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PubMed2005

The sociocultural context of korean american men's smoking behavior.

The purpose of this article is to explore the sociocultural context wherein Korean male immigrants learned and maintained smoking behavior. Participants were 11 current and 11 former cigarette smokers who resided in New York City. The participants attended one of four focus groups and talked about their experiences of smoking initiation, changes in smoking behavior over time, smoking in Korea and the United States, strategies used for smoking cessation, and suggestions for a smoking cessation program. The focus group interviews were audiotaped and transcribed verbatim. Themes were identified from answers to the five topic questions and then compared across the four focus groups. Smoking is a common thread in Korean men's social world and a prime component of Korean men's gender identity. In contrast, smoking in the United States is increasingly being stigmatized.

Acculturation↗
PubMed1995

Issues in conducting research with vulnerable families.

This article explores methodological and ethical issues in the conduct of research with vulnerable families. Some methodological and ethical issues are common to all family research, regardless of the families' vulnerability; however, many research issues are more problematic in vulnerable families, and a few issues are relatively unique to vulnerable families. Vulnerable families are defined as families that are susceptible to harm because of their socioeconomic status, their minority status, or other stigmatizing status. Methodological issues include definition of family; recruitment and retention of participants; reliability and validity of instruments; and racism, classism, and sexism. Ethical issues include confidentiality, reporting abuse and neglect, conflict of research ethics and personal ethics, identifying problems nobody can fix, balancing demands and benefits, and interpretation of data. Examples of methodological and ethical issues are drawn from several research studies in which the primary author was or is currently involved.

Data Collection↗
PubMed2005

Is clonidine useful for treatment of clozapine-induced sialorrhea?

Clozapine has shown superior efficacy in treatment of refractory schizophrenia, but its use is limited by emergent side-effects. Among other adverse effects, sialorrhea is a troublesome side-effect, its stigmatizing nature results in poor treatment compliance. Several hypotheses have been put forward in the etiology of clozapine-induced sialorrhea. 2 adrenergic antagonism is hypothesized to be involved in its pathophysiology, based on the response to clonidine and lofexidine. Oral clonidine (50 to 100 g/day) was tried on 12 stable outpatients of schizophrenia maintained on clozapine. Wet area over the pillow as reported by the patients was recorded at baseline and at 4 weeks of treatment along with the subjective response after the treatment. Most of the patients reported a decrease in sialorrhea without any adverse events. We describe encouraging results in an open case series of oral clonidine for clozapine-induced sialorrhea.

Adrenergic alpha-Agonists↗
PubMed2002

Potentially dangerous behavior in the mentally ill: attitudes of journalists and medical students toward compulsory admission.

Compulsory admission is a critical measure that may lead to stigmatization of patients. The authors investigated what medical students and journalists consider legitimate conditions for compulsory admission. The most frequently quoted conditions in both groups were violent attempts against others. About one third of each group considered continuous neglect as a reason. Students significantly more often than journalists advocated for civil commitment in the case of suicide attempts and violent attempts. Medical students with personal contact with mentally disordered persons advocated significantly more often for coercive measures in the case of suicide attempts. Comparing journalists and medical students having personal contact with mentally disordered persons revealed that medical students significantly more often supported commitment. Journalists displayed a more liberal attitude toward the mentally ill than did medical students.

Adult↗
PubMed2005

Naming oneself criminal: gender difference in offenders' identity negotiation.

This qualitative research examines gender differences in offenders'ability to negotiate a positive identity once the pejorative labels of criminal, prostitute, drug dealer, and incompetent parents have been imputed onto them. In-depth semi-structured focused interviews were conducted with a purposeful information-rich sample of eight male and eight female offenders. Content analysis reveals that males were much more adept than female offenders at juggling with conventional and street norms to justify and/or resist stigmatizing labels in order to construct a favorable identity. Appeal to such personal strengths as know-how, competence, loyalty, and a code of honor allowed male offenders to challenge the boundaries between conventional and delinquent worlds. Concomitantly such an appeal gave rise to a sense of efficacy perception and an optimistic explanatory style. In contrast, even though female offenders were able to justify the labels of drug dealer, prostitute, and thief by appeal to higher loyalties and reject that of insane, all their justifications collapsed when having to negotiate the identity of incompetent mother. Female offenders' negative internal attributions and deprivation of the normative center-motherhood resulted in apathy, anomie, and lack of confidence in their ability to do something worthwhile. Rehabilitation guidelines would build female offenders' personal strengths while redirecting those exhibited by male offenders into lawful enterprises.

Adult↗
PubMed2001

Educating the public about mental illness and homelessness: a cautionary note.

OBJECTIVE: To determine whether the viewing of a video depicting the successful struggles of homeless persons with mental illness in finding and maintaining housing can have a positive impact on attitudes toward homeless persons with mental illness. METHOD: Five hundred and seventy-five high school students attending a brief educational session on mental illness participated in 1 of 3 comparison versions of the 2-hour program (control, video, video plus discussion). All completed an "Attitudes toward Homelessness and Mental Illness Questionnaire." Demographic and prior exposure variables were entered as a covariates in between-group analyses of variance. RESULTS: Females and subjects who had more prior encounters with homeless persons were found to have the most positive attitudes. After controlling for these effects, the video alone had a negative impact on attitudes relative to the other groups, while the video followed by a discussion with one of the people featured in it had a largely positive impact. CONCLUSIONS: The apparent immediacy and the evocative power of video presentations cannot substitute for direct contact for the purpose of promoting positive attitude change. The findings are consistent with prior research emphasizing the importance of direct interaction with members of stigmatized groups to reduce negative attitudes. Education programs trying to destigmatize mental illness and homelessness using videos should proceed with caution.

Adolescent↗
PubMed2003

Stigma and the daily news: evaluation of a newspaper intervention.

OBJECTIVE: To evaluate a media intervention designed to improve one newspaper's portrayal of mental illnesses, specifically, schizophrenia. The project was part of an international antistigma program, Open the Doors, organized by the World Psychiatric Association. METHODS: The media intervention attempted to influence news content directly by providing reporters with more accurate background information and helping them develop more positive story lines. The evaluation compared story content and length over a 24-month period: 8 months prior to the antistigma intervention and 16 months postintervention. RESULTS: Positive stories outnumbered negative stories by a factor of 2 in both pre- and postperiods. Positive mental health stories increased by 33% in the postintervention period and their word count increased by an average of 25%. Stories about schizophrenia also increase by 33%, but their word count declined by 10%. At the same time, negative stories about mental illness increased by 25% and their word count by 100%. The greatest increase was in negative news about schizophrenia. Stigmatizing stories about schizophrenia increased by 46%, and their length increased from 300 to 1000 words per story per month. CONCLUSION: The immediate effects of the media intervention were positive, resulting in more and longer positive news stories about mental illness and more positive news stories about schizophrenia. However, when considered from a broader perspective, locally focused efforts yielded meager results in light of the larger increases in negative news, particularly in negative news concerning people with schizophrenia--the target group for the program.

Humans↗
PubMed2004

Ethics in psychiatric research: study design issues.

OBJECTIVE: To identify and discuss ethical aspects of study design issues in psychiatric research. METHOD: We conducted a literature review and conceptual analysis of study design in psychiatric research focusing on placebo, medication tapering and withdrawal (washout), and symptom provocation (challenge) designs. RESULTS: While advances in the care and treatment of persons with psychiatric disorders are crucial to the improved well-being of this stigmatized and often forgotten population, past abuses demonstrate the importance of the thoughtful application of ethical principles in the conduct of research. Some ethical issues have particular relevance to psychiatric research arising primarily from the specific vulnerabilities of those with mental illness and the risks posed by some research methodologies. Accordingly, sensitivity is required in the design of psychiatric research. CONCLUSION: Placebo, challenge, and washout study designs can present particular risks in the population of persons with mental illness. These issues are described and suggestions offered to promote the ethical design of psychiatric research.

Ethics, Medical↗
PubMed2005

Listening to the past: history, psychiatry, and anxiety.

This article explores the history of psychiatry and the rise of biological psychiatry and suggests ways in which the study of history can shed light on current psychiatric practice and debate. Focusing on anxiolytics (meprobomate in the 1950s and benzodiazepines in the 1960s, 1970s, and 1980s) as a case study in the development of psychopharmacology, it shows how social and political factors converged to popularize and later stigmatize outpatient treatments for anxiety. The importance of social context in the creation of new therapeutic paradigms in modern psychiatry suggests the need to take into account a broad range of historical variables to understand how modern psychopharmacology has emerged and how particular treatments for disorders have been developed, diffused, and assessed.

Anti-Anxiety Agents↗
PubMed1991

The effect of sexual assault on a small isolated community.

This paper documents the case of one family in which the two young boys were sexually abused by a school principal. Each family member suffered deleterious psychological sequelae as a result of the abuse. Since more than half the boys of one generation in this community were assaulted by the same perpetrator, we have postulated that the whole community suffered from a sense of betrayal, powerlessness and stigmatization.

Adolescent↗
PubMed1994

Research funding of psychiatric disorders in Canada: a snapshot, 1990-1991.

Although mental illness accounts for up to 14% of total direct health care costs and an estimated cost of over five billion dollars annually, research funding of psychiatric disorders is regarded as underfunded relative to other biomedical research. This study was conducted to determine the amount of funds allotted to the research of specific psychiatric disorders in Canada. Data was obtained from a national database of peer-reviewed health research funding. Based on the title of the research grant, all projects that pertained to psychiatric disorders were identified and classified according to diagnosis. Research funding for psychiatric disorders totalled $16,391,000 from 1990 to 1991, or 3.7% of all biomedical research funding for that period. The relative contributions of federal, provincial and private (nonprofit) agencies to the funding total were 54%, 39% and 8%, respectively. Research funding for mental illness remains disproportionately low relative to other medical illnesses. The role of private nonprofit agencies, in particular, is much more limited for psychiatric disorders than for other identified medical illnesses. These data suggest that increased attention to research advocacy is required to increase psychiatric research support. Advocacy strategies should include: 1. publicizing the value and scope of psychiatric research in Canada; 2. working to de-stigmatize mental illness; 3. strengthening personal and professional affiliations with patient advocacy groups; 4. increasing the number and the qualifications of psychiatric researchers; 5. improving the scientific quality of research programs; and 6. organizing national research collaborations.

Canada↗
PubMed1994

Psychosocial impact of laryngectomy mediated by perceived stigma and illness intrusiveness.

In addition to prolonging life, successful treatment by laryngectomy also results in functional disability (loss of speech) and physical disfigurement (stoma). It was hypothesized that these after-effects contribute to perceived stigma which, in turn, compromises quality of life. The hypothesis that the psychosocial impact of perceived stigma operates through illness intrusiveness--illness-induced disruptions that interfere with continued involvements in valued activities and interests--was tested. Data were collected from 51 laryngectomy recipients via standardized interviews. As hypothesized, results indicated that: 1. both perceived stigma and illness intrusiveness are related to psychosocial well-being and emotional distress; 2. illness intrusiveness mediates the relation between perceived stigma and psychosocial outcomes; 3. the psychosocial impact of illness intrusiveness is most devastating in the context of highly stigmatized self-perception; and 4. unique profiles of illness intrusiveness across individual life domains may be associated with specific psychosocial outcomes. Findings are discussed in relation to the hypothesis that illness intrusiveness is a common underlying determinant of the psychosocial impact of chronic illness.

Adaptation, Psychological↗
PubMed1995

Learning difficulties in children with Tourette syndrome.

Children with Tourette syndrome have been shown to have a variety of school difficulties. These difficulties, however, may be related to a single factor or to a combination of problems including tic severity, the use of tic-suppressing medication, executive dysfunction, a direct consequence of having a stigmatizing disorder, and coexisting attention deficit disorder, hyperactivity, obsessive-compulsive behaviors, or other psychopathologies. The goals for the treating health care team are to identify the presence of these factors, to clarify which are the major source of distress, and to develop an individualized multimodal treatment program. The prompt diagnosis of underlying problems and the prescription of appropriate therapy can play an important role in preventing school failure in children with Tourette syndrome.

Adrenergic alpha-Agonists↗
PubMedDate not supplied

The travesty of choosing after positive prenatal diagnosis.

OBJECTIVE: To integrate the findings of qualitative studies of expectant parents receiving positive prenatal diagnosis. DATA SOURCES: Seventeen published and unpublished reports appearing between 1984 and 2001 and retrieved between December of 2002 and March of 2003. The electronic databases searched include Academic Search Elite, AIDS Information Online (AIDSLINE), Anthropological Index Online, Anthropological Literature, Black Studies, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Digital Dissertations, Dissertation Abstracts Index (DAI), Educational Resource Information Center (ERIC), MEDLINE, PsycInfo, Public Affairs Information Service (PAIS), PubMed, Social Science Abstracts (SocSci Abstracts), Social Science Citation Index, Social Work Abstracts, Sociological Abstracts (Sociofile), Women's Resources International, and Women's Studies. STUDY SELECTION: Qualitative studies involving expectant parents living in the United States of any race, ethnicity, nationality, or class who learned during any time in pregnancy of any fetal impairment by any means of diagnosis were eligible for inclusion. DATA EXTRACTION: Metasummary techniques, including the calculation of frequency effect sizes, were used to aggregate the findings. Metasynthesis techniques, including constant comparison analysis and the reciprocal translation of concepts, were used to interpret the findings. DATA SYNTHESIS: The topical emphasis in the findings is on the termination of pregnancy following positive diagnosis. The thematic emphasis is on the dilemmas of choice and decision making. Positive prenatal diagnosis was for couples an experience of chosen losses and lost choices. Couples managed information to minimize stigmatization and cognitive dissonance. CONCLUSIONS: Existing guidelines for caring for couples after perinatal losses must accommodate the chosen loss experientially defining positive prenatal diagnosis.

Abortion, Induced↗
PubMed2005

Sex work research: methodological and ethical challenges.

The challenges involved in the design of ethical, nonexploitative research projects with sex workers or any other marginalized population are significant. First, the size and boundaries of the population are unknown, making it extremely difficult to get a representative sample. Second, because membership in hidden populations often involves stigmatized or illegal behavior, concerns regarding privacy and confidentiality are paramount and difficult to resolve. In addition, they often result in challenges to the validity of the data. Third, in spite of evidence to the contrary, associations between sex work and victimization are still strong, dichotomies remain prevalent, and sex workers are often represented as a homogeneous population. Drawing on three research projects in which the author has been involved-all grounded in a sex-as-work approach-as well as the work of others, this article provides several strategies for overcoming these challenges. Clear guidelines for ethical, nonexploitive methodologies are embedded in the solutions provided.

Crime Victims↗
PubMed2005

Practice possibilities for nurses choosing true presence with persons who live with a different sense of hearing.

Living with a different sense of hearing is a silencing experience that can change persons'patterns of relating and even deprive them of effective ways to give and receive messages with other human beings. People who live with having a different sense of hearing are often stigmatized, labeled, and judged by nurses, healthcare professionals, and family members alike. This column examines practice possibilities for nurses who choose the human becoming way of being with persons living with a different sense of hearing.

Empathy↗
PubMed2004

Caretakers of AIDS patients in rural Tanzania.

Socio-economic characteristics of caretakers of bed-ridden AIDS patients in two rural communities of Rungwe district, Tanzania were sought. The study also explored what caretaking entailed. Data were collected from 60 caretakers between September and November 2002. The proportion of female caretakers was significantly higher than that of male caretakers; the majority of the caretakers were old. The majority of the AIDS patients were family members of the caretakers. The caretakers' households lacked basic needs for the patients. Some of the caretakers sold family assets in order to buy medicines for the patients. Most of the caretakers worked under stress and there was no one to counsel them. Community members offered very little or no support to caretakers and the households were stigmatized. People in the communities knew about HIV/AIDS transmission, but their behaviour did not match their knowledge.

Acquired Immunodeficiency Syndrome↗
PubMed2026

Stigma, discrimination-related events, and determinants among adult people living with systemic lupus erythematosus (SLE): Systematic review and indicator-level meta-analysis.

BackgroundSystemic lupus erythematosus (SLE) is a complex autoimmune disease with 0.4 million new cases diagnosed annually. With its wide variety of visible and invisible manifestations, people living with SLE report being exposed to stigmatization, which impacts their personal and professional lives. However, the current literature is unclear on whether healthcare management teams assess this concern during follow-up. This study aims to synthesize existing evidence on the prevalence and determinants of stigma among people living with SLE.MethodsThis systematic review and meta-analysis gathered evidence from observational studies identified from three databases on 16 July 2025. Dual independent screening, data extraction, and risk-of-bias assessment (using the Newcastle-Ottawa Scale) were performed. Results were synthesized using descriptive statistics, narrative synthesis, and indicator-level meta-analyses.ResultsWithin the past two decades, 11 studies comprising 2254 people living with SLE reported and measured stigma- and discrimination-related events using various scales. Stigma was found to be prevalent across its three constructs: interpersonal, perceived, and intrapersonal stigma. This review demonstrated that people living with SLE reported a moderate overall burden of stigma (34.71 [95% CI 26.15, 43.27]), with average stigma scores indicating psychological impact. Additionally, nearly one in two persons (46% [95% CI 28-66%]) experienced at least one form of stigma or discrimination, most commonly social isolation and unfair treatment. Mental health associations were correlated with higher stigma burden.ConclusionThis review demonstrates that stigma and discrimination are not just social challenges but also critical determinants of health. With cautious interpretation, pooled evidence reveals a consistent high prevalence of stigma and discrimination, which act as "toxic" stressors, creating a vicious cycle with psychological stress and psychiatric manifestations and disease activity. There is an urgent clinical need to move beyond a mere biological approach to disease assessment and management and to begin screening for the "invisible" burden of invalidation and discrimination.

Humans↗