Stigma resistance at the personal, peer, and public levels: A new conceptual model.

Stigma resistance is consistently linked with key recovery outcomes, yet theoretical work is limited. This study explored stigma resistance from the perspective of individuals with serious mental illness (SMI). Twenty-four individuals with SMI who were either peer-service providers (those with lived experience providing services; N = 14) or consumers of mental health services (N = 10) engaged in semistructured interviews regarding experiences with stigma, self-stigma, and stigma resistance, including key elements of this process and examples of situations in which they resisted stigma. Stigma resistance is an ongoing, active process that involves using one’s experiences, knowledge, and sets of skills at the (1) personal, (2) peer, and (3) public levels. Stigma resistance at the personal level involves (a) not believing stigma or catching and challenging stigmatizing thoughts, (b) empowering oneself by learning about mental health and recovery, (c) maintaining one’s recovery and proving stigma wrong, and (d) developing a meaningful identity apart from mental illness. Stigma resistance at the peer level involves using one’s experiences to help others fight stigma and at the public level, resistance involved (a) education, (b) challenging stigma, (c) disclosing one’s lived experience, and (d) advocacy work. Findings present a more nuanced conceptualization of resisting stigma, grounded in the experiences of people with SMI. Stigma resistance is an ongoing, active process of using one’s experiences, skills, and knowledge to develop a positive identity. Interventions should consider focusing on personal stigma resistance early on and increasing the incorporation of peers into services

Black girls navigate the physical and emotional landscape of the neighbourhood: Normalized violence and strategic agency

This article considers how young Black women living in gang-affected neighbourhoods in an urban area in England, UK navigate their safety in public and private spaces, and how these spaces overlap and intersect. Drawing on a project with 18 participants aged 14–19, the research seeks to understand how the participants inhabit, navigate and strategize for their safety through their narratives of life and survival in an unsafe neighbourhood. Findings indicate that they experience sexual harassment in public spaces and gang-associated sexual and physical violence as common, accepted aspects of their everyday realities, from as young as 12. The narratives suggest that participants navigate complex friendship groups to protect each other and their families through tight codes of trust, secrecy, privacy and conflict-management strategies. This article seeks to bring attention to how young women utilize their agency to illuminate the coping strategies they draw on to navigate their physical environments. The article concludes with a discussion of the implications for interventions

Cardiovascular magnetic resonance artefacts

The multitude of applications offered by CMR make it an increasing popular modality to study the heart and the surrounding vessels. Nevertheless the anatomical complexity of the chest, together with cardiac and respiratory motion, and the fast flowing blood, present many challenges which can possibly translate into imaging artefacts. The literature is wide in terms of papers describing specific MR artefacts in great technical detail. In this review we attempt to summarise, in a language accessible to a clinical readership, some of the most common artefacts found in CMR applications. It begins with an introduction of the most common pulse sequences, and imaging techniques, followed by a brief section on typical cardiovascular applications. This leads to the main section on common CMR artefacts with examples, a short description of the mechanisms behind them, and possible solutions

The Stigma Resistance Scale: A multi-sample validation of a new instrument to assess mental illness stigma resistance

Although associated with key recovery outcomes, stigma resistance remains under-studied largely due to limitations of existing measures. This study developed and validated a new measure of stigma resistance. Preliminary items, derived from qualitative interviews of people with lived experience, were pilot tested online with people self-reporting a mental illness diagnosis (n = 489). Best performing items were selected, and the refined measure was administered to an independent sample of people with mental illness at two state mental health consumer recovery conferences (n = 202). Confirmatory factor analyses (CFA) guided by theory were used to test item fit, correlations between the refined stigma resistance measure and theoretically relevant measures were examined for validity, and test-retest correlations of a subsample were examined for stability. CFA demonstrated strong fit for a 5-factor model. The final 20-item measure demonstrated good internal consistency for each of the 5 subscales, adequate test-retest reliability at 3 weeks, and strong construct validity (i.e., positive associations with quality of life, recovery, and self-efficacy, and negative associations with overall symptoms, defeatist beliefs, and self-stigma). The new measure offers a more reliable and nuanced assessment of stigma resistance. It may afford greater personalization of interventions targeting stigma resistance

Stigma Resistance is Positively Associated with Psychiatric and Psychosocial Outcomes: A Meta-analysis

To better understand how stigma resistance impacts functioning-related domains, we examined mean effect sizes between stigma resistance and: 1) symptoms (overall, positive, negative, and mood symptoms); 2) self-stigma; 3) self-efficacy; 4) quality of life; 5) recovery; 6) hope; 7) insight, and 8) overall outcomes (the average effect size across the constructs examined in each study). The mean effect size between stigma resistance and overall outcomes was significant and positive (r = 0.46, p < 0.001, k = 48). A large, negative effect size was found between stigma resistance and self-stigma (r = − 0.57, p < 0.001, k = 40). Large, positive effect sizes were found with self-efficacy (r = 0.60, p < 0.001, k = 25), quality of life (r = 0.51, p < 0.001, k = 17), hope (r = 0.54, p < 0.001, k = 8), and recovery (r = 0.60, p < 0.001, k = 7). Stigma resistance had a significant medium and small relationship with insight and symptoms, respectively. Race significantly moderated overall outcomes, self-stigma, mood symptoms, functioning, and hope associations. Education significantly moderated symptoms, functioning, and mood symptoms associations, and age significantly moderated self-stigma and negative symptom associations. Stigma resistance may be a key requirement for recovery. Individual characteristics influence resisting stigma and future work should prioritize cultural factors surrounding stigma resistance

A meta-analytic review of self-reported, clinician-rated, and performance-based motivation measures in schizophrenia: Are we measuring the same “stuff”?

An array of self-reported, clinician-rated, and performance-based measures has been used to assess motivation in schizophrenia; however, the convergent validity evidence for these motivation assessment methods is mixed. The current study is a series of meta-analyses that summarized the relationship between methods of motivation measurement in 45 studies of people with schizophrenia. The overall mean effect size between self-reported and clinician-rated motivation measures (r = 0.27, k = 33) was significant, positive, and approaching medium in magnitude, and the overall effect size between performance-based and clinician-rated motivation measures (r = 0.21, k = 11) was positive, significant, and small in magnitude. The overall mean effect size between self-reported and performance-based motivation measures was negligible and non-significant (r = −0.001, k = 2), but this meta-analysis was underpowered. Findings suggest modest convergent validity between clinician-rated and both self-reported and performance-based motivation measures, but additional work is needed to clarify the convergent validity between self-reported and performance-based measures. Further, there is likely more variability than similarity in the underlying construct that is being assessed across the three methods, particularly between the performance-based and other motivation measurement types. These motivation assessment methods should not be used interchangeably, and measures should be more precisely described as the specific motivational construct or domain they are capturing

Greater Metacognition and Lower Fear of Negative Evaluation: Potential Factors Contributing to Improved Stigma Resistance among Individuals Diagnosed with Schizophrenia

Stigma resistance, one's ability to block the internalization of stigma, appears to be a key domain of recovery. However, the conditions in which one is most likely to resist stigma have not been identified, and models of stigma resistance have yet to incorporate one's ability to consider the mind of others. The present study investigated the impact of the interaction between metacognition, or one's ability to form an integrated representation of oneself, others, and the world, and fear of negative evaluation on one's ability to resist stigma.Narratives of encounters with stigma shared by 41 persons with schizophrenia or schizoaffective disorders were first coded for spontaneous expressions of fear of negative evaluation from others. Two-step cluster analyses were then conducted in order to test the hypothesis that metacognition and fearing negative evaluation from others are important, interacting pathways which contribute to resisting stigma.Those with high (n = 11; 26.8%), intermediate (n = 9; 22.0%), and low metacognition (n = 21; 51.2%) significantly differed on stigma resistance (F = 9.49, p<0.001) and the high metacognition group was most likely to resist stigma. Those with high and low metacognition did not express fear of negative evaluation, while those with intermediate metacognition did express fear of negative evaluation

Language and hope in schizophrenia-spectrum disorders

Hope is integral to recovery for those with schizophrenia. Considering recent advancements in the examination of clients’ lexical qualities, we were interested in how clients’ words reflect hope. Using computerized lexical analysis, we examined social, emotion, and future words’ relations to hope and its pathways and agency components. Forty-five clients provided detailed narratives about their life and mental illness. Transcripts were analyzed using the Linguistic Inquiry and Word Count program (LIWC), which assigns words to categories (e.g., “anxiety”) based on a pre-existing dictionary. Correlations and linear multiple regression were used to examine relationships between lexical qualities and hope. Hope and its subcomponents had significant or trending bivariate correlations in expected directions with several emotion-related word categories (anger and sadness) but were not associated with expected categories such as social words, positive emotions, optimism, achievement, and future words. In linear multiple regressions, no LIWC variable significantly predicted hope agency, but anger words significantly predicted both total hope and hope pathways. Our findings indicate lexical analysis tools can be used to investigate recovery-oriented concepts such as hope, and results may inform clinical practice. Future research should aim to replicate our findings in larger samples