Examining the Effects of Digital Stories to Address Mental Illness and Sexual and Gender Minority-Related Stigma.

INTRODUCTION: Sexual and gender minority (SGM) individuals living with mental illness often experience stigma associated with marginalized identities of sexual orientation, gender identity, and mental illness (MI). Sharing stories of lived experiences is an effective approach to reducing various forms of stigma; however, it is unclear whether stories shared by SGM living with mental illness (SGM MI) can reduce MI- and SGM-related stigma. METHODS: Using a randomized controlled trial design, participants watched digital stories of self-identified SGM individuals living with a mental illness, non-SGM individuals living with mental illness, or a control condition (TedTalks on environmental issues and growing up in China) to examine the use of representative digital stories in addressing SGM- and MI-related stigma. RESULTS: In a sample of 218 participants, digital stories of SGM MI effectively reduced MI-related stigma (personal stigma (from 33.19 to 31.90) and discrimination (from 8.33 to 7.57)), but were ineffective at reducing SGM-related personal stigma (negative attitudes toward lesbians and gay men, transphobia, or genderism; p > .05). CONCLUSION: Our study highlights the need to develop culturally adapted anti-stigma programs in collaboration with individuals with lived intersectional SGM and MI experiences.

Mental Distress, Label Avoidance, and Use of a Mental Health Chatbot: Results From a US Survey.

BACKGROUND: For almost two decades, researchers and clinicians have argued that certain aspects of mental health treatment can be removed from clinicians' responsibilities and allocated to technology, preserving valuable clinician time and alleviating the burden on the behavioral health care system. The service delivery tasks that could arguably be allocated to technology without negatively impacting patient outcomes include screening, triage, and referral. OBJECTIVE: We pilot-tested a chatbot for mental health screening and referral to understand the relationship between potential users' demographics and chatbot use; the completion rate of mental health screening when delivered by a chatbot; and the acceptability of a prototype chatbot designed for mental health screening and referral. This chatbot not only screened participants for psychological distress but also referred them to appropriate resources that matched their level of distress and preferences. The goal of this study was to determine whether a mental health screening and referral chatbot would be feasible and acceptable to users. METHODS: We conducted an internet-based survey among a sample of US-based adults. Our survey collected demographic data along with a battery of measures assessing behavioral health and symptoms, stigma (label avoidance and perceived stigma), attitudes toward treatment-seeking, readiness for change, and technology readiness and acceptance. Participants were then offered to engage with our chatbot. Those who engaged with the chatbot completed a mental health screening, received a distress score based on this screening, were referred to resources appropriate for their current level of distress, and were asked to rate the acceptability of the chatbot. RESULTS: We found that mental health screening using a chatbot was feasible, with 168 (75.7%) of our 222 participants completing mental health screening within the chatbot sessions. Various demographic characteristics were associated with a willingness to use the chatbot. The participants who used the chatbot found it to be acceptable. Logistic regression produced a significant model with perceived usefulness and symptoms as significant positive predictors of chatbot use for the overall sample, and label avoidance as the only significant predictor of chatbot use for those currently experiencing distress. CONCLUSIONS: Label avoidance, the desire to avoid mental health services to avoid the stigmatized label of mental illness, is a significant negative predictor of care seeking. Therefore, our finding regarding label avoidance and chatbot use has significant public health implications in terms of facilitating access to mental health resources. Those who are high on label avoidance are not likely to seek care in a community mental health clinic, yet they are likely willing to engage with a mental health chatbot, participate in mental health screening, and receive mental health resources within the chatbot session. Chatbot technology may prove to be a way to engage those in care who have previously avoided treatment due to stigma.

On the use of aspect-based sentiment analysis of Twitter data to explore the experiences of African Americans during COVID-19.

According to data from the U.S. Center for Disease Control and Prevention, as of June 2020, a significant number of African Americans had been infected with the coronavirus disease, experiencing disproportionately higher death rates compared to other demographic groups. These disparities highlight the urgent need to examine the experiences, behaviors, and opinions of the African American population in relation to the COVID-19 pandemic. By understanding their unique challenges in navigating matters of health and well-being, we can work towards promoting health equity, eliminating disparities, and addressing persistent barriers to care. Since Twitter data has shown significant promise as a representation of human behavior and for opinion mining, this study leverages Twitter data published in 2020 to characterize the pandemic-related experiences of the United States' African American population using aspect-based sentiment analysis. Sentiment analysis is a common task in natural language processing that identifies the emotional tone (i.e., positive, negative, or neutral) of a text sample. Aspect-based sentiment analysis increases the granularity of sentiment analysis by also extracting the aspect for which sentiment is expressed. We developed a machine learning pipeline consisting of image and language-based classification models to filter out tweets not related to COVID-19 and those unlikely published by African American Twitter subscribers, leading to an analysis of nearly 4 million tweets. Overall, our results show that the majority of tweets had a negative tone, and that the days with larger numbers of published tweets often coincided with major U.S. events related to the pandemic as suggested by major news headlines (e.g., vaccine rollout). We also show how word usage evolved throughout the year (e.g., outbreak to pandemic and coronavirus to covid). This work also points to important issues like food insecurity and vaccine hesitation, along with exposing semantic relationships between words, such as covid and exhausted. As such, this work furthers understanding of how the nationwide progression of the pandemic may have impacted the narratives of African American Twitter users.

"A Great Way to Start the Conversation": Evidence for the Use of an Adolescent Mental Health Chatbot Navigator for Youth at Risk of HIV and Other STIs.

Chatbot use is increasing for mobile health interventions on sensitive and stigmatized topics like mental health because of their anonymity and privacy. This anonymity provides acceptability to sexual and gendered minority youth (ages 16-24) at increased risk of HIV and other STIs with poor mental health due to higher levels of stigma, discrimination, and social isolation. This study evaluates the usability of Tabatha-YYC, a pilot chatbot navigator created to link these youth to mental health resources. Tabatha-YYC was developed using a Youth Advisory Board (n = 7). The final design underwent user testing (n = 20) through a think-aloud protocol, semi-structured interview, and a brief survey post-exposure which included the Health Information Technology Usability Evaluation Scale. The chatbot was found to be an acceptable mental health navigator by participants. This study provides important design methodology considerations and key insights into chatbot design preferences of youth at risk of STIs seeking mental health resources.

The Impact of a Culturally Meaningful Storytelling Intervention on Stigma and Attitudes About Mental Health Treatment.

ABSTRACT: The fear of being devalued or discriminated against is a salient deterrent to seeking mental health care, especially in communities of color where racial stigma also impacts mental health and perceptions of service utilization. To address this issue, our research team partnered with This Is My Brave Inc to develop and evaluate a virtual storytelling intervention to highlight and amplify the voices of Black and Brown Americans living with mental illness and/or addiction. We utilized a pretest-posttest survey design administered electronically to viewers of the series ( n = 100 Black, indigenous, people of color and n = 144 non-Hispanic White). Results indicated that postintervention, scores on public stigma and perceived discrimination measures were significantly reduced. We identified significant interaction effects, such that Black, indigenous, people of color viewers showed a greater rate of improvement on outcomes. This study provides strong preliminary evidence of the impact of a culturally meaningful virtual approach to addressing stigma and improving attitudes about mental health treatment.

Development of a Conversational Agent for Individuals Ambivalent About Quitting Smoking: Protocol for a Proof-of-Concept Study.

BACKGROUND: Cigarette smoking is the leading preventable cause of disease and death in the United States. Despite the availability of a plethora of evidence-based smoking cessation resources, less than one-third of individuals who smoke seek cessation services, and individuals using these services are often those who are actively contemplating quitting smoking. There is a distinct dearth of low-cost, scalable interventions to support smokers not ready to quit (ambivalent smokers). Such interventions can assist in gradually promoting smoking behavior changes in this target population until motivation to quit arises, at which time they can be navigated to existing evidence-based smoking cessation interventions. Conversational agents or chatbots could provide cessation education and support to ambivalent smokers to build motivation and navigate them to evidence-based resources when ready to quit. OBJECTIVE: The goal of our study is to test the proof-of-concept of the development and preliminary feasibility and acceptability of a smoking cessation support chatbot. METHODS: We will accomplish our study aims in 2 phases. In phase 1, we will survey 300 ambivalent smokers to determine their preferences and priorities for a smoking cessation support chatbot. A "forced-choice experiment" will be administered to understand participants' preferred characteristics (attributes) of the proposed chatbot prototype. The data gathered will be used to program the prototype. In phase 2, we will invite 25 individuals who smoke to use the developed prototype. For this phase, participants will receive an overview of the chatbot and be encouraged to use the chatbot and engage and interact with the programmed attributes and components for a 2-week period. RESULTS: At the end of phase 1, we anticipate identifying key attributes that ambivalent smokers prefer in a smoking cessation support chatbot. At the end of phase 2, chatbot acceptability and feasibility will be assessed. The study was funded in June 2022, and data collection for both phases of the study is currently ongoing. We expect study results to be published by December 2023. CONCLUSIONS: Study results will yield a smoking behavior change chatbot prototype developed for ambivalent smokers that will be ready for efficacy testing in a larger study. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44041.

Preliminary effectiveness study of the Cope Notes digital mental Health program.

BACKGROUND: Cope Notes is a subscription-based EMI that uses Short Message Service (SMS) technology to deliver daily text messages that promote hope, reduce stigma, and encourage coping and the use of positive psychology strategies. AIM: We aimed to evaluate the preliminary effectiveness of Cope Notes, a brief ecological momentary intervention (EMI). METHODS: We conducted a longitudinal study where participants (N = 64) completed measures of depression, anxiety, perceived stress, coping, emotional intelligence, label avoidance, attitudes towards treatment-seeking, and readiness for change before the intervention, 1 month post-intervention, and 2 months post-intervention. This study includes mixed repeated measures ANOVAs to analyze over time. RESULTS: Findings show that participants with severe depression experienced a significant decrease in anxiety and depressive symptoms, and perceived stress (p < .001) and showed a significant increase in emotional intelligence at 1 month post-intervention. Participants with mild to moderate depression experienced a significant increase in overall coping and problem-focused coping. CONCLUSIONS: While further investigation of Cope Notes' feasibility and acceptability is warranted, these findings support that the Cope Notes EMI holds promise as a low-cost, impactful mental health solution for populations with limited access to care and those experiencing self-stigma preventing help-seeking.

"You don't accept he's completely ok": a reflexive thematic analysis of parents' roles in monitoring their child's health and symptoms after finishing childhood cancer treatment.

OBJECTIVES/PURPOSE: Childhood cancer survival brings continued mental and physical health challenges both for the child and for the family. In this study, we investigated how parents viewed their roles in their child's health and symptom monitoring during the survivorship period. METHODS: Twenty-one parents of childhood cancer survivors (n = 18 mothers; parent mage = 49.78 years, child mage = 18.50 years; range = 12-25 years), whose children were at least one year off-treatment (m = 3.67 years; SD = 2.25; various diagnoses), completed semi-structured interviews. Interviews were recorded, transcribed, and analyzed using reflexive thematic analysis. RESULTS: Analyses generated three themes which reflect roles that parents may adopt in the context of monitoring symptoms in their childhood cancer survivor. "Vigilant Mama and Papa" (theme 1) described parents who expressed a strong sense of responsibility for protecting their child's health during survivorship resulting in careful monitoring of their child's symptoms and health. "Pragmatic Mamas and Papas" (theme 2) described parents who adopted an approach to symptom and health monitoring that emphasized moving past cancer and focusing on the future. Finally, "Encouraging Mamas and Papas" (theme 3) described parents who focused on educating and preparing their child to develop an autonomous approach to health and symptom self-monitoring as they transitioned to survivorship and adulthood. CONCLUSION: Parents take on varying roles in monitoring their child's symptoms and health after finishing childhood cancer treatment. IMPLICATIONS FOR CANCER SURVIVORS: Understanding the ways in which parents continue to be involved in their child's cancer journey helps researchers develop interventions to support dyadic coping in survivorship.

Novel Application of Dot Survey Methodology at a Youth Health Clinic: A Pilot Study.

PURPOSE: We tested a novel dot survey methodology at our clinic that provides sexual health services to youth ages 13 to 24. We conducted two interactive dot surveys to assess their feasibility and acceptability while gaining insight into patients' attitudes about mental health. METHODS: We adapted a dot survey approach to assess youths' familiarity with mental health and attitudes toward related services. We also assessed their attitudes toward participating in this survey method. All patients with scheduled appointments were eligible to participate. Participants used dot stickers to indicate their responses on survey posters displayed in the waiting room. RESULTS: Three hundred patients participated between June and September 2021 (150 participants/survey). About 95% of participants liked seeing others' responses to the dot surveys, and over 70% reported that the surveys made them think more about mental health. Over 90% would participate in future dot surveys at the clinic. Survey items with the most consensus among participants included that 74.5% "really agree" youth face barriers to accessing mental health services (n = 141, mean = 4.61, standard deviation = 0.79) and 87.1% "really agree" primary care providers should ask youth about their mental health (n = 139, mean = 4.81, standard deviation = 0.59). DISCUSSION: The dot surveys were effective at assessing patients' attitudes about mental health and feasible to conduct in our waiting room. Results confirmed that this survey method was well received among patients. Dot surveys can be adapted by other clinical settings to engage youth regarding their health-related attitudes.

Parental Perspectives on Health Care Transition in Adolescent and Young Adult Survivors of Pediatric Cancer.

The health care transition (HCT) from pediatric to adult care is pivotal for childhood cancer survivors (CCS) and their parents. However, there is little research examining parental needs during HCT, despite this being a key predictor of successful HCT. The goal of this study was to investigate the needs of parents of CCS during HCT. Using an integrative review of the literature structured around the social-ecological model (SEM) of CCS transition readiness yielded 454 articles, including three hand-searched articles. Six articles were included in the final analysis. Data were extracted into nine factors derived from SEM. Articles were published within the last decade, largely qualitative, and mainly examined parents and CCS together. Parents most frequently mentioned relationships with their practitioner and CCS as contributing to HCT readiness, while abstract factors, such as goal-setting and expectations around HCT, were not mentioned. Our results are limited by the dearth of research on this topic, the homogeneity of samples, and joint presentation of CCS and parent data. Nonetheless, our results indicate that parents do not weigh all aspects of SEM equally, with macrolevel barriers, such as sociodemographic factors being viewed as less salient for HCT readiness. Parents mostly focused on interpersonal factors, such as their relationships with practitioners and CCS, indicating that practitioners should emphasize these in preparing parents for HCT.

A Qualitative Evaluation of an Adapted Assertive Community Treatment Program: Perspectives During COVID-19.

The Pinellas County Empowerment Team (PCET) was an adapted assertive community treatment (ACT) program created to meet the needs of Pinellas County residents with serious behavioral health concerns and high frequency of hospitalization (medical and psychiatric) and incarceration. Recent research demonstrates that individuals participating in ACT programs can transition to lower-intensity services. To understand the needs and barriers in transitioning PCET clients to lower-intensity services and the unique experiences during the coronavirus (COVID-19) pandemic, the researchers conducted a qualitative evaluation which includes a case record review and in-depth interviews with clients of PCET and staff members. Our findings indicated several barriers to transitioning PCET clients, including a lack of sufficient behavioral health support outside the ACT program and some clients' concerns regarding their abilities once out of the program.

Characterizing User Experiences With an SMS Text Messaging-Based mHealth Intervention: Mixed Methods Study.

BACKGROUND: Limited access to mental health care services due to provider shortages, geographic limitations, and cost has driven the area of mobile health (mHealth) care to address these access gaps. Reports from the Cohen Veterans Network and National Council for Behavioral Health show that in states where mental health care is more accessible, 38% of people still do not receive the care they need. mHealth strategies help to provide care to individuals experiencing these barriers at lower cost and greater convenience, making mHealth a great resource to bridge the gaps. OBJECTIVE: We present a mixed methods study to evaluate user experiences with the mental mHealth service, Cope Notes. Specifically, we aimed to investigate the following research questions: How do users perceive the service in relation to stigma, impact of the intervention, and perceived usefulness? How do users rate the Cope Notes service and SMS text messaging along various dimensions of acceptability? What is the relationship between Cope Notes SMS text message ratings, user personality, and coping strategies? What are user perspectives of leveraging ubiquitous sensing technologies to improve delivery and provide tailored content? METHODS: We performed qualitative interviews with Cope Notes users (N=14) who have used the service for at least 30 days to evaluate their experiences and usefulness of the service. These interviews were coded by 2 raters (SLK and JL), and the interrater reliability was calculated with SPSS (IBM Corp) at 61.8%. In addition, participants completed quantitative measures, including a user experiences survey, personality inventory (Big Five Inventory-10), and coping assessment (Brief Coping Orientation to Problems Experienced). RESULTS: We derived 7 themes from our qualitative interviews: Likes or Perceived Benefits, Dislikes or Limitations, Suggested Changes, Stigma or Help Seeking, Perceptions of Ubiquitous Sensing, Cultural Sensitivity, and Alternative mHealth Resources. Exploratory analyses between acceptability ratings of Cope Notes and personality factors showed statistically significant positive relationships between seeing oneself as someone who is generally trusting and acceptability items, the most significant being item 7 (I fully understood the sentiment behind Cope Notes Messages) with (rs(10)=0.82, P=.001). We also found statistically significant relationships between acceptability and Brief Coping Orientation to Problems Experienced items, with the strongest positive correlation between participants strongly endorsing coping by accepting the reality that an event has happened and acceptability item 7 (rs(8)=0.86, P=.001). CONCLUSIONS: Our study found that Cope Notes subscribers appreciate the service for reframing their mental wellness with statistically significant correlations between personality and acceptability of the service. We found that some users prefer a more personalized experience with neutral to positive reactions to a potential companion app that continuously monitors user behavior via smartphone sensors to provide just-in-time interventions when users need it most.

Enhancing care transitions intervention with peer support to improve outcomes among older adults with co-occurring clinical depression: a pilot study.

The Care Transitions Intervention (CTI) is an evidence-based intervention aimed at supporting the transition from hospital back to the community for patients to ultimately reduce preventable re-hospitalization. In a pilot randomized controlled trial, we examined the preliminary effectiveness of an Enhanced Care Transitions Intervention (ECTI), CTI with the addition of peer support, for a racially/ethnically diverse sample of older adults (age 60+) with co-morbid major depression. We observed a significant decline in health-related quality of life (HRQOL) after being discharged from the hospital among those who received CTI. Additionally, those who received ECTI either maintained HRQOL scores, or, saw improvement in HRQOL scores. Findings suggest the Enhanced Care Transitions Intervention can maintain or improve HRQOL and reduce disparities for older participants from diverse racial/ethnic backgrounds with clinical depression.

Factors predicting help seeking for mental illness among college students.

BACKGROUND: Evidence supports the contribution of various stigma-related constructs to help-seeking. These constructs have yet to be tested in a single model among college students, a group highly affected by mental illness. AIMS: Using data from 153 college students, this study examines factors contributing to help seeking for mental illness. METHOD: Using path analysis, the current study evaluated a model of the relationship between level of familiarity, personal stigma, desired social distance, label avoidance, attitudes towards treatment seeking and intentions to seek treatment. RESULTS: Findings support a model of help-seeking describing the relationship between familiarity with mental illness, personal stigma, social distance, label avoidance, attitudes and intentions to seek treatment. CONCLUSIONS: Findings suggest label avoidance, attitudes towards treatment seeking and intentions to seek treatment might be augmented through interventions aimed at increasing college students' levels of familiarity, or intimate contact, with individuals with mental illness. Additional implications for practice and further research are addressed.

Challenging the Stigma of Mental Illness Through Creative Storytelling: A Randomized Controlled Trial of This Is My Brave.

This Is My Brave (TIMB) is a contact-based mental illness stigma reduction program set in theaters. A randomized controlled trial of TIMB, compared the effect of TIMB videos to a comparison and control condition video. Pre- and post-surveys (153 adults) assessed mental illness stigma, beliefs about recovery and empowerment, and willingness to seek treatment. Univariate ANCOVAs revealed participants in the TIMB video condition experienced a greater reduction in perceived difference from people with mental illnesses than the comparison and control groups. Participants in the comparison and TIMB video conditions experienced greater reductions in social distance than the control group. Contrary to our hypothesis, participants in the TIMB video condition did not endorse improved beliefs about recovery and empowerment as compared to the comparison and control groups. These findings provide evidence for TIMB as an effective program for stigma reduction, particularly reducing perceived difference from people with mental illnesses and decreasing desired social distance.

Investigating the mobility of the peer specialist workforce in the United States: Findings from a national survey.

OBJECTIVE: The objectives of the current study were to characterize (a) peer specialist interest in enrolling in/returning to higher education and perceived barriers, (b) perceptions of the local availability of higher education/continuing education programming, and (c) perceived barriers to the advancement of the peer workforce. METHOD: We utilized both close-ended and open-ended items from a large, collaboratively developed national survey of peer specialists. Analytic methods included both descriptive and basic inferential statistics (N = 801) and qualitative coding and analysis (subsample N = 451). RESULTS: High levels of interest in higher education were found, with nearly 80% of participants reporting that they would enroll/return to college were it feasible. Analysis of open-ended responses regarding perceived barriers to career advancement revealed 5 major themes: financing and administrative policies; perceived public discrimination and devaluation of the peer specialist role by coworkers and agency leadership; lack of opportunities and mechanisms for advancement; the simultaneous need for advanced education and the inaccessibility of college or graduate degrees; and individual level barriers, including internalized stigma and derailed work histories due to disability. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: As the peer workforce continues to grow, it is critical that the field grapple with fundamental questions as to how to best support the development and advancement of the peer workforce. Our findings underscore persistent workplace challenges and perceived barriers to advancement, insights which may help the field develop strategies for improving development supports. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Examining the Impact of This Is My Brave on Mental Illness Stigma and Willingness to Seek Help: A Pilot Study.

This Is My Brave (TIMB) is a contact-based mental illness stigma reduction program, set in theaters, meant to reduce stigma, increase beliefs about empowerment and recovery, and improve attitudes towards treatment seeking for mental health concerns. The authors conducted the first empirical evaluation of TIMB using a pre-post survey design. Approximately 481 audience members of TIMB performances were invited to complete a survey of stigmatizing attitudes towards mental illness, beliefs about recovery and empowerment, and willingness to seek treatment at pre-and post-performance. Analyses of responses from 372 participants using paired samples t-tests revealed changes in the desired direction on all variables from pre-test to post-test. Audience members experienced a decrease in stigma, improvements in beliefs about recovery and empowerment, and greater willingness to seek treatment. TIMB is a promising stigma-reduction program and there is a need for a more detailed investigation of the program's impact using more rigorous methodology.

Challenging the Stigma of Mental Illness Among College Students.

PURPOSE: This study investigated the impact of contact- and education-based antistigma interventions on mental illness stigma, affirming attitudes, discrimination, and treatment seeking among college students. METHODS: Data were collected from 198 students of a Chicago University campus in spring of 2014. Participants were randomly assigned to one of three conditions: a contact-based antistigma presentation, education-based presentation, or control condition. Measures of stigma, discrimination, affirming attitudes, and treatment seeking were administered at preintervention and postintervention. RESULTS: A 3 × 2 analysis of variance was completed for each measure to examine condition by trial interactions. Both contact- and education-based interventions demonstrated a significant impact on personal stigma, perceptions of empowerment, discrimination, attitudes towards treatment seeking, and intentions to seek treatment from formal sources. No difference in effect was demonstrated between the contact- and education-based conditions. CONCLUSIONS: These findings suggest that these two approaches should be considered for challenging mental illness stigma among college students.

Mental illness stigma and disclosure in college students.

OBJECTIVE: The aim of this study was to investigate the relationship between mental illness identity, shame, secrecy, public stigma, and disclosure amongst college students. Participants included 1393 college students from five postsecondary institutions. METHODS: Structural equation modeling was used to examine two path models predicting disclosure and desire to join a program aiding with disclosure. RESULTS: Variables found to be significant in predicting disclosure included mental illness identity and public stigma. In turn, desire for disclosure predicted desire to join a program aiding in disclosure. Gender and race/ethnic differences were observed, with men and Whites more likely to want to disclose a mental illness or join a program aiding with disclosure compared with women and non-Whites, respectively. CONCLUSIONS: These findings suggest that some college students may find programs aiding in disclosure useful in assisting them to achieve their desire to be "out" with their mental illness.

Does humor influence the stigma of mental illnesses?

Public stigma is a barrier for people with mental illness. Humor may have the potential to decrease stigmatizing attitudes in the context of disclosure. Participants completed measures on stigmatizing attitudes and humor style and were then randomized to one of three conditions (self-disclosure comedy sketch, the same comedy sketch with no disclosure, and a control comedy sketch). After reviewing the comedy sketch, the participants repeated the attitude measures and provided perceptions of the comic. Humor styles and perceptions significantly interacted with condition to reduce stigma. Perceptions of the self-disclosed comic were associated with reduced stigma. People exhibiting affiliative humor style (i.e., they enjoy making others laugh) were shown to have significantly greater stigma changes in the disclosed condition compared with the nondisclosed and control conditions. Affiliative humor endorsers also interacted with the nondisclosed condition, suggesting that mental health comedy might generally reduce stigma in people who use humor to improve relationships.