Stigma Project

Stigma is a socially constructed phenomenon characterized by stereotypes and prejudice that lead to discrimination. Mental illness stigma remains the foremost barrier to seeking help in the United States and globally. Further, mental illnesses are associated with a disproportionately higher stigma than physical illnesses in the United States, a well-established finding. However, this has only recently been investigated in Pakistan. Generally, the literature indicates that there is a higher mental illness stigma in Eastern, developing countries (e.g., Pakistan) than in Western, developed countries (e.g., the United States). However, there is a dearth of literature comparing mental and brain illness in either country. Hence, the current study examined mental and brain illness stigma, discriminatory potential, and causal beliefs in a cross-cultural sample. A total of 918 students completed the survey with 458 Pakistani and 460 United States participants. Results supported the hypotheses such that Pakistan had a higher overall stigma and discriminatory potential than the United States. However, there was no difference in stigma and discriminatory potential between mental and brain illness. Moreover, Pakistan predominately endorsed moral causal beliefs, whereas the United States endorsed biogenetic causal beliefs which were higher for mental than brain illness in both countries. Our findings suggest the need to invest in formalized stigma reduction campaigns in Pakistan leveraging psychoeducation and contact with people with lived experience. The continued endorsement of biogenetic causal beliefs in the United States remains a concern as it has been associated with reduced help-seeking and perpetuating negative attitudes toward mental illness

Post-Traumatic Stress Disorder and Blast Exposure in Active-Duty Military Service Members

Objective: Active-duty military personnel in the current wars have experienced unique stressors that deviate from standard PTSD assessment and diagnosis. This situation calls for a refinement of military-related PTSD assessment. To this end, this study assessed the utility of the Trauma Symptom Inventory (TSI) in diagnosing PTSD among active-duty military personnel. The past literature has validated the TSI using populations with a small sample size. Hence, this study aimed to fill the gap by using a large sample size of 670 military members to examine whether the TSI is useful for military populations. Setting: Participants were referred to Carolina Psychological Health Services, in Jacksonville, North Carolina by military neurologists and other qualified medical officers from the Naval Hospital in Camp Lejeune, a military base located in Jacksonville, NC, for neuropsychological evaluation due to reported cognitive deficits related to military deployment (i.e., head injury due to exposure to blast injuries). Participants: Based on clinical diagnosis, comprehensive neuropsychological testing, and self-reported data, personnel were classified into four groups: blast exposure (n = 157), PTSD diagnosis (n = 90), both blast exposure and PTSD (n = 283), and neither blast exposure nor PTSD (n = 140), which helps provide a comprehensive picture of the utility of the TSI. Results: The TSI’s 10 clinical scales could distinguish between all groups. Discriminant function analysis showed that an optimally weighted combination of scales correctly predicted 66.67% of PTSD-positive cases and 35.11% of PTSD-negative cases. Conclusion: These findings provide support for the use of the TSI in the assessment of PTSD in active-duty military personnel. Due to the release of TSI-2, there is a need to replicate this data. However, the validity data has indicated a high concordance between the TSI and TSI-2, bolstering confidence in the current findings of the study