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Badran L, Rizkalla N, Segal SP. Muslim considerations in seeking mental health help in California and Israel: a qualitative approach. BMC Public Health 2025; 25:1077. [PMID: 40114131 PMCID: PMC11927169 DOI: 10.1186/s12889-025-22224-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 03/06/2025] [Indexed: 03/22/2025] Open
Abstract
BACKGROUND Existing evidence indicates that Muslim minorities underutilize mental health services despite a pressing need. Employing the Theory of Planned Behavior (TPB), this study seeks to explore considerations that influence mental health help-seeking by Muslims residing in California and Israel. METHODS A qualitative approach involving semi-structured interviews guided by the TPB principles was implemented with 78 Muslim participants. Thematic analysis was conducted to identify key themes. RESULTS Employing both deductive and inductive approaches, four major themes were identified: attitudes (advantages, disadvantages, and the influence of religiosity), subjective norms (the impact of significant others), perceived behavioral control (facilitators and challenges), and intentions toward seeking mental health support (influenced by gender, and prior experience). Common social and cultural norms were identified in both groups within the patterns of the TPB. The family's significance as a supportive resource emerged in both groups, but the extended family had a more profound impact among Muslims in Israel. Stigma as a barrier against seeking mental health help was stronger among Muslims in Israel, while financial barriers and socio-political context were highlighted more by Californian Muslims. CONCLUSIONS The findings highlighted the importance of adopting a holistic approach to mental health help-seeking among Muslims due to commonalities in approaches, irrespective of geographical differences. Variance between the two groups primarily stemmed from social factors, particularly stigma and the influence of extended family. The results underscore the universality of common aspects and emphasize the importance of addressing social norms and socio-economic realities to enhance engagement among Muslims in both countries.
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Affiliation(s)
- Leena Badran
- School of Social Welfare, University of California Berkeley, Berkeley, USA.
- Med School, Psychiatry and Behavioral Science, University of California Davis, 4701 X St, Davis, CA, USA.
| | - Niveen Rizkalla
- Center for Effective Global Action (CEGA)and, the School of Public Healthaq, University of California Berkeley, Berkeley, USA
| | - Steven P Segal
- School of Social Welfare, University of California Berkeley, Berkeley, USA
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Al-Qerem W, Jarab A, Khdour M, Eberhardt J, Alasmari F, Hammad A, Zumot R, Khalil S. Assessing mental health literacy in Jordan: a factor analysis and Rasch analysis study. Front Public Health 2024; 12:1396255. [PMID: 39011325 PMCID: PMC11248750 DOI: 10.3389/fpubh.2024.1396255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/19/2024] [Indexed: 07/17/2024] Open
Abstract
Background 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. Method 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. Results 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.
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Affiliation(s)
- Walid Al-Qerem
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Anan Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates
- Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Maher Khdour
- College of Pharmacy, Al-Quds University, Abu Dis, Palestine
| | - Judith Eberhardt
- School of Social Sciences, Humanities and Law, Department of Psychology, Teesside University, Middlesbrough, United Kingdom
| | - Fawaz Alasmari
- College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Alaa Hammad
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Ruba Zumot
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
| | - Sarah Khalil
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan
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Fekih-Romdhane F, Daher-Nashif S, Stambouli M, Alhuwailah A, Helmy M, Shuwiekh HAM, Mohamed Lemine CMF, Radwan E, Saquib J, Saquib N, Fawaz M, Zarrouq B, Naser AY, Obeid S, Saleh M, Haider S, Miloud L, Badrasawi M, Hamdan-Mansour A, Barbato M, Motwakil Bakhiet A, Khalil NS, Adawi S, Grein F, Loch AA, Cheour M, Hallit S. Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries. BMC Public Health 2023; 23:1671. [PMID: 37649023 PMCID: PMC10469418 DOI: 10.1186/s12889-023-16622-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries. METHOD The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females). RESULTS Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes. CONCLUSION Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
- Department of Psychiatry Ibn OmraneThe Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunis, Tunisia.
| | - Suhad Daher-Nashif
- School of Medicine, Keele University, Keele, Staffordshire, UK
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Manel Stambouli
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- Department of Psychiatry Ibn OmraneThe Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunis, Tunisia
| | | | - Mai Helmy
- Psychology department, College of Education, Sultan Qaboos University, Muscat, Oman
- Psychology department, Faculty of Arts, Menoufia University, Menofia Governorate, Egypt
| | | | | | - Eqbal Radwan
- Department of Biology, Faculty of Science, Islamic University of Gaza, Gaza Strip, Palestine
| | - Juliann Saquib
- College of Medicine, Clinical Sciences Department, Sulaiman AlRajhi University, Bukariyah, Al-Qassim, Saudi Arabia
| | - Nazmus Saquib
- College of Medicine, Clinical Sciences Department, Sulaiman AlRajhi University, Bukariyah, Al-Qassim, Saudi Arabia
| | - Mirna Fawaz
- Nursing Department, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Btissame Zarrouq
- Faculty of Medicine and Pharmacy, Laboratory of Epidemiology and Research in Health Sciences, Fez, Morocco
| | - Abdallah Y Naser
- Department of Applied Pharmaceutical Sciences and Clinical Pharmacy, Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Byblos, Lebanon
| | - Maan Saleh
- Department of Psychiatry Khobar, Imam Abdulrahman Bin Faisal University, Dammam, KSA, Saudi Arabia
| | - Sanad Haider
- Faculty of Medicine and Health Sciences, Behavioral Sciences Dep. A, Aden, Yemen
| | - Lahmer Miloud
- The National Centre of Research in Social and Cultural Anthropology, Oran, Algeria
| | - Manal Badrasawi
- Department of Nutrition and Food Technology, Faculty of Agriculture and Veterinary Medicine, An-Najah National University, Nablus, Palestine
| | | | - Mariapaola Barbato
- Department of Psychology, College of Natural and Health Sciences, Zayed University, Dubai, UAE
| | | | | | - Samir Adawi
- College of Medicine and Health Sciences, Behavioural Medicine, Sultan Qaboos University, Muscat, Oman
| | | | - Alexandre Andrade Loch
- Laboratorio de Neurociencias (LIM 27), Faculdade de Medicina, Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Universidade de Sao Paulo, Sao Paulo, SP, BR, Brazil
- Instituto Nacional de Biomarcadores Em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico E Tecnológico, Sao Paulo, Brazil
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
- Department of Psychiatry Ibn OmraneThe Tunisian Center of Early Intervention in Psychosis, Razi Hospital, Tunis, Tunisia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, P.O. Box 446, Lebanon.
- Research and Psychiatry Departments, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Al-Omari M, Abu Khait A. Feasibility, Acceptability, and Preliminary Effectiveness of Cognitive-Reminiscence Therapy among Jordanian People with Major Depressive Disorders: A Mixed Methods Study. Issues Ment Health Nurs 2023:1-13. [PMID: 37229657 DOI: 10.1080/01612840.2023.2205511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Depression is a major public health problem around the world. Negative automatic thoughts are cognitive errors that build in the mind, leading to depression. Cognitive-reminiscence therapy is one of the most effective psychosocial methods for managing cognitive errors. This study aimed to evaluate cognitive reminiscence therapy's feasibility, acceptability, and preliminary effectiveness among Jordanian patients with major depressive disorder. A convergent-parallel design was employed. A convenience sampling method was used to recruit 36 participants (Site 1: n = 16, Site 2: n = 20). A total of 31 participants were included in the analysis, divided into six groups, with 5-6 participants in each group. Cognitive-reminiscence therapy included eight supported sessions of up to 2 h each, delivered over 4 wk. Recruitment, adherence, retention, and attrition rates of 80%, 86.1%, and 13.9%, respectively, indicated the feasibility of the therapy. The acceptability of therapy was reflected in the following four themes: Positive Cognitive Reminiscence Therapy Perspectives and Outcomes; Cognitive Reminiscence Therapy Sessions Challenge; Suggestions for Improving Cognitive Reminiscence Therapy Sessions; and Motivational Home Activities. A significant reduction in the mean of depressive symptoms and negative automatic thoughts and a significant increase in the self-transcendence mean demonstrated the effectiveness of the intervention. The study's results suggest that cognitive reminiscence therapy is feasible and acceptable among patients with major depressive disorder. This therapy is a promising nursing intervention to reduce depressive symptoms and negative automatic thoughts and increase self-transcendence for those patients.
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Affiliation(s)
| | - Abdallah Abu Khait
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Altwaijri Y, Kazdin AE, Al-Subaie A, Al-Habeeb A, Hyder S, Bilal L, Naseem MT, De Vol E. Lifetime prevalence and treatment of mental disorders in Saudi youth and adolescents. Sci Rep 2023; 13:6186. [PMID: 37061556 PMCID: PMC10105730 DOI: 10.1038/s41598-023-33005-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 04/05/2023] [Indexed: 04/17/2023] Open
Abstract
Previous global and regional studies indicate that adolescents and young adults (i.e., youth) are affected by various mental disorders with lifelong consequences. However, there are no national estimates of mental disorders prevalent among Saudi youth. Using data from the Saudi National Mental Health Survey (SNMHS), we examined the lifetime prevalence, treatment, and socio-demographic correlates of mental disorders among Saudi youth (aged 15-30). A total of 4004 interviews were conducted using the adapted Composite International Diagnostic Interview (CIDI 3.0). Cross tabulations and logistic regression were used to generate estimates for the SNMHS youth sample (n = 1881). The prevalence of a mental disorder among Saudi youth was 40.10%, where anxiety disorders affected 26.84% of the sample, followed by disruptive behavior disorders (15.44%), mood disorders (9.67%), substance use disorders (4%) and eating disorders (7.06%). Sex, education, parental education, income, marital status, region, and family history of disorders were significant correlates of various classes of mental disorders. Only 14.47% of Saudi youth with any mental disorder received treatment for a lifetime disorder. Age, parental education, and family history of disorders emerged as significant correlates of mental health treatment. Lifetime mental disorders are highly prevalent among Saudi youth. There is an unmet need for culturally sensitive and age-appropriate treatment of lifetime mental disorders among youth in Saudi Arabia.
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Affiliation(s)
- Yasmin Altwaijri
- King Salman Center for Disability Research, Riyadh, Saudi Arabia.
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia.
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| | - Alan E Kazdin
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Abdullah Al-Subaie
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Edrak Medical Center, Riyadh, Saudi Arabia
| | - Abdulhameed Al-Habeeb
- National Center for Mental Health Promotion, Ministry of Health, Riyadh, Saudi Arabia
| | - Sanaa Hyder
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Health and Meaningful Dialogue (HAMD) Centre, Manchester, UK
| | - Lisa Bilal
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Talal Naseem
- King Salman Center for Disability Research, Riyadh, Saudi Arabia
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
- SABIC Psychological Health Research & Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Edward De Vol
- Biostatistics, Epidemiology and Scientific Computing Department, King Faisal Specialist Hospital and Research Centre, MBC 03, PO Box 3354, Riyadh, 11211, Saudi Arabia
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Saade S, Parent-Lamarche A, Khalaf T, Makke S, Legg A. What barriers could impede access to mental health services for children and adolescents in Africa? A scoping review. BMC Health Serv Res 2023; 23:348. [PMID: 37024835 PMCID: PMC10080850 DOI: 10.1186/s12913-023-09294-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 03/15/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Few studies have examined the mental health needs of African children and teenagers. Based on this gap, this scoping review aims to identify barriers to mental health services, treatments and services sought, and where mental health services are received. METHODS To pursue the stated objectives, we searched the following databases a) PsycINFO, b) CINAHL, c) Medline, and d) Web of Science. The search yielded 15,956 records in total. RESULTS Studies included in this review were conducted in six African countries: Ethiopia, Mali, Egypt, South Africa, Nigeria, and Tunisia. The majority of the studies were conducted in South Africa (33.32%), followed by Ethiopia (25%), and Egypt (16.67%). In terms of treatments and services sought, both professional and traditional/alternative treatments were reported. The most frequently noted services were psychiatric treatments (25%), screening and diagnostic assessment (16.67%), as well as psychiatric and psychological consultations (16.67%). The most frequently reported treatment centers were psychiatric hospitals. As for treatment barriers, the three most frequently encountered barriers were: a preference for traditional/alternative and complementary treatments (33.33%), followed by stigma (25%), and a lack of knowledge/unfamiliarity with the mental health condition (25%). CONCLUSION The results of this study are alarming due to the significant barriers to accessing mental health services coupled with the use of potentially harmful interventions to treat those mental health conditions. We hope this scoping review will help shed light on this important issue and help tomorrow's generation reach its full potential.
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Affiliation(s)
- Sabine Saade
- Department of Psychology, American University of Beirut, P.O.Box 11-0236, Riad El-Solh/Beirut, 1107 2020, Lebanon.
| | - Annick Parent-Lamarche
- Département de gestion des ressources humaines, Université du Québec à Trois-Rivières, 3351, boulevard des Forges, Trois-Rivières, QC, G8Z 4M3, Canada
| | - Tatiana Khalaf
- Department of Psychology, American University of Beirut, P.O.Box 11-0236, Riad El-Solh/Beirut, 1107 2020, Lebanon
| | - Sara Makke
- Department of Psychology, American University of Beirut, P.O.Box 11-0236, Riad El-Solh/Beirut, 1107 2020, Lebanon
| | - Alexander Legg
- Department of Psychology, CUNY John Jay College of Criminal Justice, 524 W 59th Street, New York, NY, 10019, USA
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Dussault JM, Zimba C, Akello H, Stockton M, Hill S, Aiello AE, Keil A, Gaynes BN, Udedi M, Pence BW. Estimating the effect of anticipated depression treatment-related stigma on depression remission among people with noncommunicable diseases and depressive symptoms in Malawi. PLoS One 2023; 18:e0282016. [PMID: 36928834 PMCID: PMC10019662 DOI: 10.1371/journal.pone.0282016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/06/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE While mental health stigma research is sparse in Malawi, research in other settings suggests that stigma represents a barrier to mental health treatment and recovery. Accordingly, we conducted an analysis to understand the role of treatment-related stigma in depression care in Malawi by estimating the effect of patients' baseline anticipated treatment-related stigma on their 3-month probability of depression remission when newly identified with depression. METHODS We conducted depression screening and treatment at 10 noncommunicable disease (NCD) clinics across Malawi from April 2019 through December 2021. Eligible cohort participants were 18-65 years with depressive symptoms indicated by a PHQ-9 score ≥5. Questionnaires at the baseline and 3-month interviews included a vignette-based quantitative stigma instrument that measured treatment-related stigma, i.e., concerns about external stigma because of receiving depression treatment. Using inverse probability weighting to adjust for confounding and multiple imputation to account for missing data, this analysis relates participants' baseline levels of anticipated treatment stigma to the 3-month probability of achieving depression remission (i.e., PHQ-9 score < 5). RESULTS Of 743 included participants, 273 (37%) achieved depression remission by their 3-month interview. The probability of achieving depression remission at the 3-month interview among participants with high anticipated treatment stigma (0.31; 95% Confidence Interval [CI]: 0.23, 0.39)) was 10 percentage points lower than among the low/neutral stigma group (risk: 0.41; 95% CI: 0.36, 0.45; RD: -0.10; 95% CI: -0.19, -0.003). CONCLUSION In Malawi, a reduction in anticipated depression treatment-related stigma among NCD patients initiating depression treatment could improve depression outcomes. Further investigation is necessary to understand the modes by which stigma can be successfully reduced to improve mental health outcomes and quality of life among people living with depression.
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Affiliation(s)
- Josée M. Dussault
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | | | | | - Melissa Stockton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America
- New York State Psychiatric Institute, New York, New York, United States of America
| | - Sherika Hill
- Center for Child and Family Policy, Duke University, Durham, NC, United States of America
| | - Allison E. Aiello
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States of America
- Department of Epidemiology and Robert N. Butler Columbia Aging Center, Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Alexander Keil
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States of America
| | - Bradley N. Gaynes
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States of America
- Department of Psychiatry, UNC School of Medicine, Chapel Hill, NC, United States of America
| | - Michael Udedi
- NCDs & Mental Health Unit, Ministry of Health Malawi, Lilongwe, Malawi
| | - Brian W. Pence
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, NC, United States of America
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Ayyash M, Ayyash M, Saad F, Alaouie M, Blackwood RA. A comparison of the experiences, challenges and coping strategies for parents of children with autism residing in the United States and The Arab World. J Natl Med Assoc 2023; 115:254-262. [PMID: 36828706 DOI: 10.1016/j.jnma.2023.01.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 07/25/2022] [Accepted: 01/30/2023] [Indexed: 02/25/2023]
Abstract
Most research on autism has targeted White Americans. Although challenges and coping mechanisms are present for all parents, some aspects are influenced by culture. This study aims to compare the experiences, challenges and coping strategies for parents of children with autism residing in the US and Arab countries. A survey, available in both English and Arabic, was posted electronically on social media support groups for parents of children with autism in Arab countries and the US. The survey covered experiences, challenges and coping strategies for raising a child with autism spectrum disorder. 165 surveys were collected from 15 Arab countries and 235 surveys were collected from 32 US states. On a scale from 1 to 5, with 5 being highest satisfaction, US parents reported a higher satisfaction for the overall diagnostic process with median score of 3.0 compared to 2.5 for parents in Arab countries. Parents in both countries reported information seeking/self-education about autism and acceptance and/or religion as the 2 most valuable coping strategies. Lower satisfaction with all aspects of the diagnosis process was found among parents in Arab countries compared to those residing in the US. Lack of community support for Arab parents was also a more significant challenge compared to US parents. With such poor community support for Arab parents, it is pivotal to expand upon initiatives that minimize the stigma and shame associated with an autism diagnosis to ultimately reduce challenges and allow for better parental experiences.
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Affiliation(s)
- Marwa Ayyash
- Department of Emergency Medicine, Henry Ford Health System, Detroit, MI; Arab American Health Initiative, Dearborn, MI
| | - Mariam Ayyash
- Arab American Health Initiative, Dearborn, MI; Department of Obstetrics & Gynecology, Henry Ford Health System, Detroit, MI.
| | - Fatima Saad
- Arab American Health Initiative, Dearborn, MI; University of Michigan-Dearborn, Dearborn, MI
| | | | - R Alexander Blackwood
- Arab American Health Initiative, Dearborn, MI; Michigan Medicine, Department of Pediatrics and Communicable Diseases, Ann Arbor, MI; Office for Health Equity and Inclusion, Ann Arbor, MI
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9
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Zhang M, Zhang Y, Zhu Y, Lin X, Zhi Y, Zhu Y, Shi C, Kong Y. Stigmatized experience is associated with exacerbated pain perception in depressed patients. Behav Res Ther 2023; 161:104252. [PMID: 36645948 DOI: 10.1016/j.brat.2023.104252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/03/2023] [Accepted: 01/08/2023] [Indexed: 01/15/2023]
Abstract
Patients with depression not only have to cope with depressive and physical symptoms but also face stigmatization due to mental illness. Pain is a clinical symptom of many patients with depression. However, it is unclear whether stigmatized experience associated with mental illness directly affects depressed patients' pain perception. Here, using the event reflection task, Study 1 (N = 95) examined whether stigmatized experiences due to depression would affect patients' self-reported pain assessment. Study 2 (N = 43) further employed thermal stimuli at different intensities to examine whether stigmatization would affect patients' evoked pain. We found that patients with depression who experienced stigmatization based on mental illness reported higher pain catastrophizing and performed increased pain perception for noxious stimuli than those who did not. Our studies provide first-hand experimental evidence of the effect of stigmatized experiences on depressed patients' pain perception. The findings contribute insights for improving clinical treatment, suggesting that interventions should minimize stigmatization associated with mental illness to help patients maintain healthier physical and psychological states.
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Affiliation(s)
- Ming Zhang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yuqi Zhang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yue Zhu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191, China; NHC Key Laboratory of Mental Health, Peking University, Beijing, 100191, China
| | - Xiaomin Lin
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yongkang Zhi
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Yupu Zhu
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Chuan Shi
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, 100191, China; National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Beijing, 100191, China; NHC Key Laboratory of Mental Health, Peking University, Beijing, 100191, China.
| | - Yazhuo Kong
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 100049, China; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK.
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Gearing RE, Brewer KB, Cheung M, Leung P, Chen W, He X. Suicide in China: Community Attitudes and Stigma. OMEGA-JOURNAL OF DEATH AND DYING 2023; 86:809-832. [PMID: 33535898 DOI: 10.1177/0030222821991313] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
China accounts for an estimated third of the world's suicides, yet individuals experiencing suicidality typically do not seek out or receive treatment. This study examines community perceptions and public stigma toward suicide. In Shanghai, China 186 adults were recruited to participate in a survey with an experimental vignette describing a suicidal individual, manipulated on gender and age, followed by questions eliciting attitudes toward suicide. Most participants agreed that the suicidal subject had a serious problem, with seriousness of the problem decreasing with participant's age. Participants reported moderate levels of public stigma. More stigma was found toward adolescent subjects rather than adult. Male subjects were perceived as being more likely to change than females. The public's accurate view of suicide without biases could help prevent suicide from getting worse. Public perceptions regarding a suicidal individual's likelihood to change could lead to stigma reduction, which can subsequently help with effective crisis intervention.
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Affiliation(s)
- Robin E Gearing
- Center for Mental Health Research and Innovation in Treatment Engagement and Service (MH-RITES Center), University of Houston, Graduate College of Social Work, Houston, Texas, United States
| | - Kathryne B Brewer
- College of Health and Human Services, University of New Hampshire, Durham, New Hampshire, United States
| | - Monit Cheung
- Graduate College of Social Work, University of Houston, Houston, Texas, United States
| | - Patrick Leung
- Graduate College of Social Work, University of Houston, Houston, Texas, United States
| | - Wanzhen Chen
- University of Science and Technology, East China University of Science and Technology, Shanghai, China
| | - Xuesong He
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
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11
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Chang C, Palermo E, Deswert S, Brown A, Nuske HJ. Money can't buy happiness: A randomized controlled trial of a digital mental health app with versus without financial incentives. Digit Health 2023; 9:20552076231170693. [PMID: 37361441 PMCID: PMC10286537 DOI: 10.1177/20552076231170693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 04/03/2023] [Indexed: 06/28/2023] Open
Abstract
Mental health disorders are prevalent among college students and increasing in frequency and severity. However, there is a significant gap between those who need treatment and those who engage in treatment. Given the documented efficacy of financial incentives for promoting health behavior change and engagement in treatment, financial incentives may help, along with nonfinancial behavioral incentives such as motivational messaging, gamification, and loss aversion techniques. We compared brief (28-day) use of two versions of a behavioral economics-inspired digital mental health app, NeuroFlow: (1) the full app including financial incentives and nonfinancial behavioral incentives (treatment group) and (2) a version of the app with nonfinancial behavioral incentives only (control group). In our intent-to-treat analyses, in order to examine the primary outcome of app engagement, a one-way analysis of variance (ANOVA) (treatment vs. control) was conducted, and to examine the secondary outcomes (depression, anxiety, emotion dysregulation, and wellbeing), a two-way repeated measures ANOVAs (treatment vs. control × baseline vs. post-trial) were conducted. We found that there were no differences between treatment groups on app engagement or the change in the mental health/wellness outcome measures. There was a main effect of timepoint on symptoms of anxiety and emotion dysregulation, such that there were significantly lower self-reported symptoms at post-trial relative to baseline. Our results suggest that financial incentives in digital mental health apps over and above nonfinancial behavioral incentives do not have an impact on app engagement or mental health/wellness outcomes.
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Affiliation(s)
- Cheryl Chang
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Emma Palermo
- College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychiatry, Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Sky Deswert
- Department of Psychiatry, Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Alyssa Brown
- Department of Psychiatry, Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Heather J Nuske
- Department of Psychiatry, Penn Center for Mental Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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12
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Sociocultural insights on dementia care-giving in Arab and Muslim communities: the perspectives of family care-givers. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Abstract
Little is known about the experiences of informal family care-giving for persons with ADRD in the context of Arab and Muslim communities. This paper offers fresh insight into the less-studied private sphere of the home, showing how families respond to the onset and long-term care of persons with Alzheimer's disease and related dementias (ADRD). It considers the extent to which sociocultural and religious influences are appropriated by family care-givers as coping mechanisms and motivators for care. Drawing upon interviews with 32 family care-givers for older persons living with ADRD in Qatar, findings reveal the intersectionality of the care-giving experience with various sociocultural, religious and emotional influences through seven emergent themes: (a) reasons and motivations for care-giving; (b) role of the extended family; (c) socio-demographic attributes of care-givers, their allocated responsibilities and how these intersect; (d) socio-religious attitudes towards care-giving of older persons; (e) social stigma; (f) personal knowledge of ADRD; and (g) coping mechanisms. The paper is concluded with key implications of these sociocultural insights for theory, policy and practice, which could inform Qatar's health and social care provision sector as well as other Arab and Muslim communities that share similar cultural and religious belief systems.
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13
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Ilter Bahadur E, Asena M, Yavuz Y, Karabulut E, Ozmert EN. The role of adverse childhood experience and social support type in postpartum depression in Turkey. J Obstet Gynaecol Res 2021; 47:4289-4297. [PMID: 34608717 DOI: 10.1111/jog.15049] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 09/07/2021] [Accepted: 09/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Improved knowledge of causal and protective factors is crucial for Postpartum depression (PPD) prevention and management. AIMS To investigate the relationship between adverse childhood experience (ACE), perceived social support and PPD in a middle-income non-Western country, and to investigate which type of ACE and which sources of social support were associated with PPD. METHODS The study was cross-sectional study and conducted in a one center from Turkey during March-June 2019. Women up to 1-week postpartum were included in the study. The Edinburgh Postpartum Depression Scale (EPDS), a validated ACE questionnaire, and the Multidimensional Scale of Perceived Social Support were completed. RESULTS Nine hundred women took part in the study. The proportion identified with PPD and ACE were 10% and 8.8%, respectively. In bivariate analysis, having previous PPD, unwanted pregnancy, insufficient antenatal care, low family income, history of ACE, and perception of low social support were associated with PPD (p < 0.05). Family support was perceived as beneficial, in both women with no history or ≥2 instances of ACE. However, perceived support from friends and/or a special person was lowest in the ≥2 ACE group (p < 0.05). In logistic regression, unwanted pregnancy, emotional abuse, and neglect, incarceration of a household member, and poor special person support were factors significantly associated with developing PPD (p = 0.005). CONCLUSIONS Emotional abuse, neglect, household dysfunction, and perceived poor support from a special person were risk factors for PPD. A history of maternal childhood trauma and poor social support might indicate the need for early PPD interventions.
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Affiliation(s)
- Evin Ilter Bahadur
- Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Muhammed Asena
- Department of Pediatrics, Gaziyaşargil Education and Research Hospital, University of Health Science, Diyarbakir, Turkey
| | - Yılmaz Yavuz
- Department of Pediatrics, Gaziyaşargil Education and Research Hospital, University of Health Science, Diyarbakir, Turkey
| | - Erdem Karabulut
- Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Elif Nursel Ozmert
- Division of Developmental Pediatrics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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14
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Tsamadou E, Voultsos P, Emmanouilidis A, Ampatzoglou G. Perceived facilitators of and barriers to mental health treatment engagement among decision-making competent adolescents in Greece. BMC Psychiatry 2021; 21:461. [PMID: 34548063 PMCID: PMC8456699 DOI: 10.1186/s12888-021-03471-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 09/09/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND A subset of adolescents with mental disorders are likely to have decision-making capacity that facilitates their therapy engagement. However, there are high rates of drop-out in mental health settings. AIM This study aims to identify perceived barriers to or facilitators of mental health care engagement among adolescents with decision-making competence in Greece. METHODS A qualitative study was conducted using semi-structured interviews of adolescents with a wide range of mental health problems. In addition, two psychometric assessment measures were used to define who to include or exclude from the study sample. RESULTS Positive attitudes and experiences with therapy were reported as strong ("major") facilitators of therapy engagement for adolescents with mental disorders, whereas negative experiences with therapy were reported as strong barriers to it. Furthermore, and most importantly, a "good" adolescent-therapist relationship was reported as a strong facilitator, whereas negative experiences of participants with their therapist were reported as strong barriers. Moreover, goals such as getting rid of symptoms, improving personal well-being, and improving social skills and relationships (especially with peers) emerged as strong facilitators of therapy engagement. Importantly, the early remission of symptoms emerged from the study as a strong barrier to therapy engagement for participants. Among the weaker ("minor") perceived facilitators were goals such as confessing to a trustworthy person, becoming able to achieve personal expectations and life goals, enhancing independence and self-esteem, and developing a positive self-image. The (active or supportive) role of family emerged as a facilitator. The stigma related to mental health emerged as both a ("minor") facilitator of and barrier to therapy engagement for participants. Friends were reported as having a role ranging from neutral to mildly supportive. CONCLUSION A number of more or less strong barriers and facilitators were identified that, for the most part, were consistent with prior literature. However, the authors identified some nuances that are of clinical importance. For instance, adolescents are most likely to terminate the treatment prematurely if they experience early symptom remission. Highlighting the role of therapy in achieving their goals or improving their families' well-being might be used by therapists to reduce the attrition rate.
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Affiliation(s)
- E Tsamadou
- Department of Child & Adolescent Psychiatry, Hippokration General Hospital of Thessaloniki, Konstantinoupoleos 49, Postal Code 546 42, Thessaloniki, Greece
- Laboratory of Forensic Medicine & Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, Postal Code 541 24, Thessaloniki, Greece
| | - P Voultsos
- Laboratory of Forensic Medicine & Toxicology (Medical Law and Ethics), School of Medicine, Faculty of Health Sciences, Aristotle University, University Campus, Postal Code 541 24, Thessaloniki, Greece.
| | - A Emmanouilidis
- Department of Child & Adolescent Psychiatry, Hippokration General Hospital of Thessaloniki, Konstantinoupoleos 49, Postal Code 546 42, Thessaloniki, Greece
| | - G Ampatzoglou
- Department of Child & Adolescent Psychiatry, School of Medicine, Faculty of Health Sciences, Aristotle University, Campus, Postal Code 541 24, Thessaloniki, Greece
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15
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Cheung M, Leung P, Chen W, Gearing RE, Brewer KB, Chen X, Li X, He X. Public stigma on substance users in China. JOURNAL OF SUBSTANCE USE 2021. [DOI: 10.1080/14659891.2021.1953163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Monit Cheung
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Patrick Leung
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Wanzhen Chen
- School of Social and Public Administration, East China University of Science & Technology, Shanghai, China
| | - Robin E. Gearing
- Graduate College of Social Work, University of Houston, Houston, Texas, USA
| | - Kathryne B. Brewer
- Department of Social Work, University of New Hampshire, Durham, New Hampshire, USA
| | - Xin Chen
- School of Social Sciences, Soochow University, Suzhou, China
| | - Xiao Li
- School of Social and Public Administration, East China University of Science & Technology, Shanghai, China
| | - Xuesong He
- School of Social and Public Administration, East China University of Science & Technology, Shanghai, China
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16
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Heinz I, Baldofski S, Beesdo-Baum K, Knappe S, Kohls E, Rummel-Kluge C. "Doctor, my back hurts and I cannot sleep." Depression in primary care patients: Reasons for consultation and perceived depression stigma. PLoS One 2021; 16:e0248069. [PMID: 33667268 PMCID: PMC7935275 DOI: 10.1371/journal.pone.0248069] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/18/2021] [Indexed: 12/03/2022] Open
Abstract
Background General practitioners (GPs) play a significant role in depression care. Recognition of depression is crucial for adequate treatment but is impeded by a high portion of depressed patients only reporting physical symptoms to their GP. Among the many reasons for this phenomenon is mental health stigma. We investigated how patients with depression differed from patients without depression regarding the types and number of complaints presented to their GP, as well as their depression stigma. For the subgroup of patients with depression, potential associations between perceived depression stigma and number and types of presented complaints were investigated to see if these might reflect the patient’s intention to conceal mental health symptoms due to fear of being stigmatized by others. Further, we investigated if perceived depression stigma is related to depression treatment. Methods Data on depressive symptoms (assessed by the Depression Screening Questionnaire; DSQ), depression stigma (assessed by the Depressions Stigma Scale; DSS), type of complaints reported to the GP and treatment-related factors were collected from 3,563 unselected primary care patients of 253 GPs in a cross-sectional epidemiological study (“VERA study”) in six different German regions. Data of a total of 3,069 patients was used for analysis on complaints reported to the GP (subsample of the VERA study), and for 2,682 out of 3,069 patients data on a stigma questionnaire was available. Results Nearly half of the primary care patients with depression (42.2%) reported only physical complaints to their GP. Compared to patients without a depression diagnosis, patients with depression reported twice as many complaints to their GP with a mean of 2.02 (1.33) vs. 1.2 (0.69), including a more frequent combination of physical and mental symptoms (28.8% vs. 3.5%). Patients with depression showed higher total stigma compared to patients without depression, Mdn = 48 (IQR 40–54) vs. Mdn = 46.3 (IQR 29–53), due to higher perceived stigma, Mdn = 27 (IQR 21–32) vs. Mdn = 25.9 (IQR 20–29). Perceived stigma was associated with male gender (beta -.14, p = .005) and a lack of pharmacological treatment (beta -.14, p = .021) in patients with a depression diagnosis. Conclusion The number of complaints presented to the GP might function as a marker to actively explore depression in primary care patients, in particular when both physical and mental symptoms are reported. Perceived depression stigma should also be addressed especially in male patients. Further research should clarify the role of perceived stigma as a potential inhibitor of pharmacological treatment of depression in primary care.
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Affiliation(s)
- Ines Heinz
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
- German Alliance Against Depression, Leipzig, Germany
- * E-mail:
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Katja Beesdo-Baum
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Susanne Knappe
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Center for Clinical Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
| | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Leipzig, Leipzig, Germany
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17
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Miller-Graff L, Ellis K, Hosny N. PTSD Coach Online-Arabic: A Randomized Controlled Pilot Trial to Examine Feasibility, Acceptability, and Preliminary Effectiveness. J Trauma Stress 2021; 34:23-34. [PMID: 33159373 DOI: 10.1002/jts.22621] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 12/20/2022]
Abstract
The Egyptian Revolution of 2011 resulted in high-level exposure to sociopolitical violence, placing a large burden on the mental health care system that cannot be effectively met given the small number of available providers in Egypt. We conducted a nonblinded, randomized controlled pilot trial of an online, self-directed tool for managing posttraumatic stress symptoms (PTSS). The study aimed to evaluate the feasibility, acceptability, and preliminary effectiveness of the PTSD Coach Online-Arabic. Trauma-exposed Egyptian adults with clinically significant PTSS (N = 87; intervention group: n = 41) completed assessments at baseline, weekly over the treatment period, posttest, and 3-month follow-up. Of participants who completed weekly surveys, 88.9% used the program; 22.0% of participants reported regular, weekly use. Most tools received good likeability and perceived benefit scores, but lower perceived benefit scores on three tools suggest that some content may require additional adaptation. Intent-to-treat analyses using multilevel modeling with multiple imputation to account for missing data were conducted. Effect sizes for PTSS were below the cutoff for small effects at posttest, d = -0.14, but demonstrated a small positive effect at 3-months, d = -0.25. There was a small positive effect of treatment on anxiety at posttest, d = -0.37, and a medium effect at 3-month follow-up, d = -0.49. Treatment effects for depressed mood were below the cutoff for small effects at posttest and 3-months, ds = -0.14 and -0.18. These findings suggest that the PTSD Coach Online-Arabic may be a promising supplemental resource for support in this setting.
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Affiliation(s)
- Laura Miller-Graff
- Department of Psychology, Kroc Institute for International Peace Studies, University of Notre Dame, Notre Dame, Indiana, USA
| | - Kate Ellis
- Department of Psychology, The American University in Cairo, New Cairo, Egypt
| | - Nadine Hosny
- Department of Psychology, The American University in Cairo, New Cairo, Egypt
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18
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Mohammadzadeh M, Awang H, Mirzaei F. Mental health stigma among Middle Eastern adolescents: A protocol for a systematic review. J Psychiatr Ment Health Nurs 2020; 27:829-837. [PMID: 32170971 DOI: 10.1111/jpm.12627] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/26/2020] [Accepted: 02/26/2020] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: Four out of every five people with mental health disorders face stigma. Mental health and, consequently, mental health stigma are very common among youth living in the Middle East countries. Several studies have investigated mental health among adolescents in the Middle East, but studies on stigma are very scattered. There is no systematic review on stigma among adolescents with mental disorders across all the Middle East countries despite the common historical roots, similar cultural backgrounds, and recent widespread problems in the area. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper will aim to review and analyse the studies on stigma among adolescents with mental disorders in the Middle East countries, from different aspects such as the age rang, kind of stigma and risk factors of stigma. The study will cover studies on all kinds of stigma among Middle Eastern adolescents up to 18 years old published between 2000 and 2019. The study terms are generally focused on four categories: (a) kinds of Stigma, (b) Mental health problems, (c) Age range and (d) Region of study population. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Increasing understanding and awareness of different angles of mental health stigma among adolescents may be helpful for better coping with this challenge. Understanding the nature of stigma may give adolescents the ability of ignoring it and avoid starting self-stigma and/or stopping to seek help. ABSTRACT: Introduction Although many epidemiological and interventional investigations regarding improving mental health among youth in the Middle East have been performed, there is no systematic review specifically analysing the studies on stigma among adolescents with mental disorders (A-MDs) across all Middle East countries despite their common historical roots, similar cultural backgrounds, and recent widespread problems in the area. Purpose We will aim to systematically review and analyse the English language studies on stigma among A-MDs in the Middle East published between 2000 and 2019. Method The Web of Knowledge, Science Direct, PsycINFO and MEDLINE are electronic databases that will be included in this study. Furthermore, the bibliography lists of eligible articles will be manually searched for additional included articles. Descriptive statistics will be represented by mean score and standard deviation for continuous data and number/percentage for categorical data. Discussion This study may act as a resource for future studies attempting to assess and/or reduce stigma among children and adolescents with mental health issues specifically in the Middle East. Implications It is important for healthcare providers, including nursing professional, to improve their knowledge and vision towards stigma in their community. The outcomes of this study can be a shortcut reaching this information.
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Affiliation(s)
| | - Hamidin Awang
- Department of Psychiatry, Faculty of Medicine and Health sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Frahnaz Mirzaei
- Department of Educational Management, Planning and Policy, Faculty of Education, University of Malaya, Kuala Lumpur, Malaysia
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19
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Sung-Man B. The long-term effects of perceived community disorder and social stigma on depressive symptoms among adolescent school dropouts using multivariate latent growth modeling. SCHOOL PSYCHOLOGY INTERNATIONAL 2020. [DOI: 10.1177/0143034320951232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to examine the long-term effects of perceived community disorder and social stigma on depressive symptoms among adolescent school dropouts. This study used 2–4 wave data of a Longitudinal Survey and Support Plan for Dropouts. Multivariate latent growth modeling indicated that social stigma was associated with greater number of depressive symptoms and had an indirect influence on depressive symptoms through self-esteem. In addition, perceived community disorder was related to greater number of depressive symptoms. Finally, self-esteem was negatively related to depressive symptoms and female adolescents reported more depressive symptoms than male adolescents. This study suggests that policy and social efforts are needed to reduce perceived community disorder and social stigma to prevent the depression in adolescent school dropouts.
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Affiliation(s)
- Bae Sung-Man
- Department of Psychology and Psychotherapy, Dankook University, Cheonan, Republic of Korea
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20
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Rezayat F, Mohammadi E, Fallahi-Khoshknab M. The process of responding to stigma in people with schizophrenia spectrum disorders and families: A grounded theory study. Perspect Psychiatr Care 2020; 56:564-573. [PMID: 31868231 DOI: 10.1111/ppc.12468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 09/18/2019] [Accepted: 12/15/2019] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND The way people with schizophrenia spectrum disorders and families address stigma has a significant role in their vulnerability to this distressing phenomenon. However, there is little knowledge about this issue in Middle Eastern countries. PURPOSE Exploring the process of addressing stigma in people with schizophrenia spectrum disorders and families. DESIGN AND METHODS In our grounded theory study, we interviewed seven patients and nine family members and used a constant comparative analysis approach for data analysis. FINDINGS The participants expressed being socially rejected and oppressed by others. In addressing stigma, the patients and families surrendered passively and reluctantly. This main strategy sometimes led to deprivation and isolation and sometimes resulted in lessening their tension. PRACTICE IMPLICATIONS Mental health nurses can empower patients and families with the skills necessary to counter stigma and, in this way, modify the sense of disability as an obstacle to stigma resistance. Also, mental health nurses can modify the contextual factors of stigma by initiating campaigns, educating society members, and involving them in fighting stigma.
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Affiliation(s)
- Fatemeh Rezayat
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Eesa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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21
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Tang W, Kang Y, Xu J, Li T. Associations of Suicidality with Adverse Life Events, Psychological Distress and Somatic Complaints in a Chinese Medical Student Sample. Community Ment Health J 2020; 56:635-644. [PMID: 31919657 DOI: 10.1007/s10597-019-00523-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/09/2019] [Indexed: 02/05/2023]
Abstract
The present study aimed to examine the associations of suicidality with psychological distress, somatic symptoms, and stressors in medical school students. We conducted a cross-sectional survey of medical students at a large, top-ranked medical school. A total sample of 662 medical students (269 men) completed a battery of self-reported questionnaire. Of the respondents, 136 (20.5%) reported having suicidal ideation, 40 (6.0%) reported having planned suicide, and 10 (1.5%) reported having attempted suicide during the previous year. Students from rural areas and the 3rd year of study reported higher levels of suicidal ideation than their counterparts. General pain/fatigue was associated with suicidal ideation and planning, while interpersonal difficulties were associated only with suicidal ideation. This study provides evidence linking severe psychological distress, general pain/fatigue, interpersonal stress and psychosocial factors with suicide risk among Chinese medical students which provides targets for future psychological interventions.
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Affiliation(s)
- Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Yukun Kang
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Jiuping Xu
- Institute of Emergency Management and Post-disaster Reconstruction, Sichuan University, Chengdu, China.
| | - Tao Li
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.
- Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China.
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22
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Al Omari O, Wynaden D, Alkhawaldeh A, Al-Delaimy W, Heslop K, Al Dameery K, Bani Salameh A. Knowledge and Attitudes of Young People toward Mental Illness: A Cross Sectional Study. Compr Child Adolesc Nurs 2019; 43:301-313. [PMID: 31584299 DOI: 10.1080/24694193.2019.1670752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The aim of the study was to investigate young Jordanians' knowledge and attitudes toward people who have a mental illness. A cross sectional design was utilized. A convenient sample of 858 participants aged between 15-24 years old completed a survey. Participants under 19 years were accessed through their schools and those 19 years and above were accessed through universities. Results showed that although the majority of university and school students' responses were generally consistent, they disagreed on 11 items on the survey; for example, 186 (39.3%) of university students agreed that mental illness has a biological origin compared with only 119 (30%) of school students. The majority of young people 737 (85.9%) were willing to learn and 792 (92.3%) felt that they have to help people with mental illness, which make them willing to learn. In conclusion, the findings provide insights for decision makers and researchers in Jordan about young peoples' knowledge and attitudes toward mental illness. Increasing young adults' literacy through introducing educational programs such as mental health first aid courses will enrich their knowledge; help change attitudes and reduce stigma toward people living with mental illness.
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Affiliation(s)
- Omar Al Omari
- College of Nursing, Sultan Qaboos University , Muscat, Oman
| | - Dianne Wynaden
- School of Nursing, Midwifery and Paramedicine, Curtin University , Perth, Western Australia
| | | | - Wael Al-Delaimy
- Family Medicine and Public Health, University of California , San Diego, California, USA
| | - Karen Heslop
- School of Nursing, Midwifery and Paramedicine, Curtin University , Perth, Western Australia
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Zalat MM, Mortada EM, El Seifi OS. Stigma and Attitude of Mental Health Help-Seeking Among a Sample of Working Versus Non-working Egyptian Women. Community Ment Health J 2019; 55:519-526. [PMID: 29931402 DOI: 10.1007/s10597-018-0298-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 06/18/2018] [Indexed: 01/19/2023]
Abstract
This study was conducted to assess the level of mental health difference between working and non-working women, to explore their stigma and attitude toward seeking psychological help for mental-health problems. World Health Organization's Self-reporting questionnaire (SRQ-20), adoption of Discrimination-Devaluation scale (D-D) scale for measuring self-stigma and attitude toward Seeking Mental Health Services (IASMHS) Inventory were used. The sampled teachers reported a higher attitude towards seeking mental health services when compared to housewives. Social support and personal stigma were the main factors that significantly predict total IASMHS. Although working females are more susceptible to mental health disorders, yet less stigmatized towards mental health problems and a better attitude for seeking mental health services than housewives.
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Affiliation(s)
- Marwa Mohamed Zalat
- Department of Family and Community Medicine, College of Medicine, Taibah University, Al Madinah City, Saudi Arabia.
- Department of Community, Occupational and Environmental Medicine, Zagazig University, Zagazig City, 44519, Egypt.
| | - Eman Mohamed Mortada
- Department of Community, Occupational and Environmental Medicine, Zagazig University, Zagazig City, 44519, Egypt
- Health and Rehabilitation Sciences College, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Omnia Samir El Seifi
- Department of Community, Occupational and Environmental Medicine, Zagazig University, Zagazig City, 44519, Egypt
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Hasan AA, Tumah H. Determinants of quality of life among people diagnosed with schizophrenia at outpatient clinics. Perspect Psychiatr Care 2019; 55:30-39. [PMID: 29645261 DOI: 10.1111/ppc.12278] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 02/26/2018] [Accepted: 03/06/2018] [Indexed: 01/09/2023] Open
Abstract
PURPOSE The study examines the determinants of the quality of life (QoL) among outpatients with schizophrenia in Jordan. DESIGN AND METHODS A cross-sectional study design was used with 157 people with schizophrenia treated in outpatient clinics. Demographic, clinical and psychosocial variables were examined for their influence on QoL. Data were analysed with descriptive statistics, Pearson product moment correlation and stepwise forward multiple linear regression. FINDINGS The majority of the study participants were female, single, unemployed, had secondary level of education or less and were being supported financially by family members. QoL correlated negatively with advanced age, male gender, longer duration of illness, high body mass index and prescribed typical anti-psychotic medication. However, it was correlated positively with employment and being married. Illness duration, recurrent hospitalisation, knowledge level about schizophrenia, psychiatric symptoms and coping mechanisms were found to be key significant predictors of QoL among participants. PRACTICAL IMPLICATIONS The study findings enhance our understanding of socio-demographic, clinical and psychosocial characteristics influencing the QoL in people with schizophrenia. Involvement of families in the management process may improve patients' ability to be integrated in the community and be more socially active.
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Affiliation(s)
- Abd Alhadi Hasan
- Fakeeh College for Medical Sciences, Alhamra District, Palestine Street, Jeddah, Saudi Arabia
| | - Hussein Tumah
- Fakeeh College for Medical Sciences, Alhamra District, Palestine Street, Jeddah, Saudi Arabia
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25
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Hasan AAH. The correlation between the quality of life and clinical variables among outpatients with schizophrenia. Psychiatry Res 2019; 271:39-45. [PMID: 30465980 DOI: 10.1016/j.psychres.2018.09.062] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 05/08/2018] [Accepted: 09/28/2018] [Indexed: 01/09/2023]
Abstract
The study identifies the correlation between the quality of life (QoL) among outpatients with schizophrenia and clinical outcomes. A cross-sectional study design was used with 157 people with schizophrenia treated in outpatient clinics. Demographic, clinical and psychosocial variables were examined for their influence on QoL. Data were analysed with descriptive statistics, Pearson product moment correlation and stepwise forward multiple linear regression. The majority of the study participants were female, single, unemployed, had secondary level of education or less and were being supported financially by family members. QoL correlated negatively with advanced age, male gender, longer duration of illness, high body mass index and prescribed typical anti-psychotic medication. However, it was related positively with employment and being married. Illness duration, recurrent hospitalisation, knowledge level about schizophrenia, psychiatric symptoms and coping mechanisms were found to be key significant predictors of QoL among participants. The study findings enhance our understanding of socio-demographic, clinical and psychosocial characteristics influencing the QoL in people with schizophrenia. Involvement of families in the management process may improve patients' ability to be integrated in the community and be more socially active.
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Affiliation(s)
- Abd Al-Hadi Hasan
- Fakeeh College for Medical Sciences, Fakeeh College for Medical Science, 1222, Jeddah, Saudi Arabia.
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26
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Garthus-Niegel S, Horsch A, Handtke E, von Soest T, Ayers S, Weidner K, Eberhard-Gran M. The Impact of Postpartum Posttraumatic Stress and Depression Symptoms on Couples' Relationship Satisfaction: A Population-Based Prospective Study. Front Psychol 2018; 9:1728. [PMID: 30283380 PMCID: PMC6157399 DOI: 10.3389/fpsyg.2018.01728] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 08/27/2018] [Indexed: 11/13/2022] Open
Abstract
The couple relationship is of particular importance in the transition to parenthood and in the early childhood years because it is related to the well-being and mental health of partners, children, and the family. One factor that may substantially influence relationship quality and couple satisfaction after childbirth is the woman’s experience of birth. Approximately 2–4% of women develop posttraumatic stress disorder (PTSD) after childbirth, with potentially wide-ranging negative consequences for the women themselves and their families. To date, some qualitative studies have explored the influence of postpartum PTSD on couple relationship satisfaction. However, quantitative studies are sparse, with mixed results and methodological limitations. We hypothesized that postpartum PTSD will be prospectively associated with low couple relationship satisfaction, even when taking into account a variety of potential confounding variables, and that the effect of postpartum PTSD symptoms on couple relationship satisfaction will be mediated by postpartum depression symptoms. This study is based on data from the Akershus Birth Cohort study, a prospective cohort study. Information from hospital records and questionnaires completed at 17 weeks gestational age, as well as at 8 weeks and 2 years postpartum were used (n = 1480). PTSD symptoms were measured by the Impact of Event Scale and couple relationship satisfaction was assessed using a modified version of the Mehrabians Marital Satisfaction Scale. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale. Data were analyzed using bivariate correlations, multivariate regression analyses, and mediation analyses. Postpartum PTSD symptoms were prospectively related to low couple relationship satisfaction at 2 years postpartum, even when controlling for a considerable number of background factors. When including postpartum depression symptoms as predictor in the analyses, the effect of postpartum PTSD was no longer significant. Moreover, more detailed analyses showed that postpartum depression symptoms acted as a significant mediator, fully explaining the association of postpartum PTSD with couples’ relationship satisfaction. Early detection of couples’ relationship problems and the provision of professional help, particularly in high-risk couples may not only improve the quality of the couple relationship but also improve parenting and promote positive child outcomes.
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Affiliation(s)
- Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität, Dresden, Germany.,Department of Child Health, Norwegian Institute of Public Health, Nydalen, Norway
| | - Antje Horsch
- Institute of Higher Education and Research in Healthcare (IUFRS), Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.,Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland
| | - Eric Handtke
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität, Dresden, Germany
| | | | - Susan Ayers
- Centre for Maternal and Child Health Research, School of Health Sciences, City, University of London, London, United Kingdom
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine of the Technische Universität, Dresden, Germany
| | - Malin Eberhard-Gran
- Department of Child Health, Norwegian Institute of Public Health, Nydalen, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine Campus Ahus, University of Oslo, Oslo, Norway
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Zolezzi M, Alamri M, Shaar S, Rainkie D. Stigma associated with mental illness and its treatment in the Arab culture: A systematic review. Int J Soc Psychiatry 2018; 64:597-609. [PMID: 30019976 DOI: 10.1177/0020764018789200] [Citation(s) in RCA: 126] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mental health has not had the same public profile as physical health. This has contributed to the stigma associated with mental illness and to its treatments. Research investigating how the traditions and values amongst those with an Arab heritage contribute to stigmatizing beliefs, attitudes or actions in the provision of mental healthcare has not been widely reported. AIM To systematically review the literature and summarize the findings of studies reporting stigmatizing beliefs, actions and attitudes toward treatment of people with mental illness in the Arab population. METHODS PubMed, Ovid, Psycharticles and Embase were used to identify original studies of non-institutionalized Arab adults or children reporting findings relevant to stigma toward mental illness. A manual search of the bibliography of all selected original studies was also undertaken. Independent data extraction was performed by two reviewers, who then met to compare data and reach consensus. Findings were classified as stigmatizing beliefs, actions or attitudes toward mental health treatments. RESULTS A total of 33 articles were retrieved for full review. Those utilizing qualitative methodology provided insight into the many ways mental illness is viewed and defined among those with an Arab heritage. Among the studies using quantitative methodology, most compared stigmatizing beliefs, attitudes toward mental health treatments or stigmatizing actions among different Arab populations, some also investigated correlations between characteristics of the Arab population tested with stigmatizing beliefs, actions and attitudes toward mental health treatments. Findings from studies undertaken in Qatar reported greater stigmatizing beliefs, actions or attitudes toward mental health treatments among Qatari versus non-Qatari Arabs. CONCLUSION A large diversity in the stigmatizing beliefs, actions and attitudes toward treatment of mental illness within the Arab population were identified. The influence of cultural variations on stigma should be explored further and used to tailor anti-stigma interventions in this population.
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Affiliation(s)
| | - Maha Alamri
- College of Pharmacy, Qatar University, Doha, Qatar
| | - Shahd Shaar
- College of Pharmacy, Qatar University, Doha, Qatar
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28
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Abd Alhadi H. Determinant of treatment delay in the first episode of psychosis: a qualitative study. ACTA ACUST UNITED AC 2018. [DOI: 10.15406/jpcpy.2018.09.00532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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30
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Shulla RM, Toomey RB. Sex differences in behavioral and psychological expression of grief during adolescence: A meta-analysis. J Adolesc 2018; 65:219-227. [PMID: 29674176 DOI: 10.1016/j.adolescence.2018.04.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 03/28/2018] [Accepted: 04/02/2018] [Indexed: 10/17/2022]
Abstract
This meta-analysis synthesizes the results of 14 independent studies conducted in the U.S. (N = 6979 participants) that examined sex differences in internalized, externalized, and PTSD symptoms associated with grief during adolescence. The mean age of participants was 12.22 years (SD = 2.31) with 50% male and 50% female sex assigned at birth. While no mean-level differences were found between adolescent females and males in externalizing behaviors associated with grief (d = 0.03), on average, females reported higher levels of internalized grief responses (d = 0.18) and higher levels of PTSD symptoms (d = 0.36) than their male counterparts. Findings suggest the need for additional, more nuanced research to investigate possible sex differences in externalized behaviors relating to grief. In addition, research should examine whether tailored therapeutic and intervention measures and resources are needed for adolescents experiencing internalized grief and PTSD symptoms given sex differences in these reactions.
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Affiliation(s)
- Rachel M Shulla
- Family Studies and Human Development, The University of Arizona, Tucson, AZ, USA
| | - Russell B Toomey
- Family Studies and Human Development, The University of Arizona, Tucson, AZ, USA.
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31
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Rayan A, Fawaz M. Cultural misconceptions and public stigma against mental illness among Lebanese university students. Perspect Psychiatr Care 2018; 54:258-265. [PMID: 28726343 DOI: 10.1111/ppc.12232] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/06/2017] [Accepted: 07/02/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to examine cultural misconceptions about mental illness and how they are associated with the public stigma against mental illness among Lebanese university students. METHODS A sample of 203 participants completed the study. Data about cultural misconceptions, attitudes about mental illness, and public stigma of mental illness were obtained. The researchers examined the mean difference in public stigma according to cultural beliefs about mental illness. RESULTS The majority of students believe that mental health professionals have inadequate knowledge and expertise to treat mental disorders. Various cultural misconceptions about mental illness were reported. Public stigma significantly differed based on these cultural misconceptions. CONCLUSION Psychiatric nurses should play a vital role in reshaping the inappropriate cultural view about mental illness.
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Affiliation(s)
- Ahmad Rayan
- Faculty of Nursing, Zarqa University, Zarqa, Jordan
| | - Mirna Fawaz
- Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
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32
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Hasan AAH, Musleh M. Self-stigma by people diagnosed with schizophrenia, depression and anxiety: Cross-sectional survey design. Perspect Psychiatr Care 2018; 54:142-148. [PMID: 28198022 DOI: 10.1111/ppc.12213] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Revised: 12/31/2016] [Accepted: 01/15/2017] [Indexed: 11/29/2022] Open
Abstract
AIM This study investigated self-attitudes towards schizophrenia, depression and anxiety. METHODS A survey was conducted with 564 people with a schizophrenia, depression and anxiety who are currently being treated at a psychiatric clinic in Amman, Jordan. RESULTS The research found that stigma towards schizophrenia, depression and anxiety was based around three factors: preconceived stereotypes, personal responsibility/blame and the perceived inability of a patient to recover. Schizophrenia, in particular, was linked more strongly to negative stereotypes and an inability to recover and less associated to personal responsibility/blame in comparison to depression and anxiety. DISCUSSION Three identical stigma factors emerged for each diagnosis which reflected themes identified in previous literature. People with schizophrenia are seen as more dangerous and less likely to recover than those suffering from other mental illness. Anxiety was seen most favourably by the self; it was associated with less negative stereotypes and seen as more likely to cure. Interestingly, anxiety and depression were seen almost identically. CONCLUSION The self-perception of mental health conditions, such as schizophrenia, depression and anxiety, have important implications for the planning of anti-stigma and awareness raising programmes. By gaining a thorough understanding of these perceptions and the rationale behind them, it may be possible to develop effective, tailor-made interventions.
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Affiliation(s)
- Abd Al-Hadi Hasan
- Assistant Professor in Mental Health Nursing, Fakeeh College for Medical Sciences, Alhamra District, Palestine Street, Jeddah, Saudi Arabia
| | - Mahmoud Musleh
- Assistant Professor in Mental Health Nursing, Fakeeh College for Medical Sciences, Alhamra District, Palestine Street, Jeddah, Saudi Arabia
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33
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Rayan A, Mahroum MH, Khasawneh A. The correlates of stigma toward mental illness among Jordanian patients with major depressive disorder. Perspect Psychiatr Care 2018; 54:192-197. [PMID: 28543049 DOI: 10.1111/ppc.12222] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/12/2017] [Accepted: 04/17/2017] [Indexed: 11/30/2022] Open
Abstract
AIM This study aims to assess the correlates of stigma toward mental illness among patients diagnosed with major depressive disorder (MDD). METHODS One hundred and sixty one Jordanian outpatients suffering from MDD completed the study. Participants completed the demographic questionnaire, the Center for Epidemiological Studies for the intensity of depression, and the Devaluation-Discrimination Scale to assess stigma. RESULTS Participants reported a moderate level of perceived stigma toward mental illness. Age, perceived pain, the number of relapses, and severity of depressive symptoms were significantly correlated with stigma toward mental illness among the study sample. The severity of depressive symptoms was the strongest correlate of stigma toward mental illness. CONCLUSIONS Factors associated with stigma toward mental illness should be carefully considered when implementing anti-stigma programs for patients.
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Affiliation(s)
- Ahmad Rayan
- Department of Psychiatric and Mental Health Nursing, Zarqa University, Zarqa, Jordan
| | - Maryam Husnee Mahroum
- The Acute Inpatient Psychiatric Unit at King Abdullah University Hospital, Ramtha, Jordan
| | - Aws Khasawneh
- Department of Neuro Sciences, Jordan University of Science and Technology, Irbid, Jordan
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Hasan AA, Musleh M. Barriers to Seeking Early Psychiatric Treatment amongst First-episode Psychosis Patients: A Qualitative Study. Issues Ment Health Nurs 2017; 38:669-677. [PMID: 28485998 DOI: 10.1080/01612840.2017.1317307] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIMS The aim of this study was to explore the family members' determinant of the delay in seeking psychiatric care to patients diagnosed with psychosis. METHODS Qualitative semi-structured interviews were carried out with twenty-seven family members of patients with psychosis at psychiatric outpatient clinics in Amman, Jordan. RESULTS The findings revealed that perceived stigma and fears about being labelled are the main barriers to requesting early psychiatric health care. The participants cited many different reasons linked to finding help led to delay in seeking help in the early stages of the illness including misattribution of the cause and symptoms of mental illness, family and financial factors. CONCLUSIONS The study highlights the importance of enhancing knowledge about the schizophrenia-related spectrum to ensure patients seek treatment in a more timely manner.
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Affiliation(s)
- Abd Alhadi Hasan
- a Nursing Department , Dr Soliman Fakeeh College of Nursing and Medical Sciences , Jeddah , Saudi Arabia
| | - Mahmoud Musleh
- b Nursing Department , Fakeeh College for Medical Sciences , Jeddah , Saudi Arabia
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Hasan AAH, Musleh M. Public Stigma Toward Mental Illness in Jordan: A Cross-Sectional Survey of Family Members of Individuals With Schizophrenia, Depression, and Anxiety. J Psychosoc Nurs Ment Health Serv 2017; 55:36-43. [DOI: 10.3928/02793695-20170519-05] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Accepted: 04/07/2017] [Indexed: 01/03/2023]
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36
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Wilson PG. Depression in Young People: More than Just a Bad Day-A Concept Analysis. J Community Health Nurs 2017; 34:102-111. [PMID: 28467205 DOI: 10.1080/07370016.2017.1304149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
AIM Suicide from depression is the second leading cause of death in young people. To better understand depression, a concept analysis was conducted using the Lorraine Walker and Kay Avant method. SOURCE OF DATA Three electronic databases searched using keywords such as depress*, stigma, and feeling depressed yielded 40 articles in English from 2006 through 2016. RESULTS Primary attribute was depressed mood; stress was the primary antecedent found in young people. Consequences included health, emotional, and financial well-being. CONCLUSION A better understanding of depression by healthcare providers can foster quicker assessment and treatment in young people and impact final outcome-suicide.
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Rayan A, Obiedate K. The Correlates of Quality of Life Among Jordanian Patients With Schizophrenia. J Am Psychiatr Nurses Assoc 2017; 23:404-413. [PMID: 28569084 DOI: 10.1177/1078390317710498] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Addressing the quality of life (QOL) of patients with schizophrenia is of special importance in the Arab world, where little knowledge is available about their well-being, and most of them experience stigma and living in poverty. AIMS The purpose of this study was to examine the association of sociodemographic characteristics, severity of depressive symptoms, and various aspects of public stigma against mental illness, with QOL among Jordanian patients with schizophrenia. METHOD In this descriptive correlational study, 160 Jordanian outpatients diagnosed with schizophrenia completed measures of demographic characteristics, perceived public stigma against mental illness, severity of depression, and QOL. RESULTS Participants had poor QOL. Age, marital status, relapse, education level, stigma against mental illness, and severity of depression were significantly associated with QOL among Jordanian patients with schizophrenia. Data analysis revealed that the severity of depression accounted for an additional 27% of the variance above and beyond the 36.7% accounted for by age of the participants and perceived public stigma against mental illness. CONCLUSIONS Health care professionals should develop culturally competent nursing practice considering the specific factors associated with QOL among Arab patients with schizophrenia.
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Affiliation(s)
- Ahmad Rayan
- 1 Ahmad Rayan, PhD, Zarqa University, Zarqa, Jordan
| | - Khaldoon Obiedate
- 2 Khaldoon Obiedate, RN, MSN, CNS, Jordan University Hospital, Amman, Jordan
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38
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Dardas LA, Simmons LA. The stigma of mental illness in Arab families: a concept analysis. J Psychiatr Ment Health Nurs 2015; 22:668-79. [PMID: 26118332 DOI: 10.1111/jpm.12237] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/24/2015] [Indexed: 01/22/2023]
Abstract
ACCESSIBLE SUMMARY The stigma of mental illness varies significantly from culture to culture and from person to person. To date, little is known about how mental illness stigma manifests within the Arab community. This study aimed at bringing clarity to the concept of 'mental illness stigma' as it applies to Arab families. Nursing's holistic and patient-centered approach is integral to helping Arab patients and their families appropriately incorporate individual values, beliefs, and cultural perspectives into treatment plans. This study establishes a scientific alert for professionals at all levels to avoid making false generalizations about a specific culture that are not based on specific research findings from that culture. ABSTRACT Accessing mental health services is a critical step towards reducing the burden of mental illness. The stigma of mental illness is one of the most common reasons for not seeking mental health care leading to negative health consequences and undue suffering for many individuals and their families. Stigma is embedded in its social context. What may be considered acceptable in one society may be considered unacceptable and open to stigmatization in other societies. Arabs have a shared set of values, beliefs, and traditions that are substantially different from those of Westerners. Further, in most Arab countries, formal mental health resources are scarce and people with mental illness experience the compounded disadvantages of poverty and illness stigma. To date, little is known about how mental illness stigma manifests within the Arab community making it difficult to design and test interventions that support Arab individuals with mental illness and their families in treatment seeking and adherence. Using Rodger's concept analysis method, we examined how 'mental illness stigma' operates within an Arab context as a first step towards elucidating culturally competent approaches to treatment. This analysis provides a foundation for future work in the areas of mental illness diagnosis, education, and treatment that reflect the unique characteristics of Arab culture.
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Affiliation(s)
- L A Dardas
- School of Nursing, Duke University, Durham, NC, USA
| | - L A Simmons
- School of Nursing, Duke University, Durham, NC, USA
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