Stigma has a negative effect on individuals, which may include psychological distress, anxiety, and social isolation (Pachankis, 2007). Stigma can be either concealable or visible. A concealable stigma is an attribute that is not visibly apparent, but would be devalued if known by others (e.g., sexual orientation, Page 30 2014 Appalachian Student Research Forum mental illness, sexual abuse). Some believe that individuals with a concealable stigma do not face prejudice and discrimination because the stigma is not apparent to others. However, research suggests that those with a concealable stigma may feel the constant need to hide that identity or characteristic, and this may increase distress and anxiety due to the threat of discovery (Pachankis, 2007). We hypothesized that individuals with a concealable stigma will have higher levels of stigma, rejection sensitivity, distress, and anxiety as well as lower levels of self-esteem, relative to those individuals with a visible stigma. The current sample was taken from a larger study (N=408) and consist of participants (n=70) who selfidentified a stigmatizing characteristic. The self-reported characteristics were independently coded by two research assistants as concealable or visible and finally, the assistants collectively assigned the characteristics to each group. Our sample consists of 35.7% concealable (e.g., sexuality, mental illness, history of abuse) and 64.3% visible (e.g., physical appearance, physical disability, race/ethnicity). To test our hypotheses, we used an independent t test to assess the differences in levels of stigma, self-esteem, distress, anxiety, and rejection sensitivity between concealable and visible stigma groups. Results show that self-stigma (t(68)=-.798, p=.428), public stigma (t(68)=-.149, p=.882), and self-esteem (t(68)=-1.320, p=.191) do not differ between groups. By contrast, and in support of our hypotheses, those with concealable stigma reported more rejection sensitivity (t(68)=2.315, p=.024) and anxiety (t(68)=3.030, p=.003) than those with visible stigma. Contrary to our hypotheses, distress (t(68)=-2.599, p=.011) was higher for those with visible stigma than concealable stigma. Future research should be conducted to examine levels of anxiety and rejection sensitivity in individuals with concealable stigma to understand the differences among stigmatized identities and characteristics.

In the United States, 6.7 million or 10.9% of women, between the ages of 15 and 44 have difficulty becoming or staying pregnant and of these women 6% are infertile (Centers for Disease Control and Prevention [CDC], 2012). Infertility is defined as twelve months of regular, unprotected intercourse yielding no pregnancy (Tierney, McPhee, & Papadakis, 1999). For those struggling with infertility there can be numerous negative psychological problems, including depression and anxiety (Jordan & Revenson, 1999). Given the widespread and negative impact of infertility, it is important to further understand and explain the experiences of infertile women. The present work contributes to the literature by qualitatively examining women’s infertility as a stigmatizing experience. Goffman (1963) defines stigma as an attribute that society deems as deeply discrediting and reduces an “individual from a whole and usual person to a tainted, discounted one” (p. 3). Moreover, individuals who possess a stigmatizing condition are likely viewed as a less or inferior person. Because women struggling with infertility are unable to fulfill societal norms that mandate motherhood (e.g., Gonzalez, 2000; Whiteford & Gonzalez, 1995), women experiencing infertility may perceive stigma. The aim of the current study is to explore infertility as stigmatizing in order to provide a more complete framework for understanding negative psychological outcomes among women with infertility. To this end, we conducted qualitative interviews with nine women who had been trying to conceive without success for at least one year. Participants were recruited by newspaper advertisements, campus emails, flyers in local nurse practitioner clinics and local infertility clinics in Johnson City, TN. Interviews were conducted one-on-one and were guided by general questions about the most difficult aspects of infertility and how women’s lives, including social relationships and beliefs about themselves, had been impacted by the experience. Audio-recorded interviews were transcribed verbatim and coded for themes. Five reoccurring themes were identified: culture and norms, feelings of failure and loss of 2013 Appalachian Student Research Forum Page 115 womanhood, infertility as stigmatizing condition, change of world view, and social support. Each of these themes can be discussed in relation to the public and self aspects of stigma. For example, the expectation that females progressing into adulthood will eventually have children influenced infertile women’s interactions with the world around them causing them to feel inadequate and question their purpose in life. Moreover, women in our study reported being constantly reminded of their infertility struggles through everyday social interactions with strangers, family, and friends, some of which included differential treatment due to infertility. These continual reminders led women to internalize the negative beliefs regarding not living up to societal gender expectations or stereotypes. Furthermore, women’s reports of alienation and self-isolation, as well as anger and frustration map onto previous models of stigma-related processes (e.g., Hatzenbuehler, 2009; Richman & Leary, 2009. Thus, stigma theory may provide a framework with which to more fully understand the negative psychosocial outcomes commonly reported among women encountering infertility.

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Sexual minorities (SM) are at particular risk for experiencing psychological distress due to the unique stressors they face based upon their identity. There is a well-established link between anticipatory stigma and increased anxiety symptoms among this population; however, this relation may vary due to other factors such as actively hiding one’s sexual orientation from others, or concealment. SM often conceal as a means for self-protection from rejection or violence, yet in doing so SM have to deal with the affective (e.g., shame, guilt), cognitive (e.g. preoccupation about hiding sexual orientation, negative self-evaluation, hypervigilance), and behavioral (e.g., social avoidance and isolation) burden of concealment that places them at increased risk for psychological distress. Concealment is documented as having a robust effect on both anticipated stigma and anxiety symptoms. Thus, the act of concealing may affect the relation between anticipated stigma and anxiety symptoms. We hypothesize that positive correlations will exist between anticipated stigma, concealment, and anxiety symptoms; and, concealment will moderate the anticipated stigma-anxiety symptoms linkage where, for individuals with greater levels of concealment, a stronger positive relationship between anticipated stigma and anxiety symptoms will exist. Participants were recruited from targeted social media advertisements and asked to complete measures of stigma, concealment, and psychopathology. Data was entered into SPSS and missing data was omitted from analyses. Pearson’s product-moment correlations and Hayes’ moderation analyses were utilized. Our sample (N=151) was predominantly White (n=127; 84.1%), identified as being a woman (n=108; 71.5%), and LGB (n=118; 78%). Concealment significantly moderated the relation between anticipated stigma and anxiety symptoms,t(147)=2.63,p=.01. Hypotheses were supported and higher concealment revealed a stronger relation between anticipated stigma and anxiety symptoms than for those with lower concealment.Our findings are limited due to using cross-sectional data and a sample predominantly comprised of White women. Interventions that help SM effectively cope with the emotional and cognitive burden of anticipated stigma and concealment may be of interest.

This study examines how two newspapers in Sweden, the local newspaper Nyhetsbyrån Järva and the nationwide newspaper Aftonbladet, differentiated in their discourse during the reporting of the spread of Covid-19 in the Järva-area of Stockholm. The Järva-area is made up of several suburbs to the inner city of Stockholm that have been stigmatized in the mainstream media ever since a lot of the housing in the area was built during the million programme (Miljonprogrammet) in Sweden. With the use of Fairclough's critical discourse method the newspapers were analysed through the lens of Goffman's theory of stigma and Wacquant's theory of territorial stigma. The empirical study consisted of 39 articles from the newspaper Aftonbladet and Nyhetsbyrån Järva. The newspapers were analysed and compared showing the difference in discourse of how the Järva-area is constructed as well as those who live there. The study found that Aftonbladet uses a discourse focusing more on the cultural differences of the Järva-area and the people living there as a possible cause for the spread of Covid-19. Meanwhile Nyhetsbyrån Järva uses a discourse that instead focuses on how the governmental agencies failed to supply support and meet the needs of the inhabitants of the area to hinder the spread of Covid-19. The results shows that the use of stigmatized names and associations to the Järva-area is much higher in Aftonbladet compared to Nyhetsbyrån Järva.

Bakgrund: Sedan lång tid har det funnits ett samband mellan stigmatiseringsprocesser och psykisk sjukdom. Konsekvenser av stigmatisering innebar för den drabbade att de ofta blev utstötta, ensamma och diskriminerade i samhället med svårigheter att få anställning och bostad och därtill också sämre vård. Specialistsjuksköterskan har ett ansvar att arbeta för att öka kunskap och förståelse för psykisk sjukdom i samhället men hen har också ett ansvar att bedriva en jämlik vård av hög kvalitet oavsett vilken sjukdom patienten har som hen möter. För att uppfylla detta ansvar är det angeläget att specialistsjuksköterskan är medveten om konsekvenserna av stigmatisering av personer med psykisk sjukdom och aktivt arbetar för att motverka detta. Syfte: Syftet är att beskriva hur sjuksköterskan inom psykiatrisk vård kan motverka upplevelserna av stigmatisering för personer med psykisk sjukdom. Metod: En systematisk litteratursökning genomfördes och artiklar som valdes ut granskades utifrån en integrativ metod. Dataanalysen mynnade ut i tre huvudteman med åtta underteman som kom att beskriva vårt resultat. Resultat: Resultatet visade på att patientens, sjuksköterskors och omgivningens attityder påverkade patientens upplevelse av stigma. Vad som också påverkar är patientens känsla av sammanhang, skamkänslor men även rädsla för att stigmatiseras och konsekvenserna av detta. För att specialistsjuksköterskan ska kunna motverka patientens upplevelse av stigmatisering krävs utbildningsinsatser i olika led men även en kännedom om hur patienters utbildningsnivå påverkar hens stigmatiseringsprocess. Sammanfattning: Det blev tydligt att en av specialistsjuksköterskans viktigaste uppgifter är att motverka patientens upplevelse av stigmatisering, men också delta i utbildning på olika nivåer utifrån ett personcentrerat perspektiv. / Background: An association between stigmatization processes and mental illness has been apparent for many years. Consequences of stigmatization meant those affected were often ostracized, alone and discriminated against within society, experienced difficulties in obtaining employment and housing and, in addition, received poorer care. The specialist nurse has a great responsibility to promote increased knowledge and understanding of mental illness in society. The specialist nurse also has a responsibility to provide equal quality care regardless of the illness the patient is experiencing. In order to fulfill this responsibility, it is important that the specialist nurse is aware of the consequences of stigmatizing people with mental illness and actively works to counteract this. Aim: The purpose is to describe how the nurse in psychiatric care can counteract the experiences of stigmatization for people with mental illness. Method: A systematic literature search was conducted and the articles selected were examined using an integrative method. The data analysis resulted in three main themes with eight subthemes that came to describe our results. Results: The results showed that the patients', nurses' and societal attitudes affected the patients' experience of stigma. The patients' experience of stigmatization was influenced by whether they had a sense of coherence, feelings of shame but also a fear of being stigmatized and the consequences of this. In order for the specialist nurse to counteract the patient's experience of stigmatization, educational efforts are required at various stages, but also a knowledge of how patients' educational level affects their stigma process. Conclusion: It became clear that the specialist nurse's most important task in counteracting the patient's experience of stigmatization was education at various levels from a person-centered perspective.

Cannabis is the world's most cultivated, trafficked and used illicit drug, and the move towards its legalisation has given rise to a nascent industry that is attracting increasing attention from investors, manufacturers, and researchers. Due to the plant maintaining its illegal and stigmatised status in many countries, cannabis research is limited, which has resulted in a significant gap in imperative knowledge about this burgeoning industry. Although the cannabis industry is clearly making a move from stigmatised to mainstream, little research has been conducted to investigate this transition, more particularly in a South African context. This dissertation investigates destigmatisation processes and strategies employable by cannabis organisations by way of three individual but interconnected studies. They aimed, respectively, to conduct a systematic literature review of organisational destigmatisation and establish a practitioner-driven research agenda; to depict the destigmatisation landscape of South African recreational cannabis organisations through a mixed methods content analysis and finally, to explore the influence of these organisations' destigmatisation strategies on attitudes towards cannabis. Study 1 presents a destigmatisation model as its main contribution, finding that stigma management strategies are classified into six main categories: Conforming, Hiding and Structural Responses were identified as stigma avoidance or perpetuation strategies, and Affirming, Challenging, and Infusing as destigmatisation strategies. Affirming strategies were found to be at the heart of destigmatisation, and an industry-collective approach to destigmatisation was ranked as the most prioritised research need by South African cannabis industry professionals. Study 2 found that Infusing strategies were significantly the most popular of the destigmatisation methods used by South African recreational cannabis organisations, accounting for nearly 80% of the themes, with branding tactics predominant in this category. Key insights revealed that there is a mismatch between the strategies most employed by cannabis businesses and the strategies that exert the strongest influence on attitudes, which Study 3 found to be recontextualisation of the cannabis industry, evidenced by education using scientific facts and figures. These findings highlight that a lack of knowledge is the main barrier to cannabis industry destigmatisation and should be counteracted by the rhetoric activity of educating the public. In summary, this study served to inform destigmatisation processes for core stigmatised organisations - with a focus on the cannabis industry; to catalyse cannabis destigmatisation research in a manner relevant to the South African cannabis industry; to provide a detailed description of the destigmatisation landscape of the South African cannabis industry from an organisational perspective; and, lastly, to determine the most influential destigmatisation strategies from a consumer perspective.

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