Everyday Discrimination Scale Research Articles

Racial Discrimination in Late Adolescence and Mental Health Outcomes Among Participants in the Panel Study of Income Dynamics

PurposeTo assess whether racial discrimination experienced at ages 18–21 years is associated with psychological distress and well-being, and investigate potential moderators of this relationship. MethodsWe used panel data collected from 2005 to 2017 from 661 participants in the Transition into Adulthood Supplement of the Panel Study of Income Dynamics. The Everyday Discrimination Scale measured racial discrimination. The Kessler six and Mental Health Continuum Short Form assessed psychological distress and well-being, respectively. Generalized linear mixed modeling was used to model outcomes and test potential moderating variables. ResultsApproximately 25% of participants experienced high levels of racial discrimination. In analyses of panel data, these participants had significantly worse psychological distress (odds ratio = 6.04, 95% confidence interval: 3.41, 8.67) and lower levels of emotional well-being (odds ratio = 4.61, 95% confidence interval: 1.87, 7.36) compared to those who did not. Race and ethnicity moderated the relationship. DiscussionExposure to racial discrimination in late adolescence was associated with worse mental health outcomes. This study has important implications for interventions addressing the need for mental health support that is critical for adolescents who experience racial discrimination.

Psychological/Personal recovery and its correlates in patients with first episode psychosis.

Recovery in psychosis is a multidimensional construct. The numbers of studies specially focusing on the recovery aspects in patients with first episode psychosis (FEP) are limited, with no study from India. Further, no study has looked specifically into the variables that affect recovery process in patients with FEP and little is known about factors which influence recovery in patients with FEP. To evaluate psychological recovery and its correlates in patients with FEP, currently in clinical remission. One hundred three patients of FEP in clinical remission were assessed on Recovery Assessment Scale (RAS), Positive and Negative Syndrome Scale for Schizophrenia, Calgary Depression Rating Scale for Schizophrenia, Negative Symptom Assessment 16, Rosenberg Self-esteem Scale, Social and Occupational Functioning Assessment Scale, the Alcohol, Smoking and Substance Involvement Screening Test, Beck Cognitive Insight Scale, Internalized Stigma of Mental Illness Scale, the Everyday discrimination Scale, Subjective Scale to Investigate Cognition in Schizophrenia and social cognitive deficits in theory of mind was evaluated on the Social Cognition Rating Tools in Indian Setting-Theory of Mind. The needs of the participants were assessed on the Camberwell Assessment of Needs - Research version and Supplemental Assessment of Needs. Coping, social support, medication adherence were also assessed by standardized scales. The mean weighted score was highest for goal and success orientation subscale followed by seeking and relying on social support, personal confidence and hope, overcome the illness and awareness and control over the illness as assessed by 41 items of the RAS. The main factors identified to affect psychological recovery in patients with FEP were duration of untreated psychosis, greater psychopathology, lower self-esteem, total unmet need, feeling of discrimination and stigmatization. The present study suggests that treatment of FEP should be started at the earliest and issues such as residual psychopathology, lower self-esteem, total unmet need, feeling of discrimination and stigma during the remission phase should be addressed by psychosocial interventions to promote psychological recovery in patients with first episode psychosis.

0963 Everyday Discrimination Is Associated with Sleep-Related Impairments Among Blacks During the COVID-19 Pandemic

Abstract Introduction Sleep is influenced by a set of multilevel factors including race and ethnicity. There is overwhelming evidence supporting that sleep quality is poorer within nonwhite groups. Race-based stressors and discrimination are believed to be among the logical explanation of these widespread racial/ethnic disparities in sleep health. This study aimed to highlight the effects of discrimination on sleep related impairments among Black adults. Methods Our sample included 280 Blacks and African Americans enrolled in two NIH-funded community-based sleep studies: ESSENTIAL and MOSAIC. Participants were recruited between January 2020 and April 2022 in the New York City or Tri-State area (n=101; 36%) and South Florida (n=179; 64%). Data were gathered on demographics, sleep disturbance, activity, stress, and support using the Insomnia Severity Index (ISI), PROMIS Sleep-Related Impairment (SRI) questionnaire (short form 8a), Godin Leisure-Time Exercise questionnaire, Everyday Discrimination Scale, stressful life events experienced within the past year, and the Multidimensional Scale of Perceived Social Support (MSPSS). Correlation analyses were conducted among continuous variables to explore associations among sleep, activity, support, discrimination, and stress. Controlling for age, race/ethnicity, and sex, multilinear regression analysis was conducted to examine the relationship between stressful life event exposure, discrimination, social support, and activity on sleep impairment. Results Of the 280 participants, 63% were female (n = 177) and the mean age was 43.4 years. A total of 36% (n = 101) were from the New York City/Tri-State area, while 64% (n = 179) were from the South Florida region. Controlling for age, race/ethnicity, physical activity, non-race related stressors, social support, and sex, everyday discrimination was the strongest predictor of sleep related impairments (SRI) [β = -0.198, p < 0.05]. Sex was positively associated with SRI scores [β = 0.167, p = 0.05]. On average, women reported higher SRI scores. Conclusion In this study, we found that among Blacks and African Americans in the New York City, Tri-State areas, and South Florida areas, during the Covid-19 pandemic, greater discrimination experience was associated with higher level of sleep-related impairments. Support (if any) K01HL135452, K07AG052685, R01AG072644, R01HL152453, R01MD007716, R01HL142066, R01AG067523, R01AG056031, and R01AG075007

Impact of COVID-related Discrimination on Psychological Distress and Sleep Disturbances across Race-Ethnicity

COVID-related discrimination towards historically marginalized racial-ethnic groups in the United States has been well-documented; however, its impact on psychological distress and sleep (overall and within specific racial-ethnic groups) is largely unknown. We used data from our nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Native Hawaiian/Pacific Islander, Latino, White, and multiracial adults, conducted from 12/2020-2/2021. Participants were asked how often they experienced discriminatory behaviors “because they think you might have COVID-19” (modified Everyday Discrimination Scale). Psychological distress was captured as having experienced anxiety-depression symptoms (Patient Health Questionairre-4, PHQ-4), perceived stress (modified Perceived Stress Scale), or loneliness-isolation (“How often have you felt lonely and isolated?”). Sleep disturbances were measured using the Patient-Reported Outcomes Information System Short Form Sleep Disturbance scale (PROMIS-SF 4a). Overall, 22.1% reported COVID-related discriminatory behaviors (sometimes/always: 9.7%; rarely: 12.4%). 48.4% of participants reported anxiety-depression symptoms (moderate/severe: 23.7% mild: 24.8%), 62.4% reported feeling stressed (moderate/severe: 34.3%; mild: 28,1%), 61.0% reported feeling lonely-isolated (fairly often/very often: 21.3%; almost never/sometimes: 39.7%), and 35.4% reported sleep disturbances (moderate/severe:19.8%; mild: 15.6%). Discrimination was only associated with increased psychological distress among racial-ethnic minorities. For example, COVID-related discrimination was strongly associated with anxiety-depression among Black/African American adults (mild: aOR=2.12, 95% CI=1.43-5.17; moderate/severe: aOR=5.19, 95% CI=3.35-8.05), but no association was observed among White or multiracial adults. Mitigating pandemic-related discrimination could help alleviate mental and sleep health disparities occurring among minoritized racial-ethnic groups.

Gender minority stress in transgender people: a major role for social network.

Gender minority individuals, on average, experience higher rates of mental health problems. Mounting work suggests that gender minority stress (GMS) contributes to mental health outcomes in transgender/gender-nonconforming individuals. We assessed whether GMS decreased in transgender people after initiating gender-affirming hormone therapy (GAHT), and we identified social predictors and hormonal associations for GMS at 2 time points. GMS was surveyed through self-report questionnaires tapping into proximal and distal stressors and coping constructs following the minority stress framework. Eighty-five transgender persons wishing to undertake hormonal interventions were assessed prospectively at start of GAHT and after 7.7 ± 3.5months (mean ± SD). Sixty-five cisgender persons served as a control group. (1) Proximal stressors were surveyed by the Beck Depression Inventory II, State-Trait Anxiety Inventory, Scale for Suicide Ideation, Suicidal Thoughts/Attempts, Stigma Consciousness Questionnaire, and Perceived Stress Scale; (2) distal stressors by the Everyday Discrimination Scale; and (3) coping constructs by the Resilience Scale, social network, social standing, and Marlowe Crowne Social Desirability Scale. Transgender people experienced higher rates of proximal stressors (Beck Depression Inventory II, State-Trait Anxiety Inventory, Scale for Suicide Ideation, Suicidal Thoughts/Attempts, Perceived Stress Scale) and had lower protective factors (social standing) prior to and during GAHT than cisgender people. Social network and resilience were lower in transgender people relative to cisgender peers only at baseline. Prospectively, decreasing trait anxiety was observed in transgender people. Social factors were adequate predictors of multiple GMS constructs. Specifically, a major role for social network emerged. As for hormonal associations, only serum estradiol levels in transgender women with GAHT were negatively associated with trait anxiety and suicidal thoughts/attempts but positively with resilience and social desirability. Stimulating a social environment supportive of diverse identities, particularly by investing in social networks as a resource for resilience, is likely to alleviate GMS. Longer duration of interventions with sex steroid treatment, with continued resilience-enhancing strategies, is needed to observe further alleviation of GMS in transgender persons. Also, objective and subjective GMS identification with heteronormative attitudes and beliefs should be surveyed for good measure when assessing GMS. Transgender people experienced more GMS throughout study visits than cisgender people did. With a relatively short period of GAHT, some significant changes in and predictors for experienced GMS emerged.

Using Drugs or Non-Drugs Alternatives to Alter Mental States in the Online, Virtual Era

Background: In the 1970s a body of literature was generated advocating the alternatives approach for drug misuse prevention and rehabilitation which encouraged healthy nonchemical behaviors leading to reinforcing moods. Although this behaviorally oriented approach was overshadowed with the popularity of cognitive therapy in the 1980s, many of the recommended alternative behaviors remain embedded in cognitive approaches for drug misuse prevention and rehabilitation. One objective of the present study was to replicate, in part, two studies conducted in the 1970s which examined usage patterns of non-drug alternatives. A second objective was to explore of the use of newer technologies like the internet and the smartphone to alter emotional states. A third objective was to examine perceived stress and discrimination experiences on preferences for drug and non-drug alternatives. Methods: Three questionnaires were administered: use of drugs and non-drug alternatives in response to everyday emotions; the Everyday Discrimination Scale; and the Perceived Stress Scale. A total of 483 adults participated; their mean age was 39 years. Results: The results revealed that non-drug alternatives were preferred to drugs in treating experiences of anxiety, depression, and hostility, and to induce pleasure. Drugs were used most often to deal with pain. Experiences of discrimination increased perceptions of stress, and stress, in turn, affected the use of drugs to cope with a range of emotions. Social media and virtual activities were not preferred methods for altering negative moods. Conclusions: Social media may actually be a contributor or cause of distress, rather than a means for reducing it.

MP07-14 THE ASSOCIATION BETWEEN SOCIOCULTURAL AND PSYCHOSOCIAL FACTORS AND THE SEXUAL FUNCTION OF LATINA WOMEN WITH PELVIC FLOOR DISORDERS

You have accessJournal of UrologyCME1 Apr 2023MP07-14 THE ASSOCIATION BETWEEN SOCIOCULTURAL AND PSYCHOSOCIAL FACTORS AND THE SEXUAL FUNCTION OF LATINA WOMEN WITH PELVIC FLOOR DISORDERS Unwanaobong Nseyo, Nanjun Chen, Madeleine Burg, Claudia Sevilla, Nahid Yousif, Christina Dancz, David Ginsberg, Mariana C. Stern, and Larissa V. Rodriguez Unwanaobong NseyoUnwanaobong Nseyo More articles by this author , Nanjun ChenNanjun Chen More articles by this author , Madeleine BurgMadeleine Burg More articles by this author , Claudia SevillaClaudia Sevilla More articles by this author , Nahid YousifNahid Yousif More articles by this author , Christina DanczChristina Dancz More articles by this author , David GinsbergDavid Ginsberg More articles by this author , Mariana C. SternMariana C. Stern More articles by this author , and Larissa V. RodriguezLarissa V. Rodriguez More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003222.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Female sexual function is impacted by the presence of pelvic floor disorders (PFDs). Racial disparities exist in the relationship between PFDs and sexual function. Little is understood regarding the factors that influence these disparities. We evaluated the demographic, sociocultural, and psychosocial factors, namely stress and discrimination, associated with sexual function among Latina women in a clinical setting. METHODS: We conducted a prospective cross-sectional study of Spanish and English-speaking Latina women with and without PFDs recruited from Urology and Urogynecology clinics at a large private or public hospital. We used validated questionnaires to assess the presence of PFDs, Pelvic Floor Disorders Inventory (PFDI-20), and sexual function, Pelvic Organ Prolapse/Urinary Incontinence Sexual Function questionnaire (PISQ-12). We performed a subset analysis of sexually active women with PFDs. Self-reported psychosocial stress was assessed with the 10-item Perceived Stress Scale (PSS), including protective and negative domains, and the Everyday Discrimination Scale (EDS). We performed linear regression analysis to assess the relationship between PISQ-12 score and demographic, cultural and psychosocial metrics, significant at a value of p-value ≤0.05. RESULTS: Of the 153 total study participants, 53 (34.6 %) completed the PISQ-12 with mean PISQ-12 scores of 29.9 with 8.0, 8.6 and 13.2 on the partner, behavior, and physical domains, respectively. Compared to non-sexually active women, sexually active women were slightly older (50.1 vs 47.9, p=0.34), with significantly worse bowel (27.3 vs 15.2, p=0.005), urinary (67.3 vs 31.8, p<0.001), and prolapse symptoms (45.9 vs 20.8, p<0.001). On linear regression analysis, positive associations were seen with better sexual function and Mexican-American values of familism (p=0.05), respect (p=0.04), religion (p=0.02), and being employed (p=0.05), with a trend towards significance for the PSS negative subscore (p=0.06). A negative correlation was observed for Mainstream values of independence (p=0.05), age (p=0.05). CONCLUSIONS: Among Latina women who presented to clinic for management of their PFDs, better sexual function was more associated with Mexican-American values. The specific domains of the Mexican-American values scale highlight areas of importance for maintaining sexual function despite PFDs for Latina women and suggest sociocultural drivers of disparities in sexual function among racial/ethnic minority women with PFDs. Source of Funding: CTSI Pilot Grant Funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e90 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Unwanaobong Nseyo More articles by this author Nanjun Chen More articles by this author Madeleine Burg More articles by this author Claudia Sevilla More articles by this author Nahid Yousif More articles by this author Christina Dancz More articles by this author David Ginsberg More articles by this author Mariana C. Stern More articles by this author Larissa V. Rodriguez More articles by this author Expand All Advertisement PDF downloadLoading ...

Racial discrimination and 12-month and lifetime anxiety disorders among African American men and women: Findings from the National Survey of American Life

BackgroundThe purpose of this study was to assess the associations between racial discrimination and 12-month and lifetime DSM-IV anxiety disorders among African American men and women. MethodsData was drawn from the African American sample of the National Survey of American Life (N = 3570). Racial discrimination was assessed with the Everyday Discrimination Scale. 12-month and lifetime DSM-IV outcomes were any anxiety disorder, posttraumatic stress disorder (PTSD), generalized anxiety disorder (GAD), panic disorder (PD), social anxiety disorder (SAD), and agoraphobia (AG). Logistic regressions were utilized to assess the relationships between discrimination and anxiety disorders. ResultsThe data indicated that racial discrimination was associated with increased odds for 12-month and lifetime anxiety disorders, AG, and PD and lifetime SAD among men. Regarding 12-month disorders among women, racial discrimination was associated with increased odds for any anxiety disorder, PTSD, SAD, and PD. With respect to lifetime disorders among women, racial discrimination was associated with increased odds for any anxiety disorder, PTSD, GAD, SAD, and PD. LimitationsThe limitations of this study include the utilization of cross-sectional data, self-reported measures, and the exclusion of non-community dwelling individuals. ConclusionsThe current investigation showed that African American men and women are not impacted by racial discrimination in the same ways. These findings suggest that the mechanisms through which discrimination operates among men and women to influence anxiety disorders is potentially a relevant target for interventions to address gender disparities in anxiety disorders.

The Role of Social Defeat in Neurological differences in Psychotic Patients

IntroductionThe social defeat hypothesis (SDH) suggests that a chronic experience of social defeat increases the likelihood of the development of psychosis. The SDH indicates that a negative experience of exclusion leads to an increase in the baseline activity of the mesolimbic dopamine system (MDS), which in turn leads to the onset of psychosis. Social defeat models have previously been produced using animal models and preclinical literature; however, these theories have not fully been tested in human clinical samples. There have been studies implying changes in brain structure due to social defeat interactions; however, research evidence is varied.ObjectivesThis study aims to uncover whether exposure to SoDe has an impact on brain structure. Furthermore, we hope to understand if these changes are relevant to other mental health disorders.Methods698 (506 no SoDe, 191 SoDe) participants between the ages of 15-41 were recruited from the PRONIA-FP7 study. SoDe was measured from the self-reported questionnaires’ Bullying Scale’ and ‘The Everyday Discrimination Scale’. T1-weighted structural MRI data were processed; five 2 sample t-test analyses were carried out to compare the GMV differences in the entire sample and between the four groups.ResultsThe VBM analysis showed significant group interactions in the right thalamus proper when comparing participants who had experience SoDe to participants who had not experienced SoDe including all 4 groups along with left cerebral white matter differences. In the ROP subgroup, significant group interactions in the left cerebellum white matter were found along with right cerebral white matter, left cerebral white matter and right Thalamus proper.ConclusionsThe findings suggest that there are significant group interactions in thalamus and cerebral white matter. This is in keeping with some previous research suggesting volumetric changes in the thalamus due to stress and psychosis. Similarly for white matter there is some evidence suggesting differences due to SoDe and psychosis. However, there is a scarcity of research in this area with different research suggesting distinctive findings and therefore the evidence is inconclusive. In the ROP group analysis significant group interactions were present in the cerebellum due to SoDe experience. There is research suggesting the cerebellum’s role in multiple different aspects like social interaction, higher-order cognition, working memory, cognitive flexibility, and psychotic symptoms, with every research suggesting multiple different things the role of the cerebellum in SoDe in the ROP population is in question. Nonetheless this large-scale research presents some interesting novel finding and leads the way to a new area of research. Further analysis will explore the relationship between groups on markers of stress (CRP) and neuroinflammation as potential mediation of the environmental effects of SoDe.Disclosure of InterestNone Declared

Perceived discrimination in the community pharmacy: A cross-sectional, national survey of adults.

Discrimination experiences have been documented in various health care settings; little is known about discrimination experiences in the community pharmacy setting. This study aimed to (1) describe perceived everyday discrimination, including racial discrimination, in community pharmacies, (2) examine factors associated with perceived everyday discrimination, (3) examine the relationship between perceived racial discrimination and delays in picking up prescriptions, and (4) examine the relationship between perceived racial discrimination and forgoing prescriptions. A cross-sectional survey was conducted in 2021 with a U.S. Qualtrics research panel. The 9-item Everyday Discrimination Scale (EDS) was used to assess perceived discrimination (range 9-45, higher scores indicate higher perceived discrimination). One question asked whether respondents perceived racial discrimination. Two questions asked whether respondents delayed or forwent getting a prescription(s) in the past year. Descriptive statistics were calculated for all variables. A generalized linear model examined factors associated with perceived discrimination; logistic regression examined the relationships between perceived racial discrimination and delays in getting or forgoing prescription(s). Participants (n= 578) were 40.2 (±16.5) years old. Most were white (55.5%), 24.4% were black, and 29.4% were Hispanic or Latino. The mean EDS score was 16.5 (±8.8); 18.7% perceived racial discrimination. Overall, 36.3% and 33.0% reported a delay in getting and forgoing their prescriptions, respectively. Age (P < 0.0001), sexual identity or orientation (P= 0.010), ethnicity (P= 0.049), annual income (P= 0.012), and prescription insurance (P= 0.008) were associated with perceived discrimination. Those with perceived racial discrimination had significantly higher odds of a delay in getting their prescription(s) than those without perceived racial discrimination (odds ratio 2.6 [95% CI 1.3-5.3]). Study findings elucidate discrimination experiences in the community pharmacy and the impact of racial discrimination on individuals' decision in obtaining their medications in a timely manner. Community pharmacy staff need to recognize their implicit biases and obtain training on best practices that promote equitable treatment of diverse patients.

Discrimination of Sexual and Gender Minority Patients in Prostate Cancer Treatment: Results from the Restore-1 Study.

This study is the first to quantify experiences of discrimination in treatment undertaken by sexual and gender minority prostate cancer patients. Participants were 192 gay and bisexual and one transgender prostate cancer patients living in the US recruited from North America's largest online cancer support group. In this online survey, discrimination in treatment was measured using the Everyday Discrimination Scale (EDS), adapted for medical settings. Almost half (46%) endorsed at least one item, including 43% that the provider did not listen, 25% that they were talked down to, 20% that they received poorer care than other patients, 19% that the provider acted as superior, and 10% that the provider appeared afraid of them. While most (26.3%) rated the discrimination as "rare" or "sometimes" (EDS=1-3), 20% reported it as more common (EDS≥4). Most attributed the discrimination to their sexual orientation, or to providers being arrogant or too pushed for time. Discrimination was significantly associated with poorer urinary, bowel, and hormonal (but not sexual) EPIC function and bother scores, and with poorer mental health (SF-12). Those who had systemic/combined treatment (versus either radiation only or surgery only) were more likely to report discrimination. This study provides the first evidence that discrimination in prostate cancer treatment, including micro-aggressions, appear a common experience for gay and bisexual patients, and may result in poorer health outcomes.

Posttraumatic stress disorder in demobilized ex-combatants from illegal armed groups in Colombia: Cross-sectional study.

The objective of this study was to describe the psychological and quality of life outcomes in demobilized Colombian ex-combatants. A cross-sectional study was conducted on 58 ex-combatants from the Colombian government's reintegration program. Posttraumatic stress disorder (PTSD) was measured by the Mini-International Neuropsychiatric Interview. We applied the Beck-II Depression Inventory, Resilience Scale, Everyday Discrimination Scale, and World Health Organization Quality of Life-Short Version (WHOQOL-BREF) for measuring symptoms of depression, resilience, discrimination, and quality of life, respectively. The prevalence of PTSD was 63,8%, principally on ex-combatants with ≤10 years in the reinstatement program. Females with primary/elementary school, extremely low social status, unipersonal family type, family income <1 minimal wage, and symptoms of depression showed a higher prevalence ratio (>1.30). The mean scores of depression symptoms, resilience, and quality of life were systematically poorer in the group with PTSD. Significant differences were found Resilience scale domains Personal Competence (p = .043) and Acceptance of Self and Life (p = .012), WHOQOL-BREF Psychological (p = .029) and Environment domains (p = .015). Colombian ex-combatants with PTSD attending a reinstatement program presented a higher frequency of depression symptoms, lower quality of life, and lower resilience than those without PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Perceived ethnic discrimination, suicidal ideation and mastery in a multi-ethnic cohort: the HELIUS study.

The association between perceived ethnic discrimination (PED) and mental health conditions is well studied. However, less is known about the association between PED and suicidal ideation, or the role of positive psychosocial factors in this association. To examine the association between PED and suicidal ideation among ethnic minority groups in Amsterdam, The Netherlands, and investigate whether ethnicity and mastery (people's extent of feeling in control of their lives and environment) moderate this association. Cross-sectional data from the multi-ethnic HELIUS study were analysed (n = 17 053) for participants of South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin. PED was measured using the Everyday Discrimination Scale, suicidal ideation using item 9 of the Patient Health Questionnaire-9 and mastery using the Pearlin-Schooler Mastery Scale. Logistic regression analyses demonstrated a small positive association between PED and suicidal ideation (OR = 1.068, 95% CI 1.059-1.077), which did not differ among ethnic minority groups. Mastery did not moderate the association between PED and suicidal ideation among the ethnic minority groups. Our findings support the hypothesis that PED is associated with suicidal ideation and this association does not significantly vary between ethnic minority groups. Although higher levels of mastery were associated with lower suicidal ideation, mastery did not moderate the relationship between PED and suicidal ideation. Besides targeting ethnic discrimination as a societal problem, future longitudinal research is needed to investigate whether interventions aimed at improving mastery could reduce suicidal ideation in ethnic minority groups.

Discrimination Exposure and Polygenic Risk for Obesity in Adulthood: Testing Gene-Environment Correlations and Interactions

Introduction: Exposure to discrimination has emerged as a risk factor for obesity. It remains unclear, however, whether the genotype of the individual can modulate the sensitivity or response to discrimination exposure (gene × environment interaction) or increase the likelihood of experiencing discrimination (gene-environment correlation). Methods: This was an observational study of 4,102 white/European Americans in the Health and Retirement Study with self-reported, biological assessments, and genotyped data from 2006 to 2014. Discrimination was operationalized using the average of nine Everyday Discrimination Scale items. Polygenic risk scores (PRSs) for body mass index (BMI) and waist circumference (WC) were calculated using the weighted sum of risk alleles based on studies conducted by the Genetic Investigation of Anthropometric Traits (GIANT) consortium. Results: We found that greater PRS-BMI was significantly associated with more reports of discrimination (β = 0.04 ± 0.02; p = 0.037). Further analysis showed that measured BMI partially mediated the association between PRS-BMI and discrimination. There was no evidence that the association between discrimination and BMI, or the association between discrimination and WC, differed by PRS-BMI or PRS-WC, respectively. Conclusion: Our findings suggest that individuals with genetic liability for obesity may experience greater discrimination in their lifetime, consistent with a gene-environment correlation hypothesis. There was no evidence of a gene-environment interaction. More genome-wide association studies in diverse populations are needed to improve generalizability of study findings. In the meantime, prevention and clinical intervention efforts that seek to reduce exposure to all forms of discrimination may help reduce obesity at the population level.

Assessment of Psychological Variables amongst Indian Medical Professionals: A Cross-sectional Study

Background: The doctor–patient relationship is of critical importance to patient satisfaction and is impacted by various doctor-related factors. Aim: To assess the levels of emotional intelligence (EI), empathy, everyday/perceived discrimination and verbal aggression amongst medical professionals and medical students, and to understand the interrelations between these variables and their differences across groups. Materials and Methods: This cross-sectional study included convenience sampling of 191 medical students, and 94 medical professionals (residents and attending doctors). They were administered the Wong and Law emotional intelligence scale, Toronto empathy questionnaire, everyday discrimination scale and verbal aggression sub-scale from the Buss–Perry aggression scale. Data was analysed using Statistical Package for Social Sciences 20. Results: EI was significantly greater amongst professionals as compared to students, and positively correlated to years of experience in the medical profession. Everyday discrimination increased with years of experience in the medical fraternity and was also negatively correlated with the ‘emotion regulation’ component of EI. Female participants had higher levels of empathy and lower levels of everyday discrimination. Conclusion: In Indian medical professionals the levels of EI increase with years of experience and are higher for medical professionals than students. The levels of perceived discrimination increase with years of experience and were greater for medical professionals and male doctors. Perceived discrimination and verbal aggression showed a negative association with empathy and EI. Understanding the factors that impact the doctor–patient relationship, as well as the doctor’s personal experience in the medical fraternity, are crucial to improve patient satisfaction, as well as to improve the well-being of the medical professionals.

Understanding colourism in the UK: development and assessment of the everyday colourism scale

ABSTRACT This paper details the development and psychometric validation of the Everyday Colourism Scale (ECS), a measure designed to capture perceived skin shade prejudice from the ingroup (ethnic peers) and the outgroup (White people). The ECS was adapted from the Everyday Discrimination Scale using existing research, expert reviews, and acceptability interviews. Exploratory and confirmatory factor analysis, and reliability and validity analyses were conducted based on responses from 540 people of colour living in the UK. Predictive validity was tested based on data from an additional 201 participants. Results supported a 2-factor model, with good internal and test–retest reliability, and construct validity. Colourism from White people was associated with more frequent experiences of racism, higher internalized colourism, and greater anxiety. Colourism from participants’ ethnic peers was associated with lower self-esteem and perceived social support. Findings suggest the ECS is a promising new tool for assessing perceived colourism among a multi-ethnic UK sample.

Improving healthcare quality for transgender patients in the perioperative setting: The patient's perspective.

Transgender individuals reported higher rates of discrimination and barriers to care within healthcare settings than their cisgender counterparts. There is a paucity of literature concerning the barriers experienced within perioperative healthcare settings. Participants completed a sociodemographic questionnaire and a 7-item Likert-type scale survey: the Everyday Discrimination Scale Adapted for Medical Settings. Overall, 57% of trans-individuals who underwent gender-affirming surgery reported perceptions of discrimination when interacting with healthcare providers within the perioperative setting according to responses from the Discrimination in Medical Settings Survey. There was an overall difference in the summary scores between participants based on gender transition. These findings highlight an opportunity to address barriers to care related to discrimination and negative patient-provider interactions. These findings have implications for the development and integration of patient-informed, evidence-based, trans-specific, educational and cultural competency trainings to enhance the healthcare professional's knowledge, attitudes, comfort and ability to care for the transgender population.Key phrases: Transgender individuals reported higher rates of discrimination and barriers to care; enhancing the healthcare professional's knowledge, attitudes, comfort and ability to care for the transgender population; opportunities to address barriers to care related to discrimination and negative patient-provider interactions; individuals who transitioned from male-to-female (MTF) had higher scores related to perceptions of discrimination during interactions with healthcare providers.

Cross-cultural adaptation of discrimination and vigilance scales in ELSA-Brasil.

To describe the process of cross-cultural adaptation for the use in Brazil of the everyday discrimination scale (EDS) and the heightened vigilance scale (HVS) applied in the Longitudinal Study of Adult Health (ELSA-Brasil). Conceptual, item and semantic equivalence analyses were conducted by a group of four epidemiologists; evaluation of measurement equivalence (factorial analysis of configural, metric and scalar structures, according to sociodemographic characteristics) and reliability. A total of 11,987 participants responded to the discrimination scale, and a subsample of 260 people participated in the test-retest study. In the case of HVS, 8,916 people responded, while 149 individuals did so in the test-retest study. The scales presented conceptual, item and semantic equivalence pertinent in the Brazilian context, in addition to adequate correspondence of referential/denotative meaning of terms and also of the general/connotative of the items. The confirmatory factor analysis of EDS revealed a unidimensional structure, with residual correlations between two pairs of items, presenting configural and metric invariance among the four subgroups evaluated. Scalar invariance was identified according to sex and age group, but it was not observed for race/color and education. Heightened vigilance showed low loads and high residuals, with inadequate adjustment indicators. For the items of the discrimination scale the weighted kappa coefficient (Kp) ranged from 0.44 to 0.78, and the intraclass correlation coefficient (ICC) was 0.87. For HVS items, the Kp ranged from 0.47 to 0.59 and the ICC was 0.83. Although there are correlated items, it was concluded that the EDS is a promising scale to evaluate experiences of perceived discrimination in Brazilian daily life. However, the heightened vigilance scale did not present equivalence of measurement in the current format.

Population-level contribution of interpersonal discrimination to psychological distress among Australian Aboriginal and Torres Strait Islander adults, and to Indigenous–non-Indigenous inequities: cross-sectional analysis of a community-controlled First Nations cohort study

International and population-specific evidence identifies elevated psychological distress prevalence among those experiencing interpersonal discrimination. We aim to quantify the potential whole-of-population contribution of interpersonal discrimination to psychological distress prevalence and Indigenous-non-Indigenous gaps in Australia. We did a cross-sectional analysis of data from Mayi Kuwayu: the National Study of Aboriginal and Torres Strait Islander Wellbeing. Baseline surveys were completed between June 8, 2018, and Sept 28, 2022. We analysed responses from participants who were aged 18 years or older at survey completion, whose surveys were processed between Oct 1, 2018, and May 1, 2021. Sample weights were developed on the basis of national population benchmarks. We measured everyday discrimination using an eight-item measure modified from the Everyday Discrimination Scale and classified experiences as racial discrimination if participants attributed these experiences to their Indigeneity. Psychological distress was measured using a validated, modified Kessler-5 scale. Applying logistic regression, we calculated unadjusted odds ratios (ORs), to approximate incident rate ratios (IRRs), for high or very high psychological distress in relation to everyday discrimination and everyday racial discrimination across age-gender strata. Population attributable fractions (PAFs), under the hypothetical assumption that ORs represent causal relationships, were calculated using these ORs and population-level exposure prevalence. These PAFs were used to quantify the contribution of everyday racial discrimination to psychological distress gaps between Indigenous and non-Indigenous adults. 9963 survey responses were eligible for inclusion in our study, of which we analysed 9951 (99·9%); 12 were excluded due to responders identifying as a gender other than man or woman (there were too few responses from this demographic to be included as a category in stratified tables or adjusted analyses). The overall prevalence of psychological distress was 48·3% (95% CI 47·0-49·6) in those experiencing everyday discrimination compared with 25·2% (23·8-26·6) in those experiencing no everyday discrimination (OR 2·77 [95% CI 2·52-3·04]) and psychological distress prevalence was 49·0% (95% CI 47·3-50·6) in those experiencing everyday racial discrimination and 31·8% (30·6-33·1) in those experiencing no everyday racial discrimination (OR 2·06 [95% CI 1·88-2·25]. Overall, 49·3% of the total psychological distress burden among Aboriginal and Torres Strait Islander adults could be attributable to everyday discrimination (39·4-58·8% across strata) and 27·1% to everyday racial discrimination. Everyday racial discrimination could explain 47·4% of the overall gap in psychological distress between Indigenous and non-Indigenous people (40·0-60·3% across strata). Our findings show that interpersonal discrimination might contribute substantially to psychological distress among Aboriginal and Torres Strait Islander adults, and to inequities compared with non-Indigenous adults. Estimated PAFs include contributions from social and health disadvantage, reflecting contributions from structural racism. Although not providing strictly conclusive evidence of causality, this evidence is sufficient to indicate the psychological harm of interpersonal discrimination. Findings add weight to imperatives to combat discrimination and structural racism at its core. Urgent individual and policy action is required of non-Indigenous people and colonial structures, directed by Aboriginal and Torres Strait Islander peoples. National Health and Medical Research Council of Australia, Ian Potter Foundation, Australian Research Council, US National Institutes of Health, and Sierra Foundation.

Relationship of daily, institutional and structural racism with cognition in ethnically/racially diverse middle‐age Americans

AbstractBackgroundRacism is a social determinant of health that operates at multiple levels ‐ interpersonal, institutional, structural ‐ producing stress and limiting access to resources that have dire biopsychosocial effects for historically marginalized communities. Research on older adults suggests interpersonal and structural racism, separately, are associated with worse cognition and may be an underlying reason for racial/ethnic disparities in cognitive aging. An evidence gap remains on how multilevel racism influences cognition throughout the life‐course.MethodWe assessed 942 middle‐aged community‐dwelling adults (mean age = 55, SD = 11; 64% women; 19% non‐Latinx White; 23% non‐Latinx Black; 55% Latinx). Daily interpersonal racism was ascertained by the Everyday Discrimination (ED) scale, institutional racism by the Major Discrimination (MD) Scale, and structural racism in early life was measured by residential segregation of the census block group in which parents of our respondents lived. Our outcomes were derived from a neuropsychological evaluation with the Digit Span assessing attention and working memory, and delayed recall from the Selective Reminding Test capturing episodic memory. Two fluency measures (animal and letter) were also studied. The relationship between multilevel racism indicators and cognition was estimated using age‐adjusted linear regression models. Additional models were stratified by racialized/ethnic group and added education as a covariate.ResultExposure to multilevel racism varied across racialized/ethnic group. Non‐Latinx Black respondents scored highest on interpersonal racism, second highest on institutional racism, and were more likely to grow up in segregated residential areas with higher proportion of other Black residents. Exposure to interpersonal (Figure A) and institutional racism (Figure B) was associated with lower memory scores and these associations were driven by non‐Latinx Black respondents. Structural racism was associated with lower episodic memory in the full sample.ConclusionOur findings indicate that multilevel racism related to cognition and due to higher exposure among marginalized groups may be a substantial driver of racial/ethnic disparities in cognitive health. In future, additive and multiplicative effects of our exposures will be examined.