Bakgrund Substansbrukssyndrom är ett globalt hälsorelaterat problem. Det är en neuropsykiatrisk sjukdom som medför ett kraftigt behov av intag av droger trots skadliga konsekvenser. Behovet drivs av de belönade effekterna som drogerna har på hjärnan. År 2019 miste närmare en halv miljon människor livet på grund av droger och då patientgruppen tenderar att leva med ohälsa korsar de vägar med vården kontinuerligt. Mötet med patientgruppen sker i alla delar av vårdkedjan och därmed behöver vårdpersonalen kunskap och förståelse kring deras upplevelser med hälso- och sjukvården.  Syfte  Syftet var att belysa erfarenheter av vården hos personer där ett substansbrukssyndrom finns i bakgrunden. Metod  En icke-systematisk litteraturöversikt har genomförts baserat på 15 vetenskapliga publikationer. De vetenskapliga publikationerna hämtades i databaserna PubMed, CINAHL och Psycinfo. Noggrann kvalitetsgranskning gjordes av de vetenskapliga artiklar som användes till litteraturöversikten. Vid analys av datan användes en integrerad analysmetod. Resultat Litteraturöversikten kom fram till två kategorier och fem subkategorier. Den första kategorin var upplevelsen av stigma med underkategorierna; bemötande och attityder, vårdpersonalens misstänkliggörande och strategier för att hantera stigma. Den andra kategorin var upplevelsen av otillräcklig vård med underkategorierna; ojämlik vård och smärtlindring. Slutsats Sammanfattningsvis upplever personer som lider av ett substansbrukssyndrom att de erhåller vård med lägre kvalitet. De upplever ett stigmatiserat bemötande som präglas av kränkande attityder och brist på tillit. Strategier som patientgruppen använts sig av för att undvika stigmatiseringen har många gånger lett till en destruktiv relation med vården genom undanhållande av information och att de dragit sig från att söka vård. / Background Drug use disorder is a global health-related issue. It is a neuropsychiatric disease that entails a strong need for drug intake despite harmful consequences. The need is driven by the rewarding effects that drugs have on the brain. In 2019, close to half a million people lost their lives due to drugs, and as the patient group tends to live with illness, their paths intersect with healthcare continuously. The encounter with the patient group occurs in all parts of the healthcare chain, and thus, healthcare personnel need knowledge and understanding of their experiences with health care.  Aim The aim was to illustrate healthcare experiences for people when a substance use disorder is present. Method A non-systematic literature overview based on 15 scientific publications. The scientific publications are retrieved from the databases PubMed, CINAHL and Psycinfo. A thorough quality review has been conducted of the 15 scientific publications that were used in the literature overview. The data were analyzed with an integrated analysis method. Results This literature overview came up with two categories and five subcategories. The first category was the experience of stigma with the subcategories; interactions and attitudes, healthcare staff suspicions and strategies to avoid stigma. The second category was experiences of quality of care with the subcategories; unequal care and pain management. Conclusions In summary people that suffer from a drug use disorder experience that they receive care with lower quality. They experience stigmatizing treatment characterized by abusive attitudes and lack of trust. Strategies used by the patient group to avoid stigma has often led to a destructive relationship with healthcare through withholding of information and by hesitation to seek care.

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Today around 40 million people live with human immunodeficiency virus(hiv) globally and around 8500 people in Sweden. When diagnosed withhiv, many emotions can arise which often are associated with suffering,isolation, discrimination and stigmatization. In making a difficult decisionby sharing the diagnosis, one’s life situation can change. A scientificliterature study of ten original articles was carried out with the aim ofelucidating experience of stigma among men with hiv and therebyincreasing knowledge in healthcare and society. Through the literaturesearch, five categories were identified: impact on emotions, impact on socialcommunity, impact on sexual relations, stigma in health care and theimportance of support from close relationships. The result showed thatmany men experience stigma from the environment that affects theiremotions and relationships. Men with hiv experienced stigma from theirrelatives and from the health care, which affected different aspects of theirquality of life. Increased knowledge and understanding of hiv can help menfeel less isolated in health care and society which leads to reduceddiscrimination. Continued research about men's experience with hiv isneeded to be able to reduce shame, stigmatization and prejudice. Men’sexperiences will benefit through acceptance of the diagnosis. / Idag lever runt 40 miljoner människor med humant immunbristvirus (hiv)världen över och 8500 i Sverige. När någon diagnostiseras med hiv kan detuppstå många känslor som ofta associeras med lidande, isolering,diskriminering och stigmatisering. Genom att ta svåra beslut och dela medsig av diagnosen kan livssituationen förändras. En vetenskapliglitteraturstudie på tio orginalartiklar genomfördes med syftet att belysaupplevelser av stigmatisering hos män med hiv och därmed öka kunskapeninom vården samt i samhället. Genom litteratursökningen identifierades femkategorier: påverkan på känslor, påverkan på social gemenskap, påverkan påsexuella relationer, stigmatisering inom hälso-och sjukvården samt vikten avstöd från närstående. Resultatet visade att många män uppleverstigmatisering från omgivningen som påverkar känslor och relationer. Mänmed hiv upplevde stigmatisering från närstående och från vården vilketpåverkade olika aspekter av livskvaliteten. Genom att öka kunskapen ochförståelsen kring hiv kan männen känna mindre utanförskap i vården och isamhället, vilket kan göra att diskrimineringen minskas. Fortsatt forskningom mäns upplevelser av hiv behövs för att kunna minska skam ochstigmatisering. Fördomar behöver minskas och acceptans kring diagnosenkommer att gynna många mäns upplevelser i vården och i samhället.

This dissertation explores cannabis industry workers’ experiences of stigmatization. I conducted 23 interviews over a period of seven months with people who had been or were currently employed in the state-legal cannabis industry. I thematically analyzed and organized participant responses around significant moments of concept formation and understanding about cannabis. Participants shared first-time stories which served as initial encounters with either cannabis itself or the stigmatizing attitudes that sometimes surrounded it. There were discussions of how friends, family, and adults in general talked about cannabis and the impact that talk had on participants’ own attitudes toward cannabis. Perhaps most importantly, participants shared and described strategies for managing cannabis industry stigma. The interviews are presented within the context of an account of the contemporary social environment surrounding cannabis. The result of a long and political history rife with larger-than-life real world and fictional characters alike, much of our understanding of cannabis is influenced by the way it has been treated over the past century. As our collective discussion about the legitimacy of drug prohibition gains momentum, there is a growing need to consider the unintended social and material consequences that may beset those who would consider deriving their livelihood from these developing industries. Industry regulators, state representatives, company owners, and the industry as a whole must make efforts to support the needs of the growing workforce and reduce barriers to entry.

The unifying theme of the chapters presented in this thesis is how people who are not in paid work respond to the stigma of unemployment or the possibility of being regarded as (similar to the) unemployed. Although unemployment is a topic of continuing interdisciplinary interest, most of the extant psychological research has tended to focus on investigating those unemployed people who are officially registered as such. While such an approach is helpful, less research attention has been paid to the fact that there are many groups who are not in paid employment, such as stay-at-home mothers or students. There may be circumstances under which those people may be perceived as very similar to the unemployed. As a consequence, they may perceive a stigma of unemployment. In this thesis we develop this idea by conceptualising people who are not in paid employment in terms of their social identities. The primary goals of this thesis are twofold: first, to demonstrate that the stigma of unemployment not only impacts on the behaviour of registered unemployed people, but also on other people who are not in paid employment. Second, to demonstrate that people not in paid work respond to perceptions of stigma and the possibility of being seen as unemployed by using psychological strategies that are based on their group memberships. Therefore, this thesis investigates how social identification processes interact with perceptions of stigma to influence possible coping behaviour and well-being. In Chapter 1 we begin by reviewing the extant literature on unemployment and stigma. In Chapter 2 we introduce the social identity approach and illustrate how it can be applied to research on groups of people who are not in paid employment in a way that advances both fields. In Chapter 3 we develop the rationale of this thesis and outline a concept to investigate behaviour and responses of different kinds of people not in paid work. In Chapter 4 we present a survey study of unemployed people that supports the notion that they do perceive stigma impacting on their well-being. We present two experiments with university students in Chapter 5 aimed to investigate a threat of possible future unemployment. The findings demonstrate that future job prospects may impact on social identification with other students and well-being. In Chapter 6 we present two studies with stay-at-home mothers that provide evidence that stay-at-home mothers also perceive the stigma of unemployment, but cope with it in different ways than registered unemployed people and students. An experiment with stay-at-home mothers sought to investigate how an imposed unemployed identity affects their coping strategies and well-being. Both studies found support that an alternative identity of being a mother can be a powerful coping resource that is able to protect against negative effects of perceived stigma on well-being. Finally, in Chapter 7, we review and integrate our findings, discuss limitations, and consider theoretical and practical implications. In addition, we suggest new avenues for theoretical and practical work in the research fields of unemployment, stigma, and social identity. We conclude that, overall, the findings we present in this thesis point to the powerful role that stigmatisation and social identification processes can play in determining responses of people who are not in paid work.

Background: Little is known about how abnormal communication from someone with schizophrenia is perceived by those interacting with the individual. The N400 event-related potential (ERP) is an index of how difficult it is to process incongruent words and is sensitive to context about the identity of the speaker. Knowledge of an individual’s diagnosis provides such context, and responses to a diagnosis have typically been examined from a stigma framework. Purpose: The current study aimed to examine the effect of context regarding the speaker, on the N400 ERP in the listener in response to speech that contained schizophrenia-associated communication abnormalities, and the relationship between the N400 and stigma. Methods: 73 first year undergraduate students listened to segments of conversation between two people while continuous EEG was recorded. Participants were told that the responder in the conversation was either a university student, had a stroke, had schizophrenia (and had recovered), or had schizophrenia (and symptoms were emphasized). The last word of the response in the conversation was varied to be a typical ending, a word approximation, or a neologism. Results: A significant N400 was observed over centro-parietal electrode sites in response to word approximations and neologisms when participants were told that the responder was a university student, but not in the other conditions. The amplitude of the N400 was significantly greater in response to neologisms than in response to word approximations. Participants also rated that they would be more likely to continue speaking to someone using typical words, than word approximations, and in both cases, more like than someone using neologisms. There was no significant relationship between the amplitude of the N400 and any of the stigma measures. Discussion: Telling participants either about the functional symptoms of schizophrenia, the diagnosis, or both resulted in a significantly reduced N400. This suggests a processing bias in which knowledge of either the symptoms or diagnosis of schizophrenia reduces the difficulty of integrating atypical speech. This does not appear to be a result of stigmatizing attitudes per se, but may be the result of an expectancy for someone with schizophrenia to communicate in abnormal ways. / Thesis (Master, Psychology) -- Queen's University, 2013-08-08 21:15:41.691

Detta arbete har tagit upp frågan om hur personer som har ett spelberoende upplever sig i vardagslivet. Syftet med studien var att studera ifall personer som har ett spelberoende upplever sig avvikande i vardagslivet och i sådant fall hur.

M.A. / This study emerged from the apparent contradiction posed by the frequent occurrence of stigma and the prevalent concept of ‘living positively with HIV/AIDS’ in South Africa. It was anchored in the need and commitment to resolve this paradox. This study contributes to filling a relative dearth of research which explores this phenomenon. Fieldwork consisted of observation, group interviews and in-depth interviews at two public hospitals in the greater Johannesburg area. People living with HIV/AIDS (PLHAs) experience stigma to differing extents in various contexts. In particular, PLHAs experience stigma in healthcare settings, from family, sexual partners and the community at large. Social identity is used in two significant ways as a defence mechanism against stigma in personal relationships. The first is to attempt to discredit stigmatising stereotypes as applied to the PLHA by emphasising how he/she is moral and valuable to those around HIV/her. By using this approach, termed ‘identity fixes’, the PLHA attempts to reduce the stigma which he/she is likely to experience in her/his social relationships. The second is to refuse to accept the ideology which underpins stigma. This denies that HIV/AIDS is an appropriate basis for stigma. The acceptance of this alternative ideology is marked by public disclosure. The goal of adopting this identity termed the ‘positive resistance identity’ is to challenge and oppose the stigma itself. / Prof. Tina Uys

Approved for public release; distribution in unlimited. / This study examines stigma associated with mental health services counseling in the Marine Corps for the purpose of assessing areas of concern where lack of awareness or stigma exists. Marines with longstanding unresolved personal problems or more immediate emotional distress may be less effective, they may also not know where to go for help. Secondly, stigma may be associated with the fear of negative performance evaluations and decreased future promotions, which may reflect an underutilization of the available mental health services. Results of this study reflect: 1)that stigma does exist; 2)that Marines have a poor knowledge of the availability and variety of mental health services; 3)that there is little in the way of destigmatization training within the Marine Corps. By studying civilian models which may have a destigmatization component, this study presents possible methods for incorporating destigmatization training into the OSCAR program. Theoretically, the results of this study, garnered through interviews with practitioners, literature, and an OSCAR program review, can be used to further the efficacy of Marine Corps mental health services by way of education and destigmatization training. / Captain, United States Marine Corps

Studien syftar till att undersöka vilka strategier den ADHD-diagnostiserade använder i sitt arbetsliv för att hantera de negativa effekterna på identiteten och sociala relationer som diagnosen medför. Studien har en kvalitativ ansats och är inspirerad av metoden grundad teori.  Data har samlats in genom fem semistrukturerade intervjuer med personer som har ADHD. Resultatet visar att de diagnostiserade i arbetslivet använder en kontextuell sensitivitet för att hantera stigmat som diagnosen innebär i arbetslivet. Detta strider mot ADHD-diagnosens kriterier i DSM som beskriver den diagnostiserade som en individ som är impulsiv, ouppmärksam och hyperaktiv. Resultatet visar att de diagnostiserade snarare är mycket känsliga för kontexten. Begreppet kontextuell sensitivitet utgör således kärnkategorin i studien och inrymmer stigmahanteringsstrategierna mörka eller komma ut med diagnosen, överskrida eller betona diagnosen, ignorera eller protestera mot reaktioner på diagnosen samt omformulera eller bekräfta diagnosen. Tidigare forskning med ett aktörsperspektiv i andra sammanhang än arbetslivet tyder på att de diagnostiserades strategier styrs av kontexten. Det innebär att begreppet kontextuell sensitivitet skulle kunna användas i andra studier med ett stigmatiseringsperspektiv. Teorier och tidigare forskning stödjer kritiken mot DSM och den biomedicinska tolkningen av ADHD som resultatet av föreliggande studie visar på. Studien synliggör behovet av mer forskning inom området.