Prevalence, Characteristics and Socio-Demographic Correlates of Self-Stigma among Leprosy Affected Persons - A Case Study

This study has determined the prevalence of self-stigma, its characteristics in terms of alienation, stereotype endorsement, perceived discrimination and social withdrawal and stigma resistance among leprosy-affected persons and its relationship and extent of this relationship with various socio-demographic features. This has been done by carrying out a cross-sectional survey of 120 active people affected by leprosy during 2020-21. An internationally validated and standardised instrument (ISMI) was used to measure self-stigma. Statistical techniques such as independent t-test, Pearson’s and point biserial correlation and regression analysis were used for data analysis. The study found significant correlations between ISMI self-stigma scores and socio- demographic variables with moderate to minor deviation across the four components of the ISMI scale. The high to low correlation of various components of the ISMI scale found is discrimination experience, followed by stigma resistance, stereotype endorsement and alienation. Overall, the highest self-stigma was found in disabled people affected by leprosy, followed by those whose age was less than 40 years, followed by unemployed and male people affected by leprosy. It was concluded that alienation was maximum among people affected by leprosy who were either disabled, aged less than 40 years or were males. Discrimination experience was reported mainly by unemployed, disabled, males and younger people affected by leprosy. The findings indicate that proper methodology and components of Cognitive Behavioural Therapy may help reduce self-stigma among leprosy-affected persons

Survey and analysis of current situation and influencing factors of self⁃stigma among patients with mental disorders in a district of Shanghai， China / 上海预防医学

Objective To describe the current situation of self-stigma in patients with mental disorders and investigate its related influencing factors. Methods Using cluster sampling method， general situation and self-stigma of 3 926 patients with mental disorders were investigated with a questionnaire. Results The average total score of stigma in patients with mental disorders was 32.81±14.41. There were statistically significant differences between social factors and occupation， economic status， mental symptoms and behavior involving violence， insight， medication compliance， adverse drug reactions， family monitoring， relationship between guardian and patient， and social participation and social function. There were statistically significant differences between ability factors and occupation， education level， marital status， diagnosis， past accidents and dangerous behaviors， mental symptoms involving violence， insight， medication compliance， disability assessment， implementation of guardianship subsidy measures， family guardianship， relationship between guardians and patients， and social participation and social function. There were statistically significant differences between treatment factors and occupation， marriage， diagnosis， mental symptoms involving violence， insight， medication compliance， adverse drug reactions， family supervision， relationship between guardian and patient， and social participation and social function. According to multiple linear stepwise regression analysis， factors with influence on the total score of stigma， in descending order， were adverse drug reactions， family monitoring， mental status and behavior involving violence， employment， medication compliance， and social function and social participation. Conclusion Patients with mental disorders have a high score of self-stigma， which is related to adverse drug reactions， family monitoring， mental status and behavior involving violence， employment， medication compliance， and social function and social participation.

Comparisons of the Clinical Variables between High and Low Self-Stigma Group in the Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The purpose of this research was to investigate the differences of clinical variables between high and low self-stigma group in the outpatients with schizophrenia. METHODS: 209 schizophrenic outpatients were assigned to high self stigma group (n=76) and low self stigma group (n=133) based on the scores of perceived stigma, and compared age, sex, education, age of onset, duration of illness, number of hospitalization, symptom, social functioning, insight, self-esteem, empowerment between two groups. RESULTS: 1) The high self-stigma group had significantly lower age of onset, higher duration of illness and number of hospitalizations compared to the low self-stigma group. 2) In the PANSS, the high self-stigma group showed significantly higher score in the total score and general symptoms compared to the low self-stigma group. No significant difference was found in the positive symptoms and negative symptoms between two groups. 3) The high self-stigma group had significantly lower empowerment and self-esteem compared to the low self-stigma group. 4) The high self-stigma group had significantly higher insight compared to the low self-stigma group. CONCLUSION: Self-stigma in patients with schizophrenia directly reduces self-esteem and empowerment, and may cause depression and a lower quality of life. Therefore, identifying self-stigma and its degree is one of the important factors for good outcome.

Reliability and validity of the chinese version of self-stigma scale for patients with diabetes / 中国实用护理杂志

Objective To translate the Self-Stigma Scale (SSS )into chinese version and check its reliability and validity. Methods The Chinese version of Self-Stigma Scale was translated by Brislin method, the reliability and validity was tested in 750 diabetes patients. Results The Chinese version of Self-Stigma Scale includs 28 items three dimensions. Total scale Cronbach′s α :0.949, all subscales>0.8, Retest reliability coefficient:0.873.The scale average validity index (S-CVI/Ave) was 0.944. Confirmatory factor analysis results show that the GFI: AGFI: 0.833, 0.805, RMSEA: 0.065 the fitting indicators show that the fitting is good. Conclusions The revised Chinese SSS has good reliability and validity. It can be a suitable tool to evaluate stigma level of diabetes patient.

O auto-estigma dos usuários de álcool e drogas ilícitas e os serviços de saúde: uma revisão integrativa da literatura / The self-stigma of alcohol and illicit drug users and health services: an integrative review of the literature / El auto-estigma de los usuarios de alcohol y drogas ilícitas y los servicios de salud: um repaso integrativa de la literatura

OBJETIVOS: identificar, analisar e sintetizar evidências científicas sobre a relação entre o estigma existente nos serviços de saúde no que se refere aos usuários de álcool e drogas ilícitas e o auto-estigma destes usuários. MÉTODO: revisão integrativa da literatura, através de cinco etapas distintas. RESULTADOS: do total de artigos encontrados nas bases de dados, 07 foram selecionados e analisados, resultando nas categorias "O estigma público nos serviços de saúde" e "A relação entre o estigma nos serviços de saúde e o auto-estigma em usuários de álcool e drogas ilícitas". CONCLUSÃO: o auto-estigma é influenciado pelo estigma público propagado, principalmente, por autoridades e por profissionais de saúde. Uma das alternativas para atenuar o cenário do auto-estigma é o apoio social.

OBJECTIVES: To identify, analyze and synthesize scientific evidence on the relationship between the stigma existing in health services regarding alcohol users and illicit drugs and the self-stigma of these users. METHOD: integrative review of the literature, through five distinct stages. RESULTS: of the total of articles found in the databases, 07 were selected and analyzed, resulting in the categories "Public stigma in health services" and "The relationship between stigma in health services and self-stigma in alcohol users and illicit drugs. " CONCLUSION: self-stigma is influenced by public stigma propagated, mainly by authorities and health professionals. One of the alternatives to attenuate the scenario of self-stigma is social support.

OBJETIVOS: identificar, analizar y sintetizar evidencias científicas sobre la relación entre el estigma existente en los servicios de salud en el que se refiere a los usuarios de alcohol y drogas ilícitas y el auto-estigma de estos usuarios. MÉTODO: revisión integrativa de la literatura, por medio de cinco etapas distinguidas. RESULTADOS: del total de artículos encontrados en las bases de datos, 07 fueron seleccionados y analizados, resultando en las categorias "El estigma público en los servicios de salud" y "La relación entre el estigma en los servicios de salud y el auto-estigma em usuarios de alcohol y drogas ilícitas". CONCLUSIÓN: el auto-estigma es influenciado por el estigma público propagado, principalmente, por autoridades y por profesionales de salud. Una de las alternativas para atenuar el escenario del auto-estigma es el apoyo social.

A cross-sectional study on the biopsychosocial factors influencing quality of life and adherence to treatment of people living with HIV (PLHIV) in the National Capital Region / The Health Sciences Journal

Introduction@#This study investigated the association of selected biopsychosocial factors (i.e., CD4 cell count, self-stigma, and social stigma) with the quality of life and adherence to treatment of people living with HIV in the National Capital Region.@*Methods@#A cross-sectional study design was conducted to document the health status and behavior of respondents affiliated with a clinic in Quezon City. Participants answered an online questionnaire containing the Berger HIV Stigma Scale, WHO-QOL for HIV, and HIV Treatment Adherence SelfEfficacy Scale. Bivariate analyses and prevalence risk ratios were used to determine the association of selected biopsychosocial factors with quality of life and adherence to treatment.@*Results@#One hundred respondents were analyzed, of which 42% had CD4 cell counts < 350 cells/mm3, 43% had high self-stigma and 36% had high social stigma while 11% had poor QOL and 7% had poor ATT. There was no significant association of CD4 cell count, self-stigma and social stigma with quality of life and with adherence to treatment.@*Conclusion@#A weak association was noted between poor QOL and low CD4 cell counts and among those who felt higher social stigma, but the relationships were not significant. The association between poor ATT and the selected biopsychosocial factors was not significant.

Stigma of bipolar disorder:A review / 中国心理卫生杂志

Many studies had shown that the stigma is the important factor for diagnosis,treatment and re-covery of bipolar disorder.The stigma not only has negative effects on the patients and also on the marriage,fami-lies,study,work,medication treatment,and many other aspects.This paper reviews the development of definition of stigma,the characteristics,effects,interventions of stigma of bipolar disorder,finally,make a summary and put for-ward the prospects.

The effect of self-stigma on self-esteem and social support in mental illness / 中华行为医学与脑科学杂志

Objective To explore how the self-stigma of mental illness influence self-esteem and social support.Methods 109 mental illness from Jinan,Tianjin and Harbin were asked to finish a questionnaire integrated from the ISMI,SES,PSSS,and the data were calculated by SPSS18.0.Results According to the regression of self-stigma and its five attributes on the self-esteem,self-stigma was negative correlated with self-esteem,with self-alienated was the most significant attribute,the next being the public relations avoidance and the incompetent sensation,while the flight from reality and the discrimination experience were not remarkable attributes (Y =4.585-0.722x(F=59.508,P＜0.001) and Y =4.470-0.388x1 +0.813x2-0.198x3-0.064x4-0.192x5 (F=16.609,P＜ 0.001)).According to the regression of self-stigma and its five attributes on social support,self-stigma was negatively correlated with social support,self-alienated was the most remarkable attribute,and the next were the public relations avoidance and the discrimination experience,while the flight from reality and the incompetent sensation were not remarkable to the social support.(Y =3.710-0.354x(F=9.116,P＜0.01) ; Y =3.474-0.391x1 +0.102x2+ 0.301x3+0.047x4-0.301x5 (F=5.695,P＜0.001)).Conclusion The self-stigma of mental illness has negative influence on the self-esteem and social support.

Dimensionalidad, consistencia interna y distribución de la escala homonegatividad internalizada en estudiantes mexicanos de ciencias de la salud / Dimensionality, Internal consistency, and Distribution of the Internalized Homonegativity Scale Among Mexican Health Sciences Students

Este artículo tiene como objetivos estudiar la consistencia interna, estructura factorial, distribución y diferencias entre sexos de la escala de Homonegatividad Internalizada (IHN; Currie, Cunningham, & Findlay, 2004) ampliada a un total de 17 ítems (IHN-17). La IHN-17 se aplicó a una muestra no probabilística de 231 estudiantes universitarios de ciencias de la salud del noreste de México (121 mujeres y 103 hombres). Se eliminó un ítem por problemas de consistencia interna y carga factorial baja. Con los 16 ítems restantes se obtuvo una consistencia interna alta (α = .88). Un modelo de 3 factores (manifestación pública de la homosexualidad, α = .81; aceptación interna del deseo homosexual, α = .81; y promiscuidad, α = .69) jerarquizados a uno general tuvo un ajuste de bueno a adecuado por mínimos cuadrados generalizados y resultó invariante entre ambos sexos. La distribución se ajustó a una curva normal y los hombres promediaron más alto que las mujeres, aunque la diferencia solo fue significativa en el factor de manifestación pública. Se concluye que la IHN-16 con su modelo jerárquico posee mayor consistencia y validez de contenido que la original. Se sugiere su uso y estudio en México.

The aims of this article were to study the internal consistency, factor structure, distribution and sex differences in averages of the Internalized Homonegativity scale (IHN; Currie, Cunningham, & Findlay, 2004) extended to a total of 17 items (IHN-17). The IHN-17 scale was applied to a non-probability sample of 231 health sciences college students from northeastern Mexico (121 women and 103 men). An item was removed due to problems of internal consistency and low factor loading. The internal consistency was high with the remaining 16 items (α = .88). A model of three low-order factors (public display of homosexuality, α = .81; internal acceptance of homosexual desire, α = .81, and promiscuity, α = .69) nested in a general factor had a fit to the data from good to adequate by generalized least squares, and was invariant between both sexes. The IHN-16 total score followed a normal distribution, and men averaged higher than women, although the difference was statically significant only in the factor of public display. It is concluded that IHN-16 scale with its hierarchical model has higher consistency and more content validity than the original one. Its use and study are suggested in Mexico.

Recovery narratives: 'see how far i've come' / Narrativas de recuperação: 'veja onde cheguei'

As the paradigm shift towards a recovery-oriented mental health system becomes more prominent, individuals with lived experience of mental illness will continue to write and speak their narratives of mental illness and recovery. This article discusses the social reality of people with mental illness: how they are stigmatized by the media and how competing narratives within the mental health system afflict people with this disability. It also discusses the empowering process of constructing a narrative that enables the narrator/speaker to find meaning in her/his experience while putting a realistic 'face' on mental illness and recovery for the general public. It further describes how telling a narrative to diverse audiences, including a college class of 'people in recovery' enhances the author's personal recovery by giving his life new meaning and purpose.

Na medida em que a mudança de paradigma para um sistema de saúde mental orientado à recuperação se torna mais proeminente, indivíduos com experiências de vivência de doença mental continuarão a escrever e contar suas historias de doença mental e recuperação. Este artigo discute a realidade social das pessoas com doenças mentais: como elas são estigmatizadas pela imprensa e como outras linhas discursivas dentro do sistema de saúde mental as afetam. O artigo também discute o processo de capacitação que a construção da narrativa oferece ao narrador/palestrante, possibilitando-o a encontrar um significado para sua experiência ao mesmo tempo em que fornece uma 'face' realista à doença mental e recuperação para o público em geral. O artigo também descreve como o processo de contar a narrativa a audiências variadas, inclusive uma turma de faculdade de 'pessoas em recuperação', acentua a recuperação pessoal do autor na medida em que dá à sua vida um novo sentido e propósito.

Efficacy of a Group Treatment, Self-Stigma Overcome Programs for Inpatients with Schizophrenia / 신경정신의학

OBJECTIVES: Compared with the general population, individuals with schizophrenia are known to have lower self-esteem, in part because of internalized self-stigma. The aim of this study was to assess the efficacy of a Self-stigma Overcome Program (SOP), named self-esteem enhancement program for inpatients with schizophrenia. METHODS: The 46 patients with schizophrenia from Yongin Mental Hospital Rehabilitation Ward were randomly assigned to a SOP group or to a control group. The SOP groups received 15 sessions of SOP treatment over four months. SOP combined existing structured modules for the purpose of increasing self-esteem and empowerment with cognitive behavior therapy (CBT) techniques. The program module was divided into three building blocks: sense of security, sense of purpose, and sense of competence. All the subjects were assessed before and after the treatment period on measures of psychosocial functioning, diagnostic variables, and symptomatology. RESULTS: Compared with patients in the control condition, SOP group patients showed significant improvements on measures of empowerment and internalized stigma. The SOP groups subjectively also reported more improved self-respect, self-understanding, and positive self-regard. However, there were no significant improvements on measures of self-esteem and quality of life. CONCLUSION: These results indicate that individuals with schizophrenia appear to be benefit from a self-esteem enhancement module, particularly when they are involved in a rehabilitation program. These findings encourage a reconsideration of patients' empowerment and competence in order to ensure lasting effects on overall functional outcome of chronic schizophrenics.