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Wei Y, Sha L, McWeeny R, Johal R, Easton C, Baxter A, Cao B, Greenshaw A, Carr W. Evaluating the effectiveness of a school-based mental health literacy intervention from a comprehensive demographic and social-cognitive perspective. Sci Rep 2024; 14:5901. [PMID: 38467742 PMCID: PMC10928151 DOI: 10.1038/s41598-024-56682-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 03/09/2024] [Indexed: 03/13/2024] Open
Abstract
Childhood and adolescence are a critical period for the onset of mental and neurodevelopmental disorders and a time when many can be first identified. Research demonstrates that mental health literacy applied in school settings may be an effective approach to address these challenges. In contrast to many existing studies conducted in multicultural and multilingual settings that treated subjects' language as a demographic feature, the present study recognizes English proficiency as a social-cognitive factor and views the school-based mental health literacy (MHL) intervention as a learning process. The present study aimed to assess the effectiveness of school-based mental health literacy intervention and explore how ethnicity and English proficiency as a social-cognitive factor, as a modified, rather than a fixed variable, impacted the intervention outcomes. Grade 9 students (n = 240) from schools in West Canada with diverse social/cultural background received the intervention in the classroom delivered by trained teachers and completed the pre-test and post-test over a 6-month period. The intervention was effective in improving knowledge and help-seeking attitudes among all students. Non-Chinese and native English-speaking students performed the best on all outcomes. Gender demonstrated an association with changes in stigma, stress and wellbeing. English proficiency was linked to knowledge acquisition, while ethnicity was connected to changes of attitude-related outcomes. These findings deepened our understanding of how demographic and social-cognitive factors underlie changes in mental health literacy outcomes, which will facilitate the development of mental health literacy interventions for diverse student populations.
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Affiliation(s)
- Yifeng Wei
- Department of Psychiatry, University of Alberta, 1E1 Walter Mackenzie Health Sciences Centre (WMC), 8440 112 St NW, Edmonton, AB, T6G 2B7, Canada.
| | - Li Sha
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Robert McWeeny
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Rav Johal
- Richmond School District No. 38, Richmond, BC, Canada
| | | | | | - Bo Cao
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Andrew Greenshaw
- Department of Psychiatry, University of Alberta, Edmonton, AB, Canada
| | - Wendy Carr
- Faculty of Education, University of British Columbia, Vancouver, BC, Canada
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Lee A, Choi H. Effects of Social Acknowledgment and Interpersonal Shame on Complex Posttraumatic Stress Disorder Symptoms of Sexual Violence Survivors in South Korea. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241234353. [PMID: 38440809 DOI: 10.1177/08862605241234353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
Sexual violence (SV) survivors face negative social reactions, which can affect their recovery. Based on the socio-interpersonal model of trauma, understanding how societal circumstances impact SV survivors' mental health is important. This study examined conditional indirect effects of interpersonal shame and social acknowledgment on the relationship between perceived SV event severity and complex post-traumatic stress disorder (CPTSD) symptoms. Cross-sectional data from 157 community-based adults who had previously experienced SV were collected from an online panel. Exploratory factor analysis of the Social Acknowledgment Questionnaire was conducted, followed by conditional indirect analyses using Models 1, 4, and 7 of PROCESS macro. First, results showed that a two-factor model of social acknowledgment consisting of "social disapproval" and "social recognition" was more suitable for this study than a three-factor model predominantly used by Western societies. Second, interpersonal shame partially mediated the relationship between perceived SV event severity and CPTSD symptoms. Third, the conditional indirect effect of social disapproval on the mediating effect of interpersonal shame was significant when the social disapproval level was high. This indicates that the indirect effect of interpersonal shame on CPTSD increases when the social disapproval level is high. This study supported the socio-interpersonal perspective of trauma and suggested that increasing social acknowledgment beyond personal-level intervention would be a critical step for recovery of SV survivors to decrease their interpersonal shame and CPTSD.
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Affiliation(s)
- Ahyeon Lee
- Chungbuk National University, Cheongju, South Korea
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3
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Sadath A, Kavalidou K, McMahon E, Malone K, McLoughlin A. Associations between humiliation, shame, self-harm and suicidality among adolescents and young adults: A systematic review. PLoS One 2024; 19:e0292691. [PMID: 38329967 PMCID: PMC10852296 DOI: 10.1371/journal.pone.0292691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 09/26/2023] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Suicide is the second leading cause of death among young people worldwide. Research indicates that negative social contexts involving familial and peer relationships have far-reaching influences on levels of suicidality in later life. While previous systematic reviews have focused on evaluating associations between negative life events such as abuse and bullying in childhood and subsequent suicidality, this systematic review examines the prevalence of, and association between the processes of humiliation and shame in later self-harm, suicidal ideation, and suicide among adolescents and young adults. METHODS A systematic literature search of databases including MEDLINE, Web of Science Core Collection, CINAHL, PsycINFO, and Embase was conducted to identify potential studies. ProQuest was searched to identify relevant grey literature research. A combination of MESH terms and keywords was used. All original quantitative studies published in English that examined the prevalence, or association between humiliation or shame and suicidal behaviours and/or death by suicide were included. Studies were assessed for methodological quality using Joanna Briggs Institute critical appraisal tools. The protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) [CRD42022289843]. RESULTS Narrative synthesis was performed. A total of 33 studies reporting the prevalence of, or association between humiliation (n = 10) or shame (n = 23) and suicidal thoughts/behaviours were included. The prevalence of humiliation among those with any suicidality ranged from 18% to 28.1%, excluding an outlier (67.1%), with two studies presenting a significant association between humiliation and self-harm in their fully adjusted analyses. The studies that outlined humiliation and suicidal thinking (intent/suicide plan) had no association after adjustment for confounders. For shame, half of the studies found an association in adjusted models (n = 10), and this was evident for both suicidal ideation and self-harm. CONCLUSION To our knowledge, this is the first study to attempt a systematic review on this topic. The dearth of research in this field of enquiry is reflective of unique challenges associated with assessments of humiliation and shame in various clinical settings amongst adolescent and young adult populations. Nonetheless, given the importance and relevance of the psychological imprint of humiliation in youth morbidity and mortality in the field of mental health, it is timely to attempt such a systematic review. In light of the associated role of humiliation and shame in self-harm and suicidality among young people, we recommend that these processes need to be explored further via prospective studies and assessed as part of a comprehensive bio-psycho-social assessment when focusing on life stressors for adolescent and young adults presenting with suicidality to emergency departments and mental health services.
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Affiliation(s)
- Anvar Sadath
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Katerina Kavalidou
- National Suicide Research Foundation, University College Cork, Cork, Ireland
- National Clinical Programme, Health Service Executive (HSE), Dublin, Ireland
| | - Elaine McMahon
- School of Public Health, University College Cork, Cork, Ireland
- National Suicide Research Foundation, University College Cork, Cork, Ireland
| | - Kevin Malone
- Department of Psychiatry and Mental Health Research, St. Vincent’s University Hospital, University College Dublin, Dublin, Ireland
| | - Aoibheann McLoughlin
- Department of Psychiatry and Mental Health Research, St. Vincent’s University Hospital, University College Dublin, Dublin, Ireland
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Lee CS, Sin EJ, Park M, Okazaki S, Choi Y. Cultural family processes, depressive symptoms, and suicidal ideation: A longitudinal study of Asian American youths. Suicide Life Threat Behav 2023; 53:802-817. [PMID: 37526389 DOI: 10.1111/sltb.12984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/22/2023] [Accepted: 07/20/2023] [Indexed: 08/02/2023]
Abstract
INTRODUCTION This prospective study examined the direct and interactive effects of depressive symptoms and cultural family processes (i.e., intergenerational cultural conflict, academic parental control, cultural socialization parenting) on Asian American youths' suicidal ideation from adolescence to young adulthood. METHODS We utilized three-wave data of 408 Korean American and 378 Filipino American youths (M = 15.00 years, SD = 1.91 at Wave 1). For each ethnicity, we tested (1) whether depressive symptoms and cultural family processes predicted past-year suicidal ideation; and (2) whether cultural family processes moderated the depressive symptom-suicidal ideation link. RESULTS Across ethnicities, depressive symptoms significantly predicted suicidal ideation after controlling for cultural family processes. For Filipino youths, intergenerational cultural conflict significantly predicted suicidal ideation after controlling depressive symptoms and exacerbated the depressive symptom-suicidal ideation link. For Filipino youths, depressive symptoms were significantly associated with suicidal ideation only at lower levels of cultural socialization parenting. For Korean youths, academic parental control exacerbated the depressive symptom-suicidal ideation link. CONCLUSION Findings suggest that while depressive symptoms have a robust effect on Asian American youths' suicidal ideation, this effect may be moderated by cultural family processes. Different findings for Korean and Filipino youths highlight the importance of disaggregating analyses by ethnicity to guide prevention efforts.
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Affiliation(s)
- Christina S Lee
- New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Esther J Sin
- New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Michael Park
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Sumie Okazaki
- New York University Steinhardt School of Culture, Education, and Human Development, New York, New York, USA
| | - Yoonsun Choi
- Crown Family School of Social Work, Policy and Practice, University of Chicago, Chicago, Illinois, USA
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Liao KYH, Wei M, Tsai PC, Kim J, Cheng HL. Language discrimination, interpersonal shame, and depressive symptoms among international students with Chinese heritage: collective self-esteem as a buffer. COUNSELLING PSYCHOLOGY QUARTERLY 2023. [DOI: 10.1080/09515070.2023.2164845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- Kelly Yu-Hsin Liao
- Department of Counseling, Administration, Supervision, and Adult Learning, Cleveland State University, Cleveland, OH, USA
| | - Meifen Wei
- Department of Psychology, Iowa State University, Ames, USA
| | - Pei-Chun Tsai
- Department of Psychology, Radford University, Radford, USA
| | - Jisu Kim
- Department of Counseling, Administration, Supervision, and Adult Learning, Cleveland State University, Cleveland, OH, USA
| | - Hsiu-Lan Cheng
- Department of Counseling Psychology, University of San Francisco, Chicago, IL, USA
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Li Z, Li B, Tsou Y, Oosterveld P, Rieffe C. Moral emotions in early childhood: Validation of the Chinese moral emotion questionnaire. SOCIAL DEVELOPMENT 2022. [DOI: 10.1111/sode.12645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Zijian Li
- Unit of Developmental and Educational Psychology Institute of Psychology Faculty of Social and Behavioral Sciences Leiden University The Netherlands
| | - Boya Li
- Unit of Developmental and Educational Psychology Institute of Psychology Faculty of Social and Behavioral Sciences Leiden University The Netherlands
| | - Yung‐Ting Tsou
- Unit of Developmental and Educational Psychology Institute of Psychology Faculty of Social and Behavioral Sciences Leiden University The Netherlands
| | - Paul Oosterveld
- Unit of Developmental and Educational Psychology Institute of Psychology Faculty of Social and Behavioral Sciences Leiden University The Netherlands
| | - Carolien Rieffe
- Unit of Developmental and Educational Psychology Institute of Psychology Faculty of Social and Behavioral Sciences Leiden University The Netherlands
- Department of Human Media Interaction Faculty of Electrical Engineering, Mathematics and Computer Science University of Twente Enschede The Netherlands
- Department of Psychology and Human Development Institute of Education University College London London UK
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7
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Lin YC, Wee JY, Marks RB, O'Connell KL, Hassler ME, Law KC. Shame-proneness and suicidal ideation: The roles of depressive and anger rumination. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2021.100303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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8
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Mantzoukas S, Kotrotsiou S, Mentis M, Paschou A, Diamantopoulos E, Kotrotsiou E, Gouva M. Exploring the Impact of Shame on Health-Related Quality of Life in Older Individuals. J Nurs Scholarsh 2021; 53:439-448. [PMID: 33870602 DOI: 10.1111/jnu.12663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people. DESIGN AND METHODS A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software. RESULTS Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women bW = -0.173, pW = .004, effect on men bM = -0.138, pM = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (bW = -0.392, pW = .002 and bM = -0.384, pM = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033). CONCLUSION Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame. CLINICAL RELEVANCE These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.
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Affiliation(s)
| | | | - Manolis Mentis
- Assistant Professor, Department of Education and Social Work, University of Patra, Greece
| | - Athina Paschou
- Teaching Fellow, Department of Nursing, University of Ioannina, Greece
| | | | | | - Mary Gouva
- Professor, Department of Nursing, University of Ioannina, Greece
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9
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Zhao J, Chi Y, Ju Y, Liu X, Wang J, Liu X, Lew B, Siau CS, Jia C. Shame and Suicidal Ideation among Undergraduates in China: The Mediating Effect of Thwarted Belongingness and Perceived Burdensomeness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072360. [PMID: 32244371 PMCID: PMC7178018 DOI: 10.3390/ijerph17072360] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/27/2020] [Indexed: 01/26/2023]
Abstract
Undergraduate students with shame are more likely to experience suicidal ideation, but there remains a lack of research investigating the factors underlying this relationship. The interpersonal theory of suicide posits that suicidal ideation is influenced by the simultaneous presence of thwarted belongingness and perceived burdensomeness. We examined the prevalence of suicidal ideation among undergraduate students in China and examined the association between shame and suicidal ideation mediated by perceived burdensomeness and thwarted belongingness. A survey was conducted in July 2018 involving 2320 undergraduate students, and the twelve-month prevalence of suicidal ideation was 8.95%. Shame played a crucial role in predicting suicidal ideation, and the mediating effects of perceived burdensomeness and thwarted belongingness between shame and suicidal ideation were significant. Suicidal ideation is common among undergraduate students in China and merits greater attention. Shame, perceived burdensomeness, and thwarted belongingness may be important factors to assess among undergraduate students in suicide risk assessment and psychological intervention.
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Affiliation(s)
- Jingjing Zhao
- School of Marxism, Shandong University, Jinan 250012, China
| | - Yanna Chi
- School of Public Health, Shandong University, Jinan 250012, China
| | - Yanli Ju
- School of Public Health, Shandong University, Jinan 250012, China
| | - Xiyao Liu
- School of Public Health, Shandong University, Jinan 250012, China
| | - Jingjing Wang
- School of Public Health, Shandong University, Jinan 250012, China
| | - Xinglai Liu
- School of Public Health, Shandong University, Jinan 250012, China
| | - Bob Lew
- Department of Social Psychology, Putra University of Malaysia, Serdang 43400, Selangor Malaysia
| | - Ching Sin Siau
- Faculty of Social Sciences and Liberal Arts, UCSI University, Kuala Lumpur 56000, Malaysia
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan 250012, China
- Correspondence: ; Tel.: +86-0531-8838-2141-8803
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10
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Wei M, Liu S, Ko SY, Wang C, Du Y. Impostor Feelings and Psychological Distress Among Asian Americans: Interpersonal Shame and Self-Compassion. COUNSELING PSYCHOLOGIST 2020. [DOI: 10.1177/0011000019891992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We examined how the association between impostor feelings and psychological distress was mediated by interpersonal shame and moderated by self-compassion in a sample of 433 Asian American students at an East Coast public university. First, we found that the positive association between impostor feelings and psychological distress was partially mediated by interpersonal shame (i.e., shame related to others viewing them negatively or dishonoring their family due to their deficits). Second, self-compassion significantly moderated the positive association between impostor feelings and interpersonal shame. Specifically, this positive association was stronger for those with lower self-compassion than for those with higher self-compassion. Third, the index of moderated mediation further supported that self-compassion moderated the mediation through an indirect effect of impostor feelings on psychological distress through interpersonal shame. We found additional results which supported the moderation and moderated mediation hypotheses for the three specific components of self-compassion (i.e., common humanity, self-judgment, and over-identification).
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Affiliation(s)
| | - Shuyi Liu
- Iowa State University, Ames, IA, USA
| | | | - Cixin Wang
- University of Maryland at College Park, College Park, MD, USA
| | - Yi Du
- University of California, Berkeley, Berkeley, CA, USA
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11
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Javier SJ, Belgrave FZ. "I'm not White, I have to be pretty and skinny": A qualitative exploration of body image and eating disorders among Asian American women. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2019; 10:141-153. [PMID: 31156760 PMCID: PMC6538263 DOI: 10.1037/aap0000133] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The purpose of the current study was to examine the relationships between body image, eating disorders, and treatment-seeking motivations among Asian American women in emerging adulthood (ages 18-24). Twenty-six Asian American women participated in qualitative focus groups of 4 to 6 individuals each from December 2015 to February 2016. Constructivist grounded theory was used to analyze focus group data. The resulting theoretical model, the "Asian American Body Image Evolutionary Model," maintains that a central phenomenon of perceptions and interpretation of messages about body image and eating, is rooted in three influencing factors: (1) Societal influence of mainstream White culture and Asian culture; (2) interpersonal influences of immediate family and close others; and (3) individual influence. An individual's perceptions and subsequent interpretation of messages may lead to disordered eating and decisions around treatment-seeking. The model developed can be utilized by practitioners or clinicians to help obtain a better understanding of the societal, interpersonal, and intrapersonal forces that may shape conceptualizations about body image and eating behaviors among Asian American women. In addition, findings from this study can be incorporated into prevention programs and interventions that focus on mental health among this population.
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Affiliation(s)
- Sarah J Javier
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Faye Z Belgrave
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
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12
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Kennedy AC, Prock KA. "I Still Feel Like I Am Not Normal": A Review of the Role of Stigma and Stigmatization Among Female Survivors of Child Sexual Abuse, Sexual Assault, and Intimate Partner Violence. TRAUMA, VIOLENCE & ABUSE 2018; 19:512-527. [PMID: 27803311 DOI: 10.1177/1524838016673601] [Citation(s) in RCA: 158] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Child sexual abuse (CSA), sexual assault (SA), and intimate partner violence (IPV) occur within social contexts that shape how survivors judge themselves and are evaluated by others. Because these are gendered sexual and intimate crimes that violate social norms about what is appropriate and acceptable, survivors may experience stigma that includes victim-blaming messages from the broader society as well as specific stigmatizing reactions from others in response to disclosure; this stigmatization can be internalized among survivors as self-blame, shame, and anticipatory stigma. Stigma and stigmatization play an important role in shaping survivors' thoughts, feelings, and behaviors as they recover; their risk of revictimization; and their help-seeking and attainment process. In this review, we synthesize recent CSA, SA, and IPV research ( N = 123) that examines female survivors' self-blame, shame, internalized stigma, and anticipatory stigma as well as negative social reactions in response to survivors' disclosure. We highlight critical findings as well as implications for research, practice, and policy, and we note gaps in our current knowledge.
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Affiliation(s)
- Angie C Kennedy
- 1 School of Social Work, Michigan State University, East Lansing, MI, USA
| | - Kristen A Prock
- 1 School of Social Work, Michigan State University, East Lansing, MI, USA
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13
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Chu J, Robinett EN, Ma JKL, Shadish KY, Goldblum P, Bongar B. Cultural versus classic risk and protective factors for suicide. DEATH STUDIES 2018; 43:56-61. [PMID: 29394156 DOI: 10.1080/07481187.2018.1430085] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The current study examined the predictive value of cultural versus classic risk and protective factors for suicide in a community sample of 322 ethnic, sexual, and gender minority adults. Cultural factors played a significant and substantial role in predicting suicide attempts (explained 8% of variance in attempts and correctly classified 8.5% of attempters) over and above the classic factors of hopelessness, depression, and reason for living (which explained 17% of variance in attempts and correctly classified 14.1% of attempters). Findings suggest that cultural factors are important to include in standard suicide practice.
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Affiliation(s)
- Joyce Chu
- a Palo Alto University , Palo Alto , CA , USA
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14
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Chu C, Buchman-Schmitt JM, Stanley IH, Hom MA, Tucker RP, Hagan CR, Rogers ML, Podlogar MC, Chiurliza B, Ringer-Moberg FB, Michaels MS, Patros C, Joiner TE. The interpersonal theory of suicide: A systematic review and meta-analysis of a decade of cross-national research. Psychol Bull 2017; 143:1313-1345. [PMID: 29072480 PMCID: PMC5730496 DOI: 10.1037/bul0000123] [Citation(s) in RCA: 547] [Impact Index Per Article: 78.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Over the past decade, the interpersonal theory of suicide has contributed to substantial advances in the scientific and clinical understanding of suicide and related conditions. The interpersonal theory of suicide posits that suicidal desire emerges when individuals experience intractable feelings of perceived burdensomeness and thwarted belongingness and near-lethal or lethal suicidal behavior occurs in the presence of suicidal desire and capability for suicide. A growing number of studies have tested these posited pathways in various samples; however, these findings have yet to be evaluated meta-analytically. This paper aimed to (a) conduct a systematic review of the unpublished and published, peer-reviewed literature examining the relationship between interpersonal theory constructs and suicidal thoughts and behaviors, (b) conduct meta-analyses testing the interpersonal theory hypotheses, and (c) evaluate the influence of various moderators on these relationships. Four electronic bibliographic databases were searched through the end of March, 2016: PubMed, Medline, PsycINFO, and Web of Science. Hypothesis-driven meta-analyses using random effects models were conducted using 122 distinct unpublished and published samples. Findings supported the interpersonal theory: the interaction between thwarted belongingness and perceived burdensomeness was significantly associated with suicidal ideation; and the interaction between thwarted belongingness, perceived burdensomeness, and capability for suicide was significantly related to a greater number of prior suicide attempts. However, effect sizes for these interactions were modest. Alternative configurations of theory variables were similarly useful for predicting suicide risk as theory-consistent pathways. We conclude with limitations and recommendations for the interpersonal theory as a framework for understanding the suicidal spectrum. (PsycINFO Database Record
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Affiliation(s)
- Carol Chu
- Florida State University, Department of Psychology, Tallahassee, FL
- McLean Hospital, Belmont, MA
- Harvard Medical School, Department of Psychiatry, Cambridge, MA
| | | | - Ian H. Stanley
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Melanie A. Hom
- Florida State University, Department of Psychology, Tallahassee, FL
| | - Raymond P. Tucker
- Louisiana State University, Department of Psychology, Baton Rouge, LA
| | | | - Megan L. Rogers
- Florida State University, Department of Psychology, Tallahassee, FL
| | | | - Bruno Chiurliza
- Florida State University, Department of Psychology, Tallahassee, FL
| | | | | | - Connor Patros
- Temple University, Department of Psychology, Philadelphia, PA
| | - Thomas E. Joiner
- Florida State University, Department of Psychology, Tallahassee, FL
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15
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Wong YJ, Wang L, Li S, Liu H. Circumstances preceding the suicide of Asian Pacific Islander Americans and White Americans. DEATH STUDIES 2017; 41:311-317. [PMID: 28010247 DOI: 10.1080/07481187.2016.1275888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the circumstances preceding suicide among Asian and Pacific Islander Americans (APIAs) and White American decedents using data from the National Violent Death Reporting System in the United States. After controlling for gender and age, APIAs had lower rates of recent disclosure of suicide ideation, recent mental health treatment, recent mental health problems, and intimate partner problems, but higher rates of school problems than White Americans. There were also significant Race × Age moderation effects for recent mental health, financial, and school problems and a significant Race × Gender moderation effect for intimate partner problems.
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Affiliation(s)
- Y Joel Wong
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Lei Wang
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Shaozhuan Li
- a Department of Counseling and Educational Psychology , Indiana University Bloomington , Bloomington , Indiana , USA
| | - Huabing Liu
- b School of Education, Loyola University Chicago , Chicago , Illinois , USA
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16
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Chu J, Khoury O, Ma J, Bahn F, Bongar B, Goldblum P. An Empirical Model and Ethnic Differences in Cultural Meanings Via Motives for Suicide. J Clin Psychol 2017; 73:1343-1359. [PMID: 28170095 DOI: 10.1002/jclp.22425] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Revised: 10/09/2016] [Accepted: 10/31/2016] [Indexed: 11/11/2022]
Abstract
OBJECTIVE The importance of cultural meanings via motives for suicide - what is considered acceptable to motivate suicide - has been advocated as a key step in understanding and preventing development of suicidal behaviors. There have been limited systematic empirical attempts to establish different cultural motives ascribed to suicide across ethnic groups. METHOD We used a mixed methods approach and grounded theory methodology to guide the analysis of qualitative data querying for meanings via motives for suicide among 232 Caucasians, Asian Americans, and Latino/a Americans with a history of suicide attempts, ideation, intent, or plan. We used subsequent logistic regression analyses to examine ethnic differences in suicide motive themes. RESULTS This inductive approach of generating theory from data yielded an empirical model of 6 cultural meanings via motives for suicide themes: intrapersonal perceptions, intrapersonal emotions, intrapersonal behavior, interpersonal, mental health/medical, and external environment. Logistic regressions showed ethnic differences in intrapersonal perceptions (low endorsement by Latino/a Americans) and external environment (high endorsement by Latino/a Americans) categories. CONCLUSION Results advance suicide research and practice by establishing 6 empirically based cultural motives for suicide themes that may represent a key intermediary step in the pathway toward suicidal behaviors. Clinicians can use these suicide meanings via motives to guide their assessment and determination of suicide risk. Emphasis on environmental stressors rather than negative perceptions like hopelessness should be considered with Latino/a clients.
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Cross-sectional and temporal association between non-suicidal self-injury and suicidal ideation in young adults: The explanatory roles of thwarted belongingness and perceived burdensomeness. Psychiatry Res 2016; 246:573-580. [PMID: 27835855 PMCID: PMC5161648 DOI: 10.1016/j.psychres.2016.07.061] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Revised: 06/23/2016] [Accepted: 07/05/2016] [Indexed: 11/24/2022]
Abstract
Non-suicidal self-injury (NSSI) is a strong predictor of suicidal ideation and attempts. Consistent with the interpersonal theory of suicide, preliminary evidence suggests that NSSI is associated with higher levels of perceived burdensomeness (PB) and thwarted belongingness (TB). However, no study to date has examined the cross-sectional and prospective relationships between NSSI, TB, PB, and suicidal ideation (SI). To fill this gap, this study examined the mediating role of TB and PB in the relationship between NSSI and SI at baseline and follow-up. Young adults (N=49) with and without histories of NSSI completed self-report measures of TB, PB, and SI at three time points over two months. NSSI history was associated with higher levels of PB, TB, and SI at all time points. TB and PB significantly accounted for the relationship between NSSI history and SI at baseline. However, the relationship between NSSI history and SI at follow-up was mediated by PB, not TB. Findings provide evidence for the roles of TB and PB in the relationship between NSSI and SI, and partial support for the interpersonal theory of suicide. Future research and clinical implications are discussed.
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Kene P, Brabeck KM, Kelly C, DiCicco B. Suicidality among immigrants: Application of the interpersonal-psychological theory. DEATH STUDIES 2016; 40:373-382. [PMID: 26890379 DOI: 10.1080/07481187.2016.1155675] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Immigrants constitute a significant percentage of the total population living in the United States; however, there is a paucity of research unique to suicidality among immigrants. The present article examines the applicability of the three variables of the interpersonal-psychological theory of suicidal behavior-acquired capability for suicide, sense of thwarted belongingness, and perceived burdensomeness-to conceptualize, assess, and treat suicidality among immigrants. Risk and protective factors and mechanisms are discussed in the context of 2 case studies and immigrant paradox. Clinical implications include assessment and treatment of immigrant-specific experiences. Obstacles to treatment and future research directions are presented.
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Affiliation(s)
- Prachi Kene
- a Department of Counseling, Educational Leadership, and School Psychology , Rhode Island College , Providence , Rhode Island , USA
| | - Kalina M Brabeck
- a Department of Counseling, Educational Leadership, and School Psychology , Rhode Island College , Providence , Rhode Island , USA
| | - Catherine Kelly
- a Department of Counseling, Educational Leadership, and School Psychology , Rhode Island College , Providence , Rhode Island , USA
| | - Brian DiCicco
- a Department of Counseling, Educational Leadership, and School Psychology , Rhode Island College , Providence , Rhode Island , USA
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Kim SY, Shen Y, Hou Y, Tilton KE, Juang L, Wang Y. Annual Review of Asian American Psychology, 2014. ASIAN AMERICAN JOURNAL OF PSYCHOLOGY 2015; 6:291-332. [PMID: 26925199 PMCID: PMC4765738 DOI: 10.1037/aap0000031] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
This 2014 review of Asian American psychology is the sixth review in the series. It includes 316 articles that met the inclusion criteria established by the past five annual reviews. Featured articles were derived from three sources: 137 were generated via the search term "Asian American" in PyscINFO, 111 were generated via a search for specific Asian American ethnic groups, and 32 were generated via author searches of articles that met the inclusion criteria. The top primary topic was health and health-related behaviors, the most frequently employed study design was cross-sectional, and the most studied Asian American ethnic group was Chinese. This year's review includes information on the target population of the primary topic, the age range and developmental period of participants, and whether the study design was cross-sectional or longitudinal. It also identifies top authors and journals contributing to the 2014 annual review. These new features reveal that the most common target population of the primary topic was youths; studies most commonly included emerging adults ages 18-25; cross-sectional study design was employed more often than longitudinal design; the top contributor to the 2014 review was Stephen Chen, who authored the highest number of papers included; and the Asian American Journal of Psychology generated the highest number of publications for this review.
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Affiliation(s)
- Su Yeong Kim
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 471-5524
| | - Yishan Shen
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 983-7551
| | - Yang Hou
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 660-2236
| | - Kelsey E Tilton
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 956-459-4212
| | - Linda Juang
- University of Potsdam, College of Human Sciences, Education, Karl-Liebknecht-Str. 24-25, 14476 Potsdam, Germany, +49 (0)172 1882255,
| | - Yijie Wang
- University of Texas at Austin, Department of Human Development and Family Sciences, 108 East Dean Keeton Street, Stop A2702, Austin, TX 78712, , (512) 289-8136
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Roy D, Jayaram G, Vassila A, Keach S, Rao V. Depression after traumatic brain injury: a biopsychosocial cultural perspective. Asian J Psychiatr 2015; 13:56-61. [PMID: 25453532 DOI: 10.1016/j.ajp.2014.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/06/2014] [Accepted: 10/13/2014] [Indexed: 11/29/2022]
Abstract
There are several challenges in diagnosing and treating mental illness amongst South Asians. Often times, formulating a patient's case presentation cannot adequately be accomplished strictly using a biopsychosocial model. The cultural components play an imperative role in explaining certain psychiatric symptoms and can guide treatment. With the growing population of immigrants coming to the United States, many of which require treatment for mental illness, it is essential that clinicians be cognizant in incorporating cultural perspectives when treating such patients. The authors describe the case of a 24-year old South Asian male who suffered an exacerbation of a depressive syndrome after a traumatic brain injury. Using a biopsychosocial cultural approach, this case highlights how South Asian cultural values can contribute to and incite psychiatric symptoms while simultaneously providing protective drivers for treatment outcomes.
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Affiliation(s)
- Durga Roy
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA.
| | - Geetha Jayaram
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Alex Vassila
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | | | - Vani Rao
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
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