Anti-stigma Intervention for Chinese American Older Adults

Effects Of Anti-Stigma Intervention For Chinese American Older Adults With Mood And Anxiety Disorders

Approximately 50 participants will be enrolled and screened to achieve 45 eligible patients with mood/anxiety disorders to complete a 10 weekly anti-stigma group intervention (ASGI) in addition to several self-report internalized stigma and psychiatric measures.This study will examine changes in internalized stigma and psychiatric symptoms pre- and post-ASGI with 3 months post-intervention follow-up.

Study Overview

• Status: Completed
• Conditions: Mood Disorders; Anxiety Disorders
• Intervention / Treatment: Behavioral: 10 sessions of ASGI

• Study Type: Interventional
• Enrollment (Actual): 16
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • New York
    • New York, New York, United States, 10016
      • New York University School of Medicine

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 55 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Self-reported Chinese heritage;
• 55 years or older
• Mandarin and/or Cantonese speaking and ability to read and/or comprehend spoken Chinese language.
• Currently receiving treatment from a mental health provider at Gouverneur Medical Center Asian Bicultural Clinic (GMC ABC) and willing to continue mental health care through the study.
• Willing to provide release for communication between primary mental health care provider and study staff throughout the study.
• Documented by mental health provider after consent for release of information as having mood and anxiety disorder diagnosis in the past year;
• A willingness to participate in the ASGI with stated availability;
• Able and willing to provide informed consent.

Exclusion Criteria:

• Lifetime psychosis, neurocognitive, or significant neurological disorders;
• Current manic episode;
• Past 6 months of alcohol/substance use disorder;
• Serious safety concerns of suicide or homicide.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Other: Anti-Stigma Group; Complete a 10 weekly anti-stigma group intervention (ASGI) in addition to several self-report internalized stigma and psychiatric measures.

Behavioral: 10 sessions of ASGI; 10-session intervention will occur weekly for 45 minutes per session: psychoeducation about mood and anxiety disorders, focusing on identification of risk factors and biological theory to counter stigma; psychoeducation regarding 'therapeutic modules' (psychotropics and psychotherapy) to treat depression, with an emphasis on the importance of psychiatric treatment adherence, providing behavioral strategies for anticipated and experienced forms of mental illness related work, social, or family discrimination

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Self stigma of mental illness scale	This 40-item self-report scale assesses the extent of patient self-stigma. Items are rated on a 9-point Likert-type scale (1= Strongly Disagree; 9= Strongly Agree). Total score from 1 to 9 (average score) Higher score means worse outcome	23 weeks
Recovery assessment scale	Empowerment will be assessed using the 15-item scale from the Recovery Assessment Scale. This scale measures domains of recovery including 1) personal confidence and hope 2) willingness to ask for help 3) goal and success orientation 4) reliance on others 5) symptom coping. Patients are asked to describe themselves using a 5-point agreement scale (1= strongly disagree, 5= strongly agree) regarding their recovery. Total score from15 to 75 (summed score) Higher score means better outcome	23 weeks
Self-protective Withdrawal and Secrecy scale	Changes in use of self-protective withdrawal and secrecy as a strategy for coping with public stigma will be evaluated using two scales to assess patients' responses to their stigmatized status.; Secrecy subscale: a 5-item Likert-type scale (1=strongly agree, 6=strongly disagree) assessing use of concealment of mental illness.Total score: 5 to 30 (summed score); Withdrawal subscale consists of 7 items (1=strongly agree, 6=strongly disagree) assessing "limiting social interaction to those who know about and tend to accept one's stigmatized condition". Total score: 6 to 42 (average score). For the overall scale, summed score will be used. Higher score means better outcome	23 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Changes in social support	The subjective support and social interaction subscales from the Abbreviated Duke Social Support Scale (ADSSS) will be used to measure changes in social support. It is an 11-item Likert-type scalewhich has been shown to correlate well with mental and physical health outcomes.; Social interaction sub-scale: patients are asked 4 items to describe their telephone and face-to-face interaction patterns during the past week (1=none, 2=1-2 people, 3=more than 2 people).Total score: 4 to 12 (summed score ).; Satisfaction with social support sub-scale: they are asked to respond to 7 questions such as "Does it seem that your family and friends understand you most of the time, some of the time, or hardly ever?" (1=hardly ever, 2=some of the time, 3=most of the time). Total score: 7 to 21 (summed score) For the overall scale, total score from 11 to 33 (summed score of two subscales). A higher score means better outcome	23 weeks
Changes in patient depressive symptoms measured by Patient Health Questionnaire-9 (PHQ-9)	The Patient Health Questionnaire-9 (PHQ-9) is a 9-item interview assessing depressive symptoms which is a reliable and valid measure of depression severity (0=not at all, 1=several days, 2=more than half the days, 3=nearly everyday). Total score: 27 (summed score). A higher score means worse outcome	23 weeks
Changes in patient anxiety symptoms associated with stigma reduction	The Generalized Anxiety Disorder 7-item Scale (GAD-7) is a 7-item interview assessing anxiety symptoms (0=not at all, 1=several days, 2=more than half the days, 3=nearly everyday). Total score: 21 (summed score will be used). A higher score means worse outcome	23 weeks

Collaborators and Investigators

• Sponsor: NYU Langone Health
• Collaborators: Substance Abuse and Mental Health Services Administration (SAMHSA)

Study record dates

Study Major Dates

• Study Start (Actual): August 19, 2019
• Primary Completion (Actual): March 13, 2020
• Study Completion (Actual): March 13, 2020

Study Registration Dates

• First Submitted: January 25, 2019
• First Submitted That Met QC Criteria: January 25, 2019
• First Posted (Actual): January 29, 2019

Study Record Updates

• Last Update Posted (Actual): May 20, 2020
• Last Update Submitted That Met QC Criteria: May 19, 2020
• Last Verified: May 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Disease; Anxiety Disorders; Mood Disorders
• Other Study ID Numbers: 18-01236

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No