scholarly journals COVID-19 and Asian American college students: Discrimination, fear, and mental health

2021 ◽  
Vol 19 (9) ◽  
pp. 121-131
Author(s):  
Angela Chia-Chen Chen, PhD, RN, PMHNP-BC ◽  
SeungYong Han, PhD ◽  
Wei Li, PhD ◽  
Karen J. Leong, PhD ◽  
Lihong Ou, MSN, RN

Introduction: Our research addressed double victimization among Asian Americans by COVID-19 and anti-Asian racial discrimination during the pandemic. Guided by the Vulnerable Populations framework that argues that health status reflects the dynamic interplay between resource availability and relative risk, we investigated time-sensitive questions that explored relative risk (perceived racial discrimination, fear of COVID-19), resources (COVID-19 prevention knowledge, resilience), and mental health status (post-traumatic stress disorder (PTSD), depression) in Asian American undergraduate and graduate students during the pandemic.Methods: A mixed-methods research was conducted to examine the relationships among the relative risk, resources, and mental health outcomes in this population. We adapted questions from valid and reliable measures to assess key variables. Descriptive and regression analyses along with content analysis were used to analyze the quantitative and qualitative data.Results: Our sample included 74 Asian American students (AA students) who participated in the online survey (53 complete cases were included in the statistical analysis) and an additional 10 AA students who were interviewed via Zoom. The results of hierarchical regression models confirmed a positive association between fear of COVID-19 and both mental health outcomes (PTSD and depression), and a negative association between COVID-19 prevention knowledge and mental health outcomes. Perceived racial discrimination was significantly and positively associated with PTSD and depression while controlling for sociodemographic variables. However, its association with outcomes diminished when fear of COVID-19 and COVID-19 prevention knowledge were added to the models. Our interview results supported the survey findings with more nuanced details not revealed in the survey.Conclusion: The findings of this research will help public health officials and universities identify practices useful for promoting culturally congruent safety and protection in response to pandemics and other health emergencies.

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e042030 ◽  
Author(s):  
Muna Alshekaili ◽  
Walid Hassan ◽  
Nazik Al Said ◽  
Fatima Al Sulaimani ◽  
Sathish Kumar Jayapal ◽  
...  

ObjectiveThis study aims to assess and compare demographic and psychological factors and sleep status of frontline healthcare workers (HCWs) in relation to non-frontline HCWs.Design, settings, participants and outcomesThis cross-sectional study was conducted from 8 April 2020 to 17 April 2020 using an online survey across varied healthcare settings in Oman accruing 1139 HCWs.The primary and secondary outcomes were mental health status and sociodemographic data, respectively. Mental health status was assessed using the Depression, Anxiety, and Stress Scale (DASS-21), and insomnia was evaluated by the Insomnia Severity Index. Samples were categorised into the frontline and non-frontline groups. χ2 and t-tests were used to compare groups by demographic data. The Mantel-Haenszel OR was used to compare groups by mental health outcomes adjusted by all sociodemographic factors.ResultsThis study included 1139 HCWs working in Oman. While working during the pandemic period, a total of 368 (32.3%), 388 (34.1%), 271 (23.8%) and 211 (18.5%) respondents were reported to have depression, anxiety, stress and insomnia, respectively. HCWs in the frontline group were 1.5 times more likely to report anxiety (OR=1.557, p=0.004), stress (OR=1.506, p=0.016) and insomnia (OR=1.586, p=0.013) as compared with those in the non-frontline group. No significant differences in depression status were found between the frontline and non-frontline groups (p=0.201).ConclusionsTo our knowledge, this is the first study to explore the differential impacts of the COVID-19 pandemic on different grades of HCWs. This study suggests that frontline HCWs are disproportionally affected compared to non-frontline HCWs, with managing sleep–wake cycles and anxiety symptoms being highly endorsed among frontline HCWs. As psychosocial interventions are likely to be constrained owing to the pandemic, mental healthcare must first be directed to frontline HCWs.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258893
Author(s):  
Rima Styra ◽  
Laura Hawryluck ◽  
Allison Mc Geer ◽  
Michelle Dimas ◽  
Jack Sheen ◽  
...  

Objective Explore how previous work during the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak affects the psychological response of clinical and non-clinical healthcare workers (HCWs) to the current COVID-19 pandemic. Methods A cross-sectional, multi-centered hospital online survey of HCWs in the Greater Toronto Area, Canada. Mental health outcomes of HCWs who worked during the COVID-19 pandemic and the SARS outbreak were assessed using Impact of Events—Revised scale (IES-R), Generalized Anxiety Disorder scale (GAD-7), and Patient Health Questionnaire (PHQ-9). Results Among 3852 participants, moderate/severe scores for symptoms of post- traumatic stress disorder (PTSD) (50.2%), anxiety (24.6%), and depression (31.5%) were observed among HCWs. Work during the 2003 SARS outbreak was reported by 1116 respondents (29.1%), who had lower scores for symptoms of PTSD (P = .002), anxiety (P < .001), and depression (P < .001) compared to those who had not worked during the SARS outbreak. Multivariable logistic regression analysis showed non-clinical HCWs during this pandemic were at higher risk of anxiety (OR, 1.68; 95% CI, 1.19–2.15, P = .01) and depressive symptoms (OR, 2.03; 95% CI, 1.34–3.07, P < .001). HCWs using sedatives (OR, 2.55; 95% CI, 1.61–4.03, P < .001), those who cared for only 2–5 patients with COVID-19 (OR, 1.59; 95% CI, 1.06–2.38, P = .01), and those who had been in isolation for COVID-19 (OR, 1.36; 95% CI, 0.96–1.93, P = .05), were at higher risk of moderate/severe symptoms of PTSD. In addition, deterioration in sleep was associated with symptoms of PTSD (OR, 4.68, 95% CI, 3.74–6.30, P < .001), anxiety (OR, 3.09, 95% CI, 2.11–4.53, P < .001), and depression (OR 5.07, 95% CI, 3.48–7.39, P < .001). Conclusion Psychological distress was observed in both clinical and non-clinical HCWs, with no impact from previous SARS work experience. As the pandemic continues, increasing psychological and team support may decrease the mental health impacts.


2021 ◽  
pp. 216770262095731
Author(s):  
Yara Mekawi ◽  
Courtland S. Hyatt ◽  
Jessica Maples-Keller ◽  
Sierra Carter ◽  
Vasiliki Michopoulos ◽  
...  

Despite a consistent body of work documenting associations between racial discrimination and negative mental health outcomes, the utility and validity of these findings have recently been questioned because some authors have posited that personality traits may account for these associations. To test this hypothesis in a community sample of African Americans ( n = 419, age: M = 43.96 years), we used bivariate relations and hierarchical regression analyses to determine whether racial discrimination accounted for additional variance in depression, anxiety, and posttraumatic stress symptoms beyond the role of personality. Bivariate relations between personality traits and racial discrimination were small and positive (i.e., rs ≈ .10). Regression results demonstrated that racial discrimination accounted for variance in depression, anxiety, and posttraumatic stress independent of personality traits ( ps < .01). These results suggest that personality traits do not fully explain associations between racial discrimination and negative mental health outcomes, further supporting the detrimental impact of racial discrimination on the mental health of African Americans.


2021 ◽  
Vol 11 (1) ◽  
pp. 7
Author(s):  
Carol S. North ◽  
Alina M. Surís ◽  
David E. Pollio

The coronavirus disease of 2019 (COVID-19) pandemic rapidly spread around the world, resulting in massive medical morbidity and mortality and substantial mental health consequences. Post-traumatic stress disorder (PTSD) is an important psychiatric disorder associated with disasters, and many published scientific articles have reported post-traumatic stress syndromes in populations studied for COVID-19 mental health outcomes. American diagnostic criteria for PTSD have evolved across editions of the manual, and the current definition excludes naturally occurring medical illness (such as viral illness) as a qualifying trauma, ruling out this viral pandemic as the basis for a diagnosis of PTSD. This article provides an in-depth nosological consideration of the diagnosis of PTSD and critically examines three essential elements (trauma, exposure, and symptomatic response) of this diagnosis, specifically applying these concepts to the mental health outcomes of the COVID-19 pandemic. The current criteria for PTSD are unsatisfying for guiding the response to mental health consequences associated with this pandemic, and suggestions are made for addressing the conceptual diagnostic problems and designing research to resolve diagnostic uncertainties empirically. Options might be to revise the diagnostic criteria or consider categorization of COVID-19-related psychiatric syndromes as non-traumatic stressor-related syndromes or other psychiatric disorders.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Delan Devakumar ◽  
Alexis Palfreyman ◽  
Amaran Uthayakumar-Cumarasamy ◽  
Nazifa Ullah ◽  
Chavini Ranasinghe ◽  
...  

Abstract Background Armed conflict has significant impacts on individuals and families living in conflict-affected settings globally. Scholars working to prevent violence within families have hypothesised that experiencing armed conflict leads to an increase in family violence and mental health problems. In this review, we assessed the prevalence of family violence in conflict settings, its association with the mental health of survivors, moderating factors, and the importance of gender relations. Methods Following PRISMA guidelines, we systematically reviewed quantitative and qualitative studies that assessed the prevalence of family violence and the association between family violence and mental health problems, within conflict settings (PROSPERO reference CRD42018114443). Results We identified 2605 records, from which 174 full text articles were screened. Twenty-nine studies that reported family violence during or up to 10 years after conflict were eligible for inclusion. Twenty one studies were quantitative, measuring prevalence and association between family violence and mental health problems. The studies were generally of high quality and all reported high prevalence of violence. The prevalence of violence against women was mostly in the range of 30–40%, the highest reported prevalence of physical abuse being 78.9% in Bosnia and Herzegovina. For violence against children, over three-quarters had ever experienced violence, the highest prevalence being 95.6% in Sri Lanka. Associations were found with a number of mental health problems, particularly post-traumatic stress disorder. The risk varied in different locations. Eight qualitative studies showed how men’s experience of conflict, including financial stresses, contributes to their perpetration of family violence. Conclusions Family violence was common in conflict settings and was associated with mental health outcomes, but the studies were too heterogenous to determine whether prevalence or risk was greater than in non-conflict settings. The review highlights an urgent need for more robust data on perpetrators, forms of family violence, and mental health outcomes in conflict-affected settings in order to help understand the magnitude of the problem and identify potential solutions to address it.


2019 ◽  
Vol 185 (5-6) ◽  
pp. e711-e718 ◽  
Author(s):  
David L Chin ◽  
John E Zeber

Abstract Introduction Studies examining the mental health outcomes of military personnel deployed into combat zones have focused on the risk of developing post-traumatic stress disorder conferred by mild or moderate traumatic brain injury (TBI). However, other mental health outcomes among veterans who sustained critical combat injuries have not been described. Materials and Method We examined the associations of moderate and severe TBI and combat injury with the risk for anxiety and mood disorders, adjustment reactions, schizophrenia and other psychotic disorders, cognitive disorders, and post-traumatic stress disorder. We conducted a retrospective cohort study of U.S. military service members critically injured in combat during military operations in Iraq and Afghanistan from February 1, 2002, to February 1, 2011. Health care encounters from (1) the Department of Defense (DoD) Trauma Registry (TR), (2) acute and ambulatory care in military facilities, and (3) civilian facilities are reimbursed by Tricare. Service members who sustained severe combat injury require critical care. We estimated the risk of mental health outcomes using risk-adjusted logit models for demographic and clinical factors. We explored the relationship between TBI and the total number of mental health diagnoses. Results Of the 4,980 subjects who met inclusion criteria, most injuries occurred among members of the Army (72%) or Marines (25%), with mean (SD) age of 25.5(6.1) years. The prevalence of moderate or severe TBI was 31.6% with explosion as the most common mechanism of injury (78%). We found 71% of the cohort was diagnosed with at least one poor mental health condition, and the adjusted risk conferred by TBI ranged from a modest increase for anxiety disorder (odds ratio, 1.27; 95% confidence interval [CI], 1.11–1.45) to a large increase for cognitive disorder (odds ratio, 3.24; 95% CI, 2.78–3.77). We found TBI was associated with an increased number of mental health diagnoses (incidence rate ratio, 1.52; 95% CI, 1.42–1.63). Conclusions Combat-associated TBI may have a broad effect on several mental health conditions among critically injured combat casualties. Early recognition and treatment for trauma-associated mental health are crucial to improving outcomes among service personnel as they transition to post-deployment care in the DoD, Department of Veterans Affairs, or community health systems.


2019 ◽  
Vol 34 (s1) ◽  
pp. s4-s4
Author(s):  
Elizabeth Newnham ◽  
Xue Gao ◽  
Elizabeth Nathan ◽  
Mark Boyes ◽  
Feng Jiao ◽  
...  

Introduction:Prolonged conditions of chronic stress have the potential to cause mental health difficulties and disrupt developmental processes for children and adolescents. Natural disasters disproportionately affect low-resource areas, yet little is known about the interaction between trauma exposure, chronic stressors, and mental health.Aim:To determine the rates of post-traumatic stress disorder (PTSD), depression and anxiety among adolescents affected by earthquakes in China and Nepal, and examine the specific roles of trauma exposure and chronic stressors across the three mental health outcomes.Methods:A school-based, cross-sectional study of 4,215 adolescents (53% female, ages 15-19 years) was conducted in disaster-affected areas of southern China and Nepal. Participants completed a series of translated and culturally adapted standardized assessments. Mixed effects logistic regression analyses were conducted for each mental health outcome.Results:The overall rate of PTSD was 22.7% and was higher among Nepalese participants (China: 19.4% vs. Nepal: 26.8%, p<0.001), but did not differ between genders (China: p=0.087 and Nepal: p=0.758). In both countries, the level of trauma exposure was a significant risk factor for PTSD, depression, and anxiety (China: OR’s 1.09-1.18 and Nepal: OR’s 1.08-1.13). Chronic stressors significantly improved the model and further contributed to mental health outcomes (China: OR’s 1.23-1.26 and Nepal: OR’s 1.10-1.23). Multilevel risk and protective factors across all mental health outcomes will be presented.Discussion:While there are limited opportunities to protect adolescents from disaster exposure, there is significant potential to address the effects of ongoing economic insecurity, domestic violence, and school cessation that are likely to worsen mental health outcomes. Programs that identify chronic stressors for adolescents in disaster-affected settings, and work to address poverty and violence, will have cascading effects for mental health, development, and security.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yuriy Nesterko ◽  
Michael Friedrich ◽  
Elmar Brähler ◽  
Andreas Hinz ◽  
Heide Glaesmer

Abstract Background In Germany, the term ‘migration background’ has been established to differentiate between immigrants and natives. In the present study post-traumatic stress disorder (PTSD), anxiety, and depression were analysed in immigrant populations in Germany by considering self-attribution as well as attribution by others on one’s own ‘migration background’. Methods In a population-based survey (N = 2317), socio-demographic characteristics, migration background (official statistics definition vs. self-attribution as well as the anticipated attribution by others), PTSD (PCL-5), and symptoms of anxiety and depression (PHQ-4) were assessed. Logistic regression models were applied to predict mental health outcomes by considering socio-demographic and immigration-related factors. Results A total of 10.7% of respondents (N = 248) had a ‘migration background’. Immigrants of the 2nd generation compared to 1st generation immigrants are less likely to see themselves as immigrants. Attribution as an immigrant (self and/or by others) was found as significant predictor for PTSD and depression, but not anxiety. Conclusions It seems useful to focus on immigration-related factors considering subjective perspectives and not only comparing immigrants and natives using a federal statistics definition. Our findings suggest that research on the association between immigration-related factors such as attribution as an immigrant and mental health outcomes might be a promising approach to better identify subgroups at higher risk of mental distress.


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