Alcohol use disorder (AUD) is a highly stigmatized condition, often associated with negative stereotypes such as being morally weak, incompetent, unpredictable, and aggressive. People with AUD are at risk of experiencing self-stigma, a social-cognitive experience in which people think others hold negative stereotypes about them, expect to be treated unfairly, and/or believe that negative stereotypes are personally accurate. Women in the criminal justice system with AUD in particular are at risk of experiencing self-stigma due to intersecting sources of disadvantage. Given that self-stigma can lead to treatment avoidance and dropout, it is important to understand risk factors for self-stigma to inform prevention and intervention efforts in the justice system. Incarcerated women with AUD (=185) completed measures of alcohol self-stigma as well as a variety of theoretically relevant risk factors including sociodemographics, baseline levels of stress and depression, and alcohol-related factors (i.e., length of drinking history, frequency/amount of use, consequences of use, physician advice to stop, belief that legal involvement is related to alcohol use, alcohol-related charges, self-efficacy to quit, readiness for treatment, pressures to enter treatment, factors that influence treatment) and other stigmatized conditions (drug use, exchanging sex, and homelessness). Results showed that experiencing more consequences of alcohol use, pressures to enter treatment, and perceived stress were associated with internalized stigma and anticipated/enacted stigma. This study begins to identify which incarcerated women with AUD are most at risk of experiencing self-stigma that may interfere with alcohol treatment.

Based on a step-wedge randomized control trial (intervention n = 136; comparison n = 137), this study investigated the impact of a peer mentor intervention for youth living with HIV aged 15-24 years in Ndola, Zambia. Using piecewise hierarchical linear modeling (HLM), change in internalized stigma predicted change in mindfulness, and mindfulness was a significant predictor of better self-reported adherence to antiretroviral therapy (ART) across both intervention groups. Intervention group membership did not predict rate of change in mindfulness, but predicted a reduction in internalized stigma and an increase in self-reported ART adherence. Following the peer mentor intervention, internalized stigma was significantly lower in the intervention group than the comparison group. Findings highlight the need to develop and implement interventions specific to adolescents living with HIV with a biopsychosocial approach that attends to both the physical and psychological needs specific to adolescents. Our findings support the inclusion of mindfulness-based components in interventions targeting ART adherence for adolescents living with HIV.

The internalization of mental illness stigma is associated with an array of negative consequences; however, not all individuals experience the deleterious effects of internalized mental illness stigma. The present dissertation focuses on factors associated with internalized stigma, and will be the first to examine simultaneously both risk (i.e., shame, shame proneness and shame aversion, insight, and centrality and valence) and protective factors (social support and self-compassion) of internalized mental illness stigma. Using two of the most widely used assessments of internalized mental illness stigma (i.e., Self-Stigma of Mental Illness Scale [SSMIS] and the Internalized Mental Illness Scale [ISMI]), risk and protective factors were examined among adults recruited through Amazon Mechanical Turk (AMT; n = 215) and Facebook (n = 153) who self-reported a mental illness diagnosis. Whereas among AMT participants, shame proneness and centrality were significant predictors of the process of internalization of mental illness stigma (measured by the Stereotype Self-Concurrence subscale of the SSMIS), among Facebook participants centrality was the only significant predictor of process of the internalization of mental illness stigma. In addition, whereas among AMT participants, shame proneness (measured by the PFQ-2), centrality, valence, and social support were significant predictors of the experience of internalized stigma (measured by the ISMI), among Facebook participants state shame, centrality, valence, and social support were significant predictors of the experience of internalized stigma. Thus, centrality was the only significant risk factor across measures and samples. It is possible that the current dissertation may help to differentiate individuals at particular risk for internalization and ultimately to harness resilience for those diagnosed with a mental illness, particularly among those diagnosed with mood or anxiety-related diagnoses.

Submitted by isabela.moljf@hotmail.com (isabela.moljf@hotmail.com) on 2016-08-08T17:24:50Z No. of bitstreams: 1 flavianebevilaquafelicissimo.pdf: 1341224 bytes, checksum: e7bbc0b7ac0a9565972c7b2d8646a853 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-08-09T11:56:03Z (GMT) No. of bitstreams: 1 flavianebevilaquafelicissimo.pdf: 1341224 bytes, checksum: e7bbc0b7ac0a9565972c7b2d8646a853 (MD5) / Made available in DSpace on 2016-08-09T11:56:03Z (GMT). No. of bitstreams: 1 flavianebevilaquafelicissimo.pdf: 1341224 bytes, checksum: e7bbc0b7ac0a9565972c7b2d8646a853 (MD5) Previous issue date: 2013-01-23 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / O alcoolismo é uma condição fortemente estigmatizada pela população geral, conduzindo o alcoolista a internalizar esse estigma e sofrer com as consequências negativas desse fenômeno. Um adequado repertório de habilidades sociais permite ao indivíduo aumentar sua rede de apoio social, atuando como minimizador das consequências negativas da internalização do estigma. Diante dessa constatação, o presente trabalho buscou responder a três objetivos: (1) Revisar a literatura científica em busca de evidências de déficits no repertório de habilidades sociais em alcoolistas e da eficácia do Treinamento de Habilidades Sociais (THS) para o tratamento dessa condição; (2) caracterizar e comparar o repertório de habilidades sociais de dependentes e não dependentes de álcool e (3) descrever o estigma internalizado em alcoolistas e sua relação com o repertório de habilidades sociais. Para responder ao primeiro objetivo, foi conduzida uma revisão sistemática da literatura, a qual analisou 33 estudos interessados nessa relação. Os resultados indicaram uma ausência de estudos que comprovem a existência de déficits no repertório de habilidades sociais em alcoolistas. Entretanto, o THS foi apontado como uma técnica eficaz no tratamento para essa condição. Para responder aos objetivos dois e três, foram entrevistados 123 dependentes de álcool e 114 não dependentes dessa substância, através de uma entrevista estruturada utilizando os instrumentos: questionário sociodemográfico, Mini International Neuropsychiatric Interview, Inventário de Habilidades Sociais e a Internalized stigma of mental illness adaptada para a população de dependentes de substâncias no Brasil. Os dados foram analisados quantitativamente e indicaram uma diferença na habilidade de autocontrole da agressividade entre dependentes e não dependentes de álcool, demonstrando um pior desempenho dessa habilidade em alcoolistas. Ainda, foi encontrada uma correlação negativa entre o estigma internalizado e o repertório de habilidades sociais, sendo que a habilidade de conversação e desenvoltura social se destacou como uma habilidade que contribui significativamente para o a internalização do estigma. Conclui-se que o repertório de habilidades sociais é uma variável significativa no processo de internalização do estigma e, portanto, deve ser considerada em programas voltados para a diminuição desse fenômeno. / Alcoholism is a condition strongly stigmatized by the general population, which leads alcoholics to internalize their stigma and suffer alone the negative consequences of such phenomena. However, an adequate repertoire of social skills allows a person to expand its social network and support groups, minimizing the negative consequences of internalizing such stigma. Taking this into consideration, this current study sough to address three topics: (1) Evidences available through a review of scientific literature on alcoholics social skills deficit and how effective Social Skills Training (SST) is for the treatment of such condition; (2) characterization and comparison between social skills of alcoholics and non-alcoholics, and (3) description of the stigma internalized by alcoholics and its relationship to an individual’s social skills repertoire. In order to answer the first topic, a systematic review of the literature pertaining the subject was conducted, where 33 related studies were analyzed. Our findings indicate a lack of studies able to confirm deficits in alcoholic’s social skills repertoire. However, SST is considered an effective form of treatment for such condition. To address topics two and three, 123 alcoholics and 114 non-alcoholics were consulted by means of a structured interview, where the following instruments were utilized: a socio-demographic questionnaire, a Mini International Neuropsychiatric Interview, a Social Skills Inventory and Internalized stigma of mental illness – especially adapted to the brazilian population dependent on such substances. A quantitative analysis of the collected data indicates an actual difference between alcoholics and non-alcoholics in terms of their anger management abilities, showing alcoholics to be more aggressive than nonalcoholics. Moreover, a negative correlation was also found between internalized stigma and social skills, where the ability to socialize and conversation skills stand out as significant contributors to the internalization of the alcoholic stigma. In conclusion, the repertoire of social skills is an important variable for understanding the internalization of such stigma and, therefore, must be taken into consideration by programs which seek to reduce this phenomenon.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2017-05-17T14:05:14Z No. of bitstreams: 1 fabriciacretonnery.pdf: 1389756 bytes, checksum: 7b9d42489973e21dbeb3d33de859dca5 (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2017-05-17T16:26:00Z (GMT) No. of bitstreams: 1 fabriciacretonnery.pdf: 1389756 bytes, checksum: 7b9d42489973e21dbeb3d33de859dca5 (MD5) / Made available in DSpace on 2017-05-17T16:26:01Z (GMT). No. of bitstreams: 1 fabriciacretonnery.pdf: 1389756 bytes, checksum: 7b9d42489973e21dbeb3d33de859dca5 (MD5) Previous issue date: 2013-12-20 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / CNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico / O estudo do estigma entre a população portadora de transtorno mental tem apresentado significativos avanços na literatura internacional, representado um indicativo de necessidade e relevância de estudos na área. No entanto, grande parte dos estudos tem apresentado como foco de investigação a perspectiva do estigmatizador e pouco se conhece sobre o fenômeno na perspectiva do estigmatizado, o chamado estigma internalizado ou autoestigma. O estigma internalizado é considerado o efeito negativo mais significativo do estigma social e pode provocar a perda de status, baixa autoestima e esperança, falta de aderência ao tratamento, entre outros prejuízos. Faz-se necessário o desenvolvimento de estudos na área, inclusive no desenvolvimento de instrumentos de avaliação, pois esta é uma ferramenta importante para avanços do conhecimento e melhorias de intervenção. Neste contexto, a presente pesquisa foi dividida em dois estudos: 1) Realizar a tradução e adaptação cultural da Internalized Stigma of Mental Illness – ISMI para o contexto brasileiro; 2) Avaliar as propriedades psicométricas da escala ISMI adaptada para o Brasil. No primeiro estudo a ISMI foi traduzida para o português e retrotraduzida para o inglês. Todas as observações foram acatadas pelo comitê de peritos para a consolidação da versão final, que foi submetida ao pré-teste. Não foi necessária nenhuma alteração e a versão foi avaliada em suas propriedades psicométricas. No segundo estudo foram entrevistados 308 pacientes dos serviços de saúde mental da cidade de Juiz de Fora, MG. O questionário foi composto pelos instrumentos: Escala de Estigma Internalizado para Transtorno Mental – ISMI BR; Escala de Autoestima de Rosenberg (EAER); Escala de Esperança de Herth (EEH); Escala de rastreamento populacional para depressão do Centro de Estudos Epidemiológicos (CES-D) e questionário sócio demográfico. Quanto ao tipo de tratamento a qual os pacientes se vinculavam, 25% (n=76) frequentavam o serviço diariamente e 75% (n=232) frequentavam o serviço para consultas periódicas. No que se refere ao diagnóstico, a maior incidência foi de Transtornos de Humor (afetivos), com 47,7%, seguido de Transtornos neuróticos, relacionados ao estresse e somatoformes ( 27,3%) e Esquizofrenia, transtornos esquizotípicos e delirantes (25%). A média de idade foi de 46 anos variando de 19 a 72 anos de idade. Quanto ao tempo de tratamento, 35% (n=108) relataram fazer tratamento a mais de 11 anos. A fidedignidade do instrumento foi considerada alta, uma vez que o Coeficiente alpha de Cronbach foi de 0,90, o Coeficiente de Spearman-Brown (Split-half) foi de 0,86 e a correlação teste reteste foi de 0,80. A evidência de validade de construto pela Análise por hipótese mostrou-se de acordo com os apontamentos da literatura. Os índices de correlação foram satisfatórios, sendo: ISMI e EE =-0,62; ISMI e EAER =-0,67 e ISMI e CES-D =0,59. A Escala de Estigma Internalizado para Transtorno Mental – ISMI-BR apresentou boas propriedades psicométricas demonstrando ser útil para a população brasileira. A escala poderá contribuir para investigação, compreensão e avanços no tratamento do estigma internalizado entre portadores de transtorno mental. / The study of stigma among the population with mental illness have shown significant advances in the international literature, representing an indication of need and relevance of studies in the area. However, most studies have focused on the perspective of stigmatizer and little is known about the phenomenon from the perspective of the stigmatized, called internalized stigma or self-stigma. Internalized stigma is considered the most significant negative effect of social stigma and can result in loss of status, low self-esteem, hopelessness, lack of adherence to treatment, among other damages. It is necessary to develop studies in the area, including the development of assessment tools, which is important tool for advances in knowledge and for improving interventions. In this context, the present study was divided into two studies: 1) To do the translation and cultural adaptation of Internalized Stigma of Mental Illness scale - ISMI for the Brazilian context, 2) To assess the psychometric properties of the ISMI for Brazil scale. In the first studie, the ISMI was translated into Portuguese and translated back into English. All comments were accepted by the committee of experts to consolidate the final version, which was submitted to the pre-test. There was no change needed and the version was evaluated on its psychometric properties. In the second studie 308 patients of mental health services were interviewed in the city of Juiz de Fora, MG. The questionnaire was composed of the instruments: the Escala de Estigma Internalizado para Transtorno Mental – ISMI-BR; the Rosenberg Self-Esteem Scale (EAER), the Herth Hope Scale (EEH), Center for Epidemiologic Studies (CES-D) and demographic questionnaire . Regarding the type of treatment to which patients were linked, 25% (n=76) attended the service daily and 75% (n=232) attending the service for periodic cappointments. With regard to diagnosis, the highest incidence was Mood disorders (affective), with 47.7 %, followed by Neurotic, stress-related and somatoform disorders (27.3%) and Schizophrenia, schizotypal and delusional disorders (25%). The mean age was 46 years ranging from 19 to 72 years old. Regarding the duration of treatment, 35% (n=108) reported being in treatment fo more than 11 years. The reliability of the instrument was considered high, since the Cronbach's alpha coefficient was 0.90, the Spearman-Brown coefficient (split-half) was 0.86 and test-retest correlation was 0.80. The evidence for the construct valididy by the hypothesis Analysis was consistent with the literature. Correlation coefficients were satisfactory, being: ISMI and EE=-0.62; ISMI and EAER=-0.67 and ISMI and CES- D=0.59. The Internalized Stigma of Mental Illness Scale - ISMI - BR presented good psychometric properties and demonstrated to be useful for the Brazilian population. The scale can contribute to research, knowledge and advances in the treatment of internalized stigma among individuals with mental illness.

No description available.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2016-03-21T12:24:38Z No. of bitstreams: 1 gabrielacorreialubamboferreira.pdf: 1797589 bytes, checksum: 6f7a48189b07c886def0eba6c9622a6f (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2016-04-24T02:10:46Z (GMT) No. of bitstreams: 1 gabrielacorreialubamboferreira.pdf: 1797589 bytes, checksum: 6f7a48189b07c886def0eba6c9622a6f (MD5) / Made available in DSpace on 2016-04-24T02:10:46Z (GMT). No. of bitstreams: 1 gabrielacorreialubamboferreira.pdf: 1797589 bytes, checksum: 6f7a48189b07c886def0eba6c9622a6f (MD5) Previous issue date: 2013-12-19 / Existe atualmente no Brasil uma preocupação em se estudar a população usuária de crack, uma vez que o uso dessa substância trouxe maior complexidade para o planejamento de estratégias de enfrentamento ao consumo. A dependência de substâncias psicoativas é uma condição altamente estigmatizada, tendo como principal consequência a internalização do estigma, que ocorre quando o indivíduo se torna consciente dos estereótipos negativos associados à sua condição e aplica-os a si próprio. O suporte social tem sido descrito como uma importante ferramenta para o enfrentamento do estigma e para o restabelecimento dos laços sociais. Diante disso, o presente estudo apresentou dois objetivos: (1) Revisar a literatura científica acerca da relação entre estigma internalizado e suporte social; (2) Avaliar a relação entre estigma internalizado e suporte social entre dependentes de crack em situação de vulnerabilidade social. Para responder ao primeiro objetivo, foram analisados 13 estudos cujos resultados indicaram uma associação negativa entre estigma internalizado e suporte social, sendo o suporte social uma estratégia de enfrentamento ao estigma. Quanto ao segundo objetivo, foram entrevistados 114 dependentes de crack, utilizando os instrumentos: Questionário Sociodemográfico, MINI, Versão Brasileira da ISMI adaptada para Dependentes de Substâncias e Escala de Suporte Social para Pessoas Vivendo com HIV/AIDS adaptada para dependentes de substâncias. Noventa e cinco por cento dos participantes eram do sexo masculino com média de idade de 36,5 anos (DP=8,2), 70% não estavam trabalhando, 58,2% estudaram até o Ensino Fundamental, e 85% relataram não viver com algum companheiro. Cerca de 74% eram pessoas em situação de rua. As associações entre estigma internalizado e suporte social foram examinadas através da análise de correlação. As análises revelaram que a correlação entre as variáveis de suporte social e estigma internalizado não foi estatisticamente significativa. Entretanto, ao se avaliar esta relação a partir das fontes de suporte relatadas pelos participantes encontrou-se que ter apoio de profissionais de saúde e de familiares não parece ser suficiente para diminuir o estigma internalizado. Os resultados ressaltam a importância da realização de estudos que aprofundem no conhecimento das relações sociais dos dependentes de crack, a fim de que propostas de enfrentamento ao estigma internalizado possam ser elaboradas de forma ajustada às suas necessidades. / In Brazil, there is now a concern in studying crack dependents, since the use of this substance brought greater complexity to the planning of coping strategies for consumption. Substance dependence is a highly stigmatized condition, having internalized stigma as the main effect, which occurs when the individual becomes aware of the negative stereotypes associated with his condition and applies them to himself. Social support has been described as an important tool for fighting stigma and repairing social ties. Thus, the aims of this study were: (1) to review the literature regarding the relationship between internalized stigma and social support, (2) to evaluate the relationship between internalized stigma and social support among crack dependents in social vulnerability . For the first aim, 13 studies were analyzed whose results indicated a negative association between internalized stigma and social support, with social support as acoping strategy to stigma. Regarding the second aim, 114 crack dependentes were interviewed, using the instruments: Sociodemographic Questionnaire, MINI International Neuropsychiatric Interview, Brazilian version of ISMI scale adapted for Substance Dependent and Social Support for People Living with HIV/AIDS adapted for substance dependence. Ninety-five percent of participants were male with a mean age of 36.5 years (SD=8.2) , 70% were unemployed , 58.2% studied up to elementary school , and 85% reported not living with a partner. About 74 % were homeless. The associations between internalized stigma and social support were examined by correlation analysis. The analysis showed that the correlation between the support and social stigma internalized was not statistically significant. However, when evaluating this relationship from the sources of support reported by the participants, we found that having support from health professionals and family members do not seem to be enough to reduce internalized stigma. The results highlight the importance of studies that deepen the understanding of social relations of crack dependents, so that coping strategies for internalized stigma can be developed according to their needs.

The purpose of the study was to examine the impact of internalized stigma of mental illness on the career development of college students with hidden disabilities. The availability of research investigating career variables within this population is limited and is primarily focused within the vocational rehabilitation arena. Therefore, one of the goals of the current study was to link separate bodies of literature on college students with disabilities, career development, and internalized stigma of mental illness. The second goal was to examine the interaction of internalized stigma of mental illness between career decision self-efficacy and career exploration on the perceived likelihood of achieving hoped for occupational possible selves (OPS). The study included college students with hidden disabilities and investigated variables related to mental illness and career. Participants were administered a background information questionnaire, the Career Decision Self-Efficacy scale (CDSE-SF), selected subscales of the Career Exploration Survey (CES), and the Internalized Stigma of Mental Illness scale (ISMI). Contrary to hypotheses, career decision making self-efficacy, career self-exploration, and internalized stigma of mental illness did not have a direct effect on the perceived likelihood of achieving hoped for OPS. However, career environment exploration did have a direct and positive association with perceived likelihood of achieving hoped for OPS. Results further indicated internalized stigma of mental illness did not moderate the effect of career decision self-efficacy and career exploration on the perceived likelihood of achieving one's hoped for occupational self. Study implications, limitations, and future directions are discussed.