The chronic load carried by minority status, including anti-Muslim prejudice.
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526 to 550 of 599Inclusive altruism born of suffering: the relationship between adversity and prosocial attitudes and behavior toward disadvantaged outgroups.
This article reports the results of 2 studies examining altruism born of suffering (E. Staub & J. R. Vollhardt, 2008). More specifically, we examined inclusive altruism born of suffering, which is directed toward members of disadvantaged outgroups. Drawing on and integrating clinical and social psychological theories, we hypothesized that individuals who had suffered from adverse life events would be more likely to help the outgroups in need than those who had not suffered. This was demonstrated for helpers who had experienced various forms of suffering (interpersonal and group-based harm, natural disasters) and for 2 distinct types of prosocial behavior and attitudes (long-term volunteering and disaster aid) benefiting outgroups within society and from other countries. We also found that prosocial attitudes toward tsunami victims were highest among those who had suffered in a similar wa…
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HIV, gender, race, sexual orientation, and sex work: a qualitative study of intersectional stigma experienced by HIV-positive women in Ontario, Canada.
Background: HIV infection rates are increasing among marginalized women in Ontario, Canada. HIV-related stigma, a principal factor contributing to the global HIV epidemic, interacts with structural inequities such as racism, sexism, and homophobia. The study objective was to explore experiences of stigma and coping strategies among HIV-positive women in Ontario, Canada.
Methods and findings: We conducted a community-based qualitative investigation using focus groups to understand experiences of stigma and discrimination and coping methods among HIV-positive women from marginalized communities. We conducted 15 focus groups with HIV-positive women in five cities across Ontario, Canada. Data were analyzed using thematic analysis to enhance understanding of the lived experiences of diverse HIV-positive women. Focus group participants (n = 104; mean age = 38 years; 69% ethnic minority; 23% le…
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In sickness and in health: a qualitative study of how Chinese women with HIV navigate stigma and negotiate disclosure within their marriages/partnerships.
In China, there are currently an estimated 180,000 women between 16 and 45 years of age living with HIV. However, we know very little about their lived experiences. Given the spread of the AIDS epidemic in China and the burden it exerts on quality of life, there is an urgent need to understand how HIV affects Chinese women, particularly in the context of their marriages. How do they negotiate the extreme stigma of their illness in making decisions about disclosure and social support, especially in the context of their family life? We recruited 26 Chinese women with HIV in Beijing and Shanghai for in-depth interviews employing a phenomenological approach. We examined the process and outcomes of disclosure within the course of the women's search for social support. Women in HIV-discordant relationships often experienced a termination of their marriage after disclosure, yet others exhibited…
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What stops us from healing the healers: a survey of help-seeking behaviour, stigmatisation and depression within the medical profession.
Background: Doctors are poor at help-seeking, particularly for mental ill health; attitudes of colleagues reflecting stigmatisation may be important factors influencing decisions to seek support.
Aims: This article focuses on doctors' attitudes to depression rather than mental illness in general. It seeks to determine the extent to which doctors perceive depression is stigmatised within the medical profession and whether the level of perceived stigma affects patterns of help-seeking behaviour.
Method: : A postal survey was sent to 1488 General Practitioners and 152 psychiatrists in Devon and Cornwall. Questions assessed stigmatising attitudes to depression; help-seeking behaviour and barriers to help-seeking. Prevalence of self-reported depression and time off work was measured.
Results: The response rate was 76.6%. Doctors perceived that many of their profession hold stigmatising views …
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Rethinking the concept of acculturation: implications for theory and research.
This article presents an expanded model of acculturation among international migrants and their immediate descendants. Acculturation is proposed as a multidimensional process consisting of the confluence among heritage-cultural and receiving-cultural practices, values, and identifications. The implications of this reconceptualization for the acculturation construct, as well as for its relationship to psychosocial and health outcomes, are discussed. In particular, an expanded operationalization of acculturation is needed to address the "immigrant paradox," whereby international migrants with more exposure to the receiving cultural context report poorer mental and physical health outcomes. We discuss the role of ethnicity, cultural similarity, and discrimination in the acculturation process, offer an operational definition for context of reception, and call for studies on the role that con…
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Beliefs about wife beating: an exploratory study with Lebanese students.
In recent years, there has been a growing interest in understanding the sociocultural contexts and risk factors for domestic violence in the Arab world. This study provides an analysis of the religious, legal, and familial contexts of domestic violence in Lebanon and assesses contemporary attitudes toward women and wife beating in a sample of 206 Lebanese university students. Gender, patriarchal attitudes, religion, childhood experiences with family violence, and mother's employment status were investigated as predictors of attitudes toward wife beating. Consistent with feminist theories of wife abuse, gender and attitudes toward women's roles emerged as the strongest predictors of beliefs about wife beating.
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The influence of social stigma and discriminatory experience on psychological distress and quality of life among rural-to-urban migrants in China.
The global literature has revealed a potential negative impact of social stigma on both physical and mental health among stigmatized individuals; however, the mechanisms through which social stigma affects the individual's quality of life and mental health are not well understood. This research simultaneously examines the relationships of several determinants and mediating factors of psychological distress and quality of life. Data were collected through a cross-sectional survey among 1006 adult (predominantly male) rural-to-urban migrants in 2004-2005 in Beijing, China. Participants reported on their perceived social stigma, discriminatory experiences in daily life, preparation for migration, discrepancy between expectation and reality, coping with stigma-related stress, psychological distress, and quality of life. Structural equation modeling was performed. We found that perceived soci…
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"A disease like any other"? A decade of change in public reactions to schizophrenia, depression, and alcohol dependence.
Objective: Clinicians, advocates, and policy makers have presented mental illnesses as medical diseases in efforts to overcome low service use, poor adherence rates, and stigma. The authors examined the impact of this approach with a 10-year comparison of public endorsement of treatment and prejudice.
Method: The authors analyzed responses to vignettes in the mental health modules of the 1996 and 2006 General Social Survey describing individuals meeting DSM-IV criteria for schizophrenia, major depression, and alcohol dependence to explore whether more of the public 1) embraces neurobiological understandings of mental illness; 2) endorses treatment from providers, including psychiatrists; and 3) reports community acceptance or rejection of people with these disorders. Multivariate analyses examined whether acceptance of neurobiological causes increased treatment support and lessened stigm…
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Mental health disparities research: the impact of within and between group analyses on tests of social stress hypotheses.
Social stress models are the predominant theoretical frame for studies of the relationship between social statuses and mental health (Dressler, Oths, & Gravlee, 2005; Horwitz, 1999). These models propose that prejudice, discrimination and related social ills exert an added burden on socially disadvantaged populations (populations subjected to stigma, prejudice and discrimination) that can generate mental health problems. Researchers have used a variety of methodological approaches to study this hypothesis. In this paper we argue that researchers have not paid sufficient attention to the implications of this methodological variability, particularly the distinction between studies of within-group and studies of between-groups variation, in interpreting empirical tests of social stress theory. To fully evaluate the evidence, we need to carefully consider the convergence and divergence of re…
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A socio-psychological investigation into limitations and incentives concerning reporting a clinically suspect situation aimed at improving early detection of classical swine fever outbreaks.
The aim of this study was to identify limitations and incentives in reporting clinically suspect situations, possibly caused by classical swine fever (CSF), to veterinary authorities with the ultimate aim to facilitate early detection of CSF outbreaks. Focus group sessions were held with policy makers from the veterinary authorities, and representatives of veterinary practitioners and pig farmer unions. Personal interviews with a small group of pig farmers and practitioners were held to check limitations raised and solutions proposed during the focus group sessions. An electronic questionnaire was mailed to pig farmers and practitioners to investigate perceptions and attitudes with respect to clinically suspect situations possibly caused by CSF. After triangulating the responses of veterinary authorities, veterinary practitioners and farmers, six themes emerged across all groups: (1) lac…
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Gardner A (2010)MEDLINE-indexed journal, not yet read by usJournal of theoretical biology50 citations Sex-biased dispersal of adults mediates the evolution of altruism among juveniles.
Population viscosity has been proposed as an important mechanism for the evolution of cooperation. The idea is that if individuals do not disperse far during the course of their lives, they will tend to interact with their genealogical relatives, which may give kin-selected benefits for cooperation. However, in the simplest model of population structure, the evolution of cooperation is unaffected by the rate of dispersal, owing to dispersal also mediating competition between social partners. This surprising result has generated much research interest in recent years. Here I show that dispersal does matter if there is a sex difference in dispersal rate, even when the expression of cooperation is not conditional upon the actor's dispersal status or sex. In particular, I show that cooperation among juveniles is relatively favoured when there is a small sex bias in adult dispersal in favour …
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Nurses' attitudes to mental illness: a comparison of a sample of nurses from five European countries.
Background: Mental health problems are of serious concern across Europe. A major barrier to the realisation of good mental health and well-being is stigma and discrimination. To date there is limited knowledge or understanding of mental health nurses' attitudes towards mental illness and individuals experiencing mental health problems.
Objectives: To describe and compare attitudes towards mental illness and those experiencing mental health problems across a sample of registered nurses working in mental health settings from five European countries and the factors associated with these attitudes.
Design: A questionnaire survey.
Settings: A total of 72 inpatient wards and units and five community facilities in Finland, Lithuania, Ireland, Italy and Portugal.
Participants: 810 registered nurses working in mental health settings.
Methods: The data were collected using The Community Attitudes …
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Female circumcision: toward an inclusive practice of care.
Female circumcision is a cultural tradition that includes cutting of female genitals without medical necessity. Over 130 million girls and women have been circumcised globally. This article reports on partial findings from a qualitative study that examined the lives of Somali Muslim women who were circumcised. A reoccurring theme of resentment toward North American health care practitioners who condemn the women for having experienced the practice of circumcision in their birth country was found. Discussion will include the physical and social stigma, the complex legal aspects, and ways to deal with female circumcision in a culturally competent manner.
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Understanding the effect of ethnic density on mental health: multi-level investigation of survey data from England.
Objectives: To determine if living in areas where higher proportions of people of the same ethnicity reside is protective for common mental disorders, and associated with a reduced exposure to discrimination and improved social support. Finally, to determine if any protective ethnic density effects are mediated by reduced exposure to racism and improved social support.
Design: Multi-level logistic regression analysis of national survey data, with area-level, own-group ethnic density modelled as the main exposure. Participants and setting 4281 participants of Irish, black Caribbean, Indian, Pakistani, Bangladeshi, and white British ethnicity, aged 16-74 years, randomly sampled from 892 "middle layer super output areas" in England.
Main outcome measures: Common mental disorders (assessed via structured interviews); discrimination (assessed via structured questionnaire); and social support …
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Fiske ST (2010)MEDLINE-indexed journal, not yet read by usThe American psychologist49 citations Envy up, scorn down: how comparison divides us.
Comparison compels people, even as it stresses, depresses, and divides us. Comparison is only natural, but the collateral damage reveals envy upward and scorn downward, and these emotions, arguably, poison people and their relationships. Summaries of several experiments--using questionnaire, psychometric, response-time, electromyographic, and neuroimaging data--illustrate the dynamics of envy up and scorn down, as well as proposing how to mitigate their effects. Initial studies suggest the importance of status. Other data show how scorn down minimizes thought about another's mind; power deactivates mental concepts. Regarding envy up, other studies demonstrate that Schadenfreude (malicious joy) targets envied outgroups. However, counterstereotypic information, empathy, and outcome dependency can mitigate both scorn and envy.
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Personal factors associated with reported benefits of Huntington disease family history or genetic testing.
Aims: A family history of Huntington disease (HD) or receiving results of HD predictive genetic testing can influence individual well-being, family relationships, and social interactions in positive and negative ways. The aim of this study was to examine benefits reported by people with an HD family history or those who have undergone predictive HD testing, as well as the personal variables associated with perceived benefits.
Methods: Seventy-four of 433 people completing the International Response of a Sample Population to HD risk (I-RESPOND-HD) survey reported benefits. Knowledge and understanding was perceived as the most common benefit from participants in both groups. The next most frequent perceived benefits from a family history were connecting with others and achieving life meaning and insights. The next most common perceived benefits from genetic testing were life planning and s…
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"We fear the police, and the police fear us": structural and individual barriers and facilitators to HIV medication adherence among injection drug users in Kiev, Ukraine.
Ukraine has one of the most severe HIV/AIDS epidemics in Europe, with an estimated 1.63% of the population living with HIV/AIDS in 2007. Injection drug use (IDU) remains the predominant mode of transmission in Kiev - the capital and largest city. Prior reports suggest that the HIV infection rate among IDUs in Kiev reaches 33%, and many have poor and inequitable access to highly active antiretroviral therapy (HAART). Among those with access to HAART, little is understood about barriers and facilitators to HAART medication adherence. In May 2009, two semi-structured focus groups were conducted with HIV-infected IDUs seeking treatment at the City AIDS Center, Kiev. The goal was to use this information to adapt and tailor, to Ukrainian culture, an evidence-based intervention for improving adherence to HAART. All 16 participants attributed HIV infection to IDU. Their average age was 31.6 (SD=…
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Developing culturally sensitive cognitive behaviour therapy for psychosis for ethnic minority patients by exploration and incorporation of service users' and health professionals' views and opinions.
Background: Studies of cognitive behaviour therapy (CBT) for schizophrenia demonstrate that African-Caribbean and Black African patients have higher dropout rates and poor outcomes from treatment.
Aim: The main aim of the study was to produce a culturally sensitive adaption of an existing CBT manual for therapists working with patients with psychosis from specified ethinic minority communities (African-Caribbean, Black-African/Black British, and South Asian Muslims). This will be based on gaining meaningful understanding of the way members (lay and service users) of these minority communities typically view psychosis, its origin and management including their cultural influences, values and attitudes.
Method: This two-centre (Hampshire and West London) qualitative study consisted of individual semi-structured interviews with patients with schizophrenia (n = 15); focus groups with lay mem…
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Torres L, Ong AD (2010)MEDLINE-indexed journal, not yet read by usCultural diversity & ethnic minority psychology139 citations A daily diary investigation of Latino ethnic identity, discrimination, and depression.
The objectives of the current study were to document the effects of discrimination on Latino mental health and to identify the circumstances by which ethnic identity serves a protective function. Instances of discrimination and depressive symptoms were measured every day for 13 days in a sample of Latino adults (N = 91). Multilevel random coefficient modeling showed a 1-day lagged effect in which increases in depression were observed the day following a discriminatory event. The findings also revealed differential effects of ethnic identity exploration and commitment. Whereas ethnic identity exploration was found to exacerbate the influence of daily discrimination on next-day depression, ethnic identity commitment operated as a stress buffer, influencing the intensity of and recovery from daily discrimination. The findings are discussed within a stress and coping perspective that identif…
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Barriers to treatment and culturally endorsed coping strategies among depressed African-American older adults.
Objective: Older adults are particularly vulnerable to the effects of depression, however, they are less likely to seek and engage in mental health treatment. African-American older adults are even less likely than their White counterparts to seek and engage in mental health treatment. This qualitative study examined the experience of being depressed among African-American elders and their perceptions of barriers confronted when contemplating seeking mental health services. In addition, we examined how coping strategies are utilized by African-American elders who choose not to seek professional mental health services.
Method: A total of 37 interviews were conducted with African-American elders endorsing at least mild symptoms of depression. Interviews were audiotaped and subsequently transcribed. Content analysis was utilized to analyze the qualitative data.
Results: Thematic analysis of…
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Depression, stigma, and suicidal ideation in medical students.
Context: There is a concerning prevalence of depression and suicidal ideation among medical students, a group that may experience poor mental health care due to stigmatization.
Objective: To characterize the perceptions of depressed and nondepressed medical students regarding stigma associated with depression.
Design, setting, and participants: Cross-sectional Web-based survey conducted in September-November 2009 among all students enrolled at the University of Michigan Medical School (N = 769).
Main outcome measures: Prevalence of self-reported moderate to severe depression and suicidal ideation and the association of stigma perceptions with clinical and demographic variables.
Results: Survey response rate was 65.7% (505 of 769). Prevalence of moderate to severe depression was 14.3% (95% confidence interval [CI], 11.3%-17.3%). Women were more likely than men to have moderate to severe d…
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Social factors associated with Major Depressive Disorder in homosexually active, gay men attending general practices in urban Australia.
Objectives: Social factors associated with Major Depressive Disorder (MDD) were identified among gay men attending high HIV caseload general practices in Sydney and Adelaide.
Methods: Men who visited four participating practices were invited to self-complete a survey. A self-screening tool (PHQ-9), based on the Diagnostic and Statistical Manual of Mental Disorders, version four (DSM-IV), was used to measure depressive disorders.
Results: The rate of MDD (PHQ-9 score 10 or above) among the 195 HIV-positive gay men was significantly higher than that among the 314 non-HIV-positive gay men (31.8% vs 20.1%, p=0.002). Current MDD was independently associated with younger age, lower income, recent major adverse life events, adopting denial and isolation as coping strategies, less social support, less gay community involvement and recent sexual problems. HIV-status, however, was not independentl…
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Iverach L, O'Brian S, Jones M, Block S, Lincoln M, Harrison E, Hewat S, Menzies RG, Packman A, Onslow M (2009)MEDLINE-indexed journal, not yet read by usJournal of anxiety disorders153 citations Prevalence of anxiety disorders among adults seeking speech therapy for stuttering.
The present study explored the prevalence of anxiety disorders among adults seeking speech therapy for stuttering. Employing a matched case-control design, participants included 92 adults seeking treatment for stuttering, and 920 age- and gender-matched controls from the Australian National Survey of Mental Health and Well-being. A conditional logistic regression model was used to estimate odds ratios for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases (ICD-10) anxiety disorders. Compared with matched controls, the stuttering group had six- to seven-fold increased odds of meeting a 12-month diagnosis of any DSM-IV or ICD-10 anxiety disorder. In terms of 12-month prevalence, they also had 16- to 34-fold increased odds of meeting criteria for DSM-IV or ICD-10 social phobia, four-fold increased odds of meeting crite…
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Ross CA, Goldner EM (2009)MEDLINE-indexed journal, not yet read by usJournal of psychiatric and mental health nursing208 citations Stigma, negative attitudes and discrimination towards mental illness within the nursing profession: a review of the literature.
The aim of this paper was to review the existing literature pertaining to stigma, negative attitudes and discrimination towards mental illness, specifically as viewed through the lens of the nursing profession. The results of the literature review were synthesized and analysed, and the major themes drawn from this were found to correspond with Schulze's model identifying three positions that healthcare workers may assume in relation to stigma of mental illness: 'stigmatizers', 'stigmatized' and 'de-stigmatizers'. In this paper, the nursing profession is examined from the perspectives of the first two major themes: the 'stigmatizers' and 'stigmatized'. Their primary sub-themes are identified and discussed: (1) Nurses as 'the stigmatizers': (a) nurses' attitudes in general medical settings towards patients with psychiatric illness and (b) psychiatric nurses; (2) Nurses as 'the stigmatized'…
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Beiser M (2009)MEDLINE-indexed journal, not yet read by usTranscultural psychiatry59 citations Resettling refugees and safeguarding their mental health: lessons learned from the Canadian Refugee Resettlement Project.
The Ryerson University Refugee Resettlement Project (RRP), a decade-long study of 1348 Southeast Asian refugees who came to Canada between 1979 and 1981, is one of the largest, most comprehensive and longest-lived investigations of refugee resettlement ever carried out. Knowledge gleaned from the RRP about research methodology, about the resettlement experience, about the social costs of resettling refugees, about factors that promote or hinder integration, about risk and protective factors for refugee mental health, and about the refugees' consumption of mental health and social services is summarized in the form of 18 "Lessons." The lessons are offered in order to encourage and stimulate further research, as well to suggest policy and practice innovations that could help make resettlement easier, less costly, more effective, and more humane.
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