A Longitudinal Investigation of Internalized Stigma,Constrained Disclosure,and Quality of Life Across 12 Weeks in Lung Cancer Patients on Active Oncologic Treatment

Introduction

Internalized lung cancer stigma (i.e., feelings of regret, shame, and self-blame about one’s lung cancer) is related to poorer psychological outcomes. Less is known about how internalized stigma relates to physical and functional outcomes or how constrained disclosure (i.e., avoidance of or discomfort about disclosing one’s lung cancer status to others) relates to well-being. Furthermore, no study has examined whether internalized stigma and constrained disclosure predict changes in well-being for lung cancer patients. This longitudinal study characterized relationships of internalized stigma and constrained disclosure with emotional and physical/functional outcomes.

Personal contact with HIV‐positive persons is associated with reduced HIV‐related stigma: cross‐sectional analysis of general population surveys from 26 countries in sub‐Saharan Africa

Introduction : HIV‐related stigma hampers treatment and prevention efforts worldwide. Effective interventions to counter HIV‐related stigma are greatly needed. Although the “contact hypothesis” suggests that personal contact with persons living with HIV (PLHIV) may reduce stigmatizing attitudes in the general population, empirical evidence in support of this hypothesis is lacking. Our aim was to estimate the association between personal contact with PLHIV and HIV‐related stigma among the general population of sub‐Saharan Africa. Methods : Social distance and anticipated stigma were operationalized using standard HIV‐related stigma questions contained in the Demographic and Health Surveys and AIDS Indicator Surveys of 26 African countries between 2003 and 2008. We fitted multivariable logistic regression models with country‐level fixed effects, specifying social distance as the dependent variable and personal contact with PLHIV as the primary explanatory variable of interest. Results : We analyzed data from 206,717 women and 91,549 men living in 26 sub‐Saharan African countries. We estimated a statistically significant negative association between personal contact with PLHIV and desires for social distance (adjusted odds ratio [AOR] = 0.80; p < 0.001; 95% Confidence Interval [CI], 0.73–0.88). In a sensitivity analysis, a similar finding was obtained with a model that used a community‐level variable for personal contact with PLHIV (AOR = 0.92; p < 0.001; 95% CI, 0.89–0.95). Conclusions : Personal contact with PLHIV was associated with reduced desires for social distance among the general population of sub‐Saharan Africa. More contact interventions should be developed and tested to reduce the stigma of HIV.     

正念减压训练对焦虑障碍患者病耻感的影响

目的 探讨正念减压训练对焦虑障碍患者病耻感的影响。方法 选取2017年2月至2019年3月在合肥市第四人民医院神经症科病房接受治疗的焦虑障碍患者36例作为干预组。同时选取年龄、性别、文化程度、首发年龄、焦虑程度相匹配的焦虑障碍患者38例作为对照组,两组均进行康复活动训练,干预组在此基础之上进行每周2次共4周的正念减压训练,采用病耻感量表（SSMI-C）和汉密尔顿焦虑评分量表（HAMA）分别测评两组患者干预前后的病耻感和焦虑程度,评估干预效果。结果 干预后,干预组SSMI-C的歧视、病情掩饰因子分及病耻感总分与HAMA评分均低于干预前,且低于对照组（P <0.05）。干预组干预前后歧视因子分差值与HAMA差值存在相关（r=0.666, P=0.003）。结论 正念减压训练能有效降低焦虑障碍患者的病耻感,同时改善患者的焦虑症状。     

脑出血患者病耻感与急性应激障碍相关性研究

目的 探讨脑出血患者病耻感现状及与急性应激障碍的相关性。方法 采用方便抽样法选取2018年10月到2019年6月在华北理工大学附属医院神经外科住院的253例脑出血患者进行研究。运用一般资料调查表、病耻感量表（SSCI）、斯坦福问卷（SARSQ）对脑出血患者进行调查。结果 脑出血患者病耻感得分为（80.76±8.361分）;相关性分析发现,病耻感与ASD总分及各维度得分成正相关性（P<0.001）;多元回归分析表明,性别、文化程度、居住地、合并功能障碍数、ASD及回避维度是病耻感的主要影响因素（P<0.05）。结论 脑出血患者病耻感较高,急性应激障碍对脑出血患者病耻感有影响,医护人员应及早预防ASD发生,避免加重患者病耻感。     

Menstruation and homelessness: Challenges faced living in shelters and on the street in New York City

A growing literature attests to menstrual management difficulties of girls, women and other people who menstruate. Largely ignored are the menstruation-management needs of people experiencing homelessness. We explored these realities in New York City through in-depth interviews with individuals living on the street and in shelters (n = 22), key informant interviews with staff at government agencies, shelters and service provider organizations (n = 15), and field audits of public toilets. This paper explores both pragmatic difficulties presented by inadequate access to toilets, bathing spaces, and laundering services, and pervasive menstrual stigma. Amplifying the difficulties was near-constant pressure “to pass,” as someone who was not homeless in order to enable increased access to toilets, and as someone who was not menstruating, in order to engage in the activities of daily living. Our findings highlight the need for improved quality and accessibility of bathrooms for sheltered and street-dwelling homeless, and expedited access to bathing and laundering. Such actions are essential given the steady increase in homelessness in NYC and – under the long shadow of COVID – especially timely.     

Internalized stigma in psoriasis: A multicenter study

Internalized stigma is the adoption of negative attitudes and stereotypes of the society regarding a person's illness. It causes decreased self‐esteem and life‐satisfaction, increased depression and suicidality, and difficulty in coping with the illness. The primary aim of this study was to investigate the internalized stigma state of psoriatic patients and to identify the factors influencing internalized stigma. The secondary aim was to identify the correlation of internalized stigma with quality of life and perceived health status. This multicentre, cross‐sectional study comprised 1485 patients. There was a significant positive correlation between mean values of Psoriasis Internalized Stigma Scale (PISS) and Psoriasis Area and Severity Index, Body Surface Area, Dermatological Life Quality Index and General Health Questionnaire‐12 (P < 0.001 in all). Lower percieved health score (P = 0.001), early onset psoriasis (P = 0.016), family history of psoriasis (P = 0.0034), being illiterate (P < 0.001) and lower income level (P < 0.001) were determinants of high PISS scores. Mean PISS values were higher in erythrodermic and generalized pustular psoriasis. Involvement of scalp, face, hand, genitalia and finger nails as well as arthropathic and inverse psoriasis were also related to significantly higher PISS scores (P = 0.001). Our findings imply that psoriatic patients experience high levels of internalized stigma which are associated with psoriasis severity, involvement of visible body parts, genital area, folds or joints, poorer quality of life, negative perceptions of general health and psychological illnesses. Therefore, internalized stigma may be one of the major factors responsible from psychosocial burden of the disease.     

From niche to stigma—Headshops to prison: Exploring the rise and fall of synthetic cannabinoid use among young adults

The aim of this paper will be to consider the rise and subsequent fall in NPS use at national and local level with a focus on synthetic cannabinoid products in Kent. We will examine the local practice and policy responses by Kent’s Young Persons’ Drug and Alcohol Service towards a possible change in patterns of NPS drug consumption. The county has seen an expansion in the number of Headshops and we present local media coverage on NPS, and the Trading Standards and Kent Police intervention Operation Lantern to regulate Headshops. Through quantitative and qualitative data sets on socially vulnerable young people and prison populations we explore young adults’ perception of pleasure and harm in the use of NPS. Emergent data suggests young adults are now assessing the differences between NPS and more traditional illicit drugs, with this impacting on decision-making about the substances being used. When ‘legal highs’ first appeared they were associated with a more niche middle class demographic, ‘psychonauts’ and experimental users interested in pursuing recreational drug diversity. We examine macro and micro data to suggest that populations most likely to become involved in NPS use are those with degrees of stigma linked to socially vulnerable young adults suggesting that Spice is no longer a feature of middle class recreational drug use.     

青少年癫痫患者的病耻感现状及其对遵医行为和健康状况的影响

目的探讨青少年癫痫患者的病耻感现状及其对遵医行为和健康状况的影响。方法选取2018年6月至2019年5月就诊于我院的123例青少年癫痫患者作为研究对象,填写一般资料调查表、Kilifi癫痫患者羞耻感中文版量表、Morisky服药依从性问卷和中文版青少年癫痫患者生活质量问卷,共发放问卷123份,收回有效问卷115份,有效回收率93.50%。结果青少年癫痫患者病耻感平均(9.34±3.39)分,遵医行为平均(6.34±1.28)分,健康状况平均(64.70±16.42)分。青少年癫痫患者病耻感与病程有关,≥5年病程患者的病耻感明显高于<5年患者(P<0.05)。青少年癫痫患者的病耻感得分与遵医行为、健康状况均呈负相关(P<0.05)。结论青少年癫痫患者普遍存在病耻感,并影响其遵医行为和健康状况,应采取多种措施降低其病耻感。     

A survey of the British public's attitudes towards drug dependence

Aims To determine the attitude of the British public towards people with drug dependence and their treatment. Design A postal quota survey of the British public was performed to determine attitude towards people with illicit drug dependence and treatment policies. Results Respondents disagreed with the idea that 'drug addicts' have a mental illness and regarded them as untrustworthy, deceitful and unreliable. Clinical implication Respondents had a stigmatized view of 'drug addiction', although they may be more sympathetic to the concept of an individual 'drug addict'. However, they did not have strong views concerning professional treatment decisions, including child protection issues.     

Cumulative risk and AIDS-orphanhood: Interactions of stigma,bullying and poverty on child mental health in South Africa

Research shows that AIDS-orphaned children are more likely to experience clinical-range psychological problems. Little is known about possible interactions between factors mediating these high distress levels. We assessed how food insecurity, bullying, and AIDS-related stigma interacted with each other and with likelihood of experiencing clinical-range disorder. In South Africa, 1025 adolescents completed standardised measures of depression, anxiety and post-traumatic stress. 52 potential mediators were measured, including AIDS-orphanhood status. Logistic regressions and hierarchical log-linear modelling were used to identify interactions among significant risk factors. Food insecurity, stigma and bullying all independently increased likelihood of disorder. Poverty and stigma were found to interact strongly, and with both present, likelihood of disorder rose from 19% to 83%. Similarly, bullying interacted with AIDS-orphanhood status, and with both present, likelihood of disorder rose from 12% to 76%. Approaches to alleviating psychological distress amongst AIDS-affected children must address cumulative risk effects.