1) The study examined how stigma stress affects people with mental illnesses like schizophrenia. It looked at how people appraise stigma as a stressor, their emotional and cognitive responses, and how those responses impact outcomes.
2) The results showed that higher perceived stigma stress was linked to increased social anxiety and feelings of shame. Social anxiety and shame then predicted lower self-esteem and more hopelessness in participants.
3) Certain coping responses, like only comparing oneself to other people with mental illnesses, predicted poorer social performance and increased desire for social distance from others. Cognitive coping responses were generally not related to emotional stress responses.
Chronic Emotional Detachment, Disorders, and Treatment-Team BSarah M
This document discusses chronic emotional detachment and how it may lead to increased rates of mental health disorders like anxiety, depression, and PTSD. It hypothesizes that suppressing natural emotions to conform to societal pressures causes stress and depersonalization over time. When a distressing trigger occurs, this imbalance can lead to mental disorders. The document reviews literature linking emotional suppression to increased disorders in populations like veterans and refugees. It proposes studying the relationship between evolutionary survival mechanisms and societal norms. The methodology section describes a mixed-methods study using surveys, interviews, and archival data from a random sample to understand subjective emotional experiences and medication effectiveness.
Running head ASSIGNMENT-TEST DEVELOPMENT PROPOSAL .docxhealdkathaleen
Running head: ASSIGNMENT-TEST DEVELOPMENT PROPOSAL 1
ASSIGNMENT-TEST DEVELOPMENT PROPOSAL 2
Assignment-Test Development Proposal
Name:
Institutional Affiliation:
Assignment-Test Development Proposal
The outlines associated with the construct of depression may be associated with the different mental issues that are faced by many individuals in the country. The description connected with depressive lifestyles serves as a characteristic of the issues that ignore events connected to the existing construct system. Therefore, rather that participating in active testing, revision, and expansion of interpreting different experiences, depressed individuals should avoid anxiety that accompanies it. The brittle and relatively construct system should be avoided to eliminate issues of fatalism and suicidal possibilities. It is crucial to understand the severe disorders to ensure that clients in the market are able to deal with negative symptoms associated with depression.
A Discussion of the Construct of Depression in the Society
A huge research framework has confirmed the fact that depression is a disorder that is suffered by almost everyone in the modern society. Individuals suffering from depression suffer from anticipatory failure. They lack the motivation of viewing the future as a positive framework of development. Their current mental instability influences them to become negative about the life around them. Individuals with depression tend to construct themselves in a negative manner (Abas, et al., 2013). The events around them are polarized to become negative. The issues are made to reach extreme manners.
This influences them to distant their thinking from reality and more into a cocoon that limits them from achieving their potential. Personal construct theory is an important theory in dealing with the issue. It has ensured that it emphasizes on structural depressive construing aspects. It documents the coherence loosening of the organization of a person’s self-concept (Roberts, Faull, & Tod, 2016). Depression and its deepening rate are seen as a way through which one acquires a more negative status when the disorder continues to grow. The theory reiterates that the construct system structure that possesses a negative construing status show that the disorder possesses dangerous symptoms that should be perceived from a prospective prediction. Issues such as serious suicide risk that hospitalized psychiatric patients.
Assessment of the Construct of Depression
The importance of the construct of depression in the modern society comes from the impact that it has on the environment around us. Subsequent research shows that personality styles are significant in enabling the development of the depressive symptoms. Personality styles are the reason as to why individuals would promote a vulnerability status of the concept of depression. Di ...
2009 the role of psychological flexibility in mental health stigma and psycho...dfperezr
This document summarizes a research study that investigated the relationship between mental health stigma, psychological distress, and psychological flexibility. The study found that individuals who endorsed more stigmatizing attitudes toward people with psychological disorders also reported greater psychological distress. Additionally, psychological flexibility was found to be a shared factor between higher levels of mental health stigma and psychological distress. Exploring psychological flexibility may help explain the link between stigmatizing others and one's own psychological well-being.
This document summarizes a research study that surveyed 837 mental health professionals to determine their views on various models of mental illness. It found that professionals' endorsement of models differed depending on the specific illness. For schizophrenia, they most endorsed a biological model followed by cognitive and behavioral aspects. For depression, a social model was most endorsed followed by cognitive and behavioral aspects, with biological being least endorsed. For antisocial personality disorder, professionals most endorsed social constructionist and nihilist models, suggesting lack of interest in viewing it as a mental illness. The implications of professionals' endorsed models are discussed, such as impacts on treatment approaches, responsibility attribution, stigma, and access to social benefits.
This document summarizes the systematic stigmatization of mental health in the US medical care system. It discusses how there is a lack of training and resources for healthcare providers, leading to discrimination and stigmatization of individuals with mental disorders. This includes labeling, stereotyping, social distancing, and status loss. The stigmatization is perpetuated at multiple levels - through relationships with family/friends, by the general public due to lack of knowledge, and by healthcare providers themselves due to lack of training and empathy. The US healthcare system reinforces these stigmas through lack of appropriate coverage and providers. Changes are needed such as increased education for providers and moving towards an integrated healthcare system.
Respond to at least two colleagues by explaining how they could use .docxcarlstromcurtis
Respond to at least two colleagues by explaining how they could use strategies to advocate for a client with a somatic symptom disorder given the reasons for advocacy they described.
Colleague 1: Brooke
Somatic symptom disorders are mental disorders that manifest with physical symptoms that are not always clear to explain with medical diagnosis (APA, 2013). One specific example of such a disorder is the Illness Anxiety Disorder (F45.21). This disorder is diagnosed when there is a pervasive and impacting preoccupation with having a serious medical condition in circumstances when no predisposition or existing symptomatology indicate there should be medical concern (APA, 2013). The diagnosed individual will exhibit heightened anxiety regarding their perceived condition. Furthermore, the diagnosis is classified as either “care-seeking type,” whereby the individual frequently seeks out medical guidance from professionals or “care-avoidant type: whereby the individual avoids medical care despite their ongoing concerns (APA, 2013).
This can present a unique challenge for guiding professionals, as the client is potentially in need of both medical and mental health care. Therefore, a biopsychosocial assessment is recommended to gain the most thorough, comprehensive picture of the client and their current set of circumstances. This multi aspect evaluation serves to understand the biological, or physical, contributors to the individual’s somatic diagnosis, while also delving into their perceptions and beliefs (psychological) and their social environment and experiences. When this information is gathered from these varied perspectives, intervention can be designed to target specific areas of need, with the understanding that medical care may be required, concurrently, with mental health support (Dimsdale, Patel, Xin and Kleinman, 2007).
Because of the complexity of such diagnoses, a multidisciplinary approach is deemed most effective when working with such clients. Because of the psychological involvement in this disorder, psychotherapy aimed at modifying existing thought patterns would be considered sound practice (Kirmayer and Sartorius, 2007). To expand, cognitive behavioral therapy (CBT) can be applied, increasing the client's awareness of their current thought patterns, possible triggers and strategies to combat negative thinking. Additionally, the prescription of medication to address the co-occurring anxiety or other resulting physical symptoms would be provided by a medical professional, such as a psychiatrist. This approach, widely accepted, allows for the client’s case to be viewed through different lenses.
While there is certainly significant validity in approaching such cases through a multidisciplinary team, the professionals required to ensure this effective intervention all have to be “on board.” This may require advocacy on the part of a social worker to convey the importance of employing this approach. It can b ...
1) The study compares core beliefs between patients with social phobia, other anxiety disorders, and non-psychiatric controls by having them complete a schema questionnaire.
2) Results found that patients with social phobia showed higher levels of early maladaptive schemas (EMS) related to disconnection/rejection compared to those with other anxiety disorders.
3) Regression analysis identified the EMS of mistrust/abuse, social undesirability/defectiveness, entitlement, emotional deprivation, unrelenting standards and shame as explaining most of the variance in anxiety felt in social situations and fear of negative evaluation in the study subjects.
Chronic Emotional Detachment, Disorders, and Treatment-Team BSarah M
This document discusses chronic emotional detachment and how it may lead to increased rates of mental health disorders like anxiety, depression, and PTSD. It hypothesizes that suppressing natural emotions to conform to societal pressures causes stress and depersonalization over time. When a distressing trigger occurs, this imbalance can lead to mental disorders. The document reviews literature linking emotional suppression to increased disorders in populations like veterans and refugees. It proposes studying the relationship between evolutionary survival mechanisms and societal norms. The methodology section describes a mixed-methods study using surveys, interviews, and archival data from a random sample to understand subjective emotional experiences and medication effectiveness.
Running head ASSIGNMENT-TEST DEVELOPMENT PROPOSAL .docxhealdkathaleen
Running head: ASSIGNMENT-TEST DEVELOPMENT PROPOSAL 1
ASSIGNMENT-TEST DEVELOPMENT PROPOSAL 2
Assignment-Test Development Proposal
Name:
Institutional Affiliation:
Assignment-Test Development Proposal
The outlines associated with the construct of depression may be associated with the different mental issues that are faced by many individuals in the country. The description connected with depressive lifestyles serves as a characteristic of the issues that ignore events connected to the existing construct system. Therefore, rather that participating in active testing, revision, and expansion of interpreting different experiences, depressed individuals should avoid anxiety that accompanies it. The brittle and relatively construct system should be avoided to eliminate issues of fatalism and suicidal possibilities. It is crucial to understand the severe disorders to ensure that clients in the market are able to deal with negative symptoms associated with depression.
A Discussion of the Construct of Depression in the Society
A huge research framework has confirmed the fact that depression is a disorder that is suffered by almost everyone in the modern society. Individuals suffering from depression suffer from anticipatory failure. They lack the motivation of viewing the future as a positive framework of development. Their current mental instability influences them to become negative about the life around them. Individuals with depression tend to construct themselves in a negative manner (Abas, et al., 2013). The events around them are polarized to become negative. The issues are made to reach extreme manners.
This influences them to distant their thinking from reality and more into a cocoon that limits them from achieving their potential. Personal construct theory is an important theory in dealing with the issue. It has ensured that it emphasizes on structural depressive construing aspects. It documents the coherence loosening of the organization of a person’s self-concept (Roberts, Faull, & Tod, 2016). Depression and its deepening rate are seen as a way through which one acquires a more negative status when the disorder continues to grow. The theory reiterates that the construct system structure that possesses a negative construing status show that the disorder possesses dangerous symptoms that should be perceived from a prospective prediction. Issues such as serious suicide risk that hospitalized psychiatric patients.
Assessment of the Construct of Depression
The importance of the construct of depression in the modern society comes from the impact that it has on the environment around us. Subsequent research shows that personality styles are significant in enabling the development of the depressive symptoms. Personality styles are the reason as to why individuals would promote a vulnerability status of the concept of depression. Di ...
2009 the role of psychological flexibility in mental health stigma and psycho...dfperezr
This document summarizes a research study that investigated the relationship between mental health stigma, psychological distress, and psychological flexibility. The study found that individuals who endorsed more stigmatizing attitudes toward people with psychological disorders also reported greater psychological distress. Additionally, psychological flexibility was found to be a shared factor between higher levels of mental health stigma and psychological distress. Exploring psychological flexibility may help explain the link between stigmatizing others and one's own psychological well-being.
This document summarizes a research study that surveyed 837 mental health professionals to determine their views on various models of mental illness. It found that professionals' endorsement of models differed depending on the specific illness. For schizophrenia, they most endorsed a biological model followed by cognitive and behavioral aspects. For depression, a social model was most endorsed followed by cognitive and behavioral aspects, with biological being least endorsed. For antisocial personality disorder, professionals most endorsed social constructionist and nihilist models, suggesting lack of interest in viewing it as a mental illness. The implications of professionals' endorsed models are discussed, such as impacts on treatment approaches, responsibility attribution, stigma, and access to social benefits.
This document summarizes the systematic stigmatization of mental health in the US medical care system. It discusses how there is a lack of training and resources for healthcare providers, leading to discrimination and stigmatization of individuals with mental disorders. This includes labeling, stereotyping, social distancing, and status loss. The stigmatization is perpetuated at multiple levels - through relationships with family/friends, by the general public due to lack of knowledge, and by healthcare providers themselves due to lack of training and empathy. The US healthcare system reinforces these stigmas through lack of appropriate coverage and providers. Changes are needed such as increased education for providers and moving towards an integrated healthcare system.
Respond to at least two colleagues by explaining how they could use .docxcarlstromcurtis
Respond to at least two colleagues by explaining how they could use strategies to advocate for a client with a somatic symptom disorder given the reasons for advocacy they described.
Colleague 1: Brooke
Somatic symptom disorders are mental disorders that manifest with physical symptoms that are not always clear to explain with medical diagnosis (APA, 2013). One specific example of such a disorder is the Illness Anxiety Disorder (F45.21). This disorder is diagnosed when there is a pervasive and impacting preoccupation with having a serious medical condition in circumstances when no predisposition or existing symptomatology indicate there should be medical concern (APA, 2013). The diagnosed individual will exhibit heightened anxiety regarding their perceived condition. Furthermore, the diagnosis is classified as either “care-seeking type,” whereby the individual frequently seeks out medical guidance from professionals or “care-avoidant type: whereby the individual avoids medical care despite their ongoing concerns (APA, 2013).
This can present a unique challenge for guiding professionals, as the client is potentially in need of both medical and mental health care. Therefore, a biopsychosocial assessment is recommended to gain the most thorough, comprehensive picture of the client and their current set of circumstances. This multi aspect evaluation serves to understand the biological, or physical, contributors to the individual’s somatic diagnosis, while also delving into their perceptions and beliefs (psychological) and their social environment and experiences. When this information is gathered from these varied perspectives, intervention can be designed to target specific areas of need, with the understanding that medical care may be required, concurrently, with mental health support (Dimsdale, Patel, Xin and Kleinman, 2007).
Because of the complexity of such diagnoses, a multidisciplinary approach is deemed most effective when working with such clients. Because of the psychological involvement in this disorder, psychotherapy aimed at modifying existing thought patterns would be considered sound practice (Kirmayer and Sartorius, 2007). To expand, cognitive behavioral therapy (CBT) can be applied, increasing the client's awareness of their current thought patterns, possible triggers and strategies to combat negative thinking. Additionally, the prescription of medication to address the co-occurring anxiety or other resulting physical symptoms would be provided by a medical professional, such as a psychiatrist. This approach, widely accepted, allows for the client’s case to be viewed through different lenses.
While there is certainly significant validity in approaching such cases through a multidisciplinary team, the professionals required to ensure this effective intervention all have to be “on board.” This may require advocacy on the part of a social worker to convey the importance of employing this approach. It can b ...
1) The study compares core beliefs between patients with social phobia, other anxiety disorders, and non-psychiatric controls by having them complete a schema questionnaire.
2) Results found that patients with social phobia showed higher levels of early maladaptive schemas (EMS) related to disconnection/rejection compared to those with other anxiety disorders.
3) Regression analysis identified the EMS of mistrust/abuse, social undesirability/defectiveness, entitlement, emotional deprivation, unrelenting standards and shame as explaining most of the variance in anxiety felt in social situations and fear of negative evaluation in the study subjects.
1. The document explores how social identity processes may play an important role in cognitive appraisal of stress. A survey was administered to 163 students measuring personality, coping strategies, social support, and gender. Students rated scenarios as more stressful if they were student-specific versus general.
2. Females and those reporting higher levels of emotion-focused coping rated scenarios as more stressful, regardless of whether the scenarios were student-specific or general. No other relationships were found between the predictor variables and ratings of stressfulness.
3. The findings suggest that social identity may not impact cognitive appraisal of stress as expected based on self-categorization theory. Gender and emotion-focused coping were the only significant predictors of perceived
This document describes a pilot study that explored using compassion-focused therapy (CFT) to treat personality disorders. 8 participants with personality disorders received 16 weeks of CFT in a group setting. Quantitative measures assessed self-criticism, shame, depression, anxiety, and well-being before, after, and 1 year later. Qualitative analysis also examined themes. Results found significant reductions in shame, social comparison, self-hatred, and increases in self-reassurance that were maintained or improved further after 1 year. CFT shows potential for treating difficult personality disorders by targeting shame and self-criticism. Further research with randomized controlled trials is still needed.
20 Other Conditions That May Be a Focus of Clinical AttentionV-c.docxlorainedeserre
20 Other Conditions That May Be a Focus of Clinical Attention
V-codes and z-codes
V-codes and Z-codes are conditions that may be the focus of clinical attention but are not considered mental disorders. They correspond to International Classification of Diseases, Ninth Revision, Clinical Modification ICD-9-CM (V-codes) and International Classification of Diseases, Tenth Revision, Clinical Modification ICD-10-CM (Z-codes that become effective in 2015. In most instances, third-party payers do not cover charges for delivering services to an individual if the diagnosis is solely a V- or Z-code alone. If the V- or Z-code is not the primary diagnosis then it should be documented following the primary diagnosis. In addition, when writing the psychosocial assessment any psychosocial and cultural factors that might impact the client's diagnosis should be documented. The psychosocial stressors reflected in these diagnoses are widespread across all classes and cultures and have been shown to impact all aspects of an individual's life from the physical and psychological to the financial. Furthermore, these conditions have been shown to significantly impact the diagnosis and outcome for a multitude of mental and medical disorders. V- and Z-codes are grouped into numerous categories including: relational problems, problems related to abuse/neglect, educational and occupational problems, housing and economic problems, problems related to the social environment, problems related to the legal system, other counseling services, other psychosocial, personal and environmental problems, and problems of personal history (APA, 2013).
Broadly speaking, the category “Relational Problems” describes interactional problems between family members (e.g., parent/caregiver-child) or partners that result in significant impairment of family functioning or development of symptoms in the distressed individual, spouses, siblings, or other family members. Relational problems are broken down into two categories, Problems Related to Family Upbringing and Other Problems Related to Primary Support Group. For example, in the first category a Parent-Child Relational Problem involves interactional problems between one or both parents and a child that lead to dysfunction in behavioral (e.g., inadequate protection, overprotection), cognitive (e.g., antagonism toward or blaming of the other) or affective (e.g., feeling sad and angry) realms. Here, the critical factor is the quality of the parent-child relationship or when the dysfunction in this relationship is impacting the course and outcome of a psychological or medical condition. Other examples include Sibling Relational Problem, Upbringing Away from Parents, and Child Affected by Parental Relationship Distress. Similarly, family relationships and interactional patterns leading to problems related to primary support group include Partner Relational Problem, Disruption of Family by Separation/Divorce, High Expressed Emotion Level with ...
20 Other Conditions That May Be a Focus of Clinical AttentionV-c.docxRAJU852744
20 Other Conditions That May Be a Focus of Clinical Attention
V-codes and z-codes
V-codes and Z-codes are conditions that may be the focus of clinical attention but are not considered mental disorders. They correspond to International Classification of Diseases, Ninth Revision, Clinical Modification ICD-9-CM (V-codes) and International Classification of Diseases, Tenth Revision, Clinical Modification ICD-10-CM (Z-codes that become effective in 2015. In most instances, third-party payers do not cover charges for delivering services to an individual if the diagnosis is solely a V- or Z-code alone. If the V- or Z-code is not the primary diagnosis then it should be documented following the primary diagnosis. In addition, when writing the psychosocial assessment any psychosocial and cultural factors that might impact the client's diagnosis should be documented. The psychosocial stressors reflected in these diagnoses are widespread across all classes and cultures and have been shown to impact all aspects of an individual's life from the physical and psychological to the financial. Furthermore, these conditions have been shown to significantly impact the diagnosis and outcome for a multitude of mental and medical disorders. V- and Z-codes are grouped into numerous categories including: relational problems, problems related to abuse/neglect, educational and occupational problems, housing and economic problems, problems related to the social environment, problems related to the legal system, other counseling services, other psychosocial, personal and environmental problems, and problems of personal history (APA, 2013).
Broadly speaking, the category “Relational Problems” describes interactional problems between family members (e.g., parent/caregiver-child) or partners that result in significant impairment of family functioning or development of symptoms in the distressed individual, spouses, siblings, or other family members. Relational problems are broken down into two categories, Problems Related to Family Upbringing and Other Problems Related to Primary Support Group. For example, in the first category a Parent-Child Relational Problem involves interactional problems between one or both parents and a child that lead to dysfunction in behavioral (e.g., inadequate protection, overprotection), cognitive (e.g., antagonism toward or blaming of the other) or affective (e.g., feeling sad and angry) realms. Here, the critical factor is the quality of the parent-child relationship or when the dysfunction in this relationship is impacting the course and outcome of a psychological or medical condition. Other examples include Sibling Relational Problem, Upbringing Away from Parents, and Child Affected by Parental Relationship Distress. Similarly, family relationships and interactional patterns leading to problems related to primary support group include Partner Relational Problem, Disruption of Family by Separation/Divorce, High Expressed Emotion Level with.
CanJPsychiatry 2012;57(8)464–469On the Self-Stigma of Mental Il.docxjasoninnes20
CanJPsychiatry 2012;57(8):464–469
On the Self-Stigma of Mental Illness: Stages, Disclosure, and Strategies for Change
Patrick W Corrigan, PsyD1; Deepa Rao, PhD, MA2
1 Distinguished Professor and Associate Dean for Research, College of Psychology, Illinois Institute of Technology, Chicago, Illinois. Correspondence: Illinois Institute of Technology, 3424 South State Street, Chicago, IL 60616; [email protected] 2 Research Assistant Professor, Department of Global Health, University of Washington, Seattle, Washington.
Page 464
People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result. In our article, we more fully define the concept of self-stigma and describe the negative consequences of self-stigma for people with mental illness. We also examine the advantages and disadvantages of disclosure in reducing the impact of stigma. In addition, we argue that a key to challenging self-stigma is to promote personal empowerment. Lastly, we discuss individual- and societal-level methods for reducing self-stigma, programs led by peers as well as those led by social service providers.
Les personnes souffrant de maladie mentale font depuis longtemps l’objet de préjugés et de discrimination. Les chercheurs ont pu étudier ce phénomène comme étant celui des stigmates, et ont commencé à examiner des façons de réduire ces stigmates. Les stigmates du public sont la forme prédominante qui a été observée et étudiée, car elle représente les préjugés et la discrimination dirigés vers un groupe par l’ensemble de la population. L’auto-stigmatisation se produit lorsque les gens internalisent ces attitudes du public et par la suite, souffrent de nombreuses conséquences négatives. Dans notre article, nous définissons plus complètement le concept de l’auto-stigmatisation et décrivons les conséquences négatives que l’auto-stigmatisation provoque chez les personnes souffrant de maladie mentale. Nous examinons aussi les avantages et désavantages de la divulgation pour réduire l’effet des stigmates. En outre, nous alléguons qu’un moyen de défier l’auto-stigmatisation consiste à promouvoir l’habilitation personnelle. Enfin, nous présentons des méthodes au niveau individuel et sociétal de réduire l’auto-stigmatisation, des programmes menés par les pairs ainsi que ceux menés par des prestataires de services sociaux.
In making sense of the prejudice and discrimination experienced by people with mental illnesses, researchers have come to distinguish public stigma from self-stigma.1 Public stigma is what commonly comes to mind when discussing the phenomenon, and repre ...
Dr. Salman Kareem will present on social cognition in schizophrenia. Social cognition involves mental processes underlying social interactions and includes perceiving others' intentions. It has several domains impaired in schizophrenia including emotion perception, theory of mind, and attributional style. Social cognition is distinct from neurocognition and negative symptoms, and impacts daily functioning. While treatments show some potential, current medications have not reliably improved social cognition.
The document discusses influences on mental health and illness. It defines mental health as optimal functioning and mental illness as functional impairment. Cultural factors can impact how individuals view and experience mental illness. Prolonged stress can lead to physical and psychological responses like anxiety, defense mechanisms, and potentially psychosis. Diagnosis of mental illness involves using the DSM system across five axes. Treating mental illness faces challenges like stigma, access to care, and cost issues.
Junxian KuangLaura SinaiENG099101572018In the essay O.docxtawnyataylor528
Junxian Kuang
Laura Sinai
ENG099/101
5/7/2018
In the essay “On Being a Cripple”, Nancy Mairs shares her experiences, attitudes towards life as a multiple sclerosis patient. First, she claims that the diseases she has faced are brain tumor and MS, and those diseases literally changed her fate. The relationships of her family member and the attitude of Nancy’s mother have affected by MS. Also, she writes about her identities in society, her friends who have the same physical issue, thoughts from disabled parents’ children, and her desire to travel. MS affected Nancy Mairs’s family member as well as her thoughts.
Subjective Socioeconomic Status Causes Aggression: A Test of the Theory
of Social Deprivation
Tobias Greitemeyer and Christina Sagioglou
University of Innsbruck
Seven studies (overall N � 3690) addressed the relation between people’s subjective socioeconomic
status (SES) and their aggression levels. Based on relative deprivation theory, we proposed that people
low in subjective SES would feel at a disadvantage, which in turn would elicit aggressive responses. In
3 correlational studies, subjective SES was negatively related to trait aggression. Importantly, this
relation held when controlling for measures that are related to 1 or both subjective SES and trait
aggression, such as the dark tetrad and the Big Five. Four experimental studies then demonstrated that
participants in a low status condition were more aggressive than were participants in a high status
condition. Compared with a medium-SES condition, participants of low subjective SES were more
aggressive rather than participants of high subjective SES being less aggressive. Moreover, low SES
increased aggressive behavior toward targets that were the source for participants’ experience of
disadvantage but also toward neutral targets. Sequential mediation analyses suggest that the experience
of disadvantage underlies the effect of subjective SES on aggressive affect, whereas aggressive affect was
the proximal determinant of aggressive behavior. Taken together, the present research found compre-
hensive support for key predictions derived from the theory of relative deprivation of how the perception
of low SES is related to the person’s judgments, emotional reactions, and actions.
Keywords: aggression, relative deprivation, social class, socioeconomic status
In most Western societies, wealth inequality is at its historic
height. For example, in the United States, the richest 1% possesses
more than 40% of the country’s wealth (Wolff, 2012). In Germany,
the biggest economy in the European Union, the median household
in the top 20% of the income class has 74 times more wealth than
the bottom 20% (European Central Bank, 2013). Although there is
widespread consensus among citizens that wealth inequality
should be reduced (Kiatpongsan & Norton, 2014; Norton & Ari-
ely, 2011), the wealth gap is actually increasing. For example, in
the United States, in 2012 the top 0.1% (including ...
This systematic review and meta-analysis examines the evidence for the effectiveness of psychological interventions in reducing internalized stigma among adults with schizophrenia spectrum disorders. The review identified 27 studies that met eligibility criteria. Meta-analysis of 18 studies found a statistically significant overall effect in lowering internalized stigma. Subgroup analysis found Narrative Enhancement and Cognitive Therapy to have a statistically significant and highly homogenous effect. In conclusion, most psychological interventions are successful in reducing internalized stigma, especially NECT, and combining multiple therapies may be more beneficial.
The document discusses the philosophy and practice of clinical outpatient therapy. It begins with a disclaimer stating the purpose is to improve therapy practice through a deeper understanding of methods. It then provides biographical information about the author, including their experience and training in substance abuse counseling, community mental health, and family therapy models from the 1970s-1990s. The document goes on to discuss perspectives on the causes of psychosis, including biological, psychological, and hybrid models. It also addresses the debate around treating psychosis primarily through medication versus psychotherapy.
Cognitive-behavioral therapy (CBT) is an effective treatment for social phobia. CBT aims to change negative thoughts and beliefs that cause social phobia by teaching skills like exposure therapy. It has advantages like helping patients learn to challenge cognitive distortions and gain support from group members. However, it also has disadvantages as social phobia patients fear evaluation and criticism, making group therapy difficult for some. CBT can be time-limited but has shown success in treating symptoms of social phobia in both children and adults.
1PAGE 21. What is the question the authors are asking .docxfelicidaddinwoodie
1
PAGE
2
1. What is the question the authors are asking?
They asked about a reduction in judgmental biases regarding the cost and probability associated with adverse social events as they are presumed as being mechanisms for the treatment of Social Anxiety Disorder (SAD). Also, the authors poised on the changes in judgmental biases as mechanisms to explain cognitive-behavioral therapy for social anxiety disorder. On top of that, they stated that methodological limitations extant studies highlight the possibility that rather than causing symptom relief, a significant reduction in judgmental biases tends to be consequences of it or correlate. Considerably, they expected cost bias at mid-treatment to be a predictor of the treatment outcome.
2. Why do the authors believe this question is important?
According to the authors, this question was relevant as methodological limitations of present studies reflect on the possibility that instead of causing symptom belief, a significant reduction in judgmental biases can be consequences or correlated to it. Additionally, they ought to ascertain the judgment bias between treated and non-treated participants. Significantly, this was important as they had to determine the impact of pre and post changes in cost and probability of the treatment outcomes. But, probability bias at mid-treatment was a predictor of the treatment outcome contrary to the cost bias at mid-treatment that could not be identified as a significant predictor of the treatment outcome.
3. How do they try to answer this question?
They conducted a study to evaluate the significant changes in judgmental bias as aspects of cognitive-behavioral therapy for social anxiety disorders. To do this, they conducted a study using information from two treatment studies; an uncontrolled trial observing amygdala activity as a response to VRE (Virtual Reality Exposure Therapy) with the use of functional magnetic resonance imaging and a randomized control trial that compared Virtual Reality Exposure Therapy with Exposure Group Therapy for SAD. A total of 86 individuals who met the DSM-IV-TR criteria for the diagnosis of non-generalized (n=46) and generalized (n=40) SAD participated. After completing eight weeks of the treatment protocol, the participants who identified public speaking as their most fearsome social situation were included. The SCID (Structured clinical interview for the DSM-IV) was used to ascertain diagnostic and eligibility status on Axis 1 conditions within substance abuse, mood and anxiety disorder modules. The social anxiety measures were measured with the use of BFNE (Brief Fear of Negative Evaluation), a self-reporting questioner that examined the degree to which persons fear to be assessed by other across different social settings. Additionally, the OPQ (Outcome Probability Questionnaire) self-reporting questionnaire was used to evaluate individual’s estimate on the probability that adverse, threatening events will occur at t ...
Running Head ADVANCED NURSING RESEARCH1ADVANCED NURSING RES.docxtoddr4
Running Head: ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH
4
Advanced Nursing Research (Research Study)
Student Name
Institution-Affiliated
Different Parts of a Research Study
Research topic
A systematic review of the association between stigma and or on help-seeking among mental health patients.
Research Problem
Stigma or the process of labelling, discrimination and prejudice towards individuals suffering from mental health problems is considered to have numerous adverse consequences compared to the health conditions themselves according to Thornicroft, Mehta, Clement, Evans-Lacko, Doherty, Rose & Henderson, (2016). In addition, research has found stigma to be responsible for the failure of numerous individuals suffering from mental health to seek help from both their close relatives or trusted individuals and from healthcare providers (Clement, Schauman, Graham, Maggioni, Evans-Lacko, Bezborodovs, Thornicroft, 2015).
Given an increase in mental health disorders and the challenges that such disorders pose to both individuals and society, numerous studies have been conducted to examine the association between stigma and help-seeking among mental health patients. However, research has largely focused on the attitudes that constitute stigma towards mental health patients and little on the interventions required to reduce or eradicate stigma. Moreover, since the failure to reduce stigma prevents mental health patients from seeking help and hence worsening their conditions, there is need for further studies regarding the association between stigma and help-seeking and the need to reduce stigma making the study not only relevant but significant.
Research purpose
The purpose of this paper is to explore the association between stigma and help-seeking among mental health patients and to identify proven strategies or actionable recommendation for reducing stigma.
Research objectives
The objective of the study will be to (1) Explore the extent to which stigma posses a barrier to help-seeking among mental health patients, (2) Identify whether stigma affects certain populations more than others and (3) propose strategies that can help reduce stigma.
Research question
The study will aim to answer the following questions (1) What is the association between stigma towards mental health patients and help-seeking? (2) To what extent does stigma constitute a barrier to the search for help among mental health patients and (3) Are there populations that are more deterred from seeking help due to stigma?
Research hypothesis
Ho: Stigma towards mental health patients deters them from seeking help
Ha: There is no association between stigma and the search for help among mental health patients.
In addition, the study hypothesizes that a reduction in stigma would result in increased help-seeking among mental health patients.
References
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., ... & Thornicroft, G. (2.
Due Facilitating group to post by Day 1; all other students post AlyciaGold776
The facilitating group posted discussion prompts on somatization disorder, depression, and the link between social media use and depression in adolescents.
For somatization disorder, they asked how therapeutic interventions would be formulated and how success would be evaluated. For depression, they asked how views on living with depression may have changed after watching a video, what interventions and resources would be used and how treatment success would be evaluated. For social media and adolescent depression, they asked for non-pharmacological interventions and an appropriate medication choice along with important patient education.
A peer responded by discussing screening and treatment of somatization disorder including psychotherapy and medications. For depression, the peer discussed the neurobiology, diagnostic criteria, treatment options of
The document outlines a program proposal called "Stop the Stigma" aimed at educating the Bulloch County community about mental illness and reducing stigma. It discusses the prevalence of mental illness in the US and defines the different types of stigma (public, self, institutional). A literature review found that anti-stigma interventions can help increase mental health literacy. The proposal describes conducting an interactive activity to differentiate facts/myths about mental illness, followed by a video and lecture. Pre- and post-tests would measure changes in knowledge about mental illness among participants from a local NAMI chapter. The goal is to encourage help-seeking and support for those with mental illness.
This document discusses social cognition in individuals with bipolar disorder. It begins by defining social cognition and outlining its key dimensions. It then reviews studies comparing social cognition abilities in individuals with bipolar disorder versus healthy controls. The studies show impairments in areas like theory of mind, emotion processing, and attributional biases. Differences are also seen between bipolar type I and II. While some social cognition abilities are preserved, deficits tend to be more pronounced than in individuals with schizophrenia. Overall, the document analyzes research on social cognition challenges in bipolar disorder.
ALCohoL ReSeARCh C u r r e n t R e v i e w s506 Alcohol .docxADDY50
ALCohoL ReSeARCh: C u r r e n t R e v i e w s
506 Alcohol Research: C u r r e n t R e v i e w s
Resilience to Meet the
Challenge of Addiction
Psychobiology and Clinical Considerations
Tanja N. Alim, M.D.; William B. Lawson, M.D.; Adriana Feder, M.D.; Brian M.
Iacoviello, Ph.D.; Shireen Saxena, M.S.; Christopher R. Bailey; Allison M.
Greene, M.S.; and Alexander Neumeister, M.D.
Tanja N. Alim, M.D., is an assis-
tant professor and William B.
Lawson, M.D., is a professor
and chair of the Department
of Psychiatry, both at the
Department of Psychiatry and
Behavioral Sciences, Howard
University, Washington, DC.
Adriana Feder, M.D., is an assistant
professor; Brian M. Iacoviello,
Ph.D., is a postdoctoral fellow;
and Shireen Saxena, M.S.,
Christopher R. Bailey, and
Allison M. Greene, M.S., are
research associates; all at the
Mood and Anxiety Disorders
Program, Department of Psychiatry,
Mount Sinai School of Medicine,
New York, New York.
Alexander Neumeister, M.D., is
a professor in the Department of
Psychiatry and Radiology, New
York University Langone Medical
Center, New York, New York.
Acute and chronic stress–related mechanisms play an important role in the
development of addiction and its chronic, relapsing nature. Multisystem adaptations in
brain, body, behavioral, and social function may contribute to a dysregulated
physiological state that is maintained beyond the homeostatic range. In addition,
chronic abuse of substances leads to an altered set point across multiple systems.
Resilience can be defined as the absence of psychopathology despite exposure to
high stress and reflects a person’s ability to cope successfully in the face of adversity,
demonstrating adaptive psychological and physiological stress responses. The study of
resilience can be approached by examining interindividual stress responsibility at
multiple phenotypic levels, ranging from psychological differences in the way people
cope with stress to differences in neurochemical or neural circuitry function. The
ultimate goal of such research is the development of strategies and interventions to
enhance resilience and coping in the face of stress and prevent the onset of addiction
problems or relapse. Key WoRDS: Addiction; substance abuse; stress; acute stress
reaction; chronic stress reaction; biological adaptation to stress; psychological
response to stress; physiological response to stress; resilience; relapse; coping
skills; psychobiology
evidence from different disciplinessuggests that acute and chronicstress–related mechanisms play
an important role in both the develop-
ment and the chronic, relapsing nature
of addiction (Baumeister 2003; Baumeister
et al. 1994; Brady and Sinha 2005).
Stress is defined as the physiological
and psychological process resulting from
a challenge to homeostasis by any real
or perceived demand on the body
(Lazarus and Fokman 1984; McEwen
2000; Selye 1976). Stress often induces
multisystem adaptations that occur in
the brain and .
ALCohoL ReSeARCh C u r r e n t R e v i e w s506 Alcohol .docxSHIVA101531
ALCohoL ReSeARCh: C u r r e n t R e v i e w s
506 Alcohol Research: C u r r e n t R e v i e w s
Resilience to Meet the
Challenge of Addiction
Psychobiology and Clinical Considerations
Tanja N. Alim, M.D.; William B. Lawson, M.D.; Adriana Feder, M.D.; Brian M.
Iacoviello, Ph.D.; Shireen Saxena, M.S.; Christopher R. Bailey; Allison M.
Greene, M.S.; and Alexander Neumeister, M.D.
Tanja N. Alim, M.D., is an assis-
tant professor and William B.
Lawson, M.D., is a professor
and chair of the Department
of Psychiatry, both at the
Department of Psychiatry and
Behavioral Sciences, Howard
University, Washington, DC.
Adriana Feder, M.D., is an assistant
professor; Brian M. Iacoviello,
Ph.D., is a postdoctoral fellow;
and Shireen Saxena, M.S.,
Christopher R. Bailey, and
Allison M. Greene, M.S., are
research associates; all at the
Mood and Anxiety Disorders
Program, Department of Psychiatry,
Mount Sinai School of Medicine,
New York, New York.
Alexander Neumeister, M.D., is
a professor in the Department of
Psychiatry and Radiology, New
York University Langone Medical
Center, New York, New York.
Acute and chronic stress–related mechanisms play an important role in the
development of addiction and its chronic, relapsing nature. Multisystem adaptations in
brain, body, behavioral, and social function may contribute to a dysregulated
physiological state that is maintained beyond the homeostatic range. In addition,
chronic abuse of substances leads to an altered set point across multiple systems.
Resilience can be defined as the absence of psychopathology despite exposure to
high stress and reflects a person’s ability to cope successfully in the face of adversity,
demonstrating adaptive psychological and physiological stress responses. The study of
resilience can be approached by examining interindividual stress responsibility at
multiple phenotypic levels, ranging from psychological differences in the way people
cope with stress to differences in neurochemical or neural circuitry function. The
ultimate goal of such research is the development of strategies and interventions to
enhance resilience and coping in the face of stress and prevent the onset of addiction
problems or relapse. Key WoRDS: Addiction; substance abuse; stress; acute stress
reaction; chronic stress reaction; biological adaptation to stress; psychological
response to stress; physiological response to stress; resilience; relapse; coping
skills; psychobiology
evidence from different disciplinessuggests that acute and chronicstress–related mechanisms play
an important role in both the develop-
ment and the chronic, relapsing nature
of addiction (Baumeister 2003; Baumeister
et al. 1994; Brady and Sinha 2005).
Stress is defined as the physiological
and psychological process resulting from
a challenge to homeostasis by any real
or perceived demand on the body
(Lazarus and Fokman 1984; McEwen
2000; Selye 1976). Stress often induces
multisystem adaptations that occur in
the brain and .
This document analyzes how peers label and stigmatize other youth with mental illness using Modified Labeling Theory. It finds that self-labeling predicts negative outcomes for youth but some refuse clinical labels. Anti-stigma campaigns using contact with those with mental illness and youth-led initiatives show effectiveness, though effects may decline after the program ends. The theory is then used to evaluate components of anti-stigma campaigns.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
1. The document explores how social identity processes may play an important role in cognitive appraisal of stress. A survey was administered to 163 students measuring personality, coping strategies, social support, and gender. Students rated scenarios as more stressful if they were student-specific versus general.
2. Females and those reporting higher levels of emotion-focused coping rated scenarios as more stressful, regardless of whether the scenarios were student-specific or general. No other relationships were found between the predictor variables and ratings of stressfulness.
3. The findings suggest that social identity may not impact cognitive appraisal of stress as expected based on self-categorization theory. Gender and emotion-focused coping were the only significant predictors of perceived
This document describes a pilot study that explored using compassion-focused therapy (CFT) to treat personality disorders. 8 participants with personality disorders received 16 weeks of CFT in a group setting. Quantitative measures assessed self-criticism, shame, depression, anxiety, and well-being before, after, and 1 year later. Qualitative analysis also examined themes. Results found significant reductions in shame, social comparison, self-hatred, and increases in self-reassurance that were maintained or improved further after 1 year. CFT shows potential for treating difficult personality disorders by targeting shame and self-criticism. Further research with randomized controlled trials is still needed.
20 Other Conditions That May Be a Focus of Clinical AttentionV-c.docxlorainedeserre
20 Other Conditions That May Be a Focus of Clinical Attention
V-codes and z-codes
V-codes and Z-codes are conditions that may be the focus of clinical attention but are not considered mental disorders. They correspond to International Classification of Diseases, Ninth Revision, Clinical Modification ICD-9-CM (V-codes) and International Classification of Diseases, Tenth Revision, Clinical Modification ICD-10-CM (Z-codes that become effective in 2015. In most instances, third-party payers do not cover charges for delivering services to an individual if the diagnosis is solely a V- or Z-code alone. If the V- or Z-code is not the primary diagnosis then it should be documented following the primary diagnosis. In addition, when writing the psychosocial assessment any psychosocial and cultural factors that might impact the client's diagnosis should be documented. The psychosocial stressors reflected in these diagnoses are widespread across all classes and cultures and have been shown to impact all aspects of an individual's life from the physical and psychological to the financial. Furthermore, these conditions have been shown to significantly impact the diagnosis and outcome for a multitude of mental and medical disorders. V- and Z-codes are grouped into numerous categories including: relational problems, problems related to abuse/neglect, educational and occupational problems, housing and economic problems, problems related to the social environment, problems related to the legal system, other counseling services, other psychosocial, personal and environmental problems, and problems of personal history (APA, 2013).
Broadly speaking, the category “Relational Problems” describes interactional problems between family members (e.g., parent/caregiver-child) or partners that result in significant impairment of family functioning or development of symptoms in the distressed individual, spouses, siblings, or other family members. Relational problems are broken down into two categories, Problems Related to Family Upbringing and Other Problems Related to Primary Support Group. For example, in the first category a Parent-Child Relational Problem involves interactional problems between one or both parents and a child that lead to dysfunction in behavioral (e.g., inadequate protection, overprotection), cognitive (e.g., antagonism toward or blaming of the other) or affective (e.g., feeling sad and angry) realms. Here, the critical factor is the quality of the parent-child relationship or when the dysfunction in this relationship is impacting the course and outcome of a psychological or medical condition. Other examples include Sibling Relational Problem, Upbringing Away from Parents, and Child Affected by Parental Relationship Distress. Similarly, family relationships and interactional patterns leading to problems related to primary support group include Partner Relational Problem, Disruption of Family by Separation/Divorce, High Expressed Emotion Level with ...
20 Other Conditions That May Be a Focus of Clinical AttentionV-c.docxRAJU852744
20 Other Conditions That May Be a Focus of Clinical Attention
V-codes and z-codes
V-codes and Z-codes are conditions that may be the focus of clinical attention but are not considered mental disorders. They correspond to International Classification of Diseases, Ninth Revision, Clinical Modification ICD-9-CM (V-codes) and International Classification of Diseases, Tenth Revision, Clinical Modification ICD-10-CM (Z-codes that become effective in 2015. In most instances, third-party payers do not cover charges for delivering services to an individual if the diagnosis is solely a V- or Z-code alone. If the V- or Z-code is not the primary diagnosis then it should be documented following the primary diagnosis. In addition, when writing the psychosocial assessment any psychosocial and cultural factors that might impact the client's diagnosis should be documented. The psychosocial stressors reflected in these diagnoses are widespread across all classes and cultures and have been shown to impact all aspects of an individual's life from the physical and psychological to the financial. Furthermore, these conditions have been shown to significantly impact the diagnosis and outcome for a multitude of mental and medical disorders. V- and Z-codes are grouped into numerous categories including: relational problems, problems related to abuse/neglect, educational and occupational problems, housing and economic problems, problems related to the social environment, problems related to the legal system, other counseling services, other psychosocial, personal and environmental problems, and problems of personal history (APA, 2013).
Broadly speaking, the category “Relational Problems” describes interactional problems between family members (e.g., parent/caregiver-child) or partners that result in significant impairment of family functioning or development of symptoms in the distressed individual, spouses, siblings, or other family members. Relational problems are broken down into two categories, Problems Related to Family Upbringing and Other Problems Related to Primary Support Group. For example, in the first category a Parent-Child Relational Problem involves interactional problems between one or both parents and a child that lead to dysfunction in behavioral (e.g., inadequate protection, overprotection), cognitive (e.g., antagonism toward or blaming of the other) or affective (e.g., feeling sad and angry) realms. Here, the critical factor is the quality of the parent-child relationship or when the dysfunction in this relationship is impacting the course and outcome of a psychological or medical condition. Other examples include Sibling Relational Problem, Upbringing Away from Parents, and Child Affected by Parental Relationship Distress. Similarly, family relationships and interactional patterns leading to problems related to primary support group include Partner Relational Problem, Disruption of Family by Separation/Divorce, High Expressed Emotion Level with.
CanJPsychiatry 2012;57(8)464–469On the Self-Stigma of Mental Il.docxjasoninnes20
CanJPsychiatry 2012;57(8):464–469
On the Self-Stigma of Mental Illness: Stages, Disclosure, and Strategies for Change
Patrick W Corrigan, PsyD1; Deepa Rao, PhD, MA2
1 Distinguished Professor and Associate Dean for Research, College of Psychology, Illinois Institute of Technology, Chicago, Illinois. Correspondence: Illinois Institute of Technology, 3424 South State Street, Chicago, IL 60616; [email protected] 2 Research Assistant Professor, Department of Global Health, University of Washington, Seattle, Washington.
Page 464
People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result. In our article, we more fully define the concept of self-stigma and describe the negative consequences of self-stigma for people with mental illness. We also examine the advantages and disadvantages of disclosure in reducing the impact of stigma. In addition, we argue that a key to challenging self-stigma is to promote personal empowerment. Lastly, we discuss individual- and societal-level methods for reducing self-stigma, programs led by peers as well as those led by social service providers.
Les personnes souffrant de maladie mentale font depuis longtemps l’objet de préjugés et de discrimination. Les chercheurs ont pu étudier ce phénomène comme étant celui des stigmates, et ont commencé à examiner des façons de réduire ces stigmates. Les stigmates du public sont la forme prédominante qui a été observée et étudiée, car elle représente les préjugés et la discrimination dirigés vers un groupe par l’ensemble de la population. L’auto-stigmatisation se produit lorsque les gens internalisent ces attitudes du public et par la suite, souffrent de nombreuses conséquences négatives. Dans notre article, nous définissons plus complètement le concept de l’auto-stigmatisation et décrivons les conséquences négatives que l’auto-stigmatisation provoque chez les personnes souffrant de maladie mentale. Nous examinons aussi les avantages et désavantages de la divulgation pour réduire l’effet des stigmates. En outre, nous alléguons qu’un moyen de défier l’auto-stigmatisation consiste à promouvoir l’habilitation personnelle. Enfin, nous présentons des méthodes au niveau individuel et sociétal de réduire l’auto-stigmatisation, des programmes menés par les pairs ainsi que ceux menés par des prestataires de services sociaux.
In making sense of the prejudice and discrimination experienced by people with mental illnesses, researchers have come to distinguish public stigma from self-stigma.1 Public stigma is what commonly comes to mind when discussing the phenomenon, and repre ...
Dr. Salman Kareem will present on social cognition in schizophrenia. Social cognition involves mental processes underlying social interactions and includes perceiving others' intentions. It has several domains impaired in schizophrenia including emotion perception, theory of mind, and attributional style. Social cognition is distinct from neurocognition and negative symptoms, and impacts daily functioning. While treatments show some potential, current medications have not reliably improved social cognition.
The document discusses influences on mental health and illness. It defines mental health as optimal functioning and mental illness as functional impairment. Cultural factors can impact how individuals view and experience mental illness. Prolonged stress can lead to physical and psychological responses like anxiety, defense mechanisms, and potentially psychosis. Diagnosis of mental illness involves using the DSM system across five axes. Treating mental illness faces challenges like stigma, access to care, and cost issues.
Junxian KuangLaura SinaiENG099101572018In the essay O.docxtawnyataylor528
Junxian Kuang
Laura Sinai
ENG099/101
5/7/2018
In the essay “On Being a Cripple”, Nancy Mairs shares her experiences, attitudes towards life as a multiple sclerosis patient. First, she claims that the diseases she has faced are brain tumor and MS, and those diseases literally changed her fate. The relationships of her family member and the attitude of Nancy’s mother have affected by MS. Also, she writes about her identities in society, her friends who have the same physical issue, thoughts from disabled parents’ children, and her desire to travel. MS affected Nancy Mairs’s family member as well as her thoughts.
Subjective Socioeconomic Status Causes Aggression: A Test of the Theory
of Social Deprivation
Tobias Greitemeyer and Christina Sagioglou
University of Innsbruck
Seven studies (overall N � 3690) addressed the relation between people’s subjective socioeconomic
status (SES) and their aggression levels. Based on relative deprivation theory, we proposed that people
low in subjective SES would feel at a disadvantage, which in turn would elicit aggressive responses. In
3 correlational studies, subjective SES was negatively related to trait aggression. Importantly, this
relation held when controlling for measures that are related to 1 or both subjective SES and trait
aggression, such as the dark tetrad and the Big Five. Four experimental studies then demonstrated that
participants in a low status condition were more aggressive than were participants in a high status
condition. Compared with a medium-SES condition, participants of low subjective SES were more
aggressive rather than participants of high subjective SES being less aggressive. Moreover, low SES
increased aggressive behavior toward targets that were the source for participants’ experience of
disadvantage but also toward neutral targets. Sequential mediation analyses suggest that the experience
of disadvantage underlies the effect of subjective SES on aggressive affect, whereas aggressive affect was
the proximal determinant of aggressive behavior. Taken together, the present research found compre-
hensive support for key predictions derived from the theory of relative deprivation of how the perception
of low SES is related to the person’s judgments, emotional reactions, and actions.
Keywords: aggression, relative deprivation, social class, socioeconomic status
In most Western societies, wealth inequality is at its historic
height. For example, in the United States, the richest 1% possesses
more than 40% of the country’s wealth (Wolff, 2012). In Germany,
the biggest economy in the European Union, the median household
in the top 20% of the income class has 74 times more wealth than
the bottom 20% (European Central Bank, 2013). Although there is
widespread consensus among citizens that wealth inequality
should be reduced (Kiatpongsan & Norton, 2014; Norton & Ari-
ely, 2011), the wealth gap is actually increasing. For example, in
the United States, in 2012 the top 0.1% (including ...
This systematic review and meta-analysis examines the evidence for the effectiveness of psychological interventions in reducing internalized stigma among adults with schizophrenia spectrum disorders. The review identified 27 studies that met eligibility criteria. Meta-analysis of 18 studies found a statistically significant overall effect in lowering internalized stigma. Subgroup analysis found Narrative Enhancement and Cognitive Therapy to have a statistically significant and highly homogenous effect. In conclusion, most psychological interventions are successful in reducing internalized stigma, especially NECT, and combining multiple therapies may be more beneficial.
The document discusses the philosophy and practice of clinical outpatient therapy. It begins with a disclaimer stating the purpose is to improve therapy practice through a deeper understanding of methods. It then provides biographical information about the author, including their experience and training in substance abuse counseling, community mental health, and family therapy models from the 1970s-1990s. The document goes on to discuss perspectives on the causes of psychosis, including biological, psychological, and hybrid models. It also addresses the debate around treating psychosis primarily through medication versus psychotherapy.
Cognitive-behavioral therapy (CBT) is an effective treatment for social phobia. CBT aims to change negative thoughts and beliefs that cause social phobia by teaching skills like exposure therapy. It has advantages like helping patients learn to challenge cognitive distortions and gain support from group members. However, it also has disadvantages as social phobia patients fear evaluation and criticism, making group therapy difficult for some. CBT can be time-limited but has shown success in treating symptoms of social phobia in both children and adults.
1PAGE 21. What is the question the authors are asking .docxfelicidaddinwoodie
1
PAGE
2
1. What is the question the authors are asking?
They asked about a reduction in judgmental biases regarding the cost and probability associated with adverse social events as they are presumed as being mechanisms for the treatment of Social Anxiety Disorder (SAD). Also, the authors poised on the changes in judgmental biases as mechanisms to explain cognitive-behavioral therapy for social anxiety disorder. On top of that, they stated that methodological limitations extant studies highlight the possibility that rather than causing symptom relief, a significant reduction in judgmental biases tends to be consequences of it or correlate. Considerably, they expected cost bias at mid-treatment to be a predictor of the treatment outcome.
2. Why do the authors believe this question is important?
According to the authors, this question was relevant as methodological limitations of present studies reflect on the possibility that instead of causing symptom belief, a significant reduction in judgmental biases can be consequences or correlated to it. Additionally, they ought to ascertain the judgment bias between treated and non-treated participants. Significantly, this was important as they had to determine the impact of pre and post changes in cost and probability of the treatment outcomes. But, probability bias at mid-treatment was a predictor of the treatment outcome contrary to the cost bias at mid-treatment that could not be identified as a significant predictor of the treatment outcome.
3. How do they try to answer this question?
They conducted a study to evaluate the significant changes in judgmental bias as aspects of cognitive-behavioral therapy for social anxiety disorders. To do this, they conducted a study using information from two treatment studies; an uncontrolled trial observing amygdala activity as a response to VRE (Virtual Reality Exposure Therapy) with the use of functional magnetic resonance imaging and a randomized control trial that compared Virtual Reality Exposure Therapy with Exposure Group Therapy for SAD. A total of 86 individuals who met the DSM-IV-TR criteria for the diagnosis of non-generalized (n=46) and generalized (n=40) SAD participated. After completing eight weeks of the treatment protocol, the participants who identified public speaking as their most fearsome social situation were included. The SCID (Structured clinical interview for the DSM-IV) was used to ascertain diagnostic and eligibility status on Axis 1 conditions within substance abuse, mood and anxiety disorder modules. The social anxiety measures were measured with the use of BFNE (Brief Fear of Negative Evaluation), a self-reporting questioner that examined the degree to which persons fear to be assessed by other across different social settings. Additionally, the OPQ (Outcome Probability Questionnaire) self-reporting questionnaire was used to evaluate individual’s estimate on the probability that adverse, threatening events will occur at t ...
Running Head ADVANCED NURSING RESEARCH1ADVANCED NURSING RES.docxtoddr4
Running Head: ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH
4
Advanced Nursing Research (Research Study)
Student Name
Institution-Affiliated
Different Parts of a Research Study
Research topic
A systematic review of the association between stigma and or on help-seeking among mental health patients.
Research Problem
Stigma or the process of labelling, discrimination and prejudice towards individuals suffering from mental health problems is considered to have numerous adverse consequences compared to the health conditions themselves according to Thornicroft, Mehta, Clement, Evans-Lacko, Doherty, Rose & Henderson, (2016). In addition, research has found stigma to be responsible for the failure of numerous individuals suffering from mental health to seek help from both their close relatives or trusted individuals and from healthcare providers (Clement, Schauman, Graham, Maggioni, Evans-Lacko, Bezborodovs, Thornicroft, 2015).
Given an increase in mental health disorders and the challenges that such disorders pose to both individuals and society, numerous studies have been conducted to examine the association between stigma and help-seeking among mental health patients. However, research has largely focused on the attitudes that constitute stigma towards mental health patients and little on the interventions required to reduce or eradicate stigma. Moreover, since the failure to reduce stigma prevents mental health patients from seeking help and hence worsening their conditions, there is need for further studies regarding the association between stigma and help-seeking and the need to reduce stigma making the study not only relevant but significant.
Research purpose
The purpose of this paper is to explore the association between stigma and help-seeking among mental health patients and to identify proven strategies or actionable recommendation for reducing stigma.
Research objectives
The objective of the study will be to (1) Explore the extent to which stigma posses a barrier to help-seeking among mental health patients, (2) Identify whether stigma affects certain populations more than others and (3) propose strategies that can help reduce stigma.
Research question
The study will aim to answer the following questions (1) What is the association between stigma towards mental health patients and help-seeking? (2) To what extent does stigma constitute a barrier to the search for help among mental health patients and (3) Are there populations that are more deterred from seeking help due to stigma?
Research hypothesis
Ho: Stigma towards mental health patients deters them from seeking help
Ha: There is no association between stigma and the search for help among mental health patients.
In addition, the study hypothesizes that a reduction in stigma would result in increased help-seeking among mental health patients.
References
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., ... & Thornicroft, G. (2.
Due Facilitating group to post by Day 1; all other students post AlyciaGold776
The facilitating group posted discussion prompts on somatization disorder, depression, and the link between social media use and depression in adolescents.
For somatization disorder, they asked how therapeutic interventions would be formulated and how success would be evaluated. For depression, they asked how views on living with depression may have changed after watching a video, what interventions and resources would be used and how treatment success would be evaluated. For social media and adolescent depression, they asked for non-pharmacological interventions and an appropriate medication choice along with important patient education.
A peer responded by discussing screening and treatment of somatization disorder including psychotherapy and medications. For depression, the peer discussed the neurobiology, diagnostic criteria, treatment options of
The document outlines a program proposal called "Stop the Stigma" aimed at educating the Bulloch County community about mental illness and reducing stigma. It discusses the prevalence of mental illness in the US and defines the different types of stigma (public, self, institutional). A literature review found that anti-stigma interventions can help increase mental health literacy. The proposal describes conducting an interactive activity to differentiate facts/myths about mental illness, followed by a video and lecture. Pre- and post-tests would measure changes in knowledge about mental illness among participants from a local NAMI chapter. The goal is to encourage help-seeking and support for those with mental illness.
This document discusses social cognition in individuals with bipolar disorder. It begins by defining social cognition and outlining its key dimensions. It then reviews studies comparing social cognition abilities in individuals with bipolar disorder versus healthy controls. The studies show impairments in areas like theory of mind, emotion processing, and attributional biases. Differences are also seen between bipolar type I and II. While some social cognition abilities are preserved, deficits tend to be more pronounced than in individuals with schizophrenia. Overall, the document analyzes research on social cognition challenges in bipolar disorder.
ALCohoL ReSeARCh C u r r e n t R e v i e w s506 Alcohol .docxADDY50
ALCohoL ReSeARCh: C u r r e n t R e v i e w s
506 Alcohol Research: C u r r e n t R e v i e w s
Resilience to Meet the
Challenge of Addiction
Psychobiology and Clinical Considerations
Tanja N. Alim, M.D.; William B. Lawson, M.D.; Adriana Feder, M.D.; Brian M.
Iacoviello, Ph.D.; Shireen Saxena, M.S.; Christopher R. Bailey; Allison M.
Greene, M.S.; and Alexander Neumeister, M.D.
Tanja N. Alim, M.D., is an assis-
tant professor and William B.
Lawson, M.D., is a professor
and chair of the Department
of Psychiatry, both at the
Department of Psychiatry and
Behavioral Sciences, Howard
University, Washington, DC.
Adriana Feder, M.D., is an assistant
professor; Brian M. Iacoviello,
Ph.D., is a postdoctoral fellow;
and Shireen Saxena, M.S.,
Christopher R. Bailey, and
Allison M. Greene, M.S., are
research associates; all at the
Mood and Anxiety Disorders
Program, Department of Psychiatry,
Mount Sinai School of Medicine,
New York, New York.
Alexander Neumeister, M.D., is
a professor in the Department of
Psychiatry and Radiology, New
York University Langone Medical
Center, New York, New York.
Acute and chronic stress–related mechanisms play an important role in the
development of addiction and its chronic, relapsing nature. Multisystem adaptations in
brain, body, behavioral, and social function may contribute to a dysregulated
physiological state that is maintained beyond the homeostatic range. In addition,
chronic abuse of substances leads to an altered set point across multiple systems.
Resilience can be defined as the absence of psychopathology despite exposure to
high stress and reflects a person’s ability to cope successfully in the face of adversity,
demonstrating adaptive psychological and physiological stress responses. The study of
resilience can be approached by examining interindividual stress responsibility at
multiple phenotypic levels, ranging from psychological differences in the way people
cope with stress to differences in neurochemical or neural circuitry function. The
ultimate goal of such research is the development of strategies and interventions to
enhance resilience and coping in the face of stress and prevent the onset of addiction
problems or relapse. Key WoRDS: Addiction; substance abuse; stress; acute stress
reaction; chronic stress reaction; biological adaptation to stress; psychological
response to stress; physiological response to stress; resilience; relapse; coping
skills; psychobiology
evidence from different disciplinessuggests that acute and chronicstress–related mechanisms play
an important role in both the develop-
ment and the chronic, relapsing nature
of addiction (Baumeister 2003; Baumeister
et al. 1994; Brady and Sinha 2005).
Stress is defined as the physiological
and psychological process resulting from
a challenge to homeostasis by any real
or perceived demand on the body
(Lazarus and Fokman 1984; McEwen
2000; Selye 1976). Stress often induces
multisystem adaptations that occur in
the brain and .
ALCohoL ReSeARCh C u r r e n t R e v i e w s506 Alcohol .docxSHIVA101531
ALCohoL ReSeARCh: C u r r e n t R e v i e w s
506 Alcohol Research: C u r r e n t R e v i e w s
Resilience to Meet the
Challenge of Addiction
Psychobiology and Clinical Considerations
Tanja N. Alim, M.D.; William B. Lawson, M.D.; Adriana Feder, M.D.; Brian M.
Iacoviello, Ph.D.; Shireen Saxena, M.S.; Christopher R. Bailey; Allison M.
Greene, M.S.; and Alexander Neumeister, M.D.
Tanja N. Alim, M.D., is an assis-
tant professor and William B.
Lawson, M.D., is a professor
and chair of the Department
of Psychiatry, both at the
Department of Psychiatry and
Behavioral Sciences, Howard
University, Washington, DC.
Adriana Feder, M.D., is an assistant
professor; Brian M. Iacoviello,
Ph.D., is a postdoctoral fellow;
and Shireen Saxena, M.S.,
Christopher R. Bailey, and
Allison M. Greene, M.S., are
research associates; all at the
Mood and Anxiety Disorders
Program, Department of Psychiatry,
Mount Sinai School of Medicine,
New York, New York.
Alexander Neumeister, M.D., is
a professor in the Department of
Psychiatry and Radiology, New
York University Langone Medical
Center, New York, New York.
Acute and chronic stress–related mechanisms play an important role in the
development of addiction and its chronic, relapsing nature. Multisystem adaptations in
brain, body, behavioral, and social function may contribute to a dysregulated
physiological state that is maintained beyond the homeostatic range. In addition,
chronic abuse of substances leads to an altered set point across multiple systems.
Resilience can be defined as the absence of psychopathology despite exposure to
high stress and reflects a person’s ability to cope successfully in the face of adversity,
demonstrating adaptive psychological and physiological stress responses. The study of
resilience can be approached by examining interindividual stress responsibility at
multiple phenotypic levels, ranging from psychological differences in the way people
cope with stress to differences in neurochemical or neural circuitry function. The
ultimate goal of such research is the development of strategies and interventions to
enhance resilience and coping in the face of stress and prevent the onset of addiction
problems or relapse. Key WoRDS: Addiction; substance abuse; stress; acute stress
reaction; chronic stress reaction; biological adaptation to stress; psychological
response to stress; physiological response to stress; resilience; relapse; coping
skills; psychobiology
evidence from different disciplinessuggests that acute and chronicstress–related mechanisms play
an important role in both the develop-
ment and the chronic, relapsing nature
of addiction (Baumeister 2003; Baumeister
et al. 1994; Brady and Sinha 2005).
Stress is defined as the physiological
and psychological process resulting from
a challenge to homeostasis by any real
or perceived demand on the body
(Lazarus and Fokman 1984; McEwen
2000; Selye 1976). Stress often induces
multisystem adaptations that occur in
the brain and .
This document analyzes how peers label and stigmatize other youth with mental illness using Modified Labeling Theory. It finds that self-labeling predicts negative outcomes for youth but some refuse clinical labels. Anti-stigma campaigns using contact with those with mental illness and youth-led initiatives show effectiveness, though effects may decline after the program ends. The theory is then used to evaluate components of anti-stigma campaigns.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
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Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
How to Build a Module in Odoo 17 Using the Scaffold MethodCeline George
Odoo provides an option for creating a module by using a single line command. By using this command the user can make a whole structure of a module. It is very easy for a beginner to make a module. There is no need to make each file manually. This slide will show how to create a module using the scaffold method.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
আমাদের সবার জন্য খুব খুব গুরুত্বপূর্ণ একটি বই ..বিসিএস, ব্যাংক, ইউনিভার্সিটি ভর্তি ও যে কোন প্রতিযোগিতা মূলক পরীক্ষার জন্য এর খুব ইম্পরট্যান্ট একটি বিষয় ...তাছাড়া বাংলাদেশের সাম্প্রতিক যে কোন ডাটা বা তথ্য এই বইতে পাবেন ...
তাই একজন নাগরিক হিসাবে এই তথ্য গুলো আপনার জানা প্রয়োজন ...।
বিসিএস ও ব্যাংক এর লিখিত পরীক্ষা ...+এছাড়া মাধ্যমিক ও উচ্চমাধ্যমিকের স্টুডেন্টদের জন্য অনেক কাজে আসবে ...
1. A Stress-Coping Model of Mental Illness Stigma: II. Emotional
Stress Responses, Coping Behavior and Outcome
Nicolas Rüscha,b, Patrick W. Corrigana, Karina Powella, Anita Rajaha, Manfred
Olschewskic, Sandra Wilknissd, and Karen Batiae
a Illinois Institute of Technology, Chicago
b Department of Psychiatry and Psychotherapy, University of Freiburg, Germany
c Department of Medical Biometry and Statistics, University of Freiburg, Germany
d Thresholds Institute, Chicago
e Heartland Alliance for Human Needs & Human Rights, Chicago
Abstract
Stigma can be a major stressor for people with schizophrenia and other mental illnesses, leading to
emotional stress reactions and cognitive coping responses. Stigma is appraised as a stressor if
perceived stigma-related harm exceeds an individual’s perceived coping resources. It is unclear,
however, how people with mental illness react to stigma stress and how that affects outcomes such
as self-esteem, hopelessness and social performance. The cognitive appraisal of stigma stress as well
as emotional stress reactions (social anxiety, shame) and cognitive coping responses were assessed
by self-report among 85 people with schizophrenia, schizoaffective or affective disorders. In addition
to self-directed outcomes (self-esteem, hopelessness), social interaction with majority outgroup
members was assessed by a standardized role-play test and a seating distance measure. High stigma
stress was associated with increased social anxiety and shame, but not with cognitive coping
responses. Social anxiety and shame predicted lower self-esteem and more hopelessness, but not
social performance or seating distance. Hopelessness was associated with the coping mechanisms of
devaluing work/education and of blaming discrimination for failures. The coping mechanism of
ingroup comparisons predicted poorer social performance and increased seating distance. The
cognitive appraisal of stigma-related stress, emotional stress reactions and coping responses may add
to our understanding of how stigma affects people with mental illness. Trade-offs between different
stress reactions can explain why stress reactions predicted largely negative outcomes. Emotional
stress reactions and dysfunctional coping could be useful targets for interventions aiming to reduce
the negative impact of stigma on people with mental illness.
Keywords
stigma; stress; coping; anxiety; shame; self-esteem; hopelessness; social performance
Send all correspondence to Nicolas Rüsch, Joint Research Programs in Psychiatric Rehabilitation, Illinois Institute of Technology, 3424
S State Street, Chicago IL 60616, USA. Email: E-mail: nicolas.ruesch@uniklinik-freiburg.de, Phone: 312 567 7969, Fax: 312 567 6753.
Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers
we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting
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NIH Public Access
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Published in final edited form as:
Schizophr Res. 2009 May ; 110(1-3): 65–71. doi:10.1016/j.schres.2009.01.005.
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2. 1. INTRODUCTION
Stigma is a stressor for many people with schizophrenia and other mental illnesses and therefore
a major clinical and public health issue (Corrigan, 2005; Hinshaw, 2007; Thornicroft, 2006).
Yet some individuals with mental illness are demoralized by stigma while others remain
relatively unaffected (Corrigan and Watson, 2002; Rüsch et al., 2006b). In part 1 of this two-
part paper, we discussed public and personal predictors of stigma stress, that is whether
stigmatized individuals feel that the potential harm of stigma exceeds their resources to cope
with this threat (Rüsch et al., submitted). In part 2, we apply the same social-psychological
stress-coping model of stigma (Major and O’Brien, 2005) to examine emotional and cognitive
reactions to stigma stress appraisal and how these reactions affect broader outcomes for
stigmatized individuals (Figure 1). While previous work investigated other stressors and coping
in schizophrenia (Betensky et al., 2008; Cooke et al., 2007; Myin-Germeys and van Os,
2007; Roe et al., 2006), we focus here on stigma-related stress and its consequences. This can
provide a better understanding of how stigma affects people with mental illness and help to
identify targets for interventions that aim to reduce stigma’s negative impact (Knight et al.,
2006; Lysaker et al., 2007a; MacInnes and Lewis, 2008).
Reactions to stigma stress can explain why individuals cope more or less successfully with
stigma. Stress appraisal leads to two sets of responses (Figure 1), involuntary emotional
reactions and deliberate cognitive coping responses. Two key emotions in the context of stigma
are social anxiety and shame (Lazarus, 1993). Social anxiety is a reaction to stigma as a threat
in social interactions (Spencer et al., 1999). Likewise, shame is prominent in mental illness
(Rüsch et al., 2007b), an emotional correlate of internalized stigma (Rüsch et al., 2006a) and
a reaction to being socially exposed and humiliated as a devalued person (Lewis, 1998). This
is consistent with findings that shame and social anxiety are consequences of social devaluation
among members of the public (Gilbert and Miles, 2000) and of stigmatizing experiences in
persons with psychosis (Birchwood et al., 2007).
Coping responses, on the other hand, are conscious and volitional regulation efforts in response
to stressors (Miller, 2006). In their classic paper, Crocker and Major (1989) explored three
coping mechanisms that can help preserve the self-esteem of stigmatized individuals. First,
group members can devalue domains in which their group stereotypically performs poorly,
such as work and education in the case of people with mental illness. Negative feedback or
failures such as unemployment are then less likely to have a negative impact on the person
because these domains become peripheral in the person’s self-concept. The second coping
mechanism is to compare oneself primarily with ingroup members, i.e. with other people with
mental illness; because other ingroup members are likely to be similarly disadvantaged,
ingroup comparisons are usually less painful and self-esteem threatening than comparisons
with more advantaged majority outgroup members (i.e., members of the public). Third, a person
may choose to attribute negative feedback to discrimination rather than to internal causes such
as lack of ability, blaming discrimination instead of blaming the self (Major et al., 2003).
Emotional or cognitive stress responses influence global outcomes. No reaction to stigma is
universally beneficial or detrimental (Major and O’Brien, 2005) because one coping response
may be helpful in one domain but harmful in another. For example, a person with mental illness
may use the coping mechanism of ingroup comparisons to stabilize self-esteem. However, lack
of outgroup comparisons may undermine motivation and learning opportunities, resulting in
lower academic, vocational or social performance in the long run. Therefore we measured four
outcomes, two of which are related to a person’s self-image and two to social performance.
First we studied self-esteem and hopelessness as a pair of self-directed outcomes. Self-esteem
is of interest because the above-mentioned cognitive coping responses can protect self-esteem
(Crocker and Major, 1989; Major et al., 2003) and experiencing stigma is often associated with
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3. lower self-esteem (Corrigan et al., 2006; Link et al., 2001; Lysaker et al., 2007b, 2008b; Rüsch
et al., 2006a; Wright et al., 2000; Yanos et al., 2008). Hopelessness, as a negative self-directed
outcome, is a proxy for demoralization as a consequence of stigma, its relevance being
underlined by its association with suicidality (Brezo et al., 2006). Although not assessing
stigma stress appraisal, previous studies found aspects of internalized stigma, such as feeling
devalued or agreeing with negative stereotypes, and impaired self-experience as reflected by
illness narratives to be associated with reduced hope in schizophrenia (Lysaker et al., 2006,
2008a; Yanos et al., 2008). A second pair of outcomes referred to social behavior in the
interaction with “normal” majority outgroup members, who are often the source of stigma.
Social behavior was measured by a standardized role-play test and a seating distance measure.
We examined the hypotheses that first, higher stigma-induced stress appraisal predicts higher
levels of emotional stress reactions and cognitive coping responses; and second, that emotional
and cognitive stress responses predict broader outcomes.
2. MATERIALS AND METHODS
2.1. Participants
In part 1 (Rüsch et al., submitted) we reported details of study participants. Briefly, 85 persons
with mental illness participated. Twenty-three (27%) participants had schizophrenia, 22 (26%)
schizoaffective, 30 (35%) bipolar I or II, and the remaining 10 (12%) recurrent unipolar major
depressive disorders. Overall, 33 subjects (39%) suffered from a comorbid current alcohol- or
substance-related abuse or dependence.
2.2. Emotional and cognitive responses to stigma stress
Social anxiety and shame were measured as involuntary emotional responses to stigma. Social
anxiety was assessed by the fear score of the Liebowitz Social Anxiety scale (Liebowitz,
1987), with a sum score across 24 situations (Cronbach’s alpha=.92). Shame-proneness in
social situations was measured by Tangney’s Test of Self-Conscious Affect (TOSCA-3;
Tangney et al., 2000), a scenario-based self-report questionnaire. We used a short version,
validated by Tangney and colleagues, that consists of 11 negative instead of 16 scenarios
(Cronbach’s alpha=.75; Rüsch et al., 2007a).
Three voluntary, cognitive coping responses to mental illness stigma were measured following
Crocker and Major (1989). First, devaluing domains in which the stigmatized group
stereotypically performs poorly, such as work and education in the case of people with mental
illness (‘I care a lot if I am successful in terms of work, training or education’); second, ingroup
comparisons (‘When I think about my successes or failures and how I compare to others, I
primarily compare myself to other people who also have a mental illness, not so much to
“normals” ’); and third attributing negative outcomes to discrimination (‘When I suffer a
setback and don’t achieve something I wanted, for example looking for a job or an apartment,
I usually think: “I did not get what I wanted because other people discriminated against me
because of my mental illness” ’). After reverse-coding the first, higher scores from 1 to 9
indicated stronger endorsement of the respective coping mechanisms.
2.3. Outcomes
General self-esteem was measured using Rosenberg’s ten-item Self-Esteem Scale with an
average score between 0 and 3 (Cronbach’s alpha=.88; Rosenberg, 1965). Hopelessness, a
proxy for demoralization as a possible consequence of stigma, was assessed by Beck’s 20-item
Hopelessness Scale (Beck et al., 1974; Steed, 2001) with higher sum scores between 20 and
100 indicating more hopelessness (Cronbach’s alpha=.92). We used a standardized and widely
used role-play test, the Maryland Assessment of Social Competence (Bellack et al., 2006;
Sayers et al., 1995), as a measure of social performance in the pursuit of social, treatment- and
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4. employment-related goals and of the ability and motivation to interact with outgroup members
in order to achieve goals in domains that are threatened by stigma. Following a short practice
scene, three social scenes, three minutes each, were administered by a trained confederate. We
adapted three scenes that were provided by Dr. Bellack. The first involved speaking with a
new neighbor; the second scene required talking to a psychiatrist about difficulties with new
medication and symptom monitoring; in the last scene the participant had to negotiate with a
supervisor of a job training program. Role-plays were videotaped and rated in terms of
conversational and non-verbal content and effectiveness from 1, very poor, to 5, very good.
Interrater reliability between three raters that rated all subjects was high with intra-class
correlation coefficients 0.85 for verbal content, 0.84 for non-verbal content and 0.90 for
effectiveness, respectively. To derive an index of overall social performance, we calculated a
mean score across the three scenes and evaluated domains.
To measure social distance from “normal” majority group members (Penn and Corrigan,
2002), participants were asked to go to another room in which they found a table with a single
seat at the head and four chairs along the length. It was explained that a “healthy and talkative”
man/woman (always the gender of the participant) would arrive in a minute, sit down in the
single seat at the head of the table and talk to the participant. The participant was then asked
to sit down in one of the four chairs on the side of the table. Once the participant sat down, the
seat number was recorded (between 1 and 4, with higher numbers indicating increased distance
from the talkative healthy person).
3. RESULTS
3.1. Stress appraisal, reactions and outcomes across diagnostic groups
We examined possible differences in levels of cognitive stress appraisal, emotional stress
reactions, coping responses and outcomes between the four groups of subjects with
schizophrenia, schizoaffective disorder, bipolar disorder or unipolar depression. Analyses of
variance did not indicate significant group effects, except for the coping mechanism of ingroup
comparisons (F=2.84, p=.04) and hopelessness (F=3.01, p=.04). Post-hoc Scheffé tests showed
significantly higher use of ingroup comparisons in the schizophrenia (M=4.7, SD=2.5) than in
the bipolar group (M=2.9, SD=1.8; p=.049); and a trend for less hopelessness in the
schizophrenia (M=40.9, SD=12.5) than in the unipolar depression group (M=55.5, SD=17.5,
p=.10). Other group differences were non-significant. Subjects with versus without substance-
or alcohol-related disorders did not differ with respect to stress appraisal, stress reactions or
outcomes (all p-values >.20).
3.2. Stress appraisal and emotional and cognitive responses
As far as our first hypothesis was concerned, higher cognitive appraisal of stigma stress was
associated with more social anxiety (r=.24, p=.02) and shame (r=.25, p=.02). Examining the
association of primary and secondary appraisals, that underlie stress appraisal, with emotional
stress reactions, we found that more perceived resources to cope with stigma were related to
decreased social anxiety (r=−.23, p=.03); perceiving stigma as more harmful was linked to
higher levels of shame (r=.26, p=.02). Cognitive stress appraisal, on the other hand, was not
significantly related to any of the three cognitive coping responses (p-values >.40).
3.3. Correlations between stress responses and outcomes
With regard to our second hypothesis, higher levels of both social anxiety and shame were
associated with low self-esteem and more hopelessness, but not with behavioral measures,
except for a link between more social anxiety and increased seating distance from outgroup
members (Table 1). On the other hand, stronger endorsement of all three cognitive coping
responses was associated with increased seating distance; and proneness to ingroup
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5. comparisons was strongly linked to poorer social performance. None of the cognitive coping
responses were related to self-esteem, but two coping mechanisms, devaluing work/education
and blaming discrimination, were significantly associated with more hopelessness.
3.4. Regressions on outcomes
Regressions on each of the four outcome variables examined the five emotional and cognitive
stress response variables as predictors of outcome to investigate whether univariately
significant predictors acted independently (Table 2). Because of its skewed distribution, seating
distance was coded as a binary dependent variable (close, score 1 or 2, versus distant, score 3
or 4) in a logistic regression (Table 2). The five independent variables in these regressions were
only moderately interrelated (all correlation coefficients <.50). Reduced self-esteem and
increased hopelessness were independently predicted by the emotional stress reactions of social
anxiety and shame. The cognitive coping response of devaluing work/education predicted more
hopelessness beyond the variance explained by shame and social anxiety. Regarding behavioral
outcome measures, endorsement of ingroup comparisons as a coping mechanism predicted
both poorer social performance and increased seating distance from outgroup members. Social
anxiety or shame did not predict behavioral measures beyond the variance explained by coping
responses.
We then repeated the four regression analyses to control for two possible confounding variables
(Table 3), depressive symptoms and diagnosis of schizophrenia or schizoaffective disorder
(versus bipolar disorder or unipolar depression). Because the subgroup comparisons had not
shown any significant group differences between the schizophrenia and schizoaffective group,
both were collapsed into one diagnostic category and contrasted with affective disorders as an
independent dummy variable. Diagnosis did not predict any of the outcomes, while depressive
symptoms predicted self-directed outcomes but not behavior (Table 3). After controlling for
depression, social anxiety remained a significant predictor of self-esteem and hopelessness,
but shame did not. Devaluing work and education remained a significant predictor of
hopelessness; and ingroup comparisons still predicted social performance, but predicted
seating distance only at a trend level.
Since correlations and regressions supported the link between stress appraisal, emotional
responses (social anxiety and shame) and two outcome variables (self-esteem and
hopelessness), additional regression analyses examined whether the effect of stress appraisal
on self-esteem and hopelessness was mediated by emotional responses. Stress appraisal was
regressed on self-esteem and hopelessness first by itself and then together with social anxiety
and shame. According to Baron and Kenny (1986) a mediational model is supported if the
independent variable (stress appraisal) predicts the dependent variable (self-esteem or
hopelessness), but is no longer significant in the full model that includes the mediator variables
(shame and social anxiety). While stress appraisal, when regressed on self-esteem or
hopelessness alone, was significant (p=.005 and p=.015, respectively), it turned non-significant
(p=.10 and p=.23, respectively) after adding shame and social anxiety as independent variables
to the equation.
4. DISCUSSION
We tested a model of cognitive appraisal of stigma-induced stress and its consequences,
emotional stress reactions and coping responses, that in turn shape broader outcomes (Major
and O’Brien, 2005) among people with schizophrenia and other mental illnesses. Part 1 of this
study discussed predictors of stigma-related stress appraisal and here in part 2 we investigated
the consequences of stigma stress. Our first hypothesis on the link between stress appraisal and
responses was supported for involuntary emotional responses, underlining the role of shame
and social anxiety for stigmatized individuals (Birchwood et al., 2007; Lewis, 1998; Rüsch et
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6. al., 2006a; Spencer et al., 1999). However, we could not find evidence for the hypothesized
impact of stress appraisal on cognitive coping mechanisms. Stigma stress as well as coping
responses play out partly in threatening situations in which stigmatizing cues become salient
(Kaiser et al., 2004; McCoy and Major, 2003) which may limit the sensitivity of our trait-based
investigation.
Our second hypothesis regarding stress responses and outcomes was partially supported.
Mediating the influence of stress appraisal on self-directed outcomes, emotional stress
responses predicted self-esteem and hopelessness but, unlike cognitive coping responses, were
largely unrelated to social performance. Emotional stress responses, particularly social anxiety,
predicted a negative self-concept as indicated by hopelessness and low self-esteem even after
controlling for depressive symptoms and diagnosis. Cognitive coping mechanisms, on the other
hand, were more predictive of social performance than of self-directed outcomes. Devaluing
work and education, which predicted hopelessness beyond the variance explained by shame
and social anxiety, seems a particularly problematic coping style. Distancing oneself from this
domain may have short-term benefits for self-esteem in case of professional failures, but
reduces long-term hope to compete professionally even after taking depressive symptoms and
diagnosis into account. All cognitive coping responses were associated with increased seating
distance from “normal” majority outgroup members which is plausible because these coping
responses imply cognitive distancing from outgroup standards.
Crocker and Major (1989) pointed out potential negative consequences of the self-protective
coping strategies which was underlined by our finding of a strong association between the
coping style of ingroup comparisons and poor social performance. Ingroup comparisons may
buffer self-esteem, but they can undermine motivation and achievement in various domains.
Upward comparisons with advantaged outgroups, on the contrary, increase performance even
if lowering self-esteem (Seaton et al., 2008). This highlights the unfortunate fact that for
stigmatized individuals there is no easy way out. The coping strategy of ingroup comparisons,
facilitated by social segregation typical for many people with serious mental illness, may come
at the price of decreased social performance.
Before drawing conclusions, limitations of our study have to be considered. First, our data are
cross-sectional and therefore cannot determine causality. While this stress-coping model of
stigma (Major and O’Brien, 2005) plausibly suggests that stress leads to stress reactions which
in turn influence outcomes, reverse causality or feedback loops are possible and longitudinal
studies need to investigate the direction of causal relationships. Second, stigma stress and
responses are often related to threatening situations which were not assessed by the trait-
measures in our study. Third, involuntary stress responses like decreased test performance
(Quinn et al., 2004) or physiological reactions (Blascovich et al., 2001), other coping
mechanisms beyond those examined in our study (Roe et al., 2006) and additional outcomes
such as health or educational achievement should be investigated in future research.
Nevertheless, our findings highlight the role of cognitive appraisal of stigma-related stress as
well as emotional and cognitive reactions that in turn shape broader outcomes. Our results were
mostly independent of psychiatric diagnosis which is consistent with stigma as a stressor across
different mental illnesses.
In part 1 we had identified factors that predict the perception of mental illness stigma as stressful
and therefore may render stigmatized individuals more vulnerable to stigma stress. In part 2
we found evidence that stigma stress leads to both involuntary emotional reactions and
cognitive coping responses which in turn shape broader outcomes. Both parts support the stress-
coping model of stigma (Major and O’Brien, 2005) when applied to people with schizophrenia
and other mental illnesses. Our findings have implications for interventions that aim to reduce
stigma-related stress and thus the negative impact of public stigma on stigmatized individuals,
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7. whether in group programs (Knight et al., 2006; MacInnes and Lewis, 2008) or in individual
settings using narrative approaches (Lysaker et al., 2007a). These interventions could address
emotional stress reactions such as social anxiety and shame as well as coping responses that
offer a short-term relief, but may undermine long-term outcomes.
Reference List
Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research:
Conceptual, strategic, and statistical considerations. Journal of Personality & Social Psychology
1986;51:1173–1182. [PubMed: 3806354]
Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: The Hopelessness Scale.
Journal of Consulting & Clinical Psychology 1974;42:861–865. [PubMed: 4436473]
Bellack AS, Brown CH, Thomas-Lohrman S. Psychometric characteristics of role-play assessments of
social skill in schizophrenia. Behavior Therapy 2006;37:339–352. [PubMed: 17071212]
Betensky JD, Robinson DG, Gunduz-Bruce H, Sevy S, Lencz T, Kane JM, Malhotra AK, Miller R,
McCormack J, Bilder RM, Szeszko PR. Patterns of stress in schizophrenia. Psychiatry Research
2008;160:38–46. [PubMed: 18514323]
Birchwood M, Trower P, Brunet K, Gilbert P, Iqbal Z, Jackson C. Social anxiety and the shame of
psychosis: a study in first episode psychosis. Behaviour Research & Therapy 2007;45:1025–1037.
[PubMed: 17005158]
Blascovich J, Spencer SJ, Quinn D, Steele C. African Americans and high blood pressure: The role of
stereotype threat. Psychological Science 2001;12:225–229. [PubMed: 11437305]
Brezo J, Paris J, Turecki G. Personality traits as correlates of suicidal ideation, suicide attempts, and
suicide completions: A systematic review. Acta Psychiatrica Scandinavica 2006;113:180–206.
[PubMed: 16466403]
Cooke M, Peters E, Fannon D, Anilkumar AP, Aasen I, Kuipers E, Kumari V. Insight, distress and coping
styles in schizophrenia. Schizophrenia Research 2007;94:12–22. [PubMed: 17561377]
Corrigan, PW. On the stigma of mental illness: Practical strategies for research and social change.
American Psychological Association; Washington: 2005.
Corrigan PW, Watson AC. The paradox of self-stigma and mental illness. Clinical Psychology: Science
& Practice 2002;9:35–53.
Corrigan PW, Watson AC, Barr L. The self-stigma of mental illness: Implications for self-esteem and
self-efficacy. Journal of Social & Clinical Psychology 2006;25:875–884.
Crocker J, Major B. Social stigma and self-esteem: The self-protective properties of stigma. Psychological
Review 1989;96:608–630.
Gilbert P, Miles JNV. Sensitivity to social put-down: Its relationship to perceptions of social rank, shame,
social anxiety, depression, anger and self-other blame. Personality and Individual Differences
2000;29:757–774.
Hinshaw, SP. The mark of shame: Stigma of mental illness and an agenda for change. Oxford University
Press; Oxford: 2007.
Kaiser CR, Major B, McCoy SK. Expectations about the future and the emotional consequences of
perceiving prejudice. Personality & Social Psychology Bulletin 2004;30:173–184. [PubMed:
15030632]
Knight MTD, Wykes T, Hayward P. Group treatment of perceived stigma and self-esteem in
schizophrenia: A waiting list trial of efficacy. Behavioural and Cognitive Psychotherapy
2006;34:305–318.
Lazarus RS. From psychological stress to the emotions: A history of changing outlooks. Annual Review
of Psychology 1993;44:1–21.
Lewis, M. Shame and stigma Shame. In: Gilbert, P.; Andrews, B., editors. Interpersonal behavior,
psychopathology, and culture. Oxford University Press; Oxford: 1998. p. 126-140.
Liebowitz MR. Social phobia. Modern Problems of Pharmacopsychiatry 1987;22:141–173. [PubMed:
2885745]
Rüsch et al. Page 7
Schizophr Res. Author manuscript; available in PMC 2010 May 1.
NIH-PA
Author
Manuscript
NIH-PA
Author
Manuscript
NIH-PA
Author
Manuscript
8. Link BG, Struening EL, Neese-Todd S, Asmussen S, Phelan JC. Stigma as a barrier to recovery: The
consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services
2001;52:1621–1626. [PubMed: 11726753]
Lysaker PH, Buck KD, Hammoud K, Taylor AC, Roe D. Associations of symptoms, psychosocial
function and hope with qualities of self-experience in schizophrenia: Comparisons of objective and
subjective indicators of health. Schizophrenia Research 2006;82:241–249. [PubMed: 16442265]
Lysaker PH, Buck KD, Roe D. Psychotherapy and recovery in schizophrenia: A proposal of key elements
for an integrative psychotherapy attuned to narrative in schizophrenia. Psychological Services 2007a;
4:28–37.
Lysaker PH, Roe D, Yanos PT. Toward understanding the insight paradox: Internalized stigma moderates
the association between insight and social functioning, hope, and self-esteem among people with
schizophrenia spectrum disorders. Schizophrenia Bulletin 2007b;33:192–199. [PubMed: 16894025]
Lysaker PH, Salyers MP, Tsai J, Spurrier LY, Davis LW. Clinical and psychological correlates of two
domains of hopelessness in schizophrenia. Journal of Rehabilitation Research & Development 2008a;
45:911–919. [PubMed: 19009477]
Lysaker PH, Tsai J, Yanos P, Roe D. Associations of multiple domains of self-esteem with four
dimensions of stigma in schizophrenia. Schizophrenia Research 2008b;98:194–200. [PubMed:
18029145]
MacInnes DL, Lewis M. The evaluation of a short group programme to reduce self-stigma in people with
serious and enduring mental health problems. Journal of Psychiatric & Mental Health Nursing
2008;15:59–65. [PubMed: 18186830]
Major B, McCoy SK, Kaiser CR, Quinton WJ. Prejudice and self-esteem: A transactional model.
European Review of Social Psychology 2003;14:77–104.
Major B, O’Brien LT. The social psychology of stigma. Annual Review of Psychology 2005;56:393–
421.
McCoy SK, Major B. Group identification moderates emotional responses to perceived prejudice.
Personality and Social Psychology Bulletin 2003;29:1005–1017. [PubMed: 15189619]
Miller, CT. Social psychological perspectives on coping with stressors related to stigma. In: Levin, S.;
van Laar, C., editors. Stigma and group inequality: Social psychological perspectives. Lawrence
Erlbaum Associates; Mahwah: 2006. p. 21-44.
Myin-Germeys I, van Os J. Stress-reactivity in psychosis: Evidence for an affective pathway to psychosis.
Clinical Psychology Review 2007;27:409–424. [PubMed: 17222489]
Penn DL, Corrigan PW. The effects of stereotype suppression on psychiatric stigma. Schizophrenia
Research 2002;55:269–276. [PubMed: 12048150]
Quinn DM, Kahng SK, Crocker J. Discreditable: stigma effects of revealing a mental illness history on
test performance. Personality & Social Psychology Bulletin 2004;30:803–815. [PubMed: 15200689]
Radloff LS. The CES-D scale: A self-report depression scale for research in the general population.
Applied Psychological Measurement 1977;1:385–401.
Roe D, Yanos PT, Lysaker PH. Coping with psychosis: An integrative developmental framework. Journal
of Nervous & Mental Disease 2006;194:917–924. [PubMed: 17164630]
Rosenberg, M. Society and the adolescent self-image. Princeton University Press; Princeton: 1965.
Rüsch N, Corrigan PW, Bohus M, Jacob GA, Brueck R, Lieb K. Measuring shame and guilt by self-
report questionnaires: A validation study. Psychiatry Research 2007a;150:313–325.
Rüsch N, Corrigan PW, Wassel A, Michaels P, Olschewski M, Wilkniss S, Batia K. A stress-coping
model of mental illness stigma: I. Predictors of cognitive stress appraisal. Schizophrenia Research
2009;110:59–64. [PubMed: 19269140]
Rüsch N, Hölzer A, Hermann C, Schramm E, Jacob GA, Bohus M, Lieb K, Corrigan PW. Self-stigma
in women with borderline personality disorder and women with social phobia. Journal of Nervous
& Mental Disease 2006a;194:766–773.
Rüsch N, Lieb K, Bohus M, Corrigan PW. Self-stigma, empowerment, and perceived legitimacy of
discrimination among women with mental illness. Psychiatric Services 2006b;57:399–402.
Rüsch N, Lieb K, Göttler I, Hermann C, Schramm E, Richter H, Jacob GA, Corrigan PW, Bohus M.
Shame and implicit self-concept in women with borderline personality disorder. American Journal
of Psychiatry 2007b;164:500–508.
Rüsch et al. Page 8
Schizophr Res. Author manuscript; available in PMC 2010 May 1.
NIH-PA
Author
Manuscript
NIH-PA
Author
Manuscript
NIH-PA
Author
Manuscript
9. Sayers MD, Bellack AS, Wade JH, Bennett ME, Fong P. An empirical method for assessing social
problem solving in schizophrenia. Behavior Modification 1995;19:267–289. [PubMed: 7625993]
Seaton M, Marsh HW, Dumas F, Huguet P, Monteil JM, Regner I, Blanton H, Buunk AP, Gibbons FX,
Kuyper H, Suls J, Wheeler L. In search of the big fish: Investigating the coexistence of the big-fish-
little-pond effect with the positive effects of upward comparisons. British Journal of Social
Psychology 2008;47:73–103. [PubMed: 17535459]
Spencer SJ, Steele CM, Quinn DM. Stereotype threat and women’s math performance. Journal of
Experimental Social Psychology 1999;35:4–28.
Steed L. Further validity and reliability evidence for Beck Hopelessness Scale scores in a nonclinical
sample. Educational and Psychological Measurement 2001;61:303–316.
Tangney, JP.; Dearing, RL.; Wagner, PE.; Gramzow, R. The Test of Self-Conscious Affect-3 (TOSCA-3).
George Mason University; Fairfax: 2000.
Thornicroft, G. Shunned: Discrimination against people with mental illness. Oxford University Press;
Oxford: 2006.
Wright ER, Gronfein WP, Owens TJ. Deinstitutionalization, social rejection, and the self-esteem of
former mental patients. Journal of Health & Social Behavior 2000;41:68–90. [PubMed: 10750323]
Yanos PT, Roe D, Markus K, Lysaker PH. Pathways between internalized stigma and outcomes related
to recovery in schizophrenia spectrum disorders. Psychiatric Services 2008;59:1437–1442.
[PubMed: 19033171]
Rüsch et al. Page 9
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Author
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10. Figure 1.
Cognitive appraisal of stigma-related stress, stress reactions and outcomes (part 2, adapted
from Major and O’Brien, 2005)
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Table 1
Correlations of emotional and cognitive stress responses (left column) with outcome variables (top row) a
Self-esteem d Hopelessness e Social per- formance f Seating distance g
Social anxiety b −.50 ** .55 ** .01 .23 *
Shame c −.45 ** .41 ** .07 .16
Devaluing work/education −.04 .22 * −.15 .26 *
Ingroup comparisons −.00 .06 −.50 ** .27 *
Blaming discrimination −.09 .22 * −.13 .27 *
*
p <.05
**
p <.01 (two-tailed)
a
Correlations with self-esteem, hopelessness and social performance are bivariate Pearson correlations; because of its skewed distribution, correlations
with seating distance are Spearman rank correlations
b
Liebowitz Social Anxiety Scale (Liebowitz, 1987)
c
Test of Self-Conscious Affect (Tangney et al., 2000)
d
Rosenberg’s Self-Esteem Scale (Rosenberg, 1965)
e
Beck’s Hopelessness Scale (Beck et al., 1974)
f
Maryland Assessment of Social Competence (Bellack et al., 2006)
g
Seating distance from a talkative “normal” person
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Table
2
Regressions
on
outcome
variables
Dependent
variable
Independent
variables
beta/B
a
T/Wald
a
p
R
2
/Nagel-kerke
R
2
a
Self-esteem
b
Social
anxiety
c
−0.40
−3.50
.001
.32
Shame
d
−0.27
−2.52
.014
Devaluing
work/education
−0.03
−0.34
.73
Ingroup
comparisons
0.13
1.27
.21
Blaming
discrimination
0.04
.38
.71
Hopelessness
e
Social
anxiety
c
0.44
3.97
<.001
.37
Shame
d
0.21
2.03
.046
Devaluing
work/education
0.19
2.06
.043
Ingroup
comparisons
−0.10
−1.05
.30
Blaming
discrimination
0.05
0.48
.64
Social
Performance
f
Social
anxiety
c
0.09
0.76
.45
.30
Shame
d
0.10
0.92
.36
Devaluing
work/education
−0.14
−1.45
.15
Ingroup
comparisons
−0.54
−5.39
<.001
Blaming
discrimination
0.03
0.31
.76
Seating
Distance
g
Social
anxiety
c
0.01
0.29
.59
.12
Shame
d
−0.01
0.04
.85
Devaluing
work/education
−0.06
0.14
.71
Ingroup
comparisons
0.24
4.02
.045
Blaming
discrimination
0.09
0.51
.48
a
Linear
regressions
on
self-esteem,
hopelessness
and
social
performance;
and
logistic
regression
on
seating
distance
(close
versus
far)
b
Rosenberg’s
Self-Esteem
Scale
(Rosenberg,
1965)
c
Liebowitz
Social
Anxiety
Scale
(Liebowitz,
1987)
d
Test
of
Self-Conscious
Affect-3
(Tangney
et
al.,
2000)
e
Beck’s
Hopelessness
Scale
(Beck
et
al.,
1974)
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Table
3
Regressions
on
outcome
variables,
controlling
for
depressive
symptoms
and
diagnosis
Dependent
variable
Independent
variables
beta/B
a
T/Wald
a
p
R
2
/Nagel-
kerke
R
2
a
Self-esteem
b
Social
anxiety
c
−0.22
−1.99
.050
.48
Shame
d
−0.12
−1.18
.24
Devaluing
work/education
e
−0.02
−0.25
.81
Ingroup
comparisons
e
−0.00
−0.01
.99
Blaming
discrimination
e
0.12
1.21
.23
Depressive
symptoms
f
−0.59
−4.75
<.001
Schizophrenia
or
schizoaffective
disorder
0.03
0.28
.78
Hopelessness
g
Social
anxiety
c
0.31
2.75
.007
.44
Shame
d
0.13
1.25
.22
Devaluing
work/education
e
0.18
2.00
.049
Ingroup
comparisons
e
−0.01
−0.06
.95
Blaming
discrimination
e
0.03
0.27
0.79
Depressive
symptoms
f
0.26
2.34
.02
Schizophrenia
or
schizoaffective
disorder
0.11
1.24
.22
Social
Performance
h
Social
anxiety
c
0.12
0.94
.35
.30
Shame
d
0.13
1.08
.29
Devaluing
work/education
e
−0.14
−1.41
.16
Ingroup
comparisons
e
−0.57
−5.23
<.001
Blaming
discrimination
e
0.05
0.41
.68
Depressive
symptoms
f
−0.08
−0.68
.50
Schizophrenia
or
schizoaffective
disorder
0.01
0.06
.96
Seating
Distance
i
Social
anxiety
c
−0.02
0.56
.45
.14
Shame
d
0.01
0.01
.91
Devaluing
work/education
e
0.06
0.13
.72
Ingroup
comparisons
e
−0.21
2.84
.09
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Dependent
variable
Independent
variables
beta/B
a
T/Wald
a
p
R
2
/Nagel-
kerke
R
2
a
Blaming
discrimination
e
−0.08
0.36
.55
Depressive
symptoms
f
0.01
0.04
.84
Schizophrenia
or
schizoaffective
disorder
0.50
0.61
.43
a
Linear
regressions
on
self-esteem,
hopelessness
and
social
performance;
and
logistic
regression
on
seating
distance
(close
versus
far)
b
Rosenberg’s
Self-Esteem
Scale
(Rosenberg,
1965)
c
Liebowitz
Social
Anxiety
Scale
(Liebowitz,
1987)
d
Test
of
Self-Conscious
Affect-3
(Tangney
et
al.,
2000)
e
Cognitive
coping
response
to
stigma-related
stress
(Crocker
and
Major,
1989)
f
Center
for
Epidemiologic
Studies
Depression
Scale
(Radloff,
1977)
g
Beck’s
Hopelessness
Scale
(Beck
et
al.,
1974)
h
Maryland
Assessment
of
Social
Competence
(Bellack
et
al.,
2006)
i
Seating
distance
from
a
talkative
“normal”
person
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