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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11 pages, 721 KiB

Open AccessArticle

Psychosocial Variables Related to Weight-Related Self-Stigma in Physical Activity among Young Adults across Weight Status

by Xavier C. C. Fung, Amir H. Pakpour, Ya-Ke Wu, Chia-Wei Fan, Chung-Ying Lin and Hector W. H. Tsang

Int. J. Environ. Res. Public Health 2020, 17(1), 64; https://doi.org/10.3390/ijerph17010064 - 20 Dec 2019

Cited by 31 | Viewed by 4933

Abstract

A healthy lifestyle with sufficient physical activity (PA) can contribute to weight management. Yet, many people do not maintain a healthy lifestyle. To explain PA, we propose a model that incorporates the Theory of Planned Behavior (TPB) with weight-related self-stigma. We recruited 325 [...] Read more.

A healthy lifestyle with sufficient physical activity (PA) can contribute to weight management. Yet, many people do not maintain a healthy lifestyle. To explain PA, we propose a model that incorporates the Theory of Planned Behavior (TPB) with weight-related self-stigma. We recruited 325 young adults to complete questionnaires regarding their physical activities, weight-related self-stigma, and TPB factors. We used structural equation modeling to examine the model fit and the path invariance across weight groups. The model showed excellent model fit, but path invariance was not supported. Weight-related self-stigma significantly explained the perceived behavioral control, behavioral intention, and engagement of PA. People without overweight and people with overweight have different considerations for PA. Weight-related self-stigma is important for PA as well. To promote a healthy lifestyle, healthcare providers should provide different suggestions or interventions that suit their patients’ weight-related concerns. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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11 pages, 585 KiB

Open AccessArticle

Exploring the Knowledge, Attitudes, and Behavioural Responses of Healthcare Students towards Mental Illnesses—A Qualitative Study

by Taylor Riffel and Shu-Ping Chen

Int. J. Environ. Res. Public Health 2020, 17(1), 25; https://doi.org/10.3390/ijerph17010025 - 18 Dec 2019

Cited by 27 | Viewed by 9675

Abstract

Background: The stigma of mental illness causes delays in seeking help, and often compromises victims’ therapeutic relationships with healthcare providers. The knowledge, attitudes, and behavioural responses of future healthcare professionals toward individuals with mental illnesses are explored here to suggest steps that will [...] Read more.

Background: The stigma of mental illness causes delays in seeking help, and often compromises victims’ therapeutic relationships with healthcare providers. The knowledge, attitudes, and behavioural responses of future healthcare professionals toward individuals with mental illnesses are explored here to suggest steps that will reduce mental illness stigma in healthcare providers. Methods: A generic qualitative approach—Qualitative Description—was used. Eighteen students from nine healthcare programs at a Canadian University participated in individual semi-structured interviews. Participants answered questions regarding their knowledge, attitudes, and behavioural responses towards individuals with mental illnesses. Thematic content analysis guided the data analysis. Results: Four main themes were constructed from the data: positive and negative general perceptions toward mental illness; contact experiences with mental illnesses; mental illness in a healthcare setting; and learning about mental illness in healthcare academia. Conclusions: Students showed well-rounded mental health knowledge and mostly positive behaviours toward individuals with mental illnesses. However, some students hold stigmatizing attitudes and do not feel prepared through their academic experiences to work with individuals with mental illnesses. Mental health education can reduce the stigma toward mental illness and improve the care delivered by healthcare professionals. Full article

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13 pages, 1007 KiB

Open AccessArticle

Level of Stigma among Spanish Nursing Students toward Mental Illness and Associated Factors: A Mixed-Methods Study

by Julián Rodríguez-Almagro, Antonio Hernández-Martínez, David Rodríguez-Almagro, José Miguel Quiros-García, María del Carmen Solano-Ruiz and Juan Gómez-Salgado

Int. J. Environ. Res. Public Health 2019, 16(23), 4870; https://doi.org/10.3390/ijerph16234870 - 3 Dec 2019

Cited by 31 | Viewed by 5794

Abstract

Mental health problems have been identified by the World Health Organization as a global development priority. Negative attitudes toward mental health patients have been documented in multiple health professionals. The aim of this study was to determine the level of stigma and associated [...] Read more.

Mental health problems have been identified by the World Health Organization as a global development priority. Negative attitudes toward mental health patients have been documented in multiple health professionals. The aim of this study was to determine the level of stigma and associated factors toward people with mental health problems among students doing their degree in nursing. An explanatory sequential mixed-methods approach. A cross-sectional descriptive observational study was carried out on a sample of 359 students doing their degree in nursing. Students had to be enrolled in any of the four years of study of the degree at the time the questionnaire was done. We explored the perception and experience of students doing their degree in nursing regarding the level of stigma, through in-depth interviews (n = 30). The mean overall Mental Health Stigma Scale (MHSS) score was 30.7 points (SD = 4.52); 29.5% (n = 106) scored low for stigma, 49.9% (n = 179) showed moderate stigma, and 20.6% (n = 74) scored high. The multivariate analysis showed that 4th-year students had an OR of 0.41 (CI95%: 0.20–0.84) for high/moderate stigma and that 3rd-year students had an OR of 0.49 for high/moderate stigma compared with 1st-year students. We also observed that students with family members with mental health problems had an OR of 2.05 (CI95%: 1.19–3.56) for high/moderate stigma compared with students who did not have family members with mental health problems. The following categories emerged: fear and lack of knowledge, breaking the silence, and integration into society. The levels of mental health stigma in our sample of nursing students were moderate. Stigma levels were lower in 3rd- and 4th-year students (i.e., after having received training in mental health), and in students with family members with mental health problems. Full article

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9 pages, 470 KiB

Open AccessArticle

Psychological Pathway from Obesity-Related Stigma to Anxiety via Internalized Stigma and Self-Esteem among Adolescents in Taiwan

by Chung-Ying Lin, Meng-Che Tsai, Chih-Hsiang Liu, Yi-Ching Lin, Yi-Ping Hsieh and Carol Strong

Int. J. Environ. Res. Public Health 2019, 16(22), 4410; https://doi.org/10.3390/ijerph16224410 - 11 Nov 2019

Cited by 24 | Viewed by 3915

Abstract

The objective of this research was to examine the pathway from public stigma, to perceived stigma, to depression in adolescents via internalized stigma. Adolescents in grade 7 through 9 from a junior high school in Changhua County in Taiwan completed self-administered surveys from [...] Read more.

The objective of this research was to examine the pathway from public stigma, to perceived stigma, to depression in adolescents via internalized stigma. Adolescents in grade 7 through 9 from a junior high school in Changhua County in Taiwan completed self-administered surveys from March to July in 2018. Adolescents were asked questions regarding depressive symptoms, obesity-related perceived stigma, and internalized stigma. Structural equation modeling was used to fit the pathway model. The pathway was first analyzed with the full sample and then stratified by actual and perceived weight status. Our final analytic sample consisted of 464 adolescents. The pathway model suggested an acceptable model fit. Perceived weight stigma (PWS) was significantly associated with internalized stigma regardless of actual or self-perceived weight status. Internalized stigma was significantly associated with anxiety for both actual (β = 0.186) and self-perceived nonoverweight (non-OW) participants (β = 0.170) but not for overweight (OW) participants (neither actual nor self-perceived). For OW adolescents, perceived weight stigma was associated with anxiety. However, the internalization process did not exist. It may be that the influence of perceived weight stigma is larger than internalized stigma on anxiety. It may also be that the level of internalization was not yet high enough to result in anxiety. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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19 pages, 1006 KiB

Open AccessArticle

Men’s Intentions to Recommend Professional Help-Seeking to Their Partners in the Postpartum Period: the Direct and Indirect Effects of Gender-Role Conflict

by Catarina Luís, Maria Cristina Canavarro and Ana Fonseca

Int. J. Environ. Res. Public Health 2019, 16(20), 4002; https://doi.org/10.3390/ijerph16204002 - 19 Oct 2019

Cited by 4 | Viewed by 3818

Abstract

Women’s partners may act as facilitators of professional help-seeking for mental health problems in the postpartum period. This study aimed to examine the sociodemographic and clinical correlates of men’s intentions to recommend professional help-seeking to their partners if they display postpartum mood and [...] Read more.

Women’s partners may act as facilitators of professional help-seeking for mental health problems in the postpartum period. This study aimed to examine the sociodemographic and clinical correlates of men’s intentions to recommend professional help-seeking to their partners if they display postpartum mood and anxiety disorders and to explore the relationship between gender-role conflict and the intention to recommend help-seeking. A cross-sectional study included 214 adult men in a heterosexual relationship with a partner within the reproductive age. Men presented a high intention to recommend professional help to their partners. All dimensions of gender-role conflict were directly associated with the intention to recommend professional help-seeking (p < 0.05). High levels of gender-role conflict (dimensions success, power and competition, and restricted emotionality) were found to lead to increased levels of stigma and lower levels of intention to seek professional help, which, in turn, translated into lower intention to recommend help-seeking. These results emphasize the importance of developing universal awareness-raising and education campaigns directed at men aiming to reduce levels of gender-role conflict and stigma, and normalize the use of mental health services, to increase men’s intentions to recommend professional help-seeking to their partners. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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17 pages, 1384 KiB

Open AccessArticle

The Body as an Object of Stigmatization in Cultures of Guilt and Shame: A Polish–Vietnamese Comparison

by Małgorzata Lipowska, Ha Truong Thi Khanh, Mariusz Lipowski, Joanna Różycka-Tran, Mariola Bidzan and Thu Tran Ha

Int. J. Environ. Res. Public Health 2019, 16(16), 2814; https://doi.org/10.3390/ijerph16162814 - 7 Aug 2019

Cited by 26 | Viewed by 7201

Abstract

The aim of this paper is to examine cross-cultural differences in body stigmatization between the individualistic Christian culture of guilt (Poland) and the collectivistic Buddhist/Confucian culture of honor and shame (Vietnam). The study included 1290 university students from Poland (n = 586) [...] Read more.

The aim of this paper is to examine cross-cultural differences in body stigmatization between the individualistic Christian culture of guilt (Poland) and the collectivistic Buddhist/Confucian culture of honor and shame (Vietnam). The study included 1290 university students from Poland (n = 586) and Vietnam (n = 704). Subjects filled in the body esteem scale and the perceived stigmatization questionnaire, and body measurements were collected to calculate anthropometric indices. Participants from Vietnam were less satisfied with their appearance than their Polish peers. Men in both countries assessed themselves more favorably. No anthropometric index predicted body esteem in Vietnamese women, while only indices related to fat levels were predictors in Polish women. Men with a V-shaped body assessed themselves as stronger and as having a better physical condition. A possible explanation of the observed cross-cultural differences is that interdependent self-construal makes young adults in collectivistic societies more susceptible to criticism, and the Confucian values of modesty and shame lead to them not perceiving their bodies as sexual objects. The Christian sense of guilt does not influence the perception of sexuality. Absence of friendly behavior mediated the relation between anthropometric indices and body esteem in both cultures. Full article

(This article belongs to the Special Issue Stigma, Health and Wellbeing)

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