IU Indianapolis ScholarWorks :: Browsing by Subject "Stigma"

Browsing by Subject "Stigma"

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A systematic review of interventions to reduce HIV-related stigma among primary and secondary school teachers
(Taylor & Francis, 2022) Martin, Roxanne; Ashimosi, Celestine; Nyandiko, Winstone; Chory, Ashley; Aluoch, Josephine; Scanlon, Michael; Vreeman, Rachel; Center for Global Health Equity, School of Medicine
HIV/AIDS-related stigma (HIV stigma) affects every aspect of adolescents' HIV management. Adolescents living with HIV (ALWH) are particularly vulnerable in schools where they have described experiencing HIV stigma. Teachers play a significant role in their students' lives. Stigmatizing attitudes or behaviors by teachers not only impact ALWH directly, but may influence the attitudes and behaviors of their peers. There is a dearth of literature exploring interventions to address HIV stigma in school-based settings. The objective of this review is to examine interventions to reduce HIV stigma among teachers globally. To conduct this systematic review, we used the PRISMA guidelines. Two articles met the inclusion criteria. Both eligible studies aimed to reduce HIV stigma among teachers or teachers in training through teacher training interventions in sub-Saharan Africa. The interventions included an interactive CD-ROM, a 2-day workshop, and peer facilitated workshops. Both studies demonstrated a significant decrease in HIV stigma in at least one study measure. Findings from this review are inconclusive. There is evidence to suggest that interventions can successfully decrease HIV stigma among teachers, but it is very limited. More research is needed in order to develop, implement, and evaluate stigma reducing interventions in the classroom.
Bewitching sex workers, blaming wives: HIV/AIDS, stigma, and the gender politics of panic in western Kenya
(Taylor & Francis, 2018-02) Pfeiffer, Elizabeth J.; Maithya, Harrison M.K.; Microbiology and Immunology, School of Medicine
Since access to HIV testing, counselling, and drug therapy has improved so dramatically, scholars have investigated ways this 'scale-up' has interacted with HIV/AIDS-related stigma in sub-Saharan Africa. Drawing on data collected during ethnographic research in a trading centre in western Kenya, this paper critically analyses two violent and localised case studies of panic over the ill health of particular community residents as a nuanced lens through which to explore the dynamic interplay of gender politics and processes of HIV/AIDS-related stigma in the aftershocks of the AIDS crisis. Gaining theoretical momentum from literatures focusing on stigma, gender, witchcraft, gossip, and accusation, we argue that the cases highlight collective anxieties, as well as local critiques of shifting gender roles and the strain of globalisation and legacies of uneven development on myriad forms of relationships. We further contend that these heightened moments of panic and accusation were deployments of power that ultimately sharpened local gender politics and conflicts on the ground in ways that complicated the social solidarity necessary to tackle social and health inequalities. The paper highlights one community's challenge to eradicate the stigma associated with HIV/AIDS during a period of increased access to HIV services.
Children with new onset seizures: A prospective study of parent variables, child behavior problems, and seizure occurrence
(Elsevier, 2015-12) Austin, Joan K.; Haber, Linda C.; Dunn, David W.; Shore, Cheryl P.; Johnson, Cynthia S.; Perkins, Susan M.; IU School of Nursing
OBJECTIVE: Parent variables (stigma, mood, unmet needs for information and support, and worry) are associated with behavioral difficulties in children with seizures; however, it is not known how this relationship is influenced by additional seizures. This study followed children (ages 4-14 years) and their parents over a 24-month period (with data collected at baseline and 6, 12, and 24 months) and investigated the effect of an additional seizure on the relationship between parenting variables and child behavior difficulties. METHODS: The sample was parents of 196 children (104 girls and 92 boys) with a first seizure within the past 6 weeks. Child mean age at baseline was 8 years, 3 months (SD 3 years). Data were analyzed using t-tests, chi-square tests, and repeated measures analyses of covariance. RESULTS: Relationships between parent variables, additional seizures, and child behavior problems were consistent across time. Several associations between parent variables and child behavior problems were stronger in the additional seizure group than in the no additional seizure group. CONCLUSIONS: Findings suggest that interventions that assist families to respond constructively to the reactions of others regarding their child's seizure condition and to address their needs for information and support could help families of children with continuing seizures to have an improved quality of life.
The Double Bind of Reproductive Expectations: Exploring the Mechanisms Through Which Voluntarily Childfree Women and Mothers are Penalized in Promotion Decisions
(2022-05) Weigold, H. Arispa; Ashburn-Nardo, Leslie; Pietri, Eva; Andel, Stephanie
An increasing number of working age adults are choosing to delay or forego parenthood entirely, but little research has explored how voluntarily childfree adults are perceived and treated in the workplace. While a large body of research has examined the impacts of motherhood on working women, little work has been done to understand the experiences of voluntarily childfree women. This study explored perceptions of working women based on their reproductive choices and whether these perceptions relate to differences in promotion decisions. Based on social backlash theory, I hypothesized that voluntarily childfree (VCF) women would be penalized in promotion decisions, and that perceptions of agentic-dominance and communality would explain this relationship. Using a sample of 220 participants recruited through Amazon Mechanical Turk, I tested my proposed mediation model and found no support for my hypotheses. Counter to expectations, no evidence of the motherhood penalty emerged either. Despite the lack of significant findings in this study, future work should consider assessing the relationships proposed with different experimental design.
Effectiveness of Psychosocial Occupational Therapy Interventions in Promoting Occupational Performance for Individuals with Serious Mental Illness: A Rapid Systematic Review
(2023-05-05) Stephenson, Sally; Gurevitz, Shelley; Hamilton, Jessica; Mays, Mallory; Claybon, Anna; Sego, Daniel; Chase, Tony; Department of Occupational Therapy, School of Health and Human Sciences
This rapid systematic review discusses the current evidence of studies related to occupational therapy interventions in improving the occupational performance of those diagnosed with a Serious Mental Illness (SMI). Psychosocial interventions are one of the main ways that participation and performance in occupations can be addressed within the occupational therapy treatment of individuals with SMI. In those who have an SMI, occupational performance and participation can be impacted due to symptomology and by the stigma of living with SMI, ultimately leading to occupational injustice. The current review analyzed 25 studies that implemented a psychosocial intervention in their treatment for those diagnosed with an SMI. The review identified three categories of psychosocial interventions (cognitive-based, skills training, and occupation-based) with six subcategories: metacognition, cognitive remediation, psychoeducation, social skills, life skills, and vocational rehabilitation. Findings reveal a strong level of evidence for the use of psychosocial interventions in supporting occupational performance and ultimately increasing occupational justice for individuals with SMI. The current review supports the use of psychosocial intervention approaches which can guide occupational therapy practitioners working with SMI populations.
HIV Stigma: Perspectives from Kenyan Child Caregivers and Adolescents Living with HIV
(SAGE Journals, 2017-05) McHenry, Megan S.; Nyandiko, Winstone M.; Scanlon, Michael L.; Fischer, Lydia J.; McAteer, Carole I.; Aluoch, Josephine; Naanyu, Violet; Vreeman, Rachel C.; Pediatrics, School of Medicine
Stigma shapes all aspects of HIV prevention and treatment, yet there are limited data on how HIV-infected youth and their families are affected by stigma in sub-Saharan Africa. The authors conducted a qualitative study using focus group discussions among 39 HIV-infected adolescents receiving care at HIV clinics in western Kenya and 53 caregivers of HIV-infected children. Participants felt that while knowledge and access to treatment were increasing, many community members still held negative and inaccurate views about HIV, including associating it with immorality and believing in transmission by casual interactions. Stigma was closely related to a loss of social and economic support but also included internalized negative feelings about oneself. Participants identified treatment-related impacts of stigma, including nonadherence, nondisclosure of status to child or others, and increased mental health problems. Qualitative inquiry also provided insights into how to measure and reduce stigma among affected individuals and families.
The Impact of Tuberculosis on the Well-Being of Adolescents and Young Adults
(MDPI, 2021-12-08) Moscibrodzki, Patricia; Enane, Leslie A.; Hoddinott, Graeme; Brooks, Meredith B.; Byron, Virginia; Furin, Jennifer; Seddon, James A.; Meyersohn, Lily; Chiang, Silvia S.; Pediatrics, School of Medicine
The health needs of adolescents and young adults (AYAs) have been neglected in tuberculosis (TB) care, control, and research. AYAs, who are distinct from younger children and older adults, undergo dynamic physical, psychological, emotional, cognitive, and social development. Five domains of adolescent well-being are crucial to a successful transition between childhood and adulthood: (1) Good health; (2) connectedness and contribution to society; (3) safety and a supportive environment; (4) learning, competence, education, skills, and employability; and (5) agency and resilience. This review summarizes the evidence of the impact of TB disease and treatment on these five domains of AYA well-being.
Implicit Stigma of Mental Illness: Attitudes in an Evidence-Based Practice
(2012-08-07) Stull, Laura Grace; McGrew, John H., 1953-; Salyers, Michelle P.; Rand, Kevin L.; Ashburn-Nardo, Leslie; Williams, Jane R.
Stigma is a barrier to recovery for people with mental illness. Problematically, stigma also has been documented among mental health practitioners. To date, however, most research has focused on explicit attitudes regarding mental illness. Little research has examined implicit attitudes, which has the potential to reveal evaluations residing outside of conscious control or awareness. Moreover, research has tended to use a mixed sample of practitioners and programs. The extent to which both explicit and implicit stigma is endorsed by mental health practitioners utilizing evidence-based practices is unknown. The purposes of the current study were to 1) carefully examine implicit and explicit stigmatizing attitudes, or biases, among Assertive Community Treatment (ACT) staff and 2) explore the extent to which explicit and implicit biases predicted the use of treatment control mechanisms. Participants were 154 ACT staff from nine states. They completed implicit (Implicit Association Test) and explicit measures of stigma. Overall, participants exhibited positive explicit and implicit attitudes towards people with mental illness. When modeled using latent factors, implicit, but not explicit bias significantly predicted the endorsement of restrictive or controlling clinical interventions. Practitioners who perceived individuals with mental illness as relatively more dangerous and helpless (both explicit and implicit), as well as participants from Indiana and those with less education were more likely to endorse use of control mechanisms. Thus, despite overall positive attitudes toward those with mental illness for the sample as a whole, even low levels of stigma at the individual level were found to affect clinical care. Mental health professionals, and specifically ACT clinicians, should work to be aware of ways in which their biases influence how they intervene with consumers.
Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments
(Wiley, 2018-02) Lysaker, Paul H.; Pattison, Michelle L.; Leonhardt, Bethany L.; Phelps, Scott; Vohs, Jenifer L.; Medicine, School of Medicine
Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.
Investigating Religious Orientation and the Attribution Model of Mental Illness Stigma
(2019-05) Johnson-Kwochka, Annalee V.; Salyers, Michelle P.; Minor, Kyle S.; Stull, Laura; Ashburn-Nardo, Leslie
Objectives: The Attribution Model of mental illness stigma posits that attributions about the causes and controllability of mental illness contribute to prejudicial emotional reactions, which in turn may lead to discriminatory behaviors towards people with mental illnesses. Given that people make different assumptions about different mental illnesses, if this model is correct, it suggests that specific diagnoses would elicit different types of stigma. Another important, but unexamined, predictor is extrinsic religious orientation, which correlates positively with other types of prejudice and may predict higher levels of mental illness stigma. The purpose of this study was to test the Attribution Model of stigma and examine the relationships between diagnosis, religious orientation, and stigma. Methods: Participants (n = 334) were recruited via Amazon Mechanical Turk, randomized to read one of three vignettes about a person with a mental illness (i.e., schizophrenia, anorexia nervosa, depression), and completed measures of mental illness stigma, religious orientation and affiliation, familiarity with mental illness, and authoritarianism. Using latent variable path analysis, analysis of covariance, and multiple regression analyses, relationships in the Attribution Model of mental illness stigma were assessed, as well as the impact of diagnosis and extrinsic religiosity on specific aspects of stigma as measured by the Attribution Questionnare-27 subscales (i.e., blame, anger, pity, danger/fear, avoidance, segregation, and coercion). Results: Assessment of the Attribution Model indicated moderate overall model fit after respecification. Path coefficients indicated strong relationships between variables that were generally consistent with paths predicted by the model. One notable exception was that feelings of pity were not associated with greater helping behaviors. Analysis of covariance suggested that diagnosis was a key predictor of stigma, and that schizophrenia was the most stigmatized. Multiple regression analyses revealed that extrinsic religiosity was also an important predictor of stigma; extrinsic religiosity appeared to increase certain types of stigma, and moderate the relationship between diagnosis and stigma overall. Discussion: Although the respecified Attribution Model fit the data fairly well, the findings suggest that either the scale or the model would benefit from further refinement. Results support prior evidence that severe mental illnesses like schizophrenia are more stigmatized than other diagnoses. Extrinsic religiosity was also predictive of increased stigma, both directly and indirectly. As a moderator, extrinsic religiosity may decrease the impact of diagnosis on stigma, raising stigma for diagnoses perceived as more “controllable” (i.e., anorexia nervosa, depression) such that levels were similar to schizophrenia. Limitations and suggestions for future research are discussed.

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