The current models for stigma measurement are disease-specific and created for use with adults, despite the fact that stigma may be experienced also by adolescents and may be layered, and not simply the result of one disease. Stigma in adolescents may effect their life outcome, as many emotional and social changes are happening at this point in life, therefore developing a measure to address stigma in youth is important. Focus groups of youth will be chosen based on sexual orientation, ethnic minority, street involvement, visible physical disability and history of sexual exploitation, with an eye to ensuring the sample contains individuals experiencing layered stigma. The result of research will be an adolescent- specific measure of perceived stigma, enacted stigma and internalized stigma that can be used to understand how stigma effects the perceptions, risk-behaviours and futures of youth, and to develop stigma reduction strategies.

Syftet med uppsatsen är att undersöka hur socialarbetare resonerar kring olika grupper av hemlösa och om det finns skillnader i bedömningen av boendelösningar utifrån vilken orsak till hemlöshet en klient har. Uppsatsen baseras på personintervjuer med sex socialarbetare inom samma kommun. De teorier som användes för att analysera data var symbolisk interaktionism och stigmateori. Resultatet visade att socialarbetarna hade olika syn på skälen till hemlöshet då de arbetar på olika positioner inom kommunen och har olika erfarenhet av arbete med hemlösa. Utifrån de boendelösningar som den studerade kommunen erbjuder hade socialarbetarna olika sätt att se på dem. Några tyckte att det var för mycket krav på de hemlösa och inte tillräckligt med boendelösningar, medan andra inte höll med. Alla intervjupersonerna ansåg att bostadsmodellen Bostad först kan uppfattas som ett tillskott till möjligheter att lösa boendet för hemlösa eftersom modellen inte i första hand utgår från krav på att klienten ska vara drogfri. Socialarbetarna ansåg att ansvaret för de hemlösa ska vara på en samhällelig nivå, det vill säga att det inte är individen själv som har skapat problemet utan det sociala systemet i samhället och dessutom i förlängningen att hemlöshet i sig är ett samhälleligt skapat fenomen. / The aim of the essay was to examine how the social workers reason about the client’s reason for being homeless and how the social workers think about the housing solutions and if possible highlight the ambivalence that can be seen between the client’s reason for homelessness and the housing solutions that are at hand. This essay is based on interviews with six social workers with various titles within the same municipality. The theories that have been used are symbolic interactionism and stigma theory. The results show that these social workers have different attitudes with regard to the approach of the causes of homelessness. Based on the housing solutions of the municipality the social workers approached the homeless clients differently. Some social workers opinions were that there were too many requirements for the homeless to live up to and too few housing solutions to place them in. The social workers that were interviewed said that they believed that the housing model Housing First will be a great addition to the options in housing for the homeless. The reason for this attitude towards the model is that it is based on the requirement for abstinence. The social workers thought that the responsibility for the homeless ought to be on a society level, in other words it is not the individual itself that has created the problem but the social system. In a longer perspective this means that homelessness is created by society.

Motyvacijos slėpti stigmą tyrimo ypatumai Sveikatos arba susijusi su liga stigma – labai pavojinga, nes sukelia stresą jau dėl turimos ligos ir dėl galimos, jei pradėtų gydytis, stigmos, pablogina darbo ir socialinę situaciją, dėl baimės, kad netapti stigmatizuotu, žmogus gali nepradėti gydymo ar jį nutraukti. Priklausomai nuo ligos sunkumo išeitis gali būti mirtina. Priklausomai nuo ligos, kartais išeitis gali būti mirtina. Inkontinencija yra plačiai paplitęs stigmatizuojantis susirgimas, labiau paplitęs tarp moterų. Kad išvengti diskreditacijos kitų akyse, šios moterys vengia sekso, nedirba, jų fizinis aktyvumas limituotas, joms atsiranda depresija, sumažėja jų savigarba. Jos gyvena su baime būti pastebėtos šlapios, kad kas nors pajus kvapą ir kenčia nuo žinojimo, kad negali sukontroliuoti savo šlapimo pūslės veiklos, tačiau nesigydo ir slepia tai net nuo savo šeimos narių. Šio kokybinio tyrimo tikslas buvo ištirti motyvus, kurie verčia Lietuvos moteris slėpti inkontinenciją. Buvo apklausta 12 moterų. Amžiaus vidurkis – 50,5 metai. Apklausai naudotas pusiau struktūruotą interviu. Rezultatai buvo analizuojami naudojant kontent – analizės metodo principus. Atlikus tyrimą buvo gauta, kad inkontinencijos stigmą slepiama siekiant išlaikyti savo vertę, garbę, pasiekimus, savo turimus santykius bei priklausymą savo grupei ir išvengti atstūmimo. Dažniausia tiriamosios turėjo keletą vieną su kitu susijusius motyvus. Nesigydoma ir dėl nepasitikėjimo Lietuvoje esančia medicinos... [toliau žr. visą tekstą] / Research on stigma hiding motivation The disease- associated stigma can be particularly difficult. Not only are they at risk to develop other stress- related illnesses, but the clinical course of the stigmatised illness itself may be worsened. Other outcomes also affected, such as the ability to work or lead a normal social life. The fear of being labelled with the disease may cause individuals to delay or avoid seeking treatment. The outcome might be tragical, depending on the disease. Incontinence is wide spread stigmatising disease, which affects women more than men. To avoid disclosure, they are limiting their activities, stop working, refusing to have sex, getting depressed and lowered self –esteem. They are suffering from fear to be noticed wet, that somebody will smell, suffer that cannot control their blader, but they refuse to visit doctor and keep all that in secrecy even from own family. The aim of this quality research was to find out the motives to hide incontinence stigma. Quality semi- structured interviu was made with 12 women. Age mean – 50,5 years. Findings: the motives to hide incontinence stigma mainly are to keep up self – esteem, status and authority, to avoid shame; keep relationship with their family and group and to avoid rejection. In most cases, was found few related motives for stigma hiding. The results shows, that in the peoples mind incontinence is related with getting old. The women hide their stigma and do not seek the treatment also because... [to full text]

Indiana University-Purdue University Indianapolis (IUPUI) / STUDY 1: Objective: Stigma resistance is consistently linked with key recovery outcomes, yet theoretical work is limited. This study explored stigma resistance from the perspective of individuals with serious mental illness (SMI). Methods: Twenty-four individuals with SMI who were either peer-service-providers (those with lived experience providing services; n = 14) or consumers of mental health services (n = 10) engaged in semi-structured interviews regarding experiences with stigma, self-stigma, and stigma resistance, including key elements of this process and examples of situations in which they resisted stigma. Results: Stigma resistance is an ongoing, active process that involves using one’s experiences, knowledge, and sets of skills at the 1) personal, 2) peer, and 3) public levels. Stigma resistance at the personal level involves a) not believing stigma or catching and challenging stigmatizing thoughts, b) empowering oneself by learning about mental health and recovery, c) maintaining one’s recovery and proving stigma wrong, and d) developing a meaningful identity beyond mental illness. Stigma resistance at the peer level involves using one’s experiences to help others fight stigma and at the public level, resistance involved a) education, b) challenging stigma, c) disclosing one’s lived experience, and d) advocacy work. Discussion: Findings present a more nuanced conceptualization of resisting stigma, grounded in the experiences of people with SMI. Interventions should consider focusing on personal stigma resistance early on and increasing the incorporation of peers into services. STUDY 2: Background: Despite strong links between stigma resistance and recovery outcomes, limitations of existing measures of stigma resistance have contributed to this construct remaining largely under-studied. This study sought to develop and validate an improved measure of mental illness stigma resistance, grounded in the perspectives of people with lived experience. Method: An item pool was developed from qualitative interviews (Study 1) and items were piloted in an online MTurk sample with people self-reporting a mental illness diagnosis (n=489). Best performing items were selected and preliminary factor structure was examined using exploratory factor analysis in a subset of the sample (30%, n=161). The new measure was then administered to individuals at two state mental health consumer recovery conferences (n=202) and confirmatory factor analyses were conducted to assess factor structure and refine the measure. Validity of the new scale was then examined through correlations with theoretically relevant measures. Results: The EFA suggested possible models of either 1, 3, or 5 factors. CFA demonstrated that the 5-factor model best fit the remaining MTurk data (n=328) and this was replicated in the conference sample; these samples were then combined to refine the measure across a heterogeneous sample (n=530). The final 20-item measure demonstrated good internal consistency for the total score (.93) and each of the 5 subscales (.71 - .88), good test-retest reliability (.74), and strong construct validity. Discussion: This study produced an improved measure of stigma resistance with strong psychometric properties and construct validity. Use of this new measure will allow for a more nuanced assessment of stigma resistance across important domains of recovery.

Using the account episode (Schonbach,1992) as a framework, this study examined several variables related to how attributions are made and managed in the context of voluntary childlessness, arguably an instance of concealable stigma (e.g., Park, 2005; 2002). More specifically, the means by which voluntarily childless persons account for their childless decision (and how these accounts are evaluated) were examined, along with factors salient to social identity and intergroup perceptions (e.g., social dominance orientation, self-construal). Extant scholarship suggested that excuses and justifications would be evaluated differently in terms of both their acceptability and the interpersonal implications they carry. Findings indicate that excuses and justifications were not related to the account's acceptability, but did produce different attributions of interpersonal warmth and competence in those who used them. The acceptability of the target's childless decision was higher for those with a strong independent self-construal, and lower for those holding a high social dominance orientation. Few differences between the voluntarily childless man and woman were found. All findings are discussed in the context of both account evaluation and perceptions of the voluntarily childless.

Individuals experiencing a mental illness are often stigmatized. Children also stigmatize those who experience a mental illness. There is national interest in reducing the negative effects of stigma, especially in children. Unfortunately, children anti-stigma interventions are being used without being empirically tested for their effectiveness. A goal of the Opening Minds Anti-stigma initiative of the Mental Health Commission of Canada is to identify programs and resources that have been empirically tested and found to be effective in reducing stigma. This study was funded by the Opening Minds Initiative of the Mental Health Commission of Canada to: First, investigate the effectiveness of providing children ages 11-14 with mental illness education using a storybook in order to reduce their mental illness stigma; and, second, to examine children’s perceptions of the anti-stigma book used to provide the education. A quasi-experimental design was used to test the effectiveness of the mental illness educational storybook in reducing mental illness stigma. The Youth Opinion Survey for Stereotype and Social Distance measurement was used to obtain baseline information before the education was provided. A pre-test, post-test process was used. Several qualitative questions, embedded in the post-test questionnaire, were provided to the children participating with an opportunity to use their own words to describe what they thought about mental illness before and after the education, what they learned from the educational storybook and whether or not they liked the education they received. The results show that the exposure to an educational storybook about children mental illness stigma was effective in reducing the percentage of negative responses at post-test. The participants used less negative words to describe someone “with a mental illness”. An improvement in the overall scores at post-test was seen for both stereotype and social distance. After the study was completed, the feasibility of conducting a study of this type was evaluated. Recommendations for the possibility of using this method for future studies are included. / Thesis (Ph.D, Nursing) -- Queen's University, 2013-07-03 11:39:54.603

Denna studie syftar till att undersöka hur individer som lider av samsjuklighet, då definierat som att ha både missbruksproblematik och en eller flera psykiatriska diagnoser, upplever sin vård inom den kommunala missbruksvården och psykiatrin. Detta görs genom kvalitativa intervjuer med ovan nämnda grupp och resultatet tolkas utifrån Goffmans teori om stigma samt Scheffs teori om mentalsjukdom. Resultatet pekar på att socialtjänsten upplevs som bättre än psykiatrin på att ta hänsyn till den komplexa sjukdomsbilden hos informanterna. Detta visar sig genom hur informanterna upplevde bemötande från personalen på respektive enhet samt hur dialogen förs under eventuella samarbeten mellan enheterna.

Titel: Att leva med hiv - En litteraturstudie om personers upplevelser av att leva med en stigmatiserad sjukdom. Bakgrund: Idag lever ca 7000 personer med hiv i Sverige och årligen upptäcks ca 450 nya sjukdomsfall. Sjukdomen behöver inte längre leda till en för tidig död då effektiv bromsmedicin funnits sedan 1996. Hiv är dock fortfarande en stigmatiserande sjukdom som dessutom förknippas med andra stigmatiserande attribut. Att leva med hiv har en stor inverkan i personers liv då allmänhetens syn fortfarande försvårar möjligheten att vara öppen om hivsamt att vårdpersonals ovilja påverkar vårdkvaliteten. Syfte: Syftet med denna litteraturstudie var att belysa hiv-smittade personers erfarenheter av att leva med hiv. Metod: En litteraturstudie genomfördes baserad på nio vetenskapliga artiklar med kvalitativ ansats. Resultat: Resultatet presenteras i tre huvudkategorier och totalt 8 underkategorier: “Livet påverkas av hiv”; - Att hantera en förändrad livssituation, - Att behöva ta läkemedel varje dag, “Att prata om hiv”; - Att välja att vara öppen, - En möjlighet till stöd genom att prata med någon, - Valet att hålla hiv hemligt, “Att leva med stigmatiserande sjukdom”; - En påverkad syn på sig själv, - Samhället och omgivningens syn, - Erfarenheter från möten med vården. Konklusion: Att leva med hiv kan orsaka flera svårigheter i de drabbades liv och de behöver stöd kring beslutet att vara öppna om sin hiv. Sjuksköterskor kan behöva mer kompetens inom området för att kunna ge bästa möjliga vård. Fler studier om vårdpersonals kunskapsläge och attityd är önskvärt.

Provider-based stigma is defined as the negative attitudes, beliefs, and behaviors of mental health providers toward clients they serve. Often unintentional and unknowingly conveyed, this phenomenon has been indicated in previous research (e.g. Lauber, Nordt, Braunschweig, & Rössler, 2006; Nordt, Rössler, & Lauber, 2006; Hugo, 2001; Schulze, 2007). Other instruments crafted to measure provider stigma have utilized theory in their development, without incorporating the voice of the client (e.g. Wilkins & Abell, 2010; Kennedy, Abell, & Mennicke 2014). To better address the social injustice posed by provider stigma, the profession requires a valid and reliable measure, guided by theory, which also reflects the client and family experience. This study attempts to do so, referencing the five themes of the experience-based model (Charles, 2013) to guide item development. These themes include: blame & shame; disinterest, annoyance, and/or irritation; degradation & dehumanization; poor prognosis/fostering dependence; coercion/lack of ‘real’ choice. The measure’s item pool was generated following Nunnally and Bernstein’s (1994) domain sampling method, in reflection of the experience-based model, and reviewed by a series of focus groups. The electronically hosted survey was distributed to a purposive sample of mental health service providers employed at Virginia’s public mental health agencies. Using a final sample of N = 220, factor analysis indicated a four factor solution, accounting for 32.454% of the items’ variance. Refinement resulted in a scale of 20-items demonstrating adequate internal consistency, measured by Cronbach’s alpha = 0.817. The four factors of the Mental Health Provider Self-Assessment of Stigma Scale (MHPSASS) were labeled: Irritation & Impatience (eight items); Choice & Capacity (five items); Adherence & Dependence (four items); Devalue & Depersonalize (three items). Hypothesized relationships were found between provider self-rating of burnout and MHPSASS score (Pearson’s r = 0.235, p = 0.001) as well as social desirability level and MHPSASS score (r = -0.169, p = 0.015), supporting the MHPSASS’ construct validity. As a measure of provider-based stigma, the MHPSASS displays adequate reliability and validity. Future studies are indicated, including replication. Limitations include agency response rate, unknowable individual level-response rate, social desirability, and the potentially burdensome length of the survey package.

Perceptions of HIV and AIDS are inextricably linked to stigma and discrimination and perceptions of HIV positive mothers are particularly complex. In order to obtain a perspective on social perceptions of HIV positive mothers this study interviewed eight HIV negative, workingclass mothers. By focusing on HIV negative mothers, who shared the social category of motherhood (thereby providing an insider perspective), HIV was fore-grounded and social perceptions of HIV was explored from an outsider perspective. A vignette was used to facilitate a semi-structured interview which explored issues around general perceptions of the HIV positive individual (with a particular focus on issues around stigma and blame); perceptions of HIV positive motherhood and perceptions of the impact of maternal HIV on the child. Interview data was analysed using a qualitative thematic analysis. Results highlighted that motherhood from the perspective of the mother was perceived differently to motherhood from the perspective of the child. From the perspective of the mother, respondents identified with the HIV positive mother as a black, working-class mother and viewed her as ‘normal’ and ‘ordinary.’ Identifying infected mothers as part of the group of black, working-class women, respondents drew on their similarity of being powerless in heterosexual relationships. Thus respondents viewed HIV positive mothers as blameless victims when they became infected as their perception was that promiscuity was not a part of motherhood. When motherhood was considered from the perspective of the child, respondents viewed the HIV positive mother as a soon-to-be absent mother who continued to infect her child. The infected mother was perceived to have a relatively short lifespan and as such was perceived to fail in her duty as mother when she was not available to ensure that her child developed normally. Respondents perceived that the absent and unavailable infected mother produced children who are socially, morally and developmentally disadvantaged when they are teased and ostracized by society, fail to grow and develop normally and eventually turn into criminals.