The stigma of pigmentary disorders

One of the major barriers to individuals with pigmentary disorders in achieving their life goals is the stigma of their disorder. This paper provides a review of the existing research regarding stigma reduction, focusing on public stigma, and looking at approaches used within the mental health and other stigmatized communities. A main focus of pigmentary disorder advocates is to eliminate this stigma to remove the barrier it has on success and self-efficacy. Approaching this task from a perspective well-informed by previous research is important to both ensure that stigma reduction resources are spent wisely, and that anti-stigma approaches are effective

Aspects of autonomy support and satisfaction for disadvantaged groups

Autonomy involves a sense that one’s behaviour is authentic, volitional and aligned with inner beliefs. Though extant literature describes the importance of both autonomy satisfaction and autonomy support from others with whom one interacts, little work has been conducted to understand what specific qualities comprise autonomy satisfaction and its support. In other words, we know little of how and why autonomy matters for individuals’ well-being. In two empirical chapters, I describe an understudied aspect of autonomy satisfaction: whether self-expression is congruent (autonomy satisfying) or incongruent (autonomy-thwarting) with the self. Therefore, in a first empirical chapter (Chapter 3), I investigated two types of self-expression: authentic self-expression (that supports autonomy) and inauthentic self-expression (that may undermine autonomy). I developed a new scale to assess these constructs and show they are distinct from, but closely linked with, the internal experience of feeling authentic and that they foster feelings of agency. In Chapter 4, I further examined what happens when people think of in-group others’ undermined self-expression. Specifically, I tested whether vicariously undermining autonomous self-expression can elicit a reactive response to reassert one’s own autonomy through self-expression. In two final empirical chapters, I studied autonomy support from close others within samples of individuals who identify as lesbian, gay, or bisexual (LGB; with transgender and related communities, LGBT+). Disadvantaged individuals, such as those who are LGBT+, are known to have worse well-being than the general population and may benefit more from autonomy support. Therefore, understanding autonomy support for this minority group is an important step in rectifying health disparities. Chapter 5 uses a large pre-existing dataset to analyse the importance of specific components of autonomy support within close relationships in an LGB sample, whilst Chapter 6 further explored the components of autonomy support and their relation to well-being in LGBT+ individual

Long-term mental health correlates of socialsupportive relationships in a lesbian, gay, and bisexual sample

Social support cultivates mental health, but little is known about how social support is experienced in individuals with a stigmatised identity, such as those who identify as lesbian, gay, or bisexual (LGB). The present study explored how specific elements of social support: reliance, feeling understood, and support for self-expression, experienced within parent, friend, and romantic relationships, relate to long-term mental health in an LGB sample. Responses were provided across 2 years by individuals who self-identified as gay, lesbian or bisexual in the nationally-representative dataset- Understanding Society, the UK Household Longitudinal Study (UKHLS). We predicted that having close relationships higher in social support would be linked to better general mental health 2 years after support was measured. Models partially supported hypotheses: broadly speaking, social support from friends, family, and romantic partners associated significantly with mental health measured at baseline and two years later, when relationships were considered separately. Of these, support for self-expression as provided by families were most robust even in models with conservative baseline and other relationship controls

Motivated to express: salience of oppression toward other women encourages women’s self-expression

Women’s oppression undermines and inhibits women but may also prompt an enterprising reaction. In this paper, three studies explored the extent to which women respond to awareness of the oppression of other women with an increased desire for self-expression, a reactive but constructive response. Study 1 explored reactions to two forms of other women’s oppression: restricted self-expression and restricted economic opportunities. Women reported an increased desire to self-express after exposure to either form of oppression, as compared to a control group. Study 2 compared British women’s reactions to stories of a woman versus a man being oppressed, finding the former group wrote more words about an unrelated, but timely and consequential topic (Brexit). Finally, Study 3 replicated the effect of greater self-expression after being exposed to women’s oppression, and furthermore identified an indirect effect through reactance. Findings are discussed in relation to identity, constructive forms of reactance, and implications for current women’s rights movements

Relations of civil liberties and women's health satisfaction around the globe: the explanatory power of autonomy

Research on how sociopolitical factors differentially affect the health and well-being of individuals is nascent and mechanisms responsible have not yet been identified. This work examined how the civil liberties afforded across 79 countries differentially affect the health satisfaction of men and women and tested one potential reason for this link: autonomy satisfaction, the experience of being choiceful, and free to express oneself. Women reported lower health satisfaction in countries that were lower in civil liberties, a relation mediated by autonomy. Implications for women and other marginalized groups most affected by a society’s restrictive policies and norms are discussed

Three agendas for changing the public stigma of mental illness

Objective: Antistigma programs may be guided by 3 differing agendas: services (promote treatment engagement), rights (help people achieve rightful goals), and self-worth (facilitate self-worth and efficacy). This study examined the construct validity of this perspective by examining the factor structure of importance ratings of the 3 agendas. The study examined how importance might be viewed differently by the population as a whole versus a subsample of people who reported previous experience with mental health services and hence could be directly harmed by stigma. Methods: 373 individuals recruited using Mechanical Turk completed importance ratings for each of the 3 agendas. Measures of public stigma were completed to examine concurrent validity of importance ratings. Those who reported taking medications for a psychiatric disorder were divided into a separate group and completed a measure of self-stigma. Results: Outcomes seemed to confirm the factor structure of the 3 agendas model thereby offering partial support for the framework. Group analyses showed the services agenda was viewed as more important than rights or self-worth. People with mental health experience viewed the services agenda as more important than the other 2. However, dividing the mental health group into low and high self-stigma revealed that those with low self-stigma rated the rights agenda as more important. Conclusions and Implication for Practice: Participants with lower self-stigma identify the harm brought by stigma and thus endorse rights and self-worth more than those with higher self-stigma. Implications of these findings are discussed to assist to prioritize agendas for public health campaigns

Self-stigma, identity, and co-occurring disorders

BACKGROUND: A four stage regressive model that links public stigma to self-stigma is applied to mental illness and substance use disorder. We assess this four stage model in those with co-occurring disorders versus those who have mental illness or substance use disorder alone. METHOD: 366 people who self-identified as having either a mental illness or co-occurring mental illness with substance use disorder were recruited from MTurk and completed measures on identity and self-stigma. RESULTS: Higher group identity predicted lower selfstigma in those with mental illness while this effect was not present for participants with co-occurring disorders. Limitations include that this study only looked at mental illness identity for those with both mental illness and substance use disorder; sample limitations are also discussed. CONCLUSIONS: Those with co-occurring disorders may identify more with certain groups over others

Self-stigma, identity, and co-occurring disorders

BACKGROUND: A four stage regressive model that links public stigma to self-stigma is applied to mental illness and substance use disorder. We assess this four stage model in those with co-occurring disorders versus those who have mental illness or substance use disorder alone. METHOD: 366 people who self-identified as having either a mental illness or co-occurring mental illness with substance use disorder were recruited from MTurk and completed measures on identity and self-stigma. RESULTS: Higher group identity predicted lower selfstigma in those with mental illness while this effect was not present for participants with co-occurring disorders. Limitations include that this study only looked at mental illness identity for those with both mental illness and substance use disorder; sample limitations are also discussed. CONCLUSIONS: Those with co-occurring disorders may identify more with certain groups over others