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PubMed2006

Gender, ethnicity, psychosocial factors, and quality of life among severely overweight, treatment-seeking adolescents.

OBJECTIVE: To examine gender and ethnic differences in psychosocial functioning among 100 (78% African American and 59% girls) treatment-seeking overweight 11- to 18-year-old adolescents. Self-esteem was examined as a potential mediator of the association between weight-related teasing and quality of life (QOL). METHODS: Adolescents completed measures evaluating self-esteem, dietary habits, teasing, and QOL. RESULTS: Few racial or gender differences were found. Mean QOL was similar to that reported in another study examining treatment-seeking overweight adolescents and substantially lower than what has been reported for non-treatment-seeking overweight adolescents. Self-esteem partially mediated the association between teasing and QOL. CONCLUSIONS: Severely overweight adolescents of both genders and diverse ethnicities face significant stigmatization and manifest poor overall psychosocial functioning, which is negatively associated with QOL. Furthermore, self-esteem appears to partially mediate the negative relationship between teasing and QOL.

Adolescent↗
PubMed2004

NtWBC1, an ABC transporter gene specifically expressed in tobacco reproductive organs.

To identify genes specifically or predominantly expressed in the stigmas/styles and to establish their possible function in the reproductive process of plants, a tobacco stigma/style cDNA library was constructed and differentially screened, resulting in the isolation of several cDNA clones. The molecular characterization of one of these clones is described here. After sequencing the cDNA and the isolated genomic clone, it was determined that the corresponding gene encodes a protein containing an ATP-binding cassette, characteristic of ABC transporters. This gene, designated as NtWBC1 (Nicotiana tabacum ABC transporter of the White-Brown Complex subfamily), encodes a protein that contains the typical structure of the 'half-transporters' of the White subfamily. To establish the spatial expression pattern of the NtWBC1 gene, northern blot and real-time RT-PCR analyses with total RNA from roots, stems, leaves, sepals, petals, stamens, stigmas/styles, ovaries, and seeds were performed. The result revealed a transcript of 2.5 kb present at high levels in stigmas and styles and a smaller transcript (2.3 kb) present at a lower level in stamens. NtWBC1 expression is developmentally regulated in stigmas/styles, with mRNA accumulation increasing toward anthesis. In situ hybridization experiments demonstrated that NtWBC1 is expressed in the stigmatic secretory zone and in anthers, at the stomium region and at the vascular bundle. NtWBC1 is the first ABC transporter gene with specific expression in plant reproductive organs to be identified and its expression pattern suggests important role(s) in the reproductive process.

ATP-Binding Cassette Transporters↗
PubMed2002

The mental health of farmers.

Farmers are subject to a number of unique occupational stressors, many of which have been aggravated in recent years by changes in farming practice and by economic factors. These are probably part of the explanation for the high rates of suicide in farmers and farm workers, which in the UK account for the largest number of suicides in any occupational group. Suicide is usually associated with mental illness, which, in farming communities, appears to be particularly stigmatized and poorly understood. This affects health-seeking behaviour, which is compounded by the geographical isolation and inaccessibility of many services in rural areas. Our current understanding of these issues suggests a number of potentially valuable interventions.

Agricultural Workers' Diseases↗
PubMed1999

Low-weight neonatal survival paradox in the Czech Republic.

Analysis of vital statistics for the Czech Republic between 1986 and 1993, including 3,254 infant deaths from 350,978 first births to married and single women who conceived at ages 18-29 years, revealed a neonatal survival advantage for low-weight infants born to disadvantaged (single, less educated) women, particularly for deaths from congenital anomalies. This advantage largely disappeared after the neonatal period. The same patterns have been observed for low-weight infants born to black women in the United States. Since the Czech Republic had an ethnically homogenous population, virtually universal prenatal care, and uniform institutional conditions for delivery, Czech results must be attributed to social rather than to biologic or medical circumstances. This strengthens the contention that in the United States, the black neonatal survival paradox may be due as much to race-related social stigmatization and consequent disadvantage as to any hypothesized hereditary influences on birth-weight-specific survival.

Adolescent↗
PubMed2001

Impact of the term schizophrenia on the culture of ideograph: the Japanese experience.

The ideographic Chinese writing system (in use in Asian countries that account for about a quarter of the world's population) directly expresses the meaning of schizophrenia as "the disease of disorganized mind." The term directly challenges a deeply ingrained concept of personal autonomy, and this is stigmatizing. Japanese psychiatrists are thus reluctant to tell their patients that they are suffering from schizophrenia, and, as a result, no more than 20 percent of sufferers actually do know about their diagnosis. Because taking medication is based on informed consent and the exercise of the patient's autonomy, such lack of information has important negative effects. It is unlikely that this problem can be resolved by education or information alone, and it may well be the case that in cultures using ideographs, the illness will need to be renamed. This article suggests some alternatives.

Attitude to Health↗
PubMed2002

Challenging two mental illness stigmas: personal responsibility and dangerousness.

Two stigmatizing attitudes related to dangerousness and personal responsibility may undermine the opportunities of persons with serious mental illness. This study set out to examine path models that explain how these attitudes lead to discriminatory behavior and to assess the impact of antistigma programs on components of personal responsibility and dangerousness models. Two hundred thirteen persons were randomly assigned to one of five antistigma conditions: education on personal responsibility, education on dangerousness, contact with a person with serious mental illness where personal responsibility is discussed, contact where dangerousness is discussed, or no change. Persons completed an attribution questionnaire (AQ) representing personal responsibility and dangerousness path models at pretest, posttest, and 1-week followup. They also completed tasks that represented helping behavior. Goodness of fit indexes from linear structural modeling were mixed for both models but suggested that fear of dangerousness was a key attitude leading to discriminatory behavior. Results also showed that subjects who had contact with persons with serious mental illness experienced greater changes than subjects in the education or control groups did on measures of attribution and helping behavior.

Adolescent↗
PubMed2004

Structural levels of mental illness stigma and discrimination.

Most of the models that currently describe processes related to mental illness stigma are based on individual-level psychological paradigms. In this article, using a sociological paradigm, we apply the concepts of structural discrimination to broaden our understanding of stigmatizing processes directed at people with mental illness. Structural, or institutional, discrimination includes the policies of private and governmental institutions that intentionally restrict the opportunities of people with mental illness. It also includes major institutions' policies that are not intended to discriminate but whose consequences nevertheless hinder the options of people with mental illness. After more fully defining intentional and unintentional forms of structural discrimination, we provide current examples of each. Then we discuss the implications of structural models for advancing our understanding of mental illness stigma, including the methodological challenges posed by this paradigm.

Persons with Disabilities↗
PubMed2004

Measuring mental illness stigma.

The effectiveness of efforts designed to address mental illness stigma will rest on our ability to understand stigma processes, the factors that produce and sustain such processes, and the mechanisms that lead from stigmatization to harmful consequences. Critical to such an understanding is our capacity to observe and measure the essential components of stigma processes. This article is designed to assist researchers in selecting or creating measures that can address critical research questions regarding stigma. Our conceptualization of stigma processes leads us to consider components of labeling, stereotyping, cognitive separating, emotional reactions, status loss, and discrimination. We review 123 empirical articles published between January 1995 and June 2003 that have sought to assess mental illness stigma and use these articles to provide a profile of current measurement in this area. From the articles we identify commonly used and promising measures and describe those measures in more detail so that readers can decide whether the described measures might be appropriate for their studies. We end by identifying gaps in stigma measurement in terms of concepts covered and populations assessed.

Cognition↗
PubMed2000

Zinc-finger genes that specifically express in pistil secretory tissues of petunia.

Tissue-specific expression patterns of petunia zinc-finger genes, ZPT2-10 and ZPT3-3, were analyzed by using GUS reporter system. The GUS expression directed by ZPT2-10 promoter was specifically found in the stylar transmitting tissue of pistil, and that by ZPT3-3 promoter in stigmatic and stylar transmitting tissues. These tissues play important roles in reproductive process. We discuss possible roles of the zinc-finger proteins in these specialized tissues.

Base Sequence↗
PubMedDate not supplied

"Patients like us": pregnant and parenting teens view the health care system.

As a supplement to traditional ways of measuring health care quality, the patient's perspectve is an essential indicator, yet it is often overlooked in evaluations of health care for pregnant teenagers. This report reveals how 40 young women receiving publicly funded care viewed their physicians and the clinics and other facilities at which they received health care serv ces. Pregnant and parenting urban teens face stigmatization in many aspects of their lives. The author concludes, based on her interviews with the 40 teens, that providers and health care systems should combat such negative influences with support and respect for these patients. The data also point to the need for comprehensive health care for low-income adolescents that extends beyond prenatal care, which may focus on the needs of the fetus or infant to the exclusion of the needs of the young mother.

Adolescent↗
PubMed1994

Dispelling the stigma of schizophrenia: what sort of information is best?

This study investigated what type of information reduces stigmatization of schizophrenia. Subjects were presented with one of six varying descriptions of a hypothetical case in which a target individual had recovered from a mental disorder. Subjects were asked if they knew someone with a mental illness. Those individuals who had no previous contact perceived the mentally ill as dangerous and chose to maintain a greater social distance from them. In general, knowledge of the symptoms associated with the acute phase of schizophrenia created more stigma than the label of schizophrenia alone. In contrast, more information about the target individuals post-treatment living arrangements (i.e., supervised care) reduced negative judgments. Implications for public education and future research are discussed.

Activities of Daily Living↗
PubMed2006

Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders.

Research has paradoxically linked awareness of illness to both better function outcomes and lesser hope and self-esteem. One possible explanation for these findings is that acceptance of having schizophrenia may impact outcomes differently depending on the meanings the person attaches to this acceptance, particularly whether he or she accepts stigmatizing beliefs about mental illness. To explore this possibility we performed a cluster analysis of 75 persons with schizophrenia spectrum disorders based on single measures of insight using the Positive and Negative Syndrome Scale, internalized stigma using the Internalized Stigma of Mental Illness Scale, and compared groups on concurrent assessments of hope and self-esteem. Three groups were produced by the cluster analyses: low in sight/mild stigma (n = 23), high insight/minimal stigma (n = 25), and high insight/moderate stigma (n = 27). As predicted, analysis of variance-comparing groups revealed that the high insight/moderate stigma group had significantly the lowest levels of hope on the Beck Hopelessness Scale and self-esteem using the Multidimensional Self-esteem Inventory. As predicted, the high insight/minimal stigma group also had significantly less impaired social function than the other groups. Implications for assisting persons to come to cope with awareness of illness and stigma are discussed.

Adaptation, Psychological↗
PubMed2006

Values in persons with schizophrenia.

This is an explorative study on the values of persons with schizophrenia based on transcripts of individual therapy sessions conducted for 40 persons with chart diagnoses of schizophrenia or schizotypal disorder. Values are action-guiding attitudes that subject human activities to be worthy of praise or blame. The schizophrenic value system conveys an overall crisis of common sense. The outcome of this has been designated as antagonomia and idionomia. Antagonomia reflects the choice to take an eccentric stand in the face of commonly shared assumptions and the here and now "other." Idionomia reflects the feeling of the radical uniqueness and exceptionality of one's being with respect to common sense and the other human beings. This sentiment of radical exceptionality is felt as a "gift," often in view of an eschatological mission or a vocation to a superior, novel, metaphysical understanding of the world. The aim of this study is neither establishing new diagnostic criteria nor suggesting that values play an etio-pathogenetical role in the development of schizophrenia but improving our understanding of the "meaning" of schizophrenic experiences and beliefs, and by doing so reducing stigmatization, and enhancing the specificity and validity of "psychotic symptoms" (especially bizarre delusions) and of "social and occupational dysfunction" through a detailed description of the anthropological and existential matrix they arise from.

Delusions↗
PubMed1999

HIV-related stigma in a sample of HIV-affected older female African American caregivers

Older women of color increasingly act as informal caregivers for adults and children with HIV disease. Nineteen older female (mostly African American) informal caregivers of HIV-infected individuals participated in qualitative interviews to explore their experiences with HIV-related stigma. Perceived and directly experienced stigma were examined in the context of disclosure of the presence of HIV disease. Overt HIV-related stigma was rarely experienced by these respondents, primarily because they had not widely disclosed the presence of HIV in the family and therefore had not given anyone the opportunity to ostracize or judge them. HIV-related stigma was internalized, so that disclosure decisions were based on their anticipation of censure. There also was evidence of associative stigma and of stigma management. The findings suggest the need for social work practitioners to increase awareness of the needs of stigmatized, isolated HIV-affected caregivers. Practitioners should conduct aggressive outreach and strive to provide more support to this often invisible population of caregivers to HIV-infected people.

Journal Article↗
PubMed2002

Showing results in community organization.

This article describes a community organization program and its tangible results in a stigmatized neighborhood in the center of Israel. The program lasted six years; its central goal was the autonomy of the community, the empowerment of its residents, and collaboration among the human services workers and between them and the resident leaders. The results, measured objectively and quantitatively, included a large increase in the number of community activists; strong and statistically significant increases of self-esteem and mastery of surroundings; increase in family, service delivery, and community empowerment among the activists, and the participation of residents and outsiders in a project to build their own homes in the neighborhood.

Community Networks↗
PubMed2003

Reconstructing the stepfamily: old myths, new stories.

The proliferating stepfamily has come to reflect the multiple social changes in American family life. Nevertheless, the dominance of the nuclear family culture continues to marginalize and stigmatize stepfamilies. Concepts drawn from narrative theory are used to examine how the privileged status accorded biological parentage serves to restrict society's thinking about the nature of families and parenting roles. The promotion of the nuclear family as the benchmark for family life perpetuates stepfamily invisibility and bias that permeate both stepfamily policy and practice. Illustrations from family policy and practice are offered. Social workers can help to shape more appropriate policies by fostering new family values that honor kinship ties based not only on biology, but more and more on affection and responsibility. In clinical practice social workers can assist stepfamilies in abandoning misguided attempts to reinvent themselves as nuclear families and to create their own commensurate and unique stepfamily story.

Child↗
PubMed2000

A multicenter study of 4-chloro-m-cresol for diagnosing malignant hyperthermia susceptibility.

UNLABELLED: Standardization of the in vitro contracture test (IVCT) for malignant hyperthermia (MH) susceptibility has resulted in very rare false negative tests. However, false positive results stigmatizing the patient seem to be more frequent than false negative results and make supplementary tests desirable. This multicenter approach studied the usefulness of an IVCT with 4-chloro-m-cresol (4-CmC), a ryanodine receptor-specific agonist for a better definition of MH susceptibility. Diagnosis made by the standard IVCT was compared with the results of this 4-CmC test on muscle specimens of 202 individuals from 6 European MH centers. In the 4-CmC test, the results of the MH susceptible group differed significantly from both the MH normal and the MH equivocal group. 4-CmC revealed a qualitatively dose response-curve similar to caffeine. A correlation index of r = 0.79 for the concentration thresholds underlined the strong concordance of the caffeine and the 4-CmC effects. The optimal threshold concentration was determined to be 75 microM in the pooled data of all centers and is much lower than that of caffeine (2 mM), suggesting a more than 25-fold higher affinity of 4-CmC. The predictive value of 4-CmC is as high as that of caffeine and consequently higher than that of halothane. 4-CmC seems to be a suitable drug to refine diagnosis of MH susceptibility and could be used as an additional test substance. IMPLICATIONS: Although in vitro contracture testing for malignant hyperthermia diagnosis is well standardized, with a relatively high sensitivity and specificity, false test results cannot be excluded and may be associated with serious disabilities for the concerned individuals. In this multicenter study, 4-chloro-m-cresol was evaluated as a new test substance for the in vitro contracture testing. Its use improves the accuracy of in vitro diagnosis of malignant hyperthermia susceptibility.

Caffeine↗
PubMed1997

Effective treatment of hypertrichosis with pulsed light: a report of two cases.

Hypertrichosis is an often stigmatizing cosmetic problem not only for women but also for male-to-female transsexual patients. The hitherto described therapeutic measures include chemical epilation, razoring, camouflage, electrolysis and thermolysis, and waxing. All of these measures are transient, more or less painful, and may lead to severe side effects (e.g., inflammatory responses and scarring). We report the successful treatment of the perioral and mandibular area of two transsexual patients (male to female), who we treated with a recently introduced intense, pulsed light source--the PhotoDerm VL. Two days after the nearly painless treatment, hair could be epilated easily with forceps. Biopsies of the treated area show an atrophy of the follicles, which can be contributed either to direct thermal injury or to an indirect photothermolytical effect. Six months after the last treatment, there is no local recurrence and no side effects.

Adult↗