Overthinkers, attention-seekers and wallflowers: peer perceptions of clinical anxiety disorders in adolescence

Validity and reliability of anxiety literacy (A-Lit) and its relationship with demographic variables in the Iranian general population

Introduction

Anxiety disorder is one of the most common mental disorders. This cross-sectional research aimed to determine anxiety literacy (A-Lit) psychometric properties among the Iranian population in 2022.

Methods

This research was conducted on 690 people in Iran in 2022. In this study, people were selected by proportional stratified sampling, and the validity and reliability of the A-Lit designed by Griffiths were assessed. Validity of A-Lit was assessed by face validity, content validity, and confirmatory factor analysis. Reliability of A-Lit was evaluated by the McDonald's omega coefficient, Cronbach's alpha coefficient, and test- retest. In analytical sections, the tests of One-way ANOVA, Chi-squared test, and independent samples t-test were used.

Results

The rates of S-CVI/Ave and CVR for A-Lit were 0.922 and 0.774, respectively. In confirmatory factor analysis, three items were deleted because the factor loading was less than 0.4, and goodness-of-fit indexes (Some of goodness-of-fit indexes: χ2/df = 4.175, GFI: 0.909, RMSEA = 0.068, PCFI = 0.745, AGFI = 0.883) were confirmed as the final model with 19 items. For all items, the Cronbach's alpha coefficient was 0.832, the McDonald's omega coefficient was 0.835, and the intraclass correlation coefficient was 0.874. According to the results of this study, 1.3% (n = 9) did not answer any questions correctly and 8.4% (n = 58) were able to answer 1-6 questions correctly. Approximately 72% (n = 495) were able to answer 7-12 questions, and eventually only 18.6% (n = 128) were able to answer 13 questions and more. There was a significant relationship between sex, age group, occupation status, marital status, and get information related to mental illness with A-Lit level (p < 0.05).

Conclusion

The Persian version of A-Lit was confirmed with 19 items, and this scale is a reliable tool for measuring A-Lit in the general population. The results also showed that a few people have a higher level of anxiety literacy and that educational and intervention programs need to be designed and implemented for the public population.

Social Anxiety and Depression Stigma Among Adolescents

BACKGROUND

The stigma associated with mental disorders in adolescence has a range of detrimental consequences, negatively impacting help-seeking behaviours and quality of life. Social anxiety typically has its onset during adolescence, but the associated stigma is not well understood. This study was designed to improve understanding of social anxiety and depression stigma in adolescence by examining demographic and personal variables that predict them both.

METHODS

Three hundred and fifteen adolescents (150 males, 165 females), from 2nd and 4th year of secondary school (mean ages 13.92 and 15.92 years respectively), completed the Peer Mental Health Stigmatization Scale to measure both personal and perceived stigma towards vignettes depicting social anxiety and depression. They also answered demographic questions and completed the Social Anxiety Scale for Adolescents.

RESULTS

Hierarchical multiple regression revealed that gender predicted both personal and perceived stigma towards depression and personal stigma towards social anxiety. Males scored higher on measures of personal stigma whereas females had higher scores on perceived stigma. Ability to accurately identify symptoms described in a vignette, predicted lower personal stigma towards social anxiety and higher perceived stigma towards depression. Depression was more stigmatized than social anxiety.

LIMITATIONS

The study used vignettes to represent individuals with depression and social anxiety so participant responses may not reflect their behaviour towards real peers.

CONCLUSIONS

Findings emphasise the importance of separately considering personal and perceived stigma for each condition and highlight gender differences in stigma responses that need to be considered in intervention design.

Adolescent Endorsement of the "Weak-Not-Sick" Stereotype for Generalised Anxiety Disorder: Associations with Prejudice, Discrimination, and Help-Giving Intentions toward Peers

Stigma, comprising negative stereotypes, prejudice (negative affective reactions) and discrimination towards a member of a particular group, is of increasing interest in the context of mental illness. However, studies examining clinical anxiety stigma are lacking, particularly with regard to generalised anxiety disorder (GAD). There is also a lack of research into adolescent anxiety stigma, despite adolescence being a key period for early intervention for anxiety disorders, and research showing that stigma has been implicated in low rates of help-seeking and problematic peer relationships among adolescents with mental illness. Stigma has also been negatively associated with help-giving responses toward those with mental illness. Initial studies suggest that the ‘weak-not-sick’ (WNS) stereotype may be central to anxiety stigma. The present study aims to examine the endorsement of the WNS stereotype in the context of GAD, and its relationship to prejudice, discrimination, and help-giving responses among adolescents. A vignette-based survey measure was completed by 242 adolescents (74 male, 165 female, and three participants who recorded their gender as “other”) in Ireland aged between 15 and 19 years. The results of the study found that endorsement of the WNS stereotype was significantly associated with higher prejudice and discrimination, as well as lower levels of help-giving intentions. A multiple mediator model is presented showing both a direct relationship between endorsement of WNS and help-giving, and an indirect relationship between WNS and help-giving mediated by the prejudicial components of anger, fear and pity, and discrimination as assessed by desired social distance. This study adds to the limited knowledge base on stigma towards GAD in adolescents and provides a model for how anxiety stigma may relate to help-giving. This has implications for interventions to reduce stigmatising and increase help-giving responses.