Eddie S. K. Chong

Beyond attributions: Understanding public stigma of mental illness with the common sense model.

The present study applied the common sense model (i.e., cause, controllability, timeline, consequences, and illness coherence) to understand public attitudes toward mental illness and help-seeking intention and to examine the mediating role of perceived controllability between causal attributions with public attitudes and help seeking. Based on a randomized household sample of 941 Chinese community adults in Hong Kong, results of the structural equation modeling demonstrated that people who endorsed cultural lay beliefs tended to perceive the course of mental illness as less controllable, whereas those with psychosocial attributions see its course as more controllable. The more people perceived the course of mental illness as less controllable, more chronic, and incomprehensible, the lower was their acceptance and the greater was mental illness stigma. Furthermore, those who perceived mental illness with dire consequences were more likely to feel greater stigma and social distance. Conversely, when people were more accepting, they were more likely to seek help for psychological services and felt a shorter social distance. The common sense model provides a multidimensional framework in understanding publics mental illness perceptions and stigma. Not only should biopsychosocial determinants of mental illness be advocated to the public, cultural myths toward mental illness must be debunked.

The Prevalence and Factors for Cancer Screening Behavior among People with Severe Mental Illness in Hong Kong

Objectives Screening is useful in reducing cancer incidence and mortality. People with severe mental illness (PSMI) are vulnerable to cancer as they are exposed to higher levels of cancer risks. Little is known about PSMIs cancer screening behavior and associated factors. The present study examined the utilization of breast, cervical, prostate, and colorectal cancer screening among PSMI in Hong Kong and to identify factors associated with their screening behaviors. Method 591 PSMI from community mental health services completed a cross-sectional survey. Results The percentage of cancer screening behavior among those who met the criteria for particular screening recommendation was as follows: 20.8% for mammography; 36.5% for clinical breast examination (CBE); 40.5% for pap-smear test; 12.8% for prostate examination; and 21.6% for colorectal cancer screening. Results from logistic regression analyses showed that marital status was a significant factor for mammography, CBE, and pap-smear test; belief that cancer can be healed if found early was a significant factor for pap-smear test and colorectal screening; belief that one can have cancer without having symptoms was a significant factor for CBE and pap-smear test; belief that one will have a higher risk if a family member has had cancer was a significant factor for CBE; and self-efficacy was a significant factor for CBE and pap-smear test behavior. Conclusions Cancer screening utilization among PSMI in Hong Kong is low. Beliefs about cancer and self-efficacy are associated with cancer screening behavior. Health care professionals should improve the knowledge and remove the misconceptions about cancer among PSMI; self-efficacy should also be promoted.

Risk and Protective Factors of Same-Sex Intimate Partner Violence in Hong Kong

Numerous studies have assessed risk and protective factors for intimate partner violence (IPV) among heterosexual couples around the globe. Nevertheless, few have addressed the same issue among same-sex couples, especially in cultures where same-sex intimate relationships have gained little acceptance. This exploratory study evaluated the substantial risk and protective factors for same-sex IPV based on gender-neutral theories. Three hundred and six Hong Kong residents who have been in a same-sex romantic relationship completed a web-based questionnaire. Logistic regression analyses indicated that relationship conflict and poor anger management were risk factors both of psychological and physical perpetration. Dominance and substance abuse were respectively associated with psychological aggression and physical battering despite their small effect sizes. Psychological aggression was also found to mediate the relationship between conflict and physical assault, and that between anger management and physical assault. Interventions related to the array of risk and protective factors were discussed and recommended.

Physical Activity in People With Mental Illness in Hong Kong: Application of the Health Belief Model

Physical activity is associated with various health benefits for people with mental illness (PMI). Very few studies to date have examined the factors associated with physical activity among PMI in the Chinese context. The present study examined the factors related to physical activity using the health belief model and the association between physical activity and perceived health among 443 PMI in Hong Kong using stratified sampling. Results from the structural equation modeling showed that among all the factors of the health belief model, self-efficacy was significantly related to higher levels of physical activity, and perceived barriers were significantly related to lower levels of physical activity. In addition, physical activity was significantly related to better perceived health and fewer health needs. Interventions to promote physical activity among PMI should aim to increase their self-efficacy in initiating and adhering to physical activity and to remove barriers to physical activity.

Impact of perceived HIV stigma within men who have sex with men community on mental health of seropositive MSM

ABSTRACT Emerging evidence has suggested that seropositive men who have sex with men (MSM) do not only face biased treatment from the general public but also from members of the MSM community. We conceptualized such biases perpetuated within the MSM community as human immunodeficiency virus (HIV) in-group stigma. This study examined the pathways by which perceived HIV in-group stigma impacted the mental health of seropositive MSM in Hong Kong. Internalized HIV stigma, serostatus disclosure concerns, and negative reactions towards HIV stigma were hypothesized as intermediate factors. Based on 100 Chinese seropositive MSM who were on antiretroviral therapy, results of a path analysis partially supported our hypotheses. Only negative reactions towards HIV stigma within the MSM community was a significant intermediate factor. The findings highlight the importance of understanding seropositive MSM’s different reactions to HIV stigma perpetuated within the MSM community. On top of stigma reduction research, further research may explore ways that help seropositive MSM cope with HIV in-group stigma and foster resilience.

Sexual Orientation-Based Disparities in School and Juvenile Justice Discipline Practices: Attending to Contributing Factors and Evidence of Bias

Poteat, Scheer, and Chong analyze a sample of lesbian, gay, bisexual, and questioning (LGBQ) youth and heterosexual youth and find evidence of sexual orientation-based discipline disparities in both school suspensions and juvenile justice system involvement. They discuss results from models testing how victimization and engagement in infractions are connected to sexual orientation-based discipline disparities. Discipline disparities could not be explained simply because LGBQ youth report greater victimization and engagement in more infractions than heterosexual youth. When LGBQ and heterosexual youth engage in infractions, however, the odds are greater that LGBQ youth will experience discipline than heterosexual youth. Based on these findings, the authors offer implications for continued research and addressing instances of disciplinary bias against LGBQ youth.

Fostering youth self-efficacy to address transgender and racial diversity issues: The role of gay–straight alliances.

Gay–Straight Alliances (GSAs) aspire to empower youth to address multiple systems of oppression, including those affecting transgender and racial/ethnic minority youth, yet there is little indication of factors contributing to youths’ self-efficacy to do so. We examined individual and group factors predicting self-efficacy to address transgender and racial issues among 295 youth in 33 high school GSAs. Multilevel results indicated that level of GSA engagement, individual and collective involvement in transgender- and race-specific discussions, and in some cases intergroup friendships were associated with each form of self-efficacy. The association between GSA engagement and transgender self-efficacy was stronger for youth in GSAs with greater collective transgender-specific discussions. Associations with racial self-efficacy differed based on youths’ race/ethnicity. Continued research needs to identify how GSAs and similar youth programs promote self-efficacy to address diversity issues.