THE IMPACT OF PERCEIVED DISCRIMINATION ON MENTAL DISTRESS IN OLDER ASIAN AMERICANS

Abstract Background Mental disorders are related to high individual suffering and significant socio-economic burdens. However, it remains unclear to what extent self-reported mental distress is related to individuals’ days of incapacity to work and their medical costs. This study aims to investigate the impact of self-reported mental distress for specific and non-specific days of incapacity to work and specific and non-specific medical costs over a two-year span. Method Within a longitudinal research design, 2287 study participants’ mental distress was assessed using the Hospital Anxiety and Depression Scale (HADS). HADS scores were included as predictors in generalized linear models with a Tweedie distribution with log link function to predict participants’ days of incapacity to work and medical costs retrieved from their health insurance routine data during the following two-year period. Results Current mental distress was found to be significantly related to the number of specific days absent from work and medical costs. Compared to participants classified as no cases by the HADS (2.6 days), severe case participants showed 27.3-times as many specific days of incapacity to work in the first year (72 days) and 10.3-times as many days in the second year (44 days), and resulted in 11.4-times more medical costs in the first year (2272 EUR) and 6.2-times more in the second year (1319 EUR). The relationship of mental distress to non-specific days of incapacity to work and non-specific medical costs was also significant, but mainly driven from specific absent days and specific medical costs. Our results also indicate that the prevalence of presenteeism is considerably high: 42% of individuals continued to go to work despite severe mental distress. Conclusions Our results show that self-reported mental distress, assessed by the HADS, is highly related to the days of incapacity to work and medical costs in the two-year period. Reducing mental distress by improving preventive structures for at-risk populations and increasing access to evidence-based treatments for individuals with mental disorders might, therefore, pay for itself and could help to reduce public costs.

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Does a comprehensive service user-led education programme effect more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress in medical students? A comparative cohort study

Australian & New Zealand Journal of Psychiatry ◽

10.1177/0004867420987886 ◽

2021 ◽

pp. 000486742098788

Author(s):

Giles Newton-Howes ◽

Jessica Senior ◽

Ben Beaglehole ◽

Gordon L Purdie ◽

Sarah E Gordon

Keyword(s):

Cohort Study ◽

Medical Students ◽

Lived Experience ◽

Service User ◽

Mental Distress ◽

Healthcare Providers ◽

Education Programme ◽

Positive Attitudes ◽

Comprehensive Service ◽

The Impact

Objective: This study sought to investigate the impact of a service user-led anti-stigma and discrimination education programme, encompassing numerous interventions focused on facilitating multiple forms of social contact, the promotion of recovery, and respect for human rights, on medical student attitudes. Method: A comparison cohort study was used to compare the attitudes of two cohorts of medical students who received this programme as part of their fifth (the fifth-year cohort) or sixth (the sixth-year cohort) year psychological medical education attachment (programme cohorts) with two cohorts of equivalent students who received a standard psychological medical attachment (control cohorts). Attitudes to recovery (using the Recovery Attitudes Questionnaire) and stigma (using the Opening Minds Scale for Healthcare Providers) were measured at the beginning and end of the attachments for each year and compared both within and between the cohorts using Wilcoxon signed-rank or Wilcoxon rank-sum tests. Results: With sample sizes ranging from 46 to 70 across all cohorts, after their psychological medicine attachment both the programme and control cohorts showed more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress. Significant differences between the programme cohorts and the control cohorts were found for recovery attitudes (median difference of 2, p < 0.05 in both fifth and sixth year), with particularly large differences being found for the ‘recovery is possible and needs faith’ subdomain of the Recovery Attitudes Questionnaire. There were no significant between cohort differences in terms of stigmatising attitudes as measured by the Opening Minds Scale for Healthcare Providers. Conclusion: The introduction of a comprehensive service user-led anti-stigma and education programme resulted in significant improvements in recovery attitudes compared to a control cohort. However, it was not found to be similarly superior in facilitating less stigmatising attitudes. Various possible reasons for this are discussed.

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Exploring the impact of a complex intervention for women with depression in contexts of adversity: A pilot feasibility study of COURRAGE-plus in South Africa

International Journal of Social Psychiatry ◽

10.1177/00207640211010203 ◽

2021 ◽

pp. 002076402110102

Author(s):

Rochelle A Burgess ◽

Niklas Jeske ◽

Shahana Rasool ◽

Ayesha Ahmad ◽

Anna Kydd ◽

...

Keyword(s):

Mental Health ◽

South Africa ◽

Narrative Therapy ◽

Mental Distress ◽

Social Intervention ◽

Friedman Test ◽

Time Points ◽

Symptoms Of Depression ◽

The Impact ◽

Collective Narrative

Background: Depression is a leading cause of disease burden worldwide but is often undertreated in low- and middle-income countries. Reasons behind the treatment gap vary, but many highlight a lack of interventions which speak to the socio-economic and structural realties that are associated to mental health problems in many settings, including South Africa. The COURRAGE-PLUS intervention responds to this gap, by combining a collective narrative therapy (9 weeks) intervention, with a social intervention promoting group-led practical action against structural determinants of poor mental health (4 weeks), for a total of 13 sessions. The overall aim is to promote mental health, while empowering communities to acknowledge, and respond in locally meaningful ways to social adversity linked to development of mental distress. Aim: To pilot and evaluate the effectiveness of a complex intervention – COURRAGE-PLUS on symptoms of depression as assessed by the Patient Health Questionnaire (PHQ-9) among a sample of women facing contexts of adversity in Gauteng, South Africa. Methods: PHQ-9 scores were assessed at baseline, post collective narrative therapy (midline), and post social intervention (endline). Median scores and corresponding interquartile ranges were computed for all time points. Differences in scores between time points were tested with a non-parametric Friedman test. The impact across symptom severities was compared descriptively to identify potential differences in impact across categories of symptom severity within our sample. Results: Participants’ ( n = 47) median depression score at baseline was 11 (IQR = 7) and reduced to 4 at midline (IQR = 7) to 0 at endline (IQR = 2.5). The Friedman test showed a statistically significant difference between depression scores across time points, [Formula: see text](2) = 49.29, p < .001. Median depression scores were reduced to 0 or 1 Post-Intervention across all four severity groups. Conclusions: COURRAGE-PLUS was highly effective at reducing symptoms of depression across the spectrum of severities in this sample of women facing adversity, in Gauteng, South Africa. Findings supports the need for larger trials to investigate collective narrative storytelling and social interventions as community-based interventions for populations experiencing adversity and mental distress.

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The Moderating Impact of Attending Services on the Effect of Older Adults’ Discrimination Experiences on Loneliness

Innovation in Aging ◽

10.1093/geroni/igaa057.1035 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 323-323

Author(s):

Dahee Kim ◽

Kyuho Lee

Keyword(s):

Older Adults ◽

Perceived Discrimination ◽

Well Being ◽

Religious Community ◽

Religious Activities ◽

Positive Effects ◽

Religious Behaviors ◽

Religious Services ◽

The Impact

Abstract Research has shown that perceived discriminations impact physical and mental health in later life. Discrimination experiences could make older adults consider themselves as a social misfit and decrease their social interactions, which finally increases their loneliness. Religious behaviors has been reported as a key factor of a lower sense of isolation. Considering that religious behaviors provide opportunities to engage in more extensive social networks and have supportive social ties with community members, attending religious services might decrease the impact of older adults’ perceived discrimination on loneliness. The current research aims to examine the moderating role of religious services attendance in the association between older adults’ perceived discrimination and loneliness. We used data of 4,488 adults aged 50 to 80 (M=66.27, SD=10.15) from the Health and Retirement Study (HRS) collected in 2012 and 2014. Linear regression analysis was performed to investigate whether older adults’ religious service attendance might decrease the impact of their perceived discriminations in daily life on the level of loneliness. The results indicated that more perceived discriminations older adults face on a daily basis were significantly associated with higher levels of loneliness. However, participants who frequently attended religious services showed a lower impact of perceived discriminations on their loneliness. These findings highlight the positive effects of engaging in religious activities on discriminated older adults’ social well-being. These findings also emphasize the role of the religious community as a social resource for socially marginalized older adults.

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Experiences of Mental Distress during COVID-19: Thematic Analysis of Discussion Forum Posts for Anxiety, Depression, and Obsessive-Compulsive Disorder

Illness Crisis & Loss ◽

10.1177/10541373211023951 ◽

2021 ◽

pp. 105413732110239

Author(s):

G. Brewer ◽

L. Centifanti ◽

J. Castro Caicedo ◽

G. Huxley ◽

C. Peddie ◽

...

Keyword(s):

Obsessive Compulsive Disorder ◽

Mental Distress ◽

Psychological Impact ◽

Discussion Forum ◽

Obsessive Compulsive ◽

Compulsive Disorder ◽

Care Workers ◽

Positive Experiences ◽

Anxiety Depression ◽

The Impact

The psychological impact of the COVID-19 pandemic on coronavirus patients, health care workers, and the general population is clear. Relatively few studies have, however, considered the impact of the pandemic on those with pre-existing mental health conditions. Therefore, the present study investigates the personal experiences of those with anxiety, depression, and obsessive-compulsive disorder during COVID-19. We conducted a qualitative study utilising Reddit discussion forum posts. We conducted three separate thematic analyses from 130 posts in subreddit forums aimed for people identifying with anxiety, depression, and obsessive-compulsive disorder. We identified a number of similar discussion forum themes (e.g., COVID-19 intensifying symptoms and a lack of social support), as well as themes that were unique to each forum type (e.g., hyperawareness and positive experiences during the pandemic). Findings should guide future practice and the support provided to those living with mental distress.

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The Impact of Perceived Need and Relational Factors on Mental Health Service Use Among Generations of Asian Americans

Journal of Community Health ◽

10.1007/s10900-016-0305-4 ◽

2016 ◽

Vol 42 (4) ◽

pp. 688-700 ◽

Cited By ~ 6

Author(s):

Minsun Lee ◽

David Takeuchi ◽

Zvi Gellis ◽

Philip Kendall ◽

Lin Zhu ◽

...

Keyword(s):

Mental Health ◽

Mental Health Service ◽

Health Service ◽

Asian Americans ◽

Service Use ◽

Mental Health Service Use ◽

Health Service Use ◽

Perceived Need ◽

Relational Factors ◽

The Impact

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Medicated bodies: Mental distress, social media and affect

New Media & Society ◽

10.1177/1461444816664347 ◽

2016 ◽

Vol 20 (2) ◽

pp. 549-563 ◽

Cited By ~ 6

Author(s):

Ian Tucker ◽

Lewis Goodings

Keyword(s):

Mental Health ◽

Social Media ◽

Mental Distress ◽

The Body ◽

Psychiatric Medication ◽

Social Media Site ◽

Health Social Media ◽

Care Practices ◽

The Impact

Social media are increasingly being recruited into care practices in mental health. This article analyses how a major new mental health social media site ( www.elefriends.org.uk ) is used when trying to manage the impact of psychiatric medication on the body. Drawing on Henri Bergson’s concept of affection, analysis shows that Elefriends is used at particular moments of reconfiguration (e.g. change in dosage and/or medication), periods of self-experimentation (when people tailor their regimen by altering prescriptions or ceasing medication) and when dealing with a present bodily concern (showing how members have a direct, immediate relationship with the site). In addition, the analysis illustrates how users have to structure their communication to try to avoid ‘triggering’ distress in others. The article concludes by pointing to the need to focus on the multiple emerging relationships between bodies and social media in mental health, due to the ways the latter are becoming increasingly prominent technologies through which to experience the body when distressed.

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When does uncertainty avoidance promote customer-to-customer intercultural service encounters?

International Marketing Review ◽

10.1108/imr-09-2017-0178 ◽

2019 ◽

Vol 36 (3) ◽

pp. 445-463 ◽

Cited By ~ 1

Author(s):

Nabil Ghantous ◽

Amro A. Maher

Keyword(s):

Structural Equation ◽

Perceived Discrimination ◽

Uncertainty Avoidance ◽

Equation Modeling ◽

Service Encounters ◽

Content Type ◽

National Identification ◽

Service Environments ◽

The One ◽

The Impact

Purpose Previous literature has reported inconsistent findings regarding the impact of uncertainty avoidance (UA) on intercultural experiences. This includes positive, negative and insignificant associations between UA on the one hand and cosmopolitanism or comfort with intercultural service encounters (ICSE) on the other hand. The purpose of this paper is to participate in addressing these contradictions. More specifically, this study examines how UA affects expatriate cosmopolitanism as well as approach of service environments patronized by local customers by introducing two moderators: national identification and perceived discrimination. Design/methodology/approach The authors propose a conceptual model based on the results of a literature review. The authors test it with survey data collected from Indian expatriates (n=341) living in Qatar, using structural equation modeling. Findings The results corroborate the moderating role of national identification. Under low identification, expatriate consumers engage in a prospective form of uncertainty management, leading them to adopt a more cosmopolitan stance. Under high identification, their uncertainty plays an inhibitory role, reducing their cosmopolitanism and negatively affecting their approach of service places patronized by local consumers. Perceived discrimination did not moderate the impact of UA as expected on either cosmopolitanism or approach. Originality/value This paper extends the prior research on UA by testing how two moderators could activate either a prospective or an inhibitory form of uncertainty. It also contributes to research on ICSE, by focusing on customer-to-customer interactions in a multicultural marketplace.

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Perpetual Foreigner in One’s Own Land: Potential Implications for Identity and Psychological Adjustment

10.31234/osf.io/p9q47 ◽

2021 ◽

Author(s):

Que-Lam Huynh ◽

Thierry Devos ◽

Laura Smalarz

Keyword(s):

Life Satisfaction ◽

Psychological Adjustment ◽

Asian Americans ◽

Sense Of Belonging ◽

American Culture ◽

Perceived Discrimination ◽

National Identities ◽

Identity Conflict ◽

The Us ◽

Dominant Society

The perpetual foreigner stereotype posits that members of ethnic minorities will always be seen as the “other” in the White Anglo-Saxon dominant society of the US (Devos & Banaji, 2005), which may have negative implications for them. The goal of the present research was to determine whether awareness of this perpetual foreigner stereotype predicts identity and psychological adjustment. We conducted a series of studies with 231 Asian Americans and 211 Latino/as (Study 1), 89 African Americans (Study 2), and 56 Asian Americans and 165 Latino/as (Study 3). All participants completed measures of perceived discrimination, awareness of the perpetual foreigner stereotype, conflict between ethnic and national identities, sense of belonging to American culture, and demographics. In Study 3, participants also completed measures of psychological adjustment: depression, hope, and life satisfaction. All participants were students at a large, public university on the West Coast of the US. Across studies, we found that even after controlling for perceived discrimination, awareness of the perpetual foreigner stereotype was a significant predictor of identity conflict and lower sense of belonging to American culture. From Study 3, we also found that, above and beyond perceived discrimination, awareness of the perpetual foreigner stereotype significantly predicted lower hope and life satisfaction for Asian Americans, and that it was a marginal predictor of greater depression for Latino/as. These results suggest that the perpetual foreigner stereotype may play a role in ethnic minority identity and adjustment.

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