Assessing Psychiatric Symptoms in Youth Affected by HIV: Comparing a Brief Self-Administered Rating Scale with a Structured Diagnostic Interview

Brief psychiatric assessment tools are needed for evaluating children affected by HIV for emotional and behavioral problems. We compared a self-administered symptom rating scale (CASI-4R) to a semi-structured diagnostic interview (DICA-P) in 136 U.S. children affected by HIV. Agreement and performance measures for the two instruments were computed for attention deficit hyperactivity disorder, depression, anxiety, and disruptive behavior. Correlations and regression analyses were conducted to compare the two instruments, and to evaluate their associations with social, academic, and global function. Higher CASI-4R symptom severity scores were associated with DICA diagnoses (p?<?0.02 for all disorders). Agreement (κ) between DICA diagnoses and CASI-4R Clinical Cutoffs (which incorporated symptoms and impairment) was low to moderate (0.19–0.40 for all disorders). Thirty-two percent of cases with a DICA diagnosis were identified by the CASI-4R Clinical Cutoff (sensitivity), yet over 90% of DICA-negative cases were negative by the CASI-4R (specificity). Sensitivity was higher using CASI-4R Severity Score thresholds based on median scores compared to the DICA diagnoses. The presence and severity of psychiatric symptoms and impairment were associated with poorer academic, social, and global function. The CASI-4R symptom checklist can be used to inexpensively screen youth affected by HIV for emotional and behavioral problems, although it is important that there be appropriate mental health evaluation follow-up.     

Why Can’t You Just Pick One? The Stigmatization of Non-binary/Genderqueer People by Cis and Trans Men and Women: An Empirical Test of Norm-Centered Stigma Theory

Non-binary and genderqueer identities often resonate with people whose genders are outside the man-woman dichotomy, fluid, androgynous, and/or variant. Yet the gender binary system remains the unwavering norm, often placing non-binary and genderqueer people on the margins of social acceptability, and surprisingly little research has investigated those who stigmatize non-binary/genderqueer people. The current study utilizes Worthen’s (2020) Norm-Centered Stigma Theory (NCST) and nationally representative data collected from U.S. online panelists (n?=?3009: 1419 cis men, 1461 cis women, 74 trans women, 55 trans men) to investigate how norms (cisnormativity) and gender identity axes of social power (man/woman, cis/trans, and intersecting cis/trans-man/woman identities) relate to the stigmatization of non-binary/genderqueer people. Overall findings indicate that (a) cisnormativity is integral to understanding non-binary/genderqueer stigma, (b) the stigmatizer’s gender identity axes of social power are essential to explore as related to both cisnormativity and non-binary/genderqueer stigma, and (c) cisgender women are significantly different from others when it comes to both cisnormativity and non-binary/genderqueer stigma. Overall, the results underscore the significance of focusing on the unique complexities involved in the stigmatization of non-binary/genderqueer people and work toward dismantling such negativities.