The Effects of Direct-To-Consumer-Advertising on Mental Illness Beliefs and Stigma.

Despite widespread use, little is known about how video direct-to-consumer-advertising (DTCA) influences beliefs about or stigma towards mental illness. The purpose of this study was to examine the effects of a medication advertisement on beliefs and stigma towards one mental disorder-bipolar disorder. A total of 424 participants were randomly assigned to view a medication or automobile advertisement and completed measures of beliefs and stigma towards bipolar disorder before and immediately after the advertisement. The medication advertisement did not lead to changes in perception of biological etiology, but did lead to increases in perception of prevalence, treatability, and controllability. No substantive changes were noted in stigma. In contrast to previous research and speculation, DTCA did not have an immediate, substantial impact on stigma or contribute to the "medicalization" of mental disorders.

Stigma towards Marijuana Users and Heroin Users.

Despite high levels of stigmatizing attitudes and behaviors toward individuals with substance use problems, there is surprisingly limited research on understanding the contributors to such high levels. College students with no history of marijuana or heroin use (N=250) completed self-report measures to examine the level of substance use stigma towards individuals using two illicit substances (marijuana and heroin) and the contribution of three perceiver characteristics (sex, previous contact with substance users, and five beliefs about substance use) to three dimensions of stigma (social distance, negative emotions, and forcing treatment). Greater levels of internalized stigma were noted towards individuals who use heroin (versus marijuana). For marijuana use, those who had less previous contact and higher endorsement of certain beliefs (rarity, severity, and less controllability) were associated with greater stigmatizing attitudes. For heroin use, the associations were weak or non-existent. The findings strengthen the argument that substance use stigma needs to be examined and perhaps addressed substance by substance, rather than as a group. Further, contact interventions may be a particularly effective strategy for altering substance use stigma.

Implementing a brief hallucination simulation as a mental illness stigma reduction strategy.

Due to the prevalence and serious consequences associated with mental illness stigma, a number of educational interventions have been developed to decrease stigma. One potential intervention is administering brief simulations of auditory hallucinations, but no empirical evaluations have been published. This research examined the efficacy of a brief simulation on stigma across two listening conditions. After completing a stigma measure, participants (N = 127) listened to a simulation and were randomly assigned to one of two listening conditions: (1) sitting in a research lab, or (2) ambulating around a college campus completing two tasks. All participants then completed the stigma measure a second time. Regardless of listening condition, the simulations led to changes on two aspects of stigma--less willingness to help/interact and stronger attitudes for forcing treatment on those with mental illness. These findings suggest that brief simulations require additional careful evaluation of their efficacy prior to wide implementation.

An examination of two brief stigma reduction strategies: filmed personal contact and hallucination simulations.

Mental illness stigma is quite prevalent with dire consequences. A number of interventions to decrease stigma have been formulated, but have variable effectiveness and limited dissemination. This research examined the impact of two brief interventions: a film depicting individuals with schizophrenia (filmed contact) and a simulation of auditory hallucinations. Participants (N = 143) were randomly assigned to one of three interventions: (1) filmed contact, (2) simulation, or (3) no intervention, and completed two stigma measures prior to, immediately after, and 1 week after the intervention. The filmed contact intervention led to decreases in stigma which persisted across 1 week. However, the simulation led to increases in stigma. The results suggest that a filmed contact intervention may decrease two aspects of mental illness stigma (social distance and negative emotions), which has implications for wide dissemination. The efficacy of a hallucination simulations intervention remains dubious.

Personality and non-suicidal deliberate self-harm: Trait differences among a non-clinical population.

Limited information is available on understanding why particular individuals engage in non-suicidal deliberate self-harm (DSH), especially among non-clinical populations. An array of personality traits, such as those included in the five-factor model of personality, may further an understanding of DSH. The purpose of this study was to examine personality traits among non-clinical groups with or without a history of DSH. College students (N=238) completed self-report measures of DSH and personality. Both multivariate (MANOVA, discriminant analysis) and univariate (ANOVA) statistical procedures supported the hypothesis that those with a history of DSH (n=59) had significantly higher levels of neuroticism and openness to experience, and significantly lower levels of agreeableness and conscientiousness. Contrary to expectations, there were no differences in extraversion between the two groups. These results indicate personality differences among those with a history of DSH, which with additional research, may prove to be risk factors or targets of intervention for future DSH or collateral problems.

Psychometric evaluation of the National Opinion Research Center DSM-IV Screen for Gambling Problems (NODS).

The present study examined the reliability, validity, and clinical utility of a brief self-report measure of gambling behavior, the National Opinion Research Center DSM-IV Screen for Gambling Problems (NODS). Participants were 157 consecutively enrolled male military veterans taking part in substance use disorder treatment. The NODS displayed good internal consistency. Concurrent and discriminant validity were demonstrated by comparing scores on the NODS to scores on the South Oaks Gambling Screen and to a measure of medical problems, respectively. Overall, the NODS appears to be a reliable, valid, and clinically useful measure of gambling problems among patients in substance use disorder treatment programs.

Factors and measurement of mental illness stigma: a psychometric examination of the Attribution Questionnaire.

OBJECTIVE: A number of scales are employed to measure mental illness stigma, but many fail to have documented or adequate psychometric properties. The purpose of this study was to further evaluate the psychometric properties of one such measure, the Attribution Questionnaire (AQ). METHODS: Based on responses from 774 college students, exploratory factor analyses were conducted followed by an examination of the reliability and validity of the newly formed factor scales. RESULTS: A six-factor structure emerged and four of these factor scales (Fear/Dangerousness, Help/Interact, Forcing Treatment, and Negative Emotions) had acceptable internal consistency, test-retest reliability, and convergent validity with other stigma measures. CONCLUSIONS: Twenty items from the AQ provide reliable and valid measurement of four important aspects of stigmatizing attitudes/beliefs towards the mentally ill. Accurate measurement of these attitudes/beliefs will be critical to more fully understanding the stigma process and developing effective strategies to address stigma.

Social anhedonia and schizotypy: the contribution of individual differences in affective traits, stress, and coping.

While social anhedonia is a promising indicator of vulnerability to schizophrenia, it remains uncertain whether anhedonia is a core feature of schizotypy or merely a secondary associated characteristic. This issue was examined by comparing dimensional scores on schizophrenia spectrum personality disorder symptoms derived from clinical interviews among three groups: a) "pure" social anhedonics with high scores on the Revised Social Anhedonia Scale (SAS; [Eckblad, M.L., Chapman, L.J., Chapman, J.P., Mishlove, M., 1982. The Revised Social Anhedonia Scale. Unpublished test, University of Wisconsin, Madison.]) and low scores on the Magical Ideation Scale (MIS, [Eckblad, M.L., Chapman, L.J., 1983. Magical ideation as an indicator of schizotypy. Journal of Consulting and Clinical Psychology, 51, 215-225.]), b) subjects with high MIS and low SAS scores, and c) controls with low scores on both scales. This study also sought to identify individual differences in stress reactivity, personality, coping style, and social support that might be related to severity of clinical symptoms among at-risk subjects. Compared to controls, the SAS group had higher levels of schizotypal, schizoid, and paranoid symptoms and the MIS group had higher schizotypal symptoms. Among social anhedonics, individual differences in perceived stress, trait negative affectivity, and coping style accounted for over 40% of the variance in schizotypal and paranoid symptoms. This cross-sectional study bolsters support for the validity of social anhedonia as a primary feature of schizotypy. Longitudinal studies are required to determine whether these individual differences potentiate clinical outcomes among social anhedonics.

Improving Pediatric Education for Emergency Medical Services Providers: A Qualitative Study.

OBJECTIVES: Previous studies have illustrated pediatric knowledge deficits among Emergency Medical Services (EMS) providers. The purpose of this study was to identify perspectives of a diverse group of EMS providers regarding pediatric prehospital care educational deficits and proposed methods of training improvements. METHODS: Purposive sampling was used to recruit EMS providers in diverse settings for study participation. Two separate focus groups of EMS providers (administrative and non-administrative personnel) were held in three locations (urban, suburban, and rural). A professional moderator facilitated focus group discussion using a guide developed by the study team. A grounded theory approach was used to analyze data. RESULTS: Forty-two participants provided data. Four major themes were identified: (1) suboptimal previous pediatric training and training gaps in continuing pediatric education; (2) opportunities for improved interactions with emergency department (ED) staff, including case-based feedback on patient care; (3) barriers to optimal pediatric prehospital care; and (4) proposed pediatric training improvements. CONCLUSION: Focus groups identified four themes surrounding preparation of EMS personnel for providing care to pediatric patients. These themes can guide future educational interventions for EMS to improve pediatric prehospital care. Brown SA , Hayden TC , Randell KA , Rappaport L , Stevenson MD , Kim IK . Improving pediatric education for Emergency Medical Services providers: a qualitative study. Prehosp Disaster Med. 2017;32(1):20-26.

A perceived Benefits and Barriers Scale for strenuous physical activity in college students.

PURPOSE: Due to relatively low physical activity among college students, a standardized, reliable, and valid scale of perceived benefits and barriers for this population is critical. The purpose of this study was to develop a new scale, the Physical Activity Benefits and Barriers Scale, and determine whether the scale was appropriate for college students. METHODS: An exploratory factor analysis of 26 benefit and 24 barrier items of physical activity was administered to 493 college students, followed by an examination of the relationship between the newly derived factors and physical activity, as well as test-retest reliability. RESULTS: Twenty-eight items loaded on 10 factors that accounted for 60% of the variance, and 9 of the 10 factors were moderately associated with strenuous physical activity. DISCUSSION: Psychometric properties were acceptable on this new scale, with the low motivation factor accounting for the highest amount of the variance in strenuous physical activity.

When the Mannequin Dies, Creation and Exploration of a Theoretical Framework Using a Mixed Methods Approach.

INTRODUCTION: Controversy exists in the simulation community as to the emotional and educational ramifications of mannequin death due to learner action or inaction. No theoretical framework to guide future investigations of learner actions currently exists. The purpose of our study was to generate a model of the learner experience of mannequin death using a mixed methods approach. METHODS: The study consisted of an initial focus group phase composed of 11 learners who had previously experienced mannequin death due to action or inaction on the part of learners as defined by Leighton (Clin Simul Nurs. 2009;5(2):e59-e62). Transcripts were analyzed using grounded theory to generate a list of relevant themes that were further organized into a theoretical framework. With the use of this framework, a survey was generated and distributed to additional learners who had experienced mannequin death due to action or inaction. Results were analyzed using a mixed methods approach. RESULTS: Forty-one clinicians completed the survey. A correlation was found between the emotional experience of mannequin death and degree of presession anxiety (P < 0.001). Debriefing was found to significantly reduce negative emotion and enhance satisfaction. Sixty-nine percent of respondents indicated that mannequin death enhanced learning. These results were used to modify our framework. CONCLUSIONS: Using the previous approach, we created a model of the effect of mannequin death on the educational and psychological state of learners. We offer the final model as a guide to future research regarding the learner experience of mannequin death.

Measuring perceived benefits and perceived barriers for physical activity.

OBJECTIVES: To evaluate the psychometric properties and relationship to physical activity levels of the Exercise Benefits/Barriers Scale (EBBS) among college students. METHODS: A total of 398 college students completed the EBBS and a measure of self-efficacy, the Physical Exercise Self-Efficacy Scale. In addition, a subsample of 275 students also completed a semistructured interview on physical activity, the Seven-day Physical Activity Recall. RESULTS: Psychometric properties were acceptable, but only benefits significantly accounted for variance in physical activity levels. CONCLUSIONS: Surprisingly, the factorial structure differed from the test developers'.

Administrative, clinical, and ethical issues surrounding the use of waiting lists in the delivery of mental health services.

The waiting list is commonly used in the delivery of mental health services. Despite their prevalence, their design and management are generally not standardized; rather, they take place on an ad hoc basis as a response to undesirable circumstances. The formulation and management of a waiting list initially appear to be simple, straightforward, and benign. However, on close examination, waiting lists are complicated, and implementation involves pervasive costs and benefits. This article delineates the costs and benefits involved in the use of waiting lists. It outlines administrative, clinical, and ethical issues intrinsic in the use of waiting lists and provides recommendations aimed at assisting in their design and management. While recommendations encompassing the range of possible unique situations are impractical, guidelines for consideration of important variables are provided.

Standardized measures for substance use stigma.

Despite indications that the stigma associated with substance use is high and may play a role in discouraging treatment participation, there is limited research in this area and only a few psychometrically sound measures of substance use stigma exist. The purpose of this study was to formulate and evaluate the psychometric properties of three substance use stigma measures. College students (N=565) completed three measures of substance use stigma that were modified from three established measures of mental illness stigma. Two of the three modified measures (Social Distance Scale for Substance Users and Affect Scale for Substance Users) emerged as having acceptable psychometric properties, whereas one modified measure (Dangerousness Scale for Substance Users) had inadequate psychometric properties. In regard to sex differences, women had significantly higher substance use stigma on the two psychometrically sound measures (p<.01). Perhaps, with standardized measures, there can be greater progress towards better understanding the mechanisms leading to high levels of substance use stigma and ultimately address failures to seek out treatment due to stigma.

Past and recent deliberate self-harm: emotion and coping strategy differences.

Only limited information on nonsuicidal deliberate self-harm behavior among nonclinical populations is available, and it is unclear whether coping and emotional difficulties remain among those with a past history of self-harm behavior. The purpose of this study is to examine emotions and coping strategies among three nonclinical groups with a recent, past, and no history of nonsuicidal deliberate self-harm behavior. College students completed self-report measures of self-harm behavior, suicidal thoughts, emotional dispositions, and coping strategies. Contrary to expectations, there were few differences in coping strategies among the three groups ( p > .0033). Those with a recent history (n = 23; in the last 12 months) and past history (n = 32; more than 12 months ago) of self-harm behavior reported greater levels of negative emotion (e.g., hostility, guilt, sadness) than those who have never self-harmed (n = 161; p < .0045). This indicates that although self-harm behavior had discontinued (>12 months ago), negative emotion differences were present, and both recent and past self-harmers merit concern in managing their negative emotions to lower their risk for future difficulties.