What About Language?: A Mixed Methods Examination of the Impact of Person-Centered Language on Students' Perceptions of Individuals Who Commit Sex Offenses.

Person-centered language is a well-known approach to reducing stigmatizing labels among marginalized groups. However, little research has explored person-centered language's impact in criminal justice classrooms. Utilizing a mixed-method research design, this study explores the impact of person-centered language on students' perceptions of persons convicted of sex offenses. The study used three sections of an online Sex Crimes course. The course sections were identical, except for the language used and awareness of person-centered language; the control group section did not utilize person-centered language, the second section utilized person-centered language, and the third section utilized person-centered language and was given an informational lecture on stigmatizing language. Quantitative data was collected from the Perceptions of Sex Offenders Scale at the beginning and end of the semester. Students' end-of-semester reflection papers served as the qualitative component. The findings suggest shifts in punitive attitudes toward sentencing and management for the group exposed to person-centered language and the informational lecture. These differences were not apparent for the other groups and subscales. While qualitative data provided a more in-depth understanding of students' perceptions, overall, exposure to person-centered language didn't seem to impact student perceptions. However, exposure alongside a lecture about person-centered language, seemingly had a more pronounced impact on students' perceptions, suggesting that transparency surrounding language and reducing stigma are important components of person-centered language. The findings have implications for using person-centered language for criminal justice pedagogical practices, as well as considerations beyond the classroom (e.g., program development and curricula).

The Care of Older People With Depression in Nigeria: Qualitative Exploration of the Experience of Lay Providers in Primary Care Settings.

OBJECTIVES: There is a large treatment gap for mental health conditions in sub-Saharan Africa where most patients who receive any care do so from lay primary health care workers (PHCW). We sought to examine the experiences of PHCW who provide care for older people with depression in Nigerian primary health care (PHC) settings. METHODS: Qualitative study design. A total of 24 PHCW participated. Using in-depth key informant interviews (KIIs), we explored the views of 15 PHCW selected from 10 rural and urban PHCs in South-Western Nigeria. An additional focus group discussion comprising nine participants was also conducted to discuss emerging themes from KIIs. Data were analysed using thematic analysis. RESULTS: Three overall themes were identified: views about depression, treatment options, and community outreach implications. Participants perceived depression in older people as being characterised by a range of mood, behavioural, and cognitive symptoms which made clinical assessments particularly challenging. Common treatment options used by PHCW included general advice and counselling, as well as frequent need to prescribe mild analgesics, vitamins and occasional sedatives in line with patients' expectations. Antidepressants were rarely used even though PHCW are authorised. While home visits are part of their expected work schedule, PHCW rarely implemented these due to non-availability of transport facilities. Mobile technology was identified as a possible way of overcoming this constraint to providing community based mental healthcare for older people. CONCLUSION: PHCWs perceived that patients' poor cognitive performance, expectations to prescribe sedatives, analgesics and vitamins, as well as non-existence of community-based services were existing barriers to providing evidenced based continued care for older people with depression in the study settings.

Psychological Interventions for Internalized Weight Stigma: A Systematic Review of Feasibility, Acceptability, and Preliminary Efficacy.

Background: Internalized weight stigma (IWS) is highly prevalent and associated with deleterious mental and physical health outcomes. Initiatives are needed to address IWS and promote effective coping and resilience among individuals who are exposed to weight stigma. We conducted a systematic review of psychological interventions for IWS and examined their feasibility, acceptability, and preliminary efficacy at reducing IWS and related negative physiological and psychological health outcomes. Methods: Eight databases were searched. Inclusion criteria included: (1) psychological intervention; (2) published in English; and (3) included internalized weight stigma as an outcome. Exclusion criteria included: (1) commentary or review; and (2) not a psychological intervention. A systematic narrative review framework was used to synthesize results. Results: Of 161 articles screened, 20 were included. Included interventions demonstrated high feasibility, acceptability, and engagement overall. Sixteen of 20 included studies observed significant reductions in IWS that were maintained over follow-up periods, yet data on whether interventions produced greater reductions than control conditions were mixed. Studies observed significant improvements in numerous physical and mental health outcomes. Conclusions: Findings indicate that existing interventions are feasible, acceptable, and may provide meaningful improvements in IWS and associated health outcomes, highlighting the potential for psychological interventions to promote improved health and wellbeing in individuals with IWS. Additional research using rigorous study designs (e.g., randomized controlled trials) is needed to further evaluate the efficacy of interventions for IWS.

Stigma and health outcomes in multiple sclerosis: a systematic review.

BACKGROUND: Stigma is increasingly recognised as contributing to disability in MS. This systematic review aimed to answer the following question: To what extent is stigma associated with psychological and physical health outcomes in MS? METHODS: The inclusion criteria were: scientific publication of original quantitative research in adults with MS and/or Clinically Isolated Syndrome; outcome measures including a measurement of stigma and psychological and/or physical health; peer reviewed articles in the English language. Pubmed, PsycINFO and Science Direct were searched in November 2023. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the methodological quality and risk of bias in all of the identified studies. The following data was extracted: (1) author and publication year, (2) country, (3) design, (4) sample size and demographics, (5) stigma measure, (6) psychological and/or physical health outcomes, 8) key findings. RESULTS: 18 Studies were identified, reporting in total 22,021 adult participants with multiple sclerosis, with individual sample sizes ranging from 33 to 6,670. The review consistently identified stigma to be significantly associated with adverse psychological and physical health outcomes in all 18 identified studies. Over half of all identified studies investigated depression and stigma and over half investigated quality of life and stigma, and a significant association was demonstrated for both of these variables with stigma in all of these studies. DISCUSSION: Limitations are that most studies were Western with primarily white participants. Only variables studied could be reported and therefore only a selective perspective of stigma in MS could be explored. A meta-analysis was not feasible, due to the variety of stigma definitions and measures employed. A model of stigma in MS is presented and possible interventions to manage stigma in MS are discussed. A need for international action to develop a consensus measure of MS stigma and determine the trajectory and causal dynamics of MS stigma is highlighted.

Development of an infertility perception scale for women (IPS-W).

PURPOSE: The purpose of this study was to develop an Infertility Perception Scale for Women (IPS-W). METHODS: Initial items were based on an extensive literature review and in-depth interviews with five infertile women and fifteen women not diagnosed with infertility. Forty-one items were derived from a pilot survey. Data were collected from 203 women who had experienced intrauterine insemination (IUI) and in-vitro fertilization (IVF) more than once. The data were analyzed to verify the reliability and validity of the scale. RESULTS: Four factors containing 21 items were extracted from the exploratory factor analysis (EFA) to verify the construct validity. The four factors of infertility perception scale were perceived feelings, personal stigma, social stigma, and acceptance. These factors explained 59.3% of the total variance. The confirmatory factor analysis (CFA) confirmed a four-factor structure of the 21-item IPS-W. All fit indices were satisfactory (χ2/df ≤ 3, RMSEA < 0.08). These items were verified through convergent, discriminant, known group validity, concurrent validity testing. The internal consistency reliability was acceptable (Cronbach's α = 0.90). CONCLUSION: The scale reflects the perception of infertility within the cultural context of Korea. The findings can help nurses provide support that is appropriate for individual circumstances by examining how women experiencing infertility perceive infertility.

Lived Experience Perspective on Internalised Stigma and the EUPD Diagnosis.

INTRODUCTION: EUPD (a personality disorder, characterised by emotion dysregulation, impulsivity and unstable relationships) is a controversial diagnosis affecting around 1 in 100 people, often times for a large part of their life, causing immense suffering to the individual and their families and friends. AIM: As someone diagnosed with EUPD, I offer a lived experience perspective on internalised stigma building on growing attention to the impact of prejudice and discrimination faced when navigating the healthcare system with this diagnosis. IMPLICATIONS FOR PRACTICE: Include a recommendation to go 'back to basics' and focus on us (especially when accessing crisis care) feeling heard, seen, validated, empowered and understood.

Understanding the Social Drivers for LGBTQIA+ Youth Suicide.

LGBTQIA+ youth are disproportionately affected by mental health issues including suicidal ideation and suicide attempts. Minoritized youth have numerous social and structural factors influencing their health, including a lack of access to care and resources. However, these youth and their caregivers also have many unique and individual cultural strengths. Awareness of special considerations and work toward dismantling structural drivers is essential in improving the health of these youth. Additionally, it is important to support minoritized youth and their caregivers through tailored evidence-based treatments in addressing social and structural drivers to influence individual, community, educational, institutional, and policy levels and prevent suicide in achieving mental health equity.

'Just because I'm smiling doesn't mean I'm not in pain': navigating the layered stigma of chronic pain and suicidality in social worlds.

This article aims to provide an illustrated account of layered stigmatisation processes and consequences for those who experience chronic pain and accompanying suicidality. Using constructivist grounded theory, I draw from 20 in-depth interviews conducted from 2022 to 2023 to explore how chronic pain and suicidality operate within people's social worlds. Findings demonstrate how layered stigmatising processes, occurring based on chronic pain and suicidality, operate consistently across multiple social arenas to create interactional troubles, which result in enduring negative social, emotional, and financial impacts. Three themes were constructed, including (1) self-stigma and the multiple roles of the family, (2) missed connections, and (3) anticipated stigma and workplace discrimination. Taken together, themes support the overarching category, 'interactional troubles'. Findings suggest a need for attunement to stigmatising processes' omnipresence and the depth of their consequences. Clinical interventions may benefit from emphasizing participants' social worlds and incorporating the complexity of navigating social arenas given layered stigmatisation. Moreover, policies that support those with chronic pain and mental illness could offset the long-term negative economic consequences of discrimination.

Unravelling Migraine Stigma: A Comprehensive Review of Its Impact and Strategies for Change.

Migraine-related stigma is a pervasive issue impacting nearly half of chronic migraine patients, with significant consequences for their quality of life, disability and mental health. Despite its profound effects, migraine stigma remains under-recognised in both clinical practice and research. This narrative review explores the three primary types of stigmas affecting migraine patients: public, structural and internalised. Public stigma involves negative societal attitudes and stereotypes that trivialise the condition. Structural stigma is reflected in policies that restrict access to necessary care and resources. Internalised stigma occurs when patients absorb these negative views, leading to self-blame and diminished self-worth. Addressing these different types of stigmas is crucial for improving the understanding, diagnosis and treatment of migraine. Educational efforts, advocacy and policy reform are essential strategies in this context. A deep understanding of stigma is vital for developing effective interventions that enhance clinical management and patient quality of life. Ultimately, reducing stigma can lead to better health outcomes and a more comprehensive approach to migraine care.

Influence of age and self-stigmatization on social eating and drinking issues in French outpatients living with and beyond head and neck cancer: a mixed-method study.

PURPOSE: Social eating (SE) is a corner stone of daily living activities, quality of life (QoL), and aging well. In addition to feeding functional disorders, patients with head and neck cancer (HNC) face individual and social psychological distress. In this aging population, we intended to better assess the influence of age on these challenges, and the role of self-stigmatization limiting SE in patients with and beyond HNC. METHODS: This was an exploratory multicenter cross-sectional mixed method study. Eligibility criteria were adults diagnosed with various non-metastatic HNC, before, during, or until 5 years after treatment. SE disorders were explored with the Performance Status Scale Public Eating rate (PSS-HN PE). In the quantitative part of the study, SE habits, Functional Assessment of Cancer Therapy Body Image Scale (FACT-MBIS) and specific to HNC (FACT-HN35) were also filled in by the patients. In the qualitative study, the semi-structured interview guide was drawn out to explore stigma, especially different dimensions of self-stigmatization. RESULTS: A total of 112 patients were included, mean age 64.7 years, 23.2% of female. One-third (n = 35) of patients had an abnormal PSS-HN PE rate < 100. Younger patients had more often an impaired Normalcy of Diet mean (70.4 vs 82.7, p = .0498) and PE rates (76 vs 86.9, p = .0622), but there was no difference between age subgroups in MBIS nor FACT-HN scores. Seventy patients (72.2%) found SE and drinking « important¼ to « extremely important¼ in their daily life. The qualitative study reported self-stigmatization in two older patients and strategies they have developed to cope with in their behaviors of SE. CONCLUSION: This study confirms that SE remains of high concern in patients with and beyond HNC. Even in older patients experiencing less often functional feeding disorders, body image changes and SE issues are as impaired as in younger patients and need to be addressed.

Sequential mediation model of social support, care burden, and internalized stigma among family function and depression in caregivers of patients with schizophrenia: evidence from a cross-sectional study in southwest China.

PURPOSE: There is a lack of comprehensive measurements and systematic evaluations of the depression in caregivers of patients with psychiatric disorders and the factors influencing them in China. This study aims to explore the relationship between family function and depression in caregivers of patients with schizophrenia at the individual, family, and social levels according to the ecological system theory and attachment theory. METHODS: In this study, multi-stage, stratified cluster sampling was adopted to sample caregivers of patients with schizophrenia as subjects from one to three counties of four counties in Yunnan, from September 2022 to March 2023. Collecting the current caregiver's demographic data, family functions, social support, care burden, depression and internalized stigma. RESULTS: The results of single-factor analysis show that age, education level, relationship with patients, and the degree of self-care of patients are the influencing factors of depression of people living with schizophrenia (p < 0.05). The scores of self-rating depression scale are higher for caregivers who have not received formal education, caregivers who cannot take care of themselves and the parents, spouses and children of patients. The results of Pearson correlation analysis show that depression is positively associated with internalized stigma and care burden, and negatively associated with social support and family function (p < 0.05). The results of multiple linear regression show that after controlling age, education level, the patient's self-care capacity, and relationship with patient, the internalized stigma (ß = 0.184, p = 0.01) is positively correlated with depression. The mediation effect route of family function → social support → care burden → internalized stigma → depression was significant with 95% confidence interval [-0.150, -0.01], and the chained mediation effect was 5.904%. CONCLUSIONS: To reduce the depression level in family caregivers of schizophrenia, apart from taking measures to improve the caregiver's family function, enhancing social support, decreasing care burden, and reducing internalized stigma are suggested.

Impact of being a relative of a patient with epilepsy on the association of attitudes toward epilepsy and disease knowledge levels.

OBJECTIVE: The social prognosis for individuals with epilepsy is often poorer than their clinical prognosis, highlighting the significant influence of social factors on the progression of the disease. Relatives of patients with epilepsy (RPEs) generally have more positive attitudes towards epilepsy compared to the general population. This study aimed to examine the effect of being an RPE on the relationship between attitudes toward epilepsy and levels of disease knowledge. METHODS: This cross-sectional analytical study included 217 adult participants, comprising 93 RPEs and 124 controls (non-RPEs), selected through convenience sampling. Data were collected via face-to-face interviews using a questionnaire that included sections on socio-demographic characteristics, the Epilepsy Knowledge Scale, and the Public Attitudes Toward Epilepsy (PATE) Scale. Path analysis was conducted using the Maximum Likelihood method. Due to the non-normal distribution of exogenous variables, the robust Huber/White/sandwich estimator method was used to calculate confidence intervals and fit indices. RESULTS: The mean age of the participants was 34.7 ± 11.5 years, with 128 (59.0 %) being female. RPEs scored an average of 26.8 ± 9.9 on the PATE Scale, which was significantly lower than the average score of 29.7 ± 11.0 for non-RPEs (p = 0.047). Path analysis indicated that being an RPE indirectly fosters a positive attitude through increased knowledge levels. While the direct effect of being an RPE on attitudes was not statistically significant, the indirect effect mediated by knowledge was significant. SIGNIFICANCE: This study highlights that the level of knowledge about epilepsy, a key predictor of positive attitudes, remains important even among RPEs. In kinship contexts where neurobiological and psychosocial factors are at play, the primary determinant of attitudes toward epilepsy is still the level of knowledge about the condition. Consequently, focusing on increasing knowledge about epilepsy should be the main strategy to promote positive attitudes, providing a more promising avenue for future research and interventions.

"I don't need my kid to be high": prioritizing harm reduction when using cannabis during pregnancy.

BACKGROUND: Cannabis is the most common illicit substance used in pregnancy. As use continues to increase, understanding peoples' behaviors surrounding cannabis use during pregnancy is needed to improve maternal and child health outcomes. The aim of this study was to better understand pregnant individuals' perceptions and knowledge of cannabis use and use patterns as well as the social and environmental factors that may influence their use. METHODS: We conducted interviews with 19 participants between December 2022 and March 2023. Individuals self-identified as BIPOC (Black, Indigenous, People of Color), were over 21 years of age, spoke English or Spanish, resided in California, and had used cannabis during pregnancy in the last 0-2 years. Using qualitative, constructivist grounded theory methods, we analyzed the contexts that contributed to participants' lived experiences surrounding cannabis use behaviors during pregnancy. RESULTS: Participants reported making conscious decisions to responsibly manage their cannabis use during pregnancy to minimize potential harm to the fetus. Participants prioritized making what they perceived to be safer adjustments to their use of cannabis: (1) changing the amount of cannabis used, (2) changing the types of cannabis products used, and (3) changing sources of cannabis procurement. DISCUSSION: Our findings show that pregnant individuals are seeking information about safe cannabis use beyond medical supervision and are open to altering their cannabis consumption patterns. However, they are unable to find trustworthy and evidence-based harm reduction practices which can be implemented to mitigate harm to their unborn children. A harm reduction approach is needed in the field of maternal cannabis use to promote positive maternal and fetal health outcomes. CONCLUSIONS: More data is needed on comprehensive harm reduction approaches to cannabis use during pregnancy. This requires implementation of education on these topics in healthcare settings presented by prenatal care clinicians.

Between personal and social matters: identifying public perceptions of childfree decisions in Indonesia.

The decision of couples or individuals to not have any children or to be childfree has recently stirred up heated controversy in Indonesia, especially after some prominent social media influencers endorsed views regarding the benefits of choosing to be childfree. This endorsement led to various debates as to whether childfree is considered an appropriate decision, specifically in a society such as Indonesia. We conducted this study to explore Indonesians' perceptions in general towards childfree decisions through qualitative research. We collected responses from 53 participants aged 20-59 recruited online through various social media platforms. We limited our participants to a minimum age of 19, which was considered mature enough to have well-informed opinions regarding marriage and reproductive health issues. Findings were developed through thematic analysis and examined childfree decision making dynamics with a focus on knowledge, personal opinions, attitudes towards being childfree, stigma towards childfree people, and comparisons by gender. Implications and areas for future research are discussed.

Understanding and using experiences of social care to guide service improvements: translating a co-design approach from health to social care.

Background: Local authorities need to find new ways of collecting and using data on social care users' experiences to improve service design and quality. Here we draw on and adapt an approach used in the healthcare improvement field, accelerated experience-based co-design, to see if it can be translated to social care. We use loneliness support as our exemplar. Objectives: To understand how loneliness is understood and experienced by members of the public and characterised by social care and voluntary sector staff; to identify service improvements around loneliness support; to explore whether accelerated experience-based co-design is effective in social care; and to produce new resources for publication on Socialcaretalk.org. Design and methods: Discovery phase: in-depth interviews with a diverse sample of people in terms of demographic characteristics with experience of loneliness, and 20 social care and voluntary staff who provided loneliness support. Production of a catalyst film from the public interview data set. Co-design phase: exploring whether the accelerated experience-based co-design approach is effective in one local authority area via a series of three workshops to agree shared priorities for improving loneliness support (one workshop for staff, another for people with experience of local loneliness support, and a third, joint workshop), followed by 7-monthly meetings by two co-design groups to work on priority improvements. A process evaluation of the co-design phase was conducted using interviews, ethnographic observation, questionnaires and other written material. Results: Accelerated experience-based co-design demonstrated strong potential for use in social care. Diverse experiences of participants and fuzzy boundaries around social care compared to health care widened the scope of what could be considered a service improvement priority. Co-design groups focused on supporting people to return to pre-pandemic activities and developing a vulnerable passenger 'gold standard' award for taxi drivers. This work generated short-term 'wins' and longer-term legacies. Participants felt empowered by the process and prospect of change, and local lead organisations committed to take the work forward. Conclusions: Using an exemplar, loneliness support, that does not correspond to a single pathway allowed us to comprehensively explore the use of accelerated experience-based co-design, and we found it can be adapted for use in social care. We produced recommendations for the future use of the approach in social care which include identifying people or organisations who could have responsibility for implementing improvements, and allowing time for coalition-building, developing trusted relationships and understanding different perspectives. Limitations: COVID-19 temporarily affected the capacity of the local authority Project Lead to set up the intervention. Pandemic work pressures led to smaller numbers of participating staff and had a knock-on effect on recruitment. Staff turnover within Doncaster Council created further challenges. Future work: Exploring the approach using a single pathway, such as assessing eligibility for care and support, could add additional insights into its transferability to social care. Trial registration: This trial is registered as Current Controlled Trials ISRCTN98646409. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR128616) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 27. See the NIHR Funding and Awards website for further award information.

Local councils need to find new ways of using people's experiences of social care to improve services. We explored whether a way of improving health services can improve social care services. 'Experience-based co-design' is a complicated name. It means working with people who use health or social care services to improve that service, and interviewing people as part of this process. Accelerated experience-based co-design uses existing interviews instead of new interviews. To see if the approach works in social care, we chose the topic of loneliness because many of us experience loneliness. We worked with Doncaster City Council because it has been focusing on loneliness. We interviewed 37 people across England and recorded what they said about loneliness. We made a film about their experiences that showed examples of good or poor care. We call these touch points. We held three workshops in Doncaster. Workshop 1 was with people who work in social care as paid workers or volunteers, and workshop 2 was with people who use social care services. In both workshops, people made a list of types of support that needed improvement. Both groups attended workshop 3, watched the film and decided what to focus on from the two lists. Two groups were set up to work on improving support for loneliness in Doncaster. Each group met seven times. One focused on taxi services, and the other group focused on supporting people to do activities they did before the pandemic. A researcher attended these meetings and talked with everyone involved to see how this approach worked. At the end, there was a celebration event. We found that loneliness is complicated. We found the approach to improving support does work in social care, but it needs some changes because social care is not like health care. We suggest ways the approach can be done differently.

Development and validation of the mpox stigma scale (MSS) and mpox knowledge scale (MKS).

BACKGROUND: Few validated brief scales are available to measure constructs that may hinder mpox-related prevention and care engagement, such as knowledge and stigma. Both are highly salient barriers to infectious disease care and disease understanding, precursors to evaluating one's risk and need to, for example, accept vaccination. To address this gap, we developed and validated the Mpox Stigma Scale (MSS) and Mpox Knowledge Scale (MKS). METHODS: As part of a full-scale clinical trial, we offered an optional mpox survey to participants who self-identified as African American or Black, were 18-29 years old, and lived in Alabama, Georgia, or North Carolina (2023, N = 330). We calculated psychometric properties through confirmatory factor analyses (CFA) and applied Comparative Fit Index (CFI), Goodness of Fit Index (GFI), and Tucker-Lewis Index (TLI) values equal to or exceeding 0.90 and Root Mean Square Error of Approximation (RMSEA) and Standardized Root Mean Square Residual (SRMR) values less than 0.08 to determine adequate model fit. We computed internal reliability using Cronbach's alpha and calculated Pearson or Spearman correlation coefficients between the MSS and MKS and related variables. RESULTS: For the MSS, CFA results showed that the one-factor model fit the data well (χ2(df = 5, N = 330) = 34.962, CFI = 0.97, GFI = 0.99, TLI = 0.94, RMSEA = 0.13, SRMR = 0.03). For the MKS, the one-factor model provided a good fit to the data (χ2(df = 6, N = 330) = 8.44, CFI = 0.99, GFI = 0.99, TLI = 0.95, RMSEA = 0.15, SRMR = 0.02). Cronbach's alphas were MSS = 0.91 and MKS = 0.83, suggesting good to excellent reliability. The MSS was correlated with the MKS (r = .55, p < .001), stigmatizing attitudes (r = .24, p < .001), attitudes towards mpox vaccination (r=-.12, p = .030), and worry about contracting mpox (r = .44, p < .001). The MKS was correlated with worry about contracting mpox (r = .30, p < .001) and mpox disclosure (r=-.16, p = .003). CONCLUSIONS: The MSS and MKS are reliable and valid tools for public health practice, treatment and prevention research, and behavioral science. Further validation is warranted across populations and geographic locations. TRIAL REGISTRATION: ClinicalTrials.gov NCT05490329.

Self-Stigma of Canadian Youth With ADHD and Their Parents.

OBJECTIVE: ADHD is subject to stigma from the general population. Exposure to stigma poses the risk of developing self-stigma of youth and parents, but few studies have focused on self-stigma of ADHD. Furthermore, parental factors have been implicated in self-stigma of youth, but no previous research has assessed the association between self-stigma of parents and youth. Therefore, the objective of this study was to better understand the experience of self-stigma of youth and their parents in the context of ADHD. METHOD: Fifty-five youth with ADHD (aged 8-17) and one parent reporter per youth completed surveys to report their experiences. RESULTS: The results of this study found that both youth and parents reported significantly lower self-stigma scores compared to most previously published research. Parents of boys reported higher self-stigma scores compared to parents of girls. Youth who reported higher self-stigma also reported lower self-esteem. Self-stigma scores in youth were predicted by inattentive symptoms but not hyperactive/impulsive symptoms or parental self-stigma. CONCLUSION: Results emphasize the importance of understanding self-stigma of ADHD, symptom severity, and the need for interventions for families with ADHD.

Oxytocin modulation of explicit pandemic stigma in men with varying social anxiety levels.

OBJECTIVE: Stigma can create divisions within societies, hindering social cohesion and cooperation. Notably, it has significant public health implications, especially during infectious disease outbreaks like COVID-19. However, little is known about the neural and molecular basis of disease-related stigma and their association with individual differences. METHODS: To address this gap, we performed a double-blind, placebo-controlled, within-subject design study with 70 males, to investigate the effect of intranasal oxytocin (OT) administration on the explicit and implicit processing of disease-related stigma (i.e., COVID-19 stigma). After self-administrated 24 IU of OT or placebo, participants completed a stigma evaluation task and an Implicit Association Test (IAT) to assess the explicit and implicit processes of stigma evaluation, respectively. RESULTS: The results showed that oxytocin amplified the differences between participants with high and low social anxiety in explicit COVID-19 stigma, with a higher inclination to attribute the stigmatized status of the stigmatized targets (i.e., COVID-19 related group) to personal causes in high social anxiety individuals, but reduced blame towards the stigmatized targets in low social anxiety individuals under oxytocin compared to placebo treatment. Furthermore, oxytocin strengthened the connections between responsibility attribution and the other processes (i.e., emotional, approach motivation, social deviance). While no modulation of oxytocin on implicit stigma emerged, oxytocin did modulate the associations between specific dimensions of explicit stigma (i.e., social deviance and approach motivation) and implicit stigma. CONCLUSION: In conclusion, these findings demonstrated that intranasal oxytocin administration could temporally impact the explicit cognitive judgment in disease-related stigma but not the implicit aspect; furthermore, it modulated in distinct ways in individuals with different levels of social anxiety. These findings highlight the trait-dependent oxytocin modulation on disease-related stigma, implying that oxytocin is partly involved in the endocrine system of disease-related stigma. By unraveling the molecular basis of stigma and its association with individual traits, such as social anxiety, we can tailor interventions to meet specific needs of different individuals in the future.

Drivers and Facilitators of HIV-Related Stigma in Healthcare Settings in Ireland.

People living with HIV who experience stigma in healthcare settings are at increased risk for engaging in health avoidance behaviours, suboptimal adherence to antiretroviral therapy, and viral non-suppression. HIV-related stigma erodes trust between patients and healthcare providers, thereby undermining both individual and public health. This study aimed to identify predictors of stigmatising attitudes, stigma practices, and fear of occupational transmission among healthcare workers in the Republic of Ireland. Data were collected from 295 healthcare workers using a standardised tool designed to measure HIV-related stigma. The outcomes examined were stigmatising attitudes, stigmatising practices (such as excessive infection precaution measures), and fear of occupational transmission. Multiple linear regression analyses were conducted to explore predictors at the individual, clinic, and policy levels. The results indicated that none of the models significantly predicted stigmatising attitudes. However, stigmatising practices were positively associated with never having worked in an HIV clinic, lack of knowledge or agreement with the concept of 'undetectable equals untransmittable' (U = U), and the presence of institutional policies, collectively accounting for 25.3% of the variance. Fear of occupational transmission was positively predicted by gender and lack of knowledge or agreement with U = U, explaining 23.8% of the variance. The findings highlight the critical role of U = U knowledge in reducing stigma-related behaviours and fears among healthcare workers. Enhancing knowledge and acceptance of U = U as part of comprehensive stigma interventions may help reduce the stigma experienced by people living with HIV in healthcare settings.

RESUMEN: Las personas que viven con el VIH que se enfrentan con el estigma en el contexto de cuidado médico tienen un riesgo elevado de evitar la asistencia médica, de no cumplir con el tratamiento, y de sufrir fracasos de tratamiento. El estigma relacionado con el VIH hace daño a la confianza entre los profesionales de salud y los pacientes, y tiene efectos negativos por la salud individual y la salud pública. Comprender a los factores que promueven el estigma en el contexto de cuidado médico es fundamental para que se puedan crear soluciones para abordar el problema. Esta investigación tuvo como objetivo identificar a los predictores del miedo de transmisión del VIH entre los profesionales de salud en su sitio de trabajo, y de las actitudes y las prácticas estigmatizantes entre ellos. Hemos analizado datos que se recogieron de 295 profesionales de salud en Irlanda utilizando un cuestionario validado. Los resultados muestran que los predictores de las prácticas estigmatizantes incluyen no haber trabajado en una clínica de VIH; no tener conocimiento del U = U; y la presencia de políticas institucionales. El género y la falta de conocimiento del U = U eran predictores del miedo de transmisión del VIH. Mejorando el conocimiento del U = U entre los profesionales de salud puede ser una estrategia efectiva para que se reduzca el estigma en los contextos de cuidado médico.

Simulation with a standardised patient to reduce stigma towards people with schizophrenia spectrum disorder among nursing students: A quasi-experimental study.

OBJECTIVES: This study examined the effectiveness of simulation with a standardised patient on the perception of stigma associated with schizophrenia among undergraduate nursing students. It also assessed the reliability of the AQ-27 questionnaire in this context. METHOD: A quasi-experimental study without a control group was conducted on a non-probabilistic sample. The simulation programme used a standardised patient portrayed by a nurse with mental health experience. RESULTS: After simulation, statistically significant stigma improvements were found in six out of nine dimensions; anger and help obtained larger effect sizes (r = 0.392 and 0,307, respectively). Regarding gender, the intragroup analysis revealed that simulation improved stigma among women in six dimensions and among men in four dimensions, with anger and fear showing the highest effect size (r = 0.414 and 0.446, respectively). Regarding previous contact with mental illness among the study participants, the intergroup analysis did not show differences. In the intragroup analysis, simulation improved fear only in the contact group (p = 0,040, r = 0.353). In contrast, simulation changed the response in six dimensions in the no-contact group, similar to the entire group. CONCLUSION: Simulation with a standardised patient is an effective teaching tool for reducing the stigmatisation of people with schizophrenia, thus reducing people's perception of internal causal attribution. It allows for experiencing situations that may be anticipated in clinical practice and reflectively addressing emerging aspects during simulation.