scholarly journals Validation of the Health-Related Felt Stigma and Concealment Questionnaire

2020 ◽  
Vol 45 (5) ◽  
pp. 509-520
Author(s):  
Kelsey T Laird ◽  
Craig A Smith ◽  
Steven D Hollon ◽  
Lynn S Walker

Abstract Objective Stigma is associated with many health conditions, including chronic pain. Research on health-related stigma is limited by the lack of validated instruments that distinguish among various stigma-related constructs. We aimed to develop and validate such a measure for pediatric functional abdominal pain (FAP). Felt stigma (FS) was defined as comprising both perceived and internalized stigma. Stigma concealment (SC) was defined as efforts by stigmatized individuals to prevent others from learning of their condition. Methods Using a theory-driven approach, we adapted items from existing self-report measures of stigma to construct the health-related FS and Concealment Questionnaire (FSC-Q). Patients with FAP (N = 179, ages 11–17) completed the preliminary FSC-Q and health-related measures hypothesized to be associated with stigma. Cognitive interviewing and exploratory factor analysis (EFA) informed the final version of the measure. Results EFA identified a 2-factor model comprised of FS and SC. The FS and SC scales exhibited good internal consistency and construct validity. Consistent with study hypotheses, both factors were significantly associated with anxiety, depression, pain catastrophizing, pain threat, physical symptoms, and pain interference/disability. Higher FS was associated with higher mental healthcare utilization. The subset of participants meeting criteria for irritable bowel syndrome (IBS) reported higher FS and SC compared with those without IBS. Conclusion The FSC-Q may help advance research on health-related stigma in FAP and other chronic health conditions by allowing for assessment of distinct stigma-related constructs.

2021 ◽  
pp. 002076402110025
Author(s):  
Bárbara Almeida ◽  
Ana Samouco ◽  
Filipe Grilo ◽  
Sónia Pimenta ◽  
Ana Maria Moreira

Background: Physicians, including psychiatrists and general practitioners (GPs), have been reported as essential sources of stigma towards people diagnosed with a mental disorder (PDMDs), which constitutes an important barrier to recovery and is associated with poorer clinical outcomes. Therefore, psychiatrists and GPs are key populations where it is crucial to examine stigma, improve attitudes and reduce discrimination towards psychiatric patients. Aims: This study is the first to explore mental health-related stigma among Portuguese psychiatrists and GPs, examining the differences between these two specialities and assessing whether sociodemographic and professional variables are associated with stigma. Method: A cross-sectional study was performed between June 2018 and August 2019. A consecutive sample of 55 Psychiatrists and 67 GPs working in Porto (Portugal) filled a 25-item self-report questionnaire to assess their attitudes towards PDMDs in clinical practice. The instrument was designed by the authors, based on previous mental health-related stigma studies and validated scales. The questionnaire includes 12 stigma dimensions ( Autonomy, Coercion, Incompetence, Dangerousness, Permanence, Pity, Responsibility, Segregation, Labelling, Diagnostic Overshadowing, Shame and Parental Incompetence), and its total score was used to measure Overall Stigma (OS). Sample characteristics were examined using descriptive statistics, and the factors affecting stigma were assessed through regression analysis. Results: GPs exhibit significantly higher OS levels than psychiatrists, and present higher scores in the dimensions of dangerousness, parental incompetence, diagnostic overshadowing and responsibility. Besides medical speciality, several other sociodemographic variables were associated with sigma, including age, gender, having a friend with a mental disorder, professional category, agreement that Psychiatry diverges from core medicine and physician’s interest in mental health topics. Conclusions: Our data suggest that both psychiatrists and GPs hold some degree of stigmatizing attitudes towards PDMDs. Overall, these results bring new light to stigma research, and provide information to tailor anti-stigma interventions to Portuguese psychiatrists and GPs.


2020 ◽  
pp. 1-14
Author(s):  
Sarju Sing Rai ◽  
Elena V. Syurina ◽  
Ruth M.H. Peters ◽  
Irwanto Irwanto ◽  
Denise Naniche ◽  
...  

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Sarju Sing Rai ◽  
Ruth M. H. Peters ◽  
Elena V. Syurina ◽  
Irwanto Irwanto ◽  
Denise Naniche ◽  
...  

Abstract Background Health-related stigma is a complex phenomenon, the experience of which intersects with those of other adversities arising from a diversity of social inequalities and oppressive identities like gender, sexuality, and poverty – a concept called “intersectionality”. Understanding this intersectionality between health-related stigma and other forms of social marginalization can provide a fuller and more comprehensive picture of stigma associated with health conditions. The main objective of this paper is to build upon the concept of intersectionality in health-related stigma by exploring the convergence of experiences of stigma and other adversities across the intersections of health and other forms of social oppressions among people living with stigmatized health conditions in Indonesia. Methods This qualitative study interviewed 40 people affected by either of four stigmatizing health conditions (HIV, leprosy, schizophrenia, and diabetes) in Jakarta and West Java, Indonesia between March and June 2018. Data was analyzed thematically using an integrative inductive-deductive framework approach. Results The main intersectional inequalities identified by the participants were gender and socioeconomic status (n = 21), followed by religion (n = 13), age (n = 11), co-morbidity (n = 9), disability (n = 6), and sexuality (n = 4). Based on these inequalities/identities, the participants reported of experiencing oppression because of prevailing social norms, systems, and policies (macro-level), exclusion and discrimination from societal actors (meso-level), and self-shame and stigma (micro-level). While religion and age posed adversities that negatively affected participants in macro and meso levels, they helped mitigate the negative experiences of stigma in micro level by improving self-acceptance and self-confidence. Conclusion This study uncovered how the experience of health-related stigma intersects with other oppressions originating from the various social inequalities in an individual’s life. The findings highlight the importance of acknowledging and understanding the multi-dimensional aspect of lives of people living with stigmatized health conditions, and warrant integrated multi-level and cross-cutting stigma reduction interventions to address the intersectional oppressions they experience.


2019 ◽  
Vol 34 (6) ◽  
pp. 851-851
Author(s):  
V Merritt ◽  
S Jurick ◽  
L Crocker ◽  
S Hoffman ◽  
A Keller ◽  
...  

Abstract Objective The purpose of this study was to examine the influence of multiple mild traumatic brain injuries (mTBI) on objective neuropsychological functioning and subjective symptom reporting in a sample of combat-exposed Veterans. Method Participants included 80 combat-exposed Iraq/Afghanistan Veterans (91.3% male; age: M = 34.33, SD = 6.44) divided into three groups based on mTBI history: 0 mTBIs (n = 33), 1-2 mTBIs (n = 26), and 3+ mTBIs (n = 21). Veterans with mTBI were assessed, on average, 7.5 years following their most recent mTBI. Participants underwent comprehensive neuropsychological testing and completed self-report measures assessing psychiatric and neurobehavioral/health-related symptoms. Results ANCOVAs adjusting for level of combat exposure showed no group differences on the memory and attention/executive functioning composite scores (p’s>.05). Additionally, groups did not differ with respect to symptoms of posttraumatic stress and depression (p’s>.05). In contrast, there were significant group differences on all neurobehavioral/health-related symptoms, including post-concussive symptom clusters (p’s < .001-.005), sleep problems (p = .024), pain symptoms (p < .001), and pain catastrophizing (p = .049). In general, Veterans with 3+ mTBIs self-reported the most severe symptoms, followed by Veterans with 1-2 mTBIs and 0 mTBIs. Conclusions History of multiple, remote mTBIs is associated with elevated subjective neurobehavioral/health-related symptoms in a dose-dependent fashion, but is not associated with objective neuropsychological functioning or ratings of psychiatric distress in combat-exposed Veterans. These results advance understanding of the long-term consequences of multiple mTBIs in this population and suggest that Veterans with 3 or more mTBIs may especially benefit from (1) early treatments aimed at ameliorating sleep and pain symptoms and (2) therapies that provide tools to temper catastrophic thinking about these symptoms.


2021 ◽  
pp. 104973232110581
Author(s):  
Sarju Sing Rai ◽  
Elena V. Syurina ◽  
Ruth M. H. Peters ◽  
Annisa Ika Putri ◽  
Irwanto Irwanto ◽  
...  

A constructivist grounded theory approach was used to understand how some people living with stigmatized health conditions develop positive deviance to overcome stigma. We examined interviews from 13 identified positive deviants living with four different stigmatized health conditions (HIV, leprosy, schizophrenia, and diabetes) in Indonesia. Positive deviance develops in the form of psychological empowerment through improvement of self-belief and perception (intrapersonal component), development of understanding and skill to exert control in life (interactional component), and self-discovery of successful behaviors and strategies to avert stigma (behavioral component). Positive deviants, after being empowered, start empowering others affected by sharing their knowledge and fostering social awareness and acceptance. The findings revealed the presence of problem-solving ability and agency within the community of stigmatized individuals in Indonesia and warrant researchers to partner with the community to expedite the diffusion of transferable positive deviant strategies within and outside the communities.


2013 ◽  
Vol 11 (1) ◽  
pp. 56 ◽  
Author(s):  
Susan Herrmann ◽  
Elizabeth McKinnon ◽  
Noel B Hyland ◽  
Christophe Lalanne ◽  
Simon Mallal ◽  
...  

2014 ◽  
Vol 76 (2) ◽  
pp. 169-171
Author(s):  
Randy A. Sansone ◽  
Daron A. Watts ◽  
Michael W. Wiederman

2020 ◽  
Vol 15 (1) ◽  
pp. 7
Author(s):  
Sarju Sing Rai ◽  
Irwanto Irwanto ◽  
Ruth M.H. Peters ◽  
Elena V. Syurina ◽  
Annisa Ika Putri ◽  
...  

Health-related stigma causes a negative impact on the lives of affected people and undermines the effectiveness of public health programs. This study aimedto explore experiences and consequences of stigma among people affected by four health conditions relevant in Indonesia– HIV (Human ImmunodeficiencyVirus), leprosy, schizophrenia and diabetes. In this qualitative study 40 people affected by the four health conditions in Jakarta and West Java, Indonesia–,were interviewed between March and June 2018. Data were analyzed thematically by following an integrative inductive-deductive approach. The experiencesand consequences of people with stigma were similar, but such experience were more severe among people affected by HIV, leprosy, and schizophrenia.Those with diabetes either experienced no or less severe stigma. The participants revealed that they experienced enacted stigma in healthcare, employment,and social interactions in the structural and interpersonal levels. They also experience the stigma in the form of internalized and anticipated stigma at an individual level. Incidences of human rights violations were evident. Social, behavioral, psychological, and medical consequences were also reported.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Huda Abu-Saad Huijer ◽  
Souha Fares ◽  
Douglas J. French

Context. The Pain Catastrophizing Scale (PCS) is the most widely used measure of pain-specific catastrophizing. Objectives. The purpose of the present study was to develop and psychometrically evaluate an Arabic-language version of the PCS. Methods. In Study 1, 150 adult chronic nonmalignant pain patients seeking treatment at a hospital setting completed the PCS-A and a number of self-report measures assessing clinical parameters of pain, symptoms of depression, and quality of life. Study 2 employed a cold pressor pain task to examine the PCS-A in a sample of 44 healthy university students. Results. Exploratory factor analyses suggested a two-factor structure. Confirmatory factor analysis comparing the 2-factor model, Sullivan’s original 3-factor model, and a 1-factor model based on the total score all provided adequate fit to the data. Cronbach’s alpha coefficients across all models met or exceeded accepted standards of reliability. Catastrophizing was associated with higher levels of depression and increased pain intensity and interference. Catastrophizing predicted decreased quality of life, even after controlling for the contribution of gender, employment, depression, and pain interference. PCS-A scores were positively correlated with heightened experimental pain severity and decreased pain tolerance. Conclusion. The present results provide strong support for the psychometric properties of the PCS-A.


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