Lawrence H Yang

Chair and Professor of Social and Behavioral Sciences

Associate Director, Global Center for Implementation Science

Founding Director, Global Mental Health and Stigma Program

Professional overview

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.

Education

BA, High Honors and Phi Beta Kappa, Wesleyan University, Middletown, CT

PhD, Boston University, Boston, MA

Clinical Fellowship, Harvard Medical School (Massachusetts Mental Health Center)

Postdoctoral Fellowship, Columbia Mailman School of Public Health (NIMH funded T32 Training Program in Psychiatric Epidemiology)

Honors and awards

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)

Areas of research and study

Cognition and Psychosis

Global Health

Implementation science

Mental Health

Stigma of Health Conditions

“At-Risk” States for Psychosis

Publications

Publications

Development of an intervention to reduce self-stigma in outpatient mental health service users in Chile

Schilling, 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

2015

Journal title

Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina)

Volume

72

Issue

4

Page(s)

284-294

Abstract

Abstract

BACKGROUND: 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

Yang, L., Lo, G., Tu, M., Wu, O., Anglin, D., Saw, A., & Chen, F. P. (n.d.).

Publication year

2015

Journal title

Journal of Immigrant and Refugee Studies

Volume

13

Issue

1

Page(s)

19-39

10.1080/15562948.2013.856509

Abstract

Abstract

Encounters 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

Marriage outcome and relationship with urban versus rural context for individuals with psychosis in a population-based study in China

Yang, L. H., Phillips, M. R., Li, X., Yu, G., Zhang, J., Shi, Q., Song, Z., Ding, Z., Pang, S., & Susser, E. (n.d.).

Publication year

2015

Journal title

Social psychiatry and psychiatric epidemiology

Volume

50

Issue

10

Page(s)

1501-1509

10.1007/s00127-015-1080-8

Abstract

Abstract

Purpose: While social integration among individuals with psychosis differs by social context, this has rarely been investigated across urban vs. rural settings. For individuals with psychosis, marriage may be a key component of social integration. This study aims to compare marriage outcomes for individuals with psychosis in urban vs. rural settings in China, where marriage has been almost universal among individuals without psychosis. Methods: In a large community-based study in four provinces representing 12 % of China’s population, we identified 393 individuals with psychosis (112 never treated). We used adjusted Poisson regression models to compare marriage status for those living in urban (n = 96) vs. rural (n = 297) contexts. Results: While urban and rural residents had similar impairments due to symptoms, urban female residents were 2.72 times more likely to be unmarried than their rural counterparts (95 % CI 1.19–6.22, p < 0.0176). Stratified analyses indicated that this marital disadvantage occurred primarily among urban females with an earlier age of onset. No differences were found among males. Conclusions: Our findings indicate that urban contexts impeded opportunities for marriage for female individuals with psychosis. These data suggest that urban women with earlier age of onset have difficulty in marrying which may be related to economic expectations of women in urban areas. Research examining contextual mechanisms that affect marriage may further understanding of social integration in China and other contexts.

Mental illness stigma research in Argentina

Agrest, M., Mascayano, F., Ardila-Gómez, S. E., Abeldaño, A., Fernandez, R., Geffner, N., Leiderman, E. A., Susser, E. S., Valencia, E., Yang, L. H., Zalazar, V., & Lipovetzky, G. (n.d.).

Publication year

2015

Journal title

BJPsych International

Volume

12

Issue

4

Page(s)

86-88

10.1192/S2056474000000623

Abstract

Abstract

Studies regarding stigma towards mental illness in Argentina blossomed after the first National Mental Health Law was passed in 2010. Methodological limitations and contradictory results regarding community perceptions of stigma hinder comparisons across domestic and international contexts but some lessons may still be gleaned. We examine this research and derive recommendations for future research and actions to reduce stigma. These include tackling culture-specific aspects of stigma, increasing education of the general population, making more community-based services available and exposing mental health professionals to people with mental illness who are on community paths to recovery.

Racial and mental illness stereotypes and discrimination: An identity-based analysis of the virginia tech and columbine shootings

Stigma related to labels and symptoms in individuals at clinical high-risk for psychosis

Suicide in Latin America: a growing public health issue

Understanding the Importance of "symbolic Interaction Stigma": How Expectations about the Reactions of Others Adds to the Burden of Mental Illness Stigma

Link, B. G., Wells, J., Phelan, J. C., & Yang, L. (n.d.).

Publication year

2015

Journal title

Psychiatric Rehabilitation Journal

Volume

38

Issue

2

Page(s)

117-124

10.1037/prj0000142

Abstract

Abstract

Objective: Important components of stigma include imagining what others might think of a stigmatized status, anticipating what might transpire in an interaction with others, and rehearsing what one might do if something untoward occurs. These imagined relations are here called symbolic interaction stigma and can have an impact even if the internalization of negative stereotypes fails to occur. Concepts and measures that capture symbolic interaction stigma are introduced, and a preliminary assessment of their impact is provided. Method: Four self-report measures of symbolic interaction stigma (perceived devaluation discrimination, anticipation of rejection, stigma consciousness, and concern with staying in) were developed or adapted and administered to a sample of individuals who have experienced mental illness (N = 65). Regression analyses examined whether forms of symbolic interaction stigma were associated with withdrawal, self-esteem, and isolation from relatives independent of measures of internalization of stigma and rejection experiences. Results: As evidenced by scores on 4 distinct measures, symbolic interaction stigma was relatively common in the sample, somewhat more common than the internalization of stigma. In addition, measures of symbolic interaction stigma were significantly associated with withdrawal, self-esteem, and isolation from relatives even when a measure of the internalization of stigma was statistically controlled. Conclusion: The study suggests the potential importance of considering symbolic interaction forms of stigma in understanding and addressing stigma and its consequences. Being aware of symbolic interaction stigma could be useful in enhancing rehabilitation goals if an approach to counteracting the negative effects of these aspects of stigma can be developed.

What matters most': stigma towards severe mental disorders in Chile, a theory-driven, qualitative approach

Mascayano, F., Toso-Salman, J., Ruiz, B., Warman, K., Jofre Escalona, A., Alvarado Muñoz, R., Sia, K. J., & Yang, L. H. (n.d.).

Publication year

2015

Journal title

Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina)

Volume

72

Issue

4

Page(s)

250-260

Abstract

Abstract

BACKGROUND: Stigma towards severe mental illness manifests in different ways across cultures and only recently has a theoretical perspective emerged to understand such cultural differences. The 'What Matters Most' framework identifies culturally specific dimensions of stigma by identifying the interactions between cultural norms, roles, and values that impact personhood.OBJECTIVE: This study explores the cultural underpinnings that create and maintain stigmatizing attitudes towards severe mental illness in Chile.METHODS: In-depth interviews developed using the 'Scale of Perceived Discrimination and Devaluation', and the 'What Matters Most' framework were conducted with twenty people identified as having a severe mental illness. Interviews were coded and discussed until agreement was reached, then analyzed by an independent reviewer to determine inter-rater reliability.RESULTS: A key factor shaping stigma among women was the loss of capacity to accomplish family roles (i.e. take care of children).or men, cultural notions of 'Machismo' prevented them from disclosing their psychiatric diagnosis as a means to maintain status and ability to work. A protective factor against stigma for men was their ability to guide and provide for the family, thus fulfilling responsibilities attributable to 'Familismo'. Social appearances could play either a shaping or protecting role,contingent on the social status of the individual.DISCUSSION: In Chilean culture, stigma is rooted in gendered social characteristics and shared familial roles. Interventions should aim to address these norms and incorporate culturally salient protective factors to reduce stigma experienced by individuals with serious mental illness in Chile and other Latin American settings.

"What matters most:" A cultural mechanism moderating structural vulnerability and moral experience of mental illness stigma

Yang, L. H., Chen, F. P., Sia, K. J., Lam, J., Lam, K., Ngo, H., Lee, S., Kleinman, A., & Good, B. (n.d.).

Publication year

2014

Journal title

Social Science and Medicine

Volume

103

Page(s)

84-93

10.1016/j.socscimed.2013.09.009

Abstract

Abstract

To understand Chinese immigrants' experiences with mental illness stigma and mental health disparities, we integrate frameworks of 'structural vulnerability' and 'moral experience' to identify how interaction between structural discrimination and cultural engagements might shape stigma. Fifty Chinese immigrants, including 64% Fuzhounese immigrants who experienced particularly harsh socio-economical deprivation, from two Chinese bilingual psychiatric inpatient units in New York City were interviewed from 2006 to 2010 about their experiences of mental illness stigma. Interview questions were derived from 4 stigma measures, covering various life domains. Participants were asked to elaborate their rating of measure items, and thus provided open-ended, narrative data. Analysis of the narrative data followed a deductive approach, guided by frameworks of structural discrimination and "what matters most" - a cultural mechanism signifying meaningful participation in the community. After identifying initial coding classifications, analysis focused on the interface between the two main concepts. Results indicated that experiences with mental illness stigma were contingent on the degree to which immigrants were able to participate in work to achieve "what mattered most" in their cultural context, i.e., accumulation of financial resources. Structural vulnerability - being situated in an inferior position when facing structural discrimination - made access to affordable mental health services challenging. As such, structural discrimination increased healthcare spending and interfered with financial accumulation, often resulting in future treatment nonadherence and enforcing mental health disparities. Study participants' internalizing their structurally-vulnerable position further led to a depreciated sense of self, resulting in a reduced capacity to advocate for healthcare system changes. Paradoxically, the multi-layered structural marginalization experienced by Chinese immigrants with mental illness allowed those who maintained capacity to work to retain social status even while holding a mental illness status. Mental health providers may prioritize work participation to shift service users' positions within the hierarchy of structural vulnerability.

A brief anti-stigma intervention for Chinese immigrant caregivers of individuals with psychosis: AdaptatioN and initial findings

Assessing depression in youth at clinical high risk for psychosis: A comparison of three measures

Authors' reply

Co-occurrence of psychotic experiences and common mental health conditions across four racially and ethnically diverse population samples

DeVylder, J. E., Burnette, D., & Yang, L. H. (n.d.).

Publication year

2014

Journal title

Psychological Medicine

Volume

44

Issue

16

Page(s)

3503-3513

10.1017/S0033291714000944

Abstract

Abstract

Background. Prior research with racially/ethnically homogeneous samples has demonstrated widespread co-occurrence of psychotic experiences (PEs) and common mental health conditions, particularly multi-morbidity, suggesting that psychosis may be related to the overall severity of psychiatric disorder rather than any specific subtype. In this study we aimed to examine whether PEs are associated with the presence of specific disorders or multi-morbidity of co-occurring disorders across four large racially/ethnically diverse samples of adults in the USA.Method. Data were drawn from the National Comorbidity Survey Replication (NCS-R), the National Survey of American Life (NSAL) and separately from the Asian and Latino subsamples of the National Latino and Asian American Study (NLAAS). Logistic regression models were used to examine the relationship between PEs and individual subtypes of DSM-IV disorder, and to test for a linear dose-response relationship between the number of subtypes and PEs.Results. Prevalence of PEs was moderately greater among individuals with each subtype of disorder in each data set [odds ratios (ORs) 1.8-3.8], although associations were only variably significant when controlling for clinical and demographic variables. However, the sum of disorder subtypes was related to odds for PEs in a linear dose-response fashion across all four samples.Conclusions. PEs are related primarily to the extent or severity of psychiatric illness, as indicated by the presence of multiple psychiatric disorders, rather than to any particular subtype of disorder in these data. This relationship applies to the general population and across diverse racial/ethnic groups.

Direct-to-Consumer Racial Admixture Tests and Beliefs About Essential Racial Differences

Discrimination, arrest history, and major depressive disorder in the U.S. Black population

Anglin, D. M., Lighty, Q., Yang, L. H., Greenspoon, M., Miles, R. J., Slonim, T., Isaac, K., & Brown, M. J. (n.d.).

Publication year

2014

Journal title

Psychiatry Research

Volume

219

Issue

1

Page(s)

114-121

10.1016/j.psychres.2014.05.020

Abstract

Abstract

Everyday discrimination contributes negatively to depressive symptomatology among Blacks in the US and being arrested could add to this depression. Using data from the National Survey on American Life, the present study determined the association between an arrest history and major depressive disorder (MDD), while accounting for discrimination among African Americans, US-born Afro-Caribbeans and first-generation Black immigrants. Findings from logistic regression analyses adjusted for discrimination suggested an arrest history is associated with 12-month MDD (Adjusted OR=1.47; 95% CI=1.02-2.10) and lifetime MDD (Adjusted OR=1.56 CI=1.17-2.09). Accounting for drug and alcohol dependence attenuated the association between arrest history and 12-month MDD, but not lifetime MDD. The associations between arrest history and both 12-month and lifetime MDD, and discrimination and lifetime MDD varied by ethnic/immigrant group. Specifically, while the association between arrest history and MDD (both 12-month and lifetime) was strongest among US-born Afro-Caribbeans, evidence consistent with the immigrant paradox, the association between discrimination and lifetime MDD was particularly relevant for first-generation Black immigrants, suggesting discrimination may hinder the protection of first-generation status. Mental health prevention and treatment programs should target the stress associated with being arrested and experiencing discrimination among US Blacks.

Examining the meaning of the rural advantage in employment for social integration

Interventions to improve adherence to psychotropic medication in clients of Asian descent: A systematic review

Fancher, T. L., Lee, D., Cheng, J. K. Y., Yang, M. S., & Yang, L. (n.d.).

Publication year

2014

Journal title

Asian American Journal of Psychology

Volume

5

Issue

1

Page(s)

22-34

10.1037/a0027803

Abstract

Abstract

Fewer than half of Asian Americans prescribed psychotropic medication actually adhere to their medications. Poor psychotropic medication adherence among Asian Americans might be influenced by cultural beliefs about medication, mental illness, and stigma surrounding mental disorders, but the data are limited. Studies in Asian populations, whose belief systems are shared by many Asian American groups, may help broaden our understanding of medication adherence in Asian Americans. The purpose of this article is to synthesize existing research on interventions that might contribute to improved adherence to psychotropic medication among psychiatric patients of Asian descent. Searches of PubMed and PsycINFO for relevant articles published between 1960 and October 2010 yielded 1,520 potentially relevant studies. Nine intervention studies met the inclusion criteria for this systematic review. Most successful interventions used variations on psychoeducation that included both patients and family caregivers. Even in the absence of significant changes to adherence, patients often showed clinical improvement. Improvements in knowledge and attitude among patients and family caregivers coincided with clinical improvement. Findings highlight the effects of caregiver and patient causal beliefs on adherence outcome. Implications for adherence to psychotropic medication interventions among Asian Americans are discussed.

Perceived discrimination and psychotic experiences across multiple ethnic groups in the United States

Oh, H., Yang, L. H., Anglin, D. M., & DeVylder, J. E. (n.d.).

Publication year

2014

Journal title

Schizophrenia Research

Volume

157

Issue

1

Page(s)

259-265

10.1016/j.schres.2014.04.036

Abstract

Abstract

Objective: The objective of this study was to examine the relationship between perceived discrimination and psychotic experiences (PE) using validated measures of discrimination and a racially/ethnically diverse population-level sample. Methods: Data were drawn from two population-level surveys (The National Latino and Asian American Survey and The National Survey of American Life), which were analyzed together using survey weights and stratification variables. The analytic sample (N= 8990) consisted of Latino, Asian, African-American, and Afro-Caribbean adults living in the United States. Separate unadjusted and adjusted multivariable logistic regression models were used, first to examine the crude bivariate relationship between perceived discrimination and PE, and second to examine the relationship adjusting for demographic variables. Adjusted logistic regression models were also used to examine the relationships between perceived discrimination and specific sub-types of PE (auditory and visual hallucinatory experiences, and delusional ideation). Results: When compared to individuals who did not report any discrimination, those who reported the highest levels of discrimination were significantly more likely to report both 12-month PE (Adjusted OR. = . 4.590, p<. 0.001) and lifetime PE (adjusted OR. = . 4.270, p<. 0.001). This held true for visual hallucinatory experiences (adjusted OR. = . 3.745, p<. 0.001), auditory hallucinatory experiences (adjusted OR. = . 5.649, p<. 0.001), and delusional ideation (adjusted OR. = . 7.208, p<. 0.001). Conclusion: Perceived discrimination is associated with the increased probability of reporting psychotic experiences in a linear Fashion in the US general population.

Recent advances in cross-cultural measurement in psychiatric epidemiology: Utilizing 'what matters most' to identify culture-specific aspects of stigma

Yang, L. H., Thornicroft, G., Alvarado, R., Vega, E., & Link, B. G. (n.d.).

Publication year

2014

Journal title

International Journal of Epidemiology

Volume

43

Issue

2

Page(s)

494-510

10.1093/ije/dyu039

Abstract

Abstract

Background: While stigma measurement across cultures has assumed growing importance in psychiatric epidemiology, it is unknown to what extent concepts arising from culture have been incorporated. We utilize a formulation of culture-as the everyday interactions that 'matter most' to individuals within a cultural group-to identify culturally-specific stigma dynamics relevant to measurement.Methods: A systematic literature review from January 1990 to September 2012 was conducted using PsycINFO, Medline and Google Scholar to identify articles studying: (i) mental health stigma-related concepts; (ii) ≥1 non-Western European cultural group. From 5292 abstracts, 196 empirical articles were located. Results: The vast majority of studies (77%) utilized adaptations of existing Western-developed stigma measures to new cultural groups. Extremely few studies (2.0%) featured quantitative stigma measures derived within a non-Western European cultural group. A sizeable amount (16.8%) of studies employed qualitative methods to identify culture-specific stigma processes. The 'what matters most' perspective identified cultural ideals of the everyday activities that comprise 'personhood' of 'preserving lineage' among specific Asian groups, 'fighting hard to overcome problems and taking advantage of immigration opportunities' among specific Latino-American groups, and 'establishing trust among religious institutions due to institutional discrimination' among African-American groups. These essential cultural interactions shaped culture-specific stigma manifestations. Mixed method studies (3.6%) corroborated these qualitative results. Conclusion: Quantitatively-derived, culturally-specific stigma measures were lacking. Further, the vast majority of qualitative studies on stigma were conducted without using stigma-specific frameworks. We propose the 'what matters most' approach to address this key issue in future research.

Spontaneous labelling and stigma associated with clinical characteristics of peers 'at-risk' for psychosis

A rasch model to test the cross-cultural validity in the positive and negative syndrome scale (PANSS) across six geo-cultural groups

A theoretical and empirical framework for constructing culture-specific stigma instruments: an application in Chile

Yang, L., Valencia, E., Alvarado, R., Link, B., Huynh, N., Nguyen, K., Morita, K., Saavedra, M., Wong, C., Galea, S., & Susser, E. (n.d.).

Publication year

2013

Journal title

Cadernos de Saude Coletiva

Volume

21

Issue

1

Page(s)

71

Acculturative stress and psychotic-like experiences among Asian and Latino immigrants to the United States