Stigma in help-seeking: the case of adolescents

Stigma associated with seeking help has been found to be a key help-seeking barrier, however its role is less clear for: (a) adolescents, (b) groups outside the United States and (c) different types of therapy. This study addresses these omissions by examining the relationships between perceptions of public stigma of mental illness and the self-stigma of seeking help, and how they are related to help-seeking attitudes and intentions for both individual and group therapy among adolescents in Israel (N?=?238). Path analysis confirmed that self-stigma of seeking help was negatively related to attitudes towards psychological help which was then positively related to intentions to seek help, across both individual and group therapy. Consistent with the only other study conducted in Israel, but contrasting research from other parts of the world, the relationship between perceptions of public stigma of mental illness and self-stigma of seeking help was not present for either individual or group therapy. However, perceptions of public stigma of mental illness were a direct negative predictor of help-seeking attitudes for group therapy. Overall, participants reported more negative perceptions of group therapy than individual therapy. These results have implications for future interventions to increase help-seeking behaviours for adolescents.     

Stigma Consciousness and Subjective Well-Being in Lesbians and Gays

The stigma associated with sexual identity can affect an individual’s well-being. The main goal of this study was to analyse the role of a psychosocial variable, stigma consciousness, on the well-being of lesbian and gay (LG) individuals. For this purpose, a sample of 481 participants completed various questionnaires (M _age = 32.36, SD _age = 9.60). Analysis of these results using structural equations showed two different pathways to cope with the stigma. The first pathway consists of collective action, and the second consists of stigma concealment. Specifically, stigma consciousness positively predicts well-being through group identification and collective action. Stigma concealment, however, negatively predicts well-being through the perception of prejudice. In addition, this work has confirmed that concealment has a direct negative relationship with subjective well-being. These results are interpreted from a psychosocial perspective. Finally, based on our data, we propose future interventions that provide LG individuals with strategies to cope with their perceptions of stigma.     

Stigma as framed on YouTube: Effects of personal experiences videos on students’ beliefs about medicalizing intersex

People with physical intersex characteristics can be subject to medical interventions that risk human rights to bodily integrity and self‐determination. Proponents and opponents of medicalization use personal narrative videos on YouTube to frame intersex as a stigma best understood through a medical or social identity frame. Ninety‐nine psychology students watched one of two YouTube videos with either a medical or social identity frame, or participated in a comparison group who watched no video. Participants extracted the videos’ medical or social identity framing in their own words. The social identity video increased participants’ sense that medicine was more harmful and less beneficial, and the medical video decreased participants’ sense that medicine was harmful. Although the videos aimed at bringing about social understanding of intersex people, neither video impacted stigmatizing beliefs about intersex people as a group. Rather, effects of the videos on beliefs about harms of medicalization were moderated by two stigma measures; social distance and gender binary beliefs. Medical intervention on intersex has been justified, in part, on grounds that stigma is inevitable. While intersex stigma has rarely been empirically examined, the present study shows that people with less propensity to stigmatize see less benefit from medicalizing intersex traits and are more open to learning few framings from personal experience videos.     

Why Frankenstein is a Stigma Among Scientists

As one of the best known science narratives about the consequences of creating life, Mary Shelley’s Frankenstein; or, The Modern Prometheus (1818) is an enduring tale that people know and understand with an almost instinctive familiarity. It has become a myth reflecting people’s ambivalent feelings about emerging science: they are curious about science, but they are also afraid of what science can do to them. In this essay, we argue that the Frankenstein myth has evolved into a stigma attached to scientists that focalizes the public’s as well as the scientific community’s negative reactions towards certain sciences and scientific practices. This stigma produces ambivalent reactions towards scientific artifacts and it leads to negative connotations because it implies that some sciences are dangerous and harmful. We argue that understanding the Frankenstein stigma can empower scientists by helping them revisit their own biases as well as responding effectively to people’s expectations for, and attitudes towards, scientists and scientific artifacts. Debunking the Frankenstein stigma could also allow scientists to reshape their professional identities so they can better show the public what ethical and moral values guide their research enterprises.     

Disengagement and Engagement Coping with HIV/AIDS Stigma and Psychological Well-Being of People with HIV/AIDS

The stigma associated with HIV/AIDS poses a psychological challenge to people living with HIV/AIDS. We hypothesized that that the consequences of stigma-related stressors on psychological well-being would depend on how people cope with the stress of HIV/AIDS stigma. Two hundred participants with HIV/AIDS completed a self-report measure of enacted stigma and felt stigma, a measure of how they coped with HIV/AIDS stigma, and measures of depression and anxiety, and self-esteem. In general, increases in felt stigma (concerns with public attitudes, negative self-image, and disclosure concerns) coupled with how participants reported coping with stigma (by disengaging from or engaging with the stigma stressor) predicted self-reported depression, anxiety, and self-esteem. Increases in felt stigma were associated with increases in anxiety and depression among participants who reported relatively high levels of disengagement coping compared to participants who reported relatively low levels of disengagement coping. Increases in felt stigma were associated with decreased self-esteem, but this association was attenuated among participants who reported relatively high levels of engagement control coping. The data also suggested a trend that increases in enacted stigma predicted increases in anxiety, but not depression, among participants who reported using more disengagement coping. Mental health professionals working with people who are HIV positive should consider how their clients cope with HIV/AIDS stigma and consider tailoring current therapies to address the relationship between stigma, coping, and psychological well-being.     

The Transformative Effects of Stigma: Coping Strategies as Meaning‐Making Efforts for Immigrants Living in Greece

The present article examines the strategies that immigrants living in Greece use to cope with stigma that arises in their interaction with both Greek society and their communities of origin. Drawing on interviews and focus groups conducted with immigrants from a variety of countries, a dialogical analysis illuminates the ways in which immigrants actively negotiate stigmatizing perspectives and transform themselves. Strategies include the deployment of social categories such as those of ‘human being’ and ‘crazy’ person, and concepts such as those of ‘lawfulness’ and ‘fate’. These were used to construct meanings of equality and inclusion into society, to deny responsibility for stigma and to discredit stigma as absurd. They enabled participants to see themselves as proud, equal, self‐dependent individuals who plan actions for social change. The article suggests that coping with stigma should not only be understood in terms of stress regulation, leading to positive or negative outcomes, as suggested by current literature, but as a meaning‐making effort, through which individuals transform the way they see themselves and act within their world. A meaning‐making approach moves away from individualistic, outcome‐oriented explanations to a socially situated perspective on stigma that studies the processes through which social meanings are subjectively perceived as stigmatizing and are used to challenge stigma. Copyright © 2013 John Wiley & Sons, Ltd.     

The Menstrual Mark: Menstruation as Social Stigma

In this theoretical paper, we argue that menstruation is a source of social stigma for women. The word stigma refers to any stain or mark that renders the individual’s body or character defective. This stigma is transmitted through powerful socialization agents in popular culture such as advertisements and educational materials. We demonstrate, in our review of the psychological literature concerning attitudes and experiences of predominantly American girls and women, that the stigmatized status of menstruation has important consequences for their health, sexuality, and well-being. We argue that the stigma of menstruation both reflects and contributes to women’s lower social status and conclude with suggestions for ways to resist the stigma.     

An Attributional Analysis of Gender and Cancer-Related Stigma

This experiment examined the impact of gender on cancer-related stigma from Weiner’s (An attributional theory of motivation and emotion. Springer, New York, 1986) attributional perspective. Undergraduates (n?=?204; 59% female; 71% White) and community members (n?=?85; 62% female; 64% White) in the northeastern U.S. were assigned randomly to listen to an audiotaped interview of a target person with lung cancer in which gender and smoking status (nonsmoker, smoker, or unspecified) were manipulated. Participant and target gender predicted participants’ perceptions of disease controllability and anger toward the target person. The target person’s smoking status also predicted participants’ perceptions of disease controllability and emotional responses to the target person. Findings partially support Weiner’s (An attributional theory of motivation and emotion. Springer, New York, 1986) theory and suggest that the relationship between gender and cancer-related stigma deserves further investigation.     

心理疾病内隐污名述评

心理疾病内隐污名是个体无法内省或精确识别的与心理疾病有关的痕迹, 它潜在地调节着个体对心理疾病患者的观念和行为。心理疾病内隐污名的主要测量方法包括内隐联想测验、简式内隐联想测验、启动任务和生理心理测量。当前该研究领域集中在内隐污名的成分、公众内隐污名、自我内隐污名、去污名化评估等方面。未来研究可从心理疾病内隐污名的构成与结构、认知神经基础、测量整合和本土化等角度做进一步探讨。     

A Good Abortion Is a Tragic Abortion: Fit Motherhood and Disability Stigma

In the context of abortion stigma, most abortion stories remain untold. The stories we do tell of abortion are often told to morally recuperate the status of the woman who has an abortion through a recourse to tragedy. Tragedy frames experiences where every choice produces some suffering, so decisions are geared toward maintaining individual integrity rather than adherence to absolute moral truths. This article argues that one dominant tragic abortion narrative, that of the disabled fetus, works to recuperate the moral status of “fit” mothers while actively constructing disabled lives as unlivable and undesirable. The option to stigmatize disability in recuperating the moral status of the woman who has an abortion relies on eugenic logics that also construct a variety of women (racialized, poor, disabled, and young) as illegitimate reproductive subjects. The article analyzes narratives of Sherri Finkbine's 1962 abortion in relation to contemporary narratives of late‐term abortions involving nonviable fetuses to expose how investment in medical judgments of good births enables particular women to make use of tragic narratives to maintain their status as moral mothers without disturbing broader abortion stigma or eugenic logics.     

Bad,Pathetic and Greedy Women: Expressions of Surrogate Motherhood Stigma in a Russian Online Forum

Gestational surrogacy, in which the surrogate mother is not biologically related to the child she is carrying, is the most common type of surrogacy today. Although technologically well-developed and legal in many countries, it is stigmatized socially because it provokes and even contradicts basic traditional concepts of family, motherhood, and gender roles. The present study examines the types and expressions of the surrogacy stigma in Russia, applying a dual-pathway stigma model to a qualitative content analysis of 15,602 posts on a Russian-language online forum for surrogate mothers. Our findings reveal that the women’s choice to become surrogate mothers initiated a social process in which these women experienced four types of stigma: Bad mothers, bad wives, pathetic losers, and greedy women. Surrogate mothers described the experience and internalization of stigma as threatening their social roles in the traditional family and financial realm alike. Our study places surrogacy stigma in the context of the post-Soviet financial and social climate as experienced and expressed by participants. Furthermore, understandings of the essence of perceived surrogacy stigma may help professionals develop a more nuanced and accurate approach for psychological and social care and may lead to increased accuracy in media, law, and political representation of members of this vulnerable group.

     

Stigma consciousness modulates cortisol reactivity to social stress in women

The aim of the current study was to examine whether stigma consciousness shapes cortisol responses to social stress among women in the laboratory. Undergraduate women (N = 45) completed background measures and then participated in a public speaking task, with assessments of cortisol prior to the stressor as well as 20 and 40 minutes post stressor onset. Results from multilevel models revealed that women higher in stigma consciousness evidenced blunted cortisol reactivity following social stress across the study session compared to women lower in stigma consciousness. This interaction was robust to adjustment for a number of covariates, including demographic (e.g., age), physiological (e.g., menstrual cycle), and psychological (e.g., depressive symptomatology) factors. Potential explanations for observed cortisol patterns are discussed, including hyporeactivity of the hypothalamic–pituitary–adrenal axis and elevated anticipatory stress. In conclusion, implications for health disparities research are considered.     

Stigma by Association Among Family Members of People with a Mental Illness: A Qualitative Analysis

People with mental illness are not the sole recipients of stigmatisation; their immediate family members may be subjected to stigma by association. Through semi‐structured interviews, we investigated experiences of stigma by association among 23 immediate family members of people with mental illness. Participants reported experiencing stigma by association from community members, mental health professionals, and civil servants. Familial relationship, co‐residence, and the gender of participants appeared to play a role in their stigma experiences; parents and spouses reported different manifestations of stigma by association than siblings and children, participants who lived together with their family member with mental illness reported increased experiences of stigma by association, and in contrast to male participants, female participants reported others thinking they are overprotective and as such perpetuated, maintained, or sustained their family members' mental illness. The relevance of these factors points to the need for tailored education and emotional support provision to family members of people with mental illness. Moreover, in‐service training for mental health professionals should include the development of relevant social skills that enable the recognition of familial relationships and roles, and family members' fears, concerns, and problems. Copyright © 2014 John Wiley & Sons, Ltd.     

流动儿童歧视知觉与心理健康水平的关系及其心理机制

为了探讨流动儿童所感受到的歧视对他们心理健康水平的影响, 以及应对方式和自尊在其中所起的作用, 从北京市公立学校和打工子弟学校选取1164名流动儿童、从公立学校选取525名北京儿童、从流动儿童主要来源地的农村选取568名农村儿童作为被试, 采用问卷调查的形式, 测查了流动儿童感受到的歧视、他们的心理健康水平(社交焦虑、孤独感、抑郁)、应对方式和自尊。研究发现: (1) 流动儿童所感受到的社会歧视在学校类型、流动性上存在显著的差异, 打工子弟学校的流动儿童得分显著高于公立学校的, 流动性高的儿童得分显著高于流动性低的, 但在性别上不存在显著差异, 也不存在学校类型与性别和流动性的交互作用; (2) 流动儿童的心理健康水平在性别、学校类型和流动性上存在显著的差异, 女孩、来自公立学校的流动儿童、流动性高的儿童的心理健康水平显著差于与之相对应的被试, 除在社交焦虑和抑郁上存在学校类型和性别的交互作用外, 在孤独感上不存在学校类型和流动性的交互作用; (3) 不同类别儿童在心理健康水平上存在显著差异, 流动儿童在社交焦虑、孤独感上最差; (4) 除消极应对与自尊、积极应对与抑郁相关不显著外, 歧视、心理健康水平、应对方式、自尊两两之间都相关非常显著; (5) 歧视知觉对心理健康水平有显著的直接影响, 也通过应对方式和自尊对心理健康水平产生显著的影响。自尊不仅在歧视知觉与心理健康水平之间起到显著的部分中介作用, 在应对方式和心理健康水平之间也起到了显著的部分中介作用。     

污名现象及其心理效应

污名本质上是一种消极的刻板印象,是社会对某些个体或群体贬低性的、侮辱性的标签,对被污名者有着深刻的影响。文章从三个方面对污名的相关研究做了简要的回顾。首先介绍了几种污名的相关定义;然后介绍了污名的心理效应,包括污名他人的功能,污名对群体和个体的影响,以及社会公众对污名的态度和应对过程;第三介绍了两个污名研究的主要领域：一个是污名群体知觉、应对歧视规律的污名歧视研究,另一个是可隐匿污名的相关研究,如隐匿污名的心理过程,隐匿的情绪反应以及揭示污名的心理意义等。最后,提出了未来研究的几点展望,可隐匿污名的相关研究,内隐社会认知研究和消除污名消极影响的干预研究     

A Community’s Response to Suicide Through Public Art: Stakeholder Perspectives from the Finding the Light Within Project

Suicide is a preventable public health problem and a leading cause of death in the United States. Despite recognized need for community-based strategies for suicide prevention, most suicide prevention programs focus on individual-level change. This article presents seven first person accounts of Finding the Light Within, a community mobilization initiative to reduce the stigma associated with suicide through public arts participation that took place in Philadelphia, Pennsylvania from 2011 through 2012. The stigma associated with suicide is a major challenge to suicide prevention, erecting social barriers to effective prevention and treatment and enhancing risk factors for people struggling with suicidal ideation and recovery after losing a loved one to suicide. This project engaged a large and diverse audience and built a new community around suicide prevention through participatory public art, including community design and production of a large public mural about suicide, storytelling and art workshops, and a storytelling website. We present this project as a model for how arts participation can address suicide on multiple fronts—from raising awareness and reducing stigma, to promoting community recovery, to providing healing for people and communities in need.     

Stigma Consciousness in Intergroup Contexts: The Power of Conviction

People vary in the extent to which they expect to be stereotyped, and these differences in “stigma consciousness” have cognitive and behavioral consequences that contribute to people's experience of stereotyping, prejudice, and discrimination (20). Here it is argued that high levels of stigma consciousness also have significant interpersonal consequences. Consistent with this claim, female participants who were high in stigma consciousness acted critically toward male participants whom they believed to be sexist. Moreover, these critical behaviors elicited unfavorable responses from the male participants, responses which then provided fodder for the women's belief that they would not like the men. The results are discussed in light of previous work on the target's perspective on stereotyping and call into question the wisdom of adopting a vigilant stance when interacting with out-group members.     

A Novel Technology-Enhanced Internalized Stigma and Shame Intervention for HIV-Positive Persons With Substance Use Disorders

Internalized stigma, shame, and other negative self-conscious emotions are inadequately addressed barriers to HIV-related self-care, particularly among people actively using substances. Innovative approaches are needed to optimize antiretroviral treatment (ART) adherence as well as engagement in HIV care among people living with HIV and substance use disorders. Based on qualitative feedback from providers and patients, we iteratively developed and conducted a proof-of-concept study of a relatively brief transdiagnostic emotion regulation intervention designed to improve ART adherence and engagement in HIV care by addressing behavioral and psychological barriers, including internalized stigma and shame, among people living with HIV and active substance use disorders. The final intervention included 5 individual sessions focused on metacognitive awareness of emotions and thoughts, cognitive reframing of dysfunctional thoughts about the self using concepts such as self-compassion, and identifying and reaching the participants’ personalized HIV-self-care goal(s). All participants received daily texts querying current emotion and weekly texts querying ART adherence and substance use. To extend the effects of the intervention, we developed a personalized bidirectional text component through which participants received their personalized compassionate self-statements, informed by the intervention content, in response to their answers to emotion queries for 8 weeks after the 5 sessions. The texts modeled using compassionate self-statements as a form of cognitive reframing, consistent with cognitive restructuring of distorted core beliefs. We consented 10 participants living with HIV and active substance use disorders in the proof-of-concept pilot. Of the 8 participants who completed all intervention sessions, participants replied to 70% of all text messages sent. All 8 reported strong acceptability of the intervention content. This emotion-focused, technology-enhanced intervention demonstrated proof-of-concept, in that this patient population would participate in this intervention. A larger randomized controlled pilot is needed to determine feasibility and acceptability among people living with HIV and substance use disorders, a hard-to-reach and underserved population.     

AIDS Stigma and Contact With Persons With AIDS: Effects of Direct and Vicarious Contact.1

This paper examines the relationship between AIDS-related stigma and (a) direct, personal contact with people with AIDS (PWAs), and (b) vicarious contact—through mass media—with a public figure with AIDS or HIV. Data are presented from a 2-wave national telephone survey with a probability sample of US. adults (ns = 538 at Wave 1; 382 at Wave 2) and an oversample of Black Americans (ns = 607 and 420, respectively). Direct contact with a PWA was associated with less support for coercive AIDS policies, less blame for PWAs, and less avoidance of PWAs. Vicarious contact–operationalized as the self-reported impact of Earvin “Magic” Johnson's disclosure of his HIV infection–appeared to have its greatest impact among respondents who previously had manifested high levels of stigma. In that group, levels of stigma diminished somewhat to the extent that respondents reported having been strongly influenced by Johnson's announcement.     

You're Just Saying That Because I'm a Woman: Stigma Consciousness and Attributions to Discrimination

This study adds to tests of the construct validity of stigma consciousness by asking if people high in stigma consciousness demonstrate a greater tendency than people low in stigma consciousness to make attributions to discrimination. In a study that approached this question from both an individual difference and a situational perspective, women high or low in stigma consciousness made attributions for a negative evaluation, ostensibly written by a male peer. Under control conditions, women low in trait stigma consciousness demonstrated less of a tendency to make attributions to discrimination than women high in trait stigma consciousness. When they experienced a situationally induced increase in stigma consciousness, however, participants low in trait stigma consciousness demonstrated just as great a tendency to make attributions to discrimination as their high stigma conscious counterparts. The results provide further validation for the stigma consciousness construct, and raise questions about who benefits from attributions to discrimination.