Identification Reduces Stigma of Mental Ill‐Health: A Community‐Based Study

The stigma surrounding mental ill‐health is an important issue that affects likelihood of diagnosis and uptake of services, as those affected may work to avoid exposure, judgment, or any perceived loss in status associated with their mental ill‐health. In this study, we drew upon social identity theory to examine how social group membership might influence the stigma surrounding mental ill‐health. Participants from two urban centers in Ireland (N = 626) completed a survey measuring stigma of mental health, perceived social support as well as identification with two different social groups (community and religion). Mediation analysis showed that subjective identification with religious and community groups led to greater perceived social support and consequently lower perceived stigma of mental ill‐health. Furthermore, findings indicated that high identification with more than one social group can lead to enhanced social resources, and that identification with a religious group was associated with greater community identification. This study thus extends the evidence base of group identification by demonstrating its relationship with stigma of mental ill‐health, while also reinforcing how multiple identities can interact to enhance social resources crucial for well‐being.     

The common sense of counseling psychology: introducing the Common-Sense Model of self-regulation

Abstract

The goal of therapy is typically to improve clients’ self-management of their problems, not only during the course of therapy but also after therapy ends. Although it seems obvious that therapists are interested in improving clients’ self-management, the psychotherapy literature has little to say on the topic. This article introduces Leventhal’s Common-Sense Model of Self-Regulation, a theoretical model of the self-management of health, and applies the model to the therapeutic process. The Common-Sense Model proposes that people develop illness representations of health threats and these illness representations guide self-management. The model has primarily been used to understand how people self-manage physical health problems, we suggest it may also be useful to understand self-management of mental health problems. The Common-Sense Model’s strengths-based perspective is a natural fit for the work of counseling psychologists. The model has important practical implications for addressing how clients understand mental health problems over the course of treatment and self-manage these problems during and after treatment.     

An illness-specific version of the Revised Illness Perception Questionnaire in patients with atrial fibrillation (AF IPQ-R): Unpacking beliefs about treatment control,personal control and symptom triggers

Objective: This study modified the Revised Illness Perception Questionnaire (IPQ-R) in patients with persistent atrial fibrillation (AF).

Design: Qualitative interviews and think-aloud techniques informed modification of the IPQ-R to be specific to AF patients. Confirmatory Factor Analysis (CFA) (n = 198) examined the validity of the modified IPQ-R (AF-IPQ-R). Exploratory factor analysis (EFA) examined the new AF-triggers scale. Construct validity examined associations between the AF-IPQ-R, quality of life (QoL) and beliefs about medicines. Test–retest and internal reliability were examined.

Results: Interviews indicated that patients viewed triggers of AF rather than initial causes of illness as more applicable. Patients believed specific behaviours such as rest could control AF. Treatment control beliefs related to pharmacological and procedural treatments. These data were used to modify the IPQ-R subscales and to develop a triggers of AF scale. CFA indicated good model fit. EFA of the triggers scale indicated three factors: emotional; health behaviours; and over-exertion triggers. Expected correlations were found between the AF-IPQ-R, QoL and treatment beliefs, evidencing good construct validity.

Conclusion: The AF-IPQ-R showed sound psychometric properties. It provides more detailed specification than the IPQ-R of beliefs that may help to understand poor QoL in AF patients, and guidance for future interventions in this area.     

Posttraumatic Growth in Individuals With Chronic Illness: The Role of Social Support and Meaning Making

This study aimed to assess the predictive nature of social support, meaning making (presence of meaning and search for meaning), and demographic factors on perceived posttraumatic growth (PTG) in a sample of adults living with chronic illness (N = 110). Regression analyses indicated that presence of meaning and gender served as the strongest predictors, together accounting for 22% of the variance in PTG. Presence of meaning also moderated the relationship between social support and PTG, supporting the unique contribution of meaning making on PTG.     

Using Force: Australian Newspaper Depictions of Contacts Between the Police and Persons Experiencing Mental Illness

The media creates and sustains knowledge about socially relevant issues such as crime, mental illness, and policing. Past research suggests that while the media portrayal of the police is undoubtedly complex, their portrayal of people experiencing mental illness remains mainly negative. The depiction of their encounters in the mass media is of considerable interest because of the influential role the media has on public opinion and debate; however, there is a lack of current research in this area. This study aimed to examine media items in the major newspapers across Australia between January 2006 and December 2007 (n = 77) to investigate their portrayal of this interface. The dominant themes encountered in the initial analysis depicted people experiencing mental illness as dangerous and a threat to the public, where the mental health system has failed to manage them adequately. Further analyses found that people experiencing mental illness were stigmatised in a third of the media items reviewed and were represented significantly more negatively in these encounters than the police. Implications of these findings and some suggestions regarding possible strategies that could improve socially responsible media reporting and public discourse on mental illness are proposed.     

Loneliness, depression, social support, and quality of life in older chronically ill Appalachians

This study's purpose was to describe loneliness and to examine the relationships between loneliness, depression, social support, and QOL in chronically ill, older Appalachians. In-person interviews were conducted with a convenience sample of 60 older, chronically ill, community-dwelling, and rural adults. Those with dementia or active grief were excluded. The UCLA Loneliness Scale (Russell, Peplau, & Cutrona, 1985), Geriatric Depression Scale (Shiekh & Yesavage, 1986), Katz ADL scale (Katz, Down, & Cash, 1970), MOS Social Support Scale (Sherbourne & Stewart, 1991), and a visual analog scale for Quality of Life (Spitzer et al., 1981) scale were used. Diagnoses were obtained through chart reviews. SPSS was used for data analyses. The majority of the 65% female sample (M age = 75 years) were married and impoverished. Participants' number of chronic illnesses averaged more than 3. Over 88% of participants reported at least 1 area of functional impairment. Loneliness was prevalent with UCLA loneliness scores indicating moderate to high loneliness, ranging from 39 to 62 (possible scores were 20-80). Higher loneliness scores correlated with depression, lower Qol, and lower social support, particularly lower emotional support. This study provides evidence that loneliness is a significant problem for older chronically ill Appalachian adults and that it may be related to low emotional support. Further, it provides evidence that this population may be significantly lonely and may not self-identify as lonely. Screening for loneliness and designing interventions that target the emotional aspects of loneliness could be important in this population.     

Threat(s) and conformity deconstructed: Perceived threat of infectious disease and its implications for conformist attitudes and behavior

Threat has been linked to conformity, but little is known about the specific effects of different kinds of threat. We test the hypothesis that perceived threat of infectious disease exerts a unique influence on conformist attitudes and behavior. Correlational and experimental results support the hypothesis. Individual differences in Perceived Vulnerability to Disease predict conformist attitudes; these effects persist when controlling for individual differences in the Belief in a Dangerous World. Experimentally manipulated salience of disease threat produced stronger conformist attitudes and behavior, compared with control conditions (including a condition in which disease‐irrelevant threats were salient). Additional results suggest that these effects may be especially pronounced in specific domains of normative behavior that are especially pertinent to pathogen transmission. These results have implications for understanding the antecedents of conformity, the psychology of threat, and the social consequences of infectious disease. Copyright © 2011 John Wiley & Sons, Ltd.     

Belief in a just world and social dominance orientation: Evidence for a mediational pathway predicting negative attitudes and discrimination against individuals with mental illness

Prejudice against individuals with mental illness stems from multiple factors, including the personality traits of those harboring the prejudiced attitudes. However, little is known about the personality processes (as opposed to static correlates) leading to negative attitudes and discrimination toward individuals with mental illness. The present research tested a mediational model in which negative attitudes against such people and resulting intentions to discriminate are distally rooted in just-world beliefs, which predispose people toward higher social dominance orientation, a well-known proximal personality predictor of general prejudice. Participants completed measures of behavioral intentions, attitudes toward individuals with mental illness, social dominance orientation, and belief in a just world. The proposed mediational model was supported, and an alternative causal model was not. These results illuminate the personality-process antecedents of attitudes toward individuals with mental illness and provide a foundation for research targeting interventions intended to reduce prejudice and discrimination against this population.     

The influence of question framing on symptom report and perceived health status

Abstract

Self-reports of symptom experience and subjective ratings of health were obtained from 157 undergraduates. The format of the symptom-report question was varied so that half the participants underlined any symptoms (in a list of 30) they had experienced (endorse condition), whereas the remaining participants crossed out any they had not experienced (exclude condition). Within each of these conditions, half were asked to record symptoms over the last month, and half over the last year. Participants in the exclude condition reported, on average, 70% more symptoms than those in the endorse condition. More symptoms were reported over the last year than the last month. Adjusting for the number of symptoms reported and the perceived seriousness of the symptom set as a whole, participants rated their own state of health more negatively in the endorse than exclude condition. This is consistent with research on the “feature-positive” effect, suggesting that active responses have greater influence on self-perceptions. It is argued that self-report measures of health status must be interpreted in relative, rather than absolute terms, and that attention should be paid to the underlying cognitive processes.