Stigma Associated with PTSD: Perceptions of Treatment Seeking Combat Veterans
Abstract
OBJECTIVE: Although stigma associated with serious mental illness, substance abuse disorders, and depression has been studied very little is known about stigma associated with Posttraumatic Stress Disorder (PTSD). This study explored stigma related to PTSD among treatment-seeking Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) combat veterans. METHOD: Sixteen treatment-seeking OEF/OIF veterans with combat-related PTSD participated in focus groups. We used qualitative methods to explore PTSD-related stigma. RESULTS: Common perceived stereotypes of treatment-seeking veterans with PTSD included labels such as "dangerous/violent," or "crazy," and a belief that combat veterans are responsible for having PTSD. Most participants reported avoiding treatment early on to circumvent a label of mental illness. Participants initially reported experiencing some degree of self-stigma; however, following engagement in treatment they predominantly resisted these stereotypes. Although most participants considered combat-related PTSD as less stigmatizing than other mental illnesses, they reported difficulties with reintegration. Such challenges likely stem from both PTSD symptoms and veterans' perceptions of how the public views them. Most reported that fellow combat veterans best understood them. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Awareness of public stereotypes impacts help seeking at least early in the course of illness. Peer-based outreach and therapy groups may help veterans engage in treatment early and resist stigma.
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Coding by consensus is most consistently used as a measure of reliability in qualitative data analysis in the mental health services area.
““Coding by consensus” in this way by regularly meeting to discuss procedures for assigning codes to segments of data and resolving differences in coding procedures is most consistently used as a measure of reliability in qualitative data analysis in the mental health services area [52,53,54].”
From A Qualitative Study of Participant Feedback on an Acceptance and Commitment Therapy Group-Based Intervention for Parents of Youth with Anxiety Disorders. (2026) · cites this paper as [53]
Cites
Basics of Qualitative Research: Grounded Theory Procedures and Techniques.
Ellis, C., Strauss, A., & Corbin, J. M. (1992) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2074814 · Cited by 29,279 · see citing works
Qualitative Interviewing: The Art of Hearing Data
Brooks, F. B., Rubin, H. J., & Rubin, I. S. (1996) · Modern Language Journal · doi:10.2307/329757 · Cited by 11,122 · see citing works
Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care
Hoge, C. W., Castro, C. A., Messer, S. C., McGurk, D., Cotting, D. I., & Koffman, R. L. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa040603 · Cited by 4,778 · see citing works
The Paradox of Self-Stigma and Mental Illness
Corrigan, P. W., & Watson, A. C. (2002) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.9.1.35 · Cited by 1,919 · see citing works
Codebook Development for Team-Based Qualitative Analysis
MacQueen, K. M., McLellan, E., Kay, K., & Milstein, B. (1998) · CAM Journal · doi:10.1177/1525822x980100020301 · Cited by 1,675 · see citing works
Milliken, C. S., Auchterlonie, J. L., & Hoge, C. W. (2007) · JAMA · doi:10.1001/jama.298.18.2141 · Cited by 1,640 · see citing works
Stigmatisation of people with mental illnesses
Crisp, A. H., Gelder, M. G., Rix, S., Meltzer, H. I., & Rowlands, O. J. (2000) · British Journal of Psychiatry · doi:10.1192/bjp.177.1.4 · Cited by 1,457 · see citing works
The self–stigma of mental illness: implications for self–esteem and self–efficacy
Corrigan, P. W., Watson, A. C., & Barr, L. (2006) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2006.25.8.875 · Cited by 1,406 · see citing works
Self-citationPescosolido, B. A., Martin, J. K., Long, J. S., Medina, T. R., Phelan, J. C., & Link, B. G. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.09121743 · Cited by 1,262 · see citing works
Mental health consumers' experience of stigma.
Wahl, O. F. (1999) · Schizophrenia bulletin · doi:10.1093/oxfordjournals.schbul.a033394 · Cited by 1,009 · see citing works
Self-Stigma in People With Mental Illness
Watson, A. C., Corrigan, P. W., Larson, J. E., & Sells, M. (2006) · Schizophrenia Bulletin · doi:10.1093/schbul/sbl076 · Cited by 688 · see citing works
The Stigma of Mental Health Problems in the Military
Greene‐Shortridge, T. M., Britt, T. W., & Castro, C. A. (2007) · Military Medicine · doi:10.7205/milmed.172.2.157 · Cited by 455 · see citing works
Crisp, A. H., Gelder, M., Goddard, E., & Meltzer, H. (2005) · PubMed Central · Cited by 357 · see citing works
The Impact of Mental Illness Stigma.
Corrigan, P. W., & Kleinlein, P. (2005) · American Psychological Association eBooks · doi:10.1037/10887-001 · Cited by 340 · see citing works
Kim, P., Thomas, J. L., Wilk, J. E., Castro, C. A., & Hoge, C. W. (2010) · Psychiatric Services · doi:10.1176/ps.2010.61.6.582 · Cited by 312 · see citing works
Reavley, N. J., & Jorm, A. F. (2011) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048674.2011.621061 · Cited by 298 · see citing works
Self-stigma of people with schizophrenia as predictor of their adherence to psychosocial treatment.
Fung, K. M. T., Tsang, H. W. H., & Corrigan, P. W. (2008) · Psychiatric Rehabilitation Journal · doi:10.2975/32.2.2008.95.104 · Cited by 244 · see citing works
Mental Disorders and Access to Medical Care in the United States
Druss, B. G., & Rosenheck, R. A. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.12.1775 · Cited by 211 · see citing works
Target-Specific Stigma Change: A Strategy for Impacting Mental Illness Stigma.
Corrigan, P. W. (2004) · Psychiatric Rehabilitation Journal · doi:10.2975/28.2004.113.121 · Cited by 187 · see citing works
Greden, J. F., Valenstein, M. M., Spinner, J., Blow, A. J., Gorman, L. A., Dalack, G. W., Marcus, S. M., & Kees, M. R. (2010) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2010.05719.x · Cited by 175 · see citing works
Sources of burdens on families of individuals with mental illness
Tsang, H. W. H., Tam, P. K. C., Chan, F. H., & Chang, W. M. (2003) · International Journal of Rehabilitation Research · doi:10.1097/00004356-200306000-00007 · Cited by 124 · see citing works
Anticipated and experienced stigma among people with schizophrenia: its nature and correlates
Cechnicki, A., Angermeyer, M. C., & Bielańska, A. (2010) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-010-0230-2 · Cited by 98 · see citing works
Police responses to persons with mental illness: does the label matter?
Watson, A. C., Corrigan, P. W., & Ottati, V. (2004) · PubMed · Cited by 93 · see citing works
Knowledge of and Stigma Associated With Mental Disorders in a South African Community Sample
Sorsdahl, K. R., & Stein, D. J. (2010) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181f4b2d7 · Cited by 87 · see citing works
Yen, C., Chen, C., Lee, Y., Tang, T., Ko, C., & Yen, J. (2009) · Depression and Anxiety · doi:10.1002/da.20413 · Cited by 72 · see citing works
Björkman, T., Svensson, B., & Lundberg, B. (2007) · Nordic Journal of Psychiatry · doi:10.1080/08039480701642961 · Cited by 53 · see citing works
Stigma and Substance Use Disorders.
Rasinski, K. A., Woll, P., & Cooke, A. (2005) · American Psychological Association eBooks · doi:10.1037/10887-010 · Cited by 35 · see citing works
Flagged first, then by citations
Cited by
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Qualitative Methods in Mental Health Services Research
Palinkas, L. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.910791 · Cited by 327 · see citing works
“, 2013) and convenience sampling (Mittal et al., 2013) or both (Stergiopoulos et al.”
BackgroundInfluentialTrauma-Informed Computing: Towards Safer Technology Experiences for All
Chen, J. X., McDonald, A., Zou, Y., Tseng, E., Roundy, K., Tamersoy, A., Schaub, F., Ristenpart, T., & Dell, N. L. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3517475 · Cited by 169 · see citing works
“There are deep cultural and social stigmas around discussing trauma and mental health [119].”
BackgroundZulman, D. M., Wong, E. P., Slightam, C. A., Gregory, A., Jacobs, J., Kimerling, R. E., Blonigen, D. M., Peters, J., & Heyworth, L. K. (2019) · JAMIA Open · doi:10.1093/jamiaopen/ooz024 · Cited by 154 · see citing works
“For patients with mental health conditions, stigma is a particularly challenging obstacle to care.(5) Geographic barriers can exacerbate this problem, and Veterans in”
BackgroundRicciardelli, R., Carleton, R. N., Mooney, T., & Cramm, H. (2020) · Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine · doi:10.1177/1363459318800167 · Cited by 148 · see citing works
“…veterans with combat-related PTSD self-reported being stereotyped by others as “dangerous/ violent,” “crazy,” “cold-hearted,” “unreliable,” “unstable,” “unfit to raise your kids,” “pissed off at the world,” and as personally responsible for developing PTSD (Mittal et al., 2013: 86–90).”
BackgroundColeman, S. J., Stevelink, S. A. M., Hatch, S. L., Denny, J. A., & Greenberg, N. L. (2017) · Psychological Medicine · doi:10.1017/s0033291717000356 · Cited by 152 · see citing works
“(Stecker et al. , 2007; Visco, 2009; Langston et al. , 2010) or currently in treatment (n=5) (Sayer et al. , 2009; Gibbs et al. , 2011; Mittal et al. , 2013; Zinzow et al. , 2013; Murphy et al. , 2014).”
BackgroundMethodInfluentialMilitary service member and veteran reintegration: A critical review and adapted ecological model.
Elnitsky, C., Blevins, C. L., Fisher, M., & Magruder, K. M. (2017) · American Journal of Orthopsychiatry · doi:10.1037/ort0000244 · Cited by 106 · see citing works
“They negatively impact help-seeking among returning MSMVs with combat-related PTSD because of the social stigma (and perhaps self-stigma) related to mental health (Mittal et al., 2013).”
BackgroundA qualitative study: experiences of stigma by people with mental health problems
Huggett, C., Birtel, M. D., Awenat, Y. F., Fleming, P., Wilkes, S., Williams, S., & Haddock, G. (2018) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12167 · Cited by 106 · see citing works
“Several qualitative studies have examined mental health stigma (Alvidrez, Snowden & Kaiser, 2008; Easter, 2012; Mestdagh & Hansen, 2014; Mittal et al., 2013).”
BackgroundJacobs, J., Blonigen, D. M., Kimerling, R. E., Slightam, C. A., Gregory, A. J. P., Gurmessa, T., & Zulman, D. M. (2019) · Psychiatric Services · doi:10.1176/appi.ps.201900104 · Cited by 101 · see citing works
Psychological Antecedents of Refugee Integration (PARI)
Echterhoff, G., Hellmann, J. H., Back, M. D., Kärtner, J., Nexhmedin Morina, B., & Hertel, G. (2020) · Perspectives on Psychological Science · doi:10.1177/1745691619898838 · Cited by 100 · see citing works
“Individuals who suffer from mental health problems because of their involvement in war and violence have also been found to be stigmatized and perceived as unpredictable and dangerous by residents (Greene-Shortridge, Britt, & Castro, 2007; Mittal et al., 2013).”
BackgroundSmith, J. R., Workneh, A., & Yaya, S. (2019) · Journal of Traumatic Stress · doi:10.1002/jts.22456 · Cited by 93 · see citing works
Kim, J. E., Dager, S. R., Jeong, H. S., Ma, J., Park, S., Kim, J., Choi, Y., Lee, S. L., Kang, I., Ha, E., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0190630 · Cited by 88 · see citing works
Understanding Barriers to Mental Health Care for Recent War Veterans Through Photovoice
True, G., Rigg, K. K., & Butler, A. E. (2014) · Qualitative Health Research · doi:10.1177/1049732314562894 · Cited by 75 · see citing works
“…low utilization of mental health care by veterans (Blais & Renshaw, 2013; Elbogen et al., 2013; Gorman et al., 2011; Hoge, 2011; Hoge et al., 2014; Mittal et al., 2013; Stecker, Fortney, Hamilton, & Ajzen, 2007; Stecker et al., 2013); photographs and narrative descriptions from veterans in our…”
InfluentialOwen, J. E., Kuhn, E. R., Jaworski, B. K., McGee-Vincent, P. A., Juhasz, K. M., Hoffman, J. E., & Rosen, C. S. (2018) · mHealth · doi:10.21037/mhealth.2018.05.07 · Cited by 67 · see citing works
“com problems, like PTSD, requires weighing the best possible evidence and standards of care (8) with the challenges of providing mental health care across populations (9), including declining funding rates as a proportion of overall health care (10,11), stigma (12), lack of providers (13), and other major barriers to…”
BackgroundNilaweera, D., Phyo, A. Z. Z., Teshale, A. B., Htun, H. L., Wrigglesworth, J., Gurvich, C., Freak-Poli, R., & Ryan, J. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-04716-w · Cited by 66 · see citing works
“It is likely that the stigma associated with mental illness would be a barrier in diagnosing PTSD, particularly within military environments [80].”
BackgroundBenefits and challenges of using service dogs for veterans with posttraumatic stress disorder.
Yarborough, B. J. H., Stumbo, S. P., Yarborough, M. T., Owen‐Smith, A. A., & Green, C. A. (2018) · Psychiatric Rehabilitation Journal · doi:10.1037/prj0000294 · Cited by 63 · see citing works
Fischer, I. C., Shanahan, M. L., Hirsh, A., Stewart, J. C., & Rand, K. L. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.08.063 · Cited by 55 · see citing works
Self-stigma in PTSD: Prevalence and correlates
Bonfils, K. A., Lysaker, P. H., Yanos, P. T., Siegel, A., Leonhardt, B. L., James, A. V., Brustuen, B., Luedtke, B. L., & Davis, L. W. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.04.004 · Cited by 59 · see citing works
Posttraumatic Stress Disorder and Mobile Health: App Investigation and Scoping Literature Review
Rodriguez-Paras, C., Tippey, K., Brown, E., Sasangohar, F., Creech, S., Kum, H.-C., Lawley, M., & Benzer, J. K. (2017) · JMIR mHealth and uHealth · doi:10.2196/mhealth.7318 · Cited by 58 · see citing works
“Cultural factors stem from the societal stigma associated with receiving mental health care [24-26] and may be a particularly important factor in dissuading veterans from seeking care because of the military culture related to mental health care [27].”
BackgroundGrant, S., Colaiaco, B., Motala, A., Shanman, R., Sorbero, M. E. S., & Hempel, S. (2017) · Journal of Trauma & Dissociation · doi:10.1080/15299732.2017.1289493 · Cited by 60 · see citing works
“These advantages may be particularly important given stigma associated with PTSD (Mittal et al., 2013), and the belief held by some patients that talking about their traumatic experiences with a treatment provider would make them feel worse (Ouimette, Brown, & Najavits, 1998).”
BackgroundLi, J., Liang, W., Yuan, B., & Zeng, G. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17124507 · Cited by 55 · see citing works
“Furthermore, it has been found that people with special diseases may internalize negative stereotypes about illness and respond by internalized stigmatization [20].”
BackgroundMueser, K. T., DeTore, N. R., Kredlow, M. A., Bourgeois, M. L., Penn, D. L., & Hintz, K. (2020) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.13102 · Cited by 54 · see citing works
Introducing veteran critical theory
Phillips, G. A., & Lincoln, Y. S. (2017) · International Journal of Qualitative Studies in Education · doi:10.1080/09518398.2017.1309586 · Cited by 50 · see citing works
“Many Americans see veterans as broken or otherwise problematic (Mittal et al., 2013; Montalván, 2011).”
BackgroundAttitudes towards disclosing a mental illness among German soldiers and their comrades
Rüsch, N., Rosé, C. P., Holzhausen, F., Mulfinger, N., Krumm, S., Corrigan, P. W., Willmund, G., & Zimmermann, P. L. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.08.028 · Cited by 46 · see citing works
“Stigma may be particularly salient in the military environment as common stereotypes include dangerousness, perceptions that SWMIs are to be blamed for their illness (Mittal et al., 2013), and loss of credibility or trustworthiness (Fertout et al.”
BackgroundJacob, L., Haro, J. M., & Koyanagi, A. (2018) · Journal of Affective Disorders · doi:10.1016/j.jad.2018.02.063 · Cited by 42 · see citing works
Campbell, D. G., Bonner, L. M., Bolkan, C. R., Lanto, A. B., Zivin, K., Waltz, T. J., Klap, R. S., Rubenstein, L. V., & Chaney, E. F. (2016) · Annals of Behavioral Medicine · doi:10.1007/s12160-016-9780-1 · Cited by 38 · see citing works
“Stigma related to mental health concerns clearly exists in these populations even though, as presented earlier, the evidence is mixed regarding stigma's function as a treatment barrier (28-32,35,38,40,41).”
BackgroundInfluentialSadeghi, M., McDonald, A. D., & Sasangohar, F. (2022) · PLoS ONE · doi:10.1371/journal.pone.0267749 · Cited by 39 · see citing works
“PTSD is typically managed by a combination of therapeutic and pharmaceutical treatments, although many cases go undiagnosed or untreated potentially due to mental illness stigma and care shortages [12].”
BackgroundClary, K. L., Pena, S., & Smith, D. C. (2021) · Current Psychology · doi:10.1007/s12144-021-01768-7 · Cited by 39 · see citing works
“…post-deployment challenges and barriers to accessing care (Cornish et al., 2014), OEF and OIF treatment seeking veteran’s with PTSD from combat (Mittal et al., 2013), positive factors that influence United Kingdom military personnel with PTSD in seeking appropriate care (Murphy et al.,…”
BackgroundMelchior, H., Hüsing, P., Grundmann, J., Lotzin, A., Hiller, P., Pan, Y., Drießen, M., Scherbaum, N., Schneider, B., Hillemacher, T., et al. (2019) · European Addiction Research · doi:10.1159/000496113 · Cited by 41 · see citing works
United States Air Force Academy Cadets' Perceived Costs of Concussion Disclosure.
Rawlins, M. L. W., Johnson, B. R., Register-Mihalik, J., DeAngelis, K., Schmidt, J. D., & D'Lauro, C. J. (2019) · Military Medicine · doi:10.1093/milmed/usz162 · Cited by 18 · see citing works
Cramm, H. A., Norris, D., Schwartz, K. D., Tam‐Seto, L., Williams, A., & Mahar, A. L. (2019) · Military Behavioral Health · doi:10.1080/21635781.2019.1644260 · Cited by 36 · see citing works
“Combat veterans fear negative labels such as “dangerous” (Mittal et al., 2013) and being disregarded as different and weak (Warner, Appenzeller, Mullen, Warner, & Grieger, 2008).”
BackgroundCatch 22: The Paradox of Social Media Affordances and Stigmatized Online Support Groups
Yeshua‐Katz, D., & af Segerstad, Y. H. (2020) · Social Media + Society · doi:10.1177/2056305120984476 · Cited by 35 · see citing works
“PTSD. Common stigmas of treatment-seeking veterans of war with PTSD include labels such as violent or crazy; a belief that these individuals are responsible and therefore are blamed for their own PTSD (Mittal et al., 2013); or are un-deserving “frauds” when they seek mental health services and disability benefits from…”
BackgroundInfluentialAcceptability of a brief computerized intervention targeting anxiety sensitivity
Short, N. A., Fuller, K., Norr, A. M., & Schmidt, N. B. (2017) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2016.1232748 · Cited by 33 · see citing works
“We were interested in investigating whether acceptability was similar in veterans versus non-veterans, as they may experience higher levels of stigma that may prevent them from engaging in treatment and evaluating treatments as acceptable (Mittal et al., 2013).”
BackgroundLessard, G., Vincent, C., Gagnon, D. H., Belleville, G., Auger, É., Lavoie, V., Besemann, M., Champagne, N., Dumont, F. S., & Béland, E. (2018) · Mental Health & Prevention · doi:10.1016/j.mhp.2018.01.002 · Cited by 34 · see citing works
The role of suicide stigma in self-disclosure among civilian and veteran populations
Ammerman, B. A., Piccirillo, M. L., O’Loughlin, C. M., Carter, S. P., Matarazzo, B. B., & May, A. M. (2022) · Psychiatry Research · doi:10.1016/j.psychres.2022.114408 · Cited by 33 · see citing works
Blais, R. K., & Renshaw, K. D. (2014) · Military Psychology · doi:10.1037/mil0000036 · Cited by 33 · see citing works
“…in service members who deployed to Iraq or Afghanistan (Blais & Renshaw, 2013), treatment avoidance in VA-enrolled Iraq and Afghanistan veterans (Mittal et al., 2013), and fewer visits to a mental health professional in veterans aged 65 and older (Blais, Tsai, Southwick, & Rebecca K. Blais,…”
BackgroundBrownlow, J. A., Zitnik, G. A., McLean, C. P., & Gehrman, P. (2018) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2018.05.005 · Cited by 33 · see citing works
Roscoe, R. A. (2020) · Health Communication · doi:10.1080/10410236.2020.1754587 · Cited by 33 · see citing works
“In review, several studies demonstrate that both military and public stigma act as a barrier to seeking mental health treatment (Hernandez et al., 2016; Hoge et al., 2006, 2004; Kulesza et al., 2015; Mittal et al., 2013; Roscoe & Anderson, 2019).”
BackgroundResultInfluentialKelly, U. A. (2021) · Nursing Outlook · doi:10.1016/j.outlook.2021.02.002 · Cited by 32 · see citing works
The effects of combat-related mild traumatic brain injury (mTBI)
Kontos, A. P., Elbin, R. J., Kotwal, R. S., Lutz, R. H., Kane, S. F., Benson, P., Forsten, R. D., & Collins, M. W. (2015) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/ta.0000000000000667 · Cited by 31 · see citing works
“, being withheld from active duty/combat), stigma associated with reporting PTS symptoms, and the potential for receiving a PTSD diagnosis.(23) The USASOC personnel may deny or minimize their symptoms to remain active with their units and avoid potential stigma associated with PTS in the military.”
BackgroundStigma and Mental Health Service Utilization in Military Personnel: A Review of the Literature
Μιχαλοπούλου, Λ. Ε., Welsh, J. A., Perkins, D. F., & Ormsby, L. (2016) · Military Behavioral Health · doi:10.1080/21635781.2016.1200504 · Cited by 29 · see citing works
Mental health treatment-related stigma and professional help seeking among student veterans.
Currier, J. M., McDermott, R. C., & McCormick, W. H. (2017) · Psychological Services · doi:10.1037/ser0000129 · Cited by 30 · see citing works
Public attitudes and literacy about posttraumatic stress disorder in U.S. adults
Tsai, J., Shen, J., Southwick, S. M., Greenberg, S., Pluta, A., & Pietrzak, R. H. (2018) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2018.02.002 · Cited by 27 · see citing works
Assessing civilian perceptions of combat veterans: An IAT study.
Schreger, C., & Kimble, M. (2016) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000191 · Cited by 27 · see citing works
“From related literature, we know that bias in general, and discrimination in particular, can result in lost opportunities for housing and work and is known to result in poorer quality health care provision and differential treatment in the criminal justice system (Mittal et al., 2013).”
BackgroundA conceptual framework for a neurophysiological basis of art therapy for PTSD
Malhotra, B., Jones, L. C., Spooner, H., Levy, C. E., Kaimal, G., & Williamson, J. B. (2024) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2024.1351757 · Cited by 26 · see citing works
Marie, L., Taylor, S. E., Basu, N., Fadoir, N. A., Schuler, K. R., McKelvey, D. K., & Smith, P. N. (2019) · Journal of Clinical Psychology · doi:10.1002/jclp.22803 · Cited by 27 · see citing works
Prevalence and correlates of self-stigma in Post-Traumatic Stress Disorder (PTSD)
Lewis, C., Zammit, S., Jones, I. R., & Bisson, J. I. (2022) · European Journal of Psychotraumatology · doi:10.1080/20008198.2022.2087967 · Cited by 24 · see citing works
“Finally, those who internalise the stigma respond with self-esteem decrement and diminished self-e ffi cacy (Berge & Ranney, 2005; Corri-gan et al., 2006; Mills et al., 2020; Mittal et al., 2013).”
BackgroundInfluentialGoetter, E. M., Bui, É., Weiner, T. P., Lakin, L., Furlong, T. E., & Simon, N. M. (2017) · Psychological Services · doi:10.1037/ser0000151 · Cited by 25 · see citing works
Characterizing Social Networks and Communication Channels in a Web-Based Peer Support Intervention
Owen, J. E., Curran, M., Bantum, E. O., & Hanneman, R. A. (2016) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2015.0359 · Cited by 24 · see citing works
Logue, L. M., & Blanck, P. (2018) · Cambridge University Press eBooks · doi:10.1017/9781316459782 · Cited by 24 · see citing works
Othering refugees: Psychotherapists’ attitudes toward patients with and without a refugee background
Dumke, L., & Neuner, F. (2022) · Psychotherapy Research · doi:10.1080/10503307.2022.2150097 · Cited by 24 · see citing works
“, 2003) and research on stigma towards patients with PTSD (Mittal et al., 2013; Sansen et al., 2019).”
BackgroundMethodInfluentialNegative Consequences of Family Caregiving for Veterans With PTSD and Dementia
Pinciotti, C. M., Bass, D. M., McCarthy, C. A., Judge, K. S., WILSON, N. L., Morgan, R. O., Snow, A. L., & Kunik, M. E. (2016) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000560 · Cited by 24 · see citing works
Female Veterans: Navigating Two Identities
Strong, J. D., Crowe, B. M., & Lawson, S. (2017) · Clinical Social Work Journal · doi:10.1007/s10615-017-0636-3 · Cited by 24 · see citing works
Dickinson, S. (2020) · The Journal of Positive Psychology · doi:10.1080/17439760.2020.1752782 · Cited by 24 · see citing works
“For veterans specifically, not wanting to seem weak in the eyes of their peers or be labelled with a mental health disorder has contributed to delaying treatment for processing their trauma, or not seeking help at all (Mittal et al., 2013).”
BackgroundMisra-Hebert, A. D., Santurri, L., DeChant, R., Watts, B., Rothberg, M., Sehgal, A. R., & Aron, D. C. (2015) · Southern Medical Journal · doi:10.14423/smj.0000000000000326 · Cited by 22 · see citing works
Examining the Application of the Opening Minds Survey in the Community Health Centre Setting
van der Maas, M., Stuart, H. L., Patten, S. B., Lentinello, E., Bobbili, S. J., Mann, R. E., Hamilton, H. A., Sapag, J. C., Corrigan, P. W., & Khenti, A. (2017) · The Canadian Journal of Psychiatry · doi:10.1177/0706743717719079 · Cited by 22 · see citing works
Crombach, A., & Siehl, S. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1799-3 · Cited by 22 · see citing works
Biological Psychiatry in Displaced Populations: What We Know, and What We Need to Begin to Learn
Javanbakht, A., & Grasser, L. R. (2022) · Biological Psychiatry Cognitive Neuroscience and Neuroimaging · doi:10.1016/j.bpsc.2022.05.001 · Cited by 24 · see citing works
Monk, J. K., Ruhlmann, L. M., Goff, B. S. N., & Ogolsky, B. G. (2018) · Journal of Family Theory & Review · doi:10.1111/jftr.12280 · Cited by 22 · see citing works
Benedict, T., Singleton, M. D., Nitz, A. J., Shing, T. L., & Kardouni, J. R. (2019) · Military Medicine · doi:10.1093/milmed/usz020 · Cited by 21 · see citing works
Kieckhaefer, J. M., & Luna, S. (2020) · Journal of Experimental Criminology · doi:10.1007/s11292-019-09395-w · Cited by 20 · see citing works
“While veterans may believe they are being stigmatized by people because of their diagnosis (Buelna 2016; Mittal et al. 2013), this label may actually be a benefit in terms of support for their participation in this specialty court.”
BackgroundInfluentialOutcalt, S. D., Hoen, H. M., Yu, Z., Franks, T. M., & Krebs, E. E. (2016) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2014.10.0237 · Cited by 20 · see citing works
Carlozzi, N. E., Lange, R. T., French, L. M., Sander, A. M., Freedman, J., & Brickell, T. A. (2018) · Journal of Head Trauma Rehabilitation · doi:10.1097/htr.0000000000000373 · Cited by 20 · see citing works
Morris, P. A., Albanesi, H. P., & Cassidy, S. P. (2019) · Journal of Veterans Studies · doi:10.21061/jvs.v4i2.102 · Cited by 20 · see citing works
“Despite the evidence in the literature that women are less likely to identify as a veteran, and seek services offered for veterans from the VA or other providers (Washington et al. 2011; Mittal et al., 2013), gender did not emerge as a dominant theme in the open-ended student responses.”
BackgroundPurtle, J., Lynn, K., & Malik, M. (2016) · American Journal of Orthopsychiatry · doi:10.1037/ort0000187 · Cited by 20 · see citing works
“, that people with PTSD are dangerous or weak)—has been identified as a barrier to PTSD treatment seeking among military populations (Kim et al., 2010; Mittal et al., 2013).”
BackgroundTzouvara, V., Papadopoulos, C., & Randhawa, G. (2017) · Issues in Mental Health Nursing · doi:10.1080/01612840.2017.1383540 · Cited by 19 · see citing works
Levin‐Rector, A., Hourani, L. L., Dorn, R. A. V., Bray, R. M., Stander, V. A., Cartwright, J. K., Morgan, J. K., Trudeau, J. V., & Lattimore, P. K. (2018) · Journal of Traumatic Stress · doi:10.1002/jts.22316 · Cited by 21 · see citing works
Boykin, D. M., Keegan, F. S., Thompson, K. E., Voelkel, E. A., Lindsay, J. A., & Fletcher, T. L. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00893 · Cited by 20 · see citing works
“Additional barriers include stigma around seeking mental health care (12) and clinical symptoms such as anxiety (13) that may interfere in seeking PTSD care at the VHA.”
BackgroundPrevalence and correlates of PTSD in first episode psychosis: Findings from the RAISE-ETP study.
DeTore, N. R., Gottlieb, J. D., & Mueser, K. T. (2019) · Psychological Services · doi:10.1037/ser0000380 · Cited by 17 · see citing works
Nieforth, L. O., Rodriguez, K. E., & O’Haire, M. E. (2021) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0001021 · Cited by 20 · see citing works
Holliday, R. P., Rozek, D. C., Smith, N. B., McGarity, S., Jankovsky, M. C., & Monteith, L. L. (2019) · Professional Psychology Research and Practice · doi:10.1037/pro0000239 · Cited by 18 · see citing works
Effects of Perceived Public Regard on the Well-Being of Military Veterans
Markowitz, F. E., Kintzle, S. M., Castro, C. A., & Lancaster, S. L. (2019) · Society and Mental Health · doi:10.1177/2156869319894372 · Cited by 17 · see citing works
“Several studies show how public and self-stigma negatively impact the likelihood of seeking mental health treatment, especially for PTSD (Blais and Renshaw 2013; Held and Owens 2013; McFarling et al. 2011; Mittal et al. 2013).”
BackgroundHaim‐Nachum, S., Lazarov, A., Zabag, R., Martin, A., Bergman, M., Neria, Y., & Amsalem, D. (2024) · European Journal of Psychotraumatology · doi:10.1080/20008066.2024.2370174 · Cited by 18 · see citing works
“Second, the few studies exploring self-stigma associations with trauma-related conditions have predominately focused on veterans (combat-related traumatic events), rather than CM survivors (Bonfils et al., 2018; Harris et al., 2022; Mittal et al., 2013).”
BackgroundSelf-Stigma and Veteran Culture
Harding, S. (2016) · Journal of Transcultural Nursing · doi:10.1177/1043659616676319 · Cited by 17 · see citing works
Tai Chi for Posttraumatic Stress Disorder and Chronic Musculoskeletal Pain: A Pilot Study
Tsai, P., Kitch, S., Chang, J. Y., James, G. A., Dubbert, P. M., Roca, J., & Powers, C. H. (2017) · Journal of Holistic Nursing · doi:10.1177/0898010117697617 · Cited by 14 · see citing works
Bishop, L. S., Benz, M. B., & Reed, K. M. P. (2017) · Professional Psychology Research and Practice · doi:10.1037/pro0000165 · Cited by 14 · see citing works
“…of stigma, which have been identified as an important barrier to treatment seeking behavior and disclosure both among individuals who have survived traumatic experiences (Mittal et al., 2013), and individuals with substance use disorders (Luoma, O’Hair, Kohlenberg, Hayes, & Fletcher, 2010).”
BackgroundInfluentialDrug treatment strategies for insomnia in patients with post-traumatic stress disorder
Akinnusi, M. E., & Solh, A. A. E. (2019) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2019.1574745 · Cited by 14 · see citing works
“with treatment and are reluctant to engage in behavioral treatment for concerns of public stereotypes associatedwith PTSD [16].”
BackgroundRisk and protective factors for wellbeing in older veterans in New Zealand
Yeung, P., Allen, J., Godfrey, H. K., Alpass, F., & Stephens, C. V. (2018) · Aging & Mental Health · doi:10.1080/13607863.2018.1471584 · Cited by 13 · see citing works
“reported that veterans with mental health problems such as depression and combat-related PTSD are reluctant to seek help due to the concern of stigmatisation (Mittal et al., 2013).”
BackgroundUsry, K. (2019) · Political Psychology · doi:10.1111/pops.12589 · Cited by 13 · see citing works
“What Do You Think I Am? Crazy?”: The Joker and Stigmatizing Representations of Mental Ill‐Health
Goodwin, J., & Tajjudin, I. (2016) · The Journal of Popular Culture · doi:10.1111/jpcu.12402 · Cited by 13 · see citing works
Papazoglou, K. O. (2017) · SAGE Open · doi:10.1177/2158244017729407 · Cited by 13 · see citing works
Ray, J. M., Kemp, L., Hubbard, A., & Cucciare, M. A. (2017) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465816000539 · Cited by 12 · see citing works
“Barriers to mental health help seeking include distrust of providers, feeling embarrassed or weak (Hoge et al., 2004), stigma (Mittal et al., 2013), unfavourable prior treatment experience(s) (Fox et al., 2015), being too busy (Garcia et al., 2014), and difficulty seeking help and scheduling an…”
BackgroundSippel, L. M., Watkins, L. E., Pietrzak, R. H., Hoff, R. A., & Harpaz‐Rotem, I. (2018) · Psychiatry · doi:10.1080/00332747.2017.1395313 · Cited by 12 · see citing works
“It is possible that feeling better understood by fellow service members reduces stigma about mental health difficulties, which is important because stigma can serve as a barrier to treatment seeking (Mittal et al., 2013).”
BackgroundHarris, A. H. S., Chen, C., Mohr, B. A., Adams, R. S., Williams, T. V., & Larson, M. J. (2014) · Military Medicine · doi:10.7205/milmed-d-13-00521 · Cited by 12 · see citing works
A qualitative study of veterans’ mixed emotional reactions to receiving a PTSD diagnosis.
Hundt, N. E., Smith, T. L., Fortney, J. C., Cully, J. A., & Stanley, M. A. (2018) · Psychological Services · doi:10.1037/ser0000273 · Cited by 11 · see citing works
Patterns of Treatment and Barriers to Care in Posttraumatic Stress Disorder
Thornicroft, G., Evans-Lacko, S. E., Koenen, K. C., Kovess–Masféty, V., Williams, D. R., & Kessler, R. C. (2018) · Cambridge University Press eBooks · doi:10.1017/9781107445130.009 · Cited by 11 · see citing works
Kranke, D. A., Schmitz, S., Der‐Martirosian, C., & Dobalian, A. (2016) · Social Work in Mental Health · doi:10.1080/15332985.2016.1199392 · Cited by 11 · see citing works
“Individuals diagnosed with any type of trauma also tend to differentiate the label of trauma from a serious mental illness (Karp, 2006; Mittal et al., 2013).”
BackgroundWilderness Adventure Program May Help Combat Perceptions of Stigma Among Veterans
Forsyth, A., Lysaght, R. M., Aiken, A. B., & Cramm, H. A. (2020) · Ecopsychology · doi:10.1089/eco.2019.0031 · Cited by 11 · see citing works
“…a culture of reliance on one another, masculinity, invincibility, emotional control, and self-sufficiency: qualities that often do not promote help-seeking behavior and can contribute to stigmatization of those who seek treatment (Mittal et al., 2013; Scheinfeld et al., 2017; Sharp et al., 2015).”
Harris, A. H. S., Chen, C., Mohr, B. A., Adams, R. S., Williams, T. V., & Larson, M. J. (2016) · Military Medicine · doi:10.7205/milmed-d-16-00294 · Cited by 11 · see citing works
Yamawaki, N., Kelly, C. W., Dresden, B. E., Busath, G. L., & Riley, C. (2016) · Military Medicine · doi:10.7205/milmed-d-15-00489 · Cited by 11 · see citing works
“10 These results suggest that stigma regarding help seeking has a serious in fl uence on help-seeking behavior.”
BackgroundIsrael, B. S., Belcher, A. M., & Ford, J. D. (2024) · Journal of Dual Diagnosis · doi:10.1080/15504263.2023.2295416 · Cited by 10 · see citing works
“Patients with TRD þ OUD experience discrimination due to stigma associated with OUD (Anvari et al., 2022; Pescosolido et al., 2021) and potentially TRD (Bonfils et al., 2018; Mittal et al., 2013).”
BackgroundLiu, Q., Ding, X., Wang, Y., Chu, H., Guan, Y., Li, M., & Sun, K. (2024) · Frontiers in Pharmacology · doi:10.3389/fphar.2024.1303123 · Cited by 10 · see citing works
Heart Rate Complexity in US Army Forward Surgical Teams During Pre Deployment Training
Mulder, M. B., Sussman, M. S., Eidelson, S. A., Gross, K. R., Buzzelli, M. D., Batchinsky, A. I., Schulman, C. I., Namias, N., & Proctor, K. G. (2019) · Military Medicine · doi:10.1093/milmed/usz434 · Cited by 12 · see citing works
Factors impacting rural Pacific Island veterans’ access to care: A qualitative examination.
Whealin, J. M., Nelson, D., Kawasaki, M. M., & Mahoney, M. A. (2017) · Psychological Services · doi:10.1037/ser0000161 · Cited by 10 · see citing works
“A second study that interviewed 16 Iraq and Afghanistan veterans seeking treatment for combat-related PTSD (Mittal et al., 2013) found that veterans reported becoming more aware of their families’ stigmatizing stereotypes as a result of their having PTSD. Veterans reported that stereotypes held by…”
BackgroundResultApplying Trauma-Informed Care to Community-Based Mental Health Services for Military Veterans
Currier, J. M., Stefurak, T., Carroll, T. D., & Shatto, E. H. (2017) · Best practices in mental health · doi:10.70256/586361yqjkmt · Cited by 10 · see citing works
Ridings, L. E., Moreland, A. D., & Petty, K. H. (2018) · Psychological Services · doi:10.1037/ser0000278 · Cited by 10 · see citing works
PTSD Perceptions in U.S. Military Members and Their Families: A Qualitative Study
Thomson, J. L. (2021) · SAGE Open · doi:10.1177/21582440211006393 · Cited by 10 · see citing works
“” One of the reasons individuals with a military background reportedly do not seek mental health care is due to stigma surrounding PTSD and other mental health diagnoses (Mittal et al., 2013).”
BackgroundInfluentialGrove, A. B., Kurtz, E. D., Wallace, R. E., Sheerin, C. M., & Scott, S. M. (2021) · Military Psychology · doi:10.1080/08995605.2021.1897496 · Cited by 10 · see citing works
“Additionally, the group addresses barriers to treatment, as Veterans are not encouraged to discuss their specific trauma during group and stigma may be reduced through engagement with fellow Veterans (Mittal et al., 2013).”
BackgroundInfluentialExploring Barriers to Mental Health Treatment in the Female Veteran Population: A Qualitative Study
Graham, K., Murphy, D., & Hendrikx, L. J. (2022) · Journal of Veterans Studies · doi:10.21061/jvs.v8i3.323 · Cited by 10 · see citing works
Taking stock of incarcerated military veterans: a review of (and guide for) research
Logan, M. W., Brooke, E. J., Morgan, M. A., & Hazelwood, A. R. (2022) · Criminal Justice Studies · doi:10.1080/1478601x.2022.2140149 · Cited by 9 · see citing works
“military veterans in general are less likely to seek out treatment for their disorders out of fear of being stigmatized or labelled as ‘weak’ by their peers (Mittal et al., 2013; Johnson et al., 2009; Sayers, Farrow, Ross, & Oslin, 2009; Vogt, 2011).”
BackgroundThe Primary Role of Mental Health Treatment in Resolution of Persistent Post-concussive Symptoms
Jak, A. J. (2017) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-017-0119-8 · Cited by 9 · see citing works
- Authors
- Mittal, D., Drummond, K. L., Blevins, D., Curran, G., Corrigan, P., & Sullivan, G.
- Affiliations
- Central Arkansas Veterans Healthcare System (US)
- Centers for Disease Control and Prevention (US)
- Health Services Research & Development (US)
- Illinois Institute of Technology (US)
- Venue
- Psychiatric Rehabilitation Journal
- Published
- 2013-06
- Volume
- 36
- Issue
- 2
- Pages
- 86-92
- ISSN
- 1095-158X (ISSN-L)
- 1559-3126
- OpenAlex
- W1968870138
- Cited by
- 258
- References
- 27
- Citations by year
- 2026: 16 · 2025: 15 · 2024: 13 · 2023: 28 · 2022: 25 · 2021: 10 · 2020: 22 · 2019: 30 · 2018: 27 · 2017: 23 · 2016: 27 · 2015: 8 · 2014: 10 · 2013: 3
- FWCI
- 17.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Rehabilitation Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Department of Veterans Affairs
- VA Center for Mental Healthcare & Outcomes Research
- Sponsor name not included (LIP 31-005)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
- Keywords
- post-traumatic stress disorder, stigma, combat veterans, self-stigma, help-seeking, stereotypes, Operation Enduring Freedom, Iraq War, social reintegration, peer support, mental health stigma
- MeSH terms
- Adult, Female, Humans, Male, Patient Acceptance of Health Care, Peer Group, Self Concept, Social Support, Stereotyping, Stress Disorders, Post-Traumatic, United States, Veterans, Focus Groups, Qualitative Research, Iraq War, 2003-2011, Afghan Campaign 2001-, Social Stigma
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