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PubMed1994

Children's attitudes toward the mentally ill: an eight-year longitudinal follow-up.

In 1986, Weiss reported the measurement of the attitudes of 577 children of elementary school age toward mental illness and mentally ill persons relative to other stigmatized groups on a projective measure of social distance. It was concluded that attitudes toward deviant groups were evidenced by Kindergarten and did not change appreciably with increasing age or grade. Eight years later, 35 of the previously examined 65 Kindergarten students were still enrolled in the district. Parental permission to repeat the evaluation was received for 34 of those students. The results of this longitudinal research were remarkably similar to the results in the original cross-sectional research, again leading to the conclusion that attitudes toward the mentally ill become quite stable and enduring by the time a child enters Kindergarten. Only one stigmatized group, mentally retarded persons, significantly changed in terms of social distance and interpersonal attraction toward being more acceptable.

Adolescent↗

PubMed1990

The reluctance to acknowledge hearing difficulties among hearing-impaired workers.

The reluctance to acknowledge hearing difficulties was studied with two groups of hearing-impaired workers and their spouses. One investigation involved a group interview with workers who participated in a pilot rehabilitation programme and who experienced the disclosure of their hearing difficulties to others by being the subject of a newspaper story on occupational deafness. Analysis of the transcript showed that they were strongly stigmatized as being deaf especially by co-workers. In a second investigation, interviews conducted with hearing-impaired workers who have had no previous contact with hearing specialists were analysed. A selection was made of the interviews containing several examples of contradiction in the worker's discourse or between the worker and his wife about the experience of hearing difficulties. The reluctance to acknowledge hearing difficulties was expressed through various forms of denial, minimization of the problem, uneasiness in talking about the problem and in attempts to normalize oneself. All these expressions can be found in the same individual's discourse. It is concluded that reluctance to acknowledge hearing difficulties is part of an adaptive process that should be taken into account in rehabilitative interventions. It also calls for interventions that would prevent hearing people from stigmatizing hearing-impaired people.

Attitude↗

PubMed1983

The alcoholic stigma and the disease concept.

Acceptance by the client of the label "alcoholic" is viewed by many practitioners as a prerequisite to alcohol abuse recovery. This study demonstrates, however, that the label is a highly stigmatized term associated with the skid row habitué. The 1956 American Medical Association acceptance of alcoholism as within the "purview of medical practice" was an important step for those who believed alcoholism could be destigmatized under the disease label. This study demonstrates that although the disease concept is widely held, the image of the term "alcoholic" remains highly stigmatized. These findings have implications for clinicians in the areas of labeling and the phenomenon of client denial.

Adolescent↗

PubMed2004

Fear and stigma: the epidemic within the SARS outbreak.

Because of their evolving nature and inherent scientific uncertainties, outbreaks of emerging infectious diseases can be associated with considerable fear in the general public or in specific communities, especially when illness and deaths are substantial. Mitigating fear and discrimination directed toward persons infected with, and affected by, infectious disease can be important in controlling transmission. Persons who are feared and stigmatized may delay seeking care and remain in the community undetected. This article outlines efforts to rapidly assess, monitor, and address fears associated with the 2003 severe acute respiratory syndrome (SARS) epidemic in the United States. Although fear, stigmatization, and discrimination were not widespread in the general public, Asian-American communities were particularly affected.

Asian↗

PubMed2002

Survivors of suicide. Emerging counseling strategies.

1. Effective intervention with survivors of suicide requires knowledge of the diverse sequelae of response including blame, anger, guilt, shame, search for why, and feelings of stigmatization. 2. Fearing blame and stigmatization, survivors of suicide may be reluctant to contact helping professionals. 3. Duration and intensity of bereavement is mediated by the survivors' nature of the relationship with the deceased and their perception of the preventability of the death. 4. Group counseling is an effective intervention because it addresses the issue of disenfranchised grief.

Anger↗

PubMed2004

Stigma and help seeking related to depression: a study of nursing students.

The stigmatization of people with mental illnesses and its effect on help-seeking behaviors have been identified by the Surgeon General and the President's New Freedom Commission on Mental Health as significant issues on the nation's health care agenda. Negative perceptions regarding depression and its treatment contribute to the 30,000 suicides committed annually in the United States. Nurses have the potential to exert tremendous influence toward overcoming this problem, contingent on their attitudes toward depression and its treatment. As nurses and future nurses, students enrolled in both a basic and degree-completion baccalaureate program comprised a sample that represented the influence of the educational process. This descriptive, correlational study measured attitudes toward an individual with depression, described in a vignette, and personal help-seeking intention, and examined the effects of personal variables on help-seeking intention. Students who believed depression was not under personal control were more likely to endorse help seeking for themselves. Individuals who were women, older, upperclassmen, and Catholic reported greater acceptance of seeking psychological help. The role of the psychiatric-mental health nursing class and rotation were identified as improving stigmatizing attitudes and increasing help-seeking intention.

Adolescent↗

PubMed2006

Pharmacy students' and graduates' attitudes towards people with schizophrenia and severe depression.

OBJECTIVES: To compare the attitudes of third-year pharmacy students and pharmacy graduates towards people with schizophrenia and severe depression. METHODS: Third-year pharmacy students (n = 216) and pharmacy graduates (n = 232) completed a survey instrument with 21 common items. The third-year students had not yet received any mental health lectures or tutorials as part of their pharmacy course. The graduates had completed their university education, including mental health lectures and tutorials, plus 6 months of supervised clinical practice in the pharmacy workplace. RESULTS: There were no significant differences between the third-year students and pharmacy graduates in terms of social distance from people with schizophrenia. The rates of stigmatization of people with schizophrenia and severe depression were also similar between the groups. CONCLUSIONS: Mental health lectures and tutorials delivered by pharmacists and supervised clinical practice in the pharmacy workplace may not decrease students' social distance or stigmatization of people with mental illness. The results of our study suggest that more comprehensive education and training programs are needed to improve the ability of pharmacists to meet the needs of people with mental illness.

Attitude↗

PubMedDate not supplied

How does Catholic hospital sponsorship affect services provided?

Catholic hospitals maintain a significant presence in delivering hospital services in the United States, but little is known about the ways they differ from other ownership forms in similar market environments. This paper analyzes characteristics of Catholic, other private nonprofit, and investor-owned hospitals in metropolitan areas of the United States to identify the extent to which Catholic hospitals differ from other ownership types on three dimensions of mission-driven identity--access, stigmatized, and compassionate care services. Based on 1993 data, Catholic hospitals offered more compassionate care services than other private nonprofit hospitals, and more compassionate care and stigmatized services than investor-owned hospitals, controlling for four market and six organizational characteristics. The results may help Catholic hospitals differentiate their services and help justify their tax-exempt status.

Catholicism↗

PubMed1984

Social stigma and community recreation participation by the mentally and physically handicapped.

This paper presents research results on social stigma barriers to community recreation participation by the mentally and physically handicapped. Depth interviews with 180 physically handicapped, mentally retarded, and mentally ill persons from community and institutional residential settings were conducted to determine (a) their perception of negative, stigmatizing attitudes toward the handicapped, and (b) the degree to which these perceptions of community stigma restrict participation by the handicapped in community recreation. The study found that many handicapped people do perceive, and are affected by community stigma. Those with highly visible impairments are most likely to have experienced negative community reactions. The perception of stigmatizing attitudes leads to restricted recreation participation for some handicapped people, but not for others.

Analysis of Variance↗

PubMed1999

Seed abortion in Pongamia pinnata (Fabaceae).

In Pongamia pinnata only one of the two ovules develops into a seed in most of the pods. Since pollen was not found to be limiting and reduced fertilization could not completely explain the observed frequency of seed abortion, it implied an effect of postfertilization factors. Aqueous extracts of developing seeds and maternal tissue (placenta) did not influence abortion in vitro, suggesting that abortion may not be mediated by a chemical. Experimental uptake of (14)C sucrose in vitro indicated that both the stigmatic and the peduncular seed have similar inherent capacities of drawing resources, but the peduncular seed is deprived of resources in the presence of the stigmatic seed. This deprivation of the peduncular seed could be offset by supplying an excess of hormones leading to the subsequent formation of two seeds in a pod. The prevalence of single-seeded pods in P. pinnata seems therefore to be a result of competition between the two seeds for maternal resources. The evolutionary significance of single-seeded pods in P. pinnata is discussed with respect to possible dispersal advantage enjoyed by such pods.

Journal Article↗

PubMedDate not supplied

The stigma of eating disorders.

Those who suffer from eating disorders often carry the added burden of stigmatizing attitudes from the lay public and the medical profession. These attitudes not only restrict the opportunities for effective treatment but also confer additional handicaps. To some extent, stigmatizing beliefs are based on partial truths about these disorders, namely their dangerousness, their sometimes poor response to treatment, the sufferers' part in their maintenance, and difficulties in communication. This review explores the truth of these beliefs and suggests ways in which a more positive approach to the management of eating disorders might help to reduce the stigma. This includes empathy with the patient's predicament and an approach to treatment in which the patient's wishes are paramount.

Feeding and Eating Disorders↗

PubMedDate not supplied

Issues related to disability in India: a focus group study.

BACKGROUND: Systematic research into disability has been scarce, especially from India, even though an estimated 5% of the population may have significant disability due to physical disorders. Depression as a common psychiatric disorder affects about 3%-5% of the population. Thus, the impact of disability related to physical, mental and substance use disorders is enormous and it influences resource allocation and policy planning. METHODS: The issues relating to disability were addressed through a qualitative multicentered study. Focus groups were conducted at three sites in Chennai, Bangalore and Delhi on three themes: (i) parity, stigmatization and social participation; (ii) current practices and needs; and (iii) the General Disability Model as proposed by the World Health Organization. The focus groups were homogeneous and included members from six categories of participants: individuals with physical disability, individuals with mental disability, individuals with alcohol/drug-related disability, family members of mentally disabled persons, family members of physically disabled persons and health professionals. In all, 118 groups were conducted with a mean (SD) group size of 8.6 (1.6). RESULTS: Patients with mental and alcohol/drug-related disability were more discriminated against than those with physical disability. Awareness regarding the existing laws and social programmes was uniformly poor across the three centres. Stigmatization was a major reason for under-utilization of the meagre resources available. There was poor awareness of the Disability Act, 1996. The consumers felt more comfortable with the earlier terms of 'handicap' and 'impairment'. CONCLUSIONS: The study has implications for policy planning, clinical decision-making and social behaviour. Awareness of the laws, facilities and programmes needs to be increased, especially regarding the Disability Act, 1996 among consumers as well as health professionals. More disability-friendly facilities are required.

Disability Evaluation↗

PubMed2000

The influence of information on social and occupational outcome in mental illness on the attitudes of students in Turkey.

BACKGROUND: In this article, we have tried to evaluate the influence of a series of determinants of stigmatization of mental illness. METHOD: 700 final year students of a University in Istanbul were asked to read one of 14 different hypothetical case stories. The stories contained different combinations of characteristics assumed to play a role in stigmatization. Each vignette was presented to 50 students. The stories were collected after five minutes and the following scales were completed: Characteristics Scale and Skill Assessment Scale. Analysis was conducted on each scale. RESULTS: We found a statistically significant difference among the groups given different hypothetical cases (vignettes). According to the post-hoc analysis, only the subjects given the vignette in which social and occupational outcome information were lacking showed statistically significant difference from the rest of the population. CONCLUSION: This study suggests that information on social and occupational outcome of mental illness influences the general perception of the mentally ill.

Adult↗

PubMed2001

Stigma of mental illness.

BACKGROUND: Psychiatric patients carry the additional burden of stigma. METHODS: The views of 300 psychiatric out-patients and day-patients and 100 mental health workers concerning stigma were sought. The control group comprised 50 cardiac out-patients. RESULTS: A fair proportion of patients with schizophrenia or depression perceived that stigma had a negative effect on their self-esteem, relationships and job opportunities. The majority felt a need for an increase in public awareness of mental illness. In contrast, the cardiac patients reported very little stigmatization. CONCLUSIONS: The diagnostic label of mental illness may render the person vulnerable to stigmatization. Possible causes of stigma and ways of reducing stigma are discussed.

Adult↗

PubMedDate not supplied

[Biochemical mechanisms of radiogenic cytogenetic and somatic disorders in children residing in regions polluted by radionuclides].

Children and adults affected by the Chernobyl accident suffer with lipoperoxic stress coupled with hypovitaminoses A and E, the syndrome and its radiogenic mechanisms described by the authors previously. The relation of these biochemical disturbances to somatic consequences on mutagenic and teratogenic levels caused by chronic low-dose irradiation of children into radiopolluted regions has been investigated. Either the rational approaches to prevent or/and to treat all pathologies indicated were tested. The radionuclide polluted regions had 1-5, 5-15 and 15-40 Ci/km2 by 137Cs. Unprotected newborns (without the therapy) had vA and vE levels about one third of normal ones for minimal radioloads, the vitamins lowered further for higher Da and/or Dm up to the deep hypovitaminoses or even avitaminoses. Increasing of LPC catabolites levels for children were correlated significantly with their stigmation levels. The therapy-protected newborns had normal ranges of all indices. However, unprotected newborns showed dramatic increase for all of radiogenic indices along with fall of vA and vE, and significant inverse correlations of the indices with retinol levels. The values of radiogenic indices showed hyperbolic-like rise along with growing of vA and vE deficits below their lower limits. The combination of radiogenic biochemical deviations evaluated for Chernobyl contingents is supposed to be the primary molecular mechanisms of somatic mutations and irreversible stigmation. The peroral polyvitamin therapy is proposed as the method of choice for prevention or normalization of revealed pathologies.

Adult↗

PubMed2004

[Which psychiatric label is more stigmatizating? "ruhsal hastalik" or "akil hastaligi"].

OBJECTIVE: To determine which of the two different labels, "ruhsal hastalik" or "akil hastaligi", used for psychiatric disorders by the public in Turkey is more stigmatizing. METHOD: This study was carried out at Celal Bayar University School of Health in Turkey. The questionnaire was designed by the researchers and applied to all students (n=272) present at the school on the day of application. The attitudes and opinions of students were investigated using case vignettes describing sczhizophrenia and major depression. RESULTS: It was seen that 0.8% of the students described the depression vignette as "akil hastaligi" while 78% described it as "ruhsal hastalik" with the schizophrenia vignette, 26% of students described it as "akil hastaligi" while 65% described it as "ruhsal hastalik". The participants who described the schizophrenia vignette as "akil hastaligi" stated that persons with symptoms like those of the schizophrenia vignette should not be free in the community (p<0.0001), they would not rent their house to a person with schizophrenia (p=0.013) and persons with schizophrenia are aggressive (p<0.0001); they had more negative attitudes than the participants who described it as "ruhsal hastalik" CONCLUSION: The results of this study suggest that the concepts "akil hastaligi" and "ruhsal hastalik" are used in different ways and the concept "akil hastaligi" has a more stigmatizing meaning. Therefore "akil hastaligi" should be avoided by health professionals when dealing with patients.

Adolescent↗

PubMed2004

The theoretical basis of stigma as applied to genital herpes.

This paper defines stigma and its characteristics, outlines strategies and consequences of stigma management, describes the theoretical basis of stigma, and offers methodological considerations for those applying stigma theory to the domain of genital herpes. Stigma is an interactional process, defined within societies, in which particular social identities are collectively devalued. The subjective experience of stigma may vary due to features associated with the stigmatizing condition (e.g. concealability, course, strain, aesthetic qualities, cause and peril). The interpersonal management of stigma may include secrecy, withdrawal, covering, informing or disclosing. Future research addressing herpes-associated stigma should benefit from theoretical frameworks including attribution theory, social-cognitive theory, preoccupation model of secrecy and the illness intrusiveness framework, although the difficulty in identifying and recruiting stigmatized individuals and the lack of domain-specific measures of herpes-related stigma remain barriers to progress.

Attitude to Health↗

PubMed2004

[Current attitudes and knowledge about suicide in community members: a qualitative study].

OBJECTIVE: Understand the public's current attitudes and knowledge about suicide and, thus, provide essential information to the development of targeted public education programs-important components of the suicide prevention effort. METHODS: Seventeen mental health professionals who were extensively trained in the methods of conducting focus groups used a pre-tested focus group outline on attitudes and knowledge about suicide to conduct 101 focus groups and 18 individual in-depth interviews with a total of 842 community respondents from 6 regions in northern China. The focus groups and in-depth interviews were audio-taped, transcribed and analyzed using the QSR Nvivo text analysis software. RESULTS: Most respondents believed that suicide was a greater problem in rural areas and among women and identified physical illnesses, economic problems and interpersonal conflicts (particularly family conflicts) as the main causes of suicide. Rural residents and women were believed to exhibit impulsive suicidal behavior because of their personal limitations and over-sensitiveness. Most thought that suicide was understandable and a small proportion felt that it was acceptable behavior in certain circumstances. Almost all felt that suicide resulted in the stigmatization and a loss of 'face' for the family. Most believed that one should show concern for persons who have suicidal behavior and their family members and expressed a willingness to have superficial social relationships with them but were unwilling to establish close personal relations with them. The vast majority believed that suicide was either very difficult or impossible to prevent. CONCLUSIONS: In China the community is tolerant, sympathetic and, in some cases, accepting of suicide but there remains a substantial underlying stigmatization of suicide. Community members have some misunderstandings about suicide; the most obvious misunderstanding is the underestimation of the importance of mental illness as a cause of suicide. The content of public health messages used in suicide prevention programs should be developed by combining findings from both qualitative and quantitative research.

China↗