Cited by 258Posttraumatic Stress Disorder ResearchMental Health Treatment and AccessMigration, Health and Trauma

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Stigma Associated with PTSD: Perceptions of Treatment Seeking Combat Veterans

Mittal, Dinesh, Drummond, Karen L., Blevins, Dean, Curran, Geoffrey, Corrigan, Patrick, Sullivan, Greer·2013·Psychiatric Rehabilitation Journal

DOI 10.1037/h0094976

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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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“…2014; Coleman, Stevelink, Hatch, Denny, & Greenberg, 2017; Gould et al., 2010; Held & Owens, 2013; Kim, Britt, Klocko, Riviere, & Adler, 2011; Mittal et al., 2013), fear of losing professional and deployment opportunities (McFarlane et al., 2011), as well as unhelpful/specific personal…”
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“Many ex-service personnel can feel isolated in their experiences, with this isolation exacerbated by the experience of stigma and self-stigma, for example, internalizing perceptions that individuals with PTSD are ‘crazy’ (Mittal et al., 2013).”
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“…is consistently related to lower intentions to seek help (e.g., Blais & Renshaw, 2014; Held & Owens, 2013; Cornish, Thys, Vogel, & Wade, 2014; Mittal et al., 2013) and that those with more severe symptoms tend to report higher levels of stigma (e.g., Hoge et al., 2004; Schell & Marshall,…”
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Psychological stigma costs as barriers to healthcare use in former soldiers of the German Armed Forces: A qualitative analysis
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Background
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Background
Post-traumatic Stress Disorder and Magnetic Resonance Imaging.
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Background
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“The majority of these kids reside in developing nations where diagnosis is inaccurate and access to therapeutic services is considered a stigma to the victim and their family members since labels associated with PTSD include “dangerous/violent” or “crazy” (Mittal et al., 2013).”
Background
Proactive tobacco treatment for veterans with posttraumatic stress disorder.
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Background
An examination of stigma in the military
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“This study addresses the gap in research on empowerment among combat veterans with mental health concerns as an area that has been relatively underinvestigated (Finley, 2013; Mittal et al., 2013; Schreiber & McEnany, 2015; Zinzow et al., 2012).”
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“Thus, concern about stigmatization may also serve as an indicator of avoidance behavior (Mittal et al., 2013).”
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“Advances in mental healthcare and treatment of post-traumatic stress disorder (PTSD), for instance, might unintentionally lead to broader stigmatization of veterans as the issue increases in saliency and gains public attention (e.g., MacLean & Kleykamp, 2014; Mittal et al., 2013).”
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“Thus, those experiencing PTS may not feel they are worthy of help, especially if they are perceived as responsible for their condition (Mittal et al., 2013).”
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“Indeed, there is a stigma surrounding military veterans experiencing PTS (Hernandez et al., 2016; Mittal et al., 2013; Roscoe, 2023), and those in close relations (such as the MC) may carry a courtesy stigma.”
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Veterans’ Trauma-Related Guilt and Self-Stigma Affect Treatment-Seeking Behavior
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Do positive memory characteristics influence associations between PTSD symptoms and reckless/self-destructive behaviours? A pilot study among military veteran students
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“An additional limitation is our student veteran population may have underre-ported the severity of their PTSD symptoms due to stigma concerns or a desire to appear well-adjusted to civilian life (Markowitz et al., 2023; Mittal et al., 2013).”
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“…demonstrated that stigma-related concerns and perceived career consequences significantly reduce help-seeking behavior and delay treatment engagement, particularly among combat-exposed personnel embedded in military cultures emphasizing toughness, independence, and self-control [15,16,19].”
Jordanian University Student’s Attitudes and Perceptions on Mental Health
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“…such as delay or avoidance of treatment for fear of being stigmatized for seeking mental health treatment are prevalent (Iversen et al., 2011, Mittal et al., 2013, Quartana, Wilk, 2014, Rosen et al., 2011) and where delays in treatment occur due to system-generated bureaucratic…”
Background
The Influence of Just World Beliefs on the Stigmatization of Combat-Related PTSD
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“The belief that a combat-related PTSD diagnosis should be a foreseen and expected consequence of military enlistment (Mittal et al., 2013) may reflect a just world perspective, defined as adherence to the idea that people generally get what they deserve in life (R€usch, Todd, Bodenhausen, &…”
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Stigma and Stereotyping of Veterans who May Benefit from a Psychiatric Service Dog: A Test of the Stereotype Content Model and Weiner’s Attribution-Affect-Action Model
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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)
ORCID: Drummond, Karen L.
Curran, Geoffrey
Corrigan, Patrick
Venue: Psychiatric Rehabilitation Journal
Publisher: American Psychological Association (APA)
Published: 2013-06
Volume: 36
Issue: 2
Pages: 86-92
ISSN: 1095-158X (ISSN-L)
1559-3126
DOI: 10.1037/h0094976
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
Health Sciences › Medicine › Psychiatry and Mental health › 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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Stigma Associated with PTSD: Perceptions of Treatment Seeking Combat Veterans

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