The stigmatisation of gamblers, particularly those with a gambling disorder, and self-stigmatisation are considered substantial barriers to seeking help and treatment. To develop effective strategies to reduce the stigma associated with gambling disorder, it is essential to understand the prevailing stereotypes. This study examines the stigma surrounding gambling disorder in Germany, with a particular focus on user comments on the video platform YouTube.

The study employed a deep learning approach, combining guided topic modelling and qualitative summative content analysis, to analyse comments on YouTube videos. Initially, 84,024 comments were collected from 34 videos. After review, two videos featuring a person who had overcome gambling addiction were selected. These videos received significant user engagement in the comment section. An extended stigma dictionary was created based on existing literature and embeddings from the collected data.

The results of the study indicate that there is substantial amount of stigmatisation of gambling disorder in the selected comments. Gamblers suffering from gambling disorder are blamed for their distress and accused of irresponsibility. Gambling disorder is seen as a consequence of moral failure. In addition to stigmatising statements, the comments suggest the interpretation that many users are unaware that addiction develops over a period of time and may require professional treatment. In particular, adolescents and young adults, a group with a high prevalence of gambling-related disorders and active engagement with social media, represent a key target for destigmatisation efforts.

It is essential to address the stigmatisation of gambling disorder, particularly among younger populations, in order to develop effective strategies to support treatment and help-seeking. The use of social media offers a comprehensive platform for the dissemination of information and the reduction of the stigmatisation of gambling disorder, for example by strengthening certain models of addiction.

This study investigated the experiences of stigma and somatization among middle-aged adults with mental health issues. Using frameworks of public stigma, self-stigma, affiliate stigma, and somatization (both presenting and functional), the study explores how individuals navigate the stigma associated with mental health. Interviews were conducted with middle-aged adults in rural areas, and the data were analyzed using Interpretative Phenomenological Analysis (IPA) to gain insights into their lived experiences. The findings reveal that mental health stigma in rural China significantly influences how individuals express mental distress, often leading to somatization. Patients tend to frame their mental health issues in terms of physical symptoms, such as headaches or fatigue, to avoid stigma. The study also highlights the role of cultural norms in shaping these expressions, particularly within the context of close-knit rural communities where mental health issues is stigmatized. The implications for education and policy are discussed, emphasizing the need for improved public mental health education and more equitable distribution of healthcare resources between urban and rural areas. This study contributes to the understanding of mental health stigma in rural China and offers practical suggestions for addressing mental health challenges in underserved communities.

The purpose of this study was to explore mental health literacy among youths with a background as asylum-seekers and refugees including the role of mental health literacy as a barrier to their service use. A systematic literature study was conducted to gain an overview of mental health literacy in youths with a background as asylum-seekers and refugees. The databases MEDLINE, PubMed, CINAHL, PsycINFO and Web of Science were used to identify relevant research. The PRISMA statement was used to report on the literature search, and a thematic synthesis was used to analyze the data from the included studies. Eleven studies reporting qualitative data were included. The understanding of mental health varied. Some youths understood mental health and mental health problems as connected to body and mind, whereas others linked it to their life situation or attributed it to supernatural or religious causes. Help-seeking behavior also varied, with youths seeking support in ways they found helpful, such as through prayer, or talking to an Imam or priest, or confiding in friends and family. Professionals were often perceived as unhelpful, partly due to lack of cultural competency. Youths expressed mistrust of professionals, feeling that they focused too much on their past rather than addressing their present and future concerns. Moreover, mental health stigma was a significant barrier to seeking help. Different understandings of mental health among youths with a background as asylum-seekers and refugees influence their help-seeking behaviors. The current conceptual framework of mental health literacy does not address cultural and contextual factors. Mental health literacy should be further developed as a concept to encompass diverse perspectives. Professionals should be trained with a more holistic approach that considers cultural factors and user experiences, guiding the development of mental health literacy programs and services.

Mental health is influenced by how we perceive ourselves and others. A person's conceptual structure and how he/she understands and makes sense of the world can be explored using the repertory grid technique (RGT), an assessment tool derived from personal construct theory. This review aimed to a) draw together relevant literature that had implemented the RGT to explore the conceptual system of a person diagnosed with a mental health condition necessitating psychiatric admission, b) synthesise research findings related to the structure and content of the conceptual system, and c) provide insights into how inpatient service users construed themselves and others to inform therapeutic practice.

A systematic search of five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science) and thesis databases (EThOS and ProQuest), alongside manual searches in relevant articles and Google Scholar, was conducted. Included studies were appraised for methodological quality using the Quality Assessment Tool for Studies with Diverse Designs.

Twenty-one studies were identified and analysed using narrative synthesis. Of these 21 studies, 12 intentionally used a comparison group and compared the conceptual systems of people with different mental health diagnoses or compared conceptual systems of people with and without a diagnosed mental health condition. Findings from comparison group studies suggested that the self-esteem of a person diagnosed with a mental health condition was lower, compared to a person with no identified mental health diagnoses. Other people were typically idealised by people experiencing mental ill health; however, this finding was not observed in the experience of depression. Cognitive complexity, conceptual structure, and construing were variable across mental health conditions. Conceptual structures that were "simple" and characterised by "tight" construing were consistent with the profile of people with a mental health diagnosis, except for people with schizophrenia spectrum and psychotic disorders.

The structure of a conceptual system differed in people with and without a mental health condition and across mental health diagnoses. Considerations for how the review findings could inform psychological therapy and suggestions for future research are offered.

Stigma is prevalent among patients with schizophrenia, and its impact can be profound. Improving insight is a critical aspect of treating schizophrenia, but it is often accompanied by increased stigma. This study aims to explore how trait mindfulness and perceived social support moderate the relationship between insight and stigma in patients with stable schizophrenia. A cross-sectional study was conducted in Shanghai's Changning and Huangpu Districts from August to December 2023, recruiting patients through convenience sampling from local mental health centers. A total of 350 patients were included in the study, with their demographic information, insight, trait mindfulness, perceived social support, and stigma being measured. The study found that patients with higher BMI, unemployment or retirement status, and lower income levels experienced significantly higher stigma. The correlation analysis revealed that insight was positively correlated with stigma, while trait mindfulness and perceived social support were negatively correlated with stigma. Regression analysis showed that insight increased stigma, whereas trait mindfulness and perceived social support reduced it. Moderation analysis indicated that higher levels of both trait mindfulness and perceived social support significantly reduced the negative impact of increased insight on stigma in patients with schizophrenia. These findings highlight the importance of enhancing patients' trait mindfulness and perceived social support while improving insight in the treatment of schizophrenia.

The previous literature concerned with understanding stigma affecting patients with bipolar disorder relies predominantly on qualitative and survey approaches, and rarely contends with the potential role of social desirability on disclosure. The current project employs a 2 × 2 experimental approach to establish the presence of stigmatizing attitudes in a context with real social consequences (i.e., college housing decisions).

Participants believed they were participating in a collaborative study with campus residential life. The project was designed to establish the presence of stigmatizing attitudes affecting patients with bipolar disorder compared to an unaffected control, as well as testing whether employing pressure to respond honestly (via bogus pipeline) affects stigma disclosure.

Study 1 results revealed that after reviewing a peer's housing application, stigma consequences were observable when a student disclosed a bipolar diagnosis at a large, public southeastern university (N = 182) across all outcomes (increased desire for social distance and perceived dangerousness, decreased relatability). In this sample social desirability did not appear to influence responding. In Study 2, at a small, private northeastern college (N = 168), stigma was observable on the dangerousness and relatability outcomes, but only demonstrable in terms of social distance under the conditions of the bogus pipeline.

Together, these findings contribute persuasive experimental evidence affirming the scope and impact of stigma in the lives of patients with bipolar disorder, and underscores the capacity for social desirability to mask the presence of stigma, which has significant implications for the interpretation of past stigma research.

Suicide-related stigma (i.e. negative attitudes towards people with suicidal thoughts and/or behaviours as well as those bereaved by suicide) is a potential risk factor for suicide and mental health problems. To date, there has been no scoping review investigating the association between suicide-related stigma and mental health, help-seeking, suicide and grief across several groups affected by suicide.

To determine the nature of the relationship between suicide-related stigma and mental health, help-seeking, grief (as a result of suicide bereavement) and suicide risk.

This review was registered with PROSPERO (CRD42022327093). Five databases (Web of Science, APA PsycInfo, Embase, ASSIA and PubMed) were searched, with the final update in May 2024. Studies were included if they were published in English between 2000 and 2024 and assessed both suicide-related stigma AND one of the following: suicide, suicidal thoughts or suicidal behaviours, help-seeking, grief or other mental health variables. Following screening of 14 994 studies, 100 eligible studies were identified. Following data charting, cross-checking was conducted to ensure no relevant findings were missed.

Findings across the studies were mixed. However, most commonly, suicide-related stigma was associated with higher levels of suicide risk, poor mental health, lowered help-seeking and grief-related difficulties. A model of suicide-related stigma has been developed to display the directionality of these associations.

This review emphasises the importance of reducing the stigma associated with suicide and suicidal behaviour to improve outcomes for individuals affected by suicide. It also identifies gaps in our knowledge as well as providing suggestions for future research.

College students' mental health education is crucial for holistic individual development and societal quality. It shapes well-rounded personalities, fosters innovation, and cultivates responsible citizens, contributing to social stability and national development. Our research aims to establish an evaluation system for college student mental health education policies based on the Policy Modeling Consistency Index (PMC-Index) model and text mining techniques, quantitatively assessing 15 representative policies.

This paper first retrieves policy documents through specialized policy databases and government websites, excluding policies that have already expired or become invalid. The sample selections of this research range from 2001 to 2024, including national guidelines and specific actions. Referring to the above steps of policy effectiveness evaluation, our research comprehensively analyses the implementation effectiveness of the foregoing policies regarding mental health curricula, service systems, crisis intervention, and family cooperation. In the following, based on 10 major variables, 38 sub-variables are constructed with a binary coding system to quantify the content of policy for objectivity. Then, the ROSTCM 6.0 software is used for text segmentation and word frequency statistics, meanwhile, keywords and semantic networks of core policies will be considered for analysis. Subsequently, the PMC-Index is computed based on the multi-input-output matrix and a diagram of the PMC-Surface is drawn with the help of MATLAB to express policy consistency and deficiencies in different dimensions intuitively.

Among the 15 policies, 11 exhibit Great Consistency (GC), and 4 fall under Acceptable Consistency (AC). Higher scores are found in Policy Function (X6), Policy Evaluation (X8), and Policy Goals (X9), indicating practical implementation and clear guidance. However, lower scores in Policy Nature (X1), Policy Timeliness (X2), Policy Issuing Agency (X3), and Policy Object (X4) reveal deficiencies in policy innovation, long-term planning, and target group coverage. Particularly, short-term policies lack sustainability, limiting their long-term effectiveness in supporting students' mental health. Through PMC-Surface analysis, it is found that lower scores in timeliness and adaptability to target groups are primary factors contributing to surface depressions in the diagram, suggesting that these policies struggle to meet the diverse needs of different types of higher education institutions. The research also highlights significant areas for improvement in resource allocation, support system construction, and personalized mental health services. Some policies fail to address regional disparities, with weaker implementation in underdeveloped areas and insufficient safeguard mechanisms.

In the future, long-term planning for policy optimization is expected, in which priority would be given to localized resource allocation and close collaboration among schools, families, and society to ensure the comprehensiveness and sustainability of mental health education services. The research has identified certain strengths and weaknesses in the policies concerning mental health education for college students in China, thus providing theoretical references and specific recommendations that can be effectively implemented in higher education institutions.

Injured workers experience stigmatization, but the current literature has not applied a stigma lens to this demographic. Stigmatizing experiences are described, but not by readily using the term "stigma," making it difficult to locate these works. The purpose of this scoping review was to identify the terms and phrases that are being used to describe the stigmatizing experiences of injured workers.

A scoping review was conducted, searching MEDLINE, PsycINFO, and CINAHL for papers that described the stigma experiences of injured workers. The main objectives were to determine (i) whether the term "stigma" was used (and if it was a major or minor term) and (ii) what terms were used to describe these stigmatizing experiences. Post hoc, the terms were grouped into components of popular stigma theories (Attribution Theory, Modified Labeling Theory, and the Regressive Self-Stigma Model).

100 articles were included in the review. 48% of the studies used the term "stigma," but of these studies, only 11 (23%) used "stigma" consistently throughout their papers. There were 271 unique terms identified that described the stigmatizing experiences injured workers face, which most commonly described cognitive and behavioral forms of stigma.

This review confirmed that a stigma lens has not been adopted to describe the experiences of injured workers, but that prominent theories of public and structural stigma explain these experiences well. This review also consolidated the various terms used to describe stigma experiences of injured workers, which will improve accessibility of the current literature for knowledge users and interested parties.

This article aims to provide an illustrated account of layered stigmatisation processes and consequences for those who experience chronic pain and accompanying suicidality. Using constructivist grounded theory, I draw from 20 in-depth interviews conducted from 2022 to 2023 to explore how chronic pain and suicidality operate within people's social worlds. Findings demonstrate how layered stigmatising processes, occurring based on chronic pain and suicidality, operate consistently across multiple social arenas to create interactional troubles, which result in enduring negative social, emotional, and financial impacts. Three themes were constructed, including (1) self-stigma and the multiple roles of the family, (2) missed connections, and (3) anticipated stigma and workplace discrimination. Taken together, themes support the overarching category, 'interactional troubles'. Findings suggest a need for attunement to stigmatising processes' omnipresence and the depth of their consequences. Clinical interventions may benefit from emphasizing participants' social worlds and incorporating the complexity of navigating social arenas given layered stigmatisation. Moreover, policies that support those with chronic pain and mental illness could offset the long-term negative economic consequences of discrimination.

Mental illness is a global concern and the leading cause of years lived with disability. Research on help-seeking behaviour has focused on individual factors, but there is still much unexplained variance. Suggesting complex interactions between determinants of human behaviour a new framework called Self-Milieux is proposed to represent a person's sociocultural background. The article introduces a statistical approach to determine Self-Milieux and exemplarily examines its predictive validity for health-related research.

Self-Milieux are determined through a two-stage clustering method based on the determinants socioeconomic status and self-construal profile. Descriptive analyses are used to compare Self-Milieux characteristics. Hierarchical binary logistic regression models test the association between Self-Milieux and help-seeking behaviour, while controlling for socioeconomic status as an established predictor.

The sample size was N = 1535 (Mage = 43.17 and 64.89% female participants). Average depression severity was M = 12.22, indicating mild to moderate symptoms. Six Self-Milieux were determined and named. Participants from privileged (aOR = 0.38) and self-sufficient (aOR = 0.37) milieux were less likely to seek help from a general practitioner than those from the entitled milieu. Participants from privileged (aOR = 0.30), collaborators (aOR = 0.50), disadvantaged (aOR = 0.33), and self-sufficient (aOR = 0.21) milieux were less likely to seek help from family members than those from the entitled and family-bound milieux.

The study's strengths and limitations, as well as the cluster methodology, are discussed. The comparative results for the six Self-Milieux are interpreted based on current research. For example, participants from some milieux follow a help-seeking process proposed in previous research, while participants from other milieux seem to show a different process, one that ends in informal help-seeking.

Mental illness stigma can result in discriminative practice in pharmacy, such as providing less pharmaceutical care to people living with mental illness (PMI) than those with physical illness. Pharmacy education should aim to reduce the impact of mental illness stigma on the pharmaceutical care of PMI. Whilst previous research has shown that some interventions can reduce stereotyping and prejudice in pharmacy students, the impact on subsequent discrimination is questionable and the reasons for successful and unsuccessful outcomes are unclear. This study aimed to explore pharmacy students' views on working with PMI and how these views might interact with mental illness stigma.

Focus groups and semi-structured interviews with final year pharmacy students and recent graduates were conducted at one UK university. Question guides were developed based on the aim of the study and investigated participants' attitudes and beliefs about mental illness. Following transcription, data were analysed in line with the guiding principles of constructivist Grounded Theory.

Three major categories were developed which accounted for the data: Knowing, Doing and Valuing. Participants reported that in common with the general public, pharmacy students possess insufficient knowledge about mental illness, which limits what can be done to help and support people living with it. Finally, participants reported that mental illness is ascribed insufficient value in the pharmacy curriculum, healthcare, and in wider society. Interactions between stigma and each of these categories were identified.

The findings offer a novel, qualitative description and explanation of mental illness stigma among pharmacy students from one UK university. Further, the factors identified by pharmacy students as modifiers of preparedness for professional practice provide an evidence base for curriculum development with possible international relevance. This may help pharmacy educators to develop evidence-based strategies aimed at reducing the impact of mental illness stigma in future professional practice.

The current study examined how college students search online for mental health information and the impact of these searches on mental health literacy, stigma, and help-seeking.

Undergraduate participants (N = 270; Fall 2015 to Spring 2019) were randomly assigned to search online for information about coping with anxiety for themselves or a friend (experimental activity), or to utilize Google Maps to answer navigational questions (control).

Participants who conducted an online search demonstrated greater mental health literacy including optimism about psychotherapy, and lower levels of certain types of stigma, but lower willingness to seek/recommend professional help. Participants were more likely to recommend professional help for a friend compared to themselves.

Online searches for mental health information have the potential to increase mental health literacy. Universities can harness the Internet to reduce help-seeking barriers but should also address when it is appropriate to engage in self-help versus seek professional help.

Given the stigma of dementia, individuals with the condition may be wary to disclose their diagnosis to other people, both in face-to-face and digital settings. While sharing one's dementia diagnosis with others is essential for accessing valuable support for social, cognitive, and physical well-being, this area of research has largely been neglected. In this meta-synthesis, we aimed to systematically review qualitative research on the factors associated with online and offline self-disclosure in people with dementia.

We conducted a systematic search in 6 electronic databases. Inclusion criteria comprised qualitative and mixed-methods studies describing experiences with self-disclosure in people with any type of dementia. Quality of the included studies was assessed using the Mixed Methods Appraisal Tool. The meta-synthesis was conducted in NVivo using a thematic synthesis approach.

28 studies were included. 3 analytical themes were generated: "Concealment," "Stigma and fear," and "Taking control," the latter 2 with subthemes. Findings from this review were corroborated with people with dementia and family carers as part of Patient and Public Involvement meetings. Our findings reveal that while stigma plays a pivotal role, people with dementia can take control of the meaning of their diagnosis through self-disclosure.

Self-disclosure is complex and multifaceted. People with dementia, particularly those experiencing stigma, can benefit from post-diagnostic support that encompasses resources and interventions for self-disclosure. Further research is required to investigate people with dementia's disclosure decision-making process.

Sexual stigma operates at multiple levels (institutional, group, individual), which serves to disadvantage sexual minority (LGBQ+) individuals and increases risk for deleterious outcomes. The current study evaluated a novel multilevel sexual stigma model of intimate partner violence (MLSSM-IPV) that incorporates multiple levels of sexual stigma as related to IPV risk via several pathways (e.g. hazardous drinking, affective symptoms). We evaluated this model in a longitudinal study of LGBQ+ undergraduate college students (n = 2,415) attending 18 universities who completed surveys in the Fall and Spring semesters. Group-level sexual stigma on each campus was assessed via surveys with heterosexual students (n = 8,517) and faculty, staff, and administrators (n = 2,865), and institutional-level stigma was evaluated via a campus climate assessment. At the campus level, institutional stigma was related to LGBQ+ students' self-stigma and identity concealment. Moreover, self-stigma prospectively predicted IPV victimization, and hazardous drinking mediated the relations between self-stigma and IPV perpetration and victimization. Results suggest that interventions addressing stigma and hazardous drinking may be efficacious in reducing IPV among LGBQ+ students. Further, comprehensive efforts to improve campus climate for LGBQ+ students are likely to produce a plethora of benefits for these students.

Self-stigma refers to the process whereby individuals with mental disorders internalize negative societal attitudes and misconceptions about mental health conditions, potentially affecting their sense of self-worth and identity. This internalization can significantly impact various aspects of life, including treatment engagement, personal relationships, and overall well-being. Narrative Enhancement and Cognitive Therapy (NECT) was developed in the United States to counteract self-stigma and has been supported by multiple randomized controlled trials. However, NECT has not yet been implemented in Italy or within a public mental health system grounded in community psychiatry. This study aims to evaluate the efficacy and feasibility of the Italian version of the NECT within the public mental health sector in a large part of North-East Italy.

This pragmatic, multisite, superiority, randomized, wait-list controlled trial with two parallel arms will recruit over four hundred patients with severe mental disorders from 26 public community-based mental health centers in North-East Italy. The experimental intervention, NECT, consists of 20 group-based sessions to reduce self-stigma. The study will assess NECT's impact on several psychological dimensions, including self-stigma levels (primary outcome), self-esteem, hope, empowerment, recovery perception, mental well-being, and stigma stress (secondary outcomes). Feasibility will be evaluated by collecting data on participant adherence and treatment implementation, including eligibility screening, participation rates, intervention completion, exposure levels, and reasons for dropout.

The findings of this research are expected to contribute to the understanding of effective treatments for patients with mental disorders, particularly those burdened by high levels of self-stigma, and to improve their recovery outcomes.

ClinicalTrials.gov; Identifier: NCT06567145.

Stigma represents a major obstacle in rehabilitation and community reintegration after brain injury. However, appropriate tools to measure stigma in Spanish-speaking countries are lacking. This study examined the psychometric properties of the Spanish version of the Anticipated Stigma and Concealment Questionnaire (ASCQ). An observational cross-sectional study was conducted with 103 participants who completed the ASCQ and other measures. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were performed to assess the scale's structure. Associations between the ASCQ and other mental health measures were explored to establish its nomological validity. All ASCQ items loaded significantly onto a single factor, with factor loadings ranging from .7 to .84. While χ2 (35) = 56.282, p < .05, some fit indices indicated excellent model fit (CFI = .997 and TLI = .996), while others suggested a good fit (RMSEA = .077, 90% CI [.036, .113], and SRMR = .060). Significant associations were found between the ASCQ and measures of loneliness, depressive symptoms, quality of life, and self-esteem. The ASCQ is a valid and reliable tool for assessing anticipated stigma and the motivation to conceal information after acquired brain injury. It can aid rehabilitation professionals in identifying individuals with interpersonal difficulties during community reintegration.

Stigma contributes to fear and shame, resulting in delays in care-seeking behavior among individuals with cancer. As a social construct, stigma is affected by language, religion, culture, and local norms. This study explored pediatric cancer stigma at the time of diagnosis across diverse settings through the adaptation of two stigma measures.

This study was conducted with adolescents and caregivers of children with osteosarcoma and retinoblastoma at three centers in Jordan, Guatemala, and Zimbabwe. The Stigma-related Social Problems (SSP) and the eight-item Stigma Scale for Chronic Illness (SSCI-8) measures were translated into Arabic, Spanish, and Shona and contextually adapted for use with adolescents and caregiver proxies. Adapted measures were pilot-tested and iteratively revised.

Extensive adaptations were made to both measures to make them relevant to the local pediatric contexts. The final measures were used in nine patients and 28 caregivers. The exploratory analysis found that domain-specific and overall scale scores for both measures indicate a higher level of stigma than those found in previous studies (SSP: patient [51.23], caregiver [40.74]; SSCI-8: patient [50.41], caregiver [49.78]). Paired, patient-caregiver proxy responses were analyzed, with disagreement between the pairs for both scales.

Adapted measures detected high levels of stigma among patients with pediatric cancer and their caregiver proxies and demonstrated a lack of concordance in the reports. This suggests the importance of studying stigma in this population and the need to ask patients about their stigma without using proxy measures. The required adaptations suggest a need for stigma measures developed specifically for pediatric cancer.

The Welfare Reform Act (2012) has been criticised for harming claimants, particularly through functional assessments. Although many people with intellectual disabilities in the UK receive welfare benefits, their experiences of undergoing functional assessments are under-researched.

Eight participants with intellectual disabilities were interviewed about experiences of welfare assessment. Transcripts were analysed qualitatively using interpretative phenomenological analysis.

Analysis suggested five group experiential themes: 'Living in fear: I was nervous and scared'; 'The system is marginalising: Other people are better than me'; 'Relationship with the assessor: His attitude fucking stunk'; 'Others as a safe base: Someone there that you know, and you trust'; and 'Responding with empowerment: That's where I really shined'.

People with intellectual disabilities experience functional assessments as scary and oppressive. Assessment reinforced the stigma associated with having an intellectual disability and, to a lesser extent, claiming benefits. Individual, structural and policy levels interventions are discussed.

Maladaptive daydreaming (MD) is characterized by vivid, excessive fantasy activity that becomes prioritized over other activities and may result in avoidant coping strategies. Little is known about the relationship between MD and internalized stigma in the neurodivergent sample. The current study aimed to examine emotional dysregulation, escapism and self-perception (self-esteem and internalized stigma) as potential determinants of MD in three groups: adults on the autism spectrum, with ADHD, and both diagnoses ("AuDHD"), including their neurodivergent symptoms (autistic traits, empathizing, ADHD symptoms).

A sample of 293 persons (139 with ADHD, 74 on the autism spectrum, and 80 with both diagnoses) completed self-report scales concerning ADHD symptoms, autism spectrum symptoms, empathizing, self-esteem, daydreaming as escapism, emotional dysregulation, maladaptive daydreaming, and internalized stigma. A correlation analysis was implemented. Additionally, a group comparison and quantile regression for the 25th, 50th, and 75th percentile of maladaptive daydreaming in the three groups were executed.

The results showed that internalized stigma, emotional dysregulation, escapism, and self-esteem have significant associations with MD in the neurodiverse sample. The ADHD group achieved the lowest scores in emotional dysregulation, discrimination experience, and social withdrawal. The groups did not vary in MD rates, stereotype endorsement, stigma resistance, nonacceptance of emotional responses, and impulse control difficulties. The AuDHD group achieved higher results than the ASD group only in the ADHD symptoms. Quantile regression revealed differences in the predictors of maladaptive daydreaming in the three groups. ADHD symptoms and self-suppression escapism were significant predictors for the higher levels of MD in persons with singular autism or ADHD diagnosis.

The results showed no differences in MD rates, although there were significant variations in predictive features among the three samples. The role of internalized stigma and self-esteem was highlighted in the results as significant associates of MD prevalence. These outcomes expand the current knowledge in the context of maladaptive daydreaming, internalized stigma, self-esteem and emotional dysregulation in a neurodiverse sample and allow for proposing clinical applications and further research directions.

Alcohol use is linked to a wide and complex range of individual and societal harms. Decisions on whether and how to address alcohol-related harms are shaped by the way in which such problems are understood, particularly through the use of language and concepts in professional and lay discourse. However, all terms and concepts have a complex set of implications which vary by context. For example, some language, particularly that associated with a historically dominant 'alcoholism' model, may be clearly harmful in some contexts (eg, via public stigma) and potentially valuable in others (eg, via facilitating recovery processes), or hold 'mixed blessings'. Careful empirical attention is required to assess the implications of key terms and concepts used in efforts to understand and address alcohol use and problems amongst the public, researchers, policy makers and practitioners.

We take an author-led and empirically informed approach to critically evaluate common terms and concepts to describe alcohol use and related constructs.

We identify how alcohol-related framing and discourse is highly relevant to alcohol-related outcomes via key issues including stigma, public health goals, political and commercial interests.

Recommendations are made for key partners to consider in the use and evolution of key terms and concepts relating to the broad spectrum of alcohol use and problems.

Mentally ill offenders face stigma, being perceived as both dangerous and unpredictable. This leads to social discrimination, which causes devaluation, distancing, and unequal treatment towards them. Critical and dismissive attitudes of healthcare professionals and police toward these patients undermine their care, treatment, and prospects for rehabilitation. This study investigated the attitudes and stereotypes of health professionals and police officers who frequently interact with mentally ill offenders. Participants completed three scales: Attitudes Toward Mentally Ill Offenders (ATMIO), Community Attitudes Toward the Mentally Ill (CAMI), and Familiarity Level Scale. The sample included 523 professionals, 283 health professionals, 139 mental health professionals, and 101 police officers, with an average age of 41.4 years and 40.3% having over 20 years of experience. Results showed that all groups displayed negative attitudes toward mentally ill offenders, with little variation between them. This highlights the need for professionals to recognize their biases when caring for this population.

Physicians demonstrate low rates of help seeking for psychiatric disorders, occupational stress, and burnout due to perceived stigma. The Stigma of Occupational Stress Scale for Doctors (SOSS-D) is a brief standardized tool designed to measure stigma (personal, perceived other, and perceived structural) in physicians. The aim of this study was to gather validity evidence for a French version of the SOSS-D.

The SOSS-D was translated into French and piloted with 12 physicians. The scale was administered to physicians at the Geneva University Hospitals. We computed descriptive statistics and internal consistency coefficients. Construct validity was analyzed using exploratory (EFA) and confirmatory factor (CFA) analyses.

In total, 323 physicians participated in the survey. The internal consistency coefficient for the French SOSS-D was 0.72, 0.55 for the personal stigma subscale, 0.66 for the perceived other stigma subscale, and 0.65 for the perceived structural stigma subscale. CFA indicated a marginal fit. EFA revealed three factors: personal, perceived other, and perceived structural stigma.

Our findings support the hypothesis that stigma is a multi-dimensional construct. However, the French version of the SOSS-D scale did demonstrate some differences when compared to its English version. Identifying stigmatization beliefs among physicians may allow for increased identification of physicians at risk, and increased communication concerning preventive actions. Moreover, being aware of and fighting stigma can reduce barriers to help seeking and increased access to care resources for burnt-out physicians.

The results provide evidence of the validity and reliability of the French version of the SOSS-D indicating its suitability for use in a French-speaking physician population.

Help-seeking-that is, the attempt to attain external help for mental health, be it from formal or informal sources-can be described as an adaptive coping process. Mental illness stigma is the most frequently identified barrier that prevents students from seeking psychological help. This study analyzed college students' beliefs about mental illness and attitudes toward formal psychological help-seeking.

Two hundred and eighty-two students from the first and third undergraduate years of Psychology, Sociology, Fashion Design, and Sports Science courses participated. The majority of the sample (75.4%) was female, while only 24.6% was male, with a mean age of 20.04 years. The scales used were the Inventory of Beliefs about Mental Illness (IBMI), the Inventory of Attitudes Toward Seeking Mental Health Services (IATSMHS), and a sociodemographic questionnaire.

The results revealed that females, third-year students, and Psychology students had fewer stigmatizing beliefs about mental illness and more positive attitudes towards help-seeking. Moreover, there were statistically significant differences in beliefs and attitudes in relation to psychological support and familiarity with mental illness. We also glimpsed the impact of the COVID-19 pandemic on students' mental health, and observed a change in opinions and attitudes toward mental illness during this period. Correlation analysis showed negative correlations between stigmatizing beliefs and attitudes toward seeking help. Finally, a cluster analysis identified two profiles of individuals that reflected different levels of stigma and help-seeking attitudes.

This study delineated two distinct groups of students, which is relevant as it allows us to trace profiles to outline more uniform intervention groups and, in turn, implement new and improved interventions that are better adapted to the specific needs of college students.

People who experience gambling harms commonly experience stigmatisation, which is detrimental to psychological wellbeing, and a significant barrier to help-seeking. While there have been efforts to challenge stigmatisation, there is little empirical evidence available to inform such initiatives. To address this gap in knowledge, we conducted a thematic analysis of naturalistic data in the form of posts made on online support forums by people with experience of gambling-related harm, in order to understand how they are stigmatised, and to identify barriers to help-seeking. Five main themes were identified: (a) beliefs about the nature and origin of gambling addiction, which related to participants' beliefs about causes of gambling harm and cognitions about the nature of addiction; (b) self-stigma, which encompassed the frequent and substantial incidences of self-stigma; (c) anticipated stigma, which described the stigma and discrimination people expected to face because of their gambling harm; (d) stigmatising other people who experience gambling harm, which describes the ways in which some people who experienced gambling harms stigmatised other people who experienced gambling harms; and (e) experienced stigma and discrimination, which encompassed the experienced stigmatisation people encountered. Experiences discussed/described within the forums were developed into a timeline of gambling harms which was cyclical in nature and involved six stages: onset, concealment of problems, crisis point, disclosure of problems, recurrence of harms (sometimes termed 'relapse') and recovery. The study highlights the impact of societal stigma on individuals' self-perception and interactions, particularly emphasising the challenges experienced during relapse periods, which heighten stigma and distress. The study also identifies potential avenues for stigma reduction, including targeted campaigns addressing societal, anticipated, and self-stigma.

Australia is an ethnically diverse nation with large numbers of migrants and refugees entering the country yearly. Despite research demonstrating that individuals from culturally and linguistically diverse (CaLD) communities experience an elevated risk of developing a mental illness, mental health services uptake is consistently low. To improve the mental health outcomes of these CaLD individuals in Australia, there is an urgent need to understand barriers to treatment, such as stigma. Research has noted that gender may play a role in mental health stigma and help-seeking. Using a qualitative approach as part of the Embrace Multicultural Mental Health Project, the aim of this study was to explore gender perspectives in mental health stigma and help-seeking among Arabic-speaking and Swahili-speaking individuals in Sydney. A total of five focus group discussions and 18 interviews were undertaken online using Zoom, digitally recorded, transcribed, and thematically analysed. Three major themes were identified. The first theme related to stigma and the fears regarding mental illness being discovered by others. The second theme related to the different approaches to confronting stigma. The last theme related to the various issues considered when identifying sources of help. Our findings suggest that a nuanced approach using the 'what matters most' framework can explain how men and women within each community may experience stigma and emphasise different aspects of help-seeking. These findings can help to guide clinical practitioners in delivering gender-specific and culturally sensitive and effective treatment sessions with these CaLD individuals, in addition to offering directions for stigma-reduction initiatives.

To explore the mediating effect of shame in patients with malignant haematological diseases between fear of disease progression and social alienation.

Recruiting 310 patients with haematological malignancies as the research population, the convenience sampling method was used to investigate the general information questionnaire, the fear of disease progression scale, the social influence scale and the general alienation scale.

The patients with haematological malignancies scored (36.02 ± 9.74) points for fear of disease progression, (58.02 ± 9.52) points for stigma and (31.31 ± 5.85) points for social alienation. Social alienation in patients with haematologic malignancies was positively correlated with stigma (r = 0.500, P < 0.01) and fear of disease progression (r = 0.424, P < 0.01), and fear of disease progression was also positively correlated with stigma (r = 0.405, P < 0.01). Bootstrap test results showed that the mediating effect of stigma on the relationship between fear of disease progression and social alienation in patients with haematological malignancies was 0.159, accounting for 37.5% of the total effect.

The sense of shame plays an intermediary role between fear of disease progression and social alienation in patients with malignant haematological diseases. Clinical nurses should pay attention to the current situation of fear and shame in patients with such diseases and take appropriate intervention measures to reduce the occurrence of negative emotions such as social alienation.

Observing an association between socioeconomic status (SES) and health reliably leads to the question, "What are the pathways involved?" Despite enormous investment in research on the characteristics, behaviors, and traits of people disadvantaged with respect to health inequalities, the issue remains unresolved. We turn our attention to actions of more advantaged groups by asking people to self-report their exposure to disrespect, discrimination, exclusion, and shaming (DDES) from people above them in the SES hierarchy. We developed measures of these phenomena and administered them to a cross-sectional U.S. national probability sample (N = 1,209). Consistent with the possibility that DDES represents a pathway linking SES and health, the SES→health coefficient dropped substantially when DDES variables were controlled: 112.9% for anxiety, 43.8% for self-reported health, and 49.4% for cardiovascular-related conditions. These results illustrate a need for a relational approach emphasizing the actions of more advantaged groups in shaping health inequities.

This study identifies the stigma experienced by 12 bereaved parents 2 and 5 years after losing a child in the Sewol ferry disaster in South Korea. Using thematic analysis, we categorized the experience of stigma into two components based on Corrigan and Kosyluk's social cognitive model of stigma: public stigma and self-stigma, and each was analyzed into three types of stigma: stereotype, prejudice, and discrimination. We identified four additional factors related to stigma mitigation. The potential implications for characterizing the experiences of bereaved parents, particularly those facing stigma, are discussed in light of these findings in the longitudinal perspective.

To test the validity of a COVID-19 public stigma scale and an attributional model of stigma during the early stages of the pandemic.

We administered a cross-sectional survey that included scales related to COVID-19 stigma to U.S. adults.

We used Amazon MTurk online survey panel to recruit participants in June 2020.

U.S. adults (N = 170) participated in the study. Participants were average age of 37 and majority were men (61.2%) and White (77.6%).

The Stigma Towards Disease Scale (SDS) was adapted to measure public stigma directed towards COVID-19 (SDS-C19). Additional stigma-related measures were adapted for this study.

Factorial structure of SDS-C19 was assessed using confirmatory factor analysis (CFA). Validity of SDS was examined using Pearson correlations with other stigma measures. We evaluated the attributional model of stigma using structural equation modeling.

Internal consistency of SDS-C19 was high and a three-factor model reflecting cognitive, affective, and behavioral factors was supported (χ2 [71, N = 170] =140.954, P = .00, CFI= .946, TLI = .931, RMSEA = .076, SRMR = .087). The SDS-C19 had strong correlations with other stigma-related measures. A blame-mediated attribution model was supported (χ2 [8, N = 170] = 21.793, P = .00, CFI = .976, TLI =.956, RMSEA = .101, SRMR = .058).

The SDS-C19 is a valid tool for assessing COVID-19 stigma. SDS-C19 and the attribution model can guide public health communication.

Self-stigma is associated with low self-esteem, high shame and reduced drinking-refusal self-efficacy in people with alcohol use disorder (AUD). The Self-Stigma in Alcohol-Dependence Scale-Short Form (SSAD-SF) was designed to enable a brief, but valid assessment of AUD self-stigma.

We reduced the 64-item SSAD, originally derived from 16 stereotypes towards people with AUD, by removing the most offensive items based on perspectives of people with lived experience. The newly created scale was then assessed and validated in a cross-sectional study involving 156 people reporting alcohol issues in various treatment settings.

The 20-item SSAD-SF includes five stereotypes, with good internal consistency for each subscale and the overall scale. It reflects the four-stage progressive model of self-stigmatization with decreasing scores over the stages awareness of stereotypes, agreement with stereotypes, self-application of stereotypes, and harmful consequences for self-esteem, and highest correlations between adjacent stages. The subscales apply and harm were associated with internalized stigma, shame, reduced self-esteem, and lower drinking-refusal self-efficacy, as supported by multivariate regression models.

The SSAD-SF is a valid instrument for measuring the process of self-stigmatization in people with AUD. Self-stigma is a consistent predictor of reduced self-esteem, higher shame and lower drinking-refusal self-efficacy in people with AUD. We discuss merits of the progressive model for understanding and addressing self-stigma in AUD.

In the context of the opioid overdose crisis, understanding the barriers to seeking, attaining and remaining in treatment for patients with opioid use disorder (OUD) is a public health issue. To date, very few studies have assessed the "self-stigma" (i.e., the internalization of negative societal attitudes and stereotypes about oneself, leading to self-judgment) and "perceived stigma" (i.e., the belief that others hold negative attitudes towards oneself due to a particular condition) experienced by patients with OUD receiving opioid agonist treatment (OAT), and none have done so in France. Our study aimed to quantify self-stigma, explore some aspects of perceived stigma, determine the factors associated with greater self-stigma and examine whether the level of self-stigma was related to a delay in seeking care.

The STIGMA study was a monocentric, cross-sectional study. The data were collected in a French hospital addiction medicine department. Participants were outpatients with current or past OUD who were still receiving or had received OAT. A questionnaire assessing sociodemographics; OUD characteristics; perceived stigma; and quantification of self-stigma by the Self-Stigma Scale-Short, was administered.

A total of 73 questionnaires were included in the analysis. Nearly two-thirds of the patients had a "moderate to high" level of self-stigma. These patients were significantly younger at OUD onset and were significantly more likely to have at least one dependent child than patients reporting a "very low to low" level of self-stigma. Nearly half of the participants experienced perceived stigma from a healthcare professional regarding their OUD or OAT, and nearly one-third of the participants were refused care from a healthcare professional because of their OUD or OAT. Moreover, a quarter of the sample reported delaying care due to fear of being stigmatized. We did not find a relationship between self-stigma levels and a delay in seeking care.

Our study highlights the need to detect stigma and to improve training in addiction medicine.

It has been shown that public stigma towards people with schizophrenia hinders their psychosocial integration. Public stigma expresses itself through lexical labels used in the print media and social networks, heightening the internalization of stigma in this population, a phenomenon known as internalised stigma or self-stigma. This paper analyses the diffusion in the mass media of two dimensions of stigma: public stigma and self-stigma.

For public stigma, we searched for the lexical labels "schizophrenia", "schizophrenic", "psychosis" and "psychotic" in Chilean newspapers from 2010 to 2020, and for self-stigma, we used semi-structured interviews with people with a diagnosis of schizophrenia who are users of mental health services in Santiago de Chile. The findings were organised into four categories per stigma dimension. Lexical frequencies and semantic relationships were then analysed using the UAM Corpus tool and AntConc software.

The results showed frequent use of stigmatising labels in the written press, with harmful semantic associations such as violence, delinquency, unpredictability and danger.

Such labels tend to be accepted by those affected, evidence of their internalisation of the stigma towards the disease, and create a barrier to integration and inclusion.

Levels of motivation and help-seeking impact the effectiveness of couple relationship education (CRE), as those with greater help-seeking and motivation are more likely to attend more sessions and remain engaged. Less is known about what impacts the association between motivation and help-seeking between partners in a couple engaging in CRE. The current study aims to examine (a) the effect of couples' self-stigma for help-seeking on their own or partner's motivation to complete the relationship education program and (b) whether the effects differ between service modality (i.e., online and in-person). We sampled 276 heterosexual couples who participated in a relationship education program. A multiple-group actor-partner interdependence model analysis revealed that women and men with higher self-stigma for seeking help exhibited lower motivation to complete the program in both settings. Higher self-stigma in men for help-seeking significantly enhanced the motivation of their female partners to complete the online relationship education program.

ADHD is subject to stigma from the general population. Exposure to stigma poses the risk of developing self-stigma of youth and parents, but few studies have focused on self-stigma of ADHD. Furthermore, parental factors have been implicated in self-stigma of youth, but no previous research has assessed the association between self-stigma of parents and youth. Therefore, the objective of this study was to better understand the experience of self-stigma of youth and their parents in the context of ADHD.

Fifty-five youth with ADHD (aged 8-17) and one parent reporter per youth completed surveys to report their experiences.

The results of this study found that both youth and parents reported significantly lower self-stigma scores compared to most previously published research. Parents of boys reported higher self-stigma scores compared to parents of girls. Youth who reported higher self-stigma also reported lower self-esteem. Self-stigma scores in youth were predicted by inattentive symptoms but not hyperactive/impulsive symptoms or parental self-stigma.

Results emphasize the importance of understanding self-stigma of ADHD, symptom severity, and the need for interventions for families with ADHD.

This study aims to examine, through artificial intelligence, specifically machine learning, the emotional impact generated by disclosures about mental health on social media. In contrast to previous research, which primarily focused on identifying psychopathologies, our study investigates the emotional response to mental health-related content on Instagram, particularly content created by influencers/celebrities. This platform, especially favored by the youth, is the stage where these influencers exert significant social impact, and where their analysis holds strong relevance. Analyzing mental health with machine learning techniques on Instagram is unprecedented, as all existing research has primarily focused on Twitter.

This research involves creating a new corpus labelled with responses to mental health posts made by influencers/celebrities on Instagram, categorized by emotions such as love/admiration, anger/contempt/mockery, gratitude, identification/empathy, and sadness. The study is complemented by modelling a set of machine learning algorithms to efficiently detect the emotions arising when faced with these mental health disclosures on Instagram, using the previous corpus.

Results have shown that machine learning algorithms can effectively detect such emotional responses. Traditional techniques, such as Random Forest, showed decent performance with low computational loads (around 50%), while deep learning and Bidirectional Encoder Representation from Transformers (BERT) algorithms achieved very good results. In particular, the BERT models reached accuracy levels between 86-90%, and the deep learning model achieved 72% accuracy. These results are satisfactory, considering that predicting emotions, especially in social networks, is challenging due to factors such as the subjectivity of emotion interpretation, the variability of emotions between individuals, and the interpretation of emotions in different cultures and communities.

This cross-cutting research between mental health and artificial intelligence allows us to understand the emotional impact generated by mental health content on social networks, especially content generated by influential celebrities among young people. The application of machine learning allows us to understand the emotional reactions of society to messages related to mental health, which is highly innovative and socially relevant given the importance of the phenomenon in societies. In fact, the proposed algorithms' high accuracy (86-90%) in social contexts like mental health, where detecting negative emotions is crucial, presents a promising research avenue. Achieving such levels of accuracy is highly valuable due to the significant implications of false positives or false negatives in this social context.

Many military service members and Veterans who experience a psychological need do not seek psychotherapy, which may be due to negative attitudes and stigma toward mental health services. In this study, we investigated the effectiveness of a general vs. military-specific direct-to-consumer psychotherapy marketing video to address psychotherapy attitudes in a nationwide sample of military service members and Veterans (N = 262). Participants were randomly assigned to watch a general commercial produced by the American Psychological Association (APA Video), a military-specific commercial produced by the Department of Veteran Affairs (VA Video), or a control video. After watching the video, they were asked to complete measures assessing public and self-stigma, attitudes, intentions, and preferences for psychotherapy. Consistent with our hypotheses, participants in the direct-to-consumer marketing conditions reported experiencing significantly less self-stigma and more positive attitudes and preferences for psychotherapy after watching their videos, compared to participants in the control condition. Participants who viewed the APA video also reported significantly less public stigma than those in the control condition. Contrary to our hypotheses, the targeted VA video did not outperform the general APA video on any of the dependent variables. These results support the use of direct-to-consumer psychotherapy marketing videos, general or targeted, with military service members and Veterans. Limitations and future directions are discussed.

Self-stigma occurs when a person internalizes and applies stereotypes, prejudice, and discrimination to themselves. For adults who stutter, self-stigma is linked to negative outcomes and reduced quality of life. The development of self-stigma in people who stutter is not well understood. The aim of this study is to evaluate stuttering self-stigma in school-age children and adolescents and explore potential relationships to stuttering's overall adverse impact.

One hundred one children and adolescents who stutter, aged 10-18 years, completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), a measure of adverse impact related to stuttering, and the Childhood Self-Stigma of Stuttering Scale (Child 4S), our novel adapted version of the Self-Stigma of Stuttering Scale (4S) created for this study. The Child 4S comprises three subscales measuring three stages of self-stigma: Awareness, Agreement, and Application. Each stage was evaluated for relationships with child age and the adverse impact of stuttering.

We found a range of self-stigma scores among children and adolescents who stutter. Child age did not correlate with Awareness and Agreement; however, older children and adolescents reported greater Application. All stages of self-stigma strongly predicted adverse impact as measured by the OASES, and latter stages of the model were stronger predictors than earlier stages.

Children as young as 10 years old may experience stuttering self-stigma, and the application of self-stigma increases in adolescence, a critical period in the development of personal identity. Importantly, all stages of self-stigma predicted adverse impact related to stuttering, with latter stages being stronger predictors than earlier ones consistent with the progressive model of self-stigma being tested. The findings highlight the need for targeted, early intervention to mitigate downstream effects of stuttering self-stigma.

https://doi.org/10.23641/asha.26352556.

Individuals convicted of a sexual offense are subject to considerable levels of stigmatization that should lead to internalization of the criminal label according to some versions of labeling theory (Becker, 1963). Recent research has begun to explore how individuals resist and otherwise negotiate their identities in response to stigma, although this research has not yet been applied to the study of stigma associated with the "sex offender" label. Such research is significant because a noncriminal identity is important to facilitating and maintaining desistance from crime. Using in-depth interviews with 20 individuals previously convicted of a sexual offense in a southern U.S. state, this paper investigates the strategies individuals have used to resist stigma associated with the "sex offender" label and how these strategies may help to interrupt the process of self-stigmatization. Results suggest these individuals employ a variety of resistance strategies, which may serve as another tool for managing a "spoiled identity."

Internalized stigma among patients with tuberculosis (TB) significantly affects delayed diagnosis, increased disease transmission, and poor treatment outcomes. However, conclusive empirical evidence on psychosocial interventions to reduce internalized stigma among patients with TB in Thailand remains scarce.

This study aimed to examine the impact of a peer support intervention on reducing internalized stigma among patients with TB in Thailand.

A one-group within-subjects repeated-measure design was conducted in the Muang Maha Sarakham district, Thailand, from February 2023 to July 2023. The study included 26 participants who met specified criteria. Measurements were taken at baseline, three months, and six months following TB diagnosis and medication treatment. The peer support intervention comprised TB health education, psycho-educational sessions, self-management support, and home visits. The Internalized Stigma of Tuberculosis Scale Thai Version was used to measure internalized stigma. Statistical analyses included descriptive statistics and repeated measures ANOVA.

Mean scores of total internalized stigma and its sub-dimensions (alienation, stereotype endorsement, discrimination experience, social withdrawal, and stigma resistance) differed significantly across the three-time points (p <0.001, p <0.001, p <0.001, p <0.001, p <0.001, p = 0.002, respectively). Furthermore, stigma resistance scores significantly increased from pre-intervention to three months (p = 0.005) and from pre-intervention to six months (p = 0.007). However, no significant increase was observed from three to six months (p = 0.079).

The study underlines the positive impact of peer support intervention in reducing internalized stigma among patients with TB in Thailand over time. The findings suggest that interventions focusing on peer support can potentially address internalized stigma, highlighting the importance of integrating these strategies into healthcare practices to enhance patient care and improve TB management outcomes.

Mental illness stigma is associated with a range of negative consequences, such as reduced help-seeking for mental health problems. Since stigma affects individual, social, and structural aspects, multilevel interventions such as the Canadian programme The Working Mind have been proven to be the most effective. Given the solid evidence base for The Working Mind, it is our aim to implement and evaluate culturally adapted versions of the programme in German higher education, targeting students, employees and managers.

We will evaluate the programme with regard to its effect on mental illness stigma, openness to mental health problems, willingness to seek help, and positive mental health outcomes. Further, we will investigate the programme's effectiveness dependent on gender and personal values, various mechanisms of change, and factors facilitating and hindering implementation. The study uses a sequential explanatory mixed-methods evaluation design (QUAN → qual) that consists of three steps: (1) quasi-experimental online survey with programme participants, (2) focus groups with programme participants, and (3) qualitative interviews with programme stakeholders. The quantitative data collected in step 1 will be analysed using 2×3 analysis of variances and a parallel multiple mediation analysis. The results will inform the qualitative data to be collected in steps 2 and 3, which will be analysed using qualitative content analysis.

The study was approved by the local Ethics Committee (Ethics Committee of University Medicine Greifswald; BB 098/23). Participants have to provide written consent before taking part in a focus group or interview. As for the online survey, participants have to give their consent by agreeing to an online data protection form before they can start completing the survey. We will publish central results and the anonymised data in an Open Access Journal. Further, the statistical code will be included as a supplement to the paper(s) documenting the results of the study.

DRKS00033523.

There is a significant gap in the literature regarding trainees' perceptions of remediation. This study aims to explore surgical trainees' experiences and perspectives of remediation.

This qualitative study used semi-structured interviews with 11 doctors who have experienced formal remediation as a surgical trainee. Reflexive thematic analysis was used for data analysis.

In this study, trainees perceived remediation as a harrowing and isolating experience, with long-lasting emotions. There was a perceived lack of clarity regarding explanations of underperformance and subjective goals. Remediation was viewed as a 'performance' and tick-box exercise with superficial plans, with challenging trainee/supervisor dynamics.

These findings about trainees' perspectives on remediation show a need for trainees to be better emotionally supported during remediation and that remediation plans must be improved to address deficits. Integrating the perspectives and experiences of surgical trainees who have undergone remediation should help improve remediation outcomes and patient care.

Mental health literacy (MHL) research in Jordan is sparse and validated MHL measures are lacking. The present study validated a Jordanian version of the Mental Health Literacy Scale (MHLS) and examined Jordanian individuals' MHL.

A Google Forms survey was designed, and the link was shared through various Jordanian social media platforms. Factor analysis and Rasch analysis were performed to validate the Jordanian version of the MHLS. Binary logistic regression was performed to assess variables associated with MHL.

The Jordanian MHLS was administered to 974 participants (74.4% females; median age 27 years). The mean MHL score of the participants was 71.1% indicating average literacy levels. The factor analysis indicated that 27 items distributed across four factors had the best model fit. The Rasch analysis confirmed item separation reliability and person reliability. The regression showed a correlation between educational attainment, income, marital status and MHL level. These findings emphasize the role of educational attainment in MHL, pointing to the necessity of integrating mental health education into formal curricula to enhance MHL across all societal levels. Stigma and limited-service availability act as barriers to mental health service and access, which compound the challenge of improving MHL. Targeted educational interventions and policy reforms may help improve MHL, thereby contributing to improving mental health outcomes in Jordan and potentially other similar settings.

The clinical significance of cancer-related stigma on patients' well-being has been widely established. Stigma can be perceived and internalised by cancer patients or implemented by the general population and healthcare workers. Various interventions have been carried out to reduce cancer-related stigma, but their effectiveness is not well-understood. This review aims to synthesise evidence on the effectiveness of interventions to reduce cancer-related stigma.

An integrative review.

This integrative review combined both qualitative and quantitative studies and followed five steps to identify problems, search for the literature, appraise the literature quality, analyse data, and present data. Mixed Methods Appraisal Tool (version 2018) was applied to evaluate the quality of the included studies.

Databases included Web of Science, MEDLINE, SpringerLink, Wiley Online Journals, Cochrane Library, ScienceDirect, OVID, and China National Knowledge Infrastructure (from the inception of each database to 30 April 2021).

Eighteen quantitative, six qualitative, and five mixed-methods studies were included in this review. Cultural factors should be considered when conducting interventions to reduce cancer-related stigma. For cancer patients, multi-component interventions have demonstrated a positive effect on their perceived stigma. For general population, interactive interventions show promise to reduce their implemented stigma towards cancer patients. For healthcare workers, there is a paucity of studies to reduce their implemented stigma. Existing studies reported inconclusive evidence, partially due to the lack of a robust study design with an adequate sample size.

Multi-component and interactive interventions show promise to relieve cancer-related stigma. More methodologically robust studies should be conducted in different cultures to elucidate the most appropriate interventions for different populations to reduce cancer-related stigma.

These findings will facilitate healthcare workers to design and implement interventions to reduce cancer-related stigma, thus improving the quality of life for cancer patients.

No patient and public contribution.