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Principal Investigator: Rebecca L Pearl
Organization: UNIVERSITY OF FLORIDA
Fiscal Year: 2024
Award: $71,690
Funding agency: National Institute of Mental Health
PROJECT SUMMARY/ABSTRACT
Stigma adversely affects mental and physical health. Societal devaluation or mistreatment from others
can lead to internalization of stigma (i.e., self-stigma) among individuals with marginalized identities or traits.
Internalized stigma is robustly associated with impaired mental health and health-related quality of life
(HRQOL), often to a stronger degree than are interpersonal experiences of stigma (e.g., discrimination).
Experts have suggested that peer support or psychological counseling may help to reduce internalized stigma
and its associated health impacts, although very few studies have investigated such interventions.
Health-related stigma is an umbrella term that encompasses negative judgment, blame, avoidance,
rejection, disparagement, discrimination, or dehumanization of individuals due to a health condition or disease.
Such health conditions may be visible (such as obesity, skin diseases, or cancers that result in disfigurement),
or concealable (such as HIV, diabetes, or chronic pain). Patients who internalize health-related stigma report
avoidance of health care settings and disengagement from disease management behaviors, in addition to
showing signs of physiological stress. Thus, health-related stigma compounds disease burden and threatens
HRQOL beyond the direct effects of the health conditions themselves. Prior research on health-related stigma
has been siloed, such that studies investigate one type of stigma, its effects, and possible solutions in isolation
from stigma due to other health conditions. Consistent evidence of stigma’s harms on mental and physical
health across health conditions, and shared theoretical foundations for intervention development, indicate the
need for a unifying approach. An intervention that reduces internalized stigma among individuals with varying
health conditions would have broad impact and would shift the paradigm of how stigma is currently addressed.
The current project seeks to determine the effects of a novel, transdiagnostic, group-based counseling
intervention designed to help patients cope with and to reduce the internalization of health-related stigma. An
intervention and a self-report measure that were previously developed to address only one form of health-
related stigma will be adapted to generalize to patients of other health conditions. After piloting, a randomized
controlled trial will be conducted to test the effects of the group-based counseling intervention on internalized
stigma, mental health, and HRQOL. The counseling condition (which also includes peer support) will be
compared to a general peer support group and a waitlist control group. Participants will be 195 men and
women who report high levels of internalized stigma due to their health condition. All study procedures will be
conducted online, including assessments and treatment. Participants in the counseling and peer support
groups will receive 12 weekly group sessions, followed by 2 every-other-week and 2 monthly sessions, for a
total of 26 weeks. Findings from this study will provide new insights into the most effective and efficient method
for reducing internalized stigma, and improving HRQOL, in patients with a wide array of health conditions.
Terms: <21+ years old><AIDS Virus><Acquired Immune Deficiency Syndrome Virus><Acquired Immunodeficiency Syndrome Virus><Address><Adult><Adult Human><Affect><Behavior><Cancers><Cognitive Discrimination><Control Groups><Counseling><Cutaneous Disorder><Dehumanization><Dermatoses><Diabetes Mellitus><Diagnostic><Discrimination><Disease><Disease Management><Disorder><Disorder Management><Espanol><Foundations><HIV><Health><Human Immunodeficiency Viruses><Impairment><Individual><Intervention><Intervention Strategies><Judgment><LAV-HTLV-III><Latino><Lymphadenopathy-Associated Virus><Malignant Neoplasms><Malignant Tumor><Measures><Mental Health><Mental Hygiene><Methods><Obesity><Participant><Patient Self-Report><Patients><Physiologic><Physiological><Procedures><Psychological Health><QOL><Quality of life><Randomized, Controlled Trials><Reporting><Research><Self-Help Groups><Self-Report><Skin Diseases><Skin Diseases and Manifestations><Spanish><Stress><Support Groups><Testing><Virus-HIV><Waiting Lists><Woman><adiposity><adulthood><burden of disease><burden of illness><chronic pain><coping><corpulence><cutaneous disease><dermal disease><dermal disorder><develop therapy><diabetes><disease burden><experience><group counseling><health care settings><health related quality of life><healthcare settings><improved><insight><internalized stigma><intervention design><intervention development><interventional strategy><malignancy><maltreatment><marginalization><men><mistreatment><neoplasm/cancer><novel><peer support><physical conditioning><physical health><psychologic><psychological><randomized control trial><self help organization><self-stigma><skin disorder><social stigma><stigma><therapy design><therapy development><trait><treatment design><treatment development><waitlist>