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

The Chinese version of the stigma of loneliness scale in people with chronic diseases: an assessment of psychometric characteristics

BACKGROUND

Loneliness is prevalent in patients with chronic diseases and can threaten their health status, treatment process and quality of life. The stigma of loneliness stems from a derogatory and stigmatizing label that individuals possess towards loneliness with the possibility of being socially disadvantaged, which exacerbates the negative impact of loneliness on patients with chronic diseases and jeopardizes social support. However, few studies focused on this theme in patients with chronic diseases. This study aimed to assess the psychometric characteristics of the Chinese version of the Stigma of Loneliness Scale (SLS) among patients with chronic diseases, to provide a validated tool for related research.

METHODS

The current study consisted of a two-phase questionnaire survey of 704 patients with chronic diseases. Sample 1 comprised 318 patients (Age:40.87 ± 18.55) with chronic diseases, and the data obtained were used for item analysis and exploratory factor analysis. Sample 2 included 386 patients (Age:40.65 ± 17.08) with chronic diseases, and the resulting data were of use for confirmatory factor analysis, criterion validity, incremental validity, and Cronbach's α coefficient test. Moreover, in Sample 2, the equivalence of SLS in male and female cohorts and in outpatient and inpatient groups was further examined.

RESULTS

In the exploratory factor analysis, two dimensions were extracted: Self-Stigma of Loneliness (SSL) and Public Stigma of Loneliness (PSL). The confirmatory factor analysis revealed that the first-order two-factor model demonstrated good fit indices (χ2/df = 2.754, RMSEA = 0.067, SRMR = 0.023, CFI = 0.988, IFI = 0.989, TLI = 0.983, PNFI = 0.677, PCFI = 0.681), and it was superior to both the one-factor model and the two-factor orthogonal model. The criterion validity test indicated that the SLS scores were significantly positively correlated with the scores of UCLA Loneliness Scale, Brief Illness Perception Questionnaire, Self-Concealment Scale, Social Interaction Anxiety Scale, Social Phobia Scale, Acceptance and Action Questionnaire-Second Edition, Kessler Psychological Distress Scale-6 scores. The Cronbach's α coefficient values for the SLS, SSL, and PSL were 0.961, 0.949, and 0.960, respectively. The results of the incremental validity tests indicated that stigma of loneliness and loneliness differ in psychological construct. In addition, the SLS showed measurement equivalence in populations of patients with chronic diseases of different genders, as well as ways of seeking medical care.

CONCLUSIONS

The Chinese version of the SLS showed favorable reliability and validity in patients with chronic disease populations, which can provide instrumental endorsement for recognition and intervention studies of stigma of loneliness.

Unraveling the stigma: a qualitative descriptive exploration of the relationship between culture, religion, and mental disorders in Saudi Arabia

BACKGROUND

A lack of understanding about the needs of people in Middle Eastern and Islamic contexts living with mental health disorders, and their experiences of diagnosis-related social and personal stigma inhibits high-quality care.

METHODS

This qualitative descriptive study, based in Saudi Arabia, used the Stigma Mitigating Conceptual Model to explore mental disorder-related stigma from the perspective of challenges and strategies connected to knowledge, attitudes and behaviours. Thirteen adults with mental health disorders completed semi-structured interviews, analysed using reflexive thematic analysis.

RESULTS

Four major themes and nine subthemes pertaining to the impact of stigma on public and self/personal knowledge, attitudes, and behaviors were identified: (1) effects of the mental disorder on everyday life, (2) challenges, (3) overcoming the challenges, and (4) types of stigma experienced. Greater knowledge of mental health disorders promoted Islamic principles of compassion and support, while the absence of knowledge exacerbated public stigma and fears the individual is under the influence of the 'Evil Eye', or lacks prayers and devotion. Participant strategies to mitigate stigma include education, and more opportunities for those living with mental health disorders to share their stories.

CONCLUSIONS

Study findings provide nuance into the role of stigma in the context of cultural and religious factors in Saudi. These insights can be used to help tailor care and interventions to people from Middle Eastern contexts, as Western perspectives have predominantly driven mental health care.

'Did I Make the Right Choice': A Qualitative Exploration of Decision Regret Among Family Caregivers After Hospitalising a Patient With Schizophrenia

Committing a family member with schizophrenia to a psychiatric ward is a coping mechanism often employed under challenging circumstances. This decision entails significant emotional repercussions and ethical dilemmas, potentially undermining the psychological well-being of the family and eroding public trust in mental health services and professionals. This study investigates the experiences of regret among family members after deciding to commit a relative to a locked ward, adhering to the COREQ guidelines. Employing a descriptive qualitative methodology, we conducted in-depth interviews with 14 family members in Heilongjiang Province, China, who faced this difficult choice. Data were analysed using reflexive thematic analysis, which identified seven themes within three stages: Decision antecedent (limited comprehension of schizophrenia and treatment, deficiencies in supportive environment), decision process (suboptimal communication, hospitalisation and weighing of alternative options) and decision outcome (emotional burden of a loved one's hospital life, the indelible mark of schizophrenia, impact on family dynamics). The study highlights the need for targeted interventions, including addressing biased social media portrayals, enhancing the accuracy of medical information, ensuring transparency in psychiatric practices and improving support for families during hospitalisation.

An Italian Validation of the 5-Item Attitudes to Mental Illness Questionnaire (AMIQ): A Useful Tool for Rapid Assessment of Stigma, Acceptance, and Tolerance

Stigma negatively impacts individuals, families, and communities, affecting relationships, education, and employment and leading to an additional burden on mental health. Assessing public attitudes towards people with mental health conditions is crucial, especially in terms of public health. Therefore, the Attitudes to Mental Illness Questionnaire (AMIQ) was validated and adapted to the Italian cultural context. Translation followed four phases, involving bilingual speakers, comparison, back-translation, and expert review. In the pre-test phase, the questionnaire was administered to 21 participants anonymously. The validation test involved 213 subjects. Statistical analyses included exploratory and confirmatory factor analysis, and McDonald's Omega and Cronbach's alpha to assess the internal consistency. The results indicate good internal consistency (Omega = 0.71; Alpha = 0.72), and confirmatory factor analysis (CFI = 0.971) validated the questionnaire's construct. The study's findings align with the original validation, underscoring the questionnaire's robustness. Overall, understanding public attitudes is crucial for public health interventions combating stigma and fostering positive attitudes.