Stigma modifies the association between social support and mental health among sexual violence survivors in the Democratic Republic of Congo: implications for practice

Background and Objectives: The aim of this study was to further understanding of the relationship between social support, internalized and perceived stigma, and mental health among women who experienced sexual violence in the eastern Democratic Republic of Congo (DRC).

Methods: Drawing from baseline survey data collected in eastern DRC, researchers conducted a secondary cross-sectional analysis using data from 744 participants. Regression and moderation analyses were conducted to examine associations between social support variables, felt stigma, and depression, anxiety and posttraumatic stress disorder (PTSD).

Results: Emotional support seeking and felt stigma were positively associated with increased symptom severity across all three mental health variables. Stigma modified associations between emotional support seeking and depression (t?=??2.49, p?=?.013), anxiety (t?=??3.08, p?=?.002), and PTSD (t?=??2.94, p?=?.003). Increased frequency of emotional support seeking was associated with higher mental health symptoms of anxiety and PTSD among women experiencing all levels of stigma.

Conclusions: Enhancing understanding of social support and stigma may inform research and intervention among Congolese forced migrant populations across circumstances and geographic locations. Implications for practice and research are discussed.     

Attachment,Social Support,Resilience and Posttraumatic Stress Disorder Symptoms in Chinese Adults Living with HIV/AIDS

The present study aimed to examine the effects of attachment, social support and resilience on posttraumatic stress disorder (PTSD) symptoms in people living with HIV/AIDS. One hundred fifty-two HIV+ adults in China were investigated. The results suggested that attachment anxiety had a significant direct effect on PTSD symptoms and impacted PTSD symptoms indirectly though associations with social support and resilience. Attachment avoidance could also be considered a distal risk factor of PTSD symptoms via the mediation of social support and resilience. The findings highlight the importance of identifying trauma and PTSD symptoms in people affected by HIV/AIDS and suggest that people with attachment anxiety and low social support resources might be at high risk for PTSD.     

Coping,social support,stigma, and gender difference among people living with HIV in Guangxi,China

The current study examined whether gender, HIV-related stigma, social support, and the interaction between gender and social support are associated with coping responses among people living with HIV and AIDS (PLWHA) in Guangxi, China. A total of 2987 PLWHA in Guangxi participated from October 2012 to August 2013. Multivariate analysis of covariance was conducted with gender and social support as main factors in the model, and stigma and other variables as covariates. After controlling for demographic variables and stigma, there were significant main effects of emotional social support (F = 1.61, p < .001), functional social support (F = 1.67, p < .001), and informational social support (F = 3.67, p < .001) on various coping strategies. The interaction between gender and informational social support (F = 1.33, p < .05), internalized stigma (F = 37.03, p < .001) and perceived stigma (F = 9.16, p < .001) were associated with various coping strategies. Findings signify the importance of HIV-related stigma and social support differences in the coping strategies among PLWHA in Guangxi, China.     

Anxiety sensitivity and distress tolerance typologies and relations to posttraumatic stress disorder: A cluster analytic approach

A growing literature suggests a relationship between a high anxiety sensitivity (AS; the fear of anxiety and its related consequences)/low distress tolerance (DT; the capacity tolerate internal negative states) profile and posttraumatic stress disorder (PTSD) symptoms. However, specific profiles have not been identified or examined specifically in Veteran samples. Thus, the aims of the present study were to establish empirically derived profiles created from response patterns on the Anxiety Sensitivity Index and Distress Tolerance Scale and to examine associations with PTSD symptom clusters among a sample of combat-exposed Veterans (N = 250). A cluster analytic approach was used to identify AS/DT profiles, and a series of multivariate analyses of variance with post hoc analyses was conducted to examine the relationship between each AS/DT profile and each PTSD symptom cluster. Results indicated a 3-cluster solution including a high AS/low DT “at risk” profile, a low AS/high DT “resilient” profile, and an average AS/DT “intermediate” profile. The at-risk profile was associated with significantly greater symptoms in each PTSD cluster (i.e., hyperarousal, avoidance, re-experiencing) when compared to the other two profiles. The at-risk profile was also associated with greater depressive symptoms and lower self-reported resilience. These findings extend the previous literature by identifying a high AS/low DT “at risk” profile and its associations with PTSD symptoms, underscoring the potential utility in targeting these affect-regulation constructs for clinical intervention.     

Symptoms of Posttraumatic Stress Disorder and Social Support Among Children and Adolescents After the 2010 Haitian Earthquake

This study explored the prevalence of posttraumatic stress disorder (PTSD) symptoms related to social support received by the children and adolescents who survived the earthquake on January 12, 2010, in Haiti. A strategy of stratified sampling was used, and 540 children and teenagers were questioned. Questionnaires based on the PTSD Checklist, the Impact of Event Scale-Revised, and the Peritraumatic Distress Inventory, among others, were used and bivariate statistical analyses were carried out. The results showed high rates of complete and partial PTSD symptoms, with higher rates among females, and indicated the need for reinforcing social support as a resilience factor for youth.     

失独父母创伤后应激障碍症状的潜在类别及其相关因素

摘 要 研究旨在探讨失独父母创伤后应激障碍（PTSD）症状的潜在类别及相关因素,分析不同类别失独父母心理韧性的差异。采用创伤后应激障碍量表（PCL-5）、心理韧性量表对385名失独父母进行测查。结果发现：（1）失独父母PTSD症状存在三种潜在类别：PTSD高症状组（30%）、PTSD中度症状组（38%）、PTSD低症状组（32%）。（2）相比PTSD低症状组而言,PTSD高或中度症状组有显著的年龄和失独年限效应,PTSD高症状组中年龄≤60岁、失独年限<10年的人群所占比例较高;PTSD中度症状组的年龄≤60岁的人群所占比例更高。（3）PTSD高症状组心理韧性得分显著低于其他两组。应及时关注和干预小于60岁、失独年限<10年和低心理韧性的失独群体。     

失独父母创伤后应激障碍症状的潜在类别及其相关因素

摘 要 研究旨在探讨失独父母创伤后应激障碍（PTSD）症状的潜在类别及相关因素,分析不同类别失独父母心理韧性的差异。采用创伤后应激障碍量表（PCL-5）、心理韧性量表对385名失独父母进行测查。结果发现：（1）失独父母PTSD症状存在三种潜在类别：PTSD高症状组（30%）、PTSD中度症状组（38%）、PTSD低症状组（32%）。（2）相比PTSD低症状组而言,PTSD高或中度症状组有显著的年龄和失独年限效应,PTSD高症状组中年龄≤60岁、失独年限<10年的人群所占比例较高;PTSD中度症状组的年龄≤60岁的人群所占比例更高。（3）PTSD高症状组心理韧性得分显著低于其他两组。应及时关注和干预小于60岁、失独年限<10年和低心理韧性的失独群体。     

Constructions of social selves living with HIV/AIDS: A Jungian phenomenological study

This study explored sense of social well-being influences on self-identity and the stigma and discrimination among people living with HIV/AIDS (PLWHA). Informants were 15 PLWHA from a rural background in a South African community (female = 87%, age range = 26 to 64 years; and males = 13%, age range = 55 to 64 years). They completed semi-structured interviews on their lived experiences relating to a sense of social inclusion and belongingness. We thematically analysed the data, and interpreted the findings applying Jungian archetypes of the Self, Shadow, and Persona. Findings suggest PLWHA’s sense of a dominant Shadow to be a barrier to self-acceptance whereas a Persona (mask) was guided by a need to be socially acceptable. A positive sense of social well-being among PLWHA is important to their health and well-being.     

Health outcomes resulting from the quality of emotional expression in HIV/AIDS patients

IntroductionStudies on emotional expression and its impact upon health have mainly focused on quantitative aspects of interactions rather than on their quality.ObjectiveThe present study aimed to examine the interpersonal quality of interactions in the social sharing of emotions (SSE) in people living with HIV/AIDS (PLWHA), and its impact on patients’ physical and psychological well-being.MethodOne hundred and one PLWHA answered a questionnaire (Likert scale items) which assessed the following: shame, guilt, perceived stigma, perceived physical health, perceived mental health, SSE and the interpersonal quality of SSE (IQSSE). The main hypotheses were compiled into a theoretical model which was tested by a series of structural equation modeling (SEM) analyses.ResultsThe final solution resulted into a well-fit model which showed that: shame predicted IQSSE, perceived stigma mediated the relationship between IQSSE and guilt, and perceived mental health mediated the relationship between IQSSE and perceived physical health.ConclusionThese results corroborate previous findings which demonstrate that IQSSE is independent from quantitative aspects of SSE and that the way the SSE takes place is crucial to the benefits it induces.     

基于未感染者与感染者双重视角的艾滋病污名

艾滋病污名由公众污名和自我污名两部分构成。前者指公众所持有的对艾滋病和艾滋病感染者的偏见、刻板印象和歧视; 后者指艾滋病感染者感知到的来自公众的偏见、刻板印象和歧视, 并由此产生的负面自我认知。测量主要从未感染者和感染者两个层面展开。艾滋病的公众污名与自我污名广泛存在于个人、家庭、医疗、媒体等诸多领域, 阻碍艾滋病的有效防治并损害社会平等。减少艾滋病污名的干预既需要消除公众的偏见、刻板印象和歧视, 改善社会环境; 也需要感染者自我的心理健康和治疗意愿, 提升生活质量。未来应该从未感染者和感染者的双重视角出发, 对其相互作用机制、测量工具、干预措施及连带污名等进行深入研究。     

The Development of a Brief Distress Reduction Intervention for Individuals Recently Diagnosed With HIV in China

In China, where there are few mental health resources, the majority of HIV-related efforts have focused on medical treatment and transmission prevention rather than psychosocial support. Yet people living with HIV/AIDS (PLWHA) report high levels of psychological distress, especially upon first receiving their HIV diagnosis. We conducted mixed methods research of a qualitative study with (N = 31) individual interviews and 3 focus groups (n = 6 in each group) of HIV-affected participants, and a quantitative survey (N = 200) with individuals living with HIV in Shanghai and Beijing, China. Our qualitative data revealed themes of forms of distress experienced and types of psychosocial support that our participants wished they could have accessed upon diagnosis as well as suggestions for intervention structure that would be most feasible and acceptable. Our quantitative surveys provided further evidence of the high degree of psychosocial distress among recently diagnosed PLWHA. Our findings informed the development of the Psychology Toolbox intervention, a brief CBT skills-based intervention comprising cognitive restructuring, behavioral activation, and paced breathing, designed to be integrated into primary care for recently diagnosed PLWHA. This study describes the intervention development process and contents of each session. Future research should evaluate the intervention for efficacy as well as examine best strategies for eventual implementation and dissemination.     

Religious coping,general coping strategies,perceived social support,PTSD symptoms,resilience, and posttraumatic growth among survivors of the 2010 earthquake in Haiti

This study examines the relationships between coping strategies, perceived social support, resilience, PTSD symptoms, and posttraumatic growth (PTG) in a sample of 256 survivors of the 2010 Haiti earthquake. The results of the bivariate analysis suggested a significant positive correlation between PTG and resilience, PTSD symptoms, perceived social support, positive religious coping, and active coping. There was a significant positive relationship between perceived social support and resilience and between resilience and active coping. PTSD symptoms were positively correlated with both positive and negative religious coping. Results of the multiple regression analysis indicated that positive religious coping, active coping, perceived social support, resilience, and PTSD symptoms accounted for 34% of the variance in the participants’ PTG. The strongest predictor of PTG was positive religious coping, followed by active coping, perceived social support, resilience, PTSD symptoms, and negative religious coping. Implications and recommendations for future research were discussed.     

Post-traumatic stress disorder and hiring: The role of social media disclosures on stigma and hiring assessments of veterans

A significant percentage of veterans suffer from post-traumatic stress disorder (PTSD). Veterans are often directed to social media platforms to seek support during their transition to civilian life. However, social media platforms are increasingly used to aid in hiring decisions, and these platforms may make veterans’ PTSD more discoverable during the hiring process. Based on social identity theory and identity management theory, the integrated suspicion model, and the stigma literature, we conducted four studies that examine veterans’ PTSD disclosures on social media and the consequences in the hiring process. Study 1 suggests that 16%–34% of veterans included cues related to PTSD status on social media. Study 2, based on 290 upper-level business students, shows that veterans with PTSD were more stigmatized than veterans without PTSD, and stigmatization is associated with more suspicion and lower hiring-related ratings (of expected task performance, expected organizational citizenship behaviors (OCB), expected counterproductive work behaviors (CWB), and intention to interview). Study 3, based on 431 working professionals with hiring experience, further supports relationships from Study 2. Study 4, based on 298 working professionals, identifies peril (i.e., perceptions regarding danger) as an additional mediator for the effects of PTSD on hiring-related ratings. In sum, we identify and explore the identity management conundrum that social media disclosure poses for veterans with PTSD in the hiring process and discuss potential remedies and avenues for future research.     

Personal Meaning,Social Support,and Perceived Stigma in Individuals Receiving HIV Mental Health Services

Human immunodeficiency virus (HIV) stigma represents a significant source of stress among individuals living with HIV disease, prompting interest in research to identify factors that may help to ameliorate the stress burden associated with HIV stigma. Consistent with this research line, the current study was conducted as a cross-sectional investigation examining associations between positive global personal meaning, social support, and perceived HIV stigma. Global personal meaning refers to beliefs and aspirations through which one ascribes value and purpose in living. The study sample was comprised of individuals living with HIV disease who presented for an initial visit in a specialty HIV mental health services program. In bivariate analyses, social support was negatively correlated with multidimensional aspects of HIV stigma that included distancing, blaming, and discrimination stigma, whereas personal meaning was negatively associated only with blaming stigma. In further analyses using structural equation modeling, social support significantly mediated the association between personal meaning and both distancing and blaming stigma. Interactions between positive personal meaning and social support may be useful to consider in future research on psychological resource factors and HIV stigma. Understanding these interactions may also inform clinical efforts to address HIV stigma concerns.     

青少年感恩与创伤后应激障碍症状的关系:社会支持和心理弹性的中介作用

在"5.12"汶川地震后18个月时,采用青少年感恩量表、社会支持评定量表、心理弹性量表和创伤后应激障碍自评量表,对都江堰地区1439名经历地震的青少年进行问卷调查,考察感恩、社会支持、心理弹性与创伤后应激障碍(PTSD)症状的关系。结果表明:(1)感恩、社会支持和心理弹性均与PTSD症状呈显著的负相关,相关系数分别为-0.18,-0.17和-0.24;(2)感恩不仅直接影响PTSD症状,而且还通过社会支持和心理弹性的部分中介作用间接影响PTSD症状,中介效应占总效应的62%。     

基于长尾效应的儿童创伤后应激障碍转归机制及干预策略

儿童PTSD具有“长尾效应”, 疾病负担重、发展结局存在较大异质性, 但是少有研究对我国儿童PTSD的转归进行系统性研究, 其转归类型、路径尚不明晰, 更缺少促进儿童PTSD复原的干预研究。因此, 本研究拟对儿童及青少年进行追踪调查和准实验研究, 探讨儿童PTSD的发展轨迹及转归类型和机制, 验证基于学校的综合干预服务对促进儿童PTSD恢复的效果, 为儿童PTSD干预及个性化诊疗提供证据。     

价值观对蓄意创伤受害者创伤后应激障碍症状的影响

探讨价值观对蓄意创伤受害者创伤后应激障碍（Posttraumatic Stress Disorder ,简称PTSD）症状的影响方式。方法：采用事件冲击量表、受害人认可评价量表、施瓦兹价值观量表作为测查工具,测查了163 名蓄意创伤受害者。结果：（1）蓄意创伤受害者的PTSD三大症状表现有显著差异,闯入症状水平最高,回避症状水平次之,高警觉症状水平最低。（2）蓄意创伤受害者所持的价值观和对外界接纳的评价能较好地预测PTSD三大症状。（3）内敛价值类型通过诸如社会接纳等反映外在标准的因素影响PTSD的闯入症状。结论：蓄意创伤受害者PTSD症状表现有其自身的特点,对外界接纳的评价和自身所持的价值观对其PTSD症状有直接或间接的影响     

Intrapersonal and Interpersonal Sources of Resilience: Mechanisms of the Relationship Between Bullying Victimization and Mental Health Among Migrant Children in China

Compared with their non-migrant peers, migrant children in China face major risks and challenges that may cause them to develop behavioral and psychological problems. Nevertheless, research has seldom addressed their victimization by bullies and its association with their mental health outcomes, much less the roles of intrapersonal and interpersonal sources of resilience in that relationship. In response, this study was designed to examine how bullying victimization both directly and indirectly influences migrant children’s mental health through intrapersonal and interpersonal sources of resilience. Data were collected from a school-based multistage random sample of 1,132 migrant children in Grades 4–9 (mean age = 11.88 years, range = 8–17 years; boys = 55.6%) attending public schools in Nanjing and private schools in Guangzhou, China. Structural equation modeling performed with Amos 25.0 revealed that both intrapersonal and interpersonal sources of resilience mediated the effect of bullying victimization on migrant children’s mental health, albeit intrapersonal sources demonstrated a slightly stronger mediation effect. The results thus suggest that social workers and educators should provide effective prevention and intervention strategies that promote intrapersonal and interpersonal sources of resilience among migrant children in China.

     

Beyond stigma: Understanding the “inclined abstainers” in military behavioral health-care utilization

ABSTRACT

Low treatment utilization in Soldiers with combat-related Posttraumatic Stress Disorder (PTSD) is an ongoing issue. The critical concern is to better understand factors which prohibit a Soldier with PTSD who wants help from seeking treatment (an “inclined abstainer”). A total of 537 Active Duty Soldiers on a US Army post completed a brief survey comprising psychometrically validated measures of stigma, behavioral health treatment beliefs, resilience, PTSD symptoms, and treatment intentions. Health-care records were prospectively tracked for 12 months to determine the relation between survey answers and treatment utilization. Sixty-three percent of those who acknowledged having a mental health-related problem did not seek help within a one-year period. Greater severity of PTSD symptoms was associated with an increased likelihood of behavioral health engagement. Soldiers that were classified as “inclined abstainers” were also more likely to endorse negative beliefs about psychotherapy and report higher levels of resilience as compared to “inclined actors.” These results suggest that a treatment model of PTSD emphasizing self-efficacy and self-reliance, while addressing negative beliefs about psychotherapy, may help promote engagement of behavioral health services among Active Duty Soldiers.     

Prayer Coping,Disclosure of Trauma,and Mental Health Symptoms Among Recently Deployed United States Veterans of the Iraq and Afghanistan Conflicts

U.S. military veterans of the Iraq and Afghanistan conflicts are at risk for developing adverse mental health symptoms. This study was conducted to examine the associations between prayer coping, attitudes toward trauma disclosure, and mental health symptoms (posttraumatic stress disorder [PTSD] and depression) among 110 U.S. veterans who had returned from deployments in Operation Enduring Freedom and Operation Iraqi Freedom within the previous 6 months. Bivariate analyses revealed that prayer coping was positively correlated with an urge to talk about potentially traumatic experiences. When controlling for combat exposure, social support, and disclosure attitudes, multivariate regression analyses indicated that two of the prayer functions—praying for assistance and for calm and focus—were each uniquely linked with less PTSD and depressive symptomatology. In addition, a reliance on avoidant prayer was uniquely correlated with greater depressive symptomatology. These findings support emerging ideas about prayer as a form of trauma disclosure and highlight the relevance of this approach to coping for veterans as they readjust to civilian life.