PLOS mental health最新文献

Stigma is common in people affected with Neglected Tropical Diseases (NTDs). However, no validated tools are available to assess and monitor stigma in trachoma-affected communities. We tested the cross-cultural equivalence of the 5-question stigma indicator-affected persons (5-QSI-AP) scale in persons with trachomatous trichiasis (TT), the blinding stage of trachoma, and the 5-question stigma indicator-community stigma (5-QSI-CS) scale in person without TT, in Amhara region, Ethiopia. Conceptual, item, semantic, and operational equivalence were assessed through exploratory qualitative methods; measurement equivalence was assessed quantitatively through internal consistency, construct validity, and reproducibility. A total of 390 people participated: 181 were persons with TT, 182 persons without TT, 19 mental health, trachoma, social science, and linguistics experts, and eight interviewers. Items included in both scales were adequately relevant and important to explore stigma in the target culture. Concern about others knowing that they have TT, shame, avoidance by others, and problems getting married or in their marriage were among the issues persons with TT faced in this study community. The 5-QSI-AP had a Cronbach's α of 0.57 for internal consistency and showed adequate discriminant validity where persons with central corneal opacity from TT had higher mean stigma scores than their counterparts. The 5-QSI-CS had a Cronbach's α of 0.70 for internal consistency and a correlation of r = 0.23 with the Social Distance Scale (SDS) for convergent validity. The test-retest reliability analysis between the initial and repeat measures produced an intraclass correlation coefficient of 0.60 and 0.53 for the 5-QSI-AP and 5-QSI-CS respectively, and no evidence of systematic bias in mean stigma scores. The 5-QSI scales have satisfactory cultural validity to assess and monitor stigma in this trachoma-affected Amharic-speaking study population. With further cross-cultural validation, these brief and easy to administer scales would offer the possibility to rapidly measure and monitor stigma associated with NTDs.

Understanding and eliminating mental illness stigma is crucial for improving population mental health. In many settings, this stigma is gendered, from the perspectives of both the stigmatized and the stigmatizers. We aimed to find the differences in the level of stigma across different mental disorders while considering the gender of the study participants as well as the gender of the people depicted in the vignettes. This was a population-based, experimental vignette study conducted in Buyende District of Eastern Uganda in 2023. We created 8 vignettes describing both men and women with alcohol use disorder, major depressive disorder, generalized anxiety disorder, and schizophrenia consistent with DSM-5 criteria. Participants from 20 villages in rural Buyende District of Uganda (N=379) were first read a randomly selected vignette and administered a survey eliciting their attitudes (Personal Acceptance Scale [PAS] and Broad Acceptance Scale [BAS]) towards the person depicted in the vignette. We used analysis of variance (ANOVA) with Bonferroni-adjusted, empirical p-values to compare levels of acceptance across disorders and genders. Attitudes towards people with mental illness, as measured by the PAS, varied across different mental disorders (p=0.002). In pairwise mean comparisons, the greater acceptance of anxiety disorder vs. schizophrenia was statistically significant (Mean [SD] PAS: 2.91 [3.15] vs 1.62 [1.95], p=0.008). Secondary analyses examining differences in acceptance across gender combinations within mental disorders showed that PAS varied across gender combinations for depression (p=0.017), suggesting that acceptance is higher for women with depression than men with depression. In this population-based vignette study from rural Uganda, we found that people with schizophrenia were less accepted compared to people with anxiety disorders. We also found that there was greater acceptance of women with depression than men with depression. Anti-stigma initiatives may need to be targeted to specific disorders and genders.