ABSTRACT
Background: Stigma related to mental illness (and its treatment) is prevalent worldwide. This stigma could be at the structural or organizational level, societal level (interpersonal stigma), and the individual level (internalized stigma). Vulnerable populations, for example, gender minorities, children, adolescents, and geriatric populations, are more prone to stigma. The magnitude of stigma and its negative influence is determined by socio-cultural factors and macro (mental health policies, programs) or micro-level factors (societal views, health sectors, or individuals' attitudes towards mentally ill persons). Mental health stigma is associated with more serious psychological problems among the victims, reduced access to mental health care, poor adherence to treatment, and unfavorable outcomes. Although various nationwide and well-established anti-stigma interventions/campaigns exist in high-income countries (HICs) with favorable outcomes, a comprehensive synthesis of literature from the Low- and Middle-Income Countries (LMICs), more so from the Asian continent is lacking. The lack of such literature impedes growth in stigma-related research, including developing anti-stigma interventions. Aim: To synthesize the available mental health stigma literature from Asia and LMICs and compare them on the mental health stigma, anti-stigma interventions, and the effectiveness of such interventions from HICs. Materials and Methods: PubMed and Google Scholar databases were screened using the following search terms: stigma, prejudice, discrimination, stereotype, perceived stigma, associate stigma (for Stigma), mental health, mental illness, mental disorder psychiatric* (for mental health), and low-and-middle-income countries, LMICs, High-income countries, and Asia, South Asian Association for Regional Cooperation/SAARC (for countries of interest). Bibliographic and grey literature were also performed to obtain the relevant records. Results: The anti-stigma interventions in Asia nations and LMICs are generalized (vs. disorder specific), population-based (vs. specific groups, such as patients, caregivers, and health professionals), mostly educative (vs. contact-based or attitude and behavioral-based programs), and lacking in long-term effectiveness data. Government, international/national bodies, professional organizations, and mental health professionals can play a crucial in addressing mental health stigma. Conclusion: There is a need for a multi-modal intervention and multi-sectoral coordination to mitigate the mental health stigma. Greater research (nationwide surveys, cultural determinants of stigma, culture-specific anti-stigma interventions) in this area is required.
ABSTRACT
Aims: The present paper focused on compare the PID-5 mean score levels across two matched community and clinical samples of Portugal and the UAE. Background: The generalizability and universality of the Alternative Model of Personality Disorders has been thoroughly studied through the Personality Inventory for DSM-5 (PID-5) across countries and languages. However, studies comparing Western and Middle Eastern countries are still limited, in particular those who assess the PID-5 measurement invariance. Objectives: We examined measurement invariance of the PID-5 scales across matched Emirati and Portuguese clinical and nonclinical groups, as well as compare and contrast the PID-5 mean score levels across both countries and samples. Methods: The Arabic and the Portuguese versions of the PID-5 was administered to Emirati community participants (N = 300, 80% women and 20% men, Mage = 27.95) which were matched with Portuguese community participants (N = 300, 80.3% women and 19.7% men, Mage = 28.96), as well as clinical participants of the UAE (N = 150, 61.3% women and 38.7% men, Mage = 31.29) and Portugal (N = 150, 52% men and 48% women, Mage = 44.97). We examined measurement invariance through an unrestricted Factor Analysis based program, and mean scores levels were compared and analyzed. Results: Our findings supported the PID-5 measurement invariance across the Emirati and Portuguese clinical samples pointing to the universality and generalizability of the Alternative Model of Personality Disorders. The Emirati psychiatric sample exhibited somehow higher results than the Portuguese psychiatric participants, albeit the small effect size for most of the PID-5 scales. Conclusion: Further research is needed to examine the applicability of the PID-5 across non-clinical representative samples of Portugal and the UAE, and other Middle Eastern countries.
ABSTRACT
Objectives: We aimed to test the potential of the Arabic version of the PID-5 to distinguish between clinical and non-clinical participants, as well as to examine its convergent validity and factor structure in an Emirati clinical sample. Methods: The Arabic version of the PID-5 was administered to a clinical sample comprised of 156 participants (Mage = 31.38, SD = 8.99, 37.8% male, 62.2% female) and a community sample also comprised of 156 participants (Mage = 31.43, SD = 9.52, 37.2% male, 62.8% female). We addressed the descriptive measures, internal consistency, mean rank scores differences, convergent validity with SCL-90-R, and PID-5's factor structure. Results: As expected, the clinical sample presented statistically significantly higher scores than the non-clinical sample, with medium to high effect sizes. In addition, all the PID-5 domains showed positive correlations with most of the symptomatic constellations of the SCL-90-R as well as the PID-5 facets with all their SCL-90-R counterparts. However, our findings did not entirely replicate the PID-5 original 5-factor structure, as only a 4-factor solution was retained. Conclusions: Future studies with the Arabic PID-5 in clinical samples are needed to understand its relevance and clinical utility in Arabic countries.
