Self and public stigma towards mental illnesses and its predictors among university students in 11 Arabic-speaking countries: A multi-site study

This study aimed to explore self and public stigma towards mental illness and associated factors among university students from 11 Arabic-speaking countries. This cross-sectional study included 4241 university students recruited from Oman, Saudi Arabia, the United Arab Emirates (UAE), Syria, Sudan, Bahrain, Iraq, Jordan, Lebanon, Palestine and Egypt. The participants completed three self-administrative online questionnaires-Demographic Proforma (age, gender, family income, etc.), Peer Mental Health Stigmatization Scale and Mental Health Knowledge Questionnaire. There was a significant difference in the average mean between the 11 countries (p < 0.01) based on stigma agreement (self) and stigma awareness (public). The mean stigma agreement towards mental illnesses among university students was 19.7 (SD = 6.0), with the lowest in Lebanon, 15.9 (SD = 5.1) and the highest in UAE, 24.1 (SD = 5.6). The factors associated with stigma agreement included poor knowledge, being male, high family income, age, weak cumulative grade point average (cGPA), mothers with primary education, an unemployed parent, students in scientific colleges and fathers who completed secondary or university degrees. Furthermore, the factors associated with stigma awareness included good knowledge, acceptable cGPA and having a father who has a low income and is illiterate. Stigma towards mental illness varies among university students across Arabic-speaking countries. There is a need to sensitize youngsters to the need for a humanitarian approach in society to individuals affected by mental health concerns. Major governmental reforms must be initiated for the provision of mental health services for individuals with mental illnesses.

Implicit attitudes toward psychotherapy and explicit barriers to accessing psychotherapy in youths and parent–youth dyads

Background

Few studies have investigated implicit and explicit attitudes toward psychotherapy in youths (Study 1), although information about attitudes would improve interventions that aim to decrease barriers to accessing psychotherapy including parents (Study 2), who facilitate the help-seeking process of youths.

Method

The Study 1 sample comprised 96 youths (14–21 years) and the Study 2 sample 38 parent–youth dyads. Differences in implicit attitudes regarding psychotherapy and a medical treatment were measured with the Implicit Association Test, and psychotherapy knowledge and self-reported barriers to psychotherapy were assessed with questionnaires. The actor-partner interdependence model was used to test the dyadic effects of implicit attitudes on explicit attitudes in parents and youths.

Results

We did not find evidence for an implicit bias toward psychotherapy compared to a medical treatment, neither in youths, nor in parents. Self-reported barriers were a predictor for lower help-seeking intentions. Deficits in psychotherapy knowledge were more relevant in younger participants. Having a prior or current experience with psychotherapy and having a friend or family member with a prior or current experience with psychotherapy were predictors for better psychotherapy knowledge, but was not for lower barriers to accessing psychotherapy. Partner effects (degree to which the individual’s implicit attitudes are associated with explicit attitudes of the other dyad’s member) were not found.

Conclusion

Specific deficits in psychotherapy knowledge should be addressed in interventions to lower barriers accessing psychotherapy. Parents should be included in interventions as a valuable resource to support youths in seeking psychotherapy for mental disorders.

Peer-to-peer contact, social support and self-stigma among people with severe mental illness in Hong Kong

BACKGROUND

Self-stigma exerts a range of adversities for persons with severe mental illness (SMI), however, little is known about the association between peer contact, social support and self-stigma.

AIMS

This study aimed to explore the mediating role of social support on the relationship between peer contact and self-stigma among persons with SMI in Hong Kong.

METHODS

A total of 159 persons with SMI (schizophrenia and mood disorder) in community service centres participated in the study through completing a survey on self-stigma, social functioning, social support, perception of peer contact and mass media. Logistic regression was utilised to explore the influencing factors of self-stigma among the participants.

RESULTS

The results showed that 81.1% of participants reported moderate to severe levels of self-stigma. Self-stigma was significantly associated with diverse factors (e.g. social functioning). Importantly, positive peer contact was significantly associated with lower self-stigma of persons with SMI. Social support acted as a mediator between peer contact and self-stigma.

CONCLUSION

The results of this study suggest that contact-based interventions, such as enhancing positive peer-to-peer contact, should be conducted for reducing self-stigma among persons with SMI.

'I didn't know what to expect': Exploring patient perspectives to identify targets for change to improve telephone-delivered psychological interventions

BACKGROUND

Remote delivery of psychological interventions to meet growing demand has been increasing worldwide. Telephone-delivered psychological treatment has been shown to be equally effective and as satisfactory to patients as face-to-face treatment. Despite robust research evidence, however, obstacles remain to the acceptance of telephone-delivered treatment in practice. This study aimed to explore those issues using a phenomenological approach from a patient perspective to identify areas for change in current provision through the use of theoretically based acceptability and behaviour change frameworks.

METHODS

Twenty-eight semi-structured interviews with patients experiencing symptoms of common mental health problems, waiting, receiving or having recently received telephone-delivered psychological treatment via the UK National Health Service's Improving Access to Psychological Therapies (IAPT) programme. Interviews were recorded, transcribed verbatim, and analysed using the Theoretical Domains Framework (TDF) and Theoretical Framework of Acceptability (TFA).

RESULTS

The majority of data clustered within five key domains of the TDF (knowledge, skills, cognitive and interpersonal, environmental context and resources, beliefs about capabilities, beliefs about consequences) and mapped to all constructs of the TFA (affective attitude, ethicality, intervention coherence, self-efficacy, burden, opportunity costs, and perceived effectiveness). Themes highlighted that early stages of treatment can be affected by lack of patient knowledge and understanding, reservations about treatment efficacy, and practical obstacles such as absent non-verbal communication, which is deemed important in the development of therapeutic alliance. Yet post-treatment, patients can reflect more positively, and report gaining benefit from treatment. However, despite this, many patients say that if they were to return for future treatment, they would choose to see a practitioner face-to-face.

CONCLUSIONS

Using a combination of theoretically underpinned models has allowed the identification of key targets for change. Addressing knowledge deficits to shift attitudes, highlighting the merits of telephone delivered treatment and addressing skills and practical issues may increase acceptability of, and engagement with, telephone-delivered treatment.

Stigma Towards Mental Illness Among Tanta University Students, Egypt

A "mental disorder" can be defined as a "behavioral or psychological syndrome that occurs in an individual. It represents about 13% of the global disease burden which is expected increase to 15% by 2020. Moreover, by 2020, depression is expected to be second to ischemic heart disease as a contributor in the global disease burden. This study aimed to assessment of stigmatizing beliefs towards mental illness among students, in Tanta University, Egypt. The study was conducted on medical, pharmaceutical and science faculties, Tanta University, Egypt during October and November 2018. The methods were a self administered questionnaire consisted of two parts sociodemographic factors and Belief about Mental Illness Scale. The results were: the pharmaceutical students have more negative beliefs towards mental illness than other students. The study concluded that: science students showing a more positive belief towards mental illness followed by medical then pharmaceutical students.

Stigmatization of posttraumatic stress disorder is altered by PTSD Knowledge and the precipitating trauma of the sufferer

BACKGROUND

Reducing stigma could improve well-being and decrease discrimination toward persons with mental illness.

AIM

The current study investigated the impact of posttraumatic stress disorder (PTSD) knowledge and the characteristics of a person suffering from PTSD symptoms on stigmatization.

METHOD

University students (n = 560) read one of twelve vignettes describing someone with PTSD symptoms who varied by gender, military status, and precipitating trauma. Then, participants rated their own responses to the person in the vignette (i.e. personal stigma), their perception of how others would respond (i.e. perceived stigma), and their comfort with the person in different social settings (i.e. social distance) followed by a PTSD Knowledge Questionnaire.

RESULTS

PTSD knowledge was associated with decreased personal stigma and increased willingness to socialize with individuals in the vignettes. The precipitating trauma of the person in the vignette influenced perceived stigma ratings, lowering perceived stigma for those who had experienced a rape as opposed to a car accident. Neither the gender nor military status of the person in the vignette affected stigmatization.

CONCLUSIONS

The current findings underscore the importance of mental health education in reducing stigma and indicate that the type of precipitating trauma affects attitudes toward those with PTSD symptoms.

Accuracy, Authenticity, Fidelity: Aesthetic Realism, the "Deficit Model," and the Public Understanding of Science

Argument "Deficit model" designates an outlook on the public understanding and communication of science that emphasizes scientific illiteracy and the need to educate the public. Though criticized, it is still widespread, especially among scientists. Its persistence is due not only to factors ranging from scientists' training to policy design, but also to the continuance of realism as an aesthetic criterion. This article examines the link between realism and the deficit model through discussions of neurology and psychiatry in fiction film, as well as through debates about historical movies and the cinematic adaptation of literature. It shows that different values and criteria tend to dominate the realist stance in different domains: accuracy for movies concerning neurology and psychiatry, authenticity for the historical film, and fidelity for adaptations of literature. Finally, contrary to the deficit model, it argues that the cinema is better characterized by a surplus of meaning than by informational shortcomings.

How Movies Shape Students' Attitudes Toward Individuals with Schizophrenia: An Exploration of the Relationships between Entertainment Experience and Stigmatization

Mass media shape not only public, but also healthcare professionals' attitudes towards individuals with a mental illness. This study investigates how watching a movie about schizophrenia affects stigma-related attitudes of rehabilitation science students, who are likely to work with affected individuals. Participants watched an entertainment movie portrayal of schizophrenia. Stigma-related attitudes and social distance were assessed one week before watching the movie, directly afterwards, and one week later. No significant differences in stigmatization emerged between viewers and non-viewers. Enjoyment, appreciation, and general movie evaluation mediated viewers' transportation into the story on changes in stigmatization. Results are discussed with respect to media effects on stigma-related attitudes and their implications for mental health nursing practice and education.

Psychology Degree Beliefs and Stereotypes: Differences in the Perceptions of Majors and Non-Majors

Very little research examines the beliefs and stereotypes students have about the discipline and major of psychology. Previous research has found that psychology majors report hearing a variety of such beliefs and stereotypes more often from their fellow students than from their family members. In the current study, psychology majors/minors and non-majors/-minors ( N = 376) reported their frequency of hearing beliefs and stereotypes from friends/fellow students or family members and the extent that they agreed with those items. Majors/minors and non-majors/-minors differed significantly on their agreement with several items, such as psychology being “a dead end field,” “psychology is mostly an easy major,” and that “working with crazy people will make you go crazy.” Compared to majors/minors, non-majors/-minors were more likely to agree with the items. There was no evidence that upper-division majors/minors were less likely to believe or less likely to hear the beliefs and stereotypes than lower-division majors/minors. Students reported hearing many of the items more often from friends/fellow students than family members. We discuss the implications of these results for addressing beliefs about the psychology field and degree in introductory and careers courses.

"I'm Going to Shut Down All of Your Tricks": Depictions of Treatment Professionals in Addiction Entertainment

BACKGROUND

Previous research on addiction themed reality television shows has focused on the depiction of addiction and treatment and has concluded that these shows reinforce stigma. Existing research has not investigated the depiction of treatment professionals in these series.

OBJECTIVES

This study fills the gap in existing research by analyzing the representations of treatment professionals in reality television shows, including the ways that the shows are edited, the statements made by treatment professionals, and interactions between treatment professionals and laypersons.

METHODS

The data for this study was drawn from two popular reality shows Intervention and Celebrity Rehab with Dr. Drew. Using a total of 117 episodes, a qualitative content analysis of the representations of treatment professionals in the two series was conducted.

RESULTS

The data reveal the ways that depictions of treatment professionals are carefully controlled compared to those of people with substance use issues. In addition, treatment professionals are granted opportunities to interpret, explain, and diagnose the behaviors and experiences of people with substance use problem. Finally, when confronted with resistance treatment professionals assert their authority and demand compliance with their orders.

CONCLUSIONS/IMPORTANCE

In strategically presenting treatment professionals in sharp contrast to people with substance use problems, these portrayals of treatment professionals actually reinforce rather than contradict the stigma of addiction.

Behind the stage of deliberate self-persuasion: When changes in valence of associations to an attitude object predict attitude change

Modern theory and research on evaluative processes, combined with a comprehensive review of deliberate self-persuasion (Maio & Thomas, 2007, Pers. Soc. Psychol. Bull., 11, 46), suggest two types of strategies people can use to construct new, more desired attitudes. Epistemic strategies change the perceived valence of associations activated by the attitude object. Teleologic strategies, in contrast, keep undesired associations from being activated in the first place, thus obviating the need to change their perceived valence. Change in perceived valence of associations therefore might predict attitude change better when people pursue epistemic than teleologic strategies for deliberate self-persuasion. This hypothesis gained convergent support from three studies in which use of epistemic versus teleologic strategies was measured as an individual difference (Study 1) and manipulated (studies 2 and 3). The results of these studies supported the theoretical distinction between the two strategies and suggested further research directions.