Exploring the effectiveness of mindfulness-based and third wave interventions in addressing self-stigma, shame and their impacts on psychosocial functioning: A systematic review

Stynes, Greg; Leão, Caroline; McHugh, Louise

doi:10.1016/j.jcbs.2022.01.006

Cited by 22 publications

(10 citation statements)

References 109 publications

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“…Study findings have important implications for the development of effective psychosocial interventions. Indeed, interventions such as cognitive behavioral therapy, mindfulness [ 67 , 68 ], acceptance and commitment therapy [ 69 ], as well as compassion-based interventions [ 70 , 71 ], show promise of decreasing shame across diverse populations. The current study tests two evidence-based interventions, including group-based cognitive behavioral therapy to address HIV-related stigma among adolescents [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

HIV-Related Shame, Stigma and the Mental Health Functioning of Adolescents Living with HIV: Findings from a Pilot Study in Uganda

Nabunya

Namuwonge²

2022

Child Psychiatry Hum Dev

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This study examined the relationship between HIV-related shame, stigma and the mental health of adolescents (10–14 years) living with HIV in Uganda. Cross sectional data from a 2-year pilot study for adolescents living with HIV (N = 89) were analyzed. Multiple linear regression analyses were conducted to determine the relation between HIV-related shame, as measured by the Shame Questionnaire, stigma, and adolescents’ mental health functioning, including depressive symptoms, hopelessness, PTSD symptoms, loneliness and self-concept. The average age was 12.2 years, and 56% of participants were female. HIV-related shame was associated with higher levels of depressive symptoms ( p < 0.05), hopelessness ( p < 0.001), PTSD symptoms ( p < 0.001), loneliness ( p < 0.01), and low levels of self-concept ( p < 0.01). HIV stigma was not associated with any of the outcomes. Findings support the need for the development of strategies to help adolescents overcome the shame of living with HIV and mitigate the effects of shame on adolescents’ mental health and treatment outcomes.

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Section: Discussionmentioning

confidence: 99%

HIV-Related Shame, Stigma and the Mental Health Functioning of Adolescents Living with HIV: Findings from a Pilot Study in Uganda

Nabunya

Namuwonge²

2022

Child Psychiatry Hum Dev

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“…These cognitive defusion techniques may help reduce the impact of affiliate stigma. A meta-analysis has shown that mindfulness-based and third-wave interventions targeting self-stigma and shame were effective in decreasing internalized stigma and psychological distress in people with mental health difficulties, with changes in psychological flexibility being one of the processes of change (Stynes et al, 2022). Given the limited number of interventions tailored for alleviating stigma encountered by MHPs, these mindfulness-based and ACT interventions have the potential to be adapted for MHPs.…”

Section: Discussionmentioning

confidence: 99%

Stigma and emotional distress in Chinese mental health professionals: Moderating role of cognitive fusion.

Liu,

Lao,

Shi

et al. 2024

Stigma and Health

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Mental health professionals (MHPs) often face occupational stigma due to their affiliation to individuals who have mental illness, which can cause them to experience emotional distress. However, research on the underlying processes is lacking. The study examined how affiliate stigma mediated the relationship between occupational stigma and emotional distress among Chinese MHPs, and whether cognitive fusion moderated this relationship. A total of 223 MHPs (psychiatrists, psychiatric nurses, and psychiatric technicians) in psychiatric hospitals in China were recruited online. Participants completed assessments on occupational stigma, affiliate stigma, cognitive fusion, depressive symptoms, anxiety symptoms, and stress. The results showed that greater levels of occupational stigma were correlated with higher levels of depressive, anxious, and stress symptoms among Chinese MHPs. Affiliate stigma mediated the impact of occupational stigma on emotional distress. Conditional process analysis revealed that the indirect effect of occupational stigma on emotional distress through affiliate stigma was conditional on levels of cognitive fusion. The positive association between occupational stigma and affiliate stigma was attenuated among MHPs who were less cognitively fused. These findings suggest that cognitive defusion may play a buffering role in reducing affiliate stigma in MHPs. Strategies that target stigma reduction and cognitive defusion may alleviate the negative impact of stigma on MHPs' mental health. Clinical Impact StatementThe study analyzed the effects of stigma experiences among mental health professionals on their mental health and explored how cognitive defusion buffered these deleterious effects. Mental health professionals internalized stigma toward their profession and experienced emotional distress. Cognitive defusion mitigated the impact of occupational stigma on affiliate stigma. The significance of these findings lies in capturing the burden of occupational stigma faced by mental health professionals and highlighting the process of internalizing occupational stigma. Promoting the quality of cognitive defusion may positively impact mental health professionals' mental health.

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“…In a review ( 46 ) on self-stigma interventions six effective interventions were found [Healthy self-concept ( 47 , 48 ), Self-stigma reduction program ( 49 ), Ending self-stigma ( 50 ), Narrative enhancement and cognitive therapy ( 51–54 ), Coming out proud ( 55 , 56 ), and Anti-stigma photo-voice intervention ( 57 )], key ingredients appear to be psychoeducation, cognitive restructuring, and focus on telling one’s narrative. More recently evidence was found for the effectiveness of interventions aiming to enhance self-compassion or those based on acceptance and commitment therapy ( 58 ). Some self-help interventions are available, but the results are mixed, in line with recommendations for treatment interventions focus should be on psychoeducation and acceptance and commitment therapy ( 59 ).…”

Section: Discussionmentioning

confidence: 99%

Self-stigma and cognitive insight in individuals at ultra-high risk for psychosis

et al. 2023

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BackgroundImpaired cognitive insight and increased self-stigma have been consistently reported in individuals diagnosed with schizophrenia spectrum disorders, but little is known about its presence in individuals at ultra-high risk of developing a psychosis, although self-stigma is associated with transition.to psychosis. The current study examined whether self-stigma is already present in individuals at ultra-high risk of psychosis, and whether this is associated with impaired cognitive insight.Methods184 participants were recruited divided over three groups, namely individuals diagnosed with a schizophrenia spectrum disorder (SSD; n = 92, 34% females), individuals at ultra-high risk for psychosis (UHR; n = 43, 59% females) and general population controls (GPC; n = 49, 27% females). All participants completed assessments on demographic information (gender, age, education), and cognitive insight. In addition, participants with SSD and individuals at UHR completed a questionnaire on self-stigma.ResultsThe level of self-stigma did not differ between individuals at UHR and individuals diagnosed with SSD. Cognitive insight also did not differ significantly between the three groups, but the subscale self-reflection differed between the three groups [F(2,184) = 4.20, p = 0.02], with the UHR and SSD groups showing more self-reflection. Pearson’s correlation analyses showed that in individuals at UHR total cognitive insight and its self-reflection subscale were significantly associated with the alienation subscale of self-stigma, and in individuals with SSD self-certainty subscale of cognitive insight was significantly associated with stereotype endorsement.ConclusionFindings show that self-stigma was already present in the UHR phase, to a similar degree as in individuals with a diagnosis of a SSD, and is thus not dependent of previous experience of having a label of SSD. Cognitive insight in individuals at UHR of psychosis appears to be intact, but individuals at UHR showed more self-reflectiveness, and individuals at risk with high cognitive insight also experience high levels of self-stigma. Overall findings from our study suggest that pre-emptive interventions targeting self-stigma, while considering cognitive insight, are needed early on in manifestation of psychotic illness, preferably already in the UHR phase.

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Exploring the effectiveness of mindfulness-based and third wave interventions in addressing self-stigma, shame and their impacts on psychosocial functioning: A systematic review

Cited by 22 publications

References 109 publications

HIV-Related Shame, Stigma and the Mental Health Functioning of Adolescents Living with HIV: Findings from a Pilot Study in Uganda

HIV-Related Shame, Stigma and the Mental Health Functioning of Adolescents Living with HIV: Findings from a Pilot Study in Uganda

Stigma and emotional distress in Chinese mental health professionals: Moderating role of cognitive fusion.

Self-stigma and cognitive insight in individuals at ultra-high risk for psychosis

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