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| Name | Class |
|---|---|
| Center for Military Mental Health, Berlin, Germany | UNKNOWN |
| Illinois Institute of Technology, Chicago, USA | UNKNOWN |
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The purpose of the study is to evaluate the feasibility and efficacy of the group-based intervention "Honest, Open, Proud" among soldiers with mental illness.
Soldiers with mental illness typically face a two-fold problem. On the one hand, they have to cope with the symptoms of their mental illness; on the other hand, they often have to deal with stigma and discrimination. Both due to fear of public stigma and due to self-stigma or shame, soldiers with mental illness may decide to keep their condition a secret or even to withdraw from other people altogether in order to minimize the risk of being labeled. Secrecy can help on the short term to protect individuals from public stigma, but usually it has negative long-term consequences such as social isolation, distress and avoidance of help-seeking. Disclosure, on the other hand, carries the risk to be discriminated by others, but can reduce the burden of secrecy, lead to support by others and reduce public stigma.
In this study investigators aim to test the efficacy (see our outcomes above) of Honest, Open, Proud run by soldiers with lived experience of mental illness.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Honest, Open, Proud | Experimental | The group program is about disclosure versus secrecy of one's mental illness. The groups are facilitated by two peers (soldiers with lived experience of mental illness). Each group runs for three weeks, one meeting per week, and two hours per meeting. There is one 2-hour booster session in week 6. Fidelity to manual: rated by a research assistant who is present during the group session |
|
| Control group | No Intervention | Treatment as usual (TAU) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Honest, Open, Proud (HOP) | Behavioral | Three lessons, one for each two-hour session plus one booster session
|
| Measure | Description | Time Frame |
|---|---|---|
| Stigma Stress Scale, 8 items | (Rüsch et al. 2009a; Rüsch et al. 2009b) | 3 weeks (T1) |
| WHOQoL BREF; Domain psychological quality of life, 6 items | (WHOQoL Group 1998) | 6 weeks (T2) |
| Measure | Description | Time Frame |
|---|---|---|
| Empowerment Scale, Subscale 'Self-esteem', 9 items | (Rogers et al. 1997) | baseline, 3, 6 and 12 weeks (T3) |
| Psychological Well-Being Scale, 18 items | (Ryff 1989) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nicolas Rüsch, Dr. | Department of Psychiatry II, Section Public Mental Health, Ulm University, Bezirkskrankenhaus Günzburg | Principal Investigator |
| Gerd-Dieter Willmund, Dr. | Center for Military Mental Health, Berlin, Germany | Principal Investigator |
| Peter Zimmermann, Dr. | Center for Military Mental Health, Berlin, Germany | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Illinois Institute of Technology | Chicago | Illinois | 60616 | United States | ||
| Center for Military Mental Health |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 9255837 | Background | Rogers ES, Chamberlin J, Ellison ML, Crean T. A consumer-constructed scale to measure empowerment among users of mental health services. Psychiatr Serv. 1997 Aug;48(8):1042-7. doi: 10.1176/ps.48.8.1042. | |
| 24660946 | Background | Boyd JE, Otilingam PG, Deforge BR. Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination. Psychiatr Rehabil J. 2014 Mar;37(1):17-23. doi: 10.1037/prj0000035. |
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| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D057545 | Social Stigma |
| ID | Term |
|---|---|
| D012919 | Social Behavior |
| D001519 | Behavior |
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|
| baseline, 3, 6 and 12 weeks |
| Internalized Stigma of Mental Illness Inventory, Brief Version, 10 items | (Boyd et al. 2014) | baseline, 3, 6 and 12 weeks |
| Self-Stigma of Mental Illness Scale, Short Version, subscale Self-Concurrence, 5 items | (Corrigan et al. 2012) | baseline, 3, 6 and 12 weeks |
| Secrecy and Social Withdrawal subscales of the Stigma Coping Orientation Scales, 12 items | (Link et al. 1991) | baseline, 3, 6 and 12 weeks |
| Disclosure related distress ("In general, how distressed or worried are you in terms of secrecy or disclosure of your mental illness to others?', from 1, not at all, to 7, very much) | (Rüsch et al. 2014a) | baseline, 3, 6 and 12 weeks |
| WHOQoL-BREF, 26 items | (WHOQOL Group 1998) | 3, 6 and 12 weeks |
| Patient Health Questionnaire (PHQ-9), 9 items | (Kroenke et al. 2001) | baseline, 3, 6 and 12 weeks |
| Shame about having a mental illness, 1 item | (Rüsch et al. 2014b) | baseline, 3, 6 and 12 weeks |
| Attitudes to help-seeking, 2 items | (Rüsch et al. 2013) | baseline, 3, 6 and 12 weeks |
| Attitudes to disclosure, 2 items | (Rüsch et al. 2011) | baseline, 3, 6 and 12 weeks |
| Berlin |
| 10115 |
| Germany |
| Department of Psychiatry II, Section Pubic Mental Health, Ulm University, Bezirkskrankenhaus Günzburg | Ulm | 89073 | Germany |
| 22578819 | Background | Corrigan PW, Michaels PJ, Vega E, Gause M, Watson AC, Rusch N. Self-stigma of mental illness scale--short form: reliability and validity. Psychiatry Res. 2012 Aug 30;199(1):65-9. doi: 10.1016/j.psychres.2012.04.009. Epub 2012 May 10. |
| 24434073 | Background | Rusch N, Abbruzzese E, Hagedorn E, Hartenhauer D, Kaufmann I, Curschellas J, Ventling S, Zuaboni G, Bridler R, Olschewski M, Kawohl W, Rossler W, Kleim B, Corrigan PW. Efficacy of Coming Out Proud to reduce stigma's impact among people with mental illness: pilot randomised controlled trial. Br J Psychiatry. 2014;204(5):391-7. doi: 10.1192/bjp.bp.113.135772. Epub 2014 Jan 16. |
| 1940212 | Background | Link BG, Mirotznik J, Cullen FT. The effectiveness of stigma coping orientations: can negative consequences of mental illness labeling be avoided? J Health Soc Behav. 1991 Sep;32(3):302-20. |
| 24382666 | Background | Rusch N, Corrigan PW, Heekeren K, Theodoridou A, Dvorsky D, Metzler S, Muller M, Walitza S, Rossler W. Well-being among persons at risk of psychosis: the role of self-labeling, shame, and stigma stress. Psychiatr Serv. 2014 Apr 1;65(4):483-9. doi: 10.1176/appi.ps.201300169. |
| 24012162 | Background | Rusch N, Heekeren K, Theodoridou A, Dvorsky D, Muller M, Paust T, Corrigan PW, Walitza S, Rossler W. Attitudes towards help-seeking and stigma among young people at risk for psychosis. Psychiatry Res. 2013 Dec 30;210(3):1313-5. doi: 10.1016/j.psychres.2013.08.028. Epub 2013 Sep 4. |
| 21632739 | Background | Rusch N, Evans-Lacko SE, Henderson C, Flach C, Thornicroft G. Knowledge and attitudes as predictors of intentions to seek help for and disclose a mental illness. Psychiatr Serv. 2011 Jun;62(6):675-8. doi: 10.1176/ps.62.6.pss6206_0675. |
| 9626712 | Background | Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med. 1998 May;28(3):551-8. doi: 10.1017/s0033291798006667. |
| 19237266 | Background | Rusch N, Corrigan PW, Powell K, Rajah A, Olschewski M, Wilkniss S, Batia K. A stress-coping model of mental illness stigma: II. Emotional stress responses, coping behavior and outcome. Schizophr Res. 2009 May;110(1-3):65-71. doi: 10.1016/j.schres.2009.01.005. Epub 2009 Feb 23. |
| 19269140 | Background | Rusch N, Corrigan PW, Wassel A, Michaels P, Olschewski M, Wilkniss S, Batia K. A stress-coping model of mental illness stigma: I. Predictors of cognitive stress appraisal. Schizophr Res. 2009 May;110(1-3):59-64. doi: 10.1016/j.schres.2009.01.006. Epub 2009 Mar 6. |
| Background | Ryff, C. D. (1989): Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology (57): 1069-1081. |
| 11556941 | Background | Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13. doi: 10.1046/j.1525-1497.2001.016009606.x. |
| 40696200 | Derived | Rusch N, Helms C, Horger J, Hohle B, Bernert H, Muschner P, Rose C, Corrigan PW, Mulfinger N, Zimmermann P, Willmund GD. The peer-led Honest, Open, Proud program to decrease the impact of mental illness stigma among German military personnel: randomized controlled trial. Soc Psychiatry Psychiatr Epidemiol. 2026 May;61(5):791-801. doi: 10.1007/s00127-025-02960-x. Epub 2025 Jul 22. |