Search Results (203)

States like Hawai‘i are decriminalizing psychedelics based on emerging evidence linking their use to improved psychological well-being. Yet, in many cultural contexts, stigma surrounding mental illness may lead individuals to pursue non-traditional forms of healing, including psychedelics, in place of formal care. This study examines how psychedelic use relates to mental health treatment-seeking behaviors among Asians and Native Hawaiians and Other Pacific Islanders (NHOPIs). Using the National Survey of Drug Use and Health (NSDUH) data from 2008 to 2019 (n = 458,372), the analysis compares Non-Hispanic Whites with Asian and NHOPI respondents to assess associations between MDMA and lifetime classic psychedelic use, psychological distress (K6 scale), and formal mental health service utilization. Nested logistic regression models conducted in Stata 18 indicate that psychedelic use among White individuals is associated with a lower likelihood of seeking formal treatment. In contrast, among NHOPI individuals, psychedelic use is associated with increased odds of accessing mental health care. These findings suggest that psychedelic use may serve culturally distinct roles in coping with distress, shaped by structural stigma and the perceived trustworthiness of formal treatment systems. Full article

Background: Stigma is a major barrier to tuberculosis (TB) control worldwide. However, there is limited evidence of TB-related stigma not only toward patients but also toward their family members in Saudi Arabia. This study aims to assess the level of TB-related stigma and associated factors among individuals with TB and their families in Jazan, Saudi Arabia. Methods: A cross-sectional survey was conducted among 404 participants (272 adult patients with TB and their 132 family members). Participants were interviewed using a structured questionnaire adapted from validated TB-related stigma scales, covering sociodemographic factors and perceived stigma. Sociodemographic factors were used to compare stigma grades. Collected data were analyzed using the Statistical Package for the Social Sciences. Frequencies and percentages were used to describe qualitative variables, while the χ²-test was applied to compare TB-related stigma levels according to demographic factors. p < 0.05 was considered statistically significant. Results: Most participant patients had pulmonary TB (78.7%), while 21.3% had extrapulmonary TB. More than half of them (50.7%) experienced severe stigma, while 23.5% had mild stigma. Levels of TB-related stigma differed significantly according to the patients’ age groups (p = 0.011), residence (p < 0.001), occupation (p = 0.022), and type of TB, which was higher among those with pulmonary TB (p = 0.003). Moreover, 24.2% of family members experienced severe stigma, while 25% had mild stigma. Perceived stigma showed a negative impact on the management of TB. Levels of stigma differed significantly among family members according to their residence (p < 0.001) and marital status (p = 0.018). Conclusions: TB-related stigma is widespread among individuals with TB and their family members in Saudi Arabia. This stigma has significant negative impacts on the management of TB. Levels of perceived stigma are higher among younger patients, those living in urban areas, unemployed patients, and patients with pulmonary TB. Among family members, the stigma levels are higher for those living in urban areas and single individuals. Full article

Background: Assistive technology (AT) can support autistic adults in navigating employment-related challenges. However, limited research has explored autistic adults’ actual needs and experiences with AT in the workplace. Existing studies often overlook how well current AT solutions align with the real-world demands autistic adults face across the employment process. To address this gap, this study conducted a needs assessment to explore autistic adults’ perceived AT and AT service needs across employment stages, identify satisfaction and discontinuation patterns, and examine barriers and facilitators to effective use. Methods: A total of 501 autistic adults were recruited through an online crowdsourcing platform, Prolific. Participants completed a needs assessment that included Likert-scale items and open-ended questions. Quantitative data were analyzed using descriptive statistics and weighted needs scoring procedures. Thematic analysis was applied to qualitative responses regarding satisfaction, discontinuation, and general reflections on AT use. Results: Job retention received the highest total weighted needs score, followed closely by skill development and job performance. Participants reported lower perceived needs for AT in the job development and placement domain. Qualitative findings revealed that AT was described as essential for daily functioning and independence, but barriers such as limited access, inadequate training, and social stigma affected use. Participants also emphasized the need for more person-centered and context-specific AT services. Conclusions: AT has the potential to significantly enhance employment outcomes for autistic adults. However, current services often lack personalization and alignment with real-world needs. Findings support the development of more inclusive, tailored, and accessible AT solutions across all employment stages. Full article

Suicide is a leading cause of death among construction workers, particularly younger and lower-skilled employees. Barriers such as stigma, low mental health literacy, and traditional masculine norms hinder help-seeking in this male-dominated sector. Few mental health interventions are tailored to this context. This study developed a co-designed, theory-informed training to improve mental health literacy, reduce stigma, and increase help-seeking among construction workers in Ireland. Using the Medical Research Council’s framework, the training was developed with the Theory of Planned Behavior (TPB), Behavior Change Techniques, and extensive stakeholder co-design. Two systematic reviews, a broad literature review, and focus groups with industry managers informed the content and structure. The training will be pilot-tested using validated measures: the Literacy of Suicide Scale (LOSS), the Stigma of Suicide Scale (SOSS), and the General Help-Seeking Questionnaire (GHSQ), the results of which will be the subject of a separate study. CAIRDE is a promising, evidence-based training that addresses key mental health barriers in Irish construction. Embedding the TPB within a co-design methodology has resulted in the development of a training program that is underpinned by theoretical fidelity and cultural relevance and provides a framework for other male-dominated industries to draw upon. Future work should address remaining challenges related to stigma and help-seeking, and explore broader implementation through integration into mandatory safety training. Full article

Public stigma toward psychological help-seeking is a critical barrier to mental health service utilization, particularly among university students in culturally conservative and academically demanding disciplines such as law. In China, where Confucian values emphasize social conformity and face preservation, law students may internalize societal narratives that associate mental illness with personal weakness, deterring them from accessing psychological services. This study translated and examined the psychometric properties of the Stigma Scale for Receiving Psychological Help (SSRPH) among Chinese law students. A total of 1257 undergraduate law students from five universities in China participated in the study. Exploratory factor analysis (EFA) was conducted on a randomly selected subsample (n = 628) to examine the scale’s factor structure, followed by confirmatory factor analysis (CFA) on a second subsample (n = 629). Results supported a unidimensional factor structure with strong internal consistency (α = 0.82). CFA yielded a good model fit (CFI = 0.97, TLI = 0.95). Significant negative correlations with help-seeking attitudes (r = −0.37, p < 0.001) supported discriminant validity. While further validation is warranted, the Chinese SSRPH appears suitable for assessing perceived public stigma in legal education contexts and may inform future research and program design in stigma reduction and mental health promotion. Full article

Background/Objectives: Despite medical advances, stigma remains a major challenge for people living with HIV (PLWH). This study examined clinical, sociodemographic, and psychological predictors of HIV-related stigma, and explored whether affective temperament moderates the impact of depression on stigma. Methods: This cross-sectional observational study included 97 PLWH attending a tertiary infectious disease unit in Rome, Italy. Participants completed a battery of validated psychometric instruments assessing depressive symptoms, anxiety, manic symptoms, mixed affective states, general psychopathology, impulsivity, and affective temperament. HIV-related stigma was evaluated using the Berger HIV Stigma Scale, which measures personalized stigma, disclosure concerns, negative self-image, and concerns with public attitudes. Descriptive statistics were used to characterize the sample. Univariate linear regressions were conducted to explore associations between clinical, psychometric, and sociodemographic variables and each stigma subdimension, as well as the total stigma score. Variables significant at p < 0.05 were included in five multivariate linear regression models. Moderation analyses were subsequently performed to assess whether affective temperaments moderated the relationship between significant psychopathological predictors and stigma. Bonferroni correction was applied where appropriate. Results: Higher depressive symptom scores are significantly associated with greater internalized stigma (B = 0.902, p = 0.006) and total stigma (B = 2.603, p = 0.008). Furthermore, moderation analyses showed that anxious temperament significantly intensified the relationship between depressive symptoms and both negative self-image (interaction term B = 0.125, p = 0.001) and total stigma (B = 0.336, p = 0.002). Conclusions: Depressive symptoms and anxious temperament are associated with HIV-related stigma. Integrating psychological screening and targeted interventions for mood and temperament vulnerabilities may help reduce stigma burden in PLWH and improve psychosocial outcomes. Full article

Background: The mental health of physicians has become a pressing global concern. High rates of depression, anxiety, and burnout are reported in the literature, with each condition linked to reduced job satisfaction, increased medical errors, and ultimately suicidal ideation (SI). Although research on physicians’ mental health is emerging in Saudi Arabia, data on suicidality remain scarce. Objective: This study aims to determine the prevalence of SI and its determinants among physicians in Saudi Arabia. Methods: A cross-sectional study was conducted with 423 physicians across all medical specialties of all ranks, who were recruited using a convenience sampling technique. The study tool comprised three main sections. The first section included questions regarding sociodemographic factors, lifestyle, and work-related factors. The second section included items on suicidality and the Patient Health Questionnaire-9 to screen for depressive symptoms. The third section included the Brief Resilient Coping Scale (BRCS) to measure the coping mechanisms of the participants. Results: SI was disclosed by 9.7% of the respondents, with 0.5% reporting previous suicide attempts. Suicidal ideation was independently associated with low income (OR = 3.94, 95% CI 1.32–11.76, p = 0.014) and higher depression scores (OR = 1.09 per point, 95% CI 1.02–1.16, p = 0.008). Moreover, knowing a colleague with suicidal behavior (i.e., knowing a colleague who had contemplated suicide or had attempted suicide/died by suicide) was significantly associated with SI among our participants (p < 0.001 and p < 0.006, respectively). Higher scores on the BRCS, specifically with respect to growing from adversity and actively replacing losses, were linked to lower odds of SI (p < 0.001 and p < 0.045, respectively). Conclusions: Physicians in Saudi Arabia experience an alarming level of SI that is associated with low income and depression. The results of this study underscore the importance of additional research to evaluate the effectiveness of intervention programs designed to enhance mental health support for physicians, encourage adaptive coping mechanisms, foster peer support networks, and combat stigma associated with mental illnesses. Full article

Currently, there are no validated instruments in Italian specifically designed to assess mental illness stigma or prejudice. Moreover, implicit measures, while insightful, are often resource-intensive and impractical for large-scale population studies of Italian speakers. The present study investigated the validity of the Italian version of the Prejudice towards People with Mental Illness scale (PPMI-IT) in measuring biases toward individuals with mental health issues. The original instrument by Kenny et al. was translated from English into Italian and vice versa. A sample of 455 Italian-speaking participants (65% female; M_age = 33.39; SD = 13.21) was utilized to conduct a confirmatory factor analysis, confirming a four-factor structure (fear/avoidance, malevolence, authoritarianism, unpredictability). Factor loadings indicated that each dimension was well represented, supporting the construct validity of the scale. Model fit indices, including chi-square (χ² = 782.54, df = 296.00, χ²/df = 2.64), RMSEA (0.06, 90% CI: 0.060–0.07), CFI (0.93), TLI (0.91), and SRMR (0.06), suggest an excellent model fit. Furthermore, the analysis of correlations and the heterotrait/monotrait (HTMT) ratio provides evidence supporting the discriminant validity of the PPMI scale compared with social desirability. These findings confirm that the PPMI scale is a valid and reliable tool for assessing biases toward individuals with mental health issues, making it suitable for academic research, clinical interventions, and public policy contexts. Full article

The stigma associated with food assistance can be a barrier to resolving food insecurity. Self-reliance expectations likely contribute to this stigma. Aim: This cross-sectional study identified factors that predict perceptions of food assistance stigma. Demographics (age, sex, race, and ethnicity) were collected, and food assistance stigma (Food Resource Acceptability) and self-reliance (Self-Reliance Scale) were measured via REDCap questionnaires from 531 online participants. The research volunteer repository, Research Match, was used for recruitment. Multiple regression was conducted to determine food assistance stigma predictors. Older age, being male, and reporting higher self-reliance significantly predicted the likelihood of stigmatizing food assistance. The social expectation of self-reliance in adulthood contributes to an assigned and anticipated stigma associated with accepting food assistance. This stigma permeates many regions, particularly the United States, and likely contributes to unresolved food insecurity despite the availability of multiple food assistance resources. Future qualitative research should be conducted among older individuals and males with high levels of self-reliance to gain a deeper understanding of how food assistance stigma could be lessened so that appropriate stigma reduction interventions could be tested among this target group. Full article

Background/Objectives: Globally, one in eight people live with a mental disorder, with depression being a leading cause of disability. This study aimed to identify sociodemographic factors associated with public belief and perception of mental disorders among adults in Poland. Methods: A cross-sectional study with a self-prepared questionnaire (5-point Likert scale) was administered to a nationally representative quota sample of 1114 Polish adults (March 2025). The computer-assisted web interview (CAWI) method was applied. Results: A cross-sectional survey of 1114 adults found that 23.2% had visited psychiatrists, 15.9% psychotherapists, and 21.1% reported a family history of mental disorders. Most respondents (73.8%) believed employers are reluctant to hire individuals with mental disorders, and 53.8% perceived discrimination. Additionally, 19.4% thought mental health patients receive lower-quality care than those with physical illnesses like diabetes. Respondents from large cities (≥500,000 residents, aOR: 1.67; 95%CI: 1.11–2.51; p = 0.01), with higher education (aOR: 1.62; 95%CI: 1.26–2.07; p < 0.001), or a family history of mental disorders (p < 0.05) were more likely to hold this view. Higher education (aOR: 1.47; 95%CI: 1.11–1.94; p = 0.01), good economic status (aOR: 1.60; 1.06–2.40; p = 0.02), and personal psychiatric experience (aOR: 1.89; 95%CI: 1.24–2.87; p = 0.003) increased belief in treatment effectiveness. Males (aOR: 1.88; 95%CI: 1.36–2.61; p < 0.001) and medium-city residents (aOR: 1.82; 95%CI: 1.01–3.27; p = 0.04) more often perceived mental disorders as a sign of weakness, while women (aOR: 1.74; 95%CI: 1.36–2.22; p < 0.001) and those with affected relatives (p < 0.05) more frequently reported discrimination. Older respondents (p < 0.05), those with higher education (aOR: 1.65), and individuals with a family history of mental disorders (p < 0.05) were more likely to state that employers fear hiring people with psychiatric conditions. Conclusions: These findings underscore the need for public health interventions to reduce stigma, improve awareness, and address misconceptions about mental disorders in Poland. Full article

This study reframes closure intention in small- and medium-sized enterprises (SMEs) as an ex ante diagnostic signal rather than a post-mortem symptom of failure. The survey evidence from 385 Ecuadorian SMEs was analyzed in two stages; confirmatory factor analysis validated the scales capturing environmental pessimism and personal pressures, and a structural equation model confirmed that both latent constructs directly heighten exit propensity. A binomial logistic regression model correctly classified 71% of the cases and explained 30% of variance. Five variables proved decisive: low-level liquidity (OR = 0.84), a high debt-to-equity ratio (1.41), weak profitability (0.14), negative environmental perceptions (1.72), and a shorter operating tenure (0.91); the sector and the firm size were non-significant. The combined CFA-SEM-logit sequence yields practical early warning thresholds—debt-to-equity ratio > 1.4, current ratio < 1.0, and ROA < 0.15—that lenders, advisers, and entrepreneurs can embed in dashboards or credit screens. Recognizing closure intention as a rational, strategic step challenges the stigma surrounding exit and links financial distress and the strategic exit theory. Policymakers can use the findings to pair debt relief and liquidity programs with cognitive bias training that helps owners interpret risk signals realistically. For scholars, the results highlight closure intention as a dynamic learning process, especially pertinent in emerging economies characterized by informality and institutional fragility. Full article

Background/Objectives: Dementia is one of the leading causes of disability and dependence among older adults. Early screening may support timely intervention and risk management, contributing to better outcomes at the public health level. However, evidence relating to the factors influencing dementia screening acceptance and knowledge among older adults remains limited. This study aimed to assess dementia knowledge and screening acceptance among older adults, identify their associated factors, and explore the relationship between the two. Methods: A cross-sectional survey was conducted among 272 older adults in three Chinese communities. Data were collected using a self-administered questionnaire covering socio-demographic characteristics, dementia knowledge, and screening acceptance. The Dementia Knowledge Questionnaire and the Chinese version of the PRISM-PC scale were applied. Univariate and multivariate linear regression analyses were used. Results: The mean scores for dementia knowledge and screening acceptance were 18.86 ± 5.98 and 62.06 ± 22.18, respectively. Age and education level were negatively associated with screening acceptance. Women had higher knowledge scores than men. Income and social participation were positively associated with dementia knowledge. Knowledge level showed a weak positive correlation with screening acceptance. Conclusions: The study revealed that dementia knowledge and screening acceptance among older adults were moderate; nonetheless, both aspects warrant further improvement. Community-based efforts should prioritize health education, stigma reduction, and targeted interventions to enhance knowledge and promote proactive screening behavior. Full article

Background: Men who have sex with men (MSM) in Japan, and globally, face disparities in mental health and well-being, driven by stigma, exclusion, and minority stress. While social capital is known to enhance well-being, no previous research has examined the distinct roles of gay versus heterosexual social capital in relation to subjective happiness. Methods: We conducted a cross-sectional online survey of 1564 MSM in Greater Tokyo, using geosocial networking applications. Social capital was measured using an adapted Resource Generator to assess access to resources from MSM and heterosexual network members. Subjective happiness was assessed using the Japanese version of the Subjective Happiness Scale. Multivariable linear regression identified correlates of happiness. Results: Gay social capital was the strongest predictor of subjective happiness, exceeding the effects of self-rated health, education, employment, and age. High levels of heterosexual social capital were also associated with greater happiness but to a lesser extent. Unemployment, poor health, and attendance at gay cruising venues were negatively associated with happiness. Conclusions: These findings provide the first global evidence of the differential associations between gay and heterosexual social capital on subjective happiness. Community-based interventions that affirm identity and build peer connection may substantially improve well-being among MSM in Japan. Full article

Background: In Japan, new challenges are emerging, such as declining birth rates, an increase in age at childbirth, postpartum depression, and child abuse. Methods: This study examines the factors influencing maternal consultation behavior at public institutions using some of the data from the Japan COVID-19 and Society Internet Survey (JACSIS). A total of 6227 women (1380 pregnant and 4847 postpartum) were analyzed through logistic regression. Results: The results showed different factors influencing consultations between pregnant women and postpartum women. Among pregnant women, different trends were observed between primigravidae and multigravidae, indicating that primigravidae aged ≥40 years and multigravidae with multiple childbirths tend to seek consultations more frequently. In postpartum women, psychological distress (K6), adverse childhood experiences (ACEs), and social support networks significantly influenced consultation behavior. Postpartum women with extensive support networks (≥3 confidants) exhibited higher consultation rates. In contrast, those with elevated Edinburgh Postnatal Depression Scale (EPDS) and Mother-to-Infant Bonding Scale (MIBS-J) scores were less likely to seek help, potentially due to mental health stigma. Conclusions: This study showed that pregnant and postpartum women facing physical, mental, family, or relationship issues are seeking consultations and receiving thorough support. On the other hand, since some pregnant and postpartum women refrained from seeking consultation, it is necessary to further consider support measures that make it easier for all pregnant and postpartum women to seek advice in the future. Full article

Background/Objectives: Acne vulgaris (AV), a common dermatological condition in adolescence, has been widely recognized not only for its physical impact but also for its significant psychological and social consequences, particularly the internalization of stigma. This study specifically aimed to evaluate the state of internalized stigma in adolescents with AV and its relationship with quality of life and disease severity. Additionally, we sought to identify and assess the factors associated with internalized stigma. Methods: A total of 179 patients with AV were included in this cross-sectional observational study. We employed a convenience sampling strategy. The Internalized Stigma Scale (ISS) was used to assess patients’ stigma. The Acne Quality of Life Scale (AQLS) and the Dermatology Life Quality Index (DLQI) were used to assess patients’ quality of life. The Global Acne Grading System (GAGS) was used to assess disease severity. Results: Cronbach’s alpha coefficient for the ISS was determined to be 0.79. In our study, the mean total ISS scores for patients with AV were notably high. The ISS was significantly positively correlated with the AQLS score (r = 0.653, p < 0.001), DLQI score (r = 0.487, p < 0.001), and GAGS score (r = 0.257, p = 0.006). Linear regression analysis was performed to predict the ISS variable. Accordingly, the AQLS positively and significantly predicts (β = 0.521, p < 0.001). Conclusions: AVs often experience high levels of stigma. Internalized stigma is strongly associated with reduced quality of life and increased disease severity. Moreover, the AQLS significantly affects stigma. Full article