M231. INTERNALIZED STIGMA AS A PREDICTOR OF EMPLOYMENT STATUS IN PATIENTS WITH SCHIZOPHRENIA

Abstract Background Employment is an important social determinant of health, especially for individuals with mental illnesses where it was found that gainful employment is crucial for both functional and clinical recovery. However, individuals with mental illnesses face significantly higher levels of unemployment compared to their counterparts without. Within different diagnoses of mental illnesses, it was found that patients with schizophrenia face higher levels of unemployment compared to patients with other diagnoses. Numerous qualitative studies have identified an association between internalized stigma and unemployment in individuals with schizophrenia, however, fewer quantitative studies have examined the specific relationship between the two factors. Therefore, we aim to elucidate the relationship between employment status and internalized stigma, and more specifically, its domains in patients with schizophrenia. Methods One hundred and seventy-nine patients with schizophrenia were included in this study. Illness severity was assessed using the Clinical Global Impression scale, internalized stigma was measured using the Internalized Stigma of Mental Illness scale (ISMI), and demographic information including employment status was collected. For the purpose of analysis, employment status was categorised into two groups, with the employed group consisting of those under full-time and part-time employment, as well as full-time students. While the unemployed group consisted of individuals who were unemployed at the time of assessment. The ISMI assesses five domains of internalized stigma, which are alienation, stereotype endorsement, discrimination experience, social withdrawal and stigma resistance. Multiple logistic regression, controlling for demographic and clinical factors, was conducted to identify the domains of internalized stigma associated with predictors of employment status. Results One hundred and two participants were employed and seventy-seven were unemployed. The employed group was younger, had shorter duration of illness, more years of education and less severe illness level (all p < .001). The unemployed group consisted of more females and divorced individuals (all p < .05). The unemployed group reported significantly higher levels of internalized stigma in the total score, as well as stereotype endorsement, discrimination experience, and social withdrawal domains (all p < .05). Mean total ISMI scores for employed and unemployed groups were 62.15 (SD = 13.69) and 67.52 (SD = 13.94) respectively. Multiple logistic regression analysis, controlling for demographic and clinical factors, found that years of education (OR = 0.835, p < .05), and two domains of the internalised stigma scale, stereotype endorsement (OR = 1.210, p < .05) and stigma resistance (OR = 0.854, p < .05), were associated with employment status. Discussion More years of education and higher level of stigma resistance were found to be associated with being employed, suggesting that stigma resistance along with education may play protective roles in both obtaining and sustaining employment in patients. Higher level of stereotype endorsement was found to be associated with being unemployed, suggesting that patients who agree with the stereotypes about mental illness may face greater difficulties in gaining and sustaining employment. Hence, tailored interventions focused on specific domains of internalized stigma may be crucial components of any services targeted at improvement of occupational functioning in patients with schizophrenia.

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Impact of cisplatin-related adverse health outcomes (AHOs) on employment outcomes and self-reported health (SRH) among testicular cancer survivors (TCS).

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.e16058 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. e16058-e16058

Author(s):

Sarah L. Kerns ◽

Chunkit Fung ◽

Sophie D. Fossa ◽

Paul C Dinh ◽

Patrick O. Monahan ◽

...

Keyword(s):

Hearing Loss ◽

Renal Function ◽

Employment Status ◽

Productivity Loss ◽

Full Time ◽

Clinical Factors ◽

Disability Leave ◽

Morbidity Score ◽

Grade 3 ◽

Full Time Employment

e16058 Background: We aim to provide new information on cisplatin-related AHOs and employment status in TCS and evaluate impact on SRH. Methods: 1,815 TCS ³1 year post-chemotherapy underwent physical exam, audiometry, renal function evaluation, and completed questionnaires. Therapy data were obtained from medical records. A cumulative burden of morbidity score (CBMPt) assessed the number and severity of platinum-related AHOs (peripheral sensory neuropathy (PSN), hearing loss, tinnitus, and renal function) with grading per CTCAE v4.03. Multivariable regression assessed relations between CBMPt score, individual AHOs and employment status as well as SRH, adjusting for sociodemographic/clinical factors. Unemployment in TCS was compared with subjects in the Behavioral Risk Factor Surveillance System (BRFSS) of similar age/race/ethnicity. Results: Almost 1 in 10 TCS were either on disability leave (2.4%) or unemployed (6.8%) at a median age of 37 yr (median follow-up: 4 yr). TCS with tinnitus (OR = 3.1, grade 3 vs. 0, P = 0.04), renal dysfunction (OR = 13.5, grade 3 vs. 0, P = 0.01), or pain (OR = 7.2 and 40.9, grade 2 or 3 vs. 0, respectively; P < 0.001 each) had significantly greater odds of disability leave vs. full-time employment after adjusting for sociodemographic/clinical factors; pain was strongly correlated with PSN (Pearson r2= 0.40; P < 0.001). CBMPt score was associated with disability leave (OR = 1.5, P = 0.04), but not with unemployment. A significantly higher percentage of TCS were unemployed vs. BRFSS norms (e.g. 3.6% of TCS age 35-39 vs. 2.0% in BRFSS). PSN (OR = 2.2, grade 3 vs. 0, P = 0.02), self-reported hearing loss (OR = 1.8, grade 2/3 vs. 0, P = 0.04), and pain (OR = 2.8 and 8.5, grade 2 or 3 vs. 0, respectively; P < 0.01 each) were each associated with increased odds of unemployment vs. full-time employment. Cisplatin-related AHOs and pain were associated with significantly worse SRH (P < 0.05). Conclusions: Our findings have new, important implications regarding productivity loss and socioeconomic costs in TCS. Survivorship care strategies should include inquiries about employment status, and every effort made to assist affected TCS in returning to the work force.

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M220. SELF-STIGMA, RESILIENCE, AND RECOVERY ATTITUDES AS PREDICTORS OF FUNCTIONING IN PEOPLE WITH SERIOUS MENTAL ILLNESSES

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.532 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S219-S220

Author(s):

Sarah E Dihmes ◽

Anthony Ahmed ◽

Sherry Tucker ◽

Alex Mabe ◽

Peter Buckley

Keyword(s):

Social Support ◽

Mental Illness ◽

Goodness Of Fit ◽

Social Withdrawal ◽

Coping Styles ◽

Internalized Stigma ◽

Community Functioning ◽

Stigma Resistance ◽

Path Models ◽

The Impact

Abstract Background Studies increasingly show an association between internalized stigma and increased symptoms, and poorer social and occupational functioning. Fewer studies have informed about protective traits, attitudes, and factors that may attenuate the impact of internalized stigma on psychopathology and psychosocial functioning. The current study used path analysis to examine putative intervening roles for resilience, coping, and recovery attitudes consistent with hope, empowerment, strengths, and self-direction on the effect of internalized stigma on psychopathology and function. Methods Participants were individuals diagnosed with either schizophrenia or schizoaffective disorder (N=84). All participants had completed training and certification as peer support specialists and included 49 individuals currently employed and 35 currently unemployed. Using mailed surveys, participants were administered the Life Stressors Inventory, Internalized Stigma of Mental Illness, the Connors Davidson Resilience Scale, Maryland Assessment of Recovery in Serious Mental Illness, the Brief Symptom Inventory, Brief COPE, Social Functioning Scale, and the Social Support Questionnaire. Path analytic models were estimated using Mplus5. Three path models were estimate designating psychopathology, social support, and community function as dependent variables. Goodness of Fit indices including the Comparative Fit Index (CFI), Tucker Lewis Index (TLI), the Root Mean Square Error of Approximation (RMSEA), and the Standardized Root Mean Squared Residual were used to evaluate the fit of the models to the data. Results There were associations between five subdomains of the ISMI—Alienation (r=0.47, p<0.001), Stereotype Endorsement (r=0.29, p<0.001), Discriminatory Experiences (r=0.40, p<0.001), Social Withdrawal (r=0.47, p<0.001), and Stigma Resistance(r=-0.28, p<0.01) and the severity of psychopathology. There was a significant association between internalized stigma and overall functioning (r=0.46, p<0.001). In addition, the five subdomains of the ISMI—Alienation (r=-0.53, p<0.001), Stereotype Endorsement (r=-0.40, p<0.001), Discriminatory Experiences (r=-0.39, p<0.001), Social Withdrawal (r=-0.40, p<0.001), and Stigma Resistance(r=0.35, p<0.001) were associated with ratings of the satisfaction with social support. Associations with reported amount of social support ranged from r=0.25 for Stigma Resistance to r= -0.39 for Alienation. The final path models for the severity of psychopathology (CFI/TLI = 0.955/0.933, RMSEA=0.091, SRMR =0.049), social support (CFI/TLI = 0.957/0.935, RMSEA=0.085, SRMR =0.072), and community functioning (CFI/TLI = 0.928/0.901, RMSEA=0.087, SRMR =0.09) produced adequate goodness-of-fit estimates. In all three models, the use of maladaptive coping but not the use of adaptive coping mediated the effect of internalized stigma on the dependent variable. Recovery attitudes did not significantly predict psychopathology when resilience was included in the model, suggesting possibly collinear constructs. Discussion The study demonstrates that coping styles, recovery, and resilience attitudes are associated with functional outcomes in people with schizophrenia spectrum disorders. However, the impact of internalized stigma on psychopathology, social, and community functioning may be mediated the use of maladaptive coping styles and attitudes consistent with resilience and adaptability.

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Stigma in early detection of psychosis: Subjective experiences of those concerned

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.429 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S387-S387

Author(s):

M. Uttinger ◽

C. Rapp ◽

E. Studerus ◽

K. Beck ◽

A. Riecher-Rössler

Keyword(s):

Early Detection ◽

Social Withdrawal ◽

Subjective Experiences ◽

Scientific Debate ◽

Increased Risk ◽

Stereotype Endorsement ◽

Stigma Resistance ◽

Stigma Of Mental Illness ◽

First Results ◽

Competing Interest

IntroductionDespite the large scientific debate concerning potentially stigmatizing effects of informing an individual about being in an at-risk mental state (ARMS) for psychosis, studies investigating this topic are rare and quantitative assessment of this kind of stigmatization does not exist so far.ObjectivesThis study presents first results regarding potentially helpful or stigmatizing effects of being informed about an ARMS assessed with a newly developed quantitative self-rating (FePsy-Stigma questionnaire).MethodsForty ARMS patients participating in the prospective Basel Early Detection of Psychosis (FePsy) study as well as patients clinically assessed in the early detection service of the Psychiatric Services of Solothurn, completed the FePsy-Stigma questionnaire during their follow-up assessments at least six months after they had been informed about their increased risk of developing psychosis. The questionnaire was constructed based on a previous qualitative study and on adapted versions of formerly used instruments for assessing stigma in mental health (Internalized Stigma of Mental Illness Scale, Personal Beliefs and Experiences Questionnaire).ResultsStigmatization appeared to be low overall except for social withdrawal due to suspected stigma. Stigma resistance, stereotype awareness and expected discrimination scored considerably higher than actually experienced discrimination, alienation and stereotype endorsement.ConclusionsThe results suggest that early detection services help individuals cope with symptoms and build certain resilience toward potential stigmatization, rather than enhancing or causing the latter. In line with previous studies, our results indicate that there is a considerable difference between expected and actually experienced discrimination as well as between stereotype awareness and stereotype endorsement.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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The Politics of Part-Time Work: Gender, Employment Status, and Preferences for Redistribution

Politics & Gender ◽

10.1017/s1743923x20000653 ◽

2020 ◽

pp. 1-38

Author(s):

David S. Pedulla ◽

Michael J. Donnelly

Keyword(s):

Employment Status ◽

General Social Survey ◽

The United States ◽

Limited Attention ◽

Full Time ◽

Cross Sectional ◽

Preferences For Redistribution ◽

Time Work ◽

Part Time ◽

Part Time Work

Abstract The social and economic forces that shape attitudes toward the welfare state are of central concern to social scientists. Scholarship in this area has paid limited attention to how working part-time, the employment status of nearly 20% of the U.S. workforce, affects redistribution preferences. In this article, we theoretically develop and empirically test an argument about the ways that part-time work, and its relationship to gender, shape redistribution preferences. We articulate two gender-differentiated pathways—one material and one about threats to social status—through which part-time work and gender may jointly shape individuals’ preferences for redistribution. We test our argument using cross-sectional and panel data from the General Social Survey in the United States. We find that the positive relationship between part-time employment, compared to full-time employment, and redistribution preferences is stronger for men than for women. Indeed, we do not detect a relationship between part-time work and redistribution preferences among women. Our results provide support for a gendered relationship between part-time employment and redistribution preferences and demonstrate that both material and status-based mechanisms shape this association.

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Maintaining High Eudaimonic Wellbeing Despite Ambiguity Intolerance Among Three Employment Status Groups: Examining the Buffering Effects of Positive Psychological Attributes

International Journal of Applied Positive Psychology ◽

10.1007/s41042-021-00051-1 ◽

2021 ◽

Author(s):

Martin Mabunda Baluku ◽

Edward Bantu ◽

Betty Namale ◽

Kathleen Otto

Keyword(s):

Locus Of Control ◽

Employment Status ◽

Psychological Capital ◽

Negative Effects ◽

External Locus ◽

Internal Locus ◽

Internal Locus Of Control ◽

The Unemployed ◽

Eudaimonic Wellbeing ◽

Ambiguity Intolerance

AbstractThe unemployed, as well as individuals in self and salaried employment, face several work-related risks and uncertainties which can result in diminished psychological wellbeing especially for individuals with high ambiguity intolerance. However, positive psychology literature suggests that individuals with strong psychological resources can be resilient in difficult circumstances. Using a sample of 922 individuals (including 240 unemployed, 391 salary-employed, and 291 self-employed) from Uganda and Kenya, we investigated the moderating effects of locus of control and psychological capital on the association between ambiguity intolerance and eudaimonic wellbeing, comparing the unemployed with individuals in salaried and self-employment. Our findings indicated that ambiguity intolerance and external locus of control are negatively associated with eudaimonic wellbeing. Conversely, internal locus of control and psychological capital were positively associated with eudaimonic wellbeing. The moderation analysis revealed that whereas an external locus of control boosts the negative effects of ambiguity intolerance on eudaimonic wellbeing, internal locus of control and psychological capital buffer against the negative effects of ambiguity intolerance on eudaimonic wellbeing. Differences between employment status groups and implications are discussed.

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Gains in employment status following antidepressant medication or cognitive therapy for depression

The British Journal of Psychiatry ◽

10.1192/bjp.bp.113.133694 ◽

2015 ◽

Vol 206 (4) ◽

pp. 332-338 ◽

Cited By ~ 17

Author(s):

Jay C. Fournier ◽

Robert J. DeRubeis ◽

Jay Amsterdam ◽

Richard C. Shelton ◽

Steven D. Hollon

Keyword(s):

Cognitive Therapy ◽

Employment Status ◽

Antidepressant Medication ◽

Relative Advantage ◽

Full Time ◽

Treatment Interaction ◽

Effect Of Treatment ◽

Using Data ◽

A Site ◽

Full Time Employment

BackgroundDepression can adversely affect employment status.AimsTo examine whether there is a relative advantage of cognitive therapy or antidepressant medication in improving employment status following treatment, using data from a previously reported trial.MethodRandom assignment to cognitive therapy (n = 48) or the selective serotonin reuptake inhibitor paroxetine (n = 93) for 4 months; treatment responders were followed for up to 24 months. Differential effects of treatment on employment status were examined.ResultsAt the end of 28 months, cognitive therapy led to higher rates of full-time employment (88.9%) than did antidepressant medication among treatment responders (70.8%), χ21 = 5.78, P = 0.02, odds ratio (OR) = 5.66, 95% CI 1.16–27.69. In the shorter-term, the main effect of treatment on employment status was not significant following acute treatment (χ21 = 1.74, P = 0.19, OR = 1.77, 95% CI 0.75–4.17); however, we observed a site×treatment interaction (χ21 = 6.87, P = 0.009) whereby cognitive therapy led to a higher rate of full-time employment at one site but not at the other.ConclusionsCognitive therapy may produce greater improvements in employment v. medication, particularly over the longer term.

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Economic Abuse of Women in Amman, Jordan: A Quantitative Study

SAGE Open ◽

10.1177/2158244020982616 ◽

2020 ◽

Vol 10 (4) ◽

pp. 215824402098261

Author(s):

Rula Odeh Alsawalqa

Keyword(s):

Partner Violence ◽

Employment Status ◽

Working Women ◽

Demographic Variables ◽

Full Time ◽

Economic Abuse ◽

Number Of Children ◽

Education Levels ◽

Education And Employment ◽

Abuse Of Women

As the literature on the economic abuse of women in Arabic contexts is quite limited, we aimed to detect the correlation between this economic abuse and a variety of demographic variables. Specifically, we considered women’s age, education, income, number of children, and length of marriage, as well as the husband’s education and employment status. We distributed questionnaires that included the economic, psychological, and community composite abuse scales to 500 married working women in the capital of Amman, Jordan. The results revealed that the economic abuse of women decreased as their education levels and length of marriage increased, as long as the husband worked full-time. In addition, a husband’s high education level would also increase the likelihood of economic abuse. Most importantly, the findings showed that economic abuse definitively heightened the probability of intimate partner violence (psychological, emotional, and physical abuse, as well as harassment).

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Material deprivation and employment status in post-transition: Evidence from North Macedonia

SEER ◽

10.5771/1435-2869-2021-1-135 ◽

2021 ◽

Vol 24 (1) ◽

pp. 135-152

Author(s):

Dimitar Nikoloski

Keyword(s):

Labour Market ◽

Capital Accumulation ◽

Employment Status ◽

Material Deprivation ◽

Point Of View ◽

Work Intensity ◽

Active Labour ◽

Underlying Causes ◽

The Unemployed ◽

Adjustment Mechanisms

Poverty and social exclusion are often associated with unemployment, but being employed is not always sufficient to provide decent living conditions for workers and their families. In this context, the aim of this article, drawing on SILC micro data, is to assess the underlying causes of severe material deprivation in North Macedonia from the point of view of employment status, particularly the differences between employed and unemployed workers. The results show that employed workers face a much greater risk of severe material deprivation if they are positioned in the so-called secondary labour market; while the unemployed with low capital accumulation and those living in households with low work intensity face the highest risks of all. North Macedonia’s adjustment mechanisms do help cushion the consequences, but the article concludes with several policy recommendations for additional action to reduce severe material deprivation covering: education and training; active labour market policies; unionisation and collective bargaining; wage subsidies and taxation; and a statutory minimum wage.

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Socioeconomic gradients and mental health: implications for public health

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.147280 ◽

2015 ◽

Vol 206 (6) ◽

pp. 461-465 ◽

Cited By ~ 38

Author(s):

Sarah Stewart-Brown ◽

Preshila Chandimali Samaraweera ◽

Frances Taggart ◽

Ngianga-Bakwin Kandala ◽

Saverio Stranges

Keyword(s):

Mental Health ◽

Mental Illness ◽

Employment Status ◽

Linear Trend ◽

Well Being ◽

Odds Ratios ◽

Factors Associated ◽

Middle Range ◽

The Unemployed ◽

Mental Well Being

BackgroundResearch on mental well-being is relatively new and studies of its determinants are rare.AimsTo investigate whether the socioeconomic correlates of mental well-being mirror those for mental illness.MethodUsing logistic regression analyses, the independent odds ratios of high and low mental well-being, compared with middle-range mental well-being, were estimated for a number of sociodemographic variables known to be associated with mental illness from 13 983 participants in the 2010 and 2011 Health Surveys for England.ResultsIndependent odds ratios for low mental well-being were as expected from studies of mental illness with increased odds for the unemployed (OR = 1.46, 95% CI 1.01–2.10) and those aged 35–54 years (OR = 1.58, 95% CI 1.35–1.84) and reduced odds for the married (OR = 0.78, 95% CI 0.62–0.97). A linear trend was observed with education and equivalised income. Odds ratios for high mental well-being differed from those for low mental well-being with regard to age (55+ years: OR = 1.48, 95% CI 1.23–1.79); employment status where there was an association only with retirement (OR = 1.35, 95% CI 1.09–1.69); education where there was no association; and equivalised income for which the association was non-linear.ConclusionsOdds ratios for low mental well-being mirrored those for mental illness, but not those for high mental well-being, suggesting that the socioeconomic factors associated with positive mental health are different from those associated with mental illness.

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Evaluation of self-esteem with internalized stigmatization in the patients with mentally illness

European Psychiatry ◽

10.1016/s0924-9338(11)72168-x ◽

2011 ◽

Vol 26 (S2) ◽

pp. 461-461

Author(s):

I. Keser ◽

N. Saygin ◽

S. Turkan ◽

B. Kulaksizoglu ◽

K. Buldukoglu

Keyword(s):

Health Professionals ◽

Self Esteem ◽

Middle Level ◽

Mental Illnesses ◽

Internalized Stigma ◽

The People ◽

Stigma Of Mental Illness ◽

Recurrent Hospitalization ◽

The Relationship ◽

Specific Education

IntroductionInternalized stigmatization means a internalized reaction in the person with mentally illness as a answer against the people reject and discrimination.ObjectiveThe peoples with mentally illness believe that most people reject and devalue people with mental illnesses, they may suffer a number of negative outcomes, such as demoralization, lowered self-esteem.AimThe aim of our study was to identify the relationship between the factors effecting the internalized stigmatization and self-esteem among patients with mentally illness.MethodsIn this study, we measured the prevalence of internalized stigma among 115 outpatients referring to the Psychiatry Service of Antalya Education and Research Hospital between 2009–2010 using Rosenberg Self-Esteem(SE) Scale, the Internalized Stigma of Mental Illness(ISMI) Scale, and Personel Datasheet.ResultsOf the patients, 53.9% had middle level of SE and the 22.00–70.00 ranging of ISMI, 30.4% of the patients were found to be 21–30 years-old. We found the increase of ISMI when SE was decreased in both of gender(p = 0.01, r = -0.67) and it was also found to be decreased of ISMI when the education level was increased in the patients(p = 0.004,r = -0.27). Recurrent hospitalization of the patients increased their ISMI points(p = 0.014, r = 0.23). There was no statistical relation between the living place of the patients and their ISMI points(p = 0.523).ConclusionsOur results suggest that some factors effected internalized stigma and showed the relationship between the internalized stigmatization and self-esteem among patients with mentally illness. To decrease and prevent internalized stigmatization, a specific education should be provided to patients, families and society by health professionals.

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