How stigma interferes with symptom awareness: Discrepancy between objective and subjective cognitive performance in currently untreated persons with mental health problems.

Abstract

Stigma has been shown to interfere with self-identification as having a mental illness, perceived need, and help-seeking, but it is unclear whether it also impairs awareness of symptoms of mental illness. Objective and subjective cognitive deficits are common in mental illness, but the concordance of these assessments is generally weak. The present study aimed at investigating the role of stigma in explaining this discrepancy. A sample of 187 currently untreated persons with mental health problems was studied. Concentration performance was measured via the d2-R (i.e., the revision of the Concentration Endurance Test [d2 Test of Attention]) and subjectively (self-report). Measure discrepancy was quantified using a sensitivity score. Stigma was measured as personal stigmatizing attitudes, stigma awareness, and stigma stress. The association of stigma and sensitivity was examined via multiple regression analysis. In unadjusted regression models, stronger negative attitudes were significantly associated with overestimating, and higher stigma-stress was associated with underestimating one’s cognitive performance. These associations were reduced to a near-significant trend or disappeared when controlling for demographic variables. Subgroup analyses revealed that specific stigmatizing attitudes (i.e., differentness, untreatability) were associated with lower sensitivity in persons without prior contact to a person with mental illness, whereas in individuals without personal treatment experience, higher stigma stress was associated with greater symptom sensitivity. Interventions reducing stigmatizing attitudes may help facilitate the accurate recognition of cognitive deficits as possible first signs of a mental illness. Strengthening resources for coping with public stigma may prevent worsening of both symptoms and psychosocial functioning.

The Neuropsychological Profile of Severe and Enduring Anorexia Nervosa: A Systematic Review

“…The test utilised by Hemmingsen et al ( 2020 ) provided an indication of selective attention whilst balancing the components of speed and accuracy. It is commonly scored by the number of processed targets whilst taking into consideration the number of errors (Hahm et al, 2020 ). Using standardised norms as a comparison, Hemmingsen et al ( 2020 ) reported the participant to have made a number of processed targets within the low average range (21st percentile).…”

The Influence of Social Support and Characteristics of the Stigmatisers on Stigmatising Attitudes Towards People With Mental Illness

“…Since exemplars' (binary, biological) sex (e.g., Dolphin & Hennessy, 2016;Thibodeau et al, 2015) as well as exemplars' age (e.g., Crisp et al, 2005;Griffiths et al, 2008;Hahm et al, 2020;Mackenzie et al, 2019) have been identified as influential factors for stigmatisation and destigmatisation through exemplification in different contexts, we examined the role of these two factors for the (de-)stigmatisation of people with mental illness in general and specifically people with depression. In line with Wirth and Bodenhaus (2009), we hypothesise that female exemplars with depression evoke more negative generalised stigma-related attitudes compared to male exemplars, as depression is generally perceived as a more female-typical disorder (van Driel et al, 2018):…”

“…In addition to the aforementioned exemplars' characteristics, in the context of stigmatisation and exemplification characteristics of the potential stigmatisers (in this case: readers of an exemplar with depression) influence the (de-)stigmatising exemplification effects. Many studies point out that stigmatisation must be considered against the background of the stigmatisers' characteristics in order to develop more targeted intervention strategies for destigmatisation based on the findings (e.g., Abdullah & Brown, 2019;Hahm et al, 2020;Mackenzie et al, 2019). For example, Abdullah & Brown (2019) analysed mental illness stigma among Black Americans.…”

“…Some of their results were very specific among Black Americans compared to other racial groups so that the authors argue in support of the differentiation of mental illness stigma among different racial groups. Hahm et al (2020) also examined the stigma of mental illness and found an influence of sociodemographic variables such as potential stigmatisers' age. They found that older age was associated with more negative stigma-related attitudes towards mental illness.…”

Moral Injury in Veterans

“…The stigma associated with mental health issues consciously and subconsciously creates reluctance in veterans to acknowledge early symptoms. 24,25 Therefore, a significant proportion of veterans who suffer mental health issues do not access, repeatedly delay, or fail to complete mental health treatment. 25 The education component of awareness is essential in creating a trusting atmosphere where veterans can openly discuss mental health.…”