Embarrassment when illness strikes a close relative: a World Mental Health Survey Consortium Multi-Site Study. Issue 10 (October 2013)

• Record Type: Journal Article
• Authors: Ahmedani, B. K.; Kubiak, S. P.; Kessler, R. C.; de Graaf, R.; Alonso, J.; Bruffaerts, R.; Zarkov, Z.; Viana, M. C.; Huang, Y. Q.; Hu, C.; Posada-Villa, J. A.; Lepine, J.-P.; Angermeyer, M. C.; de Girolamo, G.; Karam, A. N.; Medina-Mora, M. E.; Gureje, O.; Ferry, F.; Sagar, R.; Anthony, J. C.
• Is Part Of: Psychological medicine. Volume 43:Issue 10(2013)
• Page Start: 2191
• Page End: 2202
• Publication Date: 2013-10
• Subjects: Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S003329171200298X
• Languages: English
• ISSNs: 0033-2917

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="sec_a1"> <title>Background</title> <p>In this global study we sought to estimate the degree to which a family member might feel embarrassed when a close relative is suffering from an alcohol, drug, or mental health condition (ADMC) <italic>versus</italic> a general medical condition (GMC). To date, most studies have considered embarrassment and stigma in society and internalized by the afflicted individual but have not assessed family embarrassment in a large-scale study.</p> </sec> <sec id="sec_a2" sec-type="methods"> <title>Method</title> <p>In 16 sites of the World Mental Health Surveys (WMHS), standardized assessments were completed including items on family embarrassment. Site matching was used to constrain local socially shared determinants of stigma-related feelings, enabling a conditional logistic regression model that estimates the embarrassment close relatives may hold in relation to family members affected by an ADMC, a GMC, or both conditions.</p> </sec> <sec id="sec_a3" sec-type="results"> <title>Results</title> <p>There was a statistically robust association such that subgroups with an ADMC-affected relative were more likely to feel embarrassed compared to subgroups with a relative affected by a GMC (<italic>p</italic> < 0.001), even with covariate adjustments for age and sex.</p> </sec> <sec id="sec_a4" sec-type="conclusion"> <title>Conclusions</title> <p>The pattern of evidence from this research is consistent with conceptual models for interventions that target individual- and family-level stigma-related feelings of embarrassment as possible obstacles to effective early intervention and treatment for an ADMC. Macro-level interventions are under way but micro-level interventions may also be required among family members, along with care for each person with an ADMC.</p> </sec> </abstract>