Negative Psychosocial Outcomes Research Articles

Social support among chronically ill adolescent and young adult patients using a hospital-based online health community as part of a palliative care program: A qualitative study.

Chronically ill adolescent and young adult (AYA) patients experience barriers to accessing psychosocial support/palliative care, increasing their risk for negative psychosocial outcomes. Online health communities (OHCs) have been recommended for AYAs as part of palliative care support programs; however, we lack research investigating palliative care programs targeting AYAs' psychosocial support needs that are delivered virtually and able to engage with patients both during and beyond inpatient admissions. Streetlight is a palliative care program designed for chronically ill AYAs. Developed as a complementary component that extends beyond the hospital setting, Streetlight Gaming and Online Team (SGOT) is an OHC aimed at facilitating social support to influence psychosocial outcomes. We investigated the existence and enactment of social support among chronically ill AYAs using SGOT and compared this to existing online social support categories to determine which support types are present within SGOT. This was a qualitative phenomenological study. We performed deductive thematic analysis based on existing online social support categories. Nine semi-structured interviews were conducted with SGOT participants. Social companionship/belonging, esteem/emotional, and informational support were most prevalent within SGOT. Thirteen subthemes emerged representing how social support impacted AYAs' psychosocial wellbeing. Notably, coping with/managing illness, sense of community and normalcy, recommendations and advice, and shared interests unrelated to illnesses were subthemes that resonated with AYAs and added value to their experiences. SGOT is an impactful OHC used to meet AYAs' social support needs. What makes SGOT especially unique is its virtual delivery, wherein AYAs can conveniently maintain beneficial relationships with other chronically ill same-aged peers. AYAs need spaces where they can feel normal and access continuous support, both within and beyond inpatient admissions. This study enhances our understanding of online AYA psychosocial support programs. Findings can be used by healthcare professionals to implement similar palliative care and psychosocial support programs.

What We Know About Homeless Veterans With Other-than-honorable and Punitive Discharges: Data From the Grant and Per Diem (GPD) Program.

The U.S. DVA Grant and Per Diem (GPD) program funds community agencies to provide housing and case management services to Veterans experiencing homelessness. GPD is one of the few VA programs that can enroll Veterans with Other-than-Honorable (OTH) military discharges. The characteristics of OTH Veterans and their outcomes in GPD are unknown. We linked the Homeless Operations and Management Evaluation System database and VA Corporate Data Warehouse to identify Veterans with complete GPD enrollment and discharge data between 2018 and 2020. We categorized Veterans into three military discharge groups: Honorable, OTH, or Punitive. We evaluated key GPD process and outcomes measures: days enrolled in GPD, use of VA-funded emergency department care while in GPD, and whether a Veteran was successfully discharged from GPD, their housing status at program exit, employment status at program exit, and connection to mental health and substance abuse treatment at discharge. We conducted multivariable regressions to determine the adjusted association (controlling for demographics and comorbidities) between military discharge status and process and outcome measures. Among 21,646 Veterans in the GPD program, 20,517 (95%) were honorably discharged; 811 (4%) had an OTH discharge; and 318 (1%) had a Punitive discharge. There was no difference in GPD length of enrollment by discharge status. Compared to honorably discharged veterans, OTH and Punitive discharged Veterans were less likely to successfully exit GPD, more likely to be homeless and employed at program exit, and were less likely to have a VA-funded emergency department visit while in GPD and less likely to be connected to mental health care or substance use treatment at program exit. The GPD program serves hundreds of homeless Veterans with OTH and Punitive discharges every year, but they seem to be at greater risk for negative health and psychosocial outcomes and do not have the same access to VA services as other Veterans. These findings may inform policy considerations about expanding VA care and opportunities for community providers to serve Veterans with OTH and Punitive discharges.

The long-term collateral consequences of juvenile justice involvement for females.

Females are the fastest growing justice involved population in the United States, yet there is relatively little empirical research on the collateral consequences of juvenile justice involvement specifically for females. A growing body of empirical research underscores linkages between juvenile justice involvement and negative health and psychosocial outcomes, both in the short and long term. The current study describes the long-term collateral consequences of juvenile justice involvement for females previously involved in the juvenile justice system, drawing from a longitudinal dataset of 166 women who were initially recruited in adolescence due to chronic and severe justice system involvement. Participants were 15 years-old on average at study enrollment and 35 years-old on average at the current assessment. This paper describes the adolescent and adult experiences of the sample, therefore depicting the developmental trajectories of risk and protective factors for females involved with juvenile justice. As adults, 73% of the sample experienced arrest and 36% experienced incarceration. High rates of mental and physical health problems were reported, including that 50% of the sample met diagnostic criteria for posttraumatic stress disorder. Over 400 children were born to the sample, with high rates of documented intergenerational child welfare involvement. Study findings are discussed in the context of best practices for supporting adolescent girls involved with the juvenile justice system.

A Phenomenological Qualitative Exploration of Mind-Body Therapy Use and Effectiveness Among Young, Middle, and Older Adult Cancer Survivors.

Having been diagnosed with and treated for cancer can have negative psychosocial repercussions that may differ across the lifespan. Mind-body therapies (MBTs), such as tai-chi/qigong (TCQ) or mindfulness-based cancer recovery (MBCR), have shown promise in decreasing negative psychosocial outcomes in cancer survivors, but few studies have explored potential differences in MBT use and effectiveness across age groups. A descriptive phenomenological qualitative design was used. Participants included young (18-39), middle (40-64), and older (65+) adult cancer survivors who were diagnosed with any type of cancer and had participated in Mindfulness-Based Cancer Recovery (MBCR) or Tai Chi/Qigong (TCQ) MBTs. Semi-structured qualitative interviews explored participants' experiences in MBTs and these were analyzed using descriptive phenomenological analysis. Among the interviews (n = 18), young (n = 6), middle-aged (n = 8), and older (n = 4) adults participated. 5 themes emerged: influences in joining the program, unique lifestyles, positive class experiences, use of media, and program impacts. Though all age groups benefitted from MBT participation, variations between age groups with respect to the benefits received and motivations for joining the program were observed. MBTs had beneficial physical and mental health effects on survivors of all age groups. These benefits were particularly connected to the ongoing life stresses common to each age cohort, such as relief from work and family roles for young adults or support during retirement transition for older adults. Hence, access to MBT programs may be beneficial as part of the survivorship plan for patients and the recruitment strategies or content can be adapted by MBT providers to better target and support age-specific groups. More research is required with a larger sample.

The Aesthetic Evaluation of the Brow-Eye Continuum After Correction of Severe Congenital Ptosis in Children With Extended Frontalis Muscle Advancement Technique.

Severe congenital ptosis is a common ocular deformity in pediatric patients that can significantly impact visual development and aesthetic appearance, leading to negative psychosocial outcomes. The frontalis muscle advancement technique is a well-established surgical treatment for severe congenital ptosis. Aesthetic changes of the brow-eye continuum often plays an important role in ptosis surgery. We conducted a single-center retrospective case series study of patients with severe congenital ptosis who underwent the frontalis muscle advancement technique at the Department of Plastic and Reconstructive Surgery, Xijing Hospital, Fourth Military Medical University between April 2020 and June 2021. The study aimed to evaluate the aesthetic changes of the eyebrow-eyelid continuum after surgery. The main outcome measurements included marginal reflex distance 1, palpebral fissure height, eyebrow position, upper eyelid to lower eyebrow distance, lower eyelid to upper eyebrow distance, and nasal base to lower eyelid distance. The study included 48 patients (66 eyelids), with 30 unilateral and 18 bilateral patients. Our analysis found that eyebrow height decreased by an average of 4.8% postoperatively relative to preoperatively in all patients. The frontalis muscle advancement technique has demonstrated effectiveness in achieving aesthetically pleasing outcomes in children with severe ptosis. It is crucial to pay careful attention to the brow-eye continuum during the correction process, as its harmony can greatly impact the final result.

First Used Nicotine/Cannabis Product and Associated Outcomes in Late Adolescents

Background Nicotine and tobacco product (NTP) and cannabis use are common in adolescence/young adulthood and increase risk for negative psychosocial outcomes. This study investigated associations among adolescent/young adults’ initial experiences with NTPs, lifetime frequency of substance use, substance-related problems, and mental health symptoms. Method Adolescents and young adults enrolled in a study on NTP and cannabis use were asked at what age they initiated the use of NTPs and were assigned to groups based on which product or substance(s) they reported using at the earliest age. Participants who reported use of NTPs (in isolation, without cannabis) first (N = 78, “NTP-only”), simultaneous use of NTPs and cannabis first (e.g., blunt or bowl; N = 25, “Simult-only”), use of both NTPs in isolation and simultaneous use at the same age (N = 48, “NTP + Simult”), and no NTP use (N = 53, “NTP-naïve”) were compared on substance use, substance-related problems, and mental health symptoms. Results Groups differed on lifetime frequency of NTP, simultaneous, and cannabis use, with NTP users reporting more substance use episodes and substance-related problems than the NTP-naïve group. The lifetime frequency of cannabis use did not differ across NTP use groups. NTP use was associated with increased anxiety and depression, with no significant differences between groups. Conclusions Adolescents and young adults who use nicotine may be at increased risk for greater nicotine use and mental health consequences, but initiating NTP use simultaneously with cannabis may not increase the risk of negative outcomes above and beyond nicotine initiation. Prospective longitudinal research is needed to establish temporal associations between first-used NTP/cannabis products and relevant outcomes.

Nonsuicidal self-injury methods among U.S. Veterans: Latent class analysis and associations with psychosocial outcomes

Nonsuicidal self-injury (NSSI) is a debilitating concern among U.S. veterans, with wall/object-punching commonly endorsed as an NSSI method. We examined how this behavior relates to other NSSI methods and psychosocial outcomes. We conducted a latent class analysis (LCA) of NSSI methods among 1,138 Gulf War Era veterans, (77.9% male), 21.7% of whom endorsed lifetime NSSI. We categorized classes based on their associations with age, sex, combat and military sexual assault exposure, then examined the association of class membership with psychosocial indicators. LCA results supported four classes: 1) High punching/banging NSSI (2.5%); 2) Multimethod NSSI methods (6.3%); 3) High-risk, multimethod NSSI (3.1%); and 4) Low-risk NSSI (88.1%). Psychosocial indicators (suicide attempt, ideation, possible depressive or posttraumatic stress disorders, poor psychosocial functioning) were worse for members of the NSSI classes versus those in the low-risk group. A subset of U.S. veterans may engage in NSSI primarily via punching/banging methods. All patterns of NSSI engagement were associated with negative psychosocial outcomes relative to those in the low-risk class of the behavior.

Nörodejeneratif Hastalıklarda Rehabilitasyonun Psikososyal Yönleri ve Yaklaşım Alanları

Psychosocial health is a concept included in definition of health by World Health Organization and corresponds to state of emotional and social well-being. In the context of neurological disorder, psychosocial health refers to social reintegration and psychological adjustment. Studies reporting that neurological diseases are associated with negative psychosocial health outcomes such as a decrease in the quality of life, a decrease in ability to establish and maintain social relationships, and an increase in high levels of depression, stress and anxiety have increased in recent years. Therefore, it is important to consider programs and interventions that can improve the psychosocial health of people with neurodegenerative diseases. Currently, it is not clear which psychosocial approaches can produce definitively positive results. The aim of this study is to examine how being an individual with Multiple Sclerosis and Parkinson's, which are the most common neurodegenerative diseases in the clinic, affects psychosocial health in the rehabilitation process and the existing evidence-based psychosocial approaches. For this purpose, a descriptive review was prepared by scanning English and Turkish articles with keywords on psychotherapeutic, psychosocial and mindfulness-based interventions and stress management, published in the determined databases in the last 10 years. Studies have shown that psychosocial approaches such as interventions for acquisition of social integration and adaptive coping strategies, cognitive and social behavioral therapy methods, concentration and movement-based mind-body exercises are effective in rehabilitation of neurodegenerative diseases. These approaches were reported to have benefits in reducing anxiety, depression and fatigue, improving sleep quality and quality of life, relationships, employment, level of participation, motivation and self-efficacy in exercise and physical activity, improving physical functions, facilitating difficult and personal experiences and adaptation to new life in rehabilitation processes and more evidence-based studies are needed.

Addendum to “Evaluating substance use outcomes of recreational cannabis legalization using a unique co-twin control design”

ABSTRACT An earlier version of this article was published in error. Our prior publication was missing reference to a prior study on this topic. Our prior research has not found an association between recreational cannabis legalization (RCL) and negative psychosocial and psychiatric outcomes. We reported significant associations between RCL with greater cannabis frequency and fewer alcohol use disorder symptoms. The current study expands on our previous research by using a cross-sectional design and different measures of problems from cannabis and alcohol use and including additional substance use variables. The current study found similar results to our previous research.

Higher baseline emotion dysregulation predicts treatment dropout in outpatients with borderline personality disorder.

Treatment dropout is high among outpatients with borderline personality disorder (BPD) and is associated with myriad negative therapeutic and psychosocial outcomes. Identifying predictors of treatment dropout can inform treatment provision for this population. The present study investigated whether symptom profiles of static and dynamic factors could predict treatment dropout. Treatment-seeking outpatients with BPD (N = 102) completed pre-treatment measures of BPD symptom severity, emotion dysregulation, impulsivity, motivation, self-harm, and attachment style to determine their collective impact on dropout prior to 6 months of treatment. Discriminant function analysis was used to classify group membership (treatment dropout vs. nondropout) but did not produce a statistically significant function. Groups were distinguished by baseline levels of emotion dysregulation with higher dysregulation predicting premature treatment dropout. Clinicians working with outpatients with BPD might benefit from optimizing emotion regulation and distress tolerance strategies earlier in treatment to reduce premature dropout. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Moderating role of meaning in life in the relationship of death anxiety, experiential avoidance and health-related quality of life among type 2 diabetes patients

Individuals diagnosed with type 2 diabetes mellitus may experience death anxiety and experiential avoidance, which may impact negatively on health-related quality of life. Meaning in life is a positive psychological resource that protects against negative psychosocial outcomes. Although a direct relationship between these variables exists, to our knowledge, previous research has not explored their interaction effect. The present study examined whether meaning in life moderates the relationship between (1) multidimensional death anxiety and health-related quality of life, and (2) experiential avoidance and health-related quality of life among type 2 diabetes mellitus patients. The pool of participants consisted of 311 type 2 diabetes outpatients drawn from a tertiary health care institution in South-East Nigeria. The participants completed several self-report measures, such as the short form of the Diabetes Quality of Life Questionnaire, Death Anxiety Inventory–Revised, Acceptance and Action Questionnaire, and the Presence of Meaning in life subscale of Meaning in Life Questionnaire. The results of a regression analysis showed that death anxiety in terms of death acceptance, death finality, and thoughts about death were independently associated with poor health-related quality of life at low, but not at average and high levels of meaning in life. Externally generated death anxiety was associated with poor health-related quality of life at low and average, but not at high levels of meaning in life. Finally, experiential avoidance was associated with poor health-related quality of life at low and average, but not at high levels of meaning in life. We concluded that psychological interventions geared towards promoting health-related quality of life of type 2 diabetes mellitus patients should consider integrating meaning in life for its protective nature in improving positive health outcomes and recovery.

Associations between older adults' social media use behaviors and psychosocial well-being.

Research examining associations between social media use behaviors and psychosocial well-being among older adults are limited. To explore associations between older adults' social media (social networking services and instant messaging applications) use behaviors and psychosocial well-being. This was a secondary data analysis. All data were retrieved from the Taiwan Communication Survey database, an annual survey that examines trends in Taiwanese residents' communication behaviors and social media use. The original investigation was conducted in Taiwan from September to December 2019. Data from 647 older adults aged over 60 years were extracted for the analyses. Social media use behaviors (users/non-users and time spent using), positive psychosocial outcomes (life satisfaction, self-determination, subjective well-being, and happiness), negative psychosocial outcomes (loneliness, depression, and anxiety), and demographic variables were included. Social media users had significantly higher levels of subjective well-being and lower levels of depression, anxiety, and loneliness compared with non-users. Time spent on social networking services was significantly and positively correlated with negative psychosocial outcomes (β = 0.103, p = 0.044, f2 = 0.011), and it was significantly and inversely correlated with positive psychosocial outcomes (β = -0.063, p = 0.049, f2 = 0.004). Time spent using an instant messaging application was significantly positively associated with positive psychosocial outcomes (β = 0.068, p = 0.031, f2 = 0.005). The proposed path model had an acceptable model fit. Study results indicated that older adults' social media use behaviors were associated with their psychosocial well-being. Older adults are recommended to use social media for appropriate time periods as an important way to promote social engagement for their psychosocial well-being.

Culture, Coping, and Racial Discrimination Stress Among Chinese American Youth: A Longitudinal Mixed Methods Study

Using a longitudinal mixed methods approach, this study examined Chinese American youth’s experiences and coping with racial discrimination. Participants included 25 second-generation Chinese American youth who participated in an 8-year, three-wave longitudinal study. The participants’ average age at Time 1 was 15.5 years. Participants were interviewed with open-ended questions about their experiences of discrimination growing up. In addition, quantitative survey data were collected to examine associations between youth’s ethnic identity, acculturation, cultural values, coping, and discrimination stress. The interview transcripts were analyzed using thematic analysis. Qualitative responses were coded and quantitative data were analyzed using independent sample t-tests. The participants reported both overt and covert experiences of racial discrimination. Despite facing racial discrimination, many Asian American youth chose to cope in culturally congruent ways that are consistent with their cultural values. Our findings provide new evidence that discrimination distress is linked to negative psychosocial outcomes, lower ethnic identity, and less recognition of heritage culture. Furthermore, our results suggest that culturally congruent coping strategies labeled as maladaptive in North American culture could be adaptive for Chinese American youth against discrimination distress. Study findings have implications for culturally responsive services and practices to support Chinese American youth to succesfully cope with racial discrimination.

A qualitative study of women care professionals’ experiences in social service non-profit organizations in Israel

ABSTRACT Although women play a significant role in non-profit organizations as employees, volunteers, and clients, there is insufficient knowledge about these women and their unique work experiences in the current era, which is characterized by outsourcing of social services. This study explored work experiences among women in professional care settings of social service non-profit organizations (SSNPOs). Forty in-depth interviews were conducted with women with postsecondary education working as care professionals (such as social workers and occupational therapists) in Israeli SSNPOs. The sample reflected Israel’s geographical, religious, ethnic, and job (full-time and part-time) diversity. Interviewees were asked about their employment experiences, struggles, and challenges. Thematic analysis was used. The findings shed light on how care work in SSNPOs enters the private sphere and is internalized, i.e. boundaries between home and work that are continuously blurred and endanger employees’ well-being. Our study suggests that women working in care professions in contracted SSNPOs are more vulnerable due to their working conditions, despite their postsecondary education and defined professions. Negative psychosocial outcomes are the major challenge for this population.

Hovering or invalidating? Examining nuances in the associations between controlling parents and problematic outcomes for college students

Objective: The purpose of these studies was to examine whether college students’ beliefs about themselves (i.e., self-compassion and beliefs about emotions) could be mechanisms explaining the relationship between problematic parenting behaviors (helicopter parenting and parental invalidation) and outcomes including perfectionism, affective distress, locus of control, and distress tolerance. Participants: Respondents included 255 (Study 1) and 277 (Study 2) college undergraduates. Methods: Simultaneous regressions and separate path analyses with helicopter parenting and parental invalidation as predictors, with self-compassion and emotion beliefs as mediators. Results: Across both studies, parental invalidation predicted perfectionism, affective distress, distress tolerance, and locus of control, and these links were often mediated by self-compassion. Self-compassion emerged as the most consistent and strongest link between parental invalidation and negative outcomes. Conclusion: People who internalize their parents’ criticism and invalidation such that they hold negative beliefs about themselves (i.e., low self-compassion) may be vulnerable to negative psychosocial outcomes.

Self-reported autistic traits and psychosocial outcomes among university students in Malaysia.

Most research on autism spectrum conditions is done on young children and not as much on young adults with autism spectrum conditions. Because of this, not much is known about how common autism spectrum conditions are in young adults and how they affect their mental and social health, especially in Southeast Asia. Based on self-reports, 2.8% of the 2732 university students we looked at in Malaysia might have been diagnosed or thought to have an autism spectrum condition. Students who said they had or thought they had autism spectrum conditions had lower self-efficacy, more stress and a lower quality of life than students who said they did not have autism spectrum conditions. The results showed that university students with autism spectrum condition are more likely to have bad psychological and social outcomes than their peers without autism spectrum condition. Also, the link between autistic traits and psychosocial outcomes could depend on the culture.

Dismantling weight stigma in eating disorder treatment: Next steps for the field.

The authors posit current guidelines and treatment for eating disorders (EDs) fail to adequately address, and often perpetuate, weight stigma. The social devaluation and denigration of higher-weight individuals cuts across nearly every life domain and is associated with negative physiological and psychosocial outcomes, mirroring the harms attributed to weight itself. Maintaining focus on weight in ED treatment can intensify weight stigma among patients and providers, leading to increased internalization, shame, and poorer health outcomes. Stigma has been recognized as a fundamental cause of health inequities. With no clear evidence that the proposed mechanisms of ED treatment effectively address internalized weight bias and its association with disordered eating behavior, it is not hard to imagine that providers' perpetuation of weight bias, however unintentional, may be a key contributor to the suboptimal response to ED treatment. Several reported examples of weight stigma in ED treatment are discussed to illustrate the pervasiveness and insidiousness of this problem. The authors contend weight management inherently perpetuates weight stigma and outline steps for researchers and providers to promote weight-inclusive care (targeting health behavior change rather than weight itself) as an alternative approach capable of addressing some of the many social injustices in the history of this field.

Locked inside: Living with uncertainty in self-management for endometriosis during the COVID-19 pandemic

ObjectiveA high symptom burden systemic inflammatory disorder, endometriosis typically entails both medical management and self-management strategies. The COVID-19 pandemic in Australia precipitated changes to healthcare provision, societal restrictions, and negative psychosocial outcomes particularly for those managing chronic illnesses (e.g., endometriosis). This study's objective was to address the following questions: “How have endometriosis self-management strategies changed since the outbreak of COVID-19, and what are the consequences of these changes?” MethodsIn total, 21 respondents residing in Australia during the COVID-19 pandemic participated in a semi-structured interview following completion of an online survey advertised by Endometriosis Australia. In the survey, respondents provided demographic and clinical information, and psychological distress was assessed. Interviews were conducted online and recorded for transcribing. Transcribed data were thematically analyzed using the template method. ResultsQualitative analysis identified five themes: i) Maintaining Relationships with Health Professionals, ii) Altered Information Seeking Strategies, iii) More Autonomous Decision Making, iv) Diminished Self-Care and Behaviour Change, and v) Shifted Priorities. Respondents reported disruptions to, and uncertainties within, the healthcare system that precipitated adverse effects upon their ability to manage endometriosis and mental health. ConclusionsThese findings suggest that for many, COVID-19-related disruptions to the healthcare system and social isolation adversely impacted their endometriosis self-management. Targeted interventions are needed to address the consequences of these, including providing reliable information to support informed decision-making regarding endometriosis self-management, and assisting with mental health challenges arising from COVID-19-related social isolation.

Exploring the impact of the reclassification of a hereditary cancer syndrome gene variant: emerging themes from a qualitative study

The complexity of genetic variant interpretation means that a proportion of individuals who undergo genetic testing for a hereditary cancer syndrome will have their test result reclassified over time. Such a reclassification may involve a clinically significant upgrade or downgrade in pathogenicity, which may have significant implications for medical management. To date, few studies have examined the psychosocial impact of a reclassification in a hereditary cancer syndrome context. To address this gap, semi-structured telephone interviews were performed with eighteen individuals who had a BRCA1, BRCA2 or Lynch syndrome-related (MLH1, MSH2, MSH6 or PMS2) gene variant reclassified. The interviews were analysed utilising an inductive, qualitative approach and emergent themes were identified by thematic analysis. Variable levels of recall amongst participants were found. Common motivations for initial testing included a significant personal and/or family history of cancer and a desire to “find an answer”. No individual whose uncertain result was upgraded reported negative psychosocial outcomes; most reported adapting to their reclassified result and appraised their genetic testing experience positively. However, individuals whose likely pathogenic/pathogenic results were downgraded reported feelings of anger, shock and sadness post reclassification, highlighting that additional psychosocial support may be required for some. Genetic counselling issues and recommendations for clinical practice are outlined.

Sources for prescription stimulant misuse: A person-centered approach to understanding links to substance use and psychiatric impairment.

Prescription stimulant misuse (PSM) is most prevalent among college students and is associated with numerous negative academic and psychosocial outcomes. A large body of literature has identified predictors of PSM in this population, however few studies have utilized a person-centered approach to examine how the sources from which students procure prescription stimulants are associated with substance-related and psychiatric impairment. We used latent class analysis (LCA) to classify a geographically and racially/ethnically diverse sample of U.S. undergraduates (N = 538) who misused prescription stimulants into groups based on their endorsement of nine sources of medication. We selected a five-group classification from the LCA with classes of peer/dealer, given by friend, own prescription, lower multiple sources (i.e., relatively infrequent endorsement of multiple sources), and any source. Compared to the reference group (given by friend), the own prescription class was less likely to report marijuana use, simultaneous alcohol and marijuana use, alcohol or marijuana consequences, and nonoral routes of administration. On the other hand, the own prescription class was more likely to screen positive for anxiety, anger, and suicidality. Similarly, the lower multiple sources group was more likely to screen positive for depression, anxiety, anger, and suicidality. Prevention and intervention efforts focused on PSM may be tailored differently for students who are misusing their own medication and/or endorsing multiple sources. Specifically, these students may need broader assistance with comorbid psychiatric conditions, particularly suicidality, while students who obtain stimulants from peers or a dealer may benefit more from substance-focused interventions. (PsycInfo Database Record (c) 2023 APA, all rights reserved).