Browsing by Subject "stigma resistance"

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    The development and validation of a new measure of stigma resistance
    (2016) Firmin, Ruth L.; Salyers, Michelle P.
    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.
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    Stigma resistance at the personal, peer, and public levels: A new conceptual model.
    (APA, 2017) Firmin, Ruth L.; Luther, Lauren; Lysaker, Paul H.; Minor, Kyle S.; McGrew, John H.; Cornwell, Madison N.; Salyers, Michelle P.; Psychiatry, School of Medicine
    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). 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 semistructured 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. 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 apart from 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. Findings present a more nuanced conceptualization of resisting stigma, grounded in the experiences of people with SMI. Stigma resistance is an ongoing, active process of using one’s experiences, skills, and knowledge to develop a positive identity. Interventions should consider focusing on personal stigma resistance early on and increasing the incorporation of peers into services.
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    Stigma Resistance is Positively Associated with Psychiatric and Psychosocial Outcomes: A Meta-analysis
    (Elsevier, 2016-08) Firmin, Ruth L.; Luther, Lauren; Lysaker, Paul H.; Minor, Kyle S.; Salyers, Michelle P.; Department of Psychology, School of Science
    To better understand how stigma resistance impacts functioning-related domains, we examined mean effect sizes between stigma resistance and: 1) symptoms (overall, positive, negative, and mood symptoms); 2) self-stigma; 3) self-efficacy; 4) quality of life; 5) recovery; 6) hope; 7) insight, and 8) overall outcomes (the average effect size across the constructs examined in each study). The mean effect size between stigma resistance and overall outcomes was significant and positive (r = 0.46, p < 0.001, k = 48). A large, negative effect size was found between stigma resistance and self-stigma (r = − 0.57, p < 0.001, k = 40). Large, positive effect sizes were found with self-efficacy (r = 0.60, p < 0.001, k = 25), quality of life (r = 0.51, p < 0.001, k = 17), hope (r = 0.54, p < 0.001, k = 8), and recovery (r = 0.60, p < 0.001, k = 7). Stigma resistance had a significant medium and small relationship with insight and symptoms, respectively. Race significantly moderated overall outcomes, self-stigma, mood symptoms, functioning, and hope associations. Education significantly moderated symptoms, functioning, and mood symptoms associations, and age significantly moderated self-stigma and negative symptom associations. Stigma resistance may be a key requirement for recovery. Individual characteristics influence resisting stigma and future work should prioritize cultural factors surrounding stigma resistance.