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Query: UMLS:C0277787 (stigma)
 13,352 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The present study tested the hypothesis that the stigma of being disabled and that of minority ethnic status yield more negative psychosocial outcomes for black than white persons with epilepsy. Black (n=55) and white (n=53) urban participants from a larger sample were matched for socioeconomic status and seizure frequency. Differences in these and key demographic variables were tested using chi(2) and t-tests and found to be non-significant. Group differences in psychosocial outcome variables were analyzed with the following results: (1) white subjects were more likely to have considered suicide and to have higher scores on the family background scale of the Washington Psychosocial Seizure Inventory (WPSI); (2) black subjects had significantly lower scores on the Beck Hopelessness Scale and significantly more optimistic attributional styles; and (3) no between-group differences were found on other psychosocial measures. The nature of family and community supports may determine intergroup differences.
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PMID:Black-white differences in the psychosocial outcomes of epilepsy. 1099 7

Suicide and suicide attempts occur at a significantly greater rate in schizophrenia than in the general population. Common estimates are that 10% of people with schizophrenia will eventually have a completed suicide, and that attempts are made at two to five times that rate. Demographically associated with suicidality in schizophrenia are being young, being early in the course of the illness, being male, coming from a high socioeconomic family background, having high intelligence, having high expectations, not being married, lacking social supports, having awareness of symptoms, and being recently discharged from the hospital. Also associated are reduced self-esteem, stigma, recent loss or stress, hopelessness, isolation, treatment non-compliance and substance abuse. Clinically, the most common correlates of suicidality in schizophrenia are depressive symptoms and the depressive syndrome, although severe psychotic and panic-like symptoms may contribute as well. This review specifically explores the issue of depression in schizophrenia, in relation to suicide, by organizing the differential diagnosis of this state and highlighting their potentially treatable or correctable causes. This differential diagnosis includes both acute and chronic disappointment reactions, the prodrome of an acute psychotic episode, neuroleptic induced akinesia and akathisia, the possibility of direct neuroleptic-induced depression, negative symptoms of schizophrenia, and the possible co-occurrence of an independent depressive diathesis. The potential beneficial roles of 'atypical' antipsychotic agents, including both clozapine and more novel agents, and adjunctive treatment with other psychopharmacological medications are considered, and the important roles of psychosocial factors and interventions are recognized.
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PMID:Suicide and schizophrenia. 1144 86

This article assesses the validity of the claim that welfare in itself has deleterious psychological consequences for single mothers. The analysis compares single mothers who are recipients of AFDC with single mothers who are not recipients in terms of their depressive symptoms (as measured by the CES-D) and hopelessness (as measured by Pearlin Mastery Scale). The analysis uses data from the National Longitudinal Survey of Youth and the National Survey of Families and Households. The authors find that higher levels of both depression and hopelessness among welfare recipients can be explained by their material hardship rather than the stigma attached to welfare. They show that AFDC recipients report similar levels of depression and hopelessness as jobless non-recipients as well as low-wage non-recipients. An additional finding is that long-term welfare recipients do not experience greater emotional problems than short-term welfare recipients. Finally, the paper shows that feelings of hopelessness mediate the relationship between material deprivation and psychological distress for both recipients and non-recipients.
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PMID:Psychological distress, hopelessness and welfare. 1146 67

The stigma associated with schizophrenia is pervasive, both in the community and among healthcare workers, and forms a real barrier to optimal recovery from the illness. The negative consequences of stigma include discrimination in housing, education and employment, and increased feelings of hopelessness in people with schizophrenia. Health professionals have a responsibility to improve their own attitudes and behaviour towards people with schizophrenia so they do not contribute to the stigma. Educational campaigns aimed at people in the community and media personnel could help to demystify mental illness and reduce the portrayal of offensive stereotypes of people with schizophrenia.
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PMID:Reducing mental illness stigma and discrimination - everybody's business. 1272 May 21

As the AIDS epidemic continues to overwhelm the acute care hospital system in Thailand, an increasing number of family members are required to provide care for persons living with AIDS (PLWA) in their homes. In response to the increasing demand for home care, a qualitative study using focus group methodology was conducted to learn more about the need for education and support for family caregivers of PLWA in Thailand. Eighteen family caregivers and 18 nurses caring for PLWA participated in four focus group discussions. The major themes identified were fear, stigma, sorrow, empathy, hopelessness, and hope. In addition, participants voiced a need for education to improve the knowledge and skills related to care of PLWA. These findings will be used to guide the development of a training program for family caregivers.
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PMID:Educational needs of family caregivers of persons living with HIV/AIDS in Thailand. 1516 73

Research has paradoxically linked awareness of illness to both better function outcomes and lesser hope and self-esteem. One possible explanation for these findings is that acceptance of having schizophrenia may impact outcomes differently depending on the meanings the person attaches to this acceptance, particularly whether he or she accepts stigmatizing beliefs about mental illness. To explore this possibility we performed a cluster analysis of 75 persons with schizophrenia spectrum disorders based on single measures of insight using the Positive and Negative Syndrome Scale, internalized stigma using the Internalized Stigma of Mental Illness Scale, and compared groups on concurrent assessments of hope and self-esteem. Three groups were produced by the cluster analyses: low in sight/mild stigma (n = 23), high insight/minimal stigma (n = 25), and high insight/moderate stigma (n = 27). As predicted, analysis of variance-comparing groups revealed that the high insight/moderate stigma group had significantly the lowest levels of hope on the Beck Hopelessness Scale and self-esteem using the Multidimensional Self-esteem Inventory. As predicted, the high insight/minimal stigma group also had significantly less impaired social function than the other groups. Implications for assisting persons to come to cope with awareness of illness and stigma are discussed.
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PMID:Toward understanding the insight paradox: internalized stigma moderates the association between insight and social functioning, hope, and self-esteem among people with schizophrenia spectrum disorders. 1689 25

Cross-sectional findings have shed considerable light on the relationships between illness stigma and psychological outcomes among persons living with HIV/AIDS in the United States. However, no studies have examined the possible long-term consequences of illness stigma on mental health among Asians and Pacific Islanders living with HIV/AIDS, a group particularly vulnerable to HIV stigma due to ingrained sociocultural norms. This 2-year longitudinal study examined the relationship between five HIV-stigma factors (social rejection, negative self-worth, perceived interpersonal insecurity, financial insecurity, discretionary disclosure) and changes in psychological distress dimensions (self-esteem, hopelessness, dread, confused thinking, sadness, anxiety) among a convenience sample of 44 HIV-seropositive Asians and Pacific Islanders in New York City from 2002 to 2004. Undocumented Asians independently endorsed higher levels of perceived interpersonal insecurity and lower levels of self-esteem than documented participants at both baseline and 2-year follow-up. Results from hierarchical multiple regression analyses indicated that baseline social rejection and perceived interpersonal insecurity were significantly associated with changes in self-esteem at 2-year follow-up, controlling for baseline self-esteem and physical symptoms at follow-up. An interaction effect between baseline financial insecurity and discretionary disclosure was significantly associated with dread at 2-year follow-up. Findings highlight the importance of stigma reduction interventions that: (1) recognize multiple layers of stigma based sexual orientation, gender, and immigration status; and (2) address both individual and structural constraints that perpetuate HIV-stigma among Asians and Pacific Islanders in the United States.
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PMID:Are psychological consequences of stigma enduring or transitory? A longitudinal study of HIV stigma and distress among Asians and Pacific Islanders living with HIV illness. 1705 41

In recent years lung cancer specialists have complained that due to stigma resulting from the association of the disease with smoking, theirs is a neglected field. This paper demonstrates that in the 1950s and 1960s, when the British Medical Research Council (MRC) started to organize clinical trials for various forms of cancer, this was not the case. Rather, the organizers of these trials saw lung cancer as a particularly promising object of research, for much was known about the disease. The cancer trials were part of a strategy to use the Randomized Controlled Trial (RCT) technology to cement the role of the MRC as the dominant body overseeing medical research in Britain. The organization of the trials, however, turned out to be very difficult, due to ethical problems and the dominance of one form of therapy, surgery. The trial results were deeply disappointing. I argue that these frustrating results contributed to the notion of hopelessness that has come to surround lung cancer, and to the shift of focus from cure to prevention that was triggered by epidemiologic studies identifying tobacco smoke as the main cause of the disease. The paper deals with an important episode in the history of clinical cancer research in postwar Britain, illustrating the ethical and practical problems faced by the organizers.
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PMID:As depressing as it was predictable? Lung cancer, clinical trials, and the Medical Research Council in postwar Britain. 1736 73

Creating a collaborative doctor-patient relationship is the bedrock upon which effective treatments are delivered. The interaction between normal developmental changes and psychopathology can present particular challenges to clinicians attempting to assess and treat young people. Assuming an attitude in which young people are seen to be doing their best, rather than being deliberately difficult or manipulative, can help clinicians avoid a controlling or punitive relationship and can facilitate collaborative problem solving. Stigma, denial and avoidance, ambivalence, hopelessness and coercion are potential threats to engagement and must be addressed specifically. Challenging patients, such as the reluctant, resistant, aggressive, self-harming or intoxicated patient require specific management strategies that can be learned.
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PMID:Tips and techniques for engaging and managing the reluctant, resistant or hostile young person. 1790 31

This is an account of a panel discussion. It focuses on an encounter with the HIV/Aids virus. Such an encounter may result in a descent into despair, hopelessness and ultimately death, or it may offer the opportunity of possible transformation of consciousness to embrace a life lived productively and meaningfully with a chronic but manageable disease. A picture is provided of the dire situation that exists regarding the HIV/Aids pandemic in South Africa. The HI-virus is compared to a malevolent trickster type energy that uses ingenious means to gain access to the host. It is an impersonal agent seeking only its own survival but if left untreated will ultimately result in the death of the host. Reference is made to characters in the musical, The Lion King, to illustrate that it is the willingness to suffer the painful emotions evoked following a diagnosis of being HIV-positive more consciously that allows for a transformation from despair and hopelessness to a life lived productively and meaningfully. Two of the panelists who are HIV-positive share their experiences of this process. One recounts how, living with Aids, his connections with others and human relatedness helped to restore his dignity and self-worth. The other relates how his willingness to state his status publicly allowed him to overcome the stigma and shame that are evoked when diagnosed as HIV-positive. This has allowed him to seek appropriate treatment with ARV's. He now lives with a chronic but manageable infection and leads a creative and significant life. The difficulties encountered regarding the prevention of HIV/Aids when attempting to change potentially destructive sexual behaviours in teenagers are discussed. An inspiring account of work in treating those that live with HIV/Aids under difficult circumstances is also discussed.
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PMID:HIV/Aids: an encounter with death or a journey into life? 1835 50


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