The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review

<div><p>Background</p><p>considerable proportion of the population experiences major life disruptions after losing a loved one to suicide. Social stigma attached to suicide survivors adds to complications occurring in the course of suicide bereavement. Despite its known risks, stigma related to suicide survivors has been sparsely investigated.</p><p>Methods</p><p>We conducted a systematic literature search in PubMed, Web of Science, PsycInfo and PsyArticles, of studies indexed up through August 2015. Articles were eligible for inclusion if they addressed experiences of stigma in suicide survivors, compared them to other bereavement populations, or investigated stigmatizing attitudes within the public. The search was restricted to English-language studies.</p><p>Results</p><p>25 records matched inclusion criteria. Study designs were heterogeneous, making comparisons difficult. Results demonstrated that suicide survivors experience stigma in the form of shame, blame, and avoidance. Suicide survivors showed higher levels of stigma than natural death survivors. Stigma was linked to concealment of the death, social withdrawal, reduced psychological and somatic functioning, and grief difficulties. Only one study investigated stigmatizing attitudes towards suicide survivors among the general population.</p><p>Limitations</p><p>Internal and external validity of the studies was restricted by a lack of valid measures and selection bias.</p><p>Conclusions</p><p>More methodologically sound research is needed to understand the impact of stigma on suicide survivors’ grief trajectories and to separate it from other grief aspects. Clinicians and grief-counselors as well as the public should be educated about the persistent stigma experienced by suicide survivors.</p></div

PRISMA Flow Diagram.

<p>PRISMA Flow Diagram.</p

Database search strategies.

<p>Database search strategies.</p

Summary of quantitative studies on levels and correlates of self- and public stigma.

<p>Summary of quantitative studies on levels and correlates of self- and public stigma.</p

Socio-demographic characteristics of the samples compared to the German general population.

1<p>Federal Statistics Office (December 2009).</p

Data_Sheet_1_Preferences for Depression Treatment Including Internet-Based Interventions: Results From a Large Sample of Primary Care Patients.docx

<p>Background: To date, little is known about treatment preferences for depression concerning new media. This study aims to (1) investigate treatment preferences for depression including internet-based interventions and (2) examine subgroup differences concerning age, gender and severity of depression as well as patient-related factors associated with treatment preferences.</p><p>Methods: Data were derived from the baseline assessment of the @ktiv-trial. Depression treatment preferences were assessed from n = 641 primary care patients with mild to moderate depression regarding the following treatments: medication, psychotherapy, combined treatment, alternative treatment, talking to friends and family, exercise, self-help literature, and internet-based interventions. Depression severity was specified by GPs according to ICD-10 criteria. Ordinal logistic regression models were conducted to identify associated factors of treatment preferences.</p><p>Results: Patients had a mean age of 43.9 years (SD = 13.8) and more than two thirds (68.6%) were female. About 43% of patients had mild depression while 57% were diagnosed with moderate depression. The majority of patients reported strong preferences for psychotherapy, talking to friends and family, and exercise. About one in five patients was very likely to consider internet-based interventions in case of depression. Younger patients expressed significantly stronger treatment preferences for psychotherapy and internet-based interventions than older patients. The most salient factors associated with treatment preferences were the patients' education and perceived self-efficacy.</p><p>Conclusions: Patients with depression report individually different treatment preferences.Our results underline the importance of shared decision-making within primary care. Future studies should investigate treatment preferences for different types of internet-based interventions.</p

Summary of methodological differences of all eight studies.

<p>Note: Negative = demonstrates negative attitude towards adiposity; Positive = positive or neutral attitude towards adiposity; Neutral = ambivalent attitude or ambiguous findings; N = sample size; FPS = Fat Phobia Scale; IAT = Implicit Association Test; BATOS = Bray Attitude towards Obesity Scale; BAOP = Beliefs About Obese People</p><p>Summary of methodological differences of all eight studies.</p

Dietitians and Nutritionists: Stigma in the Context of Obesity. A Systematic Review

<div><p>Aim</p><p>Negative attitudes towards people with obesity are common even in health care settings. So far, the attitudes and causal beliefs of dietitians and nutritionists have not been investigated systematically. The aim of this article was to review the current state of quantitative research on weight-related stigma by dietitians and nutritionists.</p><p>Method</p><p>A systematic literature review was conducted in 2014 using PubMed, PsycINFO, Web of Science and Cochrane Library.</p><p>Results</p><p>Eight studies were found that differ in regard to study characteristics, instruments and the origin of the sample. Six out of eight studies reported weight stigma expressed by dietitians and nutritionists. Their believed causes of obesity indicated a defined preference for internal factors rather than genetics or biology.</p><p>Discussion</p><p>Results of studies were not homogenous. The degree of negative attitudes by dietitians and nutritionists towards people with obesity appeared to be slightly less pronounced compared to the general public and other health care professionals. Stigma and its consequences should be included into educational programs to optimally prepare dietitians and nutritionists.</p></div

Body Mass Index (BMI) categories in the final sample.

<p>Under and normal-weight <24.9 kg/m², overweight 24.9–29.9 kg/m² and obese ≥30 kg/m².</p

Answer distribution patterns of mean FPS score.

<p>FPS – Fat Phobia Scale, SD – Standard Deviation.</p><p>Fat Phobia Scale (FPS) score of the overweight vignette was from 1 = positive attributes to 5 = negative attributes.</p