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Embarrassment when illness strikes a close relative: a World Mental Health Survey Consortium Multi-Site Study

Published online by Cambridge University Press:  09 January 2013

B. K. Ahmedani ,
S. P. Kubiak ,
R. C. Kessler ,
R. de Graaf ,
J. Alonso ,
R. Bruffaerts ,
Z. Zarkov ,
M. C. Viana ,
Y. Q. Huang  and
C. Hu
...Show all authors
B. K. Ahmedani*
Affiliation:
Center for Health Policy and Health Services Research, Henry Ford Health System, Detroit, MI, USA School of Social Work, Michigan State University, East Lansing, MI, USA
S. P. Kubiak
Affiliation:
School of Social Work, Michigan State University, East Lansing, MI, USA
R. C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
R. de Graaf
Affiliation:
Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
J. Alonso
Affiliation:
IMIM-Institut de Recerca Hospital del Mar, Parc de Salut Mar and Pompeu Fabra University (UPF), Barcelona, Spain
R. Bruffaerts
Affiliation:
Universitair Psychiatrisch Centrum, Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
Z. Zarkov
Affiliation:
Bulgaria National Center for Public Health and Analyses, Sofia, Bulgaria
M. C. Viana
Affiliation:
Department of Social Medicine, Federal University of Espírito Santo (UFES), Vitória, Espírito Santo, Brazil
Y. Q. Huang
Affiliation:
Institute of Mental Health, Peking University, Beijing, PR China
C. Hu
Affiliation:
Shenzhen Institute of Mental Health and Shenzhen Kangning Hospital, Shenzhen, PR China
J. A. Posada-Villa
Affiliation:
Pontificia Universidad Javeriana, Instituto Columbiano Del Sistema Nervioso – Clinica Montserrat, Bogotá DC, Colombia
J.-P. Lepine
Affiliation:
Hôpital Lariboisière Fernand Widal, Assistance Publique Hôpitaux de Paris, France
M. C. Angermeyer
Affiliation:
Center for Public Mental Health, Gösing, Austria
G. de Girolamo
Affiliation:
IRCCS Centro S. Giovanni di Dio Fatebenefratelli, Brescia, Italy
A. N. Karam
Affiliation:
Department of Psychiatry and Clinical Psychology, Saint George Hospital University Medical Center, Balamand University Medical School, Beirut, Lebanon
M. E. Medina-Mora
Affiliation:
National Institute of Psychiatry, Mexico City, Mexico
O. Gureje
Affiliation:
WHO Collaborating Centre of Research and Training in Mental Health, Neurosciences, and Substance Abuse and Department of Psychiatry, University of Ibadan, Nigeria
F. Ferry
Affiliation:
School of Psychology, University of Ulster, Londonderry, UK
R. Sagar
Affiliation:
Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
J. C. Anthony
Affiliation:
Department of Epidemiology, Michigan State University, East Lansing, MI, USA
*
*Address for correspondence: B. K. Ahmedani, Ph.D., Center for Health Policy and Health Services Research, Henry Ford Health System, One Ford Place, Suite 3A, Detroit, MI 48202, USA. (Email: bahmeda1@hfhs.org)
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Abstract

Background

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) versus 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.

Method

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.

Results

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 (p < 0.001), even with covariate adjustments for age and sex.

Conclusions

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.

Keywords

Family embarrassmentpsychiatric conditionsstigmaWorld Mental Health Surveys
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 10 , October 2013 , pp. 2191 - 2202
Copyright
Copyright © Cambridge University Press 2013 

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