Fernando Molero

Enacted and internalized stigma and quality of life among people with HIV: the role of group identity

PurposeThis study analyzes the mediating role of social identity in the relationship between enacted stigma and internalized stigma and quality of life of people with HIV.MethodsA total of 557 people with HIV participated in this study. Participants were recruited from hospitals and non-governmental organizations. Questionnaires measuring perceived stigma (Berger’s HIV Stigma Scale), social identity (Cameron’s three factor identity scale), and quality of life (Ruiz and Baca’s Quality of Life Questionnaire) were administered. The instruments were adapted for use with the Spanish population. Structural equation modeling (SEM) was used to test the mediation model, and multigroup SEM was conducted to evaluate its invariance.ResultsBoth enacted stigma and internalized stigma had a negative influence on the quality of life of people with HIV, but this influence occurred in different ways. Enacted stigma had a direct negative influence on quality of life. No dimension of group identity protected people with HIV from its negative influence. However, the negative influence of internalized stigma was totally mediated by some dimensions of group identification, mainly through in-group affect.ConclusionsGroup identification not only did not protect people with HIV from the negative effects of stigmatization, but it may even be detrimental in the case of internalized stigma. This suggests that in highly stigmatized groups, the salience of identity is negative and worsens the members’ opinion of their own group. This argues for different kinds of intervention to improve the quality of life of people with HIV.

Inmigración y turismo: diferencias en percepciones y actitudes hacia los extranjeros en una muestra de niños-as almerienses

Resumen El objetivo de la presente investigación es conocer la percepción que una muestra de niños-as almerienses tiene de los inmigrantes africanos—un exogrupo especialmente significativo en la provincial—, en comparación con la que tienen del endogrupoy de otro exogrupo relevante en la zona (turistas europeos). La muestra estaba formada por 495 estudiantes (49.6% niñas y 50.4% niños) cuyas edades oscilaban entre 9–14 años (media=11.57; dt=1.02). Respondieron a varias preguntas abiertas sobre ambos exogrupos y a tres escalas tipo diferencial semántico sobre los tres grupos objeto de estudio. Los resultados muestran un claro favoritismo endogrupal, apoyando las predicciones de la teoría de la Identidad Social, pero también confirman la idea de que los niños-as, desde edades muy tempranas, son capaces de distinguir entre exogrupos con características diferenciales y sus percepciones dependen, igual que las de los adultos, de las distintas posiciones sociales que ocupan dichos grupos. Así, aunque la percepción que se tiene de los inmigrantes no es negativa en términos absolutos, sí lo es cuando se la compara con la de los turistas, un grupo probablemente con un estatus más alto. Los análisis de regresión muestran que cuando se percibe a los inmigrantes más parecidos al propio grupo, más trabajadores y con más dinero, más positiva es la evaluación que se hace de ellos. Se discuten las principales implicaciones de estos resultados y se tratan de relacionar con el diseño de intervencionespara mejorar las relaciones intergrupales.

The effects of authentic leadership on turnover intention

Purpose – The purpose of this paper is to examine the relationship between employees’ perception of authentic leadership and their turnover intention as mediated by employees’ work-group identification (WID) and work engagement. Design/methodology/approach – Structural equation modeling was used to analyze the data from 623 Spanish employees. Findings – Results show that authentic leadership has a negative effect on turnover intention and positive effects on work engagement and WID. The direct relationship between authentic leadership and turnover intention was found to be partially mediated by employees’ work engagement. Practical implications – One of the strongest implications that may be drawn from this study is that authentic leaders can influence employees’ turnover intentions by positively enhancing their engagement. Thus, the study highlights authentic leadership as a key element for retaining valuable employees through the promotion of employees’ work engagement. Originality/value – To the author...

Internalized mental illness stigma and subjective well-being: The mediating role of psychological well-being

This study examines the relationships between internalized stigma, psychological well-being, and subjective well-being in a sample of people with mental illness. We conducted a cross-sectional study with 213 outpatients from the Spanish public social care network. The results showed that (a) internalized stigma was significantly negatively correlated with psychological well-being and subjective well-being (affect balance and life satisfaction) (all correlations are significant with at least p<0.05; most with p<0.001), (b) the two types of well-being were significantly positively correlated and regressions models were significant and (all correlations are at least p<0.01, and regression models are also significant), (c) the effect of internalized stigma on affect balance and life satisfaction was mediated by psychological well-being. The component of internalized stigma most consistently associated with both types of well-being was alienation (life satisfaction: B=-0.35, p=0.001; affect balance: B=-0.38, p=0.001). These findings should be confirmed in future longitudinal or experimental research. On the basis of these results we recommend that interventions to combat self-stigma aim to reduce feelings of alienation and improve self-acceptance and other aspects of positive psychological functioning.

Social Stigma and Well-Being in a Sample of Schizophrenia Patients.

OBJECTIVEnThe present study analyzes the existing relationship between three variables related to social rejection (perception of overt and subtle discrimination and stigma consciousness) and the psychological and subjective well-being among people with schizophrenia. Likewise, we will analyze the relationship between two possible strategies to cope with stigma (active coping and avoidant coping) and well-being.nnnMETHODnA cross-sectional study was conducted in a sample of 50 people with schizophrenia recruited from the social care network for people with mental illness in the Community of Madrid.nnnRESULTSnResults show, as expected, the existence of a negative association between the variables related to social rejection and psychological and subjective well-being. It was also found that avoidant coping is negatively related to well-being, while active coping is positively related, although in the latter case relations do not reach significance.nnnCONCLUSIONSnIn view of the implementation of interventions to improve the well-being of people with schizophrenia, our results suggest implementing strategies to reduce the perception of discrimination (especially subtle or indirect discrimination) and encouraging the use of active strategies to cope with stigma as opposed to avoidant-coping strategies.

Psychosocial determinants of HIV testing across stages of change in Spanish population: a cross-sectional national survey

BackgroundThe goal of this research is to study the psychosocial determinants of HIV-testing as a function of the decision or change stage concerning this health behavior. The determinants considered in the major ongoing health models and the stages contemplated in the Precaution Adoption Process Model are analysed.MethodsA cross-sectional survey was administered to 1,554 people over 16 years of age living in Spain by a computer-assisted telephone interview (CATI). The sample design was randomised, with quotas of sex and age. The survey measured various psychosocial determinants of health behaviors considered in the main cognitive theories, the interviewees stage of change concerning HIV-testing (lack of awareness, decision not to act, decision to act, action, maintenance, and abandonment), and the signal for the action of getting tested or the perceived barriers to being tested.ResultsApproximately two thirds of the population had not ever had the HIV test. The predominant stage was lack of awareness. The most frequently perceived barriers to testing were related to the health system and to the stigma. We also found that the psychosocial determinants studied differed depending on the respondents stage of change. Perception of risk, perceived self-efficacy, proximity to people who had been tested, perceived benefits of knowing the diagnosis, and a positive instrumental and emotional attitude were positively associated with the decision and maintenance of testing behavior. However, unrealistic underestimation of the risk of HIV infection, stereotypes about the infection, and the perceived severity of HIV were associated with the decision not to be tested.ConclusionsThere are various sociocognitive and motivational profiles depending on people’s decision stage concerning HIV-testing. Knowing this profile may allow us to design interventions to influence the psychosocial determinants that characterise each stage of change.

The effect of personal and group discrimination on the subjective well-being of people with mental illness: the role of internalized stigma and collective action intention

Abstract The goal of this study is to test a model in which personal discrimination predicts internalized stigma, while group discrimination predicts a greater willingness to engage in collective action. Internalized stigma and collective action, in turn, are associated to positive and negative affect. A cross-sectional study with 213 people with mental illness was conducted. The model was tested using path analysis. Although the data supported the model, its fit was not sufficiently good. A respecified model, in which a direct path from collective action to internalized stigma was added, showed a good fit. Personal and group discrimination appear to impact subjective well-being through two different paths: the internalization of stigma and collective action intentions, respectively. These two paths, however, are not completely independent, as collective action predicts a lower internalization of stigma. Thus, collective action appears as an important tool to reduce internalized stigma and improve subjective well-being. Future interventions to reduce the impact of stigma should fight the internalization of stigma and promote collective action are suggested.

Perceived discrimination, internalized stigma and psychological well-being of people with mental illness

The present study examines the relationships between perceived discrimination, internalized stigma, and well-being in a sample of people with mental illness. We conducted a cross-sectional study with 213 outpatients from the Spanish public network of social care. Perceived discrimination was positively and significantly correlated with internalized stigma (p < .01 for all measures of perceived discrimination). Blatant individual discrimination, subtle individual discrimination, and internalized stigma were negatively correlated with life satisfaction, affect balance, and psychological well-being (p < .01 for all cases, except for blatant individual discrimination and affect balance, for which is p < .05). Regression and mediation analyses indicate that subtle individual discrimination is the kind of discrimination most negatively associated to the well-being measures (life satisfaction: B = -.18, p < .10; affect balance: B = -.19, p < .10; psychological well-being: B = -.21, p < .05), and that this association is mediated by internalized stigma. Future research should confirm these findings in a longitudinal or experimental model. In light of our findings, we suggest the development and implementation of intervention programs that target subtle discrimination, and point at the importance of implementing programs to reduce internalized stigma.

Content analysis of Spanish judgements addressing the sexual transmission of HIV: 1996–2016

ABSTRACT This study performed a content analysis of the language of the Spanish judgements addressing the sexual transmission of HIV in order to determine its possible interrelationship with HIV-related stigma. All judgements and writs dictated by Spanish penal and civil jurisdictions between 1981 and December 2016 were obtained through a systematic search of the Spanish legal databases. The inclusion criterion was that the possible transmission of HIV was judged as an individual infraction, regardless of whether other infractions were involved. Twenty judgements were selected and analysed through direct content analysis assisted by the software MAXQDA 12. The majority of the cases (85%) were brought before the penal jurisdiction. Most of the judgements applied the crimes of bodily harm or grievous bodily harm (75%). Aspects closely related to the determinants of HIV-related stigma, such as the perception of HIV as a severe and easily transmitted infection, and attributions of responsibility and blame to people with HIV, were found in the judgements’ reasoning. They were associated with outdated scientific and technical knowledge. Furthermore, some arguments found are repeated literally and successively in several judgments from different years, ignoring medical advances. Most plaintiffs were unaware of their sexual partner’s HIV status. The scarce results found regarding the concealment of HIV status suggested that fear of stigma could be the reason thereof. The results suggested that training legal professionals in the epidemiological, clinical, and social aspects of HIV could influence stigma reduction, leading to a more objective consideration of the characteristics of this infection.

Adaptation of the HIV Stigma Scale in Spaniards with HIV.

The primary goal of this study was to adapt Berger, Ferrans, & Lahley (2001) HIV Stigma Scale in Spain, using Bunn, Solomon, Miller, & Forehand (2007) version. A second goal assessed whether the four-factor structure of the adapted scale could be explained by two higher-order dimensions, perceived external stigma and internalized stigma. A first qualitative study (N = 40 people with HIV, aged 28-59) was used to adapt the items and test content validity. A second quantitative study analyzed construct and criterion validity. In this study participants were 557 people with HIV, aged 18-76. The adapted HIV Stigma Scale for use in Spain (HSSS) showed a good internal consistency (α = .88) and good construct validity. Confirmatory Factor Analyses yielded a first-order, four-factor structure and a higher-order, bidimensional structure with the two expected factors (RMSEA = .051, 90% CI [.046, .056]; RMR = .073; GFI = .96; AGFI = .96; CFI = .98). Negative relations were found between stigma and quality of life (r = -.39; p < .01), self-efficacy to cope with stigma (r = -.50; p < .01) and the degree of HIV status disclosure (r = -.35; p < .01). Moreover, the people who had suffered AIDS-related opportunistic infections had a higher score in the Perceived External Stigma dimension than those who had not suffered them, t (493) = 3.02, p = .003, d = 0.26.