Blended courage: Moral and psychological courage elements in mental health treatment seeking by active duty military personnel

We propose that seeking mental health care in an environment with heightened stigma may combine elements of both psychological and moral courage. Interviews of 32 active duty US Army personnel about their process of seeking current mental health care were analyzed for themes of voluntary action, personal risk, and noble or worthwhile goals (benefits). Risks and benefits were divided into internal risks and benefits, characteristic of psychological courage; and external risks and benefits, characteristic of moral courage. Concerns about external risks were themes in all narratives, while concerns about internal risks were themes in only about half of narratives. Both internal and external benefits of treatment were themes in approximately three-quarters of the narratives, whereas doubts about internal (but not external) benefits were also expressed at a similar rate. Thus, participants described an act of blended courage, with social risks of moral courage taken for wellness goals of psychological courage.     

Can we fight stigma with science? The effect of aetiological framing on attitudes towards anorexia nervosa and the impact on volitional stigma

The present study experimentally investigated the way in which exposure to various aetiological explanations of anorexia nervosa (AN) differentially affected stigmatisation and behavioural intention outcomes. University students (N = 161) were randomly assigned to read one of four aetiological vignettes presenting the causes of AN as biological/genetic, socio‐cultural, environmental, or multifactorial. Results indicate that those who received a socio‐cultural explanation made stronger socio‐cultural causal attributions, fewer biological/genetic causal attributions, and were significantly less willing to sign a health insurance petition for AN. Unexpectedly, the multifactorial group considered individuals with AN as more responsible and blameworthy for their condition. Overall, findings were comparative with previous research and partially support the propositions of attribution theory. Results also suggest that by conceptualising the aetiology of AN as biological or genetic, or at least increasing one's knowledge of these contributing factors, it may be possible to decrease the level of blame‐based stigma associated with AN.     

Preliminary Evidence of Differences Between Stigma Source Versus Type With Individual Functioning Variables in National Guard/Reserve Troops

Extant military studies show that stigma has a variable association with seeking mental health treatment and mental health distress. Previous studies used a general measure of stigma that does not differentiate between stigma source or type. Stigma source can be either self-perceived or perceived from others, and stigma type can include stigma for disorder or stigma for help-seeking. Civilian literature demonstrates that self-stigma is more detrimental to individual functioning than stigma perceived from others, and prior studies in National Guard service members (NGSMs) show that self-stigma and stigma perceived from unit leaders were associated with lower help-seeking intentions relative to stigma perceived from unit members or family members. No military study has simultaneously explored the associations of demographic and distress variables with various stigma types and sources. To determine if prior mixed findings were due to the use of a general measure of stigma, NGSMs (n = 163) completed demographic and distress measures, as well as stigma source (e.g., self, leader) and type (i.e., general, disorder, help-seeking) assessments. General stigma was positively associated with all stigma types and sources as well as a college education. Disorder stigma was positively associated with stigma from nonmilitary sources, and self-stigma for help-seeking was negatively associated with help-seeking intentions. Likelihood of deploying again was positively associated with disorder and help-seeking stigma when perceived from someone in authority. Given the unique associations observed, future studies should utilize specific measures of stigma when examining factors related to postdeployment functioning.     

Do behavioural self-blame and stigma predict positive health changes in survivors of lung or head and neck cancers?

Survivors of lung or head and neck cancers often change tobacco and alcohol consumption after diagnosis, but few studies have examined other positive health changes (PHCs) or their determinants in these groups. The present study aims to: (a) document PHCs in survivors of lung (n?=?107) or head and neck cancers (n?=?99) and (b) examine behavioural self-blame and stigma as determinants of PHCs. We hypothesised that: (a) survivors would make a variety of PHCs; (b) behavioural self-blame for the disease would positively predict making PHCs; and (c) stigma would negatively predict making PHCs.

Methods: Respondents self-administered measures of PHC, behavioural self-blame, and stigma. Hierarchical multiple regression analysis tested the hypotheses.

Results: More than 65% of respondents reported making PHCs, the most common being changes in diet (25%), exercise (23%) and tobacco consumption (16.5%). Behavioural self-blame significantly predicted PHCs but stigma did not. However, both behavioural self-blame and stigma significantly predicted changes in tobacco consumption.

Conclusions: Many survivors of lung or head and neck cancers engage in PHCs, but those who do not attribute the disease to their behaviour are less likely to do so. Attention to this problem and additional counselling may help people to adopt PHCs.     

Living with Hereditary Haemorrhagic Telangiectasia: stigma,coping with unpredictable symptoms,and self-advocacy

Abstract

Objective: Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic condition causing frequent nose bleeds, skin lesions (telangiectasia) and arteriovenous malformations. Approximately, 50% of people experience life-threatening HHT symptoms including haemorrhages in the brain, lungs and liver. This study aimed to gain a qualitative understanding of the psychosocial impact of HHT over time. Design: Using a phenomenological framework, a rigorous narrative analysis was performed on 20 semi-structured interviews with individuals with HHT aged 20s–60s. Main outcome measures: Qualitative themes explaining life experiences prior to and following a clinical diagnosis of HHT. Results: Narratives highlighted four psychosocial themes: (i) the psychological impact of visible symptoms was significant and related to experiences of social stigma, (ii) individuals struggled to identify triggers of symptoms in order to reduce unpredictability, (iii) an illness identity was rejected by minimising HHT when talking about the present self, and by positive reframing as ‘lucky’ and (iv) self-advocacy was necessitated due to lack of expert coordinated care. Conclusion: HHT has a demanding impact on social, physical and psychological well-being. These findings have significant implications for health care, as narratives about interactions with health professionals often used the terms ‘frustrating’ and ‘not being heard’.     

The Use of Mental Health Services Among Victims of Partner Violence on College Campuses

The present study investigated the relationship between past victimization of different types of intimate partner violence (IPV; physical, psychological, and sexual) and the likelihood of using mental health services. Results indicate 86% of participants reported experiencing some form of IPV, but only 16% of those victims used mental health services to address emotional problems. The participants reported embarrassment, expense, ineffectiveness, and social stigma as the most prominent barriers to seeking help from a mental health professional. The study also found that participants who experienced physical and psychological IPV, but not sexual IPV, reported using mental health services. Sexual IPV may elicit different barriers in help-seeking behaviors. Implications for college IPV prevention programs and mental health services are discussed.     

Mental health attitudes among Middle Eastern/North African individuals in the United States

ABSTRACT

Middle Eastern/North African (MENA) individuals may have heightened risk for developing mental health problems due to unique cultural stressors. However, traditional cultural and religious practices and beliefs socialised within the family environment may reduce the likelihood of seeking mental health services. This qualitative study aimed to better understand the intersection of cultural, religious, and mental health attitudes among MENA individuals. Semi-structured telephone interviews were conducted with MENA adults who had received therapy services (N?=?13) and were analysed for emergent themes. Respondents reported lack of understanding of mental illness within their communities, and prominent levels of perceived and self-stigma. Families and religious practices/beliefs played an important role in responding to mental illness. Results suggest that incorporating psychoeducation and community awareness campaigns alongside religious services may help to reduce barriers to receiving mental health treatment.     

Religious coping,stigma, and psychological functioning among HIV-positive African American women

The present study examined the role of religious coping in psychological distress and adjustment both cross-sectionally and longitudinally among 141 HIV-positive African American women. Cross-sectional analyses showed that negative religious coping was associated with poorer mental health and functioning, and greater perceptions of stigma and discrimination. Longitudinal analyses revealed that greater negative religious coping at baseline significantly predicted greater changes in mental health in a negative direction 12 months later. Positive religious coping was not associated with any measures of psychological well-being, nor did it predict any mental health outcomes at 12 months. However, participants who experienced high levels of HIV-related stigma and reported high levels of positive religious coping were less depressed than those who reported lower levels of positive religious coping. These results suggest that for this population, negative religious coping was a more salient determinant of psychological distress than positive religious coping was of psychological health.     

Effects of religious stigma and harm on perceived psychopathology

Prior research suggests that assessment of the pathology of religious beliefs is influenced by conventionality and harm, with less conventional and more harmful beliefs resulting in higher pathology ratings. This study, involving 313 participants, investigated levels of pathology assigned to religious beliefs when the beliefs were either helpful or less severely harmful than those used in prior research, and when the associated religion was either stigmatised (Islam) or non-stigmatised (Christianity). Results indicate that an attenuated form of harm results in elevated pathology ratings. Furthermore, religious stigma impacts these perceptions when beliefs are harmful but not when beliefs are helpful. Ratings in the harm condition were higher for Christianity than for Islam, suggesting that perceived pathology of religious beliefs may depend less on general stigma assumptions and more on perceived consistency between harmful beliefs and assumed religious schemata.