How do states as social actors cope with stigma-induced status anxiety? I propose the concept of “stigma shifting” as a way in which status-anxious states overcompensate for their stigma-induced inferiority and reaffirm their place in the world: by seeking identification with higher-status states and differentiation from lower-status states. In identifying with the desired group of states, stigmatized states engage in approval-seeking behavior and reaffirm their in-group status in areas where they feel discredited. In differentiating themselves from the undesired group, stigmatized states engage in distinction-seeking behavior, claiming their superiority over this “lesser” group in areas that gave rise to their status anxiety in the first place. Stigma shifting, in other words, allows a stigmatized state to take the role of a stigmatizer. To demonstrate the concept's depth and analytical utility, I draw on the case of East Asia in three disparate issue areas: colonial redress, nuclear disaster, and international order making. Japan, stigmatized in all three areas, has reaffirmed its status by shifting the stigma onto its significant but “lesser” others: China and Korea. Ultimately, stigma shifting solidifies status hierarchies in the world—not just the hierarchy as represented by the “Western” dominance of international society but also the regional hierarchies of the non-Western world.

Reducing loneliness amongst older people is an international public health and policy priority, with signs of decreasing importance in the UK. A growing body of research on tackling loneliness indicates it is a complex challenge. Most interventions imply they address loneliness, when in fact they offer social connectedness to address social isolation and can inadvertently responsibilise the individual for the causes and solutions for loneliness. This article presents research that explored loneliness in an underprivileged community in South Wales through interviews and focus groups with nineteen older people and eighteen local service providers. Their perspective supports a growing body of evidence that loneliness amongst older people is driven by wider structural and socio-cultural exclusion. Interventions to build social connections will be more effective if coupled with policies that reverse the reduction in public services (including transport and healthcare), and challenge socio-cultural norms, including a culture of self-reliance and ageism.

Jennifer Blumenthal-Barby (2024) has called for bioethics to end talk about personhood, asserting that such talk has the tendency to confuse and offend. It will be argued that this has only limited application for (largely) private settings. However, in other settings, theorizing about personhood leaves a gap in which there is the risk that the offending concept will get uptake elsewhere, and so the problem Blumenthal-Barby nominates may not be completely avoided. In response to this risk, an argument is presented in support of the idea that the role of philosophers and bioethicists, far from ending talk of personhood, ought to be to clarify the concept, and to do so in nuanced ways, given its application for specific kinds of impairments. The case of dementia is used to illustrate this in the context of person-centered care. Ironically, given the stigma attached to dementia, far from the need to end talk of personhood, bioethicists are needed to rescue the concept and clarify its role.

The purpose of this paper is to examine the contours of evolving jurisprudence on offensive expression and negative messages, and to suggest that it can best be understood by reference to the concept of stigma. At the European Court of Human Rights, there appears to have been an increasing willingness to recognise the harm of offensive expression through an interpretation of Article 8 of the European Convention on Human Rights, but the reach of this case law remains uncertain. In particular, while some cases associate negative expression with negative stereotyping, not all of these cases do, and there are potential conflicts with freedom of speech. In the domestic context, these issues recently arose in a significant case from the Court of Appeal, R (Crowter) v Secretary of State for Health and Social Care. In this case, the appellants argued that a legal provision sends a negative ‘message’, through the negative stereotyping of disabled people, but this ‘message’ is implicit, rather than explicitly articulated. While these developments raise important questions about the future evolution of case law, we propose that a focus on stigma can more clearly highlight the harms involved.

Mental health challenges are common following cancer diagnosis, negatively impacting treatment and quality of life for breast cancer (BC) patients. This pilot study provides an understanding of the impacts of BC diagnosis and care experiences on the mental health of patients seen at the Aga Khan University Hospital in Nairobi, Kenya. We conducted 40 in-depth interviews, including 10 women with newly diagnosed BC, 10 women with metastatic BC, 10 family members and 10 healthcare professionals. Data were transcribed, translated into English as needed and coded using Dedoose software. Following BC diagnosis, it was reported that patients faced various physical, social, psychological and spiritual factors affecting their mental health and quality of life. Our interviews with each group indicated that BC patients experienced feelings of stress, anxiety and depression related to treatments and accompanying side effects. Disclosure concerns, financial impacts, relationship strain and negative outlooks on life were common among BC patients. The findings indicate that BC diagnosis and care experiences influence mental health in this population. With this basis, understanding and addressing the mental health challenges of BC patients is crucial to improve mental health and quality of life.

Research on adolescent mental health in low and middle-income countries cites the paucity of human resources and emphasises non-specialist worker (NSW)-led counselling intervention within school and health-system platforms. This pilot study aimed to evaluate the feasibility and acceptability of a transdiagnostic stepped care model, for delivering preventive psychological treatment to adolescents through NSWs in urban vulnerable community settings. Conducted in three such settlements in Mumbai and Thane districts of Maharashtra in India, this mixed-methods study engaged 500 young people, their parents and 52 NSWs.

Quantitative data, obtained through monitoring indicators, fidelity checklists and the Strengths and Difficulties Questionnaire (SDQ), revealed key stressors for adolescents, including poverty, structural inequity, cultural conformity pressures, academic anxieties and communication gap within families. Post-intervention, adolescents exhibited an enhanced capacity for positive emotions and agency. The qualitative component, incorporating observations, focus group discussions (FGDs) and in-depth interviews (IDIs) with various stakeholders, highlighted reduced stigma around mental health, yet identified barriers like time commitment, lack of incentivisation for NSWs, lack of privacy in densely populated communities and societal stigma.

This implementation research underscores that adolescent mental health stressors often originate from social determinants, exacerbated by insufficient awareness and stigma. Such stepped care models offer a pathway for communities to establish enduring support networks.

Prospective university students experience substantial academic stressors and psychological vulnerabilities, yet their mental health literacy (MHL) remains inadequately explored. This study investigates four dimensions of MHL – help-seeking behaviors, stigma, knowledge about mental health and understanding of mental illnesses. Besides, Geographic Information System (GIS) techniques are employed to analyze spatial disparities in MHL, which is the first in the context of MHL research. A total of 1,485 students were assessed for sociodemographic characteristics, admission-related variables, health behaviors and family histories of mental health issues. Data were analyzed using SPSS and ArcGIS software. Multivariable linear regression analyses unveiled predictors of the MHL dimensions, with gender, family income, admission test performance, smoking, alcohol and drug use, physical and mental health history, current depression or anxiety and family history of mental health and suicide incidents emerging as common predictors. GIS analysis unraveled notable regional disparities in MHL, particularly in knowledge of mental health and mental illness, with northern and some southern districts displaying higher literacy levels. In conclusion, these findings accentuate significant gender and sociodemographic inequalities in MHL among prospective university students, highlighting the imperative for targeted interventions to enhance MHL and foster mental well-being in this cohort.

The seminal contributions of Dante Cicchetti to the field/paradigm/metaparadigm of developmental psychopathology (DP) – and its continuing ascendance as a guiding force for multidisciplinary investigation of normative and atypical development – are legion. Our aim is to illustrate a number of DP’s core principles in the context of (a) prospective longitudinal research on children (particularly girls) with attention-deficit hyperactivity disorder and (b) theoretical and empirical work dedicated to alleviating the stigma and discrimination toward those experiencing mental health, substance use, and neurodevelopmental challenges. We feature (i) the mutual interplay of perspectives on normative and non-normative development, (ii) reciprocal and transactional processes, and the constructs of equifinaliy and multifinality; (iii) continuities and discontinuities in developmental processes and outcomes, with particular focus on heterotypic continuity; (iv) the inseparability of heritable and environmental risk; (v) multiple levels of analysis, and (vi) the benefits of qualitative perspectives. We highlight that interventions promoting recovery, along with the multi-level facilitation of protective factors/strengths, lie at the heart of both DP and anti-stigma efforts. The ongoing youth mental-health crisis provides a sobering counterpoint to the gains of the DP enterprise over the past half century.