The chronic load carried by minority status, including anti-Muslim prejudice.
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101 to 125 of 599Cook TM, Wang J (2010)cohort or longitudinalMEDLINE-indexed journal, not yet read by usBMC psychiatry62 citations Descriptive epidemiology of stigma against depression in a general population sample in Alberta.
Background: Mental health illnesses, such as depression, are responsible for a growing disease burden worldwide. Unfortunately, effective treatment is often impeded by stigmatizing attitudes of other individuals, which have been found to lead to a number of negative consequences including reduced help-seeking behavior and increased social distance. Despite the high prevalence of depression in Canada, little research has been conducted to examine stigma against depression in the Canadian general population. Such information is crucial to understanding the current state of stigmatizing attitudes in the Canadian communities, and framing future stigma reduction initiatives. The objectives of this study were to estimate the percentages of various stigmatizing attitudes toward depression in a general population sample and to compare the percentages by demographics and socioeconomic characteris…
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Maman S, Abler L, Parker L, Lane T, Chirowodza A, Ntogwisangu J, Srirak N, Modiba P, Murima O, Fritz K (2009)cohort or longitudinalMEDLINE-indexed journal, not yet read by usSocial science & medicine (1982)111 citations A comparison of HIV stigma and discrimination in five international sites: the influence of care and treatment resources in high prevalence settings.
What accounts for differences in HIV stigma across different high prevalence settings? This study was designed to examine HIV stigma and discrimination in five high prevalence settings. Qualitative data were collected as part of the U.S. National Institute of Mental Health (NIMH) Project Accept, a multi-site community randomized trial of community-based HIV voluntary counseling and testing. In-depth interviews were conducted with 655 participants in five sites, four in Sub-Saharan Africa and one in Southeast Asia. Interviews were conducted in the local languages by trained research staff. Data were audiotaped, transcribed, translated, coded and computerized for thematic data analysis. Participants described the stigmatizing attitudes and behaviors perpetuated against people living with HIV/AIDS (PLWHA). The factors that contribute to HIV stigma and discrimination include fear of transmis…
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Mental health literacy and attitude towards people with mental illness: a trend analysis based on population surveys in the eastern part of Germany.
Background: There is growing evidence that mental health literacy has improved in western countries in recent years. The question arises as to whether this trend is paralleled by an improvement of attitudes towards people with mental illness.
Aim: To examine the development of mental health literacy and the desire for social distance towards people with schizophrenia and major depressive disorder in Eastern Germany over a time period of eight years.
Method: A trend analysis was carried out using data from two population surveys conducted in the eastern part of Germany in 1993 and 2001. By means of a fully structured interview psychiatric labelling, causal beliefs, help-seeking and treatment recommendations as well as the desire for social distance was assessed.
Results: While there was an increase in the mental health literacy of the public, the desire for social distance from people wit…
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Alonso J, Buron A, Rojas-Farreras S, de Graaf R, Haro JM, de Girolamo G, Bruffaerts R, Kovess V, Matschinger H, Vilagut G, ESEMeD/MHEDEA 2000 Investigators (2009)cohort or longitudinalMEDLINE-indexed journal, not yet read by usJournal of affective disorders108 citations Perceived stigma among individuals with common mental disorders.
Background: Severe mental disorders are associated with social distance from the general population, but there is lack of data on the stigma reported by individuals with common mental disorders.
Aims: To identify the correlates and the impact of stigma among individuals with common mental disorders.
Methods: Cross-sectional, household interview survey of 8796 representing the non-institutionalized adults of Belgium, France, Germany, Italy, the Netherlands and Spain. Two perceived stigma questions (embarrassment and discrimination) were asked to respondents with significant disability. Health-related quality of life measured by the SF-12, work and activity limitation and social limitation were also assessed.
Results: Among the 815 participants with a 12-month mental disorder and significant disability, 14.8% had perceived stigma. Stigma was significantly associated with low education, bei…
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Cuddy AJ, Fiske ST, Kwan VS, Glick P, Demoulin S, Leyens JP, Bond MH, Croizet JC, Ellemers N, Sleebos E, Htun TT, Kim HJ, Maio G, Perry J, Petkova K, Todorov V, Rodríguez-Bailón R, Morales E, Moya M, Palacios M, Smith V, Perez R, Vala J, Ziegler R (2009)cohort or longitudinalMEDLINE-indexed journal, not yet read by usThe British journal of social psychology230 citations Stereotype content model across cultures: towards universal similarities and some differences.
The stereotype content model (SCM) proposes potentially universal principles of societal stereotypes and their relation to social structure. Here, the SCM reveals theoretically grounded, cross-cultural, cross-groups similarities and one difference across 10 non-US nations. Seven European (individualist) and three East Asian (collectivist) nations (N=1,028) support three hypothesized cross-cultural similarities: (a) perceived warmth and competence reliably differentiate societal group stereotypes; (b) many out-groups receive ambivalent stereotypes (high on one dimension; low on the other); and (c) high status groups stereotypically are competent, whereas competitive groups stereotypically lack warmth. Data uncover one consequential cross-cultural difference: (d) the more collectivist cultures do not locate reference groups (in-groups and societal prototype groups) in the most positive clu…
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Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey.
Background: Many people with schizophrenia experience stigma caused by other people's knowledge, attitudes, and behaviour; this can lead to impoverishment, social marginalisation, and low quality of life. We aimed to describe the nature, direction, and severity of anticipated and experienced discrimination reported by people with schizophrenia.
Methods: We did a cross-sectional survey in 27 countries, in centres affiliated to the INDIGO Research Network, by use of face-to-face interviews with 732 participants with schizophrenia. Discrimination was measured with the newly validated discrimination and stigma scale (DISC), which produces three subscores: positive experienced discrimination; negative experienced discrimination; and anticipated discrimination.
Findings: Negative discrimination was experienced by 344 (47%) of 729 participants in making or keeping friends, by 315 (43%) of 728 f…
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Implicit and explicit stigma of mental illness: links to clinical care.
This study examined implicit and explicit measures of bias toward mental illness among people with different levels of mental health training, and investigated the influence of stigma on clinically-relevant decision-making. Participants (N = 1539) comprised of (1) mental health professionals and clinical graduate students, (2) other health care/social services specialists, (3) undergraduate students, and (4) the general public self-reported their attitudes toward people with mental illness, and completed implicit measures to assess mental illness evaluations that exist outside of awareness or control. In addition, participants predicted patient prognoses and assigned diagnoses after clinical vignettes. Compared with people without mental health training, individuals with mental health training demonstrated more positive implicit and explicit evaluations of people with mental illness. Fur…
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How does being female assist help-seeking for mental health problems?
Objective: In Australia the prevalence of mental health problems does not vary by gender, but help-seeking and service utilization do. The aim of the present study was to examine a number of attitudinal factors that may influence help-seeking for mental health problems.
Method: A cross-sectional community survey was conducted with a sample of 579 rural residents (57.9% female), who completed self-report measures assessing stoicism, alexithymia, perceived and personal stigma and the various facets of the personality trait of openness to experience.
Results: Men scored higher on measures of stoicism and personal stigma associated with mental health problems than women, and compared to women had lower scores on the facets of openness to experience.
Conclusions: Higher rates of help-seeking for mental health problems by women may be due to lower levels of stoicism and personal stigma related…
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Associations of multiple domains of self-esteem with four dimensions of stigma in schizophrenia.
Research suggests global self-esteem among persons with schizophrenia may be negatively affected by stigma or stereotyped beliefs about persons with severe mental illness. Less clear however, is whether particular dimensions of self-esteem are linked to particular domains of stigma. To examine this we surveyed a range of self-esteem dimensions including lovability, personal power, competence and moral self-approval and four domains of stigma: Stereotype endorsement, Discrimination experience, Social withdrawal and Stigma rejection. Participants were 133 adults with diagnoses of schizophrenia or schizoaffective disorder. Stepwise multiple regressions controlling for a possible defensive response bias suggested that aspects of self-esteem related to lovability by others were more closely linked with lesser feelings of being alienated from others due to mental illness. Aspects of self-estee…
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Stigmatization of anorexia nervosa.
Objective: The current study examined the perceptions about an individual with anorexia nervosa (AN) relative to perceptions about a healthy person and a person with another mental or nonmental illness.
Method: Ninety-one participants recruited from the community completed questionnaires targeting perceptions about 4 individuals: a healthy person, a person with asthma, a person with schizophrenia, and a person with AN.
Results: Evaluations of personal characteristics were most negative for persons with AN. Participants believed the person with AN was most to blame for his/her condition, was best able to pull him/herself together if he/she wanted to, and was most acting this way for attention and that biological factors were least relevant in developing the illness.
Conclusion: Negative perceptions of a person with AN fell into stigma categories of self-attribution and responsibility. The…
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Racial discrimination and socioemotional and sleep problems in a cross-sectional survey of Australian school students.
Objective: To determine the prevalence of direct and vicarious racial discrimination experiences from peer, school and societal sources, and examine associations between these experiences and socioemotional and sleep outcomes.
Methods: Data were analysed from a population representative cross-sectional study of n=4664 school students in years 5-9 (10-15 years of age) in Australia. Students reported direct experiences of racial discrimination from peers, school and societal sources; vicarious discrimination was measured according to the frequency of witnessing other students experiences of racial discrimination. Students self-reported on the Strengths and Difficulties Questionnaire, with the total difficulties, conduct, emotional and prosocial behaviour subscales examined. Sleep problems included duration, latency, and disruption.
Results: 41.56% (95% CI 36.18 to 47.15) of students report…
matched on Racism (mesh), Minority Groups (mesh), racial discrimination (text)
Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom.
Objectives: To examine the longitudinal association between cumulative exposure to racial discrimination and changes in the mental health of ethnic minority people.
Methods: We used data from 4 waves (2009-2013) of the UK Household Longitudinal Study, a longitudinal household panel survey of approximately 40 000 households, including an ethnic minority boost sample of approximately 4000 households.
Results: Ethnic minority people who reported exposure to racial discrimination at 1 time point had 12-Item Short Form Health Survey (SF-12) mental component scores 1.93 (95% confidence interval [CI] = -3.31, -0.56) points lower than did those who reported no exposure to racial discrimination, whereas those who had been exposed to 2 or more domains of racial discrimination, at 2 different time points, had SF-12 mental component scores 8.26 (95% CI = -13.33, -3.18) points lower than did those wh…
matched on Racism (mesh), Minority Groups (mesh), racial discrimination (text)
Beliefs in an Unjust World: Mediating Ethnicity-Related Stressors and Psychological Functioning.
Objective: Racism is negatively associated with health. Explorations of cognitive reactions, such as beliefs in an unjust world (BUW), are needed to understand the associations between both perceived discrimination and own-group conformity pressures (OGCPS) and reduced psychological well-being.
Method: With a sample of 215 ethnic minority individuals, this study used structural equation modeling to explore BUW's mediating role between the two aforementioned forms of ethnicity-related stressors (ERS), anger rumination, and negative affect.
Results: ERS were directly positively associated with BUW, anger rumination, and negative affect. BUW were directly and positively associated with both anger rumination and negative affect. Finally, BUW significantly mediated the direct relationships between both ethnicity-related stressors and anger rumination and negative affect.
Conclusion: Although …
matched on Racism (mesh), Minority Groups (mesh), perceived discrimination (text)
Relationship between hair cortisol and perceived chronic stress in a diverse sample.
Hair cortisol (CORT) is a biomarker of chronic stress via long-term alterations in hypothalamus-pituitary-adrenal axis activity. Relationships to perceived stress measures, however, have rarely been specifically investigated. A diverse sample of 135 adults participated in a study assessing relationships between chronic stress indicator CORT to perceived stress and health indicators. CORT was not correlated to single perceived domain indices but with a global stress composite. Differences in objective and subjective measures were found for sociodemographics: racial/ethnic identity, sex and socioeconomic status (SES). Race by SES interactions predicted both CORT and perceived stress, but produced a complex and partially unanticipated pattern of results. For minorities, low and high SES showed the highest CORT, with mid-SES showing the lowest CORT; there was little change in perceived stres…
matched on Racism (mesh), Minority Groups (mesh), perceived discrimination (text)
Beyond the axes of inequality: Religion, race, and everything in between.
This study examined the mental health outcomes of a diverse group of 549 individuals experiencing discrimination based on their multiple subordinate identities: ethnicity/race, religion, nativity, and sexual orientation. Applying an intersectionality framework, the findings provide an understanding of the impact of discrimination and racism on minority groups' mental health within the heterosexual and Lesbian, Gay, bisexual, Transgender, and Queer (LGBTQ) context. Significant differences were found on levels of discrimination and racism across ethnic, racial, sexual, and gender minority groups, particularly among Muslim/Jewish, Arab/African, male, and foreign-born participants. Results suggest that subordinate identities and statuses shape the racism and discrimination experiences of the participants. The paper concludes with a discussion of practice and policy implications. (PsycInfo Da…
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The relationship between experiences of discrimination and mental health among lesbians and gay men: An examination of internalized homonegativity and rejection sensitivity as potential mechanisms.
Objective: The current study used path analysis to examine potential mechanisms through which experiences of discrimination influence depressive and social anxiety symptoms.
Method: The sample included 218 lesbians and 249 gay men (total N = 467) who participated in an online survey about minority stress and mental health. The proposed model included 2 potential mediators-internalized homonegativity and rejection sensitivity-as well as a culturally relevant antecedent to experiences of discrimination-childhood gender nonconformity.
Results: Results indicated that the data fit the model well, supporting the mediating roles of internalized homonegativity and rejection sensitivity in the associations between experiences of discrimination and symptoms of depression and social anxiety. Results also supported the role of childhood gender nonconformity as an antecedent to experiences of discrim…
matched on Minority Groups (mesh), Prejudice (mesh), minority stress (text), Homosexuality, Female (mesh)
Disparities in Pediatric Mental and Behavioral Health Conditions.
Mental and behavioral health conditions are common among children and adolescents in the United States. The purpose of this state-of the-art review article is to describe inequities in mental and behavioral health care access and outcomes for children and adolescents, characterize mechanisms behind the inequities, and discuss strategies to decrease them. Understanding the mechanisms underlying these inequities is essential to inform strategies to mitigate these health disparities. Half of United States children with a treatable mental health disorder do not receive treatment from a mental health professional. Children and adolescents in racial, ethnic, sexual, sex, and other minority groups experience inequities in access to care and disparities in outcomes for mental and behavioral health conditions. Suicide rates are nearly twice as high in Black compared to White boys 5 to 11 years ol…
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Hankerson SH, Moise N, Wilson D, Waller BY, Arnold KT, Duarte C, Lugo-Candelas C, Weissman MM, Wainberg M, Yehuda R, Shim R (2022)reviewMEDLINE-indexed journal, not yet read by usThe American journal of psychiatry63 citations The Intergenerational Impact of Structural Racism and Cumulative Trauma on Depression.
Depression among individuals who have been racially and ethnically minoritized in the United States can be vastly different from that of non-Hispanic White Americans. For example, African American adults who have depression rate their symptoms as more severe, have a longer course of illness, and experience more depression-associated disability. The purpose of this review was to conceptualize how structural racism and cumulative trauma can be fundamental drivers of the intergenerational transmission of depression. The authors propose that understanding risk factors for depression, particularly its intergenerational reach, requires accounting for structural racism. In light of the profoundly different experiences of African Americans who experience depression (i.e., a more persistent course of illness and greater disability), it is critical to examine whether an emerging explanation for so…
matched on Racism (mesh)
A critical review of current evidence on multiple types of discrimination and mental health.
Little is known about people who experience multiple types of discrimination (e.g., racism and heterosexism). While some work suggests that multiply discriminated groups are at higher risk for poor mental health, other studies propose that they may develop resilience against additional kinds of discrimination. We conducted a review of published studies on the relationship between multiple types of discrimination and mental health to critically examine evidence in support of broad risk and resilience models. Using PRISMA guidelines, we identified 40 studies that met our inclusion criteria. Typically, studies examined either whether experiencing multiple discrimination was related to poorer mental health, or whether one kind of discrimination was more predictive of poor mental health. Studies generally showed support for the risk model, with multiple forms of discrimination associated with…
matched on Racism (mesh)
The Impact of Racism on Child and Adolescent Health.
The American Academy of Pediatrics is committed to addressing the factors that affect child and adolescent health with a focus on issues that may leave some children more vulnerable than others. Racism is a social determinant of health that has a profound impact on the health status of children, adolescents, emerging adults, and their families. Although progress has been made toward racial equality and equity, the evidence to support the continued negative impact of racism on health and well-being through implicit and explicit biases, institutional structures, and interpersonal relationships is clear. The objective of this policy statement is to provide an evidence-based document focused on the role of racism in child and adolescent development and health outcomes. By acknowledging the role of racism in child and adolescent health, pediatricians and other pediatric health professionals w…
matched on Racism (mesh)
Racism and Health: Evidence and Needed Research.
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and the empirical evidence that indicates that socioeconomic factors alone do not account for racial/ethnic inequities in health. Racism is considered a fundamental cause of adverse health outcomes for racial/ethnic minorities and racial/ethnic inequities in health. This article provides an overview of the evidence linking the primary domains of racism-structural racism, cultural racism, and individual-level discrimination-to mental and physical health outcomes. For each mechanism, we describe key findings and identify priorities for future research. We also discuss evidence for interventions to reduce racism and describe research needed to…
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Tomfohr LM, Pung MA, Dimsdale JE (2016)reviewMEDLINE-indexed journal, not yet read by usHealth psychology : official journal of the Division of Health Psychology, American Psychological Association65 citations Mediators of the relationship between race and allostatic load in African and White Americans.
Objective: Allostatic load (AL) is a cumulative index of physiological dysregulation, which has been shown to predict cardiovascular events and all-cause mortality. On average, African Americans (AA) have higher AL than their White American (WA) counterparts. This study investigated whether differences in discrimination, negative affect-related variables (e.g., experience and expression of anger, depression), and health practices (e.g., exercise, alcohol use, smoking, subjective sleep quality) mediate racial differences in AL.
Method: Participants included healthy, AA (n = 76) and WA (n = 100), middle-aged (Mage = 35.2 years) men (n = 98) and women (n = 78). Questionnaires assessed demographics, psychosocial variables, and health practices. Biological data were collected as part of an overnight hospital stay-AL score was composed of 11 biomarkers. The covariates age, gender, and socioeco…
matched on Racism (mesh)
Racial/ethnic disparities in the assessment and treatment of pain: psychosocial perspectives.
Racial/ethnic disparities not only are prevalent throughout the U.S. health care system but also have proved refractory to change. Such disparities are evident and similarly persistent in the treatment of patients with chronic pain conditions, exacting high personal and societal costs. While psychosocial factors contribute significantly to this intractable problem, an integrated examination of the literature is lacking. This article provides an overview of psychosocial factors that contribute to disparities in the treatment of chronic pain patients and in their adjustment to pain. It focuses initially on aspects of pain assessment that can occasion disparate care. Because pain is a subjective phenomenon that often defies objective medical assessment, it is particularly susceptible to social psychological influences, such as stereotypes. We pay particular attention to negative racial/ethn…
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Testing a mediation framework for the link between perceived discrimination and psychological distress among sexual minority individuals.
Perceived discrimination is a risk factor for mental health problems among sexual minority individuals. An increasing number of research studies have investigated the mechanisms through which stigma-related stressors such as perceived discrimination are linked with adverse mental health outcomes for sexual minority populations. The integrative mediation framework proposed by Hatzenbuehler (2009) underscores the importance of identifying mediators in the association between stigma-related stressors and mental health outcomes. This study tested 3 mediators--expectations of rejection, anger rumination, and self-compassion--in the perceived discrimination-distress link. Moreover, it examined associations among these mediators. A nationwide sample of 265 sexual minorities responded to an online survey. Structural equation modeling results supported the mediator roles of expectations of reject…
matched on Minority Groups (mesh), Prejudice (mesh), perceived discrimination (text), Bisexuality (mesh)
Discrimination and mental health among lesbian, gay, and bisexual adults in the United States.
Health disparities among sexual minority groups, particularly mental health disparities, are well-documented. Numerous studies have demonstrated heightened prevalence of depressive and anxiety disorders among lesbian, gay, and bisexual groups as compared with heterosexuals. Some authors posit that these disparities are the result of the stress that prejudice and perceived discrimination can cause. The current study extends previous research by examining the associations between multiple types of discrimination, based on race or ethnicity, gender, and sexual orientation, and past-year mental health disorders in a national sample of self-identified lesbian, gay, and bisexual women and men (n = 577). Findings suggest that different types of discrimination may be differentially associated with past-year mental health disorders. Notably, sexual orientation discrimination was associated with h…
matched on Racism (mesh), perceived discrimination (text), Bisexuality (mesh), Homosexuality, Female (mesh)