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[Correction Notice: An Erratum for this article was reported in Vol 126(5) of Psychological Review (see record 2019-58645-001). In the article, the following citation was omitted: Goff, P. A., Thomas, M. A., & Jackson, M. C. (2008), "Ain't I a Woman?": Towards an intersectional approach to person perception and group-based harms. Sex Roles, 59, 392-403. All versions of this article have been corrected.] A growing body of research shows that older adults, Black women, and other groups often encounter stigmatization that manifests not as negative prejudice, but as indifference and inattention-that is, interpersonal invisibility. We propose an affordance-management theory to explain who is interpersonally invisible, to whom, and with what consequences. A social affordance-management perspective suggests that people seek to detect and strategically engage with those who facilitate or obstruct achievement of important goals. We argue that invisibility emerges from the perception that another person neither helps nor hurts one's ability to achieve chronically or acutely active goals. We thus distinguish among phenomena commonly subsumed under the term stigmatization: invisibility-based stigmatization of those perceived to be irrelevant, and threat-based stigmatization of those perceived to obstruct one's goals. Invisibility and threat-based stigmatization are theorized to differ in origin, manifestation, and impact. Furthermore, rather than being a static property of particular target groups, interpersonal invisibility dynamically emerges from perceiver goals, target cues, and situational features. Nonetheless, some perceivers, targets, situations, and goals are more likely to lead to invisibility than others. This affordance-based theory of invisibility helps to organize the heterogeneous field of stigma research; unifies a diverse array of social, cognitive, motivational, and affective phenomena; and suggests numerous novel directions for future stigma research from both perceiver and target perspectives. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:The stigma of perceived irrelevance: An affordance-management theory of interpersonal invisibility. 3158 Jan 43

The set of studies in this issue focus on applied interventions in occupational health psychology (OHP), that is, interventions that are intended to treat employee health and well-being problems or prevent these problems from occurring in the first place. An issue regarding many past evaluations of the effectiveness of these treatments was the relatively weak research methods, especially in regard to obtaining comparable groups to study so that internal validity is enhanced. Many of the studies presented here used the classically recommended approach of random assignment to alleviate this potential problem. We can see that there are a variety of types of potential treatments in OHP, including interventions focusing on changing the employee, other people in the employee's workplace (supervisors or coworkers), the employee's job characteristics, or the organization's climate. Although the ultimate criterion variables in OHP are indicators of employee wellness, some studies focused on improving what might theoretically be mediating variables between the interventions and employees' actual health or well-being. These outcomes include reductions of work-nonwork conflict and stigma of mental illness potentially present in the organization, its supervisors, or employees' coworkers. We note that there are probably moderators of the effectiveness of the interventions, so that a treatment may work better in some people, some situations, and some times than others. Finally, it is interesting to note that the interventions and their studies may be geographically concentrated rather than distributed equally around the globe. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Interventions in occupational health psychology. 3071 10

We examined the ways that federal, state, and local marriage recognition influence multiple domains of personal well-being of individuals in same-sex (n = 279) and different-sex (n = 266) relationships. Longitudinal data were collected across the transition to marriage equality (i.e., the U.S. Supreme Court Obergefell v. Hodges [2015] case decision, which resulted in same-sex marriage recognition federally). Prior to the ruling, levels of stigma and psychological distress were higher and family support was lower for individuals who were in same-sex (vs. different-sex) relationships. Levels of life satisfaction and family support were higher for those who were married (vs. not married). Levels of stigma and stress were lower and family support and life satisfaction were higher for those who lived in states that recognized same-sex marriage. A more supportive community climate was also associated with lower levels of stigma and stress and higher levels of family support than less supportive communities. Following the ruling, levels of stigma decreased over time, particularly for individuals in same-sex relationships, after accounting for state and local recognition. Levels of family support also increased, whereas support from friends decreased following the ruling. The findings of this study indicate that federal, state, and local marriage recognition play unique roles in changing the climate of discrimination for individuals in same-sex relationships. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Personal well-being across the transition to marriage equality: A longitudinal analysis. 3073 Jan 85

Mental health concerns are prevalent among primary care patients, but many do not utilize services for these conditions. This study aims to conduct a comprehensive assessment of barriers and facilitators to mental health care utilization among veteran primary care patients with common mental health concerns. We hypothesized that beliefs and knowledge about mental illness and mental health care would be more strongly associated with recent mental health care utilization than stigma, help-seeking behaviors, or logistical barriers. Veterans (n = 116) enrolled in primary care with current symptoms of depression (58%), posttraumatic stress disorder (37%), and/or hazardous alcohol use (50%) who either recently used mental health services (47%) or had no recent mental health treatment utilization (53%) completed a telephone-based screening, medical records review, and mail survey of 10 measures of barriers and facilitators to mental health treatment utilization. Recognition of problems as a cause for concern, odds ratio = 5.95, 95% confidence interval [2.36, 15.01], and beliefs about psychotherapy, odds ratio = 2.53, 95% confidence interval [1.39, 4.60], emerged as stronger correlates of recent mental health care utilization than stigma, self-efficacy, and external barriers to treatment. Results suggest the use of specific theories, measures, and interventions that focus on patient recognition of problems and beliefs about treatment over those that focus on other treatment barriers and facilitators. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Problem recognition and treatment beliefs relate to mental health utilization among veteran primary care patients. 3086 74

The current study was designed to examine one possible weight stigma-reduction mechanism: school-level weight diversity. It was hypothesized that greater weight diversity among same-sex peers at school would attenuate the negative association between weight and academic achievement. Across 26 urban public middle schools, 5,991 sixth-grade students (52% girls) were included: 12% African American/Black, 14% East/Southeast Asian, 30% Latino, 21% White, and 23% from other specific ethnic groups. Weight diversity was estimated as the likelihood that two randomly selected students would be from different weight categories, using Simpson's index. Standardized achievement test scores and grade point average (GPA) were used to assess academic achievement. Consistent with our contextual moderator hypothesis, high levels of weight diversity at school served a protective function. The negative association between body mass index (BMI) and achievement test scores, as well as GPA (girls only) was nonsignificant at schools with high levels of weight diversity. The study results offer a potential explanation for inconsistent findings regarding body weight and achievement, and a novel methodological approach to capture weight diversity in ways that provide new insights for school-based interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Body weight and academic achievement: The role of weight diversity in urban middle schools. 3088 59

The unique experiences of women with serious mental illness (SMI) are often overlooked in the literature in mental health and rehabilitation services. This population faces increased risk of violence, sexual abuse, treatment bias, and a number of health problems when compared with their male counterparts. Further research is needed to identify these differences and suggest clinical implications for working with women with SMI. The present qualitative research includes data from a grounded theory study analyzing interviews with 20 women with SMI to explore their treatment experiences with mental health providers. The following themes pertaining to treatment experiences of women with SMI were generated from qualitative analysis: diminishing dismissals (questions as to the legitimacy of the symptoms and concerns of women with SMI in their mental health treatment), symptom misattribution (erroneous ascriptions of their mental health symptoms), male mistrust (wariness toward, and avoidance of, male providers), psychiatric insults (perceptions that mental health providers tend to make stigmatizing diagnoses), doomsday predictions (experience of providers' negative prognoses of their future), and diagnostic reordering (tendency of mental health providers to revise prior diagnoses of women with SMI in ways that reduce stigma and build trust). Clinical implications of these findings will be discussed, including the need for enhanced awareness of providers as to the perceptions and expectations of gender bias in treatment among women with SMI. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Treatment experiences with gender and discrimination among women with serious mental illness. 3090 15

Transgender and gender nonconforming (TGNC) individuals interact with mental health care systems at high rates and experience substantial barriers to care. Rural TGNC individuals face additional disparities in accessing appropriate mental health services. Little research has focused on the mental health care providers who work with TGNC individuals in underserved areas. The current study sought to describe the mental health care services delivered by providers perceived as affirming by TGNC community members in the Central Great Plains. We conducted qualitative interviews with 10 providers to understand how providers seek cultural competency and conceptualize and work with their TGNC clients given the barriers to care. Providers held diverse theoretical orientations and described challenges to working with TGNC clients, including the impact of stigma and marginalization and financial and structural barriers to care. Emphasis was placed on individualizing care, helping clients to manage stigma and build resiliency, connecting clients to resources (when available) and support systems, and navigating the intersections of physical health care and mental health care, such as writing letters for medical transition. Providers largely educated themselves on TGNC topics and had previous experience working with marginalized populations. Overall, the providers' approaches to working with TGNC clients mapped onto models of cultural competency, but few providers described their work in the context of an evidence-based model. Implications for increasing the quality and availability of mental health care services for TGNC individuals in underserved areas are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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PMID:The provider perspective on behavioral health care for transgender and gender nonconforming individuals in the Central Great Plains: A qualitative study of approaches and needs. 3092 Feb 42

Many college men express stigma of seeking psychological help, possibly due to masculine gender role socialization proscribing help seeking. However, not every man who buys into restrictive masculine roles expresses self-stigma of seeking help, suggesting the presence of potential moderating variables. The present study examined self-compassion and self-coldness as potential moderating variables on the associations between men's masculine gender role stress and self-stigma of seeking help. College men (N = 777) were recruited via e-mail to participate in a brief online survey. Structural equation modeling revealed that masculine gender role stress was positively associated with self-stigma and self-coldness but was negatively associated with self-compassion. Both self-compassion and self-coldness were significant moderators. Men with low levels of self-compassion evidenced the strongest positive associations between masculine gender role stress and self-stigma, whereas men with low (but not high) self-coldness evidenced positive associations with self-stigma. These findings highlight differences between self-compassion and self-coldness and suggest that high levels of self-compassion may be a protective factor in reducing the associations between rigid masculinities and men's stigma of seeking help. By contrast, men with extremely negative and critical self-views may be likely to report stigma of seeking help regardless of their endorsement of rigid masculinities. Intervention and prevention implications include helping men enhance their self-compassion. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Masculine gender role stress and self-stigma of seeking help: The moderating roles of self-compassion and self-coldness. 3098 68

Previous research has found language used to describe individuals with a substance use disorder (SUD; e.g., "addict," "substance abuser") contributes to and elicits negative bias among the general public and health care professionals. However, the prevalence in which recovering individuals use these labels to self-identify and the impact of such labels are unknown. The current pilot study, a cross-sectional design, examined the usage of two labels ("addict," "person with a SUD") as well as the differences in recovery outcomes among individuals in recovery. Participants (n = 54) used both labels at high rates ("addict": 66.67%; "person with a SUD": 38.89%), though mutually exclusive use was lower ("addict" only: 35.19%, "person with a SUD" only: 7.5%). Common label use settings included mutual-aid recovery meetings, with friends and family, and on social media. Analysis of variance tests found no statistically significant differences between label groups for recovery capital, self-esteem, internalized stigma and shame, flourishing, or length in recovery. Descriptively, participants using only "person with a SUD" had more positive outcomes, although these individuals also had higher levels of internalized shame. Results suggest that language may have only a marginal impact on individuals in recovery, although professionals and the general public should continue to avoid using stigmatizing labels. Additionally, many individuals in recovery have the ability to discern context and setting, switching between positive and negative labels as appropriate. Future research is warranted given these pilot findings and should focus on long-term impacts of self-labeling and internalized stereotypes among individuals in recovery. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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PMID:Recovery dialects: A pilot study of stigmatizing and nonstigmatizing label use by individuals in recovery from substance use disorders. 3099 55

Employees in high-risk occupations can experience stigma associated with developing mental health problems and getting treatment for problems that can oftentimes be attributed to traumatic events encountered at work. The present study examined the perceived unit climate of support for mental health as a predictor of changes (over the course of 3 months) in the perceived stigma associated with seeking treatment, positive and negative attitudes toward treatment seeking, and a preference for handling mental health problem oneself, as well as talking with fellow unit members and a mental health professional about a mental health problem. Active-duty military personnel (N = 349 at Time 1, N = 112 matched at Time 2) completed measures assessing unit climate and individual beliefs about treatment at two points in time separated by 3 months. The results of structural equation modeling revealed strong evidence for perceived unit climate of support for mental health at Time 1 predicting a change in perceived stigma and attitudes toward treatment seeking at Time 2. A more positive perceived unit climate of support was associated with decreases in stigma, more positive attitudes toward treatment seeking, and less negative attitudes toward treatment seeking. Among those soldiers with a mental health problem (N = 164), a more positive perceived unit climate for mental health was associated with a greater likelihood of talking with a fellow unit member about the problem and receiving mental health treatment. Implications of the results for unit-level interventions in high-risk occupations are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Perceived unit climate of support for mental health as a predictor of stigma, beliefs about treatment, and help-seeking behaviors among military personnel. 3109 47


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