Search Results (258)

Introduction: Sexual minority men (SMM) are at increased risk for psychosocial stressor exposure, substance use, and poor mental health relative to heterosexual men. While the burden of mental health is growing in the United States, among SMM these trends are increasing at a greater rate, driving health disparities. Methods: Framed within a minority stress framework, these analyses examine how stressors explain substance use and poorer mental health over time. Participants were asked questions on stressor exposure (stigma, discrimination, internalized homophobia, perceived stress), mental health (anxiety, depression, PTSD), and substance use (alcohol to intoxication, club drugs, poly club drugs) over 36 months among 528 SMM in NYC. Results: Perceived stress increased frequency of all substance use, whereas discrimination decreased days of club and poly club drug use. Depression severity predicted increased days of club drug and poly club drug use. PTSD severity predicted increased days of club drug and poly club drug use. Conclusion: We are able to expand on the literature with granular substance use data to highlight associations with stressors and mental health. These findings support an increased need for systematic policy solutions and public health interventions to address drivers of substance use disparities among young SMM. Full article

Background: Despite their high prevalence and potential for significant morbidity, hemorrhoidal symptoms remain underreported and undertreated. Misconceptions and stigma may delay care-seeking behaviors and negatively influence patient outcomes. Methods: We conducted a cross-sectional, questionnaire-based study in Romania to assess public awareness, attitudes, and barriers related to hemorrhoidal disease. The survey included 185 participants and evaluated variables such as symptom severity, understanding of the condition, perceived stigma, and willingness to consult a physician. Results: Only 30.8% of participants had sought medical advice for hemorrhoidal symptoms. Younger age (p < 0.001), male sex (p = 0.013), and lower levels of perceived severity were significantly associated with reluctance to seek medical care. The most frequently reported barriers were embarrassment and fear of invasive diagnostic procedures. Colonoscopy and digital rectal examination were identified as major deterrents by 39.5% and 38.9% of respondents, respectively. Educational level influenced both the perceived understanding of the disease (p = 0.001) and comfort in discussing anal symptoms (p = 0.002). Gender preference for physicians was significantly associated with respondent sex (p = 0.007) but not with education or age. Conclusions: Hemorrhoidal disease remains a stigmatized and underestimated condition. Public health efforts should prioritize educational interventions, destigmatization campaigns, and improved physician–patient communication to facilitate earlier diagnosis and better disease management. Full article

About 8% of Ghanaians, including adolescents, have various types of disabilities. Although many legal and constitutional protections for people with disabilities, including adolescents, exist in Ghana, it is widely known that these persons face a variety of psychosocial issues. Several factors have been identified as contributing to the unremitting marginalisation of people with disabilities in general, but the extent to which these can be generalised to adolescents with disabilities is unknown. This study, therefore, sought to document the determinants, manifestations, and consequences of disability-related stigma among differently abled adolescents in three special schools in northern, middle, and southern Ghana. An exploratory descriptive qualitative design was used. Overall, 54 participants were purposively selected for a semi-structured interview and focus group discussions. Braun and Clarke’s procedure for thematic analysis was followed. The findings showed a variety of stigmatising experiences by adolescents with disabilities in their sociocultural context. More broadly, the cause of disability was linked to the ramifications of parental sins against the gods, being a descendant of river gods, and the consequences of bewitchment/curses by family members. Others included the perceived transmissibility of the disability and disability as a visible condition. Stigma manifested in the form of pejorative labelling, ableism, and social exclusion. The consequences of this stigma included negative psychological and emotional effects (i.e., depression, low self-esteem, and a lack of confidence) and suicidal ideation. There is an urgent need for stigma reduction interventions for adolescents with disabilities in Ghana as part of an effort to improve their wellbeing. Full article

This study investigates how demographic characteristics, severity of intimate partner violence (IPV), social support, gender equality awareness, and demographic factors (e.g., living with children at home) influence help-seeking behaviors among 2527 IPV-experienced women in Beijing, Shanghai, Guangzhou, and Shenzhen. Drawing on the help-seeking model and conservation of resource theory, the study distinguishes between formal (e.g., police, legal aid) and informal (e.g., family, friends) help-seeking. Logistic regression results reveal that greater violence severity, stronger perceived social support, and higher gender equality awareness significantly increase both formal and informal help-seeking. Notably, living with children is associated with a higher likelihood of seeking formal help, possibly due to increased concerns for children’s safety and the desire to change the abusive environment. While help-seeking behavior is on the rise overall, particularly among women with strong support networks and progressive gender attitudes, structural and cultural barriers remain. The findings underscore the need to improve public education, reduce stigma, and enhance accessibility of support systems. This study contributes to the growing literature on IPV in China and provides evidence for refining policy interventions and service delivery. Full article

Background: Marburg virus disease (MVD) is a highly lethal filoviral infection, yet its long-term health consequences remain poorly understood. We present one of the most temporally distant evaluations of MVD survivors, conducted 13 years post-outbreak in Uganda, offering novel insights into chronic physiological, biochemical, haematological, and psychosocial outcomes. Methods: A cross-sectional, community-based study compared ten MVD survivors with nineteen age- and sex-matched unexposed controls. Clinical evaluations included vital signs, anthropometry, mental health screening, and symptom reporting. Laboratory analyses covered electrolytes, inflammatory markers, renal and liver function tests, haematology, and urinalysis. Standardised psychological assessments measured anxiety, depression, perceived stigma, and social support. Findings: Survivors exhibited an elevated body mass index (BMI), higher systolic and diastolic blood pressure, and lower respiratory rates compared to controls, indicating ongoing cardiometabolic and autonomic changes. These trends may reflect persistent cardiometabolic stress and potential alterations in autonomic regulation, warranting further investigation. Biochemically, survivors exhibited disruptions in serum chloride, bilirubin, and total protein levels, suggesting subclinical hepatic and renal stress. Haematological analysis revealed persistent reticulocytosis despite normal haemoglobin levels, indicating long-term erythropoietic modulation. Despite these physiological changes, survivors reported minimal psychological morbidity, sharply contrasting with the post-recovery profiles of other viral haemorrhagic fevers. Stigma was prevalent during the outbreak; however, strong family support alleviated long-term psychosocial distress. Interpretation: Thirteen years post-infection, MVD survivors demonstrate multisystem physiological perturbations without marked psychological sequelae. These findings challenge assumptions of universal post-viral trauma and highlight the necessity for tailored survivor care models. Future longitudinal studies should investigate the mechanistic pathways underlying cardiometabolic and haematological reprogramming to inform intervention strategies in resource-limited settings. Full article

Background/Objectives: Food addiction (FA) and binge eating disorder share many overlapping features. Many individuals with binge eating disorder experience stigma; however, less is known about the stigma associated with food addiction. The current study examined the weight-based stigma and mental illness stigma associated with attributing disordered eating behaviours to an FA diagnosis or binge eating disorder diagnosis. Methods: Undergraduate students (N = 177) were randomly assigned to read one of three vignettes (FA, binge eating disorder, or control), all of which described a character experiencing the overlapping features of FA and binge eating disorder; the vignettes differed only regarding the diagnosis to which the eating behaviours were attributed. Participants then completed questionnaires assessing their attitudes towards mental illness and obesity followed by questionnaires assessing their own eating behaviours. Results: There were no significant between-group differences in mental illness stigma or weight-based stigma. Significant differences in stigma were found based on the perceived gender of the vignette character and participants’ own FA and binge eating disorder symptoms. Conclusions: Stigma may not differ based on the diagnosis ascribed to addictive-like eating behaviours. Women may be more stigmatized for addictive-like eating behaviours, and individuals who experience addictive-like eating may be more stigmatizing towards others with these behaviours. Full article

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

Background: In Oman, primary healthcare physicians (PHPs) are often the first point of contact in the healthcare system. Understanding the prevalence and impact of stigma among these professionals is crucial to fostering a supportive work environment and promoting access to mental health care. This study evaluated mental health stigma and its association with help-seeking behaviors among PHPs in Muscat, Oman. Methods: A cross-sectional analytical study was conducted from March to May 2023 using cluster random sampling to recruit 191 PHPs. Participants completed a structured questionnaire that evaluated demographic and clinical characteristics, help-seeking behaviors, and perceived stigma. The PPSS developed for this study underwent expert review, pilot tests, and reliability analysis. Data were analyzed using descriptive statistics, Chi-square tests, and multivariate logistic regression, with a significance set at p < 0.05. Results: Most of the participants were women (78.5%), aged 30–39 years (49.7%), and Omani nationals (71.2%). More than half (57.6%) reported experiencing depressive episodes, yet only 21.8% sought professional help. High levels of stigma were associated with reluctance to seek professional mental health support, and 24.6% of participants preferred not to seek help at all. Those in the stigma group were significantly more likely to rely on family or friends for support (adjusted OR = 2.873; 95% CI = 1.345–6.138; p = 0.006). Common barriers to help-seeking included a lack of belief in the effectiveness of treatment (23.0%) and concerns about confidentiality (19.9%). Conclusions: Mental health stigma remains a widespread problem among primary healthcare physicians in Oman, influencing their behavior and preferences. Interventions to reduce stigma and address barriers to mental health care, such as enhanced confidentiality safeguards and treatment skepticism, are critical to improving physician well-being and healthcare delivery. This study can inform policy and training programs aimed at improving physician well-being and patient care. Full article

Among transgender binary and nonbinary/queer (TNBQ) individuals, perceived stigma has been documented to be significantly associated with health disparities that diminish overall quality of life. The present study examined the serial mediating roles of patient–provider relationship quality and perceived barriers to care in the association between perceived stigma and quality of life among TNBQ individuals residing in Italy. Data were collected from 132 TNBQ participants aged 18–60 years (M = 28.52, SD = 8.57) through an online survey assessing perceived stigma, patient–provider relationship quality, perceived barriers to care, and quality of life. A serial mediation model was analyzed using Model 6 of the SPSS Macro Process, version 29, and separately applied to two subgroups of TNBQ participants (i.e., binary and nonbinary) to detect potential differences. Findings indicated that in both groups (i.e., binary and nonbinary populations), when considered independently, only perceived barriers to care—but not patient–provider relationship quality—mediated the relationship between perceived stigma and quality of life. A serial mediation effect was also observed, wherein the relationship between perceived stigma and quality of life was mediated sequentially through patient–provider relationship quality and barriers to care, but only for the binary group. These findings hold significant clinical relevance, as improving the perceived quality of patient–provider relationships may help reduce perceived barriers to healthcare access. In turn, this may attenuate the detrimental effects of perceived stigma on the quality of life among TNBQ individuals. Full article

Despite the availability of pre-exposure prophylaxis (PrEP) in the United Kingdom (UK), uptake among men who have sex with men (MSM) remains inconsistent, signalling a persistent ‘PrEP Gap’. Empirical studies show the important role of psychosocial factors (e.g., stigma, identity, trust in science, and sexual behaviours) in PrEP acceptability and uptake. This study aimed to identify subgroups of MSM in the UK based on psychosocial predictors of PrEP acceptability. A cross-sectional survey of MSM (N = 500) was conducted between June and September 2023. Participants completed validated measures assessing identity resilience, internalised homonegativity, LGBTQ+ connectedness, trust in science, NHS perceptions, HIV stigma, PrEP self-efficacy, condom self-efficacy, sociosexual orientation, perceived HIV risk, and PrEP acceptability. Latent Profile Analysis (LPA) was used to identify distinct subgroups based on these psychosocial dimensions. Four psychosocial profiles were defined: (1) PrEP Ambivalent (15%); (2) PrEP Accepting (36.2%); (3) PrEP Hesitant (37%); and (4) PrEP Rejecting (11.8%). These profiles provide evidence for varied combinations of personal and structural factors influencing PrEP acceptability. PrEP acceptability among MSM in the UK is shaped by distinct psychosocial configurations, influenced by identity, stigma, trust, and perceived risk. These findings highlight the need for differentiated and targeted interventions for enhancing PrEP acceptability based on psychosocial profile. Audience segmentation strategies offer a promising pathway to bridge the awareness-to-engagement gap and address the nuanced barriers facing diverse subgroups within the MSM community. Full article

University students from diverse sexual orientations encounter specific mental health challenges due to academic demands, minority stress, and societal stigma; however, research focusing on these issues is still scarce in Southeast Asia. This research aimed to examine the mental health outcomes of heterosexual and sexuality-diverse students in Thailand, concentrating on both negative aspects—such as depression, anxiety, and perceived stress—and positive aspects—like resilience, inner strength, and perceived social support. A cross-sectional survey was performed with 442 university students aged between 20 and 30, employing validated self-report instruments. Statistical methods, including t-tests and multiple regression analyses, were used to evaluate differences and relationships between sexual orientation and mental health outcomes while controlling for confounding variables. The findings revealed that sexuality-diverse students showed notably higher levels of depression (B = 0.115, p < 0.05) and lower perceived social support (B = −0.10, p < 0.05) when compared to their heterosexual counterparts. Nevertheless, there were no significant differences found in anxiety, perceived stress, resilience, or inner strength. Perceived social support proved to be a crucial protective factor, with greater levels linked to reduced depression, anxiety, and perceived stress (p < 0.01). These results underscore the necessity for inclusive university policies, specific mental health interventions, and peer and family support initiatives to enhance the well-being of sexuality-diverse students in Thailand. Full article

Spirituality has gained increasing legitimacy in psychotherapy; however, certain spiritual experiences, such as past life memories, remain marginalized in clinical settings. These experiences often arise outside therapy and may hold deep existential meaning for individuals, yet patients frequently hesitate to disclose them in conventional psychotherapy for fear of being pathologized. This qualitative study examines how individuals who experienced past life memories outside therapy decided whether to share them during psychotherapy, how therapists responded, and how these responses influenced the therapeutic process. Fifteen participants who had undergone conventional psychotherapy were interviewed using a hermeneutic phenomenological approach. The findings reveal that participants perceived their experiences as vivid and transformative, yet many refrained from sharing them due to concerns about stigma and clinical judgment. When disclosures occurred, therapist responses ranged from validating to dismissive, at times resulting in iatrogenic harm affecting the therapeutic alliance and patients’ willingness to continue. Participants expressed a desire for therapeutic spaces that could respectfully engage with spiritually meaningful experiences. The study introduces the concept of Spiritual-Psychoeducation as a potential framework for supporting the integration of such narratives in therapy. These findings suggest a need for expanded clinical sensitivity to anomalous spiritual experiences, divine gifts within the therapeutic process, as meaningful elements of psychological healing. Full article

Background/Objective: Stair falls are a major health concern for older adults, particularly those wishing to age in place. Despite extensive laboratory research on the causes of stair falls and the effectiveness of prevention interventions, there is limited understanding of how acceptable interventions are to end-users and key stakeholders in real-world home environments. This study explored older adults’ and professionals’ attitudes toward stair-fall prevention interventions, including intervention acceptability, barriers and facilitators to adoption, and priorities for implementation in home settings. Methods: This study employed a sequential mixed-method design, including a survey of 359 UK community-dwelling older adults (aged 55+), followed by focus groups with 8 older adults and 11 professionals from healthcare and housing backgrounds. Results: Older adults surveyed perceived home stair falls as a significant risk and priority for prevention but demonstrated less awareness of specific interventions to prevent falls. Focus groups with older adults and professionals established barriers and facilitators to the adoption of 10 specific stair-fall prevention interventions. Barriers included a lack of awareness, financial constraints, reluctance to alter home environments and stigma. Facilitators included raising awareness through education, clear guidance on intervention benefits and installation, practical and financial support, personalised approaches, social encouragement, and endorsement by professionals. Focus groups found the most acceptable stair-fall prevention interventions included education and skill training, improved staircase lighting and additional handrails. Conclusions: Interventions that are low-disruption, cost-effective, backed by empirical evidence, and endorsed by trusted professionals are more likely to be accepted and implemented. Further research should focus on targeted educational strategies to overcome barriers to adoption. Full article

Background: Stigma is a pervasive, though understudied, psychosocial factor affecting people with multiple sclerosis. This review synthesizes the literature on the impact of perceived, enacted, and internalized stigma on psychological health and illness identity in PwMS. Methods: A comprehensive narrative review approach was adopted, integrating findings from peer-reviewed quantitative and qualitative studies. Databases including PubMed, PsycINFO, and Scopus were searched using combinations of terms such as “multiple sclerosis”, “stigma”, “internalized stigma”, “mental health”, and “illness identity”. Studies were included if they reported on stigma-related outcomes in PwMS, discussed psychological or identity variables, or examined interventions aimed at reducing stigma or enhancing adaptive identity. The analysis focused on thematic synthesis, identifying recurrent findings, mediating mechanisms, and clinical implications. Results: Stigma in MS is consistently linked to higher depression, anxiety, and lower quality of life. Internalized stigma disrupts illness identity, often fostering engulfment and rejection of the self. Psychological mediators—such as cognitive fusion, diminished self-compassion, and weakened sense of coherence—amplify these outcomes. Particularly vulnerable are individuals with progressive disease, severe disability, minority status, or limited social support. A recursive loop emerges: stigma triggers psychological distress, which increases stigma awareness and social withdrawal. In addition to traditional psychological interventions, several emerging approaches have shown promise in reducing internalized stigma and fostering adaptive identity integration. Conclusions: Stigma is a central factor in emotional suffering and identity fragmentation in PwMS. Integrative, narrative-informed, and culturally sensitive interventions are essential to reduce stigma and foster resilience. Future research should prioritize longitudinal, mixed-method approaches to develop effective, scalable solutions. Full article

Background/Objectives: Hearing loss represents an important communication barrier which can lead to social isolation and can be a challenge for mental health status. It is generally accepted that hearing aid (HA) users can develop a stigma related to hearing loss despite the perceived benefits due to most modern technologies. Nevertheless, stigma toward HAs may persist even when patients have been well acclimatized to their use. This study aims to evaluate their experiences in everyday life, the underlying social aspects and the utility of psychometric multidimensional approach in skilled HA users. Methods: In total, 96 HA users and 85 normally hearing subjects were enrolled and asked to complete three psychometric questionnaires that investigated social functioning, body image perception, and psychological distress. HA users were additionally asked to fulfill a disease-specific survey, the International Outcome Inventory for Hearing Aids. The performance of the devices was also investigated by HA’s functional gain through free-field audiometry. Results: Even if auditory devices help with compensating the sensorial deprivation, patients often suffer from social anxiety, social phobia and body image concerns about their appearance while wearing HAs. Conclusions: This study discloses psychopathological factors associated with the HA experience that are surprisingly present after long satisfying HA use. Despite the benefits, the satisfaction and the daily use, HA users continue to be worried about body image and report more psychopathological distress in comparison to their normal hearing peers. Full article