Perceived stigma and self-stigma of problem gambling: perspectives of people with gambling problems

Minimal research has investigated the stigma associated with problem gambling, despite its major hindrance to help-seeking and recovery. This study explored perceived stigma and self-stigma to examine stigmatizing beliefs held, how they may be internalized, coping mechanisms, and effects on help-seeking. In-depth interviews with 44 people experiencing gambling problems were analysed using interpretive phenomenology. Results revealed an overwhelming perception that problem gambling attracts acute public stigma and is publicly viewed as caused by personal failings. Participants had serious concerns about being viewed as ‘a problem gambler’, fearing demeaning stereotypes, social rejection, hostile responses and devaluing behaviours. Many participants internalized perceived stigma as self-stigma, with deleterious reported effects on self-esteem, self-efficacy, perceived social worth, and mental and physical health. Deep shame was a near universal emotion and exacerbated by relapse. Secrecy was the main coping mechanism used, with perceived and self-stigma found to act as major barriers to disclosure and help-seeking. The findings can inform the development of a valid understanding and conceptualization of problem gambling stigma. This is a prerequisite for effective stigma-reduction strategies to reduce public stigma and discrimination, and to lower perceived and self-stigma and increase the use of treatment services and other interventions by people with gambling problems.     

Managing occupational identity threats and job turnover: How former and current fundraisers manage moments of stigmatized identities

Maintaining a strong group of fundraisers amidst high turnover rates is essential to the financial health of nonprofit organizations. One issue potentially harming fundraisers' success and continued presence in the field is the negative reputation sometimes associated with fundraising work. This exploratory study uses Stigma Management Communication Theory and content analysis of in‐depth interviews with current and former university fundraisers to investigate how fundraisers communicatively manage stigmatizing messages associated with their occupation. The findings suggest that current fundraisers use a greater number and variety of stigma management strategies than former fundraisers described using. The findings also highlight the potential consequences and distinctions among ways of using humor to manage stigma messages. These findings can be translated into orientation and training programs for fundraisers, teaching them successful ways of framing their occupations and work.     

“At a moment,you could collapse”: Raising children with autism in the West Bank

The current qualitative study examined knowledge, attitudes, burdens and coping strategies related to caring for a child with an autism spectrum disorder (ASD) in the West Bank. Based on a sample of 24 Palestinian parents, the study found that parents struggled with financial stressors, child behavioral and medical challenges, and depression. Few parents were aware of ASDs prior to their children's diagnoses. Furthermore, discrimination and stigma from extended family members and the larger community intensified parents' feelings of shame and experiences of social isolation. While some parents coped by withdrawing from the community or denying the diagnosis, others aimed to increase social interactions and access information. Religious coping was found to be partly adaptive for some of the participants. The study underscored the vital need to increase community awareness of ASDs and increase social support for parents in the West Bank.     

Financial insecurity and risk experiences of justice involved persons with severe mental illness

More information is needed about the financial experiences of justice-involved persons with severe mental illness. Qualitative and quantitative methods were used to examine the financial resources, financial risk experiences, and financial literacy of a random sample of 12 mental health court participants. Mental health court participants had limited financial resources, frequently ran out of money, and had engaged very few financial tools to manage their money. Justice-involved persons with severe mental illness need financial management interventions to help develop strategies for managing depleted resources and to develop the financial resources needed to live in community settings.     

Associative stigma among mental health professionals: implications for professional and service user well-being

In contrast with growing attention given to the stigma experiences of mental health service users, the stigma literature has paid almost no attention to mental health professionals. This study focuses on experiences of associative stigma among these professionals. We investigate the link between associative stigma and three dimensions of burnout as well as job satisfaction among mental health professionals, and the link of associative stigma with self-stigma and client satisfaction among service users. Survey data from 543 professionals and 707 service users from diverse mental health services are analyzed using multilevel techniques. The results reveal that among mental health professionals associative stigma is related to more depersonalization, more emotional exhaustion, and less job satisfaction. In addition, in units in which professionals report more associative stigma, service users experience more self-stigma and less client satisfaction. The results reveal that associative stigma is related to more depersonalization, more emotional exhaustion, and less job satisfaction among mental health professionals.     

Deinstitutionalization, social rejection, and the self-esteem of former mental patients

Modified labeling theorists have long argued that the stigma of mental illness has important consequences for the lives of people with mental illness. We propose that social rejection is an enduring force in the lives of people with mental illness and that these experiences are central to understanding the poor self-concepts described by many former psychiatric patients. We explore changes in a cohort of recently deinstitutionalized mental patients' (N = 88) self-esteem and experiences with social rejection using data from a three wave panel survey conducted while institutionalized and over a two-year period following the patients' discharge from a long-term state hospital. Our results indicate that social rejection is a persistent source of social stress for the discharged patients. Moreover, these experiences increase feelings of self-deprecation that, in turn, weaken their sense of mastery. Where the patients' received their follow-up care--whether in a community setting or in another state hospital--had little impact on their self-related feelings or on their experiences of social rejection. Our results provide further support for modified labeling theory and underscore the need to consider the dynamic relationship between stigmatizing experiences and self-related changes.     

Coping with guilt and shame in the impulse buying context

In this study we investigate how consumers cope with guilt and shame in the impulse buying context. Based on recent psychological research on guilt and shame, we posit that the intensity of shame experienced after buying on impulse will be positively associated with the use of avoidant coping strategies, whereas the intensity of guilt experienced will be positively associated with the use of problem-focused coping strategies. Furthermore, we predict that the use of avoidant coping strategies will be linked with more frequent depressive symptoms and worse financial well-being. These hypotheses were generally supported in an on-line survey of 274 respondents who had recently made an impulse purchase and reported the emotions and coping strategies associated with the event.     

Exploring Knowledge through Peer Tutoring in a Transitional Learning Community: An Alternative Way of Teaching Counseling Skills to Students in Social Work Education

This article is a critical review of Crossing Bridges, a Department of Health training pack for those working with 'mentally ill' parents and their children. The author argues, on the basis of both personal and professional experience, that although the pack pays lip-service to the significance of structural factors, the training resources are primarily rooted in an individual and family-focused pathology model of mental illness. Three arguments are put forward for the necessity of a wider framework: the significance of shame and stigma to those experiencing mental distress and their families; the predominance of understandings of mental illness that translate social phenomena into individualised problems, notably genetic explanations and attributions of risk and dangerousness; and the contribution of motherhood to the experiencing of mental distress in women. Initiatives within the mental health survivor movement are highlighted as examples promoting positive images of mental distress, and the implications of the issues raised for social work education are considered. The article concludes that efforts to help the children of 'mentally ill' parents, not to mention the parents themselves, must incorporate wider strategies to promote openness, respect, acceptance and ultimately, social inclusion, of those who experience mental distress.     

Compassion-Focused Therapy as an Intervention for Adult Survivors of Sexual Abuse

Child sexual abuse can have long-term negative impacts across psychological, physical, and interpersonal domains. Some of the common issues for survivors of sexual abuse include shame and self-blame, attachment-based difficulties, avoidant coping strategies, and reduced capacity for self-compassion. Compassion-focused therapy is a transdiagnostic intervention that specifically responds to these concerns. Compassion-focused therapy was originally developed for clients who experience high levels of shame and self-criticism and aims to strengthen the soothing and affiliative system through the cultivation of compassion. This article will highlight the theoretical alignment between some of the common issues and impacts associated with experiences of sexual abuse, with the core underlying principles of compassion-focused therapy. This includes (a) the capacity of the therapy’s evolutionary framework to reduce perceptions of self-blame, (b) the cultivation of compassion to respond to feelings of shame, (c) acknowledgment of the role of early attachment experiences and facilitation of corrective affiliative experiences, (d) regulation of the threat-based system following trauma, and (e) provision of an alternative to avoidant-based coping by responding to distress with compassion. It is proposed that the theoretical framework and core focus and aims of compassion-focused therapy are highly applicable for survivors of sexual abuse and therefore holds significant promise as a treatment option for this client group.     

Bullying victimization in non-heterosexual university students

In this study the prevalence, impact on mental health, and coping of bullying victimization in university students identifying as non-heterosexual was compared with their heterosexual peers. University students were surveyed on bullying experiences within the past 12 months, their mental health, and use of coping strategies. Demographic information identified gender, age, and sexual orientation. Results indicated that 14.3% of students reported victimization, and that students ages 24 to 35, and those who identified as non-heterosexual, reported higher rates of victimization. No gender differences were found. Bullied students scored significantly higher on depression, anxiety, and stress scores than non-bullied students. Comparisons of mental health scores and coping strategies of non-heterosexual and heterosexual bullied students found no significant differences, indicating both groups are equally impacted, and equally utilize adaptive and maladaptive strategies to manage the victimization. Implications for tertiary institutions include identification of effective coping resources for diverse university student populations. Limitations and recommendations for future research are considered.     

Feeling the Beat and Feeling Better: Musical Experience,Emotional Reflection,and Music as a Technology of Mental Health

Using data from the 1999 Arts and Religion Survey, this article builds on the work of Tia DeNora and the understanding of music as a technology of health by focusing on an important aspect of music's impact on mental health, emotional reflection. The study first examines the relationship between musical experiences and the perceived effectiveness of music as a coping tool in everyday life. The results indicate that musical experience is positively associated with the perception of music as an effective coping mechanism, controlling for relevant demographic and artistic factors included in the survey. The analysis then assesses the relationship between music's perceived effectiveness as a coping mechanism and emotional reflection, indicating a positive association between the two. Aesthetic disposition and parental education are also positive predictors of using music to cope and emotional reflection. The study demonstrates that those who value music as a means of coping may be more emotionally reflective and in turn, experience benefits related to positive mental health. The results also highlight the importance of considering both micro‐ and macro‐theoretical approaches to understanding musical practices and their role in health improvement.     

In the flesh: a poetic inquiry into how fat female employees manage weight-related stigma

ABSTRACT

This paper engages with the question of how fat female employees manage weight-related stigma at work. We use poetic inquiry to show the reader how it feels for our participants to be stigmatized based on their size. We interviewed 22 women who self-identify as full-figured, fat, overweight, or obese. The results consist of six poems, five of which were written by us, the researchers. These ‘tri-voiced poems’ (Leavy 2010b) illustrate the spectrum of affective responses and stigma management strategies that our participants talked about, ranging from feeling anxious, super-smart, impeccable, and funny to rebellious and confident. The sixth poem was written by one of our participants and voices her first-person experiences and perspective. Our aim is to do justice in our writing to the emotions that circulated in the interviews and to make a political statement with regards to the stigmatizing practices in organizations related to size and health.     

Intersections of Stigma,Mental Health,and Sex Work: How Canadian Men Engaged in Sex Work Navigate and Resist Stigma to Protect Their Mental Health

Men engaged in sex work experience significant stigma that can have devastating effects for their mental health. Little is known about how male sex workers experience stigma and its effects on mental health or their strategies to prevent its effects in the Canadian context. This study examined the interrelationships between stigma and mental health among 33 Canadian indoor, male sex workers with a specific goal of understanding how stigma affected men’s mental health and their protective strategies to mitigate against its effects. Men experienced significant enacted stigma that negatively affected their social supports and ability to develop and maintain noncommercial, romantic relationships. Men navigated stigma by avoidance and resisting internalization. Strategy effectiveness to promote mental health varied based on men’s perspectives of sex work as a career versus a forced source of income. Programming to promote men’s mental health must take into consideration men’s diverse strategies and serve to build social supports.     

Coping with Guilt and Shame After Gambling Loss

In this study we examined the relations between guilt and shame and coping strategies in response to gambling loss. Based on H.B. Lewis’s (Shame & guilt in neurosis. New York: International Universities Press, 1971) account of guilt and shame, we proposed that unlike guilt, the experience of shame involves the attribution of gambling loss to stable and global internal factors (i.e., self-devaluation). We hypothesized that problem gambling severity would be more strongly associated with the intensity of shame than with the intensity of guilt following gambling loss. Further, we hypothesized that the intensity of shame would be positively associated with the use of avoidant coping strategies following gambling loss. Finally, we hypothesized that the intensity of shame would mediate the association between problem gambling severity and the use of avoidant coping. These hypotheses were supported by a retrospective survey of recent gambling losses. Our finding suggests that the experience of shame and the use of avoidant coping strategies to deal with this emotion are central to problem gambling severity.     

College students coping with interpersonal stress: Examining a control-based model of coping

Objective: The ways that college students cope with stress, particularly interpersonal stress, may be a critical factor in determining which students are at risk for impairing mental health disorders. Using a control-based model of coping, the present study examined associations between interpersonal stress, coping strategies, and symptoms. Participants: A total of 135 undergraduate students from 2 universities. Methods: Interpersonal stress, coping strategies, depression, anxiety, and somatization were assessed via self-report. Results: Students reporting more interpersonal stress reported more depression, anxiety, and somatization, and they reported less use of engagement coping strategies and greater use of disengagement coping strategies. Engagement coping strategies accounted for a significant portion of the association between interpersonal stress and mental health symptoms. Unexpectedly, coping strategies did not moderate the association between stress and mental health symptoms. Conclusion: Interventions designed to improve students' coping strategies may be an effective way to reduce mental health problems on college campuses.     

An Investigation of the Association Between Shame and Problem Gambling: The Mediating Role of Maladaptive Coping Motives

Despite often being considered equivalent affective states, shame and guilt have differential associations with problem gambling with only shame showing a strong positive association with problem gambling. However, little is known about the mechanisms underlying the shame-problem gambling association. Further, shame and guilt are associated with distinct coping strategies, with shame motivating maladaptive coping (e.g., avoidance, escape) and guilt motivating adaptive coping (e.g., taking corrective action). This study aimed to examine whether maladaptive coping motives for gambling mediate the relationship between shame, but not guilt, and gambling problems. Participants were 196 (126 male) regular gamblers who completed a same and guilt scale, the Problem Gambling Severity Index, and a modified Gambling Motives Questionnaire, which assessed individual motives to engage in gambling for coping, enhancement, or social reasons. Results indicated that coping motives for gambling fully mediated the relationship between shame and problem gambling severity, but did not mediate the association between guilt and problem gambling severity. Experiencing shame contributes to problem gambling as a result of gambling to cope with negative affect. Cultivating more adaptive strategies to cope with shame may be effective in preventing and treating problem gambling.     

Peripheral Inclusion Through Informal Silencing and Voice — A Study of LGB Officers in the Swedish Police

Seen through the growth of progressive diversity policies it may appear that contemporary organizations are sites of equality. But although inclusion is the formally stated aim of many organizations, exclusionary pressures toward LGBT workers still challenge sexual minorities' access to full inclusion. A central concern in this paper is exploring how to understand inclusion in organizational contexts where inclusion is formally advocated, and yet where both inclusionary and exclusionary pressures exist. Drawing on an interview study of Swedish gay and lesbian police officers we present the concept ‘peripheral inclusion' as a way to understand inclusion in contemporary organizational life. In addition, we theorize that the dynamics between silencing and voice is a key mode that impacts the informal ways in which exclusion and inclusion occur. We thereby contribute to previous research on inclusion that has focused on the degree to which minorities are included by conceptualizing the mode in which inclusion occurs in everyday work. Studying modes and degrees of inclusion and exclusion in relation to each other highlights how inclusion is a collective and fragile process in which inclusionary and exclusionary pressures coexist, and that questions of who and what is included in contemporary organizations are shifting and open questions.     

Asian Girls are Prettier: Gendered Presentations as Stigma Management among Gay Asian Men

Despite the well‐documented cases of racism toward gay Asian men in the gay community, there is currently little research on how gay Asian men manage racial stigma. In this article, I examine the racial stigma management strategies of gay Asian men. I examine the nature of gay racial stigma toward gay Asian men and find that they use gendered presentations to counter the stereotype that they are more feminine than gay white men. While some gay Asian men engender a hypermasculine presentation, others use a hyperfeminine presentation to trade a more‐stigmatized status for one that is less stigmatizing. More important, these men actively embrace stereotypes to successfully make these transitions. This article demonstrates that stigmatized groups can manage stigma by highlighting their spoiled identities rather than attempting to minimize them.     

A fractured journey of growth: making meaning of a ‘Broken’ childhood and parental mental ill-health

The psychopathological impact of parental mental ill-health on children is well known. However, little research explores positive and negative interpretations of such exposure in childhood, from the adult child's perspective. Using interpretative phenomenological Analysis this study sought subjective interpretations of the ‘lived’ experiences of growing up in a family with parental mental ill-health. A purposive sample of seven adult children provided data for analysis through semi-structured interviews. One superordinate theme: A fractured journey of growth to adulthood, overarched six subordinate themes. Four themes captured stigma, shame, social isolation and betrayal. Juxtaposed with this, two themes captured purposeful redefinition of self and psychological growth. This study captures the chronicity of traumatic distress and sense of betrayal experienced by these participants in childhood through unrelenting exposure to parental mental ill-health. However, despite unpredictability, fear, and neglect in childhood, they identified the emergence of inner strengths in adult life: unexpected growth in empathy and compassion, high resourcefulness, and personal authenticity through higher education. Findings highlight that positively redefining ‘self’ in adult life is possible in the aftermath of childhood trauma associated with parental mental ill-health. Implications for therapy include: (a) moving forward from childhood trauma and (b) managing ongoing family dynamics in adult-life.     

Coping With Antigay Violence: In-Depth Interviews With Flemish LGB Adults

In view of the possible negative mental health outcomes of antigay violence and the limited understanding of how lesbian, gay, and bisexual (LGB) men and women cope with such experiences, this study examined the coping and social support-seeking strategies that victims adopt. In 2012, in-depth interviews were conducted with 19 Flemish sexual minority victims of violence. These in-depth interviews show that antigay violence can generate profound negative outcomes. However, the respondents employed a range of coping strategies, of which four were discerned: (1) avoidance strategies, (2) assertiveness and confrontation, (3) cognitive change, and (4) social support. Applying a diverse set of coping strategies and actively attaching meaning to negative experiences helps victims of antigay violence to overcome negative effects such as fear, embarrassment, or depressive feelings. However, the presence of a supportive network seems an important condition in order for these positive outcomes to occur.