Veterans' Exposure to News Portrayals of Military-Related Posttraumatic Stress and Support for Government Health Interventions: Influences of Stigma and Halo Communication.

This study interrogates the nature by which media perpetuates and potentially preempts stigma about military-related posttraumatic stress. Indeed, addressing the stigma of mental illness is critical to facilitating veteran comfort in seeking needed mental health care. Therefore, the authors explored how media messages about veterans experiencing posttraumatic stress (PTS) influenced how veterans viewed themselves, other veterans experiencing PTS and overall support for government policy and intervention. An experimental design was used to assess how veterans' perceptions are affected by messages adhering to the principles of the model of stigma communication, as well as its more prosocial counterpart, what the authors coin as halo communication. Findings reveal evidence that stigma messages more potently influence outcome perceptions relative to comparable halo messages in the current context. Additionally, interactive effects of message exposure (i.e. conditioned by perceived association with PTS identity) were observed on views that government health intervention is warranted for veterans managing PTS. Practical and theoretical implications are discussed.

Narrating the Sociocultural Experience and Management of Stigma Related to Military Caregiving.

Despite accelerating the recovery and rehabilitation of wounded veterans and saving the U.S. substantial sums in avoided long-term care costs, military caregivers (MCs) are an underserved community lacking resources and support. On top of managing a variety of emotional, physical, relational, and occupational challenges, MCs experience stigma. Indeed, caregiving can be a stigmatized task, especially for military-affiliated individuals who may be expected to adhere to cultural norms of personal sacrifice and resilience in the face of adversity. The current study uses narrative inquiry to better understand the unique experiences and characteristics of MCs providing care for veterans experiencing posttraumatic stress. Specifically, this study examined MCs' narratives to uncover the sociocultural experience and management of stigma related to military caregiving. Interviews with 15 military caregivers of veterans experiencing PTS demonstrated that military caregivers experienced stigma for 1) staying in the relationship, 2) enabling the veteran, 3) mismanaging the condition, and 4) flaking on plans and relationships. In response to stigma, MCs often challenged stigma through strategies of denial or evasion of responsibility. This study contributes to communication scholarship by introducing co-stigma management and further interrogating processes related to stigma management communication. In addition, the results can inform Veteran Affairs (VA) healthcare, caregiver assistance programs, health practices, and support-seeking behaviors.

The Battle Against Mental Health Stigma: Examining How Veterans with PTSD Communicatively Manage Stigma.

Veterans experiencing combat-related PTSD often refrain from seeking mental health services due to the stigma attached, which can lead to extreme and life-threatening consequences including depression, substance abuse, and suicide. Attaining a better understanding of coping mechanisms is important because it has the ability to help veterans better manage their stigma in the future and potentially help them survive PTSD and the stigma associated with it. Thus, the current study uses stigma management communication theory to uncover the ways in which veterans with PTSD communicatively manage their stigmatized identity. In-depth one-on-one interviews with United States veterans show that veterans with PTSD manage stigma using all six major strategies of stigma management communication. Some veterans managed stigma by blending contradictory strategies together. In addition, new stigma management communication strategies appeared. Not only do these results offer advancement for communication theory, but they could aid in the development of military training, military policy, mental health assessments, interventions, and destigmatizing campaigns.

Text Messages Exchanged Between Individuals With Opioid Use Disorder and Their mHealth e-Coaches: Content Analysis Study.

BACKGROUND: Opioid use disorder (OUD) has affected 2.2 million people in the United States. About 7.2 million people reported using illicit drugs in 2019, which contributed to over 70,000 overdose deaths. SMS text messaging interventions have been shown to be effective in OUD recovery. However, the interpersonal communication between individuals in OUD treatment and a support team on digital platforms has not been well examined. OBJECTIVE: This study aims to understand the communication between participants undergoing OUD recovery and their e-coaches by examining the SMS text messages exchanged from the lens of social support and the issues related to OUD treatment. METHODS: A content analysis of messages exchanged between individuals recovering from OUD and members of a support team was conducted. Participants were enrolled in a mobile health intervention titled "uMAT-R," a primary feature of which is the ability for patients to instantly connect with a recovery support staff or an "e-coach" via in-app messaging. Our team analyzed dyadic text-based messages of over 12 months. In total, 70 participants' messages and 1196 unique messages were analyzed using a social support framework and OUD recovery topics. RESULTS: Out of 70 participants, 44 (63%) were between the ages of 31 and 50 years, 47 (67%) were female, 41 (59%) were Caucasian, and 42 (60%) reported living in unstable housing conditions. An average of 17 (SD 16.05) messages were exchanged between each participant and their e-coach. Out of 1196 messages, 64% (n=766) messages were sent by e-coaches and 36% (n=430) by participants. Messages of emotional support occurred the most, with 196 occurrences (n=9, 0.8%) and e-coaches (n=187, 15.6%). Messages of material support had 110 occurrences (participants: n=8, 0.7%; e-coaches: n=102, 8.5%). With OUD recovery topics, opioid use risk factors appeared in most (n=72) occurrences (patient: n=66, 5.5%; e-coach: n=6, 0.5%), followed by a message of avoidance of drug use 3.9% (n=47), which occurred mainly from participants. Depression was correlated with messages of social support (r=0.27; P=.02). CONCLUSIONS: Individuals with OUD who had mobile health needs tended to engage in instant messaging with the recovery support staff. Participants who are engaged in messaging often engage in conversations around risk factors and avoidance of drug use. Instant messaging services can be instrumental in providing the social and educational support needs of individuals recovering from OUD.