EXAMINING THE RELATIONSHIP BETWEEN STIGMA AND HELP-SEEKING ATTITUDES AMONG STUDENT-ATHLETES

This study investigated the relationship between public stigma, self-stigma, and help-seeking attitudes in a sample of undergraduate student-athletes. Student-athletes appear to be at increased risk for developing mental health issues compared to their non-athlete counterparts (Etzel et al., 2006). However, student-athletes appear to underutilize available mental health services for fear of being labeled as mentally ill as well as other factors (Pinkerton, Hinz, and Barrow, 1989). The purpose of the current study is to explore two facets of stigma as a potential explanation for negative attitudes toward help-seeking and thus the underutilization of these mental health services. Sixty-six student-athletes completed a 10-minute paper-pencil survey. The survey included measures of self-stigma, public stigma, help-seeking attitudes, demographic variables, and an open-ended question regarding barriers to help-seeking. Results indicated that self-stigma mediated the relationship between public stigma and help-seeking attitudes, which replicates the mediated model found in Vogel et al. (2007). Self-stigma appears to explain how negative stereotypes about those who seek help are internalized to form negative attitudes toward help-seeking for student-athletes. Further, student-athletes noted barriers to help-seeking such as lack of time or knowledge of resources as well as fear of being labeled as mentally ill. Implications for research and practice are delineated

HEALTH CARE STEREOTYPE THREAT AMONG PATIENTS WITH MULTIPLE MARGINALIZED IDENTITIES: A QUALITATIVE STUDY

It is well documented that some populations experience higher rates of certain diseases. While researchers have explored factors contributing to health disparities, attention has turned to the influence of social factors. For instance, stereotype threat has recently been applied to the health care setting in order to explain growing health disparities (e.g., Aronson et al., 2013). Health care stereotype threat (HCST) may arise when patients become aware that a negative health stereotype exists about a group or groups with which they identify, thus negatively impacting their utilization of health care services. Furthermore, patients with multiple marginalized identities have unique experiences of stereotyping and discrimination within the health care system. The purpose of the current study is to address Abdou et al.’s (2016) recommendation that researchers examine health care stereotype threat among individuals with multiple marginalized identities. The present study identified patients with a chronic illness and multiple marginalized identities including: (a) identifying as Black, (b) being considered overweight by medical community, and/or (c) identifying as Lesbian, Gay, Bisexual, and Transgender (LGBT). These identities were chosen based on research indicating that physicians hold implicit bias attitudes towards and stereotypes about these groups (e.g., Blair et al., 2013; Chapman et al., 2001; Sabin et al., 2009). I utilized qualitative research methodology to contextualize patients’ experiences of stereotyping in a health setting. In person, semi-structured interviews were conducted with eight patients. During the interview process, four major categories and 22 sub-level categories emerged. Grounded theory methodology (Corbin & Strauss, 2008) was used to analyze the data. The results of the study revealed a complex relationship between negative experiences with a provider (i.e., dismissive communication and perceived stereotyping) and health care utilization. Patients’ negative experiences with providers made it more difficult for patients to continue engaging in care. Systemic barriers as well as level of coping and social support influenced patients’ perception of stereotyping and discrimination. Level of support from other providers and use of coping skills also determined the extent to which patients continued to utilize available health care in the face of discrimination. Implications for future research and clinical practice are delineated

Long-term satisfaction and quality of life following risk reducing surgery in BRCA1/2 mutation carriers

BACKGROUND: As BRCA1/2 testing becomes more routine, questions remain about long-term satisfaction and quality of life following testing. Previously, we described long term distress and risk management outcomes among women with BRCA1/2 mutations. This study addresses positive psychological outcomes in BRCA1/2 carriers, describing decision satisfaction and quality of life in the years following testing. METHODS: We evaluated satisfaction with testing and management decisions among 144 BRCA1/2 carriers. Prior to genetic testing, we assessed family history, sociodemographics and distress. At a mean of 5.3 years post-testing, we assessed management decisions, satisfaction with decisions and, among women with cancer, quality of life. RESULTS: Overall, satisfaction with decision making was high. Women who had risk reducing mastectomy or oophorectomy were more satisfied with management decisions. Participants who obtained a risk reducing oophorectomy were more satisfied with their genetic testing decision. Among affected carriers, high pretest anxiety was associated with poorer quality of life and having had risk reducing mastectomy prior to testing was associated with better quality of life. The negative impact of pre-test anxiety was diminished among women who had mastectomies before testing. CONCLUSIONS: BRCA1/2 carriers are satisfied with their testing and risk management decisions and report good quality of life years after testing. Having risk reducing surgery predicts increased satisfaction and improved quality of life