Self-perceived Discrimination Research Articles

Self-reported perceived discrimination and experiences of patients with cancer.

165 Background: Racial discrimination is a significant social determinant of health inequities. Ethnic disparities can indirectly result in different access to care, while healthcare provider ethnic bias can influence healthcare outcomes. National statistics show that Black patients have higher death rates when compared to those of other race and ethnicities. Our study aims to evaluate and compare self-reported and perceived discrimination in day-to-day life and healthcare experiences of patients who receive care at our cancer center. Methods: Cancer patients were surveyed in person at the Cancer Center at Medstar Washington Hospital Center between July 2022 and January 2023. The Everyday Discrimination Scale (EDS) by D.R. Williams and Discrimination in Medical Setting (DMS) questionnaire by M.E. Peek were used to collect data. Results: 100 patients following up at the clinic completed the paper survey. 74% were females and 26% males, 75% Black, 17% White and 8% Other Races (including Hispanic and Asian). The responses to the EDS and DMS were collected and coded as continuous variables, summed together, reported as medians, and compared across the various groups of interest. P-values between medians were reported using Kruskal Wallis test/Wilcoxon rank-sum test. Highest median scores on the EDS were found in Other Races, with a higher score representing higher self-perceived discrimination, followed by Black, and White (p<0.001). Lowest median scores on the DMS questionnaire were found in White, lower score representing lower self-perceived discrimination, followed by Other Races and Black (p<0.001). 30% of our total study population reported feeling that their quality of care was affected due to racial discrimination, out of which 83% were Black and 16% were Other Races, not including White (p= 0.006). Comparison of median scores for both the scales was not statistically different across age, gender, and cancer type. Conclusions: The results of our study demonstrate that self-reported and self- perceived racial discrimination extends to health care, and for some includes self-reported effects on the quality of health care received. Worse responses of the Other Races on the EDS and DMS scales could be explained by the low number of participants. Overall, the negative responses may have been affected by a variety of factors like varying stage of diagnosis, care received at other health-care centers, all of which would attribute to self-reported poorer experience regardless of race. There is a growing need to address these disparities to providing culturally sensitive care and addressing the root causes of systemic racism and inequality. This study is the first step in determining the day-to-day and healthcare experiences among patients at our center. We hope to follow with a prospective survey-based analysis of implicit bias among all healthcare workers.

Development and validation of the thyroid cancer self-perceived discrimination scale to identify patients at high risk for psychological problems.

To develop a Thyroid Cancer Self-Perceived Discrimination Scale (TCSPDS) to identify patients at high risk for psychological problems and to test its reliability, validity and acceptability. Using classical test theory, a total of 176 thyroid cancer patients from November 2021 to October 2022 were recruited to develop the TCSPDS. Item analysis was used to improve the preliminary TCSPDS. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation model (SEM) were used to test the construct validity of the final TCSPDS. Pearson correlation coefficient was used to analyze the validity coefficient between TCSPDS and EORTC QLQ-C30 to test the criterion-related validity (CRV) of the final TCSPDS. The internal consistency coefficient (Cronbach's alpha coefficient), split half reliability (Spearman-Brown coefficient) and test-retest reliability were used to verify the reliability of the final TCSPDS. The questionnaire completion time and effective response rate were used to validate the acceptability of the final TCSPDS. The TCSPDS consisted of 20 items and was divided into 3 subscales: 8 items for stigma, 6 items for self-deprecation, and 6 items for social avoidance. The TCSPDS had good validity (χ2/df=1.971, RMSEA=0.074, GFI=0.921, CFI= 0.930, IFI=0.932, TLI=0.901, Validity coefficient=0.767), reliability (Cronbach's alpha=0.867, Spearman-Brown coefficient=0.828, test-retest reliability coefficient=0.981) and acceptability [average completion time (15.01 ± 1.348 minutes) and an effective response rate of 95.14%]. Patients with higher TCSPDS scores reported a lower quality of life (P<0.05). The TCSPDS could be used for early identification and assessment of the level of self-perceived discrimination in patients with thyroid cancer, which may provide a scientific basis for health education, social support and psychosocial oncology services in the future, especially in Southwest China.

Self-perceived discrimination in a community pharmacy: A cross-sectional, national survey

Self-perceived discrimination in a community pharmacy: A cross-sectional, national survey

Perception of discrimination against immigrants compared to Chilean-born and its relationship with access to services and health outcomes.

Compare self-perceived discrimination between immigrants and locals in Chile and analyze the relationship between immigration and perceived discrimination and immigration, discrimination and health outcomes, adjusting for sociodemographic characteristics and social capital. Cross-sectional study, using population-based survey (CASEN2017). We selected 2,409 immigrants (representative of N = 291,270) and 67,857 locals (representative of N = 5,438,036) over 18 years of age surveyed. We estimated logistic regression models, considering the complex sample, with discrimination, self-rated health, medical treatment, healthcare system membership, complementary health insurance, medical consultation and problems when consulting as dependent variables, immigration and discrimination as main exposure variables, and social capital and sociodemographic variables as covariates of the models. Immigrants were more likely to perceive discrimination in general compared to locals (OR = 2.31; 95%CI: 1.9-2.9). However, this does not occur for all specific reasons for discrimination; skin color and physical appearance were the most frequent causes of discrimination in immigrants. The interaction between immigration and discrimination was significantly related to worse self-rated health outcomes and treatment for pathologies, disfavoring discrimination against immigrants. In both locals and immigrants, discrimination was not associated with health care access outcomes, except for problems during consultation in locals (OR = 1.61; 95%CI 1.4-1.8). In Chile, experiences of discrimination are intertwined with other forms of rejection and social exclusion, so it is urgent to raise awareness among the population to prevent these discriminatory practices, especially in health care and daily use places. It is essential to address discrimination in order to have an impact on intermediate variables and health outcomes. The extension of the results to the entire immigrant population could be very useful to deepen the problem and improve the estimates made.

Segregation, education, and inclusion of European Roma: A demographic analysis

The isolation of Romani people is rooted both in discrimination by non-Roma and in Romani informal institutions known as romaniya. Residential desegregation is a sectoral objective in the European Union public policies for Roma. The current study is based on the EU-MIDIS II study of 20,375 Romani adults from south-western and south-eastern Europe. A logistic regression with fractional polynomial transformation is used to model hypothesised relationships between education and residential segregation on the one hand and economic outcomes and discrimination on the other among segregated and non-segregated Roma. The analysis demonstrates that among Roma, more years of education were related to a higher likelihood of adult employment, living above the at-risk-of-poverty threshold, and the ability of households to make ends meet irrespective of the ethnic composition of the neighbourhood. In densely populated areas residential segregation was not significantly associated with the economic performance of the Roma. Education and residential segregation were not significant predictors of self-perceived discrimination.

Perceived discrimination when using health-care services, health outcomes, and health-care utilisation among Romani people in Europe: evidence from the Second European Union Minorities and Discrimination Survey

BackgroundThe global COVID-19 pandemic has highlighted substantial health inequities in Europe. Minorities and immigrants are the populations most likely to experience disparities related to health-care access and health outcomes. We aimed to link self-reports of health conditions with experiences of discrimination when using health-care services among Romani ethnic minorities in the European Union (EU). MethodsThe Second EU Minorities and Discrimination Survey was disseminated in 2016 to ethnic minorities, immigrants, and descendants of immigrants in 19 member states of the EU (Austria, Belgium, Cyprus, Germany, Denmark, Greece, Spain, Finland, France, Ireland, Italy, Luxembourg, Malta, Netherlands, Poland, Portugal, Sweden, Slovenia, and the UK). The primary outcomes were self-reported health status (subjective assessment of own health conditions), health-care utilisation, and unmet health-care need. Experiences of discrimination when using health-care services in the past 5 years was the key explanatory variable. Anonymised data relating to perceived discrimination, self-reported good health, health-care utilisation, and socioeconomic status were available for individuals who identify as Romani ethnic minorities in nine EU member states—Bulgaria, Croatia, Czech Republic, Greece, Hungary, Portugal, Romania, Slovakia, and Spain. We used multivariate logistic regression analyses to examine the association between perceived discrimination and self-reported health status, health-care utilisation, and unmet health-care needs, controlled for sex, age, income level, education level, health insurance coverage, and residential location. Adjusted odds ratios (ORs) and 95% CIs of self-perceived discrimination are reported. FindingsUsing data on perceived discrimination when using health care, self-reported health status, health-care access, and socioeconomic status for 7942 Romani individuals (aged 16–90 years), including 4046 Romani individuals who have used health-care services during the past 5 years, we found that perceived discrimination when utilising health care is more prevalent for Romani people than other ethnic minorities in Europe (OR 2·19, 95% CI 1·96–2·44). After controlling for sex, age, income level, education level, health insurance coverage, and residential location, our multivariate logistic regression analyses showed that the perceived discrimination of Romani people is negatively associated with self-reported good health (adjusted OR 0·84, 0·69–1·03), and health-care utilisation (adjusted OR 0·34, 0·25–0·44). Furthermore, Romani people's perceived discrimination is associated with an increased risk of unmet health-care needs (adjusted OR 3·01, 2·27–3·98). The results were robust across sexes. InterpretationA multifaceted strategy might be needed to eliminate the disparities in health outcomes and health-care access between the Romani ethnic group and other ethnic minority groups in the EU, including expanding access to health care, addressing social determinants of health, and advancing anti-discrimination regulations in the EU. FundingNone.

Oral health inequality among Indonesian workers in South Korea: role of health insurance and discrimination factors

BackgroundThe health of migrant workers is becoming an important public health issue. Although there are an increasing number of migrant workers in Korea, the health status in migrant populations remains unknown. The aims of this study were (1) to evaluate the association between income and self-rated oral health (SROH), and (2) to assess the role of health insurance and self-perceived discrimination in the association between income and SROH among Indonesian migrant workers in Korea.MethodsInformation about self-reported income, SROH, coverage/utilization of health insurance (HI), living difficulties related to oral health (LDROH), oral health literacy (OHL), and discrimination were obtained from Indonesian migrant workers in Korea (n = 248). The main explanatory variable was income, and SROH was an outcome variable. Logistic regression analyses were performed controlling for age, gender, HI, LDROH, OHL, and discrimination. The paths from income to SROH were analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM).ResultsAmong Indonesian migrant workers, the lower income group had the highest probability of a poor SROH compared to the higher income group. The variables showing a high explanatory power were discrimination among the low income group and HI among the middle income group. In PLS-SEM, the variables such as HI, LDROH, OHL, and discrimination contributed 11% to explaining the association between income and SROH.ConclusionA monotonic gradient was revealed among migrant workers according to the association between income and SROH. Discrimination and HI contributed to oral health inequalities.

What are the effects of ethnicity, sexuality, disability and obesity on the odds of experiencing discrimination among Australian males? A nationwide cross-sectional survey

ObjectivesThe global public health community has been slow to acknowledge the important role of discrimination in health inequality. Existing evidence on discrimination is largely based on studies of specific subpopulations...

Discrimination experienced by Aboriginal and Torres Strait Islander males in Australia: Associations with suicidal thoughts and depressive symptoms.

Globally, Indigenous populations have higher rates of suicidal behavior and psychological distress compared to non-Indigenous populations. Indigenous populations also report high rates of exposure to discrimination, which could potentially contribute to poor mental health outcomes. The objectives of this paper were to estimate the prevalence of discrimination among Aboriginal and Torres Strait Islander males in Australia and to examine the role of discrimination in the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms. We used cross-sectional data on 13,697 males aged 18-55 years from the Australian Longitudinal Study on Male Health. We undertook a Poisson regression with robust standard error analyses to examine Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination in the past 2 years as correlates of recent suicidal ideation. We used zero-inflated negative binomial regression to assess Aboriginal and Torres Strait Islander status and self-perceived exposure to discrimination as correlates of recent depressive symptoms. Aboriginal and Torres Strait Islander males have a twofold higher prevalence of self-perceived discrimination (39.2% vs 19.3%, p < 0.001), suicidal ideation (21.8% vs 9.4%, p < 0.001) and moderate or worse depressive symptoms (24.0% vs 12.2%, p < 0.001) as compared to their non-Indigenous counterparts. After adjusting for sociodemographics and substance use, Aboriginal and Torres Strait Islander status was significantly associated with suicidal thoughts (odds ratio = 1.49, p = 0.019) and depressive symptoms (prevalence rate ratio = 1.19, p = 0.018). About 15.3% and 28.7% of the association between Aboriginal and Torres Strait Islander status and suicidal thoughts and depressive symptoms, respectively, was explained by discrimination. Our analyses add to evidence that discrimination is a contributor to mental health disparities between Aboriginal and Torres Strait Islander and non-Indigenous populations in Australia. Reducing discrimination ought to be considered as part of strategies to improve the social and emotional well-being of Aboriginal and Torres Strait Islander people.

Self-perceived workplace discrimination and mental health among immigrant workers in Italy: a cross-sectional study

BackgroundThe process of immigration is associated with poor mental and physical health. While the workplace represents an important context of social integration, previous studies evaluating the effect of discrimination experienced in the workplace found worse mental health status among immigrants. The aim of this study was to investigate whether self-perceived workplace discrimination has any role in the mental health status of immigrants living and working in Italy, evaluating the contribution of other personal experiences, such as loneliness and life satisfaction.MethodsA cross-sectional study was conducted on a sample of 12,408 immigrants (aged 15–64) living and working in Italy. Data were derived from the first national survey on immigrants carried out by the Italian National Institute of Statistics (Istat). Mental health status was measured through the Mental Component Summary (MCS) of the SF-12 questionnaire. A linear multivariate linear regression was carried out to evaluate the association between mental health status, self-perceived workplace discrimination, and sociodemographic factors; path analysis was used to quantify the mediation effect of self-perceived loneliness, level of life satisfaction, and the Physical Component Summary (PCS).ResultsMental health status was inversely associated (p < 0.001) with self-perceived workplace discrimination (β:-1.737), self-perceived loneliness (β:-2.653), and physical health status (β:-0.089); it was directly associated with level of life satisfaction (β:1.122). As confirmed by the path analysis, the effect of self-perceived workplace discrimination on MCS was mediated by the other factors considered: self-perceived loneliness (11.9%), level of life satisfaction (20.7%), and physical health status (3.9%).ConclusionsOur study suggests that self-perceived workplace discrimination is associated with worse mental health status in immigrant workers through personal experiences in the workplace and explains the effect of the exposure to workplace discrimination on immigrants’ psychological well-being. Our findings suggest that an overall public health response is needed to facilitate the social integration of immigrants and their access to health services, particularly those services that address mental health issues.

Immigration, perceived discrimination and mental health: evidence from Venezuelan population living in Peru

BackgroundThe association between international migration and mental health is conditioned to several factors, and discrimination may play a significant role. Currently, Peru is one of the principal Venezuelan migrant-receiving countries in Latin America. There are around one million Venezuelan refugees and migrants in the country. This study evaluates the association between self-perceived discrimination and mental health problems in Venezuelan population living in Peru.MethodWe analyzed data from the Venezuelan Population Residing in Peru Survey 2018, a nationally representative urban sample aimed at collecting information on several dimensions of Venezuelan population wellbeing. We applied logistic regression models to assess the association between self-perceived discrimination and mental health problems. Moreover, we applied the propensity score matching method as a robustness check of our results.ResultsOf 9487 Venezuelans surveyed, 6806 included complete information. From this sample, 6.3% reported mental health problems related to fear, anger, anxiety, or stress. Logistic regression models showed that Venezuelans who perceived being discriminated against had 2.4 higher odds of presenting mental health problems than their non-discriminated counterparts. Moreover, propensity score matching models showed that Venezuelans who perceived being discriminated against increased by 3.5 percentage points their probability of presenting mental health problems compared to their non-discriminated counterparts.ConclusionsThere is evidence that self-perceived discrimination is associated with mental health deterioration in Venezuelan migrants living in Peru. Our findings are relevant in the current geopolitical context and could be useful in the decision making processes in international health.

Mapping out a spectrum of the Chinese public\u2019s discrimination toward the LGBT community: results from a national survey

BackgroundChina has the world’s largest lesbian, gay, bisexual, and transgender (LGBT) population. This study assessed the discrimination experienced by LGBT individuals in China in a comprehensive way, covering discrimination perpetrated by family, media, medical services, religious communities, schools, social services, and in the workplace.MethodsThe current study involved a national survey of 31 provinces and autonomous regions. Discrimination was measured both in terms of heterosexual participants’ attitudes towards LGBT individuals, and LGBT participants’ self-perceived discrimination. Pearson correlation analysis was performed to examine the difference between heterosexual participants’ attitudes towards LGBT individuals and LGBT participants’ self-perceived discrimination. Linear regression was used to investigate the association between gross domestic product per capita and discrimination.ResultsAmong 29,125 participants, 2066 (7.1%) identified as lesbian, 9491 (32.6%) as gay, 3441 (11.8%) as bisexual, 3195 (11.0%) as transgender, and 10,932 (37.5%) as heterosexual. Heterosexual people were generally friendly towards the LGBT community with a mean score of 21.9 (SD = 2.7, total scale score = 100) and the grand averaged score of self-perceived discrimination by LGBT participants was 49.9 (SD = 2.5). Self-perceived discrimination from family and social services is particularly severe. We created a series of provincial level choropleth maps showing heterosexual participants’ acceptance towards the LGBT community, and self-perceived discrimination reported by members of the LGBT community. We found that a higher level of economic development in provinces was associated with a decrease in discrimination, and we identified that every 100 thousand RMB increase in per capita GDP lead to a 6.4% decrease in discriminatory events perpetrated by heterosexuals.ConclusionsChinese LGBT groups consistently experience discrimination in various aspects of their daily lives. The prevalence of this discrimination is associated with the economic development of the province in which it occurs. In order to reduce discrimination, it is important for future studies to discover the underlying reasons for discrimination against LGBT individuals in China.

CONSEQUENCES OF AGE DISCRIMINATION IN THE WORKPLACE

Despite a growing number of middle-aged employees in the workforce, Hong Kong still lags behind other developed countries in implementing age-friendly policies to protect older workers from being discriminated in recruitment, performance appraisal, and other personnel decisions. This paper therefore aims to investigate the effects of age discrimination on work-related outcomes and well-being. A total of 333 Hong Kong Chinese employees aged 40 years and above (Mage = 46.6 years, SD = 6.21, Range = 40-68; 60% female) completed an online survey on work experiences. Self-perceived age discrimination in the workplace (Furunes & Mykletun, 2010), perception of occupational future time (Ho & Yeung, 2017; Zacher & Frese, 2009), work engagement (Schaufeli et al., 2017), work stress (Cohen et al., 1983), and psychological distress (Shek, 1989) were measured. Almost 53% of the participants reported that older workers were less likely to get the same training opportunity for new technology as their younger peers, and 46.8% perceived that older workers did not get the same promotion opportunity as their younger peers. Regression analyses further revealed that employees’ perceived age discrimination in the workplace indirectly influenced their levels of work engagement (B = -.038, SE = .017), work stress (B = .016, SE = .005), and psychological distress (B = .008, SE = .005) through perception of occupational future time. The findings of this study unveil the severity of workplace age discrimination in Hong Kong and the negative impacts of age discrimination on work-related outcomes. Recommendations for organizational practices will be discussed.

Physical violence and vulnerable adolescents: the roles of school climate and presence of similar peers

ABSTRACT Using nationally representative data from the National Longitudinal Study of Adolescent Health (a.k.a., Add Health), this study examines the impact of school climate and share of vulnerable groups of students on self-perceived discrimination and violence involvement in high school. Violence involvement is operationalized as victimization and perpetration of physical violence. Five categories of vulnerability status are analyzed: the emotionally disabled, learning disabled, physically disabled, obese and LGB. Results suggest that relatively higher odds of violence involvement for individuals who were members of vulnerable groups as adolescents are fully explained by school climate and an extensive set of individual-level controls. While the share of vulnerable groups in school is not consistently correlated with violence involvement, school climate is found to be highly predictive of self-perceived discrimination and violence involvement. Consequently, we believe that improving school climate is the most effective strategy for reducing violence involvement of vulnerable youth in school.

Microdecisions instead of coercion: patient participation and self-perceived discrimination in a psychiatric ward

Aims: Patients may experience unfair reception when in contact with psychiatric services. The aims are to illuminate these perceptions, and the extent of inpatients’ involvement in their care, and if degree of involvement depends on compulsory or voluntary care. Furthermore, we sought to determine if an educational intervention for staff members, including systematic listening and offering the inpatients involvement using microdecisions, affects the inpatients’ experiences and the use of coercion.Materials and methods: We used a naturalistic setting case control design in two psychiatric wards for one year, including all inpatients (n = 685) of which 458 took part of the microdecision intervention. Structured direct interviews were carried out with inpatients based on the Discrimination and Stigma Scale (DISC), Dyadic OPTION, and CollaboRATE instruments before (n = 19) and after (n = 46) the intervention. Frequencies of coercive measures before and after the intervention were compared (n = 685).Results: Respondents subjected to the intervention experienced less discrimination related to psychiatric care compared to responders not subjected. Tendencies of improvements post intervention were found for some aspects of involvement, as attention to concerns and possibilities to ask questions. A decrease in the use of coercive measures at three and six months after the start of the intervention was observed.Conclusion: Results suggest that the intervention could decrease the inpatients’ experiences of discrimination during psychiatric care as well as the use of coercion in the service. The Dyadic OPTION instrument showed a mixed picture with results implying improvements in some areas and impairments in others.

The Effects of Borrowers’ Discouragement, Perceptive Discrimination and Risk-taking on Entrepreneurs’ Preferences for External Financing

This paper examines the impacts of borrowers’ discouragement, self-perceived discrimination to apply for bank financing and appetite for risk-taking on preferences for external financing amongst ethnic minority businesses (EMBs) in the UK. Our results suggest three main reasons for borrower discouragement to apply for bank financing, namely financing cost, financing history and fear of prejudice. We find that borrowers’ discouragement and self-perceived discrimination significantly impact preferences for external financing. Specifically, EMBs prefer more asset financing if they are discouraged due to financing cost, whilst less asset financing if they are discouraged due to fear of prejudice. However, there is no significant impact of discouragement or self-perceived discrimination on the preference for bank financing. Entrepreneurial risk-taking explained little variation in EMBs’ preferences for external financing.

Complementary Medicine Use and Self-perceived Discrimination Among Asylum Seekers in Switzerland: A Cross-sectional Study.

Scarce data exist on the use of complementary and alternative medicine (CAM) by asylum seekers in Switzerland and their perception of discrimination. A cross-sectional study assessed the prevalence and type of CAM used by asylum seekers in one region of Switzerland and evaluated their self-perceived discrimination. Among the 61 asylum seekers who participated, lifetime prevalence of CAM use was 46%, with 28% reporting its use during the last year. Herbal medicine was the most frequently used CAM. Self-perceived discrimination was reported by 36% of asylum seekers, mainly related to their national origins. CAM users had a tendency to report more discrimination than non-users (44% vs. 30%). CAM use is prevalent among asylum seekers. Considering the importance of herbal medicine use and that only half of the respondents disclosed CAM use to their physician, clinicians should ask about it, notably because of potential risks of herb-drug interaction.

Hidden Drug Abuse in Hong Kong: From Social Acquaintance to Social Isolation.

The present paper examines the issue of hidden drug abuse in Hong Kong. Although official statistics show that the reported number of drug-abuse cases has been in decline in recent years, it has been reported that drug abusers tend to hide themselves at home to take drugs; thus, they are not discovered easily by the law enforcement and social control agents who report drug abuse cases to the Central Registry of Drug Abuse, resulting in the decrease in the reported number of drug-abuse cases. This “dark figure” phenomenon is a reflection of the official figure and reporting behavior, not the actual situation of drug abuse in Hong Kong. Through in-depth interviews of 30 ex-drug addicts, the majority of them started drug taking in early youth, the present paper identifies five stages of drug taking from social acquaintance to social isolation. It argues that although drug taking among abusers is a kind of social activity in their initial stage of drug use, they become socially isolated when their drug use is prolonged. Several reasons are identified, including users' easy accessibility to drugs and changes in the popularity of drugs and use of drug equipment. Most importantly, the hidden process is triggered and aggravated by numerous negative drug effects, such as decline in physical health, weak physical appearance leading to self-perceived discrimination, co-occurrence of psychiatric symptoms of increased anxiety and suspicion, and decline of trust among peers due to prolonged drug abuse. Possible solutions associated with clinical interventions, legislative policies, and law-enforcement operations are proposed.

Development and validation of the cancer self-perceived discrimination scale for Chinese cancer patients

BackgroundTo develop a Cancer Self-Perceived Discrimination Scale (CSPDS) for Chinese cancer patients and to assess its reliability and validity.MethodA total of 178 patients were recruited and the classical test theory was used to develop the CSPDS. Item analysis was adapted to improve the preliminary version of the CSPDS, then the reliability, the validity and the acceptability of the final version of CSPDS were assessed.ResultsThis CSPDS contained 14 items classified into 3 subscales: social withdrawal with 7 items, stigma with 4 and self-deprecation with 3. Good validity (χ2/df = 1.216, GFI = 0.935, AGFI = 0.903, I-CVIs> 0.80) and good reliability (Cronbach’s alpha = 0.829, Spearman-Brown coefficient = 0.827, test-retest reliability coefficient = 0.944) were found. The completion time was 6.06 ± 1.80 min. Participants who were female and reported poor self-rated health tended to have higher CSPDS scores (P < 0.05).ConclusionsThe results indicated that this CSPDS could be used to assess the level of self-perceived discrimination and to preliminarily screen perceived discrimination among Chinese cancer patients, especially in Southwest China. It may provide a basis for scientific assessment of targeted patient education, psychological counseling, social interventions, and psychotherapy in the future.

M60. Examining the Role of Cultural Distance and Psychosocial Disempowerment in Higher Rates of Psychotic Disorders in Ethnic Minority Groups: A Multi-National Case-Control Study

Background: Ethnic minorities have an increased risk of developing psychotic disorders, but the causes remain largely unknown. Theories such as social defeat have been suggested as possible explanatory frameworks, but empirical evidence is lacking. Here, we investigated whether psychosocial disempowerment (a perceived lack of control over one’s life), and cultural distance from the majority ethnic group accounted for the excess psychosis risk in ethnic minority groups. Methods: We used case-control data from the EU-GEI study, a 16-centre case-control study in 6 countries (England, France, the Netherlands, Italy, Spain and Brazil). Within defined epidemiological catchment areas, incidence cases with an OPCRIT-confirmed first episode of ICD-10 psychotic disorder (F10-33) were invited to participate. Population-based controls were sampled via primary care. We created a binary measure of psychosocial disempowerment, using a self-perceived discrimination questionnaire, where participants were asked if they had ever felt unfairly treated in 12 situations. We approximated cultural distance using the linguistic distance of a participant’s primary language from the majority language in each setting, informed by linguistic decision trees. Age and sex were included as confounders. Following multiple imputation to account for missing data we used logistic regression to investigate whether our exposures explained any increased psychosis risk in ethnic minority groups. Results: We recruited 1168 cases and 1498 controls, who were representative of the population at-risk. Ethnic minority status was associated with increased odds of psychotic disorder after controlling for age and sex (OR: 1.66; 95% CI: 1.59–1.73). Inclusion of psychosocial disempowerment and cultural distance in the model did not attenuate risk in ethnic minority groups (OR: 1.63; 95% CI: 1.54–1.72), despite greater exposure to psychosocial disempowerment (OR: 1.54; 95% CI: 1.47–1.62) and cultural distance (OR: 3.99; 95% CI: 3.83–4.17). Both psychosocial disempowerment (OR: 1.16; 95% CI: 1.13–1.19) and cultural distance (OR: 1.17; 95% CI: 1.14–1.22) independently predicted psychosis risk, after control for age, sex and minority status. Conclusion: Ethnic minorities had a higher risk of developing a psychotic disorder. Psychosocial disempowerment and cultural distance did not explain this risk, but had independent additional effects which appeared to follow dose-response relationships. These preliminary analyses suggest the social environment of ethnic minorities might be a significant predictor of psychosis risk, independent of ethnic minority status.