Stigma Stress Research Articles

Individual stigma in people with severe mental illness: Associations with public stigma, psychological capital, cognitive appraisal and coping orientations

IntroductionThe reason why some people with severe mental illness (SMI) maintain positive self-identity, while some are affected by the stigmatized environment is unclear. AimsTo describe the status of individual stigma and explore the relationship between self-stigma, stigma resistance and related variables in people with SMI. MethodsA cross-sectional study was conducted from April 2021 to March 2022. The Chinese version of Internalized Stigma of Mental Illness Scale and Stigma Resistance Scale were used to assess individual stigma. Perceived public stigma, psychological capital, stigma stress appraisal and coping orientations were also measured by scales. Data was provided by 422 patients with schizophrenia or bipolar disorder, from one psychiatric hospital and four community healthcare centers in China. A structural equation model was applied for analysis. ResultsThe total mean scores of self-stigma and stigma resistance were (2.06 ± 0.65), and (3.95 ± 0.84). Perceived public stigma was the primary condition for constructing individual stigma, which indirectly affected self-stigma (β = 0.268) and stigma resistance (β = −0.145). Stigma stress appraisal mediated the transformation of public stigma into individual, which had direct and indirect effects on self-stigma (β = 0.417, 0.166), and an indirect effect on stigma resistance (β = −0.374). Secrecy positively affected self-stigma (β = 0.117), while positive coping positively affected stigma resistance (β = 0.380). Psychological capital significantly directly impacted individual stigma. ConclusionsFindings highlighted how public stigma determines the degree to which patients with SMI deal with stigma stress appraisal, and how this influences individuals. Anti-stigma programs and interventions to improve individuals' psychological capital and coping capabilities should be emphasized.

Ultra-high risk for psychosis stigma: an updated Systematic Review.

To clarify if stigma associated with schizophrenia has also been directed towards the ultra-high risk for psychosis (UHR) population, the present review aimed at synthetizing the existing literature to update and extend our understanding on the topic. A systematic PRISMA-compliant review was performed in PubMed, Embase, Cochrane and Web of Science for articles published until 30/04/2023, using a combination of search terms describing the at-risk mental states for psychosis and stigma and correlated terms. Thirty-eight studies were included. Twenty-nine addressed UHR individuals directly, and 9 conducted interviews with non-patients regarding UHR. A total of 2560 UHR individuals were assessed; mean sample size was of 88.3 participants. Most of the studies were quantitative non-randomized/observational with young adults, 71.4% used SIPS (Structured Interview for Psychosis-risk Syndromes) and 25.0% used CAARMS (Comprehensive Assessment of At-Risk Mental States). Overall, the summarized studies have mainly involved individuals already attending UHR clinics from Western and high income countries. Studies can be grouped into five forms of stigma, among which the most frequently explored was perceived public stigma, followed by public stigma, self-stigma/internalized stigma, stigma stress and associative stigma. The main study design was quantitative nonrandomized, with only one interventional study. Most of the results confirmed the presence of stigma toward UHR individuals and findings provide additional support to the fact that stigma seems to be present since the very early stages of the disease. There is still a paucity of research and knowledge gaps about UHR-related stigma. Nevertheless, results suggest the presence of stigma toward UHR individuals, supporting the fact that stigma is present since the early stages of psychosis.

Translation and Validation of Family Stigma Stress Scale (FSSS) Among Caregivers of Patients With Mental Illness in Pakistan

The stigma among caregivers is significantly creating stress for them, which is ultimately disturbing their well‐being and quality of life. The aim of the current study is to translate and validate the Family Stigma Stress Scale (FSSS) in Urdu among caregivers of patients with mental illness in Pakistan. A purposive sample of 421 caregivers above 18 years of age (M = 39.43, SD = 12.41) participated in the present research, where 42.3% were men and 57.7% were women. All the participants completed FSSS and self‐structured demographic sheet. For translating the scale, WHO guidelines were followed. Data were analysed through SPSS version 26 and AMOS version 24. To test the internal consistency of the translated scale, we apply the alpha reliability test. The result indicated that the internal consistency of the overall FSSS is good (α = 0.85), while its subscale perceived harm (α = 0.90) and perceived coping resources (α = 0.87) also showed excellent internal consistency. To check that the translated version confirmed the same items, we applied confirmatory factor analysis (CFA) through AMOS version 24. The results of CFA showed that the model is in the acceptable to good fit range with χ2/df (3.16), CFI (0.98), TLI (0.97), IFI (0.98), NFI (0.97), and RMSEA (0.07). An independent sample t‐test was used to check the gender difference and illness differences related to caregiving on subscales of FSSS. Results of t‐test showed that significant gender differences were observed only on perceived harm indicating that women caregivers perceived more harm as compared to men caregivers of patients with mental illness. Moreover, we also found that caregivers of patients with psychotic disorders perceived more coping resources than caregivers of patients with neurotic disorders. By integrating the FSSS into routine assessments and screenings in healthcare settings, professionals can identify caregivers experiencing high levels of stigma‐related stress accurately. Healthcare professionals can advocate for policies and social programs that reduce stigma surrounding mental illness and provide resources for caregivers. Apart from these implications, there are some limitations in the present research, and this scale may not fully account for cultural sensitivity which potentially impacts the scale’s applicability and generalizability. Participants may provide socially desirable responses, especially when dealing with sensitive topics like family stigma. This response bias can affect the accuracy and validity of the scale. Future researchers should focus on these limitations and try to fill these gaps.

Causes and Recommendations of Stigma in PTSD

In addition to suffering from symptoms, individuals with posttraumatic stress disorder (PTSD) also suffer from self-stigma and public stigmatization due to PTSD. This article examines the stigma that patients with PTSD usually experience, and whether these stigmas are related to the identity, economic status, and other co-occurring mental illnesses of patients. Through reviewing the previous studies, this paper discusses the causes, forms and effects of stigma. In addition, it was found that individualized psychotherapy programs and mindfulness can be effective in alleviating the stress of stigma for PTSD patients. And social acceptance and support for the PTSD community can be increased by managing content about the disorder on social media and changing the content framework of news organizations, such as increasing anti-stigma and introducing knowledge about PTSD. The social acceptance and support of the PTSD community can be increased by, for example, increasing anti-stigma and knowledge about PTSD. Future research should focus on addressing the stigma associated with mental illnesses such as PTSD and addressing the psychological damage caused by stigma.

Honest, Open, Proud (HOP) for people with mental illness in Hong Kong: a randomized controlled trial.

Self-stigma among people with mental illness is negatively associated with personal and clinical recovery. Due to the concealable nature of mental illness, people with mental illness experience constant struggles between concealment and disclosure. Disclosure of mental health challenges can potentially minimize negative impacts of self-stigma and enhance self-esteem and sense of empowerment. Honest, Open, Proud (HOP) is a peer-led intervention that promotes autonomous and dignified decisions about disclosure. This study examined the effectiveness of HOP on concealment motivation, empowerment, self-stigma, stigma stress, and recovery among people with lived experience of mental illness in Hong Kong. A total of 162 participants with a mean age of 45.38 were recruited and randomized into intervention group and waitlist control group. Participants in the intervention group were invited to attend a 6-session HOP group intervention. Significant improvement in optimism score from the empowerment scale was found in the intervention group compared to the waitlist control group and the effect was sustained at 1-month follow-up. However, significant changes were not found in other outcome variables. Only improvement in optimism was observed in the current study. Future study needs to examine the effects of HOP with further modification to maximize the benefit for people with lived experience of mental illness in the local context.

Exploratory study of an ally training program for mental health support

PurposeThe purpose of this study was to evaluate the effects of an online mental health ally program on several measurements of readiness to help and stigma reduction. Allyship is one way to support people with mental health challenges beyond traditional care services.Design/methodology/approachThe efficacy of the program was evaluated in pre and postintervention surveys (n = 26) including measures of self-care, help-seeking intentions, peer-support self-efficacy, advocacy, knowledge of resources and stigma. A within-subject, repeated measures design was conducted analyzing changes at completion. Twenty-six participants who completed the program (either with or without lived experience of mental illness) were included in the study. A subgroup of participants (n = 11) who reported lived experiences of mental illness were assigned additional measures of internalized stigma, stigma stress, stigma resistance and self-esteem.FindingsAnalysis of mean differences indicated a statistically significant change in scores pre and postcompletion. The program increased peer-support, help-seeking intentions and self-esteem, while reducing internalized stigma and stigma stress. Findings provide preliminary support for program effectiveness in training individuals to support others and themselves through mental health challenges.Research limitations/implicationsTrained allies might improve the lives of individuals with mental health challenges by reducing discrimination and improving social support. We discuss the implication of allies to complement the mental health system.Originality/valueTo the best of the authors’ knowledge, this is the first exploratory study on the efficacy of an online ally training program for individuals with mental illness. The NoStigmas Ally Program is a novel and original development in ally training.

The impact of ASPECTSS-based design intervention in autism school design: a case study

PurposeThe objective of this paper is to study the efficacy of the ASPECTSS Design Index's concepts as drivers of design intervention for educational environments for students on the autism spectrum. Based on the seven principles of acoustics, spatial sequencing, escape spaces, compartmentalization, transitions, sensory zoning and safety, ASPECTSS formed the basis for a preliminary post-occupancy evaluation (POE) and survey of an existing school environment.Design/methodology/approachConcepts drawn from the review of other strategies for autism spectrum disorder (ASD) friendly design were integrated with the seven ASPECTSS principles to create a design framework and consequent design retro-fit for a Pre-K-12th grade public school for students on the autism spectrum. The following design interventions were proposed: colour-coding based navigation; acoustical treatments in key circulation spaces; introduction of transition alcoves; classroom reorganisation using compartmentalization principles and the introduction of escape spaces for de-escalation. Specifically, a classroom template of modules of ASPECTSS-compliant layouts was provided to all staff. The efficacy and impact of these interventions were assessed using a whole campus online staff survey with further probing using classroom observations and subsequent interviews.FindingsThe results show alignment between the implementation of the ASPECTSS informed design interventions and responses to nine of the Likert scale items were all significantly lower than the middle response, indicating a high degree of satisfaction from survey respondents. These questions and responses related to the colour scheme facilitating ease of navigation for visitors of the school, the acoustics of the building successfully mitigating sound magnification and subsequently student distractibility, the organisation of the classrooms enhancing learning and the de-escalation zones allowing improved management of disruptive behaviours in the classroom.Research limitations/implicationsThis study focuses primarily on the Autism ASPECTSS Design Index as a framework for assessing classroom efficacy. Other tools and frameworks may produce different insights. A single school site was studied. Validation of these findings in other school environments is necessary before generalising these strategies at scale. The use of qualitative tools, primarily teacher and staff surveys, provides one lens into the efficacy of these design strategies. Further research using measurable biometric indicators such as heart-rate and stress levels measured through wearable technology could provide a first step towards the triangulation of these findings.Practical implicationsThese findings could help provide more standardised best practices for designing learning environments for autism, potentially providing supportive strategies with real impact on learning quality, skill development and knowledge acquisition in school environments. This could potentially have economic implications by supporting more efficient progress for autistic students through their school curriculum.Social implicationsSimilar to economic impact, if validated and generalised, these findings could help with sense of accomplishment, general mental health improvement, alleviation of family stress and potential reduction of stigma in the autism community.Originality/valueThere is a slowly emerging field of design guidance for autism schools, but very little empirical evidence on the measurable efficacy of these strategies. This research provides one type of such evidence, as measured by the perceived impact from the point of view of staff and teachers at the school.

Self-Stigma's Effect on Psychosocial Functioning Among People With Mental Illness.

Consequences of self-stigma exhibit a four-step regressive model from being aware of public stigma, to agreeing with it, to applying it to oneself, to resulting harm on the self. We hypothesize the relationship between self-stigma and psychosocial functioning is mediated by three constructs: the why try effect, stigma stress coping resources, and personal recovery. Two hundred eight people with depressive and bipolar disorders participated the study. Data partially supported the regressive model of self-stigma. Awareness was not found to be associated with other regressive stages. The model representing the path between self-stigma-harm and psychosocial functioning was significant and robust. The path was mediated by the why try effect and personal recovery. Findings echo the growing body of research attempting to describe outcomes of self-stigma, in this case, psychosocial functioning. Programs meant to erase self-stigma, and its effect on functioning should incorporate the why try effect and personal recovery as strategic ingredients.

Comparing the stigma experiences and comfort with disclosure in Dutch and English populations of people living with dementia.

People living with dementia can feel hesitant disclosing their diagnosis to social networks, partly due to stigma. Little attention has been paid to the measurement of disclosure decisions and stigma, and few standardised stigma tools have been validated in languages other than English. We investigated the psychometric properties of Dutch translations of three stigma measures, and explored the stigma experiences of Dutch and English people living with dementia as well as patterns and predictors of comfort with disclosure. Community-dwelling adults living with dementia in the Netherlands (n = 40) and England (n = 40) completed either the English versions or the Dutch translations of the Comfort with Disclosure scale and three stigma measures (Stigma Impact, Stigma Stress, and Secrecy Scale). We established the psychometric properties of the stigma measures and conducted correlation and regression analyses. Internal consistency was good to excellent for all measures in the Dutch sample. Small but significant differences were found between the Dutch and English samples on the total score of the Stigma Impact Scale and its subscale social isolation. Age was negatively associated with comfort disclosing to family, and desire for secrecy was negatively associated with comfort disclosing to both family and friends. The psychometric properties of the Dutch scales were satisfactory. Many people living with dementia would feel comfortable disclosing their diagnosis to family and friends, but stigma experiences can greatly affect this decision. Cross-cultural differences in stigma experiences in persons with dementia require further investigation.

Does the peer-led Honest, Open, Proud program reduce stigma's impact for everyone? An individual participant data meta-regression analysis.

Many people with mental illness experience self-stigma and stigma-related stress and struggle with decisions whether to disclose their condition to others. The peer-led Honest, Open, Proud (HOP) group program supports them in their disclosure decisions. In randomized controlled trials, HOP has shown positive effects on self-stigma and stigma stress on average. This study examined individual predictors of HOP outcomes and tested the hypothesis that stigma stress reduction at the end of HOP mediates positive HOP effects at follow-up. Six RCTs were included with data at baseline, post (after the HOP program) and at 3- or 4-week follow-up. Baseline variables were entered in meta-regression models to predict change in self-stigma, stigma stress, depressive symptoms and quality of life among HOP participants. Mediation models examined change in stigma stress (post) as a mediator of HOP effects on self-stigma, depressive symptoms, and quality of life at follow-up. More shame at baseline, and for some outcomes reduced empowerment, predicted reduced HOP effects on stigma stress, self-stigma, depressive symptoms, and quality of life. Younger age was related to greater improvements in stigma stress after the HOP program. Stigma stress reductions at the end of HOP mediated positive effects on self-stigma, depressive symptoms and quality of life at follow-up. Participants who are initially less burdened by shame may benefit more from HOP. Stigma stress reduction could be a key mechanism of change that mediates effects on more distal outcomes. Implications for the further development of HOP are discussed.

The Impact of Mindfulness on Stigma Stress and Well-Being Among Individuals with Mental Disorders

The Impact of Mindfulness on Stigma Stress and Well-Being Among Individuals with Mental Disorders

Explaining the burden of psychosocial factors on the worsening symptoms of MS: a qualitative study of patients' experiences

BackgroundThis study was conducted with the aim of identifying the burden of psychosocial factors on the worsening symptoms of multiple sclerosis.MethodsThis as conducted with a qualitative approach and conventional content analysis among patients with Multiple sclerosis in Mashhad. Data were collected through semi-structured interviews with patients with Multiple sclerosis. Twenty-one patients with Multiple sclerosis were selected through purposive sampling and snowball sampling. The data were analyzed using Graneheim and Lundman method. Guba and Lincoln's criteria were used for evaluating research transferability. The data collection and management was performed by using the MAXQADA 10 software.ResultsIn explanation of the psychosocial factors of patients with Multiple sclerosis, one category (psychosocial tensions) and three subcategories of stress (physical symptoms, emotional symptoms, and behavioral symptoms), agitation (family disorder, treatment-related concerns, and social relationship concerns), and stigmatization (social stigma and internalized stigma) were extracted.ConclusionThe results of this study show that patients with Multiple sclerosis are faced with concerns such as stress, agitation, and fear of stigma, and need support and understanding from the family and community to overcome these concerns. Society must base its health policies on addressing the challenges faced by patients.Accordingly, the authors argue that health policies, and consequently, healthcare systems, need to address patients’ ongoing challenges as a priority in caring for patients with Multiple sclerosis.

Post-recovery Stigma in Early and Late COVID-19 Epidemic

People who recover from the novel coronavirus diseases 2019 (COVID-19) complain of psychological symptoms such as stress, anxiety, and depression by psycho-stress due to social stigma in the early stage of the epidemic. To assess the psychological stigma of early and late epidemic periods, stigma scale was compared between the first epidemic period (February-May 2020, n = 20) and the fifth epidemic period (February-May 2022, n = 21) post-recovery COVID-19 patients in outpatient clinic. The average total stigma score was significantly higher (79.6 ± 18.16) in post-recovery COVID-19 patients of the early (first) epidemic period compared to late (5th) epidemic period patients (37.5 ±10.99). Four subscales were significantly higher in early epidemic period compared to late epidemic period (enacted stigma 27.5 ± 7.25 vs. 13.0±4.18, disclosure concerns 19.5 ± 9.38 vs. 9.4 ± 2.99, negative self-image 16.2 ± 8.10 vs. 8.1±2.47, concern with public attitudes 16.6 ± 6.95 vs. 7.0 ± 2.01). In those who recovered from the early COVID-19 epidemic period, patients experienced significantly higher social stigma stress compared to the late epidemic period. In the early period of novel virus epidemics, the risk of personal stigmatization and stress should be prevented in public policy. Socio-psychological assessment and treatment should be considered for the patient in addition to physical symptoms.

Perceived Stress and Internalized Stigma among Patients with Mental Disorders in Al Ahsa Governorate – Saudi Arabia

BackgroundWHO reported that mental disorders is rising all over the world and its burden is significantly impact the individuals’ health, even the social and economic status of countries. Mental illness continues to be stigmatized in Arab countries because people in these countries hold negative attitudes toward mental illnesses. Stigma stress is one of the most stressful factors facing patients with mental illness and their families. Perceived stigma by patients with mental illness is associated with different consequences such as feeling of shame, being non-compliant to medications, being socially withdrawn. This study aims to assess perceived stress and internalized stigma among patients with mental disorders in Al-Ahsa governorate – Saudi Arabia. The total number of the subject was 125 patients with mental disorders. The study revealed that there is a significant positive relationship between patients’ perceived stress and their feelings of internalized stigma. Understanding how stigma develops and how it interacts with other psychological processes is very important so, it is recommended to develop interventions to reduce internalized stigma to improve the well-being of patients with mental disorders.

Stigma and social support and their impact on quality of life and self-esteem among women with endometriosis in Latin-America and the Caribbean.

Endometriosis is a complex disease affecting approximately 5-10% individuals worldwide. Prevalence rates in Latin-America and the Caribbean are largely unknown, with published data only from Puerto Rico and Chile. Pain associated with endometriosis negatively affects patients' health and quality of life. However, there is a need to better understand the role played by psychosocial variables such as stigma and social support in diverse cultural contexts. The purpose of this study was to examine the mediating role of endometriosis related stigma (endo-stigma) and the moderating role of social support on the endometriosis QoL and self-esteem among women with endometriosis from Latin America and the Caribbean. A cross-sectional design with online survey techniques was implemented. A total of 169 self-identified cisgender women with endometriosis from 14 Latin-American and Caribbean countries participated in the study. We used partial least squares structural equation modeling (PLS-SEM) to examine the study's hypotheses. Incapacitating pain was positively and significantly related to endometriosis QoL as measured by the EHP-5 (b = .266, p < .01). Endo-stigma was positively and significantly related to endometriosis QoL (b = .340, p< .01) and self-esteem (b = .297, p< .01). In addition, endo-stigma mediated the relationship between incapacitating pain and self-esteem (IE = .073, p = .018). Finally, social support moderated the relationship between stigma stress and endometriosis QoL (b = .060, p = .039). Findings suggest stigma could be one of the mechanisms through which the relationship between incapacitating pain and self-esteem among Latin American and Caribbean women with endometriosis could be partially explained. Furthermore, women who scored high in the need for social support and stigma stress also showed worst endometriosis QoL. These results point towards the need to develop tailored interventions targeting these factors in order to foster a better QoL and wellbeing for this population in the context of Latin America and the Caribbean.

How are various aspects of personal stigma related to secrecy about mental health problems among people diagnosed with psychotic disorders? A cross-sectional analysis.

Service users commonly keep their mental illness secret in order to avoid rejection. However, this stigma-coping orientation is not necessarily effective and may lead to a number of negative psychological consequences. The purpose of the present study was to investigate the roles of various aspects of personal stigma in predicting secrecy about mental health problems among persons with psychosis. A sample of 147 individuals diagnosed with psychotic disorders was recruited for the study. They were administered a set of questionnaires to gather data about sociodemographic and illness-related background characteristics, levels of social functioning, depressive symptoms, and overall psychopathology, elements of personal stigma (i.e., perceived stigma, experienced discrimination, self-stigma, and stigma-related stress), as well as the endorsement of secrecy as a way of coping with stigma. Hierarchical linear regression was utilized for data analysis. Personal stigma measures were entered into the regression equation as a block and explained as much as 29% of variance in the dependent variable over and above sociodemographic and clinical features. After accounting for all controls, higher perceived stigma (β = 0.47, p < .01) and higher stigma stress (β = 0.19, p < .05) were found to be independent predictors of secrecy, whereas experienced discrimination and self-stigma were not. Perceived stigma and stigma stress appraisal should be considered as targets of interventions aiming to reduce the shame and fear of rejection associated with mental illness and to guide and support people's everyday decisions about coming out. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Life satisfaction in the caregivers of schizophrenia and factors associated with it: a cross sectional study from South India

Schizophrenia is a mental disorder characterized by distortions of thinking and perception, in the process of care giving the caregivers are faced with many challenges. These challenges have a significant impact on the life satisfaction of caregivers. The study investigates various factors associate with life satisfaction in caregivers of schizophrenia&#x0D; The aim: 1. To evaluate the socio-demographic correlates associated with life satisfaction in the care givers of schizophrenia.&#x0D; &#x0D; To evaluate the association between life satisfaction with resilience, anxiety, stress, depression perceived social support, self-esteem, self-efficacy, and perceived stigma in the care takers of schizophrenia patients.&#x0D; &#x0D; Material and methods. In cross sectional study, 513 care takers of schizophrenia were evaluated using semi-structured socio demographic perfoma, DASS-21, Connor-Davidson Resilience 25 item scale, Self Esteem Scale (Rosenberg), The Satisfaction with Life Questionnaire and family stigma stress scale.&#x0D; Result. The study showed that background of the caregiver, socioeconomic status, family type, education and marital status are significantly positive correlated with life satisfaction. The study also showed significant positive correlation between resilience, perceived social support, self-esteem and self-efficacy with life satisfaction. There is also significant negative correlation between perceived stigma, anxiety stress and depression with life satisfaction.&#x0D; Conclusion. The study showed that life satisfaction in the care givers of schizophrenia depends on different biopsychosocial variables. There is strong positive correlation between self-esteem, other person support and resilience with life satisfaction, whereas there is moderate positive correlation between self-efficacy, family support and friend support with life satisfaction. There is significant negative correlation between stress, anxiety, depression, and stigma with life satisfaction. We recommended psycho educational interventional programmes in the community level which help to increase resilience self-esteem and self-efficacy. Such programmes also decrease the stigma which in turn increases the social support to the caregivers

Perceptions and Experiences of Caregivers on Child Injuries: A Qualitative Study from Central India

To explore caregivers’ perceptions of childhood injuries in the rural and urban areas of India, with a focus on causes, consequences, prevention, and treatment. We conducted eight focus group discussions with fifty female caregivers in rural and urban areas of Ujjain in Central India and used thematic content analysis. The caregivers identified how children injured themselves through falls, road traffic injuries, metallic nails and tool injuries, ingestions of foreign objects and poisons, burns, drowning, and suffocation. The reported consequences of injuries ranged from pain, infections, scar formation, phobia, stigma, and emotional stress to complications like physical disability, loss of eyesight, head injury, paralysis, and even death. Many caregivers blamed children and their mischievousness for the injuries and failed to realise/acknowledge the role of better supervision and environmental modifications in injury prevention. Caregivers used several first aid methods to respond to injuries. These included applying pressure to stop bleeding during fall and road traffic injuries, inducing vomiting by giving the poison victims saltwater to drink, and tobacco leaves to chew. In addition, some caregivers resorted to using coconut oil and toothpaste on burnt skin and giving back blows for choking. Caregivers in communities had experiences of different types of child injuries. Further education on need for better supervision, relevant environmental modification and appropriate first aid treatment of various injuries is required.

Psychological symptoms associated with self-reported events of COVID-19 contact, symptoms, or diagnosis: a large community-based survey among adults in Quebec, Canada

ObjectivesPsychological consequences of COVID-19 contact, symptoms, or diagnosis are being increasingly reported. Few studies have examined the psychological effects tied to these events, using an unaffected comparison group. Most did not consider confounding factors like fear and stigma. This study aims to (1) identify individual characteristics associated with COVID-19 contact/symptoms or diagnosis and (2) examine the independent association between COVID-19 contact/symptoms or diagnosis and psychological symptoms.MethodsFrom September 2020 to February 2021, 20,327 adults participated in community-based surveys in Quebec. Using repeated cross-sectional online questionnaire, data were collected on probable generalized anxiety disorder (GAD) and major depression episode (MDE), using the GAD-7 and the PHQ-9 scales, respectively. Self-reported events of (1) contact with a case or symptoms of COVID-19, and (2) diagnosis of COVID-19 were examined, along with several sociodemographic and pandemic-related factors.ResultsCOVID-19 contact, symptoms, or diagnosis was more frequent in young adults, healthcare or social services workers, adults living with children, and those reporting a greater sense of threat, stigma, financial losses, or daily stress. COVID-19 contact or symptoms and diagnosis were associated with probable MDE relative to the unaffected group (adjusted odds ratio [aOR]: 1.25, 95% CI: 1.12–1.39 and aOR:1.82, 95% CI: 1.48–2.2, respectively). Suicidal thoughts and psychomotor retardation were the symptoms most closely associated with a COVID-19 diagnosis.ConclusionResults from this study stress the need for better understanding, recognition, and support for people suffering from psychological symptoms following a COVID-19 diagnosis.

Research on Parents of Gender-Diverse Children: From Pathologization to Affirmation

This critical review article examines research to date on the experiences of parents of gender-diverse children. This research is expanding quickly, but its history spans decades and disciplines. Based on a review of 64 research publications from 1996 to 2021, the article traces a development from pathologizing to affirming approaches to research with parents. The earlier pathologizing approach is evident in what researchers report in terms of parent reactions, involving exclusively negative emotions and a discourse of parental “grief,” but also in how researchers approach the topic themselves, failing to conceive of alternative ways of reacting that do not involve negative emotions and trauma. This article discusses ways this earlier research could be interpreted differently, including how negative emotions can reflect secondary stigma and gender minority stress, and how grief can point to internalized cisgenderism. The review identifies changes toward an affirming approach in more recent research, which relocates the problem from gender-diverse children themselves to the society surrounding them. It also highlights directions for future research, centering around resilience rather than trauma – how parents find strength and hope in a challenging environment, and how parenting a gender-diverse child can be a positive experience for parents and children alike.