The chronic load carried by minority status, including anti-Muslim prejudice.
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576 to 599 of 599Connectedness and citizenship: redefining social integration.
Objective: Despite decades of deinstitutionalization, individuals with psychiatric disabilities living outside the hospital may be described as in the community, but not of it. To effectively address the persisting problem of social exclusion of persons with psychiatric disabilities, new conceptual tools are needed. To address this need, a new definition of social integration is offered.
Methods: The definition is based on data from a qualitative study. Data collection consisted of individual, unstructured interviews with 56 adults who have been psychiatrically disabled (N=78 interviews) as well as ethnographic visits to five service sites working to promote social integration for their users (N=8 visits). An interpretive approach was used to analyze the data.
Results: Social integration is defined as a process, unfolding over time, through which individuals who have been psychiatrically…
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How clinical diagnosis might exacerbate the stigma of mental illness.
Stigma can greatly exacerbate the experience of mental illness. Diagnostic classification frequently used by clinical social workers may intensify this stigma by enhancing the public's sense of "groupness" and "differentness" when perceiving people with mental illness. The homogeneity assumed by stereotypes may lead mental health professionals and the public to view individuals in terms of their diagnostic labels. The stability of stereotypes may exacerbate notions that people with mental illness do not recover. Several strategies may diminish the unintended effects of diagnosis. Dimensional approaches to diagnosis may not augment stigma in the same manner as classification. Moreover, regular interaction with people with mental illness and focusing on recovery may diminish the stigmatizing effects of diagnosis.
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Women's mental health in the Muslim world: cultural, religious, and social issues.
In Arab communities, several cultural factors, derived mainly from the subordinate position of women, have been shown to affect the prevalence, clinical picture, health seeking behaviour, course and management of psychopathology in women. Women are definitely at a greater risk of developing mental disorders such as depressive, somatoform, anxious or eating disorders, as well as suicidal behaviors. Furthermore, mentally ill women are more stigmatized, have less access to care and suffer from a worse social outcome. This paper describes a series of culture-related risk factors such as education, work, sexuality, marriage, and infertility, which significantly contribute to triggering mental disorders in females, or to worsen their course and outcome. The authors recommend that mental health providers should play a critical role by addressing the cultural as well as psychological conditions …
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Signaling threat: how situational cues affect women in math, science, and engineering settings.
This study examined the cues hypothesis, which holds that situational cues, such as a setting's features and organization, can make potential targets vulnerable to social identity threat. Objective and subjective measures of identity threat were collected from male and female math, science, and engineering (MSE) majors who watched an MSE conference video depicting either an unbalanced ratio of men to women or a balanced ratio. Women who viewed the unbalanced video exhibited more cognitive and physiological vigilance, and reported a lower sense of belonging and less desire to participate in the conference, than did women who viewed the gender-balanced video. Men were unaffected by this situational cue. The implications for understanding vulnerability to social identity threat, particularly among women in MSE settings, are discussed.
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Drug abuse, HIV/AIDS and stigmatisation in a Dai community in Yunnan, China.
The latest data indicate that between 540,000 and 760,000 people are infected with HIV in China. Although minority nationalities represent 8.1% of China's total population, they account for more than 30% of the reported HIV/AIDS cases. This study examined stigma and discrimination against drug abusers and people living with HIV/AIDS (PLHA) in a Dai minority nationality community in Yunnan, China. The study used qualitative research methods, which included participatory observations, in-depth interviews, focus-group discussions, transect walking and community mapping. A combination of different sampling strategies was used to maximise diversity of the initially selected sample. The data revealed deeply entrenched stigma and overt discrimination against drug abusers and PLHA that manifested in familial, work, civil and institutional contexts. The stigma reflected pre-existing cultural, rel…
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Comprehending envy.
The authors reviewed the psychological research on envy. The authors examined definitional challenges associated with studying envy, such as the important distinction between envy proper (which contains hostile feelings) and benign envy (which is free of hostile feelings). The authors concluded that envy is reasonably defined as an unpleasant, often painful emotion characterized by feelings of inferiority, hostility, and resentment caused by an awareness of a desired attribute enjoyed by another person or group of persons. The authors examined questions such as why people envy, why envy contains hostile feelings, and why it has a tendency to transmute itself. Finally, the authors considered the role of envy in helping understand other research domains and discussed ways in which people cope with the emotion.
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Culture and stigma: adding moral experience to stigma theory.
Definitions and theoretical models of the stigma construct have gradually progressed from an individualistic focus towards an emphasis on stigma's social aspects. Building on other theorists' notions of stigma as a social, interpretive, or cultural process, this paper introduces the notion of stigma as an essentially moral issue in which stigmatized conditions threaten what is at stake for sufferers. The concept of moral experience, or what is most at stake for actors in a local social world, provides a new interpretive lens by which to understand the behaviors of both the stigmatized and stigmatizers, for it allows an examination of both as living with regard to what really matters and what is threatened. We hypothesize that stigma exerts its core effects by threatening the loss or diminution of what is most at stake, or by actually diminishing or destroying that lived value. We utilize…
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Applying acceptance, mindfulness, and values to the reduction of prejudice: a pilot study.
Two classroom approaches to reducing racial and ethnic prejudice among college students were compared: a class session based on acceptance and commitment therapy (ACT) and an educational lecture drawn from a textbook on the psychology of racial differences. Undergraduates who were enrolled in two separate classes on racial differences were exposed to each approach in a counterbalanced order. Results indicate that only the ACT intervention was effective in increasing positive behavioral intentions at post and a 1-week follow-up. These changes were associated with other self-reported changes that fit with the ACT model. Implications of a potentially new model of prejudice are briefly discussed.
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Stigma, discrimination and the health of illicit drug users.
Persons who use illicit drugs are stigmatized in the United States. The conferral of a deviant social status on illicit drug users may serve to discourage use. However, stigmatization may also adversely affect the health of those who use illicit drugs, through exposure to chronic stress such as discrimination and as a barrier to accessing care. We hypothesized that aspects of stigma and discrimination would be associated with mental and physical health among illicit drug users. Using street outreach techniques, 1008 illicit drug users were interviewed about stigma and discrimination related to their drug use, and their health. We measured discrimination related to drug use, alienation, perceived devaluation, and responses to discrimination and stigma. Health measures included mental and physical health measures from the Medical Outcomes Study Short Form-36, depression symptoms from the C…
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Primary care professionals' perceptions of depression in older people: a qualitative study.
An understanding of patients' perspectives is crucial to improving engagement with health care services. For older people who may not wish to bother medical professionals with problems of living such as depression, such exploration becomes critical. General practitioners (GPs), nurses and counsellors working in 18 South London primary care teams were interviewed about their perceptions of depression in older people. All three professional groups shared a predominantly psychosocial model of the causes of depression. While presentation of somatic symptoms was seen as common in all age groups, identification of depression in older patients was complicated by co-existent physical illnesses. GPs reported that older patients rarely mentioned psychological difficulties, but practice nurses felt that older people were less inhibited in talking to them about "non-medical" problems. Many older peo…
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Stigma as ego depletion: how being the target of prejudice affects self-control.
This research examined whether stigma diminishes people's ability to control their behaviors. Because coping with stigma requires self-regulation, and self-regulation is a limited-capacity resource, we predicted that individuals belonging to stigmatized groups are less able to regulate their own behavior when they become conscious of their stigmatizing status or enter threatening environments. Study 1 uncovered a correlation between stigma sensitivity and self-regulation; the more Black college students were sensitive to prejudice, the less self-control they reported having. By experimentally activating stigma, Studies 2 and 3 provided causal evidence for stigma's ego-depleting qualities: When their stigma was activated, stigmatized participants (Black students and females) showed impaired self-control in two very different domains (attentional and physical self-regulation). These result…
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Levin T (2006)MEDLINE-indexed journal, not yet read by usThe International journal of social psychiatry18 citations Schizophrenia should be renamed to help educate patients and the public.
Background: A new name for schizophrenia, reflecting a biopsychosocial conceptualization, may have utility in educating patients and the public. If readily translatable, it would be of great value in transcultural psychiatry. It may be clinically beneficial to psychoeducation in evidence-based treatment modalities such as medication management, multifamily group psycho-education and cognitive therapy.
Discussion: Neuro-Emotional Integration Disorder (NEID) is proposed as the biopsychosocial candidate term to replace schizophrenia. The following subtypes are proposed: defensive type replacing paranoid, motoric type replacing catatonic, Brief Neuro-Emotional-Integration Breakdown (B-NEIB) replacing brief psychotic episode, NEID-Time Limited replacing schizophreniform disorder. Schizoaffective disorder might be termed NEID-Bipolar type. Anti-psychotic medication would be termed NEI-Enhancin…
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Attempted suicide among transgender persons: The influence of gender-based discrimination and victimization.
To determine the independent predictors of attempted suicide among transgender persons we interviewed 392 male-to-female (MTF) and 123 female-to-male (FTM) individuals. Participants were recruited through targeted sampling, respondent-driven sampling, and agency referrals in San Francisco. The prevalence of attempted suicide was 32% (95% CI = 28% to 36%). In multivariate logistic regression analysis younger age (<25 years), depression, a history of substance abuse treatment, a history of forced sex, gender-based discrimination, and gender-based victimization were independently associated with attempted suicide. Suicide prevention interventions for transgender persons are urgently needed, particularly for young people. Medical, mental health, and social service providers should address depression, substance abuse, and forced sex in an attempt to reduce suicidal behaviors among transgender…
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Dehumanizing the lowest of the low: neuroimaging responses to extreme out-groups.
Traditionally, prejudice has been conceptualized as simple animosity. The stereotype content model (SCM) shows that some prejudice is worse. The SCM previously demonstrated separate stereotype dimensions of warmth (low-high) and competence (low-high), identifying four distinct out-group clusters. The SCM predicts that only extreme out-groups, groups that are both stereotypically hostile and stereotypically incompetent (low warmth, low competence), such as addicts and the homeless, will be dehumanized. Prior studies show that the medial prefrontal cortex (mPFC) is necessary for social cognition. Functional magnetic resonance imaging provided data for examining brain activations in 10 participants viewing 48 photographs of social groups and 12 participants viewing objects; each picture dependably represented one SCM quadrant. Analyses revealed mPFC activation to all social groups except ex…
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Zhou YR (2006)MEDLINE-indexed journal, not yet read by usCulture, health & sexuality40 citations Homosexuality, seropositivity, and family obligations: perspectives of HIV-infected men who have sex with men in China.
The HIV epidemic has had major impact on men who have sex with men in China. Most current studies view male-to-male sex as a behavioural dimension or variable affecting HIV infection, paying little attention to the socio-cultural meanings of homosexuality and their impacts on men's experiences with HIV/AIDS. This oversight has impeded understanding of the health practices of this population. Based on a qualitative study of experiences of Chinese people living with HIV/AIDS, this paper explores the complex processes in which men who have sex with men struggle and negotiate with their sexuality, family obligations, and this disease. To facilitate Chinese men who have sex with men in responding effectively to HIV and AIDS, researchers and practitioners should take into account a wide range of contextual factors including desired gender roles, family obligations, homophobia, and HIV-related …
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Racism-related stress, Africultural coping, and religious problem-solving among African Americans.
This study explored the extent to which three types of racism-related stress (i.e., individual, institutional, and cultural) would predict the use of specific Africultural coping strategies (i.e., cognitive/emotional debriefing, spiritual-centered, collective, and ritual-centered coping) and religious problem-solving styles (i.e., self-directing, deferring, and collaborative) in a sample of 284 African American men and women. The authors found that higher institutional racism-related stress was associated with greater use of cognitive/emotional debriefing, spiritual-centered, and collective coping in African American women. Findings also indicated that higher cultural racism-related stress was predictive of lower use of self-directing religious problem-solving in African American women. Moreover, higher perceived cultural racism-related stress was related to greater use of collective cop…
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Chandra A, Minkovitz CS (2006)MEDLINE-indexed journal, not yet read by usThe Journal of adolescent health : official publication of the Society for Adolescent Medicine184 citations Stigma starts early: gender differences in teen willingness to use mental health services.
Purpose: To explore gender differences and the role of stigma in teen willingness to use mental health services.
Methods: Self-administered, written questionnaires were conducted with 274 eighth graders in a suburban community in a mid-Atlantic state. Teens reported on social support for emotional concerns, mental health experience and knowledge, and stigma and barriers associated with mental health service use. Data analysis included chi-square statistics and analysis of variance (ANOVA) to examine associations between gender and independent variables of interest. Logistic regression analyses assessed the relationship of gender, stigma, and willingness to use mental health services, adjusting for race and receipt of mental health services.
Results: More girls than boys turned to a friend for help for an emotional concern, whereas more boys turned to a family member first. Boys had less …
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Exploring the associations between intersectional discrimination, shame, coping and trauma among Muslim women in Canada.
Muslim women living in Canada commonly experience intersecting gender, race, and religious discrimination. Discrimination experiences are shown to instill feelings of shame and have been found to be related to negative mental health outcomes. Thus, to develop more effective support systems for Muslim women, it is important to understand how intersectional experiences of discrimination relate to shame, coping strategies, and psychological well-being among this population. To this end, this study investigated the association between different forms of discriminations and racial trauma among Muslim women living in Canada. Next, it examined whether shame and coping styles mediate this association. A sample of 91 Muslim women living in Canada completed an online survey measuring their discrimination experiences, shame, racial trauma, and coping style. Findings revealed that greater ethnic and…
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Clinical Psychology Graduate Programs: Falling Short in Cultural Humility Training.
Despite requirements by the American Psychological Association and the Psychological Clinical Science Accreditation System regarding training and education in cultural humility, questions remain regarding the presence and quality of the training in clinical psychology PhD and PsyD programs. This is a critical issue as inadequate training in diversity, cultural humility, and multiculturalism has substantial downstream effects on care for clients of color and may contribute to racial disparities and inequities in access to mental health services. We seek to explicitly evaluate key features of the conceptual model thought to improve the provision of mental health services for clients facing oppression and marginalization which includes perceptions of clinical psychology graduate programs' training in and assessment of cultural humility. We also assess self-efficacy related to the applicatio…
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Racial Disparities in Adversity During Childhood and the False Appearance of Race-Related Differences in Brain Structure.
Objective: Black Americans in the United States are disproportionately exposed to childhood adversity compared with White Americans. Such disparities may contribute to race-related differences in brain structures involved in regulating the emotional response to stress, such as the amygdala, hippocampus, and prefrontal cortex (PFC). The authors investigated neuroanatomical consequences of racial disparities in adversity.
Methods: The sample included 7,350 White American and 1,786 Black American children (ages 9-10) from the Adolescent Brain Cognitive Development Study (public data release 2.0). Structural MRI data, parent and child self-reports of adversity-related measures, and U.S. Census neighborhood data were used to investigate the relationship between racial disparities in adversity exposure and race-related differences in brain structure.
Results: Black children experienced more tr…
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Making the "C-ACE" for a Culturally-Informed Adverse Childhood Experiences Framework to Understand the Pervasive Mental Health Impact of Racism on Black Youth.
The high prevalence and psychological impact of childhood exposure to potentially traumatic events (PTE) is a major public health concern in the United States. Considerable evidence has demonstrated the significant racial disparities that exist with respect to PTE exposure, indicating that Black youth are particularly burdened by these harmful experiences. Racism may serve a unique role in explaining why Black youth are disproportionately exposed to PTEs, and why mental health disparities are more likely to occur following such experiences. Despite clear evidence acknowledging racism as a major life stressor for Black youth, theoretical models of early childhood adversity have largely neglected the multifaceted influence of racism on mental health outcomes. Inspired by bourgeoning literature highlighting the potentially traumatic nature of racism-related experiences for Black youth, we p…
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The Price of the Ticket: Health Costs of Upward Mobility among African Americans.
There is a growing literature that has documented diminishing health returns on upward social mobility among Black Americans. Due to historical policies and practices, upward social mobility is often an arduous, isolating process for Black Americans, especially as they navigate predominately white educational and workplace settings. This paper advances the literature in several meaningful and innovative ways. The goal of this paper is to provide a qualitative account of the health costs of upward social mobility and describe how these costs could diminish health returns despite greater levels of socioeconomic resources. Focus groups and surveys were the data collection methods for the study. Inclusion criteria for the study were that respondents identified as African American or Black, were 24 years or older and had completed college. The total sample was 32 college-educated Black men (n…
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The Witness to Witness Program: Helping the Helpers in the Context of the COVID-19 Pandemic.
The Witness to Witness Program (W2W), based on Weingarten's witnessing model (2000, 2003, 2004), began in July 2018 and originally was established to support healthcare workers and attorneys (our partners) who were experiencing empathic distress working with people involved in various stages of the detention process. The W2W program evolved to offer four primary components: clinician listening sessions geared to deep understanding of the person's story of their work and its challenges; an inventory of the person's current internal and external resources both in the present and in the past; help with removal of barriers to those resources; and development of a personal toolkit to handle stress. Additional services available to partners and their organizations included psycho-educational webinars, facilitated peer support groups, and organizational consultations to foster trauma-sensitive …
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Aboriginal women's experiences of accessing health care when state apprehension of children is being threatened.
Aims: To report findings from a study examining the impact of the threat of child removal on Aboriginal women's experiences accessing of healthcare services.
Background: A wealth of data highlights the higher proportion of Aboriginal children in government care in Canada compared with non-Aboriginal children. Aboriginal women experience poorer health outcomes than non-Aboriginal women and face significant barriers to healthcare access. However, little is known about how these phenomena may intersect.
Design: The study was conducted in two phases: (1) a secondary analysis of interviews with Aboriginal women and healthcare providers (n = 7) that were collected for a larger study; and (2) primary interviews with Aboriginal women (n = 9) and healthcare providers (n = 8), conducted between July-October 2011.
Methods: Postcolonial feminist perspectives and the principles of exploratory, qualit…
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