Representation of mental illness in Christian self-help bestsellers

The present study examined messages about mental illness in 14 contemporary Christian self-help bestsellers. Content analysis revealed that most texts focused upon depression. Categories of textual units included Underlying Assumptions Regarding Depression, Representations of Depression, Roots/Causes/Reasons for Depression, and Christian Responses to Depression. Demonic influence was the most frequently cited reason for depression. Other reasons included negative cognitions, failure as a Christian, and negative emotions. Christian responses to depression included trusting God, religious activity, and individual willpower. Discussion of these results focused upon the problematic impact of these messages upon individuals with depression, and upon suggestions for reducing mental illness stigma in religious communities.     

Correlates of religious,supernatural and psychosocial causal beliefs about depression among Latino immigrants in primary care

The purpose of this cross-sectional study was to explore causal attributions about depression and to identify psychosocial factors associated with these beliefs among Latino immigrants. We interviewed 177 primary care patients with instruments to assess causal beliefs, depressive and somatic symptoms, ethnic identity and stigma. An exploratory factor analysis of the Causal Beliefs scale yielded three factors, “Balance,” “Psychosocial” and “Malevolent Spirituality/Transgressions” that were used as dependent variables in multivariate analyses. Depressive symptoms, age, country of origin and religiosity were significantly associated with particular factors of causal beliefs. Those with higher education were most likely to endorse psychosocial causal beliefs. Stigma pertained to causal beliefs related to “malevolent forces” and “personal transgressions.” In conclusion, psychosocial and religious explanations of illness were strongly endorsed by these Latino immigrants, indicating a dual system of Western-medicine and traditional beliefs. These results suggest culturally-specific interventions for improving health knowledge and communication with patients about depression.     

Method Acting and Gestalt Therapy with Couples

SUMMARY

Techniques taken from Method acting may be useful therapeutic tools and may lend themselves to adoption by Gestalt therapists. Similarities between the goals and procedures of Method acting and Gestalt therapy are described in some detail. The importance and effectiveness of enacted fantasy are discussed, and techniques of Method acting are described in terms of their relation to Gestalt theory. The importance and application of these techniques to Gestalt therapy with couples are discussed.     

Spiritual and Religious Implications of Aging with HIV: A Conceptual and Methodological Review

ABSTRACT

Spirituality and religious practices can buffer people from stressful life circumstances and promote positive biopsychosocial outcomes. The beneficial effects of spirituality and religious practices have been documented in aging and HIV. Unfortunately, little is known about spirituality and religious practices in older adults with HIV. As the number of older adults with HIV increases, with an estimated 91,000 adults over 50 being diagnosed with this disease in the United States, spirituality and religious practices may help HIV-positive people to age successfully. Crisis competence and spiritual trajectories are ways of conceptualizing spiritual development when confronting aging with a life-changing event such as a being diagnosed with HIV. Methodological issues in studying spirituality in adults aging with HIV are identified including defining spirituality and religiosity, heterogeneity of the population, timing of diagnosis, mode of transmission, sexual orientation, religious and cultural stigma, and hardiness. Implications for possible interventions are also posited.     

The effect of personal and group discrimination on the subjective well-being of people with mental illness: the role of internalized stigma and collective action intention

The goal of this study is to test a model in which personal discrimination predicts internalized stigma, while group discrimination predicts a greater willingness to engage in collective action. Internalized stigma and collective action, in turn, are associated to positive and negative affect. A cross-sectional study with 213 people with mental illness was conducted. The model was tested using path analysis. Although the data supported the model, its fit was not sufficiently good. A respecified model, in which a direct path from collective action to internalized stigma was added, showed a good fit. Personal and group discrimination appear to impact subjective well-being through two different paths: the internalization of stigma and collective action intentions, respectively. These two paths, however, are not completely independent, as collective action predicts a lower internalization of stigma. Thus, collective action appears as an important tool to reduce internalized stigma and improve subjective well-being. Future interventions to reduce the impact of stigma should fight the internalization of stigma and promote collective action are suggested.     

Coping with Sexual Identity Stigma in the U.S. Military: An Examination of Identity Management Practices Prior to and After the Repeal of “Don’t Ask,Don’t Tell”

This study assesses the identity management strategies employed by gays, lesbians, and bisexuals in the U.S. military prior to and after the repeal of “Don’t Ask, Don’t Tell.” In-depth interviews were conducted with gay, lesbian, and bisexual service members and veterans. Data were analyzed using constant comparative analysis. Findings revealed that these service members made thoughtful and deliberate decisions about whether or not, and to whom, they would reveal their sexual identities. Identity concealment was practiced most often, even after the repeal, which was found to incite feelings of self-reproach, isolation, and stress. However, several new identity management strategies emerged after the repeal of “Don’t Ask, Don’t Tell” (i.e., strategies of openness) that stimulated positive self-feelings. By engaging in some level of openness, participants in this study were able to overcome some of the adverse effects of their minority stress.     

Assessment of a “Transgender Identity Stigma” scale among trans women in India: Findings from exploratory and confirmatory factor analyses

Background: Sexual minority stigma has been shown to influence mental health and sexual risk, but limited research is available on measuring transgender-identity stigma among trans women in India. We adapted an Exposure to Transphobia scale to the Indian context and tested a 14-item Transgender Identity Stigma Questionnaire (TGISQ) among trans women in India. We aimed to assess and validate the factor structure of the TGISQ and to assess its reliability.

Methods: Data were from a cross-sectional survey among 300 trans women (including hijras/thirunangais) from six urban/semi-urban sites in India. The TGISQ consisted of self-reported ratings on 14 items. We initially conducted exploratory factor analysis, using principal axis factoring (PAF) and promax rotation, and assessed reliability (internal consistency) using Cronbach's alpha; we then conducted confirmatory factor analysis to assess construct validity (factorial validity). Construct validity of the final 13-item Transgender Identity Stigma Scale (TGISS) was also examined by computing Pearson's correlations between TGISS and relevant theoretical constructs (e.g., depression, social support).

Results: PAF identified two factors: enacted stigma (5 items) and felt normative stigma (8 items). The final 13-item TGISS had high reliability and acceptable construct validity.

Conclusions: The TGISS was found to have adequate psychometric properties, making it the first valid and reliable scale to measure stigma and discrimination faced by trans women in India. Future studies can further refine TGISS, which might help in comparing the differences in stigma experiences among diverse subgroups of trans women, and in monitoring and evaluating the success of stigma reduction programs.     

Risk and resilience: Dual effects of perceptions of group disadvantage among Latinos

Several decades of research on the psychology of minority status has yielded highly discrepant findings. Substantial research suggests that perceptions of discrimination are linked to inferior self-regard and poor mental health, whereas other studies indicate that perceptions of discrimination are protective of global self-esteem. We tested a theoretical model of the combined (negative/positive) effects of perceived group disadvantage on self-esteem among Latinos. Structural equation modeling analyses indicated that perceptions of group disadvantage were indirectly related to self-esteem through two principal pathways. The total (direct and indirect) effect on self-esteem was not significant, suggesting that, among Latinos, the deleterious consequences of perceived belonging to a devalued and disadvantaged group were fully counterbalanced by the positive effects of intervening variables. More complex models may be needed to characterize fully the self-protective and detrimental consequences of perceived group disadvantage among Latinos.     

Expressions of emotional distress in active duty military personnel with mild traumatic brain injury: A qualitative content analysis

Service members (SMs) who sustain traumatic brain injury (TBI) during deployment have increased risk for mental health issues. Mental health treatment can be challenging in military settings where treatment seeking is often stigmatized. Adequate care relies on accurate interpretations of SMs’ verbal accounts of distress, but little is known about how SMs, embedded in a culture that values resilience and self-reliance, relay emotional distress. We performed qualitative analyses of recordings from a telephone-based intervention with 25 SMs who sustained deployment-related mild TBI (mTBI) to elucidate thematic and dialectal patterns. Consistent with our expectations, SMs rarely used explicit depressive terms while discussing their emotional distress. More prevalent was language suggestive of an overarching theme of loss of control, whereby SMs’ stress, anxiety, and anger were often attributable to SMs’ perceptions that they had incomplete jurisdiction over their own lives. This study may help mental health providers improve engagements with SMs and Veterans, preventing misunderstandings and even improper diagnoses or referrals that could result from a strict reliance on the more customary expressions of distress.