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Erschienen in: AIDS and Behavior 6/2014

01.06.2014 | Original Paper

Vicious Circle of Perceived Stigma, Enacted Stigma and Depressive Symptoms Among Children Affected by HIV/AIDS in China

verfasst von: Peilian Chi, Xiaoming Li, Junfeng Zhao, Guoxiang Zhao

Erschienen in: AIDS and Behavior | Ausgabe 6/2014

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Abstract

Previous research has found a deleterious impact of stigma on the mental health of children affected by HIV/AIDS. Little is known about the longitudinal relationship of stigma and children’s mental health. This study explores the longitudinal reciprocal effects of depressive symptoms and stigma, specifically enacted stigma and perceived stigma, among children affected by HIV/AIDS aged 6–12. Longitudinal data were collected from 272 children orphaned by AIDS and 249 children of HIV-positive parents in rural China. Cross-lagged panel analysis was conducted in the study. Results showed that the autoregressive effects were stable for depressive symptoms, perceived stigma and enacted stigma suggesting the substantially stable individual differences over time. The cross-lagged effects indicated a vicious circle among the three variables in an order of enacted stigma → depressive symptom → perceived stigma → enacted stigma. The possibility of employing equal constraints on cross-lagged paths suggested that the cross-lagged effects were repeatable over time. The dynamic interplay of enacted stigma, perceived stigma and depressive symptoms suggests the need of a multilevel intervention in stigma reduction programming to promote mental health of children affected by HIV/AIDS.
Literatur
2.
Zurück zum Zitat Chi P, Li X. Impact of parental HIV/AIDS on children’s psychological well-being: a systematic review of global literature. AIDS Behav. 2013;17(7):2554–74.PubMedCrossRef Chi P, Li X. Impact of parental HIV/AIDS on children’s psychological well-being: a systematic review of global literature. AIDS Behav. 2013;17(7):2554–74.PubMedCrossRef
3.
Zurück zum Zitat Crocker J, Major B, Steele R. Social stigma. In: Gilbert DT, Fiske ST, Lindzey G, editors. The handbook of social psychology. New York: McGraw Hill; 1998. p. 504–33. Crocker J, Major B, Steele R. Social stigma. In: Gilbert DT, Fiske ST, Lindzey G, editors. The handbook of social psychology. New York: McGraw Hill; 1998. p. 504–33.
4.
Zurück zum Zitat Goffman E. Stigma: notes on the management of spoiled identity. New York: Simon & Schuster Inc.; 1963. Goffman E. Stigma: notes on the management of spoiled identity. New York: Simon & Schuster Inc.; 1963.
5.
Zurück zum Zitat Steward WT, Herek GM, Ramakrishna J, Bharat S, Chandy S, Wrubel J, et al. HIV-related stigma: adapting a theoretical framework for use in India. Soc Sci Med. 2008;67(8):1225–35.PubMedCentralPubMedCrossRef Steward WT, Herek GM, Ramakrishna J, Bharat S, Chandy S, Wrubel J, et al. HIV-related stigma: adapting a theoretical framework for use in India. Soc Sci Med. 2008;67(8):1225–35.PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Herek GM, Capitanio JP, Widaman KF. HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999. Am J Public Health. 2002;92(3):371–7.PubMedCentralPubMedCrossRef Herek GM, Capitanio JP, Widaman KF. HIV-related stigma and knowledge in the United States: prevalence and trends, 1991–1999. Am J Public Health. 2002;92(3):371–7.PubMedCentralPubMedCrossRef
7.
Zurück zum Zitat Herek GM, Gillis JR, Cogan JC. Internalized stigma among sexual minority adults: insights from a social psychological perspective. J Couns Psychol. 2009;56(1):32.CrossRef Herek GM, Gillis JR, Cogan JC. Internalized stigma among sexual minority adults: insights from a social psychological perspective. J Couns Psychol. 2009;56(1):32.CrossRef
8.
Zurück zum Zitat Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13–24.PubMedCrossRef Parker R, Aggleton P. HIV and AIDS-related stigma and discrimination: a conceptual framework and implications for action. Soc Sci Med. 2003;57(1):13–24.PubMedCrossRef
9.
Zurück zum Zitat Brown L, Macintyre K, Trujillo L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15(1):49–69.PubMedCrossRef Brown L, Macintyre K, Trujillo L. Interventions to reduce HIV/AIDS stigma: what have we learned? AIDS Educ Prev. 2003;15(1):49–69.PubMedCrossRef
10.
Zurück zum Zitat Campbell C, Skovdal M, Mupambireyi Z, Madanhire C, Robertson L, Nyamukapa CA, et al. Can AIDS stigma be reduced to poverty stigma? exploring Zimbabwean children’s representations of poverty and AIDS. Child Care Health Dev. 2012;38(5):732–42.PubMedCrossRef Campbell C, Skovdal M, Mupambireyi Z, Madanhire C, Robertson L, Nyamukapa CA, et al. Can AIDS stigma be reduced to poverty stigma? exploring Zimbabwean children’s representations of poverty and AIDS. Child Care Health Dev. 2012;38(5):732–42.PubMedCrossRef
11.
Zurück zum Zitat Gausset Q, Mogensen HO, Yameogo WME, Berthé A, Konaté B. The ambivalence of stigma and the double-edged sword of HIV/AIDS intervention in Burkina Faso. Soc Sci Med. 2012;74(7):1037–44.PubMedCrossRef Gausset Q, Mogensen HO, Yameogo WME, Berthé A, Konaté B. The ambivalence of stigma and the double-edged sword of HIV/AIDS intervention in Burkina Faso. Soc Sci Med. 2012;74(7):1037–44.PubMedCrossRef
12.
Zurück zum Zitat Logie C, Gadalla T. Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care. 2009;21(6):742–53.PubMedCrossRef Logie C, Gadalla T. Meta-analysis of health and demographic correlates of stigma towards people living with HIV. AIDS Care. 2009;21(6):742–53.PubMedCrossRef
13.
Zurück zum Zitat Mak WWS, Poon CYM, Pun LYK, Cheung SF. Meta-analysis of stigma and mental health. Soc Sci Med. 2007;65(2):245–61.PubMedCrossRef Mak WWS, Poon CYM, Pun LYK, Cheung SF. Meta-analysis of stigma and mental health. Soc Sci Med. 2007;65(2):245–61.PubMedCrossRef
14.
Zurück zum Zitat Surkan PJ, Mukherjee JS, Williams DR, Eustache E, Louis E, Jean-Paul T, et al. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti. AIDS Care. 2010;22(7):803–15.PubMedCentralPubMedCrossRef Surkan PJ, Mukherjee JS, Williams DR, Eustache E, Louis E, Jean-Paul T, et al. Perceived discrimination and stigma toward children affected by HIV/AIDS and their HIV-positive caregivers in central Haiti. AIDS Care. 2010;22(7):803–15.PubMedCentralPubMedCrossRef
15.
Zurück zum Zitat Nyamukapa CA, Gregson S, Wambe M, Mushore P, Lopman B, Mupambireyi Z, et al. Causes and consequences of psychological distress among orphans in eastern Zimbabwe. AIDS Care. 2010;22(8):988–96.PubMedCentralPubMedCrossRef Nyamukapa CA, Gregson S, Wambe M, Mushore P, Lopman B, Mupambireyi Z, et al. Causes and consequences of psychological distress among orphans in eastern Zimbabwe. AIDS Care. 2010;22(8):988–96.PubMedCentralPubMedCrossRef
16.
Zurück zum Zitat Zhao J, Li X, Fang X, Hong Y, Zhao G, Lin X, et al. Stigma Against Children Affected by AIDS (SACAA): psychometric evaluation of a brief measurement scale. AIDS Behav. 2010;14(6):1302–12.PubMedCrossRef Zhao J, Li X, Fang X, Hong Y, Zhao G, Lin X, et al. Stigma Against Children Affected by AIDS (SACAA): psychometric evaluation of a brief measurement scale. AIDS Behav. 2010;14(6):1302–12.PubMedCrossRef
17.
Zurück zum Zitat Boyes ME, Cluver LD. Relationships among HIV/AIDS orphanhood, stigma, and symptoms of anxiety and depression in south african youth a longitudinal investigation using a path analysis framework. Clin Psychol Sci. 2013;1(3):323–30.CrossRef Boyes ME, Cluver LD. Relationships among HIV/AIDS orphanhood, stigma, and symptoms of anxiety and depression in south african youth a longitudinal investigation using a path analysis framework. Clin Psychol Sci. 2013;1(3):323–30.CrossRef
18.
Zurück zum Zitat Cluver LD, Orkin M. Cumulative risk and AIDS-orphanhood: interactions of stigma, bullying and poverty on child mental health in South Africa. Soc Sci Med. 2009;69(8):1186–93.PubMedCrossRef Cluver LD, Orkin M. Cumulative risk and AIDS-orphanhood: interactions of stigma, bullying and poverty on child mental health in South Africa. Soc Sci Med. 2009;69(8):1186–93.PubMedCrossRef
19.
Zurück zum Zitat Lin X, Zhao G, Li X, Stanton B, Zhang L, Hong Y, et al. Perceived HIV stigma among children in a high HIV-prevalence area in central China: beyond the parental HIV-related illness and death. AIDS Care. 2010;22(5):545–55.PubMedCentralPubMedCrossRef Lin X, Zhao G, Li X, Stanton B, Zhang L, Hong Y, et al. Perceived HIV stigma among children in a high HIV-prevalence area in central China: beyond the parental HIV-related illness and death. AIDS Care. 2010;22(5):545–55.PubMedCentralPubMedCrossRef
20.
Zurück zum Zitat Zhao G, Li X, Zhao J, Zhang L, Stanton B. Relative importance of various measures of HIV-related stigma in predicting psychological outcomes among children affected by HIV. Community Ment Health J. 2012;48(3):275–83 Epub 2011/06/18.PubMedCentralPubMedCrossRef Zhao G, Li X, Zhao J, Zhang L, Stanton B. Relative importance of various measures of HIV-related stigma in predicting psychological outcomes among children affected by HIV. Community Ment Health J. 2012;48(3):275–83 Epub 2011/06/18.PubMedCentralPubMedCrossRef
21.
Zurück zum Zitat Scambler G. Epilepsy. London: Routledge; 1989. Scambler G. Epilepsy. London: Routledge; 1989.
22.
Zurück zum Zitat Liamputtong P, Haritavorn N, Kiatying-Angsulee N. HIV and AIDS, stigma and AIDS support groups: perspectives from women living with HIV and AIDS in central Thailand. Soc Sci Med. 2009;69(6):862–8.PubMedCrossRef Liamputtong P, Haritavorn N, Kiatying-Angsulee N. HIV and AIDS, stigma and AIDS support groups: perspectives from women living with HIV and AIDS in central Thailand. Soc Sci Med. 2009;69(6):862–8.PubMedCrossRef
23.
Zurück zum Zitat Letteney S, LaPorte HH. Deconstructing stigma: perceptions of HIV-seropositive mothers and their disclosure to children. Soc Work Health Care. 2004;38(3):105–23.PubMedCrossRef Letteney S, LaPorte HH. Deconstructing stigma: perceptions of HIV-seropositive mothers and their disclosure to children. Soc Work Health Care. 2004;38(3):105–23.PubMedCrossRef
24.
Zurück zum Zitat Maman S, Abler L, Parker L, Lane T, Chirowodza A, Ntogwisangu J, et al. A comparison of HIV stigma and discrimination in five international sites: the influence of care and treatment resources in high prevalence settings. Soc Sci Med. 2009;68(12):2271–8.PubMedCentralPubMedCrossRef Maman S, Abler L, Parker L, Lane T, Chirowodza A, Ntogwisangu J, et al. A comparison of HIV stigma and discrimination in five international sites: the influence of care and treatment resources in high prevalence settings. Soc Sci Med. 2009;68(12):2271–8.PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS Care. 2008;20(10):1266–75.PubMedCrossRef Smith R, Rossetto K, Peterson BL. A meta-analysis of disclosure of one’s HIV-positive status, stigma and social support. AIDS Care. 2008;20(10):1266–75.PubMedCrossRef
26.
Zurück zum Zitat Uys L, Chirwa M, Kohi T, Greeff M, Naidoo J, Makoae L, et al. Evaluation of a health setting-based stigma intervention in five African countries. AIDS Patient Care and STDS. 2009;23(12):1059–66.PubMedCentralPubMedCrossRef Uys L, Chirwa M, Kohi T, Greeff M, Naidoo J, Makoae L, et al. Evaluation of a health setting-based stigma intervention in five African countries. AIDS Patient Care and STDS. 2009;23(12):1059–66.PubMedCentralPubMedCrossRef
27.
Zurück zum Zitat Whetten K, Ostermann J, Whetten RA, Pence BW, O’Donnell K, Messer LC, et al. A comparison of the wellbeing of orphans and abandoned children Ages 6–12 in institutional and community-based care settings in 5 less wealthy nations. PLoS One. 2009;4(12):e8169.PubMedCentralPubMedCrossRef Whetten K, Ostermann J, Whetten RA, Pence BW, O’Donnell K, Messer LC, et al. A comparison of the wellbeing of orphans and abandoned children Ages 6–12 in institutional and community-based care settings in 5 less wealthy nations. PLoS One. 2009;4(12):e8169.PubMedCentralPubMedCrossRef
28.
Zurück zum Zitat Li L, Lee SJ, Thammawijaya P, Jiraphongsa C, Rotheram-Borus MJ. Stigma, social support, and depression among people living with HIV in Thailand. AIDS Care. 2009;21(8):1007–13.PubMedCentralPubMedCrossRef Li L, Lee SJ, Thammawijaya P, Jiraphongsa C, Rotheram-Borus MJ. Stigma, social support, and depression among people living with HIV in Thailand. AIDS Care. 2009;21(8):1007–13.PubMedCentralPubMedCrossRef
29.
Zurück zum Zitat Simbayi LC, Kalichman S, Strebel A, Cloete A, Henda N, Mqeketo A. Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town South Africa. Soc Sci Med. 2007;64(9):1823–31.PubMedCrossRef Simbayi LC, Kalichman S, Strebel A, Cloete A, Henda N, Mqeketo A. Internalized stigma, discrimination, and depression among men and women living with HIV/AIDS in Cape Town South Africa. Soc Sci Med. 2007;64(9):1823–31.PubMedCrossRef
30.
Zurück zum Zitat He Z, Ji C. Nutritional status, psychological well-being and the quality of life of AIDS orphans in rural Henan Province China. Trop Med Int Health. 2007;12(10):1180–90.PubMedCrossRef He Z, Ji C. Nutritional status, psychological well-being and the quality of life of AIDS orphans in rural Henan Province China. Trop Med Int Health. 2007;12(10):1180–90.PubMedCrossRef
31.
Zurück zum Zitat West A, Wedgwood K. Children affected by AIDS, orphans and impact mitigation in China. In: Kaufman J, Kleinman A, Saich T, editors. AIDS and social policy in China. Cambridge: Harvard University Asia Center; 2006. p. 243–64. West A, Wedgwood K. Children affected by AIDS, orphans and impact mitigation in China. In: Kaufman J, Kleinman A, Saich T, editors. AIDS and social policy in China. Cambridge: Harvard University Asia Center; 2006. p. 243–64.
32.
Zurück zum Zitat UNAIDS, UNICEF, USAID. Children on the brink 2004: A joint report of new orphan, estimates and a framework for Action. New York: 2004. UNAIDS, UNICEF, USAID. Children on the brink 2004: A joint report of new orphan, estimates and a framework for Action. New York: 2004.
33.
Zurück zum Zitat Xu T, Yan Z, Duan S, Wang C, Rou K, Wu Z. Psychosocial well-being of children in HIV/AIDS-affected families in southwest China: a qualitative study. J Child Fam Stud. 2009;18(1):21–30.CrossRef Xu T, Yan Z, Duan S, Wang C, Rou K, Wu Z. Psychosocial well-being of children in HIV/AIDS-affected families in southwest China: a qualitative study. J Child Fam Stud. 2009;18(1):21–30.CrossRef
34.
Zurück zum Zitat Li X, Barnett D, Fang X, Lin X, Zhao G, Zhao J, et al. Lifetime incidence of traumatic events and mental health among children affected by HIV/AIDS in rural China. J Clin Child Adolesc Psychol. 2009;38(5):731–44.PubMedCrossRef Li X, Barnett D, Fang X, Lin X, Zhao G, Zhao J, et al. Lifetime incidence of traumatic events and mental health among children affected by HIV/AIDS in rural China. J Clin Child Adolesc Psychol. 2009;38(5):731–44.PubMedCrossRef
35.
Zurück zum Zitat Dowdney L. Annotation: childhood bereavement following parental death. J Child Psychol Psychiatry. 2000;41(7):819–30.PubMedCrossRef Dowdney L. Annotation: childhood bereavement following parental death. J Child Psychol Psychiatry. 2000;41(7):819–30.PubMedCrossRef
36.
Zurück zum Zitat Fendrich M, Wessiman MM, Warner V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Am J Epidemiol. 1990;131(3):538–51.PubMed Fendrich M, Wessiman MM, Warner V. Screening for depressive disorder in children and adolescents: validating the Center for Epidemiologic Studies Depression Scale for Children. Am J Epidemiol. 1990;131(3):538–51.PubMed
37.
Zurück zum Zitat Wang X. Rating scales for mental health (Chinese Journal of Mental Health Supplement). Beijing: Chinese Association of Mental Health; 1993. Wang X. Rating scales for mental health (Chinese Journal of Mental Health Supplement). Beijing: Chinese Association of Mental Health; 1993.
38.
Zurück zum Zitat Muthén LK, Muthén BO. Mplus user’s guide: Fifth edition. Los angeles: Author; 2007. Muthén LK, Muthén BO. Mplus user’s guide: Fifth edition. Los angeles: Author; 2007.
39.
Zurück zum Zitat Quintana SM, Maxwell SE. Implications of recent developments in structural equation modeling for counseling psychology. Couns Psychol. 1999;27(4):485–527.CrossRef Quintana SM, Maxwell SE. Implications of recent developments in structural equation modeling for counseling psychology. Couns Psychol. 1999;27(4):485–527.CrossRef
40.
Zurück zum Zitat Mukolo A, Heflinger CA, Wallston KA. The stigma of childhood mental disorders: a conceptual framework. J Am Acad Child Adolesc Psychiatry. 2010;49(2):92–103.PubMedCentralPubMed Mukolo A, Heflinger CA, Wallston KA. The stigma of childhood mental disorders: a conceptual framework. J Am Acad Child Adolesc Psychiatry. 2010;49(2):92–103.PubMedCentralPubMed
41.
Zurück zum Zitat Green SE. The impact of stigma on maternal attitudes toward placement of children with disabilities in residential care facilities. Soc Sci Med. 2004;59(4):799–812.PubMedCrossRef Green SE. The impact of stigma on maternal attitudes toward placement of children with disabilities in residential care facilities. Soc Sci Med. 2004;59(4):799–812.PubMedCrossRef
42.
Zurück zum Zitat Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge: Harvard University Press; 1979. Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge: Harvard University Press; 1979.
43.
Zurück zum Zitat Ungar M, Ghazinour M, Richter J. Annual research review: what is resilience within the social ecology of human development? J Child Psychol Psychiatry. 2013;54(4):348–66.PubMedCrossRef Ungar M, Ghazinour M, Richter J. Annual research review: what is resilience within the social ecology of human development? J Child Psychol Psychiatry. 2013;54(4):348–66.PubMedCrossRef
Metadaten
Titel
Vicious Circle of Perceived Stigma, Enacted Stigma and Depressive Symptoms Among Children Affected by HIV/AIDS in China
verfasst von
Peilian Chi
Xiaoming Li
Junfeng Zhao
Guoxiang Zhao
Publikationsdatum
01.06.2014
Verlag
Springer US
Erschienen in
AIDS and Behavior / Ausgabe 6/2014
Print ISSN: 1090-7165
Elektronische ISSN: 1573-3254
DOI
https://doi.org/10.1007/s10461-013-0649-z

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