Lawrence H Yang
Lawrence H Yang
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Chair and Professor of Social and Behavioral Sciences
Associate Director, Global Center for Implementation Science
Founding Director, Global Mental Health and Stigma Program
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Professional overview
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Dr. Lawrence Yang is Professor and Chair of the Department of Social and Behavioral Sciences; Associate Director of the Global Center for Implementation Science at NYU; and Founding Director of NYU’s Global Mental Health and Stigma Program. He is also PI of a generous donor gift from the Li Ka Shing Foundation to fund an initiative to promote Global Mental Health and Wellness (see link).
Dr. Yang has received extensive interdisciplinary training, including clinical psychology (Boston University), psychiatric epidemiology (Columbia University) and medical anthropology (Harvard University). Dr. Yang has received six national awards in stigma, including the Maltz Prize for Innovative and Promising Schizophrenia Research in 2021 (Brain and Behavior Research Foundation; see link). Dr. Yang has >175 peer-reviewed publications, including in journals such as the JAMA, JAMA Psychiatry, British Journal of Psychiatry, and the American Journal of Public Health. Regarding currently-funded NIH grants, he is PI of three separate R01 grants (below), is multiple PI of a D43 Implementation Science Training Grant in Vietnam, and is co-investigator on 4 R01-level grants. Lawrence is also applying his expertise to address the novel topic of “Migration Stigma”, where he led a think tank and conference sponsored by the prestigious Ernst Strüngmann Forum (June, 2022; see link), which has resulted in a recently-published book by MIT press (Migration Stigma (mit.edu)) and a publication in JAMA (see link).
Brief Research Narrative: If every public health researcher had a calling card, Dr. Lawrence Yang's would be stigma.
What began as a curiosity to think, study and write about his own culture -- Chinese culture and its influences on how stigma is expressed-- drove the GPH Professor to develop a framework for how stigma acts to impede social recovery that could be applied to cultural groups to improve the lives of countless people with mental illness and their families around the world. Dr. Yang also conducts several ongoing research studies on the forefront of global mental health and implementation science.
Building upon dissertation research conducted in Beijing, China, Lawrence initiated his stigma research via an NIMH K-award (2005-2010). Lawrence conducted a study in New York City of how stigma shapes the course of mental illness among Chinese immigrants. Lawrence formulated how culture relates to stigma--i.e. the “What Matters Most” framework—to help implement interventions to improve recovery for stigmatizing conditions. He learned that upholding face (to achieve lineage obligations) was essential, as it is for Asians in many countries. Lawrence then formulated an anti-stigma intervention to help people with mental illness take a powerful step towards regaining face. To inform global programs, Lawrence then applied the ‘what matters most’ approach to HIV stigma in Botswana. Lawrence identified that “womanhood” in Botswana is signified by “having and caring for children” (AJPH, 2021). These cultural imperatives bring pregnant women into contact with free antenatal services, including routine HIV testing, where their HIV status is discovered before their male partners, leading women diagnosed with HIV to be blamed and stigmatized. Lawrence used this framework in a completed NIMH-funded R21 grant to implement an intervention to counter culturally-salient aspects of HIV stigma that impede anti-retroviral treatment. This stigma intervention, by utilizing the perspective that a woman in Botswana who achieves ‘what matters most’ can be protected from HIV stigma, has shown promising results. Lawrence has received a new R01 (R01 TW012402) to expand this intervention for use with women with HIV with serious mental illness in Botswana. He also participated as a Scientific member of the “NIH Office of AIDS Research & NIMH HIV-Related Intersectional Stigma” Working Group (2020).
Lawrence has advanced global mental health research in China as PI of two NIMH-funded R01 studies (R01MH108385; R01 MH127631) with co-PI's, Dr.’s Michael Phillips, William Stone and Matcheri Keshavan, seeking to characterize the cognition of completely untreated psychosis in China. Recently, China has implemented programs to detect untreated psychosis countrywide. Ascertaining participants in rural China, the study has enrolled~ 300 untreated psychosis participants, who are then matched with ~300 treated psychosis participants and an additional ~300 healthy control participants. The study’s first publication shows that cognitive performance may continue to decrease as the duration of untreated psychosis becomes prolonged (JAMA Psychiatry, 2020), thus potentially shifting the scientific thinking about schizophrenia by suggesting possible novel neurodegenerative processes in the natural course of chronic psychosis. A 3-year Supplement also examines the neurobiological markers of untreated psychosis to validate three psychosis subgroups that exhibit neurobiologically distinct differences (or ‘biotypes’). A follow-up longitudinal, 5-year R01 proposal (2021-2026) to capitalize upon this rare cohort has been funded by NIMH.
Relevant to implementation science, Lawrence leads a project to help address the gap in global mental health treatment among those who need but do not receive care for mental disorders, which is disproportionately high in low- and middle-income countries. There has been a call to scale-up mental health services via sharing of mental health care with a broader array of nonspecialists (e.g., community health workers). Yet, knowledge on how to successfully implement task-sharing mental health strategies in real-world settings is lacking. Lawrence is PI of a third NIMH-funded R01 (with co-PI, Dr. Judy Bass; R01 MH122851) to validate a newly-developed measure that enables rapid assessment of modifiable critical factors affecting the implementation of task sharing mental health strategies. This R01 is based upon the “Shared Research Project”, where Dr.’s Yang and Bass examined the barriers and facilitators to scale-up task-sharing interventions in four previous, NIMH-funded global regional networks spanning 4 global hubs (i.e., Latin America; Africa, and India/ Pakistan). This current study will validate this measure within three additional, ongoing NIMH-funded task-sharing mental health programs in South Africa, Chile, and Nepal, thus advancing implementation science globally.
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Education
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BA, High Honors and Phi Beta Kappa, Wesleyan University, Middletown, CTPhD, Boston University, Boston, MAClinical Fellowship, Harvard Medical School (Massachusetts Mental Health Center)Postdoctoral Fellowship, Columbia Mailman School of Public Health (NIMH funded T32 Training Program in Psychiatric Epidemiology)
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Honors and awards
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Maltz Prize for Innovative and Promising Schizophrenia Research -- Brain and Behavior Research Foundation (2021)NIH Fellow-Training Institute for Dissemination & Implementation Research in Health (TIDIRH) (2019)Fellow (Elected), American Psychopathological Association (2018)Award for Emerging Leadership, Americal Psychological Association (2012)Award for Advancing Minority Mental Health, American Psychiatric Foundation (2012)Young Investigator Award, NARSAD/ Brain and Behavior Foundation (2010)Emerging Leader Award for Significant Contributions to the Advancement of Ethnic Minority Psychology, American Psychological Association (2010)Calderone Award for Junior Faculty, Columbia University School of Public Health (2009)REACH for the R01 Award, Columbia University Irving Institute for Clinical and Translational Research (2009)Early Career Research Award, American Psychological Association (2008)Early Career Award, Asian American Psychological Association (2008)Dalmas A. Taylor Outstanding Student Dissertation Award, American Psychological Association (Division of Clinical Psychology- Ethnic Minority Focus) (2002)Outstanding Dissertation Award, American Psychological Association (Division of International Psychology) (2002)
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Areas of research and study
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Cognition and PsychosisGlobal HealthImplementation scienceMental HealthStigma of Health Conditions“At-Risk” States for Psychosis
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Publications
Publications
Measuring internalized stigma of mental illness among Chinese outpatients with mood disorders
AbstractSmith, M. L., Yang, L. H., Huang, D., Pike, K. M., Yuan, C., & Wang, Z. (n.d.).Publication year
2018Journal title
International Journal of Culture and Mental HealthVolume
11Issue
4Page(s)
522-535AbstractInternalized stigma is a barrier to mental health care in China, and stigma reduction is expected to promote treatment utilization, especially for mood disorders and schizophrenia. We aimed to identify the most common domains of internalized stigma of mental illness and to test the hypothesis that people with more severe mood disorders evidence more internalized stigma than those with less severe disorders. The Internalized Stigma of Mental Illness (ISMI) was administered to 366 outpatients with various mood disorders in Shanghai. Reliability statistics were calculated and frequently-endorsed items were identified. The magnitude of internalized stigma was compared among diagnostic categories and among sociodemographic groups. Except for stigma resistance, the ISMI and its subscales had good internal consistency. Across subgroups, stereotype endorsement was most commonly reported. Bipolar (versus depressive) disorders, male gender, and less education were associated with more internalized stigma, especially social withdrawal. Contrasting findings in Western countries, those with family history of mental illness trended toward more internalized stigma. We conclude that anti-stigma interventions should focus on reducing social withdrawal and stereotype endorsement, especially for those with more severe mood disorders, males, less educated individuals, and those with family history of mental illness.Posttraumatic stress disorder in the short and medium term following the World Trade Center attack among Asian Americans
AbstractKung, W. W., Liu, X., Goldmann, E., Huang, D., Wang, X., Kim, K., Kim, P., & Yang, L. H. (n.d.).Publication year
2018Journal title
Journal of Community PsychologyVolume
46Issue
8Page(s)
1075-1091AbstractThis study investigated patterns of probable posttraumatic stress disorder (PTSD) and their predictors among 2,431 Asian American and 31,455 non-Hispanic White World Trade Center (WTC) Registry participants 2–3 years and 5–6 years after the WTC attack. Participants were divided into four PTSD pattern groups: resilient, remitted, delayed onset, and chronic. Asians had a lower proportion in the resilient group (76.5% vs. 79.8%), a higher proportion in the chronic (8.6% vs. 7.4%) and remitted (5.9% vs. 3.4%) groups, and a similar proportion in the delayed onset group (about 9%) compared to Whites. In multinomial logistic regression analyses, disaster exposure, immigrant status, lower income, pre-attack depression/anxiety, and lower respiratory symptoms were associated with increased odds of chronic and delayed onset PTSD (vs. resilience) among both races. Education and employment were protective against chronic and delayed onset PTSD among Whites only. These results can inform targeted outreach efforts to enhance prevention and treatment for Asians affected by future events.Understanding stigma as a barrier to accessing cancer treatment in South Africa: Implications for public health campaigns
AbstractOystacher, T., Blasco, D., He, E., Huang, D., Schear, R., McGoldrick, D., Link, B., & Yang, L. H. (n.d.).Publication year
2018Journal title
Pan African Medical JournalVolume
29AbstractIntroduction: Cancer contributes to significant illness burden in South Africa, with delayed diagnosis resulting from limited knowledge of cancer, lack of biomedical treatment and stigma. This study examines ways in which people are identified as having cancer through perspectives of traditional healing or the biomedical model. Additionally, we sought to understand the stigma associated with cancer, including stereotypes, anticipated discrimination and coping styles. Methods: Livestrong Foundation conducted 11 semi-structured focus groups with key community stakeholders in three South African townships. Interviews examined the negative consequences of being labeled with a cancer diagnosis as well as causes of, possible prevention of and barriers and methods to improve access to cancer treatment. Analyses were completed using directed content analysis. Results: Revealed three main labeling mechanisms: physical appearance of perceived signs/symptoms of cancer, diagnosis by a traditional healer, or a biomedical diagnosis by a Western physician. Being labeled led to anticipated discrimination in response to prevalent cancer stereotypes. This contributed to delayed treatment, use of traditional healers instead of biomedical treatment and secrecy of symptoms and/or diagnosis. Further, perceptions of cancer were commonly conflated with HIV/TB owing to prior educational campaigns. Conclusion: Our study deepens the understanding of the cancer labeling process in South Africa and the resulting negative effects of stigma. Future anti-stigma interventions should partner with traditional healers due to their respected community status and consider how previous health interventions may significantly impact current understandings of illness.Understanding the impact of community on the experience of suicide within the Lao Community: An expansion of the cultural model of suicide
AbstractYang, L. H., Lam, J., Vega, E., Martinez, M., Botcheva, L., Hong, J. E., Chu, J., & Lewis, S. E. (n.d.).Publication year
2018Journal title
Asian American Journal of PsychologyVolume
9Issue
4Page(s)
284-295AbstractThere is a dearth in the scientific literature examining community factors of suicide in a theoretically grounded manner, in particular for Asian American groups. This study used the cultural model of suicide to examine the experience of suicide for a Lao group in California. Interviews were conducted with focus groups and community leaders pooled from the Center for Lao Studies, and then coded using a direct content analysis, in tandem with an inductive approach. The results revealed areas in which the community had a notable impact and shaped suicide risk within the Lao group. The findings also highlighted the need for additions to the current cultural model of suicide to reflect the impact of these community factors.Using information and communication technologies to prevent suicide among secondary school students in two regions of Chile: A randomized controlled trial
AbstractMascayano, F., Schilling, S., Tapia, E., Santander, F., Burrone, M. S., Yang, L. H., & Alvarado, R. (n.d.).Publication year
2018Journal title
Frontiers in PsychiatryVolume
9AbstractBackground: There is an increasing concern for addressing suicide among adolescents in Latin America. Recent mental health policies encourage the development and implementation of preventive interventions for suicide. Such initiatives, however, have been scarcely developed, even in countries with solid mental health services such as Chile. The use of information and communications technology (ICT) might contribute to create accessible, engaging, and innovative platforms to promote well-being and support for adolescents with mental health needs and suicide risk. Objective: To evaluate a program based on ICT to prevent suicide and enhance mental health among adolescents in Chile. Method: A cluster randomized controlled trial (RCT) will be conducted including 428 high-school students aged 18-14 years in two regions of Chile. Study procedures will take place as follows: (1) design of the intervention model and creation of prototype; (2) selection and randomization of the participating public schools; (3) implementation of the 3-month intervention and evaluation at baseline, post-intervention period, and a 2-month follow-up. Suicidal ideation at the 2-month follow up is the primary outcome in this study. Secondary outcomes include negative psychological outcomes (e.g., stigma, depression, anxiety) as well as a number of protective psychological and social factors. Indicators regarding the study implementation will be also gathered. Discussion: Here we describe a novel program based on technological devices and aimed to target youth suicide in Chile. This is the first clinical trial of such a program in Latin America, and to our knowledge, the first of its kind in any middle income country.Advances in the cultural assessment of stigma to promote global mental health
Yang, L., Sia, K., & Yang, L. (n.d.). In Stigma Towards Mental Illness: a Public Health Challengs (1–).Publication year
2017Attitudes Towards the Mentally Ill: A Study with Health Workers at a University Hospital in Rio de Janeiro
AbstractSiqueira, S. R. G., Abelha, L., Lovisi, G. M., Sarução, K. R., & Yang, L. (n.d.).Publication year
2017Journal title
Psychiatric QuarterlyVolume
88Issue
1Page(s)
25-38AbstractAs there are few studies about evaluation of attitudes of health care workers to people with mental disorders in Brazil, a cross-sectional study was carried out to assess the health professionals’ attitudes working in a university hospital in Rio de Janeiro and also examine the proportion of negative and positive attitudes endorsed by healthcare professionals in Brazil towards people with mental illness in comparison with other parts of the world. Data were collected using the Community Attitudes towards the Mentally Ill (CAMI) in a random sampling frame of health professionals (n = 246) working in a University Hospital in Rio de Janeiro between April 2013 and June 2013. The CAMI consists of four sub-scales: Authoritarianism, Benevolence, Social Restrictiveness and Community Mental Health Ideology. The results showed attitudes that range from neutral to positive, with the Benevolence and Social Restrictiveness sub-scales showing the least stigmatizing results. The following individual characteristics were associated with negative attitudes: lower levels of education and less clinical experience. In general, health workers attitudes towards service users are characterized as positive when compared with other international studies. However, educational programs for health workers should be reinforced to further promote pre-existing positive attitudes towards people with mental health and the implementation of Brazilian Mental Health Policies.Baseline demographics, clinical features and predictors of conversion among 200 individuals in a longitudinal prospective psychosis-risk cohort
AbstractBrucato, G., Masucci, M. D., Arndt, L. Y., Ben-David, S., Colibazzi, T., Corcoran, C. M., Crumbley, A. H., Crump, F. M., Gill, K. E., Kimhy, D., Lister, A., Schobel, S. A., Yang, L. H., Lieberman, J. A., & Girgis, R. R. (n.d.).Publication year
2017Journal title
Psychological MedicineVolume
47Issue
11Page(s)
1923-1935AbstractBackground. DSM-5 proposes an Attenuated Psychosis Syndrome (APS) for further investigation, based upon the Attenuated Positive Symptom Syndrome (APSS) in the Structured Interview for Psychosis-Risk Syndromes (SIPS). SIPS Unusual Thought Content, Disorganized Communication and Total Disorganization scores predicted progression to psychosis in a 2015 NAPLS-2 Consortium report. We sought to independently replicate this in a large single-site high-risk cohort, and identify baseline demographic and clinical predictors beyond current APS/APSS criteria. Method. We prospectively studied 200 participants meeting criteria for both the SIPS APSS and DSM-5 APS. SIPS scores, demographics, family history of psychosis, DSM Axis-I diagnoses, schizotypy, and social and role functioning were assessed at baseline, with follow-up every 3 months for 2 years. Results. The conversion rate was 30% (n = 60), or 37.7% excluding participants who were followed under 2 years. This rate was stable across time. Conversion time averaged 7.97 months for 60% who developed schizophrenia and 15.68 for other psychoses. Mean conversion age was 20.3 for males and 23.5 for females. Attenuated odd ideas and thought disorder appear to be the positive symptoms which best predict psychosis in a logistic regression. Total negative symptom score, Asian/Pacific Islander and Black/African-American race were also predictive. As no Axis-I diagnosis or schizotypy predicted conversion, the APS is supported as a distinct syndrome. In addition, cannabis use disorder did not increase risk of conversion to psychosis. Conclusions. NAPLS SIPS findings were replicated while controlling for clinical and demographic factors, strongly supporting the validity of the SIPS APSS and DSM-5 APS diagnosis.Stigma and substance use disorders: An international phenomenon
AbstractYang, L. H., Wong, L. Y., Grivel, M. M., & Hasin, D. S. (n.d.).Publication year
2017Journal title
Current Opinion in PsychiatryVolume
30Issue
5Page(s)
378-388AbstractPurpose of review To collect and update published information on the stigma associated with substance abuse in nonclinical samples, which has not been recently reviewed. Recent findings Searching large databases, a total of only 17 articles were published since 1999, with the majority of studies conducted outside the United States. Using major stigma concepts from a sociological framework (stereotyping, devaluation in terms of status loss, discrimination, and negative emotional reactions), the studies reviewed predominantly indicated that the public holds very stigmatized views toward individuals with substance use disorders (SUDs), and that the level of stigma was higher toward individuals with SUDs than toward those with other psychiatric disorders. Summary The prevalence of SUDs is increasing in the US general population, but these disorders remain seriously undertreated. Stigma can reduce willingness of policymakers to allocate resources, reduce willingness of providers in nonspecialty settings to screen for and address substance abuse problems, and may limit willingness of individuals with such problems to seek treatment. All of these factors may help explain why so few individuals with SUDs receive treatment. Public education that reduces stigma and provides information about treatment is needed.The family economic status and outcome of people with schizophrenia in Xinjin, Chengdu, China: 14-year follow-up study
AbstractRan, M. S., Yang, L. H., Liu, Y. J., Huang, D., Mao, W. J., Lin, F. R., Li, J., & Chan, C. L. W. (n.d.).Publication year
2017Journal title
International Journal of Social PsychiatryVolume
63Issue
3Page(s)
203-211AbstractBackground: Little is known about whether family economic status might influence the long-term (e.g. over 10 years) outcome of persons with schizophrenia in the community. Aim: To examine the differences in outcome at 14-year follow-up of persons with schizophrenia from high versus low family economic status backgrounds in a Chinese rural area. Method: A prospective 14-year follow-up study was conducted in six townships in Xinjin County, Chengdu, China. All participants with schizophrenia (n = 510) were identified in an epidemiological investigation of 123,572 people aged 15 years and older and followed up from 1994 to 2008. Results: Individuals from low family economic status (<mean) in 1994 had significantly higher rate of homelessness (9.9%) and lower rate of survival (63.8%) in 2008 than those from high family economic status (3/4mean; 3.2% and 76.6%, respectively). Individuals from low family economic status had significantly lower rates of marriage and complete remission, higher mean scores on Positive and Negative Syndrome Scale (PANSS) and lower mean score on Global Assessment of Functioning (GAF) than those from high family economic status in 2008. The predictors of low family economic status of individuals in 2008 encompassed the baseline low family economic status, poor families' attitude toward the patient, younger age, older age of first onset and longer duration of illness. Conclusion: Low family economic status is a predictive factor of poor long-term outcome of persons with schizophrenia in the rural community. Individuals' family economic status should be considered in making mental health policy and providing community-based mental health services.The importance of symbolic interaction in mental illness stigma
He, E., Yang, L., & Link, B. G. (n.d.). In Stigma Towards Mental Illness: A Public Health Challenge (1–).Publication year
2017The role of culture in population mental health: prevalence of mental disorders among Asian and Asian american populations
Yang, L., & Benson, J. (n.d.). In Handbook of Cultural Neuroscience (1–).Publication year
2017Violating clan and kinship roles as risk factors for suicide and stigma among lao refugees: An application of the cultural model of suicide and “what matters most” frameworks
AbstractMandavia, A., Huang, D., Wong, J., Ruiz, B., Crump, F., Shen, J., Martinez, M., Botcheva, L., Vega, E., Chu, J., Lewis, S., & Yang, L. H. (n.d.).Publication year
2017Journal title
Israel Journal of Psychiatry and Related SciencesVolume
54Issue
1Page(s)
39-49AbstractBackground: While Asian groups have immigrated worldwide, suicide risk models have neglected to integrate cultural components. This study incorporates how stigma associated with failure to uphold clan/kinship roles can increase suicide risk in highly-marginalized Lao-Americans. Methods: One focus group with five Lao participants and 21 individual semi-structured interviews with community family members were conducted. Transcripts were coded via directed content analysis using the “What Matters Most” and Cultural Theory of Suicide frameworks. Results: Violating role-expectations associated with youth, adults and older adults appears to be associated with risk for suicide. This suggests that the failure of adults to fulfill their roles might potentially threaten loss of “full personhood” and trigger stigma, thus potentially evoking greater suicide risk. Conclusion: Interventions would benefit from cultural considerations of fulfilling role-expectations and “personhood” to combat suicide and stigma within cultural communities.attitudes toward judicial lenience and government assistance for individuals with mental illness: A comparison of Chinese and European Americans
Huang, D., Yang, L. H., Wonpat-Borja, A., Lam, J., Link, B. G., & Phelan, J. C. (n.d.).Publication year
2016Journal title
Journal of Community PsychologyVolume
44Issue
4Page(s)
516-523Experiences of Social Support Among Chinese Immigrant Mental Health Consumers with Psychosis
AbstractCheng, Z. H., Tu, M. C., & Yang, L. H. (n.d.).Publication year
2016Journal title
Community mental health journalVolume
52Issue
6Page(s)
643-650AbstractLimited research has investigated how culture impacts expressions of social support, which is crucial in developing culturally sensitive care. Using a classification based on theories of social support, we examined the social support experiences of 49 Chinese immigrant mental health consumers with psychosis, paying particular attention to frequency and sources. We found that the most common forms of social support were belonging and companionship, perceived emotional support, social control, and perceived instrumental support, while self-esteem and sense of mastery were the least common forms. Family and friends were the main sources of support. These results demonstrate the influence of Confucian values of renqing (or fulfillment of relational obligations) and guanxi (or social networks) and the negative effects of stigma in diminishing the social standing of these consumers by compromising ‘personhood.’ Clinical implications for increasing the cultural competency of clinicians and improving the mental health outcomes of Chinese immigrants are discussed.Investigating the relationship between self-esteem and stigma among young adults with history of suicide attempts
AbstractLehmann, M., Hilimire, M. R., Yang, L. H., Link, B. G., & DeVylder, J. E. (n.d.).Publication year
2016Journal title
CrisisVolume
37Issue
4Page(s)
265-270AbstractBackground: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = -.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = -.50, p = .013) compared with those without attempts (β = -.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.Principles
AbstractYang, L., Kleinman, A., & Morita, J. (n.d.). In International Encyclopedia of Public Health: Stigma (1–).Publication year
2016Page(s)
40-50AbstractStigma is a pervasive force that has powerful consequences and reduces the life opportunities of people with mental illness and other stigmatized conditions. Society also becomes burdened by the costs of people with mental illness who neglect adequate treatment and whose conditions worsen due to fears of stigma. The concept of stigma includes interior psychological processes within people with mental illness, interpersonal social processes between individuals and groups, and large-scale processes on the level of culture and politics. These models identify different mechanisms by which stigma exerts its negative effects on people with mental illness and other stigmatized conditions. Further, current antistigma interventions have drawn upon these conceptualizations to reduce stigma and its effects. Attitudes toward mental illness and other stigmatized conditions may continue to change as scientific understanding of these illnesses evolves.Stigma toward mental illness in Latin America and the caribbean: A systematic review
AbstractMascayano, F., Tapia, T., Schilling, S., Alvarado, R., Tapia, E., Lips, W., & Yang, L. H. (n.d.).Publication year
2016Journal title
Revista Brasileira de PsiquiatriaVolume
38Issue
1Page(s)
73-85AbstractObjective: Stigma toward individuals with mental disorders has been studied extensively. In the case of Latin America and the Caribbean, the past decade has been marked by a significant increase in information on stigma toward mental illness, but these findings have yet to be applied to mental health services in Latin America. The objective of this study was to conduct a systematic review of studies relating to stigma toward mental illness in Latin America and the Caribbean. The authors specifically considered differences in this region as compared with manifestations reported in Western European countries. Methods: A systematic search of scientific papers was conducted in the PubMed, MEDLINE, EBSCO, SciELO, LILACS, Imbiomed, and Bireme databases. The search included articles published from 2002 to 2014. Results: Twenty-six studies from seven countries in Latin America and the Caribbean were evaluated and arranged into the following categories: public stigma, consumer stigma, family stigma, and multiple stigmas. Conclusion: We identified some results similar to those reported in high-income settings. However, some noteworthy findings concerning public and family stigma differed from those reported in Western European countries. Interventions designed to reduce mental illness-related stigma in this region may benefit from considering cultural dynamics exhibited by the Latino population.#Schizophrenia: Use and misuse on Twitter
AbstractJoseph, A. J., Tandon, N., Yang, L. H., Duckworth, K., Torous, J., Seidman, L. J., & Keshavan, M. S. (n.d.).Publication year
2015Journal title
Schizophrenia ResearchVolume
165Issue
2Page(s)
111-115AbstractBackground: The role and prevention of stigma in mental illness is an area of evolving research. Aims: The present study is the first to examine the use and misuse of the word 'schizophrenia' on Twitter.com in comparison with another illness (diabetes) by analyzing Tweets that use the adjective and noun forms of schizophrenia and diabetes. Method: Tweets containing one of four search terms (#schizophrenia, #schizophrenic, #diabetes, #diabetic) were collected over a forty-day time period. After establishing inter-rater reliability, Tweets were rated along three dimensions: medical appropriateness, negativity, and sarcasm. Chi square tests were conducted to examine differences in the distributions of each parameter across illnesses and across each word form (noun versus adjective). Results: Significant differences were seen between the two illnesses (i.e., among "schizophrenia", "schizophrenic", "diabetes", and "diabetic") along each parameter. Tweets about schizophrenia were more likely to be negative, medically inappropriate, sarcastic, and used non-medically. The adjective ("schizophrenic") was more often negative, medically inappropriate, sarcastic, and used non-medically than the noun "schizophrenia." Schizophrenia tweets were more likely to be negative and sarcastic when used non-medically and in a medically inappropriate manner. Conclusions: Our findings confirm the presence of a great deal of misuse of the term schizophrenia on Twitter, and that this misuse is considerably more pronounced by the adjectival use of the illness. These findings have considerable implications for efforts to combat stigma, particularly for youth anti-stigma efforts.Addressing stigma relating to mental illness in low- and middle-income countries
Mascayano, F., Armijo, J. E., & Yang, L. H. (n.d.).Publication year
2015Journal title
Frontiers in PsychiatryVolume
6Analysis of psychometric properties of the Brazilian Portuguese version of the community attitudes towards the mentalii Ill (CAMI-BR)
Lima, L., Siqueira, S., Legay, L., Yang, L., Valencia, E., Sarucao, K., & Lovisi, G. (n.d.).Publication year
2015Journal title
Revista de la Facultad de Ciencias MedicasPage(s)
15-24Analysis of psychometric properties of the brazilian portuguese version of the community attitudes towards the mentally ill (CAMI-BR)
AbstractAbelha, L., Gonçalves Siqueira, S. R., Legay, L., Yang, L. H., Valencia, E., Rodrigues Sarução, K., & Lovisi, G. M. (n.d.).Publication year
2015Journal title
Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina)Volume
72Issue
4Page(s)
211-219AbstractOBJECTIVES: To perform an analysis of the psychometric properties of the Brazilian Portuguese version of the COMMUNITY ATTITUDES TOWARDS THE MENTALLY ILL (CAMI-BR), a 40-item scale divided into four sub-scales.METHODS: The study was conducted in a non-probability sample of 230 households located close to therapeutic residences in the west area of Rio de Janeiro. Reliability was assessed by test-retest and the Principal Component Analysis (PCA) was used to test the internal structure of the questionnaire.RESULTS: Most participants were women, married, with children aged 18 years or over. The overall score was 27.72 (SD = 3.31), showing attitudes ranging from neutral to positive stereotypes. The scale showed a high internal consistency (? = 0.842), consistent with other international studies. In the factor analysis, the sample was adequate (KMO = 0.800). The strength of the correlations among subscales and the factors of factor analysis were highly satisfactory. The version in Brazilian Portuguese suggests a better distinction among sub-scales through the lower correlation among them (between 0.336 and 0.441) as compared to higher values (between 0.630 and 0.770) found in the original scale. The community mental health ideology sub-scale showed a strong relation to factor 1 (? = 0.910). Benevolence had a strong relationship with factor 2 (? = 0.847); Authoritarianism and Social Restrictiveness had the highest correlation with factor 3 (? = 0.631 and 0.577 respectively).CONCLUSIONS: The scale psychometric properties were maintained after adjustment. Having registered a lower correlation between the scales the factor analysis further suggests that the Brazilian Portuguese version conveys more clearly the differences between the sub-scales.Development of an intervention to reduce self-stigma in outpatient mental health service users in Chile
AbstractSchilling, S., Bustamante, J. A., Sala, A., Acevedo, C., Tapia, E., Alvarado, R., Sapag, J. C., Yang, L. H., Lukens, E., Mascayano, F., Cid, P., & Tapia, T. (n.d.).Publication year
2015Journal title
Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina)Volume
72Issue
4Page(s)
284-294AbstractBACKGROUND: Latin America is characterized by a high prevalence of public stigma toward those with mental illness, and significant selfstigma among labeled individuals, leading to social exclusion, low treatment adherence, and diminished quality of life. However, there is no published evidence of an intervention designed to address stigma in the region. In light of this, a psychosocial intervention to reduce self-stigma among users with severe mental illness was developed and tested through an RCT in two regions of Chile.OBJECTIVES: To describe the development of the psychosocial intervention, assess its feasibility and acceptability, and evaluate its preliminary impact.METHODS: An intervention was designed and is being tested, with 80 users with severe mental illness attending two community mental health outpatient centers. To prepare the intervention, pertinent literature was reviewed, and experts and mental health services users were consulted. Feasibility and acceptability were assessed, and impact was analyzed, based on follow-up qualitative reports by the participants.RESULTS: The recovery-oriented, ten-session group intervention incorporates the Tree of Life narrative approach, along with other narrative practices, to promote a positive identity change in users, and constructivist psychoeducation, based on case studies and group discussions, to gather tools to confront self-stigma. The intervention was feasible to implement and well evaluated by participants, family members, and center professionals. Participants reported increased self-confidence, and the active use of anti-stigma strategies developed during the workshop.CONCLUSIONS: This group intervention promises an effective means to reduce stigma of mental illness within Chile and other Latin American countries and feasibility to scale up within mental health services.Effects of increased psychiatric treatment contact and acculturation on the causal beliefs of chinese immigrant relatives of individuals with psychosis
AbstractYang, L., Lo, G., Tu, M., Wu, O., Anglin, D., Saw, A., & Chen, F. P. (n.d.).Publication year
2015Journal title
Journal of Immigrant and Refugee StudiesVolume
13Issue
1Page(s)
19-39AbstractEncounters with Western psychiatric treatment and acculturation may influence causal beliefs of psychiatric illness endorsed by Chinese immigrant relatives, thus affecting help seeking. We examined causal beliefs held by 46 Chinese immigrant relatives and found that greater acculturation was associated with an increased number of causal beliefs. Further, as Western psychiatric treatment and acculturation increased, causal models expanded to incorporate biological/physical causes. However, frequency of Chinese immigrant relatives’ endorsing spiritual beliefs did not appear to change with acculturation. Clinicians might thus account for spiritual beliefs in treatment even after acculturation increases and biological causal models proliferate.Experiences of Social and Structural Forms of Stigma Among Chinese Immigrant Consumers with Psychosis
AbstractCheng, Z. H., Tu, M. C., Li, V. A., Chang, R. W., & Yang, L. H. (n.d.).Publication year
2015Journal title
Journal of Immigrant and Minority HealthVolume
17Issue
6Page(s)
1723-1731AbstractChinese immigrants tend to rely on family and close community for support given their vulnerable societal position. Yet stigma, especially from structural and familial sources, may have a particularly harmful impact upon Chinese immigrants with psychosis. Using a descriptive analysis based upon grounded theory, we examined stigma experiences of 50 Chinese immigrant consumers with psychosis, paying particular attention to frequency, sources, and themes of social and structural stigma. Although past research indicates that family is a recipient of stigma, we found instead that family members were common perpetuators of social forms of stigma. We also found that perceptions of work deficit underlie many forms of stigma, suggesting this is “what matters most” in this community. Lack of financial resources and language barriers comprised most frequent forms of structural stigma. Anti-stigma efforts should aim to improve consumer’s actual and perceived employability to target what is most meaningful in Chinese immigrant communities.