COVID-19-related stigmatization of affected people or people at risk of infection has been shown to enhance the reluctance of affected individuals to use health services and reduce their mental ...health. It is thus highly important to gain a thorough understanding of COVID-19-related stigmatization. The present study's first aim was to explore stigmatization profiles of experienced stigmatization (anticipated stigmatization, internalized stigmatization, enacted stigmatization, disclosure concerns) and stigmatization practices in 371 German people at high risk of infection using latent class analyses. The second aim was to investigate the relationship between stigmatization profiles and psychological distress via multiple regression analysis taking into account other possible negative and positive risk factors. Our results showed two stigmatization profiles: "high stigmatization group" and "low stigmatization group". Belonging to the "high stigmatization group" was significantly correlated with higher levels of psychological distress. Other risk factors significantly related to psychological distress were mental health disorders in the past, exposure to COVID-19, fear related to COVID-19, perceived risk of being infected, lower perceived self-efficacy, and lower subjective knowledge about COVID-19.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
considerable proportion of the population experiences major life disruptions after losing a loved one to suicide. Social stigma attached to suicide survivors adds to complications occurring in the ...course of suicide bereavement. Despite its known risks, stigma related to suicide survivors has been sparsely investigated.
We conducted a systematic literature search in PubMed, Web of Science, PsycInfo and PsyArticles, of studies indexed up through August 2015. Articles were eligible for inclusion if they addressed experiences of stigma in suicide survivors, compared them to other bereavement populations, or investigated stigmatizing attitudes within the public. The search was restricted to English-language studies.
25 records matched inclusion criteria. Study designs were heterogeneous, making comparisons difficult. Results demonstrated that suicide survivors experience stigma in the form of shame, blame, and avoidance. Suicide survivors showed higher levels of stigma than natural death survivors. Stigma was linked to concealment of the death, social withdrawal, reduced psychological and somatic functioning, and grief difficulties. Only one study investigated stigmatizing attitudes towards suicide survivors among the general population.
Internal and external validity of the studies was restricted by a lack of valid measures and selection bias.
More methodologically sound research is needed to understand the impact of stigma on suicide survivors' grief trajectories and to separate it from other grief aspects. Clinicians and grief-counselors as well as the public should be educated about the persistent stigma experienced by suicide survivors.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Achalasia is associated with reduced quality of life in affected patients but research regarding the psychological burden of achalasia in terms of depression and anxiety is scarce. The current study ...therefore aims to investigate rates of depression and anxiety in patients with achalasia in relation to prevalence rates in the general population and to examine the extent to which achalasia-related characteristics (time since diagnosis, symptom load, achalasia-related quality of life, treatment history) predict symptoms of depression and anxiety.
Using validated screening instruments, rates of depression and anxiety were assessed in a cross-sectional survey of a sample of 993 patients with achalasia and compared to population controls stratified by age and sex. Associations between depression and anxiety and achalasia-related factors were explored using linear regression.
Compared to population controls, screening rates of female patients with achalasia were between 3.04 (p = .004) and 7.87 (p < .001) times higher for depression and 3.10 (p < .001) times higher for anxiety, respectively. No significant differences were found for male patients with achalasia. Both achalasia-related quality of life and symptom load were independently related to impaired mental health.
Women appear to be specifically affected by the psychological burden of achalasia, pointing to sex-specific or gendered experiences of the disease. In addition to symptom reduction, psychological support may prove beneficial for improving the well-being of patients with achalasia.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Diagnosis of fetal anomaly is a significant life event and social stigma can negatively impact on the well-being of women opting for an abortion. This study investigated the psychometric properties ...of a measure of stigma among women who had had an abortion after diagnosis of fetal anomaly in a German setting.
The Individual Level Abortion Stigma (ILAS) scale was translated into German. Psychometric properties of the ILAS scale were examined among 130 women with a history of an abortion after diagnosis of fetal anomaly. Individual and situational factors associated with stigma in the context of an abortion after diagnosis of fetal anomaly were explored.
Factor analysis suggested a four-dimensional structure of the German version of the Individual Level Abortion Stigma scale (Cronbach's α, .83-.91), corresponding to the subscales of the original scale. Test-retest reliability was acceptable for the worries about judgment subscale, the self-judgment subscale, and the community condemnation subscale, but less convincing for the isolation subscale. Associations between the subscales and measures of depression, self-esteem and secrecy were found in directions consistent with theory. Women who did not perceive their fetus to have a low survival chance and women whose fetus was at higher gestational age reported higher levels of stigma, whereas higher perceived partner support was associated with lower levels of stigma.
Generalizability of study results was limited, as participants were recruited from one clinic in Germany and the study had a response rate of 46.5%.
The ILAS subscales are largely reliable and valid measures to assess stigma among women who have had an abortion after diagnosis of fetal anomaly. Suggestions for improving the assessment of stigma experienced in this population are outlined. The scales can be useful in research aiming at investigating psychological outcomes of abortion after diagnosis of fetal anomaly and improving care structures.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Internet-based psychological interventions have proven effective and yield advantages that make them a viable alternative to face-to-face therapy in many fields. Yet, the role of therapeutic alliance ...in technologically mediated interventions has been discussed critically. The aim of this meta-analysis is to summarize the association between therapeutic alliance and outcome in therapist-assisted online interventions.
A systematic search of the databases PubMed, Web of Science, PsycINFO and PubPsych was conducted for articles published before February 2020 that assess the association between therapeutic alliance and outcome in internet-based interventions involving remote therapist contact. Results were systematically screened and information on the alliance-outcome-association was extracted. A multilevel meta-analysis was conducted.
Overall, 51 effect sizes were extracted from 20 included studies. The average weighted effect size is r = 0.203 (p < .0001). The correlation was larger when alliance was measured near the end of an intervention. There was no impact of therapist contact frequency or mode and availability of self-help content on the effect size.
Therapeutic alliance and outcome are significantly correlated in internet-based therapy. This points to the relevance of a stable alliance in internet-based interventions and suggests that fostering alliance might be beneficial to treatment success.
Display omitted
•The alliance-outcome-association in internet-based interventions was examined.•The weighted mean association between alliance and outcome is r = 0.203.•Fostering alliance might be beneficial to treatment success.
Aim
Non-pharmaceutical interventions such as lockdowns have played a critical role in preventing the spread of the Covid-19 pandemic, but may increase psychological burden. This study sought to ...examine emotions reflected in social media discourse following the introduction of social contact restrictions in Central Europe.
Subjects and methods
German-language Twitter posts containing ‘#corona’ and ‘#covid-19’ were collected between 2020/03/18 – 2020/04/24. A total of 79,760 tweets were included in the final analysis. Rates of expressions of positive emotion, anxiety, sadness and anger were compared over time. Bi-term topic models were applied to extract topics of discussion and examine association with emotions.
Results
Rates of anxiety, sadness and positive emotion decreased in the period following the introduction of social contact restrictions. A total of 16 topics were associated with emotions, which related to four general themes: social contact restrictions, life during lockdown, infection-related issues, and impact of the pandemic on public and private life. Several unique patterns of association between topics and emotions emerged.
Conclusion
Results suggest decreasing polarity of emotions among the public following the introduction of social contact restrictions. Monitoring of social media activity may prove beneficial for an adaptive understanding of changing public concerns during the Covid-19 pandemic.
Background
We summarize research on the public stigmatization of persons with alcohol use disorder (AUD) in comparison with other mental health conditions and embed the results into a conceptual ...framework of the stigma process.
Methods
We conducted a systematic search using Embase, MEDLINE, PubMed and PsycINFO (via Ovid), and Web of Science for population‐based studies on the public stigma in AUD and at least 1 other mental health condition, published between October 1, 2010 and December 20, 2020, thus including all studies published since the last systematic review on this topic. The study is registered with PROSPERO (registration number: CRD42020173054).
Results
We identified 20,561 records, of which 24 met the inclusion criteria, reporting results from 16 unique studies conducted in 9 different countries. Compared to substance‐unrelated mental disorders, persons with AUD were generally less likely to be considered mentally ill, while they were perceived as being more dangerous and responsible for their condition. Further, the public desire for social distance was consistently higher for people with AUD. We found no consistent differences in the public stigma toward persons with AUD in comparison with other substance use disorders.
Conclusion
The stigmatization of persons with AUD remains comparatively high and is distinct from that of other substance‐unrelated disorders.
We summarise the literature on the stigma of alcohol use disorder (AUD) compared to other mental health conditions published in the last decade. The results of the 24 identified reports suggest that the stigmatisation of people with AUD remains comparatively high and distinct from that of other substance‐unrelated disorders. This was evident in almost all stigma aspects studied, including labelling AUD a mental illness, perceiving those affected as dangerous or responsible for their condition, and a greater desire for social distance.
Abortion Stigma: A Systematic Review Hanschmidt, Franz; Linde, Katja; Hilbert, Anja ...
Perspectives on sexual and reproductive health,
12/2016, Letnik:
48, Številka:
4
Journal Article
Recenzirano
Odprti dostop
Context
Although stigma has been identified as a potential risk factor for the well‐being of women who have had abortions, little attention has been paid to the study of abortion‐related stigma.
...Methods
A systematic search of the databases Medline, PsycArticles, PsycInfo, PubMed and Web of Science was conducted; the search terms were “(abortion OR pregnancy termination) AND stigma*.” Articles were eligible for inclusion if the main research question addressed experiences of individuals subjected to abortion stigma, public attitudes that stigmatize women who have had abortions or interventions aimed at managing abortion stigma. To provide a comprehensive overview of this issue, any study published by February 2015 was considered. The search was restricted to English‐ and German‐language studies.
Results
Seven quantitative and seven qualitative studies were eligible for inclusion. All but two dated from 2009 or later; the earliest was from 1984. Studies were based mainly on U.S. samples; some included participants from Ghana, Great Britain, Mexico, Nigeria, Pakistan, Peru and Zambia. The majority of studies showed that women who have had abortions experience fear of social judgment, self‐judgment and a need for secrecy. Secrecy was associated with increased psychological distress and social isolation. Some studies found stigmatizing attitudes in the public. Stigma appeared to be salient in abortion providers’ lives. Evidence of interventions to reduce abortion stigma was scarce. Most studies had limitations regarding generalizability and validity.
Conclusion
More research, using validated measures, is needed to enhance understanding of abortion stigma and thereby reduce its impact on affected individuals.
BACKGROUNDPatients with Barrett’s esophagus (BE) may experience psychological burden from living with a chronic medical condition, which has been identified as the most important risk factor for ...esophageal adenocarcinoma. The aim of this study was to estimate rates of depression and anxiety in a large sample of patients with BE.
METHODSA total of 794 patients with endoscopically and histologically confirmed diagnosis of BE completed validated screening instruments for depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7). Screening rates in the study sample were compared to general population estimates. Multivariable regression analyses were used to model associations between outcome variables and respondents’ sociodemographic characteristics, BE-related symptom load and incidence of inpatient treatment due to BE in the last 12 months.
RESULTSRates of positive screens were 14.2% for depression and 9.9% for anxiety. For several age by sex subgroups, rates of depression and anxiety were about three to five times higher in the study sample than in the general population. BE-related reflux and pain symptoms showed strong associations with higher levels of depressive and anxiety symptoms, while the effect of treatment was small.
CONCLUSIONStudy results indicate that a relevant proportion of patients with BE is at an increased risk for depression and anxiety, compared to general population controls. Lacking information on patients’ disease characteristics limited generalizability of results.
Termination of pregnancy after diagnosis of fetal anomaly (TOPFA) is a contested issue and stigma may negatively impact affected women’s psychological reactions. This study examined the influence of ...perceived and internalized stigma on women’s long-term adjustment to a TOPFA. One hundred forty-eight women whose TOPFA dated back 1 to 7 years responded to self-report questionnaires. The associations between perceived stigma at the time of the TOPFA, current internalized stigma and symptoms of grief, trauma and depression were modeled using multiple linear regression. The proportion of participants reporting scores above the cutoffs on the respective scale was 17.6% for grief, 18.9% for posttraumatic stress, and 10.8% for depression. After controlling for time since the TOPFA, pre-TOPFA mental health and obstetric variables, higher levels of current internalized stigma were related to higher levels of grief, trauma, and depression. Mediation analyses suggested that the effect of perceived stigma at the time of the TOPFA on symptoms of grief and trauma was mediated by current internalized stigma, but the cross-sectional design limited causal interpretation of results. Internalized stigma is associated with long-term psychological distress following a TOPFA. Perceived stigma at the time of the TOPFA may contribute to increased trauma and grief symptomatology, but results need to be validated in longitudinal studies. Health care providers and public initiatives should aim at reducing stigma among affected women.
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