Stigma, Health and Well-Being
Abstract
:1. Introduction
2. The Aims and Contributions of the Special Issue
3. Findings of the Contributions in the Special Issue
3.1. Stigma on Obesity
3.2. Stigma on Mental Illness
3.3. Stigma on Other Conditions (Homosexuality, Transgender, Physical Disability, Smoking, Solitude, Media Coverage of Pedophilia, and Public Housing Residents)
4. Conclusions and Future Directions
Author Contributions
Funding
Conflicts of Interest
References
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Study/Country | Stigmatized Condition/Population | Participants’ Features | Methods | Type of Stigma | Measured Outcome | Findings |
---|---|---|---|---|---|---|
Lipowska et al. [9]/Poland and Vietnam | Body shape | University students (n = 1290; 586 from Poland (437 women; 149 men) and 704 (461 women; 246 men) from Vietnam; mean age = 20.36 to 21.77 years | Quantitative; cross-sectional | Perceived stigma | Body Esteem Scale; Perceived Stigmatization Questionnaire | University students in the collectivistic societies were vulnerable to criticisms of their bodies. Those from the Christian culture were not. |
Lin et al. [10]/Taiwan | Obesity | Junior high school students (n = 464; 289 actual non-overweight and 176 actual overweight; 248 perceived non-overweight and 213 perceived overweight); mean age = 14.1 years | Quantitative; cross-sectional | Public stigma; perceived stigma; self-stigma | Perceived Weight Stigma Questionnaire; Weight Bias Internalization Scale; Beliefs About Obese Persons Scale; Hospital Anxiety Depression Scale | Adolescents with overweight regardless of actual or self-perceived had higher levels of perceived weight stigma and self-stigma than those without overweight. Perceived weight stigma was associated with anxiety among adolescents with overweight regardless of actual or self-perceived. |
Fung et al. [11]/Hong Kong | Obesity | Young adults aged between 18 and 30 years (n = 325; 126 males and 199 females; 104 with overweight and 221 without overweight); mean age = 21.6 years. | Quantitative; cross-sectional | Self-stigma | International Physical Activity Questionnaire; Weight Bias Internalization Scale | Incorporated with the Theory of Planned Behavior, self-stigma was found to be negatively associated with physical activity level among young adults with overweight. |
Wu et al. [12]/United States | Obesity | Asian Americans (n = 166; 92 males and 74 females); mean age = 45.7 years. | Quantitative; cross-sectional | Experienced stigma | Stigmatizing Situations Inventory; Binge Eating Scale; Suinn-Lew Asian Self-Identity Acculturation Scale; Subtle and Blatant Racism Scale; Perceived Stress Scale | Experienced weight stigma was found to be significantly associated with binge eating behaviors. Moreover, the aforementioned relationship controlled the confounding effects of racism and general stress. |
Panza et al. [13]/United States | Obesity | Sexual minority women (n = 55; 62% bisexual or pansexual, 33% lesbian or homosexual, and 5% queer); mean age = 25 years. | Quantitative; cross-sectional | Experienced stigma | Stigmatizing Situations Inventory | The female sample with sexual minority had high rates of experienced weight stigma. In addition, they frequently reported co-occurrence of perceived and experienced weight stigma because of their marginalized identities. |
Luís et al. [14]/Portugal | Postpartum mood and anxiety disorders | Male adults having a heterosexual relationship with a reproductive-age partner (n = 214); mean age = 32.61 years | Quantitative; cross-sectional | Not specified; possibly self-stigma | Gender-Role Conflict Scale; Acceptance and Action Questionnaire-II; Inventory of Attitudes Toward Seeking Mental Health Services; General Hel-Seeking Questionnaire | Male adults’ stigma may lower their intentions to recommend their partners with postpartum mood and anxiety disorders to seek professional help. |
Rodríguez-Almagro et al. [15]/Spain | Mental illness | Spanish nursing students. Quantitative study: n = 359; 61 males and 298 females; mean age = 20 years. Qualitative study: n = 30; mean age = 20.2 years | Mixed-methods; cross-sectional | Public stigma | Mental Health Stigma Scale | Nursing students in a higher year of study had lower levels of public stigma toward mental illness than those in a lower year of study. The lowered public stigma was associated with more positive attitudes toward people with mental illness. |
Riffel and Chen [16]/Canada | Mental illness | Healthcare students (n = 18 from nine healthcare programs; 12 females and 6 males) | Qualitative; qualitative description; semi-structure interview | Public stigma | -- | Most students had good knowledge of mental health and they showed positive behaviors when interacting with people with mental illness. However, stigmatizing attitudes and unpreparedness to work with people with mental illness were observed in some students. |
Chang et al. [17]/Taiwan | Attention-deficit/ hyperactivity disorder (ADHD) | Caregivers of children with ADHD (n = 400; 287 mothers, 90 fathers, and 23 others); mean age = 43.4 years. | Quantitative; cross-sectional | Affiliate stigma | Affiliate Stigma Scale; Caregivers’ Attitudes toward Children’s ADHD; Swanson, Nolan, and Pelham, version IV scale Parent Form | Higher levels of affiliate stigma were associated with caregivers’ unfavorable attitudes toward the diagnosis of ADHD and related treatments. |
Ng et al. [18]/Hong Kong | Autism spectrum disorder (ASD) | Parents of preschool children with ASD (n = 63; 15 fathers, and 48 mothers); mean age = 39.1 years. | Quantitative; cross-sectional | Affiliate stigma | Young Children’s Participation and Environment Measure; Affiliate Stigma Scale | Parents of ASD children reported affiliate stigma above the midpoint of the Affiliate Stigma Scale. Parents’ affiliate stigma was not correlated with the children’s participation in frequency and involvement. However, parents’ affiliate stigma was associated with reduced involvement of their children in community activities. |
Su and Chang [19]/Taiwan | Dementia | Family caregivers of people with dementia (n = 270; 142 females and 128 males; 167 were children of the care recipients and 36 were spouses of the care recipients); mean age = 52.3 years | Quantitative; cross-sectional | Affiliate stigma | Caregiver Burden Inventory; Affiliate Stigma Scale; Taiwanese Depressive Questionnaire; Beck Anxiety Inventory | Affiliate stigma of the family caregivers who took care of people with dementia was associated with higher levels of anxiety and caregiving burden. Moreover, male caregivers as compared with female caregivers had higher levels of affiliate stigma. |
Lee et al. [20]/Korea | Depression | Registered nurses (n = 184; 10 males and 174 females); mean age = 26.6 years. | Quantitative; cross-sectional | Self-stigma; public stigma | Attitude Toward Psychiatric Help; Beck Depression Inventory-II; Depression Stigma Scale | The relationship between public stigma and attitudes toward seeking psychiatric help is mediated via self-stigma and depression. |
Hanlon and Swords [21]/Ireland | Generalized anxiety disorder | Adolescents (n = 242; 74 males, 165 females, and 3 others); mean age = 16.5 years. | Quantitative; cross-sectional | Public stigma | Personal Depression Stigma Scale; Nine-item Emotional-ratings Scale; Social Distance Scale; Help-Giving Intentions | Endorsement of the stereotype of “weak-not-sick (i.e., the features of generalized anxiety disorder)” was associated with higher prejudice, stronger discrimination, and weaker intentions to help. |
Ma and Hsieh [22]/Taiwan | Mental illness, emotional behavioral disorders, physical disability, and intellectual disability | Occupational therapy students (n = 16; 8 females and 8 males); mean age = 20.3 years at baseline | Quantitative; quasi-experimental (baseline, post-test, and one-year follow-up) | Public stigma | Social Distance Scale; Questionnaire on Stigmatizing Attitudes Toward Mental Illness | Occupational therapy students who completed an anti-stigma course had significantly decreased social distance and stigmatizing attitudes toward the stigmatized population. The decreased public stigma was maintained for a year. |
Mahsoon et al. [23]/Saudi Arabia | Mental illness | Young adults (n = 236; 204 females and 32 males); age range = 18 to 25 years. | Quantitative; cross-sectional | Public stigma | Perceived Parental Support Scale; Mental Health Seeking Attitude Scale; Beliefs Toward Mental Illness Scale | The sample of young adults had relatively negative attitudes toward mental illness and people with mental illness. Moreover, beliefs toward mental illness, perceived parental support, and mental help-seeking attitudes were not associated. |
Sharif et al. [24]/Saudi Arabia | Mental illness | Family caregivers of people with mental illness (n = 13; 77% females; age range = 21–65 years; 38% siblings, 31% parents, 15% children, and 8% spouses) | Qualitative; semi-structured interview | Affiliate stigma | -- | Different types of burden experienced by the caregivers were highly needed. Misconceptions of mental illness were found to be harmful for the caregivers. |
Paananen et al. [25]/Finland | Mental illness | Mental health professionals (n = 624) and mental health rehabilitants and their family member (n = 300 dyads) from the clubhouses. | Qualitative; video-recorded focus group interview | Perceived stigma | -- | Perceived stigma is a phenomenon concerning most of the rehabilitants. |
Ko et al. [26]/Taiwan | Homosexuality and same-sex marriage | Non-heterosexual individuals (n = 1796 (879 males and 917 females; mean age = 29.1 years) in Wave 1 and 798 (386 males and 412 females; mean age = 29.5 years) in Wave 2) and heterosexual individuals (n = 1443 (311 males and 1132 females; mean age = 32.4 years) in Wave 1 and 539 (123 males and 416 females; mean age = 36.3 years) in Wave 2) | Quantitative; two cross-sectional (Wave 1 at 23 months before same-sex marriage referendums in Taiwan; Wave 2 at one week after the referendums) | Perceived stigma | Suicidal Ideation; Unfavorable Attitudes toward Homosexuality and Same-Sex Marriage | Perceived unfavorable attitudes were associated with suicidal ideation among heterosexual individuals and heterosexual individuals who were friendly with homosexual individuals. |
Ozamiz-Etxebarria et al. [27]/Spain | Transgender people | Undergraduate students (n = 376; 240 females, 117 males, and 19 others); mean age = 21.9 years. | Quantitative; cross-sectional | Public stigma | Gender and Transphobia Scale | University students had relatively positive attitudes toward transgender people; however, their knowledge of transgender identity needs to be improved. |
Silván-Ferrero et al. [28]/Spain | Physical disability | People with physical disability (n = 289; 134 males and 155 females); mean age = 45.1 years. | Quantitative; cross-sectional | Self-stigma | Stigma Scale for Chronic Illness 9-item Version; Conner-Davidson Resilience Scale; WHO Quality of Life Questionnaire | The negative association between self-stigma and quality of life among people with physical disability was mediated via resilience. |
Lewis et al. [29]/Scotland | Smoking | Parents who had child(ren) at home (n = 7; age range = 16 to 39 years; four single parents) | Qualitative; semi-structured interview | Self-stigma | -- | Parents may be afraid of disclosing their smoking habits in their societies because of their smoking self-stigma. Therefore, parents may perform hidden smoking and are not confident to stop smoking. |
Lin et al. [30]/Taiwan | Solitude | Junior college students (n = 562; 267 boys and 295 girls); mean age = 17.6 years | Quantitative; cross-sectional | Not specified; possibly self-stigma | Physical and Mental Health Scale; Solitude Capacity Scale | The junior college students reported that their solitude capacity was significantly associated with both physical and mental health. |
Stelzmann et al. [31]/Germany | Media coverage of pedophilia | Healthcare providers (n = 11; seven psychologists and four medical doctors; five females and six males); mean age = 36.2 years | Qualitative; semi-structured interview | Public stigma | -- | Positive attitude toward the media coverage of pedophilia has been stated in the qualitative study. However, public stigma of the media coverage of pedophilia has also been revealed among the healthcare providers. |
Jun and Han [32]/Korea | Public housing residents | Public housing residents in Seoul (n = 4574; 1898 in social-mix housing complex and 2676 in independent public housing complex; 66% males); mean age = 61.8 years. | Quantitative; using the 2017 Seoul Public Housing Residents Panel Study | Not specified; possibly experienced stigma | One item on perceived stress (4-point Likert scale) and one item on discrimination (yes or no) | The association between discrimination and stress was lower in those living in social-mix housing complexes than in those living in independent public housing complexes. |
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Lin, C.-Y.; Tsang, H.W.H. Stigma, Health and Well-Being. Int. J. Environ. Res. Public Health 2020, 17, 7615. https://doi.org/10.3390/ijerph17207615
Lin C-Y, Tsang HWH. Stigma, Health and Well-Being. International Journal of Environmental Research and Public Health. 2020; 17(20):7615. https://doi.org/10.3390/ijerph17207615
Chicago/Turabian StyleLin, Chung-Ying, and Hector W. H. Tsang. 2020. "Stigma, Health and Well-Being" International Journal of Environmental Research and Public Health 17, no. 20: 7615. https://doi.org/10.3390/ijerph17207615
APA StyleLin, C. -Y., & Tsang, H. W. H. (2020). Stigma, Health and Well-Being. International Journal of Environmental Research and Public Health, 17(20), 7615. https://doi.org/10.3390/ijerph17207615