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While serious mental illness (SMI) and substance use disorders (SUD) are common, less research has focused on causal beliefs across conditions. This is an important question when trying to understand the experience of dual diagnosis. The purpose of this paper is to examine how three factors representing causal beliefs (biogenetic, psychosocial or childhood adversity) differ by SMI and SUD. This study also examined how causal beliefs were associated with overall, process and outcome beliefs about recovery.

Using Mechanical Turks online panel, 195 research participants from the general public completed measures of recovery – overall, outcome and process – for SMI and SUD. Participants also completed the Causal Beliefs Scale yielding three causal factors for SMI and separately for SUD: biogenetic, psychosocial and childhood adversity.

Results indicated participants endorsed biogenetic cause more for SMI and SUD. Moreover, research participants endorsed biogenetic causes more than the other two for SMI. Results also showed the psychosocial cause was positively associated with recovery for SMI. Biogenetic causes were not. Almost none of the causal indicators was significantly associated with recovery for SUD.

Implications of these findings for future research and public efforts to enhance attitudes about recovery are discussed.

This study aims to examine the reliability and validity of the Arabic version of the attribution questionnaire (AQ).

The AQ is designed to assess attitudes, affects and behavioral intentions related to a hypothetical person diagnosed with schizophrenia. The original English version was translated into Literary Arabic. A total of 310 students registered in different universities, with medical and paramedical establishments excluded completed the Arabic version of AQ. Reliability was tested using Cronbach’s alpha coefficients. Structural equation modeling was used to test hypothesized paths. Correlations among exogenous (e.g. responsibility) and endogenous (e.g. help) variables in the path were examined. Fit indicators were then examined for equations that were identified.

The results revealed that the Arabic version of AQ showed acceptable psychometric properties in the assessment of stigma in the Tunisian population. All factors of this Arabic version showed Cronbach’s alpha values equal to or greater than 0.72. Structural equation models for the responsibility and dangerousness models were mostly supported. The Arabic version of AQ is valid and reliable for the assessment of stigma in Tunisian and Arabic-speaking populations.

The Arabic version of AQ may be used to promote research on stigma toward people with mental illness in larger and more representative Tunisian and Arabic-speaking populations, which will help to further address the complex and multifaceted phenomenon of stigma toward people with mental illness.

This is the first validated stigma measure in the Tunisian socio-cultural context.

The purpose of this study is to investigate Koreans' preferences for FCDM versus SDM and explored the influence of Asian cultural values on decision-making in the context of managing chronic illnesses, such as type 2 diabetes mellitus (T2DM). Shared decision-making (SDM) emphasizes collaboration between providers and service recipients to decide on the best treatment options. However, it may not fully account for the role of families in managing chronic illness, particularly for people from Eastern cultural backgrounds who value active participation from their families in decisions. In response, family-centered decision-making (FCDM) has been proposed as an alternative approach. Using a vignette experiment design, data (n = 316) were collected from Koreans in the US and in Korea who were randomly presented with either SDM or FCDM processes for reaching T2DM treatment decisions. In addition to demographic information, participants reported on three dimensions of their decision-making experience: satisfaction, perceived effectiveness, and perspective-taking. They also rated their Asian cultural values and familiarity with T2DM. Results show better satisfaction, perceived effectiveness, and perspective taking for FCDM compared to SDM when examined in context of treatment types and perceived illness severity. Moderation effects were found for familiarity of illness, with familiarity effects varying by perceived severity. Study findings provided some evidence in favor of FCDM in Asian communities addressing the disabilities and chronic illness of a family member. Although the current study investigated treatment decisions for T2DM during doctor's visits, FCDM has shown potential to be applied in other service settings.

To the Most Rev. M.A. Corrigan, Archbishop of New York:

Disclosure of mental illness is a key ingredient in contact-based public stigma change strategies. Adults who disclose their personal recovery story experience greater empowerment and heightened quality of life. Qualitative research suggests youth may similarly benefit, but also have unique benefits and costs associated with disclosure. The purpose of this paper is to examine adults’ perceived costs and benefits of mental illness disclosure for middle and high school students with a new measure, the Coming Out with Mental Illness Scale for Children (COMIS-Child).

In total, 300 adult participants from Amazon’s MTurk completed the COMIS-Child, the Beliefs about Disclosure Scale (BDS), assessing perceptions about child disclosure, and the Attribution Questionnaire, assessing public stigma.

Principal component analyses of the COMIS-Child yielded one factor representing disclosure costs and two factors for benefits (changing pubic stigma; person-defined benefits). Internal consistencies of the COMIS-Child factors were strong. Parents with children with mental illness endorsed more costs and fewer benefits from the changing public stigma factor than other respondents. Regression analyses showed decisions about youth disclosing mental illness from the BDS were associated with perceived costs, perceived benefits as personally defined, and public stigma. Disclosure beliefs were also inversely associated with public stigma.

Adults who identify more costs and fewer benefits were less likely to believe youth should disclose, favoring a more conservative approach to youth disclosure. This highlights the importance of participating in self-stigma interventions that guide an individual’s decision making about disclosure.

To the author’s knowledge, this is the first study examining adults’ perceptions of youth disclosure of mental illness.

Nurses and nursing students often hold stigmatizing attitudes toward patients with mental illness, contributing to poor health outcomes. To address this, direct contact with persons with lived experience in mental illness (i.e. consumers) has been integrated into training curricula. This has shown decreased negative attitudes and increased empathy, but gains are not typically maintained at follow-up. The purpose of this paper is to explore acceptability (i.e. feasibility, process and fidelity) and stigmatizing attitudes of nursing students after the completion of a mentor-based direct-contact curriculum to decrease stigmatizing attitudes toward persons with mental illness.

A five-week manualized contact-based mentorship program, with a mentor (i.e. consumer)–mentee (i.e. student) pairs implemented as a supplement to the clinical curriculum for 23 baccalaureate-nursing students. Feasibility (i.e. attendance), acceptability, fidelity and stigmatizing attitudes were evaluated. The Error Choice Test and the Attribution Questionnaire (AQ-9) were used to assess stigmatizing attitudes.

Feasibility was 100 percent for face-to-face meetings and participants were satisfied with the integration of the program into their curriculum, indicating high acceptability. A repeated measures ANOVA yielded significant findings for stigmatizing attitudes (F (2, 21)=6.96, p<0.02, η²=0.23). This suggests that a consumer-led mentoring program may reduce mental health stigma within student-nursing populations. The AQ-9 did not yield significant results.

This study lacked a comparison group. Future research should include a randomized controlled trial.

This study demonstrates capacity for high feasibility and acceptability for an anti-stigma curriculum in this educational context.

The purpose of this paper is to look specifically at the intersection between behavioral health and immigration stigma.

In April of 2017, 256 US participants answered an online solicitation on MTurk to answer questions regarding perceptions of others. Participants were randomized to one of four vignettes which had conditions representing diagnosis (drug abuse vs brain cancer) and immigration status (naturalized citizen vs undocumented immigrant).

Drug abuse was significantly disdained and blamed more than brain cancer. A main effect was also found for immigration status for disdain. Interaction between diagnosis and immigration status was significant for blame, but undocumented status increased the blame of students with brain cancer, the opposite condition the authors expected.

The study validated previously tested hypotheses, namely, people with behavioral health challenges are highly stigmatized being disdained and blamed for their conditions more than people with brain cancer. The study tested intersectionality by examining the hypothesis that undocumented immigration status worsens stigmatizing views of people with behavioral health conditions.

Education programs seek to increase the public’s mental health literacy so they are better able to, among other things, help others engage in care when in need. This task may be diminished when such programs overwhelm participants with too much information. In addition, participants might arrive to the program with information overload related to the covered health topic. Information overload about health topics has been shown to influence attitudes and behavioral intentions. The overall purpose of the current study was to examine the relationship between mental health information overload, topic interest, and care seeking recommendations.

The current study tested a path suggesting high mental health information overload diminishes interest in learning about mental health, which in turn reduces recommendations to others to seek appropriate help when in need. Participants completed online measures of mental health information overload, topic interest and recommendations for care seeking. The data set analyzed represents valid responses from 221 participants. Structural equation modeling was completed to confirm the path model hypothesized for this study.

Structural equation modeling showed satisfactory fit and significant betas for the hypothesized path.

This study adds to the emerging literature on the impact of health information overload and is the first to the best of the authors’ knowledge to measure mental health information overload. Program developers should consider information overload in the ongoing development of public mental health education programs.