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Objective: To assess differences in internalized stigma of mental illness based on demographic characteristics and mental healthcare utilization among college students. Participants: Students with self-reported mental illness (n = 128) were recruited via random sampling. Methods: Participants completed an online survey, including questions related to demographic characteristics and mental healthcare utilization. The survey also included the Internalized Stigma of Mental Illness (ISMI) scale. Data were analyzed using descriptive and inferential statistics. Results: Students accessing mental healthcare (pharmacological and/or psychotherapeutic) reported higher ISMI scores than students who did not access services during past year. Students with sexual minority statuses also reported higher ISMI scores than their heterosexual counterparts. Conclusions: Results highlight differences in internalized stigma based on demographics characteristics and mental healthcare utilization among college students. More research is needed to better understand intersectional stigma. Further, universities need tailored and specific interventions to address internalized stigma among students with diverse backgrounds and needs. [ABSTRACT FROM AUTHOR]

Background: Camouflaging, the strategies that some autistic people use to hide their differences, has been hypothesized to trigger mental health ramifications. Camouflaging might reflect ubiquitous impression management experiences that are not unique to autistic people and similarly impact the mental health of non-autistic people. Aims: We first examined whether individuals in the general population camouflage and manage impressions while experiencing mental health repercussions, and how gender and neurodivergent traits modified these associations. We then assessed how camouflaging and impression management arose from internalized stigma, and their inter-relationships in shaping mental health outcomes. Methods: Data were collected from 972 adults from a representative U.S. general population sample, with measures pertaining to camouflaging, impression management, mental health, internalized stigma, and neurodivergent traits. Multivariate hierarchical regression and moderated mediation analyses were used to address the two research aims. Results: Both camouflaging and self-presentation (a key component of impression management) were associated with mental health presentations in the general population, which overlapped with those previously reported in autistic people. These associations were more pronounced in women compared with men and were of different directions for individuals with higher autistic traits versus higher ADHD traits. Internalized stigma might be a key stressor that could elicit camouflaging and impression management through social anxiety, which in turn might lead to adverse mental health outcomes. Conclusions: These findings advance the conceptual clarity and clinical relevance of camouflaging and impression management across social and neurodiverse groups in the general population. The ramifications of camouflaging and impression management underscore the need to alleviate internalized stigma for better mental health across human groups. [ABSTRACT FROM AUTHOR]

Background: Self-stigma is associated with low self-esteem, high shame and reduced drinking-refusal self-efficacy in people with alcohol use disorder (AUD). The Self-Stigma in Alcohol-Dependence Scale-Short Form (SSAD-SF) was designed to enable a brief, but valid assessment of AUD self-stigma. Methods: We reduced the 64-item SSAD, originally derived from 16 stereotypes towards people with AUD, by removing the most offensive items based on perspectives of people with lived experience. The newly created scale was then assessed and validated in a cross-sectional study involving 156 people reporting alcohol issues in various treatment settings. Results: The 20-item SSAD-SF includes five stereotypes, with good internal consistency for each subscale and the overall scale. It reflects the four-stage progressive model of self-stigmatization with decreasing scores over the stages awareness of stereotypes, agreement with stereotypes, self-application of stereotypes, and harmful consequences for self-esteem, and highest correlations between adjacent stages. The subscales apply and harm were associated with internalized stigma, shame, reduced self-esteem, and lower drinking-refusal self-efficacy, as supported by multivariate regression models. Discussion: The SSAD-SF is a valid instrument for measuring the process of self-stigmatization in people with AUD. Self-stigma is a consistent predictor of reduced self-esteem, higher shame and lower drinking-refusal self-efficacy in people with AUD. We discuss merits of the progressive model for understanding and addressing self-stigma in AUD. [ABSTRACT FROM AUTHOR]

Persons with mental illness (PWMI) experience rejection, isolation, and discrimination in employment, education, and housing due to the prejudice associated with the illness. Families affiliated with PWMI often internalize the public's prejudice towards mental illness. Such internalized stigma can further impact the health and quality of life of both PWMI and their families. This study aimed to examine the level and correlates of internalized stigma in family members of PWMI in Qatar. A cross-sectional study of 106 family members was conducted using the Family Internalized Stigma Mental Illness Scale. The mean stigma score was 2.04 suggesting a mild level of stigma overall. Being married was found to be a predictor of higher levels of internalized stigma, while having college education or higher predicted lower levels of stigma. The overall stigma scores among family members were not high, which may reflect the protective stance families take towards about their relatives with mental illness. Some sociodemographic attributes predicted trends in internalized stigma among our surveyed sample. Future research efforts in this area may help increase understanding of internalized stigma in this population to inform stigma reduction efforts. [ABSTRACT FROM AUTHOR]

Background: Health-related stigma and its internalization among individuals with chronic health conditions contribute to impaired mental and physical health and quality of life. Research on health-related stigma has been siloed, with disease-specific measures that may not capture the experiences of individuals with multiple health conditions and that prevent comparisons across health conditions. The current study aimed to develop and test a transdiagnostic measure of internalized health-related stigma for use among adults with different physical health conditions. Methods: An existing measure of internalized mental health stigma was adapted to assess stigma due to chronic physical health conditions following COSMIN procedures, with input from advisory boards of community members living with a range of stigmatized health conditions (obesity, type 1 and type 2 diabetes, skin diseases, HIV, chronic pain, and cancers) and of health professionals who specialized in these conditions. The new Internalized Health-Related Stigma (I-HEARTS) Scale was tested in an online sample of 300 adults with these health conditions, recruited from ResearchMatch. Additional psychosocial measures of mental health and quality of life were administered, and participants provided information about their health conditions and demographic characteristics. Exploratory factor analysis and tests of reliability and validity were conducted to determine the psychometric properties of the I-HEARTS Scale, and k-means clustering and receiver of characteristic curve analysis were used to determine a clinically meaningful cutoff score indicating high levels of internalized stigma. Results: Factor analysis results yielded a 25-item scale with a 3-factor solution, with subscales of Perceived and Anticipated Stigma, Stereotype Application and Self-Devaluation, and Stigma Resistance. Psychometric properties for internal consistency, inter-item and item-total correlations, and test-retest reliability were strong. Certain demographics (e.g., younger age) and characteristics related to health conditions (e.g., greater symptom severity) were associated with higher levels of internalized stigma. I-HEARTS Scale scores correlated moderately to strongly with related but distinct psychosocial measures, and a cutoff score of 3.40 or higher on the 1–7 rating scale was determined to indicate clinically meaningful levels of internalized stigma. Conclusions: The I-HEARTS Scale is a reliable and valid measure for the assessment of internalized health-related stigma among adults with varied stigmatized chronic health conditions. Study pre-registration: https://osf.io/84c5d/?view_only=87238512f6d6475c87f8f64280a8a15f. [ABSTRACT FROM AUTHOR]

Aim: To understand the status of internalized stigma in patients with rheumatoid arthritis (RA) and explore its relationship with self‐esteem, social support, and coping style. Methods: This cross‐sectional study selected patients with RA who visited the Rheumatology and Immunology Department of a tertiary hospital from May 2022 to May 2023. The Chinese versions of the Internalized Stigma of Mental Illness Scale‐Rheumatoid Arthritis (ISMI‐RA), Social Support Rating Scale, Rosenberg Self‐Esteem Scale, and Medical Coping Style Questionnaire were administered to assess the internalized stigma, social support, self‐esteem, and coping styles, respectively. The Pearson correlation test or Spearman rank correlation was then used to analyze the correlation between these measures. Results: Overall, 69.5% participants reported high level of internalized stigma. The average age of the 174 participants was 52.67 ± 12.24 years, with 87.36 per cent female patients. The mean ISMI‐RA score was 54.49 ± 9.62, and the ISMI‐RA subscale with the highest average score was alienation. The Pearson's correlations show that internalized stigma was positively associated with the coping styles of avoidance (r =.212, p <.01) and acceptance (r =.560, p <.01), and that internalized stigma was negatively associated with the coping styles of confrontation (r = −.479, p <.01), social support (r = −.570, p <.01), and self‐esteem(r = −.512, p <.05). Conclusion: The high level of internalized stigma in RA patients suggests that we should develop interventions to improve patients' self‐esteem, encourage them to adopt positive coping styles, and gain more social support for them, so as to alleviate their internalized stigma. [ABSTRACT FROM AUTHOR]

Objective: The study was conducted to determine the effect of mindfulness-based psychoeducation on internalized stigma and substance abuse proclivity in individuals with substance use disorder. Design and Methods: The study was carried out as an experimental model with a pretest–posttest control group. The sample used in the study consisted of 100 individuals (50 for control group, 50 for experimental group) via power analysis. The Patient Information Form, the Internalized Stigma of Mental Illness Scale (ISMI), and the Substance Abuse Proclivity Scale (SAP) were used to collect the data. An eight-session mindfulness-based psychoeducation program was applied to the experimental group. Findings: It was determined that there was a mild decrease in the posttest SAP total mean score and the ISMI subscale and total mean score of the experimental group patients compared to the pretest. The difference between the posttest ISMI and substance abuser proclivity of the control and experimental groups was statistically significant (p <.05). Conclusion: It was determined that MB psychoeducation was effective in decreasing internalized stigma and substance abuse proclivity in patients with substance use disorder. [ABSTRACT FROM AUTHOR]

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Abstract Background Self-stigma is associated with low self-esteem, high shame and reduced drinking-refusal self-efficacy in people with alcohol use disorder (AUD). The Self-Stigma in Alcohol-Dependence Scale-Short Form (SSAD-SF) was designed to enable a brief, but valid assessment of AUD self-stigma. Methods We reduced the 64-item SSAD, originally derived from 16 stereotypes towards people with AUD, by removing the most offensive items based on perspectives of people with lived experience. The newly created scale was then assessed and validated in a cross-sectional study involving 156 people reporting alcohol issues in various treatment settings. Results The 20-item SSAD-SF includes five stereotypes, with good internal consistency for each subscale and the overall scale. It reflects the four-stage progressive model of self-stigmatization with decreasing scores over the stages awareness of stereotypes, agreement with stereotypes, self-application of stereotypes, and harmful consequences for self-esteem, and highest correlations between adjacent stages. The subscales apply and harm were associated with internalized stigma, shame, reduced self-esteem, and lower drinking-refusal self-efficacy, as supported by multivariate regression models. Discussion The SSAD-SF is a valid instrument for measuring the process of self-stigmatization in people with AUD. Self-stigma is a consistent predictor of reduced self-esteem, higher shame and lower drinking-refusal self-efficacy in people with AUD. We discuss merits of the progressive model for understanding and addressing self-stigma in AUD.

Abstract Background Health-related stigma and its internalization among individuals with chronic health conditions contribute to impaired mental and physical health and quality of life. Research on health-related stigma has been siloed, with disease-specific measures that may not capture the experiences of individuals with multiple health conditions and that prevent comparisons across health conditions. The current study aimed to develop and test a transdiagnostic measure of internalized health-related stigma for use among adults with different physical health conditions. Methods An existing measure of internalized mental health stigma was adapted to assess stigma due to chronic physical health conditions following COSMIN procedures, with input from advisory boards of community members living with a range of stigmatized health conditions (obesity, type 1 and type 2 diabetes, skin diseases, HIV, chronic pain, and cancers) and of health professionals who specialized in these conditions. The new Internalized Health-Related Stigma (I-HEARTS) Scale was tested in an online sample of 300 adults with these health conditions, recruited from ResearchMatch. Additional psychosocial measures of mental health and quality of life were administered, and participants provided information about their health conditions and demographic characteristics. Exploratory factor analysis and tests of reliability and validity were conducted to determine the psychometric properties of the I-HEARTS Scale, and k-means clustering and receiver of characteristic curve analysis were used to determine a clinically meaningful cutoff score indicating high levels of internalized stigma. Results Factor analysis results yielded a 25-item scale with a 3-factor solution, with subscales of Perceived and Anticipated Stigma, Stereotype Application and Self-Devaluation, and Stigma Resistance. Psychometric properties for internal consistency, inter-item and item-total correlations, and test-retest reliability were strong. Certain demographics (e.g., younger age) and characteristics related to health conditions (e.g., greater symptom severity) were associated with higher levels of internalized stigma. I-HEARTS Scale scores correlated moderately to strongly with related but distinct psychosocial measures, and a cutoff score of 3.40 or higher on the 1–7 rating scale was determined to indicate clinically meaningful levels of internalized stigma. Conclusions The I-HEARTS Scale is a reliable and valid measure for the assessment of internalized health-related stigma among adults with varied stigmatized chronic health conditions. Study pre-registration https://osf.io/84c5d/?view_only=87238512f6d6475c87f8f64280a8a15f .

BACKGROUND: Only a few studies have explored the relationship between psychosocial factors and medication adherence in Indian patients with noncommunicable diseases (NCDs). We aimed to examine the association of psychosocial variables with medication adherence in people with NCDs and comorbid common mental disorders (CMDs) from primary care in rural southern India. METHODS: We performed a secondary analysis using baseline data from a randomized controlled trial in 49 primary care health centers in rural southern India (HOPE study). Participants were adults (≥30 years) with NCDs that included hypertension, diabetes, and/or ischemic heart disease, and comorbid depression or anxiety disorders. Medication adherence was assessed by asking participants if they had missed any prescribed NCD medication in the past month. Data were collected between May 2015 and November 2018. The association between psychosocial and demographic variables and medication nonadherence were assessed via logistic regression analyses. RESULTS: Of the 2486 participants enrolled, almost one-fifth (18.06%) reported missing medication. Male sex (OR = 1.74, 95% CI 1.37-2.22) and higher internalized mental illness stigma (OR = 1.46, 95% CI 1.07-2.00) were associated with higher odds of missing medication. Older age (OR = 0.40, 95% CI 0.26-0.60, for participants aged 64-75 years vs 30-44 years), reporting more social support (OR = 0.65, 95% CI 0.49-0.86), and higher satisfaction with health (OR = 0.74, 95% CI 0.61-0.89) were associated with lower odds of missing medication. CONCLUSIONS: Greater internalized mental illness stigma and less social support are significantly associated with lower rates of medication adherence in patients with NCDs and comorbid CMDs in rural India.

Objective: Maladaptive daydreaming (MD) is characterized by vivid, excessive fantasy activity that becomes prioritized over other activities and may result in avoidant coping strategies. Little is known about the relationship between MD and internalized stigma in the neurodivergent sample. The current study aimed to examine emotional dysregulation, escapism and self-perception (self-esteem and internalized stigma) as potential determinants of MD in three groups: adults on the autism spectrum, with ADHD, and both diagnoses ("AuDHD"), including their neurodivergent symptoms (autistic traits, empathizing, ADHD symptoms). Methods: A sample of 293 persons (139 with ADHD, 74 on the autism spectrum, and 80 with both diagnoses) completed self-report scales concerning ADHD symptoms, autism spectrum symptoms, empathizing, self-esteem, daydreaming as escapism, emotional dysregulation, maladaptive daydreaming, and internalized stigma. A correlation analysis was implemented. Additionally, a group comparison and quantile regression for the 25th, 50th, and 75th percentile of maladaptive daydreaming in the three groups were executed. Results: The results showed that internalized stigma, emotional dysregulation, escapism, and self-esteem have significant associations with MD in the neurodiverse sample. The ADHD group achieved the lowest scores in emotional dysregulation, discrimination experience, and social withdrawal. The groups did not vary in MD rates, stereotype endorsement, stigma resistance, nonacceptance of emotional responses, and impulse control difficulties. The AuDHD group achieved higher results than the ASD group only in the ADHD symptoms. Quantile regression revealed differences in the predictors of maladaptive daydreaming in the three groups. ADHD symptoms and self-suppression escapism were significant predictors for the higher levels of MD in persons with singular autism or ADHD diagnosis. Conclusion: The results showed no differences in MD rates, although there were significant variations in predictive features among the three samples. The role of internalized stigma and self-esteem was highlighted in the results as significant associates of MD prevalence. These outcomes expand the current knowledge in the context of maladaptive daydreaming, internalized stigma, self-esteem and emotional dysregulation in a neurodiverse sample and allow for proposing clinical applications and further research directions. [ABSTRACT FROM AUTHOR]

Abstract Background Individuals with higher weight (overweight or obesity) may experience social stigma due to their weight. Weight stigma can be internalized with adverse health effects. Internalized weight stigma is relevant across different weight categories, but no validated weight-neutral measure of internalized weight bias currently exists in Norway. The current study aimed to examine the validity of a Norwegian translation of the Modified Weight Bias Internalization Scale. Methods A Norwegian translation of the Modified Weight Bias Internalization Scale (WBIS-M) was administered in an adult Norwegian sample (N = 315, of which 251 women) ranging from self-reported “very underweight” to “very overweight”. Results A confirmatory factor analysis was conducted on 11 of the original 11 items in the WBIS-M. Based on previous factor analyses with this scale, we expected a one-factor model. One of the items related to competence showed poor model fit, and concern was raised around possible item ambiguity partway through the study. Two versions of this item were therefore tested, neither of which yielded an acceptable fit. After exclusion of this item, the results showed high loadings for the remaining 10 items on one factor with a high internal consistency (α = 0.94). Convergent validity was approached by looking at the relationship between answers on the WBIS-M, self-perceived weight, and items on overall health and psychological/emotional state. Conclusion The 10-item Norwegian version of the WBIS-M shows sound psychometric properties and can be used to measure internalized weight bias in a weight-neutral fashion in a Norwegian-speaking population. Internalized weight bias was correlated with psychological/emotional state and overall health, with those reporting more internalized weight bias also reporting that they felt worse. This relationship was stronger for women than men in our sample and was partially dependent on weight. The women also showed higher internalized weight bias than the men. Future studies should include more male participants and explore alternative versions of the missing item related to competence.

Objective Internalized stigma, which refers to the internalization of negative attitudes and beliefs towards persons with mental illness, significantly impacts their self- perception and overall well-being. This research examines the correlations among internalized stigma, the severity of symptoms, and self-esteem in individuals diagnosed with major depressive disorder (MDD), specifically comparing those currently experiencing active depression with those who are in remission. Material and Method Participants were selected from a psychiatric out- patient unit based on their diagnosis of MDD. Participants provided sociodemographic information and completed assessments measuring the severity of depression, level of anxiety, self-esteem, and internalized stigma. Results Participants experiencing active depression exhibited elevated levels of depression severity, anxiety severity, and internalized stigma, while also reporting diminished self-esteem in comparison to those who were in a state of remission. Strong positive relationships were observed between the severity of depression and internalized stigma where self- esteem was negatively correlated with the stigma. The results of the regression analysis showed that there was a significant relationship between the severity of depression, self-esteem, and internalized stigma in the group of individuals with active MDD. Conclusion This study underscores the impact of depression severity and self-esteem on internalized stigma in individuals with MDD. The findings indicate the need to implement comprehensive treatment techniques that address psychological and social variables like self- esteem and internalized stigma in addition to symptom management. Future studies should investigate the long-term connections and assess the efficacy of interventions in reducing the obstacles caused by stigma in the process of recovering from depression. [ABSTRACT FROM AUTHOR]

People surviving COVID‐19 may experience social stigma related to their condition even after clinical recovery. This study aimed to: (1) investigate COVID‐19‐related experienced discrimination and internalized stigma, and (2) explore their association with symptoms of anxiety, depression, and insomnia. We conducted an online survey of people who survived COVID‐19. Perception of stigma was assessed using the COVID‐19 Experienced Discrimination Scale and the COVID‐19 Internalized Stigma Scale. Depression, anxiety, and insomnia were assessed using, respectively, the Patient Health Questionnaire‐9, the General Anxiety Disorder Scale‐7, and the Insomnia Severity Index. Multivariable logistic regression analyses for each psychopathological domain were performed. A total of 579 participants participated in this study. Overall, 25% reported some degree of experienced discrimination, and 23% reported some degree of internalized stigma. Adjusted odds ratio showed that scoring higher on internalized stigma related significantly to higher symptoms of depression (2.14; 95% confidence interval [CI], 1.35–3.39), anxiety (2.30; 95% CI, 1.48–3.59), and insomnia (2.54; 95% CI, 1.64–3.95), whereas experienced discrimination was associated to anxiety (1.55; 95% CI, 1.06–2.28) and insomnia (1.82; 95% CI, 1.24–2.69). Experiences of social stigmatization are frequent among people surviving COVID‐19 and seem to be associated with levels of psychological disturbances. Further research is required to elucidate the direction of these relationships to implement effective treatment strategies. [ABSTRACT FROM AUTHOR]

Background: Individuals with higher weight (overweight or obesity) may experience social stigma due to their weight. Weight stigma can be internalized with adverse health effects. Internalized weight stigma is relevant across different weight categories, but no validated weight-neutral measure of internalized weight bias currently exists in Norway. The current study aimed to examine the validity of a Norwegian translation of the Modified Weight Bias Internalization Scale. Methods: A Norwegian translation of the Modified Weight Bias Internalization Scale (WBIS-M) was administered in an adult Norwegian sample (N = 315, of which 251 women) ranging from self-reported "very underweight" to "very overweight". Results: A confirmatory factor analysis was conducted on 11 of the original 11 items in the WBIS-M. Based on previous factor analyses with this scale, we expected a one-factor model. One of the items related to competence showed poor model fit, and concern was raised around possible item ambiguity partway through the study. Two versions of this item were therefore tested, neither of which yielded an acceptable fit. After exclusion of this item, the results showed high loadings for the remaining 10 items on one factor with a high internal consistency (α = 0.94). Convergent validity was approached by looking at the relationship between answers on the WBIS-M, self-perceived weight, and items on overall health and psychological/emotional state. Conclusion: The 10-item Norwegian version of the WBIS-M shows sound psychometric properties and can be used to measure internalized weight bias in a weight-neutral fashion in a Norwegian-speaking population. Internalized weight bias was correlated with psychological/emotional state and overall health, with those reporting more internalized weight bias also reporting that they felt worse. This relationship was stronger for women than men in our sample and was partially dependent on weight. The women also showed higher internalized weight bias than the men. Future studies should include more male participants and explore alternative versions of the missing item related to competence. Plain English summary: Individuals with higher weight may experience social stigma due to their weight. This can include encountering beliefs that people of higher weight lack willpower or are not as smart or valuable as others. Stigma related to weight can then be internalized, leading to weight bias internalization, which is when people start to believe in weight-related stigma about themselves. A Norwegian translation of the modified weight bias internalization scale (WBIS-M) was answered by a Norwegian sample. A confirmatory factor analysis was conducted to determine whether the scale had a single-factor structure. The results showed that 10 of the original 11 items fit well, but one item related to the experience of competence should be removed. Once this item was removed, the scale had good statistical properties, indicating that internalized weight bias can be measured by the 10 items of the Norwegian WBIS-M. Internalized weight bias was related to how well people were feeling psychologically and health-wise, with those reporting more internalized weight bias also reporting that they felt worse. This relationship was stronger for women than men in our sample. Future studies should include more male participants and explore further versions of the competence item. [ABSTRACT FROM AUTHOR]

Background: The experience of stigma can exert a profound impact on the mental health and well-being of individuals with bipolar disorder (BD). Our study explores which factors of internalized stigma are associated with suicidal ideation and how they differ between the two sexes in a clinical sample of BD patients. Methods: The study follows a cross-sectional study design, employing the Clinical Global Impression for Bipolar Patients (CGI-BP) to evaluate the overall severity of illness and the alteration in patients affected by bipolar disorder, the Internalized Stigma of Mental Illness (ISMI) assessing self-stigma among individuals experiencing mental disorders, and the Columbia Suicide Severity Rating Scale (C-SSRS) identifying and assessing individuals vulnerable to suicide. Descriptive analyses, analysis of variance (ANOVA), and logistic regression analysis were conducted, and 344 BD subjects were recruited. Results: Our ANOVA results revealed a significant association between sex and suicide across ISMI sub-items (p = 0.000). Logistic regression analysis comprised three phases: Discrimination was consistently significant across all phases (p < 0.001), while Alienation and Stereotype emerged as additional predictors of suicide in later phases of the analysis (p < 0.001). Conclusions: Our study contributes to the growing body of literature on internalized stigma, sex, and suicidality among individuals with bipolar disorder. Early intervention programs and prevention strategies are needed. [ABSTRACT FROM AUTHOR]

It is unclear what types of stigma youth at clinical high risk for psychosis (CHR) experience, and the relationship between them and symptomatology. 94 CHR youth, and a control group of 45 youth with no psychosis spectrum symptoms (NP) were rated for perceived devaluation (i.e. negative views from others) and internalized mental health stigma (i.e. the extent to which they would agree with said views) as well as positive and mood symptomatology. CHR youth reported stigma more frequently than the NP group (χ2(1) = 53.55, p <.001) and at higher levels (perceived devaluation: t (137) = 8.54, p <.001; internalized stigma: t (137) = 7.48, p <.001). Surprisingly, in the CHR group, positive symptoms held no significant relationship to stigma measures. However, ratings of perceived devaluation stigma were associated with depressive symptomatology (β = 0.27, t = 2.68, p =.0087) and depression scores were conversely associated with perceived devaluation stigma (β = 0.30, t = 2.05, p =.043). These findings speak to the relationship between depressive symptomatology and perceived devaluation stigma in CHR youth. Perceived devaluation stigma showed greater clinical significance and could have different mechanisms than internalized stigma in CHR youth. It is also noteworthy that while positive symptoms play a central role in defining the CHR syndrome, they seem less relevant to the experience of stigma than mood symptoms. These findings highlight the importance of interventions aimed at ameliorating youth's exposure to negative views about mental health as those managing depressive symptomatology. [ABSTRACT FROM AUTHOR]

South Africa has the largest share of people living with HIV in the world and this population is ageing. The social context in which people seek HIV care is often ignored. Apart from clinical interventions, socio-behavioural factors impact successful HIV care outcomes for older adults living with HIV. We use cross-sectional data linked with demographic household surveillance data, consisting of HIV positive adults aged above 40, to identify socio-behavioural predictors of a detectable viral load. Older adults were more likely to have a detectable viral load if they did not disclose their HIV positive status to close family members (aOR 2.56, 95% CI 1.89-3.46), resided in the poorest households (aOR 1.98, 95% CI 1.23-3.18), or were not taking medications other than ART (aOR 1.83, 95% CI 1.02-1.99) likely to have a detectable. Clinical interventions in HIV care must be supported by understanding the socio-behavioural barriers that occur outside the health facility. The importance of community health care workers in bridging this gap may offer more optimum outcomes for older adults ageing with HIV. [ABSTRACT FROM AUTHOR]

IntroductionThis article describes the development and initial validation of a measure of implicit internalized stigma among queer people, the Implicit Internalized Sexual Orientation Stigma Affect Misattribution Procedure (Internal-SOS-AMP), a computer-administered sequential priming procedure.MethodsThe creation of the Internal-SOS-AMP involved a mixed-methods approach, including a literature review, expert interviews, stimuli selection and pilot testing, data collection from a large sample, reliability testing, correlational analyses, and confirmatory factor analysis. Psychometric testing was conducted with a national sample of 500 queer adults who completed two waves of data collection. Confirmatory factor analysis was used to evaluate two models: a one-factor model with internalized stigma specified as one overall construct and a two-factor model with internalized stigma specified as two constructs based on binary conceptions of gender (stigma regarding queer women and stigma regarding queer men).ResultsResults showed that the two-factor model best fit the data. This indicates that although implicit attitudes toward queer men and women are highly correlated, implicit internalized stigma differentiated by two gender stimuli groups (men and women) more accurately reflects the data. There was evidence of convergent validity as Internal-SOS-AMP scores showed small positive associations with explicit internalized stigma. Regarding divergent validity, Internal-SOS-AMP scores were inversely related to affirmation of a queer identity. Reliability results for the Internal-SOS-AMP showed good internal consistency and acceptable test–retest reliability.DiscussionThe creation of the Internal-SOS-AMP used best practices for measurement development. Psychometric findings show strong evidence of content validity, convergent validity, divergent validity, and reliability of the Internal-SOS-AMP.

Background: Stigma relating to mental illness has mostly been studied in communities and families. Less research has been conducted in India to understand the current subjective experience of persons with mental illness in the tertiary care hospital setting in India. Aim and Objectives: This study aimed to assess the extent of internalized stigma among persons and to see the association between self-stigma, self-esteem, insight, and adherence. Methodology: The study used a cross-sectional design. The present study was conducted in the Outpatient Department of LGB Regional Institute of Mental Health, Tezpur, Assam. For the present study, 200 persons with schizophrenia were selected. Participants of this study were persons with a clinical diagnosis of schizophrenia according to the International Classification of Diseases-10 Diagnostic Criteria for Research. Sociodemographic and clinical data sheet, Brief Psychiatric Rating Scale, the Internalized Stigma of Mental Illness Scale, Morisky Adherence Scale, and Rosenberg Self-Esteem Scale were administered. The collected data were analyzed using descriptive and inferential statistics in Statistical Package for Social Science (SPSS) 21 version. Results: The findings show that 45% of the participants were having moderate internalized stigma and 21% of the participants were having severe internalized stigma. Self-Esteem Scale (B = −341, t = −2.940, P = 005), medication adherence (B = −701, t = −9.832, P = 000), and insight (B = −711, t = −6.496, P = 000) contributed significantly to the prediction of internalized stigma among persons with schizophrenia (F [3,63] =58.712, P = 000) accounting for 85.8% variance. Conclusion: The findings confirm that self-esteem, medication adherence, and insight contributed significantly to the prediction of internalized stigma among persons with schizophrenia.

Background: Patients with schizophrenia and bipolar affective disorder (BPAD) diagnosis often experience high levels of internalized stigma, where they internalize negative societal views about mental illness. This can profoundly impact their quality of life (QOL), help-seeking behavior, adherence to treatment, increased disability, and increase the economic burden. This study was taken up to determine and compare internalized stigma in remitted patients of schizophrenia and bipolar disorder and correlate the association between internalized stigma and QOL. Methodology: A cross-sectional comparative hospital-based study with a sample size of 100 (48 patients of schizophrenia and 52 patients of bipolar disorder in remission) was taken for the study as per the International Classification of Diseases-10 criteria. Basic demographic data were collected using a semi-structured questionnaire. Remission was assessed by the Clinical Global Impressions-Severity Scale. Stigma was assessed using the Internalized Stigma of Mental Illness Scale and quality of life (QOL) was assessed using the World Health Organization Quality of Life Brief version (WHOQOL BREF), insight grading as per Comprehensive Textbook of Psychiatry 10th Edition. The level of significance was set at 0.05 for all statistical analyses. Results: A total of 100 subjects participated in the study, of which 48 belong to the schizophrenia group and 52 belong to the BPAD group. Prevalence of internalized stigma among subjects with schizophrenia is 54% and BPAD is 50%. There was a statistically significant association between diagnosis and self-stigma. Self-stigma was found to be more among female gender (P = 0.001), single (0.014), and unemployed (P = 0.010). There was a statistically significant negative correlation between internalized stigma scores and QOL. Conclusion: The current study found a strong negative correlation between internal stigma and QOL, suggesting that internal stigma may have a negative impact on social relationships, community participation, and physical and psychological well-being of the individual. Considering this, psychiatrist should formulate strategies to address internal stigma along with clinical manifestations.

Background: Older adults have been found to internalize stigma from society and this has been linked to several variables including social support, coping, psychological distress, and mental well-being. However, there is a dearth of research on how these variables interact with each other to impact the life of older adults. Aims: This study employed path analysis to explore social support and coping as boundary conditions and underlying mechanisms in the link between internalized stigma, psychological distress, and mental well-being, among older adults in Ghana. Method: Using a cross-sectional design, the study recruited 167 older adults who responded to standardized questionnaires including The Internalized Stigma of Mental Illness scale, Multidimensional Perceived Social Support Scale, The Brief Coping Inventory, Kessler Distress Scale, and the Warwick-Edinburgh Mental Well-being Scale, to determine levels of internalized stigma, social support, coping strategies, psychological distress, and mental well-being, respectively. Results: The findings revealed that at low levels of social support, there is a significant and positive correlation between internalized stigma and mental well-being (β = −.36, SE = 0.17, p <.001). Path analysis showed that the relationship between internalized stigma and mental well-being was fully mediated by problem-focused coping (β =.11, p =. 001, 95% CI [0.04, 0.21]), but not psychological distress. Problem-focused coping was also found to have a significant positive correlation with mental well-being but no significant correlation with psychological distress. Conversely, avoidant-focused coping was found to have a significant positive correlation with psychological distress and a significant negative correlation with mental well-being. Conclusions: This study revealed the importance of social support and coping to attaining mental well-being among older adults. This study provides insights into the development of tailored interventions aimed at improving social support and problem-focused coping among older Ghanaian adults facing internalized stigma, and it also establishes a base for future research. [ABSTRACT FROM AUTHOR]

Stigma-related stressors are central to understanding psychopathology, distress, and coping in stigmatized groups; individuals who experience attractions to children are a highly stigmatized group. Currently, few validated self-report measures exist to assess stigma-related stressors in minor attracted people (MAPs) and the current research describes the development and initial validation of two measures of internalized stigma and experiences of discrimination. A sample of MAPs (n = 289; mean age = 31.8 years, SD = 12.2) was recruited online and completed a set of self-report measures assessing stigma-related stress, negative mental health outcomes, substance use, and coping. Exploratory factor analyses of the two newly developed stigma-related stress measures were conducted and convergent associations with other constructs were examined for validity evidence. Exploratory factor analyses indicated a two-factor solution to both the measure of internalized stigma and experiences of discrimination. The total scale scores and factors scores generally demonstrated the anticipated patterns of correlations with mental health concerns, distress, coping, and substance use. Clinical intervention with MAPs may benefit from an exploration of stigma-related stressors in clients' lives to improve mental health outcomes. The relatively large sample that was recruited from multiple online forums is a strength of the current study. The use of a self-report measurement modality for all measures used in the study weakens that strength of the validation evidence presented here. These results provide initial validity evidence for the measures of stigma-related stress in MAPs and the promise of stigma processes in understanding negative outcomes in this population. [ABSTRACT FROM AUTHOR]

Stigma relating to substance use disorders is one of the many barriers to enrolling in substance use treatment. Stigma is also related to poorer substance use treatment outcomes, yet few studies of substance use and substance use treatment outcomes include measures of stigma. Stigma is a multi-level experience occurring as a result of discrimination within a systematic power structure promoting inequities among marginalized populations. Several domains of stigma are manifested among individuals seeking treatment for a substance use disorder, with internalized stigma being the most commonly measured. The current paper is a narrative review of measures that have been developed to measure internalized stigma related to substance use in treatment settings. Measures of stigma (n = 8) in substance use treatment settings were identified using PubMed and PsycINFO databases. The review identified various strengths of existing measures, including a broad range of measures with mostly excellent internal consistency. The review also identified limitations including the general lack of consideration for multiple domains and intersecting forms of stigma, samples with limited racial and ethnic diversity, and the lack of assessments of polysubstance use. The development of measures of the stigma that assess multiple domains of stigma and that are tested in a wide range of substance use treatment settings with racially and ethnically diverse participants is needed. This is of particular importance because stigma remains a crucial barrier to the successful initiation and completion of substance use treatment. [ABSTRACT FROM AUTHOR]

Research has highlighted that some types of mental disorders are associated with widespread discrimination and stigma, phenomena that negatively affect adherence. The aim of the present study was to examine the association between stigma and adherence to pharmacological treatment in patients diagnosed with bipolar mood disorder (BD), attention deficit hyperactivity disorder (ADHD) and schizophrenia (SZ). A total of 112 patients (age range: 20-68 years, Median age = 42.08; SD age = 12.02) from Brazil (38.4% ADHD, 34.8% SZ, and 26.8% TB) participated in the study. Treatment adherence was measured using the Medication Adherence Questionnaire, personal stigma by means of the Internalized Stigma of Mental Illness, Stigma Scale, and Perceived Devaluation and Discrimination Scale, and self-esteem with Rosenberg’s Self-Esteem Scale. Results showed an association between personal stigma and treatment adherence for all three types of disorder. The lower the personal stigma, the higher the adherence to treatment. The study highlights the role of stigma and self-esteem in relation to treatment adherence, with possible implications for future psychotherapy for these disorders. [ABSTRACT FROM AUTHOR]

Background: Stigma relating to mental illness has mostly been studied in communities and families. Less research has been conducted in India to understand the current subjective experience of persons with mental illness in the tertiary care hospital setting in India. Aim and Objectives: This study aimed to assess the extent of internalized stigma among persons and to see the association between self-stigma, self-esteem, insight, and adherence. Methodology: The study used a cross-sectional design. The present study was conducted in the Outpatient Department of LGB Regional Institute of Mental Health, Tezpur, Assam. For the present study, 200 persons with schizophrenia were selected. Participants of this study were persons with a clinical diagnosis of schizophrenia according to the International Classification of Diseases-10 Diagnostic Criteria for Research. Sociodemographic and clinical data sheet, Brief Psychiatric Rating Scale, the Internalized Stigma of Mental Illness Scale, Morisky Adherence Scale, and Rosenberg Self-Esteem Scale were administered. The collected data were analyzed using descriptive and inferential statistics in Statistical Package for Social Science (SPSS) 21 version. Results: The findings show that 45% of the participants were having moderate internalized stigma and 21% of the participants were having severe internalized stigma. Self-Esteem Scale (B = -341, t = -2.940, P = 005), medication adherence (B = -701, t = -9.832, P = 000), and insight (B = -711, t = -6.496, P = 000) contributed significantly to the prediction of internalized stigma among persons with schizophrenia (F [3,63] =58.712, P = 000) accounting for 85.8% variance. Conclusion: The findings confirm that self-esteem, medication adherence, and insight contributed significantly to the prediction of internalized stigma among persons with schizophrenia. [ABSTRACT FROM AUTHOR]

Suicide represents a significant public health problem, with around 800,000 deaths per year worldwide and up to 20 times as many episodes of self-harm and suicide attempts. Members of stigmatized groups may experience increased risk of suicide due in part to stigma-related factors, such as expectations of rejection, internalization of negative stereotypes, or potential for greater social isolation. Research suggests that adults who are attracted to children face extreme stigma, even those who do not commit sexual crimes involving children. Adults who are attracted to children also experience significantly increased risk for suicidal ideation and behavior (SIB) compared to general population samples. The current study sought to explore experiences with SIB among adults attracted to children to better understand factors underlying suicidality in this population. The lead author conducted semi-structured interviews in a community sample of 15 adults attracted to children who self-reported some form of SIB in their lifetime. Using interpretative phenomenological analysis, the lead author explored and interpreted interview data to generate themes driven by respondents' characterizations of their SIB. Superordinate themes related to suicidality in this sample included low self-esteem or self-worth, cumulative impacts of the attraction and other stressors, and concerns about the ability to have a positive future due to the attraction. Findings underscore the importance of addressing internalized stigma, treating problems like depression and social isolation, and instilling hope for the future to promote mental health and prevent SIB among adults attracted to children. [ABSTRACT FROM AUTHOR]

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The study aimed to determine the relationship between self-stigma and vocational hope among disabled university students. This study further examined whether levels of self-stigma and vocational hope reported by participants vary as a function of gender and type of disability. The sample (N=134) consisted of students with physical disability/loss of a limb (N=20), paralysis/mobility disability (N=23), visual impairment (N=32), hearing impairment (N=31), speech and communication disorder (N=28) who are studying at AL-Baath university in Homs, Syria. The following scales were applied: Internalized Stigma of Mental Illness (ISMI) and Work Hope Scale (WHS). Results indicated that the research sample reported a high level of self-stigma and low vocational hope. An analysis further showed a significant negative correlation between self-stigma and vocational hope (r= -0.862, p<0.05) where higher self-stigma was associated with lower vocational hope. The results further indicated that male participants expressed a higher level of vocational hope and a lower level of self-stigma than female participants. Finally, results found that levels of self-stigma and vocational hope reported by participants did not vary as a function of type of disability. [ABSTRACT FROM AUTHOR]

Background: Internalized stigma among patients with tuberculosis (TB) significantly affects delayed diagnosis, increased disease transmission, and poor treatment outcomes. However, conclusive empirical evidence on psychosocial interventions to reduce internalized stigma among patients with TB in Thailand remains scarce. Objective: This study aimed to examine the impact of a peer support intervention on reducing internalized stigma among patients with TB in Thailand. Methods: A one-group within-subjects repeated-measure design was conducted in the Muang Maha Sarakham district, Thailand, from February 2023 to July 2023. The study included 26 participants who met specified criteria. Measurements were taken at baseline, three months, and six months following TB diagnosis and medication treatment. The peer support intervention comprised TB health education, psycho-educational sessions, self-management support, and home visits. The Internalized Stigma of Tuberculosis Scale Thai Version was used to measure internalized stigma. Statistical analyses included descriptive statistics and repeated measures ANOVA. Results: Mean scores of total internalized stigma and its sub-dimensions (alienation, stereotype endorsement, discrimination experience, social withdrawal, and stigma resistance) differed significantly across the three-time points (p

Suicide is a leading cause of death among youth on the psychosis spectrum. Internalized mental health stigma is one risk factor for suicide that may be particularly salient for youth with psychosis-risk syndromes and early psychosis. Among this population, Black youth may face exposure to racism-related stressors that may exacerbate the negative effects of internalized stigma. This study examined whether internalized stigma and race interact to predict suicidal thoughts and behaviors (STB) in a help-seeking sample of Black and White adolescents with psychosis-risk syndromes and early psychosis. Findings suggest that Black youth with early psychosis spectrum disorders may be particularly vulnerable to the negative effects of internalized stigma as they pertain to STB. Internalized stigma may therefore represent an important treatment target in suicide prevention efforts among this population.

Sexual Minoritized (SM) people are reported to experience higher levels of psychopathology when compared to heterosexual individuals. Minority Stress Theory and Psychological Mediation Framework suggest that exposure to minority stress is responsible for this disparity. Shame is also a known risk factor for psychopathology. This study aims to test the indirect effect of discrimination on psychopathology through internalized stigma, shame, and self-criticism, in a sample of 372 SM adults. All variables were significantly correlated with each other, except internalized stigma with discrimination, anxiety, and social anxiety. Internalized stigma did not exert a significant indirect effect between discrimination and psychopathology. Shame and self-criticism were the sole significant underlying processes mediating the relationship between discrimination and psychopathology. [ABSTRACT FROM AUTHOR]

This document is an editorial from the journal Frontiers in Psychiatry that discusses the ongoing issue of stigma towards individuals with mental illnesses. It emphasizes the importance of raising awareness and providing training to diverse groups in order to challenge existing stereotypes and reduce stigmas. The editorial provides a summary of 22 articles included in the research topic, covering various aspects of mental-health-related stigma and discrimination. These articles explore topics such as the impact of stigma on mental health patients, stigma experienced by healthcare workers during the COVID-19 pandemic, public perceptions and reactions to the pandemic, attitudes of healthcare workers towards seeking psychological help, and the influence of stigma on the location and configuration of mental health establishments. The editorial also addresses the stigma associated with substance use disorder and the urgent need to reevaluate language surrounding addiction. It calls for decriminalization of drug use, allocation of resources towards prevention and treatment, and highlights instances of discrimination by clinicians towards individuals with substance use disorders. The article also discusses the role of the COVID-19 pandemic in relation to stigma and mental health. It concludes by advocating for a comprehensive strategy to overcome mental health-related stigma through public awareness, education, and destigmatizing language. [Extracted from the article]

Background: Although cross-sectional studies have suggested that HIV-related stigma and depression symptoms may result in poor HIV treatment and health outcomes, few studies have investigated potential longitudinal mechanisms in these relationships. Furthermore, longitudinal effects of HIV-related stigma on health outcomes have not been examined in people with HIV (PWH) newly initiating HIV clinical care. We examined longitudinal associations between experienced and perceived community stigma and health outcomes (antiretroviral therapy [ART] adherence and viral load), mediated by internalized stigma and depression symptoms among new-to-care PWH in the United States. Setting/Methods: Data were obtained from 371 PWH who initiated HIV medical care at 4 HIV sites at baseline and 48 weeks later between December 2013 and 2018. Validated measures were used to assess experienced stigma, perceived community stigma, internalized stigma, depression symptoms, and ART adherence, and viral load was obtained from medical records at the final study visit. Results: Serial mediation models revealed significant indirect effects of experienced stigma and perceived community stigma on ART adherence and on viral suppression, first through internalized stigma and then through depression symptoms. Conclusions: These results suggest that PWH may tend to internalize HIV-related stigma when they experience acts of stigmatization or perceive negative attitudes in society, which in turn may result in negative effects on psychological and physical well-being. These findings about how stigma in society may be an antecedent mechanism for PWH to develop internalized stigma, which in turn affects individual health outcomes, can be used to tailor both individual-level and community-level interventions. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has led to physical and psychological complications and social consequences in the form of illness-related stigma. This study aimed (1) to assess the sociodemographic and clinical variable, as well as COVID-19 related knowledge and perception of persons admitted for COVID-19/Suspected COVID-19 in Nepal, (2) to determine their levels of COVID-19-related internalized stigma, depression, and anxiety symptoms, and (3) to evaluate the correlates of COVID-19-related internalized stigma. Materials and methods: It was a cross-sectional exploratory study with a convenience sample of 395 participants (306 confirmed cases, 89 suspected cases) conducted between July-October 2020 in four health facilities in Madhesh and Lumbini provinces of Nepal. We used a semistructured questionnaire to assess sociodemographic details, clinical information, COVID-19-related knowledge, perception, COVID-19-related internalized stigma, and the Hamilton Anxiety Depression Scale (HADS) in Nepali language. Descriptive statistics, correlation analyses, and linear regression analyses were performed. The level of statistical significance was considered at p < 0.05. Results: Around 23.3% of the patients had anxiety symptoms, 32.9% had depressive symptoms, and 20.3% had high COVID-19-related internalized stigma (mean ISMI score: 2.51-4.00). Linear regression analyses showed a significant positive association of COVID-19-related internalized stigma total score, with the following eight factors, i.e., no income in the past one month (p = 0.013), below average socioeconomic status (p = 0.004), anxiety symptoms (p = <0.001), depressive symptoms (p = <0.001), recent testing positive for COVID-19 (p = <0.001), involuntary admission (p = <0.001), prior experience of being in isolation and quarantine (p = 0.045), and those who blame others for COVID-19 (p = 0.025). Conclusion: COVID-19 survivors and suspects are vulnerable to symptoms of depression, anxiety, and COVID-19-related internalized stigma. For the first time from Nepal, our data suggests that COVID-19-related internalized stigma is associated with anxiety and depression symptoms, perceived below-average socioeconomic status, involuntary admission, prior experience of being in isolation and quarantine, recent COVID-19 positive report, self-blame, below-average socioeconomic status and no income in the past one month. Mitigating and preventing internalized stigma associated with a public health crisis such as COVID-19 is imperative by diagnosing and treating such mental health issues early and designing interventions and policies especially targeting vulnerable populations focusing on their economic background and socio-cultural beliefs. [ABSTRACT FROM AUTHOR]

Abstract\nPUBLIC SIGNIFICANCE STATEMENTFor college students, holding a minoritized, stigmatized sexual orientation, gender identity, or both (SOGI) may have compounded the stress and upheaval of the COVID-19 pandemic, impacting not only their ability to freely express their SOGI but also their mental health and well-being. Using minority stress theory and mixed methodologies, we examined associations among lesbian, gay, bisexual, transgender, queer, questioning, or other sexual and/or gender diverse (LGBTQ+) college students’ (N = 368, Mage = 20.5) perceived pandemic-related changes in SOGI expression, internalized LGBTQ+ stigma, and mental health. Consistent with minority stress theory, students who thought the pandemic restricted their SOGI expression and who had more internalized LGBTQ+ stigma had worse mental health than their peers. In addition, students who thought the pandemic restricted their SOGI expression perceived that their mental health worsened due to the pandemic. The importance of SOGI expression for mental health during the pandemic has implications for tailored university programming to support LGBTQ+ students’ mental health during times of stress and transition beyond the pandemic.Lesbian, gay, bisexual, transgender, queer, questioning, or other sexual and/or gender diverse (LGBTQ+) college students who thought that the pandemic restricted their sexual orientation or gender identity (SOGI) expression had worse mental health than their peers and were more likely to perceive that their mental health worsened due to the pandemic. Findings underscore the importance of SOGI expression and the need for programs to support SOGI expression, especially during times of stress and transition, to promote mental health among LGBTQ+ young people. [ABSTRACT FROM AUTHOR]

Introduction: Cessation of substance use, a facet of recovery, as well as mitigating stigma experienced by individuals with substance use disorder (SUD), are important to supporting health and well-being of those who use substances. But there is limited and mixed evidence on whether cessation of substance use has a positive impact on individuals' stigma experiences. This study examined whether there were differences in stigma perceptions between those who self-report using substances and those who self-report not currently using substances associated with their SUD. Materials and methods: A survey was conducted among individuals in 10 counties of Michigan with self-identified history with SUD. The survey aimed to understand five dimensions of stigma perceptions: enacted stigma, anticipated stigma, internalized stigma, social withdrawal, and treatment stigma. Survey items for each measure were adapted from prior literature. The mean was calculated for each stigma measure for analyses. Data analyses tested whether there were significant differences in each of the five stigma domains between the two groups using either regression or t-test, depending on the necessity to include covariates. Results: Findings suggested that among the five stigma domains, only internalized stigma showed statistically significant differences between the two groups (b = 0.19, se = 0.08, p < 0.05) after adjusting for covariates (as needed). Those who were no longer using substances had lower internalized stigma compared to those who were currently using substances associated with their SUD. Analyses suggested that the other four stigma domains, enacted stigma, anticipated stigma, social withdrawal, and treatment stigma, did not show statistically significant differences between the two groups. Discussion: While self-stigmatization (i.e., internalized stigma) was lower among those who report no longer using, our patterns suggest a persistence of stigma regardless of cessation of substances associated with SUD, particularly among stigma domains that are based on perceptions of how others may still perceive individuals who have used substances. Though more research is needed, results suggest that public health programmatic, policy, and campaign efforts that aim to eliminate stigma should account for and tailor to both people who report using and those who report no longer using substances to capture the breadth of needs in communities. [ABSTRACT FROM AUTHOR]

Black men who have sex with men and women (BMSMW) experience pressure to fill hypermasculine ideals and may not identify with "gay" cultural norms. Existing measures of gender role expectations and internalized homophobia are not culturally appropriate for BMSMW. Researchers generally measure categorical identification with race, gender, and sexual orientation groups separately, whereas BMSMW may identify with multiple categories. We modified the Gender Role Conflict Scale to create the M-GRCS and the Internalized Homophobia Scale to include biphobia (Internalized Bi/Homophobia Scale, IBHS). To examine identification at the intersection of race, gender, and sexual orientation, we created 11 Integrated Race and Sexuality Scale (IRSS) items. With data from 429 BMSMW, we conducted exploratory factor analysis of the 59 items using categorical principal axis factoring with unweighted least squares extraction and Promax factor rotation. We created simple-summated multi-item scales and evaluated their construct validity. The rotated solution yielded four factors with 47 items and a simple factor structure: M-GRCS defined two factors (α = .93 for restricted emotionality/affection; .87 for success/power/competition); the IBHS (α = .89) and IRSS (α = .74) each defined a single factor. The IRSS factor was positively correlated with the Lukwago Racial Pride Scale, r(417) = .40. The IBHS factor was negatively correlated with the IRSS factor, r(414) = - .22. The two M-GRCS factors suggest that the construct of hypermasculinity impacts BMSMW. The high IBHS reliability indicates that homophobia and biphobia were positively correlated in this sample. These three scales have potential for future studies with BMSMW.

Due to its nature, the army is an environment with a high risk of mental illness. Research shows that mental health stigma is a common and serious barrier to early and effective treatment for mental disorders that result from the stress of military operations. Given the need for timely and effective mental health intervention, it is important to understand the barriers to seeking mental health help in a military context. Although there is stigma related to mental health in the studies and compilations carried out in the civil and military context in the national and international literature, there is no literature on mental health stigmatization in the military context, especially in the national literature. This study is a compilation research created by reviewing the national and international literature. In this article, it is aimed to present some innovative social work interventions in order to address the sources of stigma that hinders access to mental health care and the factors that reinforce them, in a military context, to potentially reduce stigma and to maximize the benefit of mental health care.

IntroductionThe COVID-19 pandemic has led to physical and psychological complications and social consequences in the form of illness-related stigma. This study aimed (1) to assess the sociodemographic and clinical variable, as well as COVID-19 related knowledge and perception of persons admitted for COVID-19/Suspected COVID-19 in Nepal, (2) to determine their levels of COVID-19- related internalized stigma, depression, and anxiety symptoms, and (3) to evaluate the correlates of COVID-19- related internalized stigma.Materials and methodsIt was a cross-sectional exploratory study with a convenience sample of 395 participants (306 confirmed cases, 89 suspected cases) conducted between July–October 2020 in four health facilities in Madhesh and Lumbini provinces of Nepal. We used a semi-structured questionnaire to assess sociodemographic details, clinical information, COVID-19-related knowledge, perception, COVID-19-related internalized stigma, and the Hamilton Anxiety Depression Scale (HADS) in Nepali language. Descriptive statistics, correlation analyses, and linear regression analyses were performed. The level of statistical significance was considered at p

IntroductionCessation of substance use, a facet of recovery, as well as mitigating stigma experienced by individuals with substance use disorder (SUD), are important to supporting health and well-being of those who use substances. But there is limited and mixed evidence on whether cessation of substance use has a positive impact on individuals’ stigma experiences. This study examined whether there were differences in stigma perceptions between those who self-report using substances and those who self-report not currently using substances associated with their SUD.Materials and methodsA survey was conducted among individuals in 10 counties of Michigan with self-identified history with SUD. The survey aimed to understand five dimensions of stigma perceptions: enacted stigma, anticipated stigma, internalized stigma, social withdrawal, and treatment stigma. Survey items for each measure were adapted from prior literature. The mean was calculated for each stigma measure for analyses. Data analyses tested whether there were significant differences in each of the five stigma domains between the two groups using either regression or t-test, depending on the necessity to include covariates.ResultsFindings suggested that among the five stigma domains, only internalized stigma showed statistically significant differences between the two groups (b = 0.19, se = 0.08, p

Background: In the literature on stigma, authors often use self-stigma or internalized stigma interchangeably to refer to this type of stigma. This results in a lack of conceptual clarity with negative repercussions for measurement and intervention. Aims: To identify how internalized stigma and self-stigma are conceptualized in people diagnosed with a mental disorder and establish similarities and differences between both concepts. Method: A scoping review was conducted. Thirty-five studies that conceptualized internalized stigma or self-stigma were selected. Results: It was identified that the concepts are defined from nine components, and there are more conceptualizations that have points in common than those that consider some component of their own. To gain conceptual clarity, the use of the term internalized stigma is recommended, being a process made up of stages: acceptance of stereotypes and prejudices by people with mental disorders and their subsequent internalization. The latter leads to negative consequences for those affected, which can be understood as the personal impact of this process, which has a crucial socio-cultural component. Lines of research are proposed to provide solidity to studies on this type of stigma. Conclusions: The term internalized stigma should be used when referring to the type of stigma that includes acceptance, internalization and personal impact for the subjects of the stigma. In contrast, self-stigma should be reserved to refer to stigma that is directed toward the 'self' and includes subtypes of stigma. [ABSTRACT FROM AUTHOR]