The Process Model of Stigmatized Loss: Identity-Threatened Experiences of Bereaved Mothers.

Despite almost one-third of women suffering from the loss of a baby through miscarriage, stillbirth, or infant loss, it is surprising how little research examines how such loss affects the identity and stigmas experienced by these individuals. Through in-depth, semi-structured interviews with bereaved mothers (in particular, mothers who lost a baby during pregnancy or within one year after birth), this research sheds light on the bereaved mother's experiences after loss. Specifically, this research applies the identity-threat model of stigma to showcase the process of stigmatized loss. Based on our findings, we also introduce the process model of stigmatized loss that can apply to all types of stigmatized loss. Key themes emerged as we explored stigmatized loss discourses. These include situational cues that trigger stigma, identity-based responses that aim to preserve both a baby's and mother's identity, as well as nonvolitional and volitional responses that help restore control and reconstruct identity. Additionally, other themes revolve around positive and negative outcomes stemming from avoiding stigmatized identity activation and identification of triggers that initiate a recursive process through stigmatized baby loss. Importantly, stigma can be perceived as both an identity threat (negative) and an identity confirmation (positive). Findings inform theory and practice alike.

Face negotiation in graduate school: the decision to conceal or reveal depression among life sciences Ph.D. students in the United States.

Background: Depression is one of the top mental health concerns among biology graduate students and has contributed to the "graduate student mental health crisis" declared in 2018. Several prominent science outlets have called for interventions to improve graduate student mental health, yet it is unclear to what extent graduate students with depression discuss their mental health with others in their Ph.D. programs. While sharing one's depression may be an integral step to seeking mental health support during graduate school, depression is considered to be a concealable stigmatized identity (CSI) and revealing one's depression could result in loss of status or discrimination. As such, face negotiation theory, which describes a set of communicative behaviors that individuals use to regulate their social dignity, may help identify what factors influence graduate students' decisions about whether to reveal their depression in graduate school. In this study, we interviewed 50 Ph.D. students with depression enrolled across 28 life sciences graduate programs across the United States. We examined (1) to what extent graduate students revealed their depression to faculty advisors, graduate students, and undergraduates in their research lab, (2) the reasons why they revealed or concealed their depression, and (3) the consequences and benefits they perceive are associated with revealing depression. We used a hybrid approach of deductive and inductive coding to analyze our data. Results: More than half (58%) of Ph.D. students revealed their depression to at least one faculty advisor, while 74% revealed to at least one graduate student. However, only 37% of graduate students revealed their depression to at least one undergraduate researcher. Graduate students' decisions to reveal their depression to their peers were driven by positive mutual relationships, while their decisions to reveal to faculty were often based on maintaining dignity by performing preventative or corrective facework. Conversely, graduates performed supportive facework when interacting with undergraduate researchers by revealing their depression as a way to destigmatize struggling with mental health. Conclusions: Life sciences graduate students most commonly revealed their depression to other graduate students, and over half reported discussing depression with their faculty advisor. However, graduate students were reluctant to share their depression with undergraduate researchers. Power dynamics between graduate students and their advisors, their peers, and their undergraduate mentees influenced the reasons they chose to reveal or conceal their depression in each situation. This study provides insights into how to create more inclusive life science graduate programs where students can feel more comfortable discussing their mental health. Supplementary Information: The online version contains supplementary material available at 10.1186/s40594-023-00426-7.

Professional Identity of Pakistani Veterinary Students: Conceptualization and Negotiation.

Most work on the professional identity of veterinary and medical professionals has been conceptualized in the USA and Europe. It reports professional identity formation to be highly individualized, triggered by experiences of identity distress, and identity negotiation strategies to be generally focused around personal reflection. However, within Asia, important sociocultural differences exist that might influence professional identity and its development. Societal values may take precedence over individual ones, and some cultures consider the veterinary profession as stigmatized. With this background, we seek to understand professional identity and its construction in Pakistani veterinary students. We selected five students through purposive sampling and invited them for narrative interviews. Social identity theory and Maslow's theory of hierarchy of needs predominantly contributed to the theoretical framework, which together with principles of social phenomenology and narrative analysis informed qualitative analysis of the transcribed interviews using an in-depth approach. We found that students' professional identity was predominantly socially constructed, though their sense of their identity was not very well developed. Role models, social stigma, professional socialization in clinical settings, gender, and to some extent, cultural interpretations of religious messages seemed to mediate professional identity development. Students responded differently to their understanding of professional stigma, making sense of stigma through strategies such as denial or internalization. Since Pakistani veterinary students experience social and personal values differently compared to those from predominantly individualistic cultures, identity formation through reflecting on personal values may be less effective than strategies that emphasize social learning and beliefs.

The Grieving Process of Opioid Overdose Bereaved Parents in Maryland.

In recent years, the opioid epidemic in the United States has garnered attention due to the increasing number of fatal overdoses. Research on overdose death has increasingly focused on the psychological impacts of drug-related bereavement and disenfranchised bereavement. This study aims to contribute to the growing body of emergent literature on drug death bereavement, by exploring the experiences of parents whose children passed away due to opioid overdose. Qualitative semi-structured interviews were conducted with six parents living in the state of Maryland who had an adult child die from opioid overdose two or more years prior to the study. Data was analyzed using thematic analysis. Themes that emerged included the grieving process, stigmatization, and social support. While overall adaptation levels varied among participants, all participants reported positive and negative outcomes related to their experience of grief and loss. Implications for clinical practice and intervention are discussed.

Space-Focused Stereotypes About People Living With HIV/AIDS and the Effects on Community-Approaching Willingness.

Targeting people living with Human Immunodeficiency Virus (HIV), this research examined the prevalence of space-focused stereotypes and their underlying mechanism on behavioral inclinations. Study 1 adopted the explicit nomination and implicit Go/No-Go association tests to explore the existence of space-focused stereotypes of people living with HIV/AIDS. The results demonstrated that space-focused stereotypes were only manifested explicitly with characteristics such as messy, dirty, and gloomy. Study 2 demonstrated a more negative evaluation and community-approaching willingness for communities that include people living with HIV/AIDS than those without HIV/AIDS. Additionally, space-focused stereotypes were found to have an indirect influence on community-approaching willingness; the influence was mediated by both emotional (threat perception) and cognitive factors (community evaluation). These results indicate the deviation of explicit and implicit space-focused stereotypes. More importantly, it revealed that space-focused stereotypes decreased community evaluation and influenced behavioral inclination. This research suggested the existence of space-focused stereotypes on another stigmatized social group. Characteristics of space (e.g., geographical segregation) might be the key to forming space-focused stereotypes.

Socially stigmatized company's CSR efforts during the COVID-19 pandemic: The effects of CSR fit and perceived motives.

Acknowledging the unique challenges of the socially stigmatized industry and the substantial but varying impact of COVID-19 on business, this study examined how corporate social responsibility (CSR) fit influences public attitudinal and behavioral responses. This study found that low (high) CSR fit generated a higher level of public-serving motive (firm-serving motive) than high (low) fit CSR. The fit effect on public-serving motives was changed by the valence of the COVID-19 impact (negative vs. positive) on the financial performance. This study also found that the fit affects attitudinal and behavioral intentions (word of mouth) mediated via public-serving motives, moderated by the valence of the pandemic impact. The findings hold implications for the stigmatized industry companies' CSR initiatives in the context of the unexpected crisis, like the pandemic.

Development and Evaluation of the Atheist Identity Concealment Scale (AICS).

The Atheist Identity Concealment Scale (AICS) was developed as a tool to assess the degree to which atheists conceal their atheist identity from others. Drawing on concealable stigmatized identity (CSI) theory, the aim of this study was to provide researchers with a valid means to effectively assess atheist identity concealment. Using three separate samples of more than 500 adults in the USA, exploratory and confirmatory factor analyses were conducted which ultimately resulted in a short, robust measure comprised of eight items. Additional validity evidence was provided by examining the relationship between the AICS and several previously validated tools (i.e., outness, nonreligiosity, depression, anxiety, stress, and self-esteem).

Is the label 'conspiracy theory' a cause or a consequence of disbelief in alternative narratives?

Using the label 'conspiracy theory' is widely perceived to be a way of discrediting wild ideas and unsubstantiated claims. However, prior research suggests that labelling statements as conspiracy theories does not reduce people's belief in them. In four studies, we probed this effect further, and tested the alternative hypothesis that the label 'conspiracy theory' is a consequence rather than a cause of (dis)belief in conspiracy-related statements. Replicating prior research, Study 1 (N = 170) yielded no evidence that the label 'conspiracy theory' affects belief in statements. In Study 2 (N = 199), we discovered that the less people believed in statements, the more they favoured labelling them as 'conspiracy theories'. In Studies 3 and 4 (Ns = 150 and 151), we manipulated the relative believability of statements and found that participants preferred the label 'conspiracy theory' for relatively less believable versus more believable statements. The current research therefore supports the hypothesis that prior (dis)agreement with a statement affects the use of the label 'conspiracy theory' more than the other way around.

'To reveal or to conceal'- Disclosure strategies in parents of children with epilepsy in India.

PURPOSE: Disclosure of epilepsy is a relevant but under-researched topic in epilepsy research. This study was done to assess the disclosure strategies in parents of CWE in a developing country with conservative culture. The study also assessed the influence of demographic factors and seizure characteristics on the choice of disclosure. Enablers and barriers behind disclosure and the consequences after disclosure were evaluated. METHODS: A cross-sectional analytical, self-report survey was done in 284 parents of CWE with the help of a semi-structured questionnaire over a 7-month period in the paediatric epilepsy clinic. Disclosure was considered present if epilepsy was revealed to two or more of the five target groups (extended family, school, friends, neighbours, and peers of children). Separate set of questions was given for reasons behind their choice and consequences after disclosure. For continuous variables, unpaired T test or Mann - Whitney U test between group and for categorized variables, Pearson's Chi square test or Fisher's exact test was used. RESULTS: 92.96 % of 284 subjects disclosed their child's epilepsy while 7.04% concealed. Demographic factors and seizure characteristics did not influence the disclosure choice. Most parents revealed to the extended family followed by teachers. Type of seizure was the commonest information revealed. The main reason behind disclosure was better acceptance of the child followed by safety while main barrier was considering epilepsy as private grief. 92.8% felt their children were better accepted after disclosure. CONCLUSION: Disclosure practices have improved in parents of CWE in India and well-being and safety of the child has overridden the fear of stigma and discrimination. This could be the first major step to bring epilepsy out of the shadows at national and global levels.

"I'm Going to Stop Myself Before Someone Stops Me": Complicating Narratives of Volitional Substance Use Treatment.

Background: Often people assume that entry into drug treatment is a voluntary action for persons who use drugs (PWUD). This narrative informs the organizational and regulatory structure of most treatment programs and consequently affects patients' ability to exert agency over their own treatment. Yet, this view ignores the complex interplay between individual and structural factors in peoples' decision-making processes, particularly among people who use drugs who are stigmatized and criminalized. Treatment programs that assume voluntary entry may lack appropriate services for the populations of treatment seekers that they serve. Methods: This paper uses semi-structured interviews with 42 participants in Opioid Substitution Treatment (OST) (including patients, clinic doctors and staff, and advocates) informed by one of the author's own lived experience in OST, to examine patients' treatment decisions, and in particular, if and how, the structural context of drugs' illegality/criminalization affected their willingness to pursue treatment. A Critical Discourse Analysis was used to identify key themes. Results: Interview data demonstrates that most people who use drugs enter treatment under constrained conditions related to drugs' illegality. Themes that emerged included: 1. A feeling of limited choices due to drugs' illegality; 2. Peer and family pressure; 3. Fear of losing children; and 4. Internalized stigma (i.e. feeling they are dirty or bad for using). Conclusion: Narratives that frame PWUD's treatment decisions as volitional provide political cover to policies that criminalize PWUD by obscuring their effect on PWUD's treatment decisions. Treatment models, particularly those that serve highly criminalized populations, should be re-conceptualized outside of normative narratives of individual choice, and be broadened to understand how larger structures constrain choices. By looking at macro-level factors, including the interplay of criminalization and drug treatment, programs can begin to understand the complexity of PWUD motivations to enter drug treatment. Recognizing the role of the War on Drugs as a force of oppression for people who use drugs, and that their treatment decisions are made within that setting, may enable people in treatment, and providers, to develop more productive ways of interacting with one another. Additionally, this may lead to better retention in treatment programs.

A brief measure of perceived courtesy and affiliate stigma on COVID-19: A study with a sample from China.

The present study aimed to assist public health efforts by developing and conducting psychometric testing of a brief measure of COVID-19-related stigma among people who were potentially but not necessarily infected. All the items were generated and selected based on extensive literature review, participant interviews, and expert evaluations. The psychometric properties were evaluated through performing confirmatory factor analysis tests, exploration structure equation modeling, measurement invariance, internal consistency coefficient, composite reliability, and criterion-related validity, using a sample of 2812 adults (600 male, 2212 female; mean age = 37.23, SD = 6.17) from Hubei Province, China. A clear two-factor structure of the COVID-19-related stigma among people who were potentially but not necessarily infected (i.e., perceived courtesy and affiliate stigma) was identified through the literature review and interviews. Results suggest that the two-factor model of COVID-19-related stigma (5 items for each factor) model fit the data, and the psychometric properties were acceptable. Measurement invariance across gender was supported. A two-factor 10-item scale was finally obtained.

Depression as a concealable stigmatized identity: what influences whether students conceal or reveal their depression in undergraduate research experiences?

BACKGROUND: Concealable stigmatized identities (CSIs) are identities that can be kept hidden or invisible and that carry negative stereotypes. Depression is one of the most common CSIs among undergraduates. However, to our knowledge, no studies have explored how students manage depression as a CSI in the context of undergraduate research, a high-impact practice for undergraduate science students. Concealing CSIs can cause psychological distress and revealing CSIs can be beneficial; however, it is unknown whether these findings extend to students with depression in the context of undergraduate research experiences. In this study, we interviewed 35 life sciences majors with depression from 12 research-intensive institutions across the United States who participated in undergraduate research. We sought to understand to what extent students reveal their depression in research and to describe the challenges of concealing depression and the benefits of revealing depression in this specific context. Additionally, we explored whether students knew scientists with depression and how knowing a scientist with depression might affect them. RESULTS: Most students did not reveal their depression in their undergraduate research experiences. Those who did typically revealed it to another undergraduate researcher and few revealed it to a faculty mentor. Students who concealed their depression feared the potential consequences of revealing their identity, such as being treated negatively by others in the lab. Students who revealed their depression highlighted a set of benefits that they experienced after revealing their depression, such as receiving support and flexibility from their research mentor. We found that few students knew a specific scientist with depression. However, students perceived that knowing a scientist with depression would help them realize that they are not the only one experiencing depression in science and that people with depression can be successful in science. CONCLUSIONS: This study illustrates that students with depression would benefit from research environments that are supportive of students with depression so that they can feel comfortable revealing their depression if they would like to. We also identified that students may benefit from knowing successful scientists with depression. We hope this study encourages undergraduate research mentors to support students with depression and ultimately reduces the stigma around CSIs such as depression.

The Anal Sex Stigma Scales: A New Measure of Sexual Stigma Among Cisgender Men Who have Sex with Men.

We conducted a series of studies to validate a new scale of stigma toward anal sex, culturally tailored to cisgender men who have sex with men (MSM). In Study 1 we conducted in-depth interviews (N = 35) to generate items. In Study 2, we reduced the item pool through an online survey (N = 268), testing scale performance, dimensionality, and convergent and discriminant validity. For Study 3, we recruited another online sample (N = 1605), randomized to exploratory or confirmatory factor analyses to finalize item reduction, then assessed validity among sexually active MSM (n = 1263). Final subscales encompassed self-stigma (6 items, Cronbach's α = .72), provider stigma (5 items, Cronbach's α = .79), and omission of information (6 items, Cronbach's α = .73; full 3-factor scale = .80). We developed a 17-item measure, grounded in the lived experience of cisgender MSM. Future work should examine associations with health-seeking behavior.

Exploring the Effect of Market Conditions on Price Premiums in the Online Health Community.

Online health communities allow doctors to fully use existing medical resources to serve remote patients. They broaden and diversify avenues of interaction between doctors and patients using Internet technology, which have built an online medical consultation market. In this study, the theory of supply and demand was adopted to explore how market conditions of online doctor resources impact price premiums of doctors' online service. Then, we investigated the effect of the stigmatized diseases. We used resource supply and resource concentration to characterize the market conditions of online doctor resources and a dummy variable to categorize whether the disease is stigmatized or ordinary. After an empirical study of the dataset (including 68,945 doctors), the results indicate that: (1) the supply of online doctor resources has a significant and negative influence on price premiums; (2) compared with ordinary diseases, doctors treating stigmatized diseases can charge higher price premiums; (3) stigmatized diseases positively moderate the relationship between resource supply and price premiums; and (4) the concentration of online doctor resources has no significant influence on price premiums. Our research demonstrates that both the market conditions of online doctor resources and stigmatized diseases can impact price premiums in the online medical consultation market. The findings provide some new and insightful implications for theory and practice.

Knowledge of Deaths in Hotel Rooms Diminishes Perceived Value and Elicits Guest Aversion.

Guest deaths are an inevitable aspect of the hospitality industry. In Study 1, participants read a vignette in which the previous guest died of natural causes, suicide, or homicide. Those who learned of a death (a) saw the room as less valuable, (b) opted to stay in a more basic room in which no death occurred, despite both rooms being offered for free, and (c) anticipated feeling uneasy when imagining an overnight stay. In Study 2, we investigated the persistence of this bias. Perceived room value and anticipatory well-being can be expected to return to baseline levels only many years after the death event. Similar to "stigmatized properties" in real estate, these data confirm an irrational and recalcitrant cognitive bias surrounding consumers' views of death-affected hotel rooms.

Transformaciones y permanencias en lo tipificado como violento en el espacio escolar (1993-2011) / Transformations and stays in defined as violent in the school space (1993-2011) / Transformações e permanência no que é classificado como violento no espaço escolar (1993-2011)

RESUMEN El presente trabajo analiza las transformaciones y permanencias de lo tipificado como violento en el espacio escolar en la prensa argentina, durante el período 1993-2011. Dadas las características del objeto de indagación, el abordaje metodológico fue cualitativo y la información se analizó en el marco del análisis socioeducativo del discurso. Entre los resultados obtenidos observamos que durante los dieciocho años se visibilizan once temáticas comunes que asocian las violencias al espacio escolar Así también, se identificaron desplazamientos de sentido que asociaron las violencias a la escuela desde diferentes referentes. Por su originalidad, este estudio constituye un antecedente para futuras indagaciones sobre las representaciones mediáticas de las violencias en el espacio escolar y sus mutaciones de sentido.

ABSTRACT The present work analyzes the changes and permanencies of defined as violent in the school space, in the press in Argentina during the period 1993-2011. Given the characteristics of the object of inquiry the methodological approach was qualitative, and the information is analyzed in the framework of the educational discourse analysis. Among the results obtained we note that during the 18 years become visible, eleven thematic linking violence to the school space. Well, it was identified that displacement associated violence to school from different referents. For its originality this study constitutes a precedent for future inquiries on media representations of violence in the school space and its mutations of sense.

RESUMO O presente trabalho analisa as transformações e permanências do tipificado como violento no espaço escolar, na imprensa argentina, durante o período de 1993-2011. Dadas as características do objeto de indagação, a abordagem metodológica foi qualitativa e a informação foi analisada no contexto da análise socioeducativa do discurso. Entre os resultados obtidos, observamos que, durante os dezoito anos, são visíveis onze temas comuns que associam violência ao espaço escolar. Além disso, foram identificados deslocamentos de significado que associaram a violência à escola de diferentes referentes. Por causa da sua originalidade, este estudo constitui um precedente para futuros inquéritos sobre as representações da mídia na violência no espaço escolar e suas mutações sensoriais.

Transformations and stays in defined as violent in the school space (1993-2011) / Transformaciones y permanencias en lo tipificado como violento en el espacio escolar (1993-2011) / Transformações e permanência no que é classificado como violento no espaço escolar (1993-2011)

Abstract The present work analyzes the changes and permanencies of defined as violent in the school space, in the press in Argentina during the period 1993-2011. Given the characteristics of the object of inquiry, the methodological approach was qualitative, and the information is analyzed in the framework of the educational discourse analysis. Among the results obtained we note that during the 18 years become visible, eleven thematic linking violence to the school space. Well, it was identified that displacement associated violence to school from different referents. For its originality this study constitutes a precedent for future inquiries on media representations of violence in the school space and its mutations of sense.

Resumen El presente trabajo analiza las transformaciones y permanencias de lo tipificado como violento en el espacio escolar en la prensa argentina, durante el período 1993-2011. Dadas las características del objeto de indagación, el abordaje metodológico fue cualitativo y la información se analizó en el marco del análisis socioeducativo del discurso. Entre los resultados obtenidos observamos que durante los dieciocho años se visibilizan once temáticas comunes que asocian las violencias al espacio escolar Así también, se identificaron desplazamientos de sentido que asociaron las violencias a la escuela desde diferentes referentes. Por su originalidad, este estudio constituye un antecedente para futuras indagaciones sobre las representaciones mediáticas de las violencias en el espacio escolar y sus mutaciones de sentido.

Resumo O presente trabalho analisa as transformações e permanências do tipificado como violento no espaço escolar, na imprensa argentina, durante o período de 1993-2011. Dadas as características do objeto de indagação, a abordagem metodológica foi qualitativa e a informação foi analisada no contexto da análise socioeducativa do discurso. Entre os resultados obtidos, observamos que, durante os dezoito anos, são visíveis onze temas comuns que associam violência ao espaço escolar. Além disso, foram identificados deslocamentos de significado que associaram a violência à escola de diferentes referentes. Por causa da sua originalidade, este estudo constitui um precedente para futuros inquéritos sobre as representações da mídia na violência no espaço escolar e suas mutações sensoriais.