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Title: Disclosure of Mental Illness in Workplace Settings
Creator: Fominaya, Adam W
Date: 2019
Description: People considering disclosure of their mental illness in the workplace have tonavigate a complex set of competing pressures to arrive at a...
Show morePeople considering disclosure of their mental illness in the workplace have tonavigate a complex set of competing pressures to arrive at a disclosure decision. Existingmodels of disclosure fail to adequately consider the role of stigma, cannot be adequatelytested with measures currently in existence, and tend to ask participants about disclosureretrospectively. These limitations were addressed using a new path model which employsmeasures currently in existence, includes stigma, and assesses disclosure motivation inindividuals who have not disclosed at work. A national sample of 365 participants wererecruited using Amazon’s Mechanical Turk Marketplace (MTurk). While thehypothesized model achieved poor fit, important findings from the models tested hereprovide clear direction for future research.
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Title: Factor Analysis of a Stigma Measure for Adults with Autism
Creator: Beedle, Robert Brian
Date: 2019
Description: This study evaluates a measurement tool for public stigma of adults with autism. Autism Spectrum Disorder (ASD) is a developmental disability...
Show moreThis study evaluates a measurement tool for public stigma of adults with autism. Autism Spectrum Disorder (ASD) is a developmental disability affecting individuals’ sensory experiences, behaviors, and social interactions (American Psychiatric Association, 2013). Current literature has examined public stigma of ASD through qualitative methods and select attitude and social distance scales, consistently reporting lower levels of negative attitudes when disclosure of ASD diagnosis is provided (Gray, 2002; Hennegan, 2010; Obeid et al, 2015). Other research suggests adults with ASD frequently experience stigma and discrimination in their daily lives across settings (MacLeod, Lewis, & Roberson, 2013; Nicolaidis et al, 2015; Thibault, 2014). Previous research has not examined whether known processes of stigma (i.e., Attribution Theory, Danger Appraisal models) are applicable to understanding the stigma reported by this population. In the current study a commonly used measure of the stigma of mental illness (Attribution Questionnaire 27) was administered to determine its psychometric properties when applied to adults with ASD. Examination of a previous measurement model for this questionnaire on a sample of participants (N = 160) indicated lack of model fit. A larger sample (N = 306) was collected to determine the data-driven factor structure of this measure. A series of exploratory factor analyses indicates a three-factor, 24-item solution that displays strong psychometric properties, as well as convergent validity with other measures of attitudes towards disabilities and ASD. Results of this study suggest additional need to research the topic of stigma towards adults with ASD.
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Title: A Randomized Controlled Trial of Direct-to-Consumer Advertising of Cognitive-Behavior Therapy for Depression
Creator: Antler, Caroline
Date: 2020
Description: Almost half of individuals in the US struggling with depression never seek treatment and, of those that do, over half receive inadequate care....
Show moreAlmost half of individuals in the US struggling with depression never seek treatment and, of those that do, over half receive inadequate care. Although the efficacy of CBT for MDD is well established, the rate of individuals receiving psychotherapy has declined. With copious evidence supporting the effectiveness of direct-to-consumer advertising (DTCA) of pharmaceuticals, the current study evaluated the potential utility of DTCA of CBT for MDD.One hundred seventy-eight adults with (a) prior exposure to DTCA for antidepressants and (b) no mental health diagnoses or treatment were randomly assigned to view one of three video conditions: CBT for depression (CBT, n = 60), CBT plus information on antidepressants (CBT+MED, n = 58), or Control (arthritis and diabetes Public Service Announcements (PSAs); n = 60). After viewing the video participants completed measures of attitudes about, and willingness to engage in, CBT and antidepressant medication. The study was conducted online with participants being recruited through Prolific and the survey created via Qualtrics.Compared to controls, participants viewing CBT DTCA videos (with or without information on antidepressants) were more willing to engage in CBT, had less public and self-stigma associated with CBT, and believed CBT has less potential for harm. Compared to the CBT group, the CBT+MED group reported greater concern about the risks of disclosing personal information in a therapy setting.These results extend previous findings by applying the DTCA marketing style to a specific diagnosis and type of therapy. Findings indicate that DTCA-style ads for CBT for MDD can be effective in reducing stigma and increasing treatment willingness. They further suggest that DTCA-style marketing of evidence-based psychotherapies can be efficacious when created for specific treatments and disorders. The findings have substantial implications for public health and the dissemination of evidence-based practice.
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Title: The effect of information overload on knowledge recall and related cognitions for an educational program based on the Mental Health First Aid Model
Creator: Bink, Andrea B.
Date: 2020
Description: Early-intervention public health education programs have been effective at teaching a skillset to help others. However, some of these programs...
Show moreEarly-intervention public health education programs have been effective at teaching a skillset to help others. However, some of these programs have also been criticized for delivering more information than is necessary to learn the skill. Receiving too much information could cause information overload and interfere with program goals. The current study investigated the differential effect on outcomes of two trainings: (i) a standard training with lecture material about depression and anxiety (illness-information), and a skillset to guide interpersonal support for someone with depression and anxiety (skill-information); and (ii) a targeted training that omitted the lecture material and only presented the skillset. Predicted outcomes were that the combination of illness-information and skill-information in the standard training would result in information overload and would interfere with skill-information recall and attitude change. The current study also investigated two variables that could influence outcomes: general information overload about mental health (MHIO) and interest in the topic of mental health. Results were that participants in the standard training endorsed significantly more information overload and performed significantly better on recall measures than participants in the targeted training. Both trainings were effective at attitude change. Finally, preexisting MHIO was associated with training information overload, care seeking, and skill-information recall. Preexisting topic interest was associated with skill-information recall. Results suggest that some background lecture material might be necessary to learn how to support someone with depression and anxiety. Also, programs that promote interpersonal support are effective at attitude change no matter how much information they provide.
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Title: The Association Between Executive Functioning, Verbal Memory, and Internalized Stigma in Predicting Psychotropic Medication Adherence Behaviors Among People with Serious Mental Illness
Creator: Powell, Karina
Date: 2020
Description: Long-term symptom management is an important consideration for many individuals with serious mental illness to maintain recovery over time,...
Show moreLong-term symptom management is an important consideration for many individuals with serious mental illness to maintain recovery over time, prevent relapse and rehospitalization, and decrease symptom severity. Psychotropic medications can be an important aspect of treatment planning; however, many barriers exist that can impact medication adherence and treatment efficacy. Research suggests that internalized stigma and neurocognition may impact medication adherence, but research has yet to investigate the relationship between these three constructs in tandem. In this study, medication adherence was measured via medication possession ratio calculated from pharmacy records (objective) and self-reported medication use (subjective). Selection of neurocognitive domains and assessment measures was informed by MATRICS and ISBD-BANC consensus batteries. The primary expectations were that verbal memory and executive functioning would be related to medication adherence behaviors and that these domains would moderate the relationship between internalized stigma and medication adherence. A consistent association was seen between measures of self-reported medication use over time, suggesting participants were generally consistent in their reported use. While analyses testing the primary hypotheses were nonsignificant, in the context of limitations of statistical power, trends emerged that may be worthy of further investigation. Future research should continue to explore the potentially multifaceted relationships between factors contributing to adherence. A more comprehensive understanding these relationships has implications for clinicians and consumers in addressing treatment barriers and disengagement by developing more nuanced and targeted interventions.
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Title: EXAMINING THE ROLES OF PUBLIC STIGMA AND ACCULTURATION ON CARE-SEEKING IN PAKISTANIS
Creator: Laique, Aamir
Date: 2021
Description: Pakistani Americans face bi-directional cultural influences related to their heritage culture and the mainstream culture of the host. The...
Show morePakistani Americans face bi-directional cultural influences related to their heritage culture and the mainstream culture of the host. The present study examined the impact of culture on the relationship between public stigma and care-seeking attitudes. A sample of 158 Pakistani Americans was collected using MTurk. Hierarchical regression was conducted to examine the moderating effect of heritage acculturation and mainstream acculturation on the relationship between public stigma and care-seeking. Multiple regression analysis predicting care-seeking from public stigma, heritage acculturation, and mainstream acculturation did not yield a statistically significant model. Hierarchical regression analyses examining the moderating effect of heritage acculturation and mainstream acculturation were non-significant. Acculturation had no notable impact on stigma and care-seeking. This study was unable to demonstrate significant results. Future considerations should include inter-generational differences, other forms of stigma that may play a crucial role, and inclusion of different measures to determine if there are other scales better suited for the target population.
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Title: Self-Stigma & Vicarious Stigma Experienced by Parents of Children with Mental Health Challenges
Creator: Serchuk, Marisa Dyan
Date: 2019
Description: Research has been limited regarding the stigma experienced by parents of children with mental health challenges. It is commonly understood...
Show moreResearch has been limited regarding the stigma experienced by parents of children with mental health challenges. It is commonly understood that stigma effects people with lived-experience (e.g., a child with mental health challenges), however, stigma has been noted to have a wide scope, which extends to family members as well. Parents of children with mental health challenges have been found to endorse aspects of self-stigma, specifically regarding public stereotypes of blame and feelings of incompetence. Vicarious stigma is a fairly new area of research, which describes the sad and/or angry response a parent may experience when witnessing their child being stigmatized. The purpose of this study is to examine emotional and behavioral outcomes related to specific types of stigma experienced by parents of children with mental health challenges. Archival data from a larger study of adult participants (N=50), who identified as having a child (age 3-10 years old) with mental health challenges, completed measures examining self-stigma, vicarious stigma, stress, depression, quality of life, disclosure, secrecy coping, and help-seeking. A novel measurement for vicarious stigma was introduced and examined in this study. Results found higher levels of self-stigma and dimensions of vicarious stigma were associated with higher levels of depression as well as diminished quality of life. Higher levels of self-stigma were also associated with lower perceived benefits of disclosing and greater levels of secrecy coping. These findings highlight the importance of further examining the role of stigma for parents of children with mental health challenges.
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Title: Mental Health Stigma and Care-Seeking in First Generation Indian Immigrants
Creator: Shah, Binoy
Date: 2019
Description: Objective: Immigrants from India face unique obstacles, including migration related factors and cultural pressures, that may contribute to...
Show moreObjective: Immigrants from India face unique obstacles, including migration related factors and cultural pressures, that may contribute to underutilization of mental health treatment services. The present thesis examined paths between mental health stigma and care-seeking in a sample of first-generation Indian immigrants, with a specific emphasis on the influences of acculturation and parental autonomy support. Method: A sample of 201 first-generation immigrants from India was ascertained using MTurk. Path analysis was conducted to examine the relationships between public stigma of mental illness, disclosure, mental health care-seeking, parental autonomy support, and bi-directional acculturation. Results: Final model was supported by good fit indicators. Greater public stigma was associated with reduced care-seeking, but greater disclosure was associated with increased care-seeking. Interestingly, parental autonomy support, mainstream acculturation, and heritage acculturation facilitated disclosure but had no discernible impact on public stigma. Conclusions: In contrast to traditional anti-stigma strategies that focus on reducing public stigma, present results suggest that it may be more beneficial to facilitate care-seeking by targeting disclosure of status. In turn, disclosure may be promoted by facilitating autonomy supportive social networks and bi-directional acculturation.
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Title: CULTURALLY SENSITIVE HELP-SEEKING AMONG ASIAN INTERNATIONAL AND ASIAN AMERICAN COLLEGE STUDENTS
Creator: Tsen, Jonathan Yee-jon
Date: 2020
Description: Asian populations are rapidly rising, representing the fastest growing racial group of immigrants in the U.S. with many seeking higher...
Show moreAsian populations are rapidly rising, representing the fastest growing racial group of immigrants in the U.S. with many seeking higher education. While many face risk for poor mental health outcomes and high suicidal ideation, Asian college students report lower rates seeking mental health services than White Americans. The purpose of this study was to test a culturally sensitive help-seeking model for Asian international and Asian American college students, and to capture relevant psychological and cultural factors that influence help-seeking. This study used an observational design to build on the current research and evaluated the effects of acculturation, enculturation, public stigma of help-seeking, self-stigma of help-seeking, and attitudes on willingness to seek psychological services. Four hundred and fifty-eight students (Age M = 23.93, SD = 4.36) represented by 265 Asian International Students and 193 Asian American Students. Using a path analysis, results demonstrated a poorly fitted model, suggesting that acculturation, enculturation, public stigma, self-stigma, attitudes, and willingness do not relate significantly to each other when viewed altogether in a model. This remained true even when modifications to the model were made, and when observing the model within only Asian American student sample or Asian international student sample. However, significant direct effects were observed between enculturation and public stigma in the total sample, as well as separately in Asian American or Asian international samples. These findings highlight the importance of exploring with different methodological approaches to gain insight on other important psychological and cultural factors that impact help-seeking among Asian international and Asian American college students.
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Title: The Development of a Measure of Public Stigma Towards Adults With Autism
Creator: Beedle, Robert Brian
Date: 2022
Description: Adults with autism (AwA) report experiences of stigma and discrimination. Yet, quantitative research suggests that public attitudes are...
Show moreAdults with autism (AwA) report experiences of stigma and discrimination. Yet, quantitative research suggests that public attitudes are relatively benign. This research discrepancy is compounded by the present lack of a stakeholder-informed, theoretically-guided measure of the stigma towards AwA. The objective of the present study was to develop a measure of stigma towards AwA following best practices survey methodology. First, existing related measures were reviewed for possible candidate items, yielding 36 draft questions related to the stigma of AwA. Next, seven stakeholders in the AwA community were recruited to provide feedback on their experiences of stigma and discrimination, as well as feedback on the draft items. Following stakeholder feedback, draft items were edited, added, or removed based on feedback from the participants with AwA and their lived experiences, resulting in a revised measure of 51 candidate items. Finally, these 51 items underwent a quantitative phase with participants recruited through MTurk (N = 357). Exploratory factor analyses were conducted in order to generate a data driven factor structure that reflected stigma theory. The end result was a 20-item, four factor solution measuring numerous components of stigma within factors including cognitive components of stigma, blame, positive and negative affect, and comfort with close contact. The resulting measurement tool was titled the Public Stigma towards Adults with Autism Scale (PSAWA) and demonstrated strong psychometric properties. The tool has utility for further studying stigma towards AwA and assessing stigma interventions.
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Title: Eating disorder support group utilization: Associations with psychological health and eating disorder psychopathology among support group attendees
Creator: Murray, Matthew F.
Date: 2023
Description: Individuals with eating disorders (EDs) report psychosocial impairments that may persist beyond ED symptom remission, suggesting a need to...
Show moreIndividuals with eating disorders (EDs) report psychosocial impairments that may persist beyond ED symptom remission, suggesting a need to examine ED treatment-adjunctive services that foster psychosocial health. One promising resource is support groups, as evidence across medical and psychiatric illnesses shows associations between group utilization and wellbeing. However, virtually no literature has examined ED-specific support groups and psychosocial health, and it is also unknown how use of supportive services relates to ED symptoms. The present study examined associations between past-month ED support group attendance and participation frequency, psychosocial health indices, and ED symptoms. A total of 215 participants who attended weekly virtual clinician-moderated ED support groups completed measures of psychosocial health, internalized stigma of mental illness, psychosocial impairment from an ED, specific types of social support elicited in group, and ED psychopathology. Adjusting for past-month ED treatment, Benjamini-Hochberg-corrected partial correlation analyses indicated that more frequent attendance was negatively related to body dissatisfaction, purging, excessive exercise, and negative attitudes toward obesity, and positively related to social support. More frequent verbal and chat participation were positively related to emotional and informational support and social companionship. Chat participation was additionally negatively related to excessive exercise and negative attitudes toward obesity. Results suggest that utilizing and participating in clinician-moderated ED support groups could provide an outlet for ED symptom management and solicitation of social support. Findings highlight areas for further consideration in the delivery of and future research on ED support groups.
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Title: Certified Rehabilitation Counselors' Knowledge, Stigma, and Self-Efficacy in Working with Non-Suicidal Self-Injury
Creator: Tseng, Yen Chun
Date: 2023
Description: Certified Rehabilitation Counselors (CRCs) are professionals who are responsible for supporting the rights and independence of people with...
Show moreCertified Rehabilitation Counselors (CRCs) are professionals who are responsible for supporting the rights and independence of people with disabilities. They provide services such as mental health counseling, vocational counseling, advocacy, and psychoeducation to people with disabilities. Suicide prevention and safety education are within the scope of services provided by CRCs as well. Non-suicidal self-injury (NSSI), one of the strongest risk factors for suicide attempts (Franklin et al., 2017; Kiekens et al., 2018), has received more attention as people with disabilities have elevated risk to engage in such behaviors (Coduti et al., 2016). NSSI refers to the socially unacceptable behavior causing intentional and direct injury to one’s own body tissue without conscious suicidal intent (Nock & Favazza, 2009). As the prevalence of NSSI increases, it is likely that in their professional tenure, CRCs will interact with clients who have engaged in NSSI. It is within CRCs scope of practice to advocate at individual, group, institutional, and societal levels to promote opportunity and access, improve quality of life for individuals with disabilities (Commission on Rehabilitation Counselor Certification, [CRCC], 2023). However, few studies have explored CRCs’ training, stigma, and self- efficacy when working with NSSI. The purpose of this study was to explore the nature and extent of NSSI training received by CRCs, CRCs’ stigma towards individuals engaging in NSSI, and factors associated with CRCs’ self-efficacy for working with clients with NSSI. CRCs practicing in the United States participated in the study (N = 91). Less than half of the participants reported that they received NSSI training in the past. In addition, they demonstrated some knowledge of NSSI while holding some misconceptions of NSSI at the same time. In addition, CRCs reported generally positive attitudes toward NSSI. Predictors examined in the study included training, knowledge, familiarity, and attitudes toward individuals engaged in NSSI while controlling for participants’ age and gender. Hierarchical regression analysis was used to analyze whether these factors were associated with self-efficacy to work with clients with NSSI. Results indicated that training and stigma (helping attitude) were significant predictors of CRCs’ self-efficacy for working with clients experiencing NSSI. Additionally, the variance in self-efficacy was accounted for by NSSI training and stigma. CRCs who received NSSI training in the past reported more positive attitudes and perceived themselves as more capable to work with clients who engaged in NSSI. This study is among the few to examine specific factors impacting CRCs’ self-efficacy in working NSSI. Implications for practice and research are discussed.
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Title: Self-Stigma, Disclosure, and Care-Seeking in People with Self-Reported Mental Illness
Creator: Shah, Binoy Biren
Date: 2023
Description: Objective: The longstanding mental illness treatment gap has only been exacerbated by the COVID-19 pandemic. One reason for this is the self...
Show moreObjective: The longstanding mental illness treatment gap has only been exacerbated by the COVID-19 pandemic. One reason for this is the self-stigma of mental illness, which has been shown to decrease care-seeking. This study aims to better understand the relationships between self-stigma and care-seeking by identifying novel mediators of this relationship. Method: A sample of 125 individuals with mental health difficulties, obtained from MTurk, completed measures of self-stigma, disclosure, care-seeking. Self-stigma was conceptualized as a distal antecedent to disclosure, and novel proximal antecedents of disclosure (i.e., approach goals, avoidance goals, and the “Why Try?” effect) were unpacked. Hypotheses were tested in steps via path analysis. Results: We found partial evidence to support our model of self-stigma. Disclosure did not mediate the relationship between self-stigma and care-seeking. Findings regarding proximal antecedents of disclosure were mixed. Conclusion: Results should be interpreted with caution due to data quality concerns. Additional research is needed to better understand how self-stigma impacts disclosure. This line of inquiry has noteworthy implications for research, policy, and clinical practice.
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