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      African Americans' Perceptions of Psychotherapy and Psychotherapists.

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          Perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression.

          The authors' goal was to examine the extent to which perceived stigma affected treatment discontinuation in young and older adults with major depression. A two-stage sampling design identified 92 new admissions of outpatients with major depression. Perceived stigma was assessed at admission. Discontinuation of treatment was recorded at 3-month follow-up. Although younger patients reported perceiving more stigma than older patients, stigma predicted treatment discontinuation only among the older patients. Patients' perceptions of stigma at the start of treatment influence their subsequent treatment behavior. Stigma is an appropriate target for intervention aimed at improving treatment adherence and outcomes.
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            The effects of stigma on the psychological well-being and life satisfaction of persons with mental illness.

            Building on modified labeling theory, I examine the relationships between stigma, psychological well-being, and life satisfaction among persons with mental illness. The study uses longitudinal data from 610 individuals in self-help groups and outpatient treatment. Results from cross-sectional and lagged regression models show adverse effects of stigma on the outcomes considered. However, much of the effects of anticipated rejection are due to discriminatory experiences. The results also indicate that stigma is related to depressive-anxiety types of symptoms but not psychotic symptoms. Although the findings show that the negative effect of stigma on life satisfaction is partly mediated by self-concept, reciprocal effects models indicate that the relationship between self-concept and life satisfaction is bi-directional. The study suggests ways in which stigma processes need to be explored in greater detail.
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              Identification of patient attitudes and preferences regarding treatment of depression.

              To identify attitudes that influence patient help-seeking behavior and aspects of treatment that influence patient preferences for management of depression. Three focus group discussions (two patient groups stratified by race and one professional group). Questions addressed experience with depression, help-seeking behaviors, treatment preferences, and perceived barriers to mental health care. Academic medical center. Eight black patients and eight white patients with depression: seven health care professionals (four physicians and three social workers). Discussions were audiotaped, transcribed, and reviewed independently by two investigators to identify and group distinct comments into categories with specific themes. Differences were adjudicated by a third investigator. Comments within categories were then checked for relevance and consistency by a health services researcher and a psychiatrist. More than 90% of the 806 comments could be grouped into one of 16 categories. Black patients raised more concerns than white patients regarding spirituality and stigma. Patients made more comments than professionals regarding the impact of spirituality, social support systems, coping strategies, life experiences, patient-provider relationships, and attributes of specific treatments. They discussed the role these factors played in their help-seeking behavior and adherence to treatment. In-depth focus group discussions with depressed patients can provide valuable and unique information about patient experiences and concerns regarding treatment for depression. Clinicians, researchers, and policymakers need to incorporate the range of factors identified by patients into their decision making for individuals with depression.
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                Author and article information

                Journal
                Professional Psychology: Research and Practice
                Professional Psychology: Research and Practice
                American Psychological Association (APA)
                1939-1323
                0735-7028
                2004
                2004
                : 35
                : 1
                : 19-26
                Article
                10.1037/0735-7028.35.1.19
                d2464bc2-a9be-46c9-bce9-024f3cd6edae
                © 2004
                History

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